Jersey Care Model Review

WQ.243/2023

WRITTEN QUESTION TO THE MINISTER FOR HEALTH AND SOCIAL SERVICES BY DEPUTY G.P. SOUTHERN OF ST. HELIER CENTRAL

QUESTION SUBMITTED ON TUESDAY 30th MAY 2023

ANSWER TO BE TABLED ON TUESDAY 6th JUNE 2023

Question

“Further to the response to Written Question 84/2023 will the Minister advise –

1. what progress, if any, has been made, since March 2023, to address the urgent need to change primary care funding mechanisms;
2. whether the review has considered the transition of the funding for the preferred funding option, Option 2 and whether this has formed part of the consultation;
3. what role, if any, does the Health Insurance Fund, or any means of charging, play in her current planning;
4. whether she will release to members, for planning purposes, the data collected by her team of health economists which covers funding for primary, secondary and tertiary spending to date and, if not, why not; and
5. whether she will commit to the long-term goal of creating a Health Care Model which is free at the point of delivery; and, if not, why not?”

Answer

Points (a) to (b)

As set out answer to Written Question 84/2023 specialist health economists are currently working to estimate total health care expenditure for Jersey (including government and non-government spend) and develop options for change. This review is focusing on funding for the whole health care system, rather than only the primary care payment mechanisms as per Option 2 as described in P114/2020.

In the meantime, progress has been made in addressing inequalities in access to primary care over 2023 including the recent announcement by the Minister for Social Security that an additional £25 per GP consultation will be introduced to both support the sector with reduced patient fees and running costs. A £12m package of support has also been announced for community pharmacies which changes reward structures to incentivise the delivery of non-dispensing health services. Ministers also expect to announce implementation of the adopted Assembly proposition to provide free GP appointments for children in the near future.

Points (c) to (e)

The Health Insurance Fund is currently an important component of the overall funding applied to health and care services in Jersey, together with the Long-Term Care Fund, consolidated tax-funded revenue, users charges, out of pocket expenditure and private insurance. The review will factor in all these components when developing options for the future funding and financing the Island’s health and care services. Until the review work is completed it is not possible to determine the role of Health Insurance Fund, user chargers or any other funding component in any future system.

The data referenced is expenditure and revenue data for the whole health system in Jersey which the Health Economics Unit (“HEU”) - the specialist advisors engaged to support the review – are using to develop the ‘Jersey Health Accounts’ (“JHA”). The JHA will provide, for the first time, an analysis of all health spending in Jersey including public, private and charitable components and, as they accord with OCED standards for health care accounts will allow for meaningful comparisons with other jurisdictions. The JHA are currently being developed but I will, of course, publish the accounts and other review information in due course.

It is a decision of the Assembly as to whether, or not, we create a model of care that is free at the point of delivery to all Islanders as opposed to our current model which includes both free and paid for services". In commissioning the current review, I have communicated to the HEU the importance of addressing health inequalities within any future system and of providing evidence of what works, from both international sources and from within Jersey. This evidence will inform future decision making.