Explain how the Island’s vaccination programme was paid for

WQ.386/2023

WRITTEN QUESTION TO THE MINISTER HEALTH AND SOCIAL SERVICES BY DEPUTY A. HOWELL OF ST. JOHN, ST. LAWRENCE AND TRINITY QUESTION SUBMITTED ON MONDAY 9th OCTOBER 2023

ANSWER TO BE TABLED ON MONDAY 16th OCTOBER 2023

Question

“Will the Minister explain how the Island’s vaccination programme was funded prior to the Covid-19 epidemic, including which budget funds  were  allocated from and  a  breakdown of the  costs of the programme in 2019; and will the Minister further advise out of which budget(s) the vaccination programme was delivered during Covid 19, and provide a breakdown of the costs involved for each of 2020, 2021, 2022 and 2023?”

Answer

There are a wide number of different vaccination programmes including shingles, HPV, flu, Covid-19, pneumococcal and childhood immunisation. The funding mechanisms for these vaccination programmes is spread across departments and has varied overtime. Against this backdrop the question has been answered as fully as possible within the timescales allowed and further work can be undertaken if required.

Operational and ministerial responsibility differ depending on which vaccine programme is being considered. For example, vaccination for flu has been funded by the

• Health Insurance Fund (HIF) under the responsibility of CLS and the Minister for Social Security,

• HCS, who offered vaccinations to school children and HCS staff,

• JHA who arranged for flu vaccinations in the prison and

• COO who has commissioned a vaccination service for Government employees.

Prior to 2017, the HIF has supported the Flu vaccination programme in respect of priority groups (older people, those with clinical risk factors) through via pharmaceutical benefit and medical benefit until a contract with General Practice and Pharmacy was introduced. (HCS, JHA and COO maintain responsibilities for some cohorts).

Pharmaceutical benefit and medical benefit are still used to subsidies the cost of other vaccinations including shingles and pneumococcal if the vaccination is delivered in General Practice. Investment by HIF in these programmes is not recorded as the Government do not collect information from GP practices regarding the nature of the consultations they undertake when claiming medical benefit.

Since 2020 operational responsibility for the COVID-19 vaccination programme is managed through Public Health under the responsibilities of the Minister for Health and Social Services.

There is an immunisation services budget for childhood and adult routine immunisations, which was managed by Health and Community Services until 31 December 2022. From 01 January 2023, the service and budget transferred to Public Health as specified in Government Plan 2023 and decided by the States Assembly in December 2022. Under this programme:

• Baby and Pre-school immunisations are administered within General Practice.

• School aged immunisations are administered by Public Health Nurses

• Adult immunisations are administered within General Practice.

Since 2020, the COVID-19 vaccination service has been funded from COVID reserves.

The table below provides financial information from 2019 to 2023 for these two vaccine programmes.

 

Health and Community Services – responsible for the immunisation services budget until 31December 2022
	2019	2020	2021	2022
Pay (£)	185,120	174,845	125,841	226,490
Non-pay (£)	759,502	705,888	656,001	833,380
Total (£)	944,621	880,733	781,843	1,059,870
Public Health – responsible for the immunisation services budget from 01 January 2023
	2019	2020	2021	2022	YTD Sept 2023
Pay (£)					150,945
Non-pay (£)					626,688
Total (£)					777,633
COVID - The first COVID vaccine was administered on 13 December 2020
	2019	2020	2021	2022	2023 Forecast
Pay (£)		103,903	3,814,420	2,281,625	645,456
Non-pay (£)		88,401	1,188,690	689,743	1,443,027
Total (£)		192,304	5,003,110	2,971,368	2,088,483