Systemic gender inequalities in Jersey's health system

2025.04.22

3.3   Deputy J. Renouf of St. Brelade of the Minister for Health and Social Services regarding gender inequalities in Jersey’s health system (OQ.98/2025):

Will the Minister explain whether it is his assessment that there are systemic gender inequalities in Jersey’s health system and what proposals, if any, there are to improve health outcomes for women?

Deputy T.J.A. Binet of St. Saviour (The Minister for Health and Social Services):

Could I just ask if the Deputy would be happy for the Assistant Minister with special responsibility for that to answer the questions?

Deputy J. Renouf :

No.

The Bailiff :

Very well, Minister, then it is for you to answer, I am afraid. Deputy T.J.A. Binet :

That is very unhelpful because the response has been printed out in very small print and my eyesight is not up to it. I will just go through the question again, sorry. Do I think there are gender inequalities? Yes, I think there are inequalities in the health system. There are other inequalities as well in the mental health sphere. Men tend to commit suicide twice as regularly as women. So there are all sorts of different areas in health that need attention. But I do accept that there are some issues about women’s health that need specific attention. What are we doing? We have got 3 specific areas that we have been working on, and there has been a needs assessment that is carried out and that is going to be looked at and further work will take place. Like I say, it is work that I delegated to my Assistant Minister and I have to say she is closer to it than I am.

1. Deputy J. Renouf :

Yes, just to explain that normally when I have been confronted with the situation the Minister approaches me beforehand to ask whether I would accept the question being taken by somebody else, that did not occur on this occasion. I guess that the Minister has pointed out that there are other inequalities and I wonder whether he would indicate, as Minister, where he places the systemic gender inequalities in his list of priorities to address?

Deputy T.J.A. Binet :

This might prove controversial but I do not think I have a list of priorities. What we are trying to do in health is make sure that everybody’s health is looked after. I have mentioned suicide. You can look at child cancer. Why would that not be a priority? I am very keen to make sure that, from a political point of view, we do everything we can to make the health service as good as we can for everybody.

2. Deputy L.M.C. Doublet of St. Saviour :

Is the Minister aware from the Public Health Strategic Needs Assessment on Women’s Health that it was highlighted within that report that the overwhelming burden of care needs falling, the majority on women, that was actually pulled out as a factor in poorer health outcomes and that is something that the Minister could potentially be working on across Ministerial portfolios? Has he noted that comment in the report and what does he intend to do about it?

Deputy T.J.A. Binet :

Yes, I accept all of that but, as I have said, we have got a number of difficulties in the Health Department, not least of which is funding. I will remind the Assembly that without money you can do very little. The budget for this year is already under acute pressure. If we want to do something more for women, which I would very much like to do, we are going to need more money. We will be addressing that problem as we go through the year. There will be a public consultation to ask the public what sort of health service they want and how much they are prepared to pay for it. We will be asking the sort of questions that will give us an indication as to where that money needs to come from. It is a complicated question. Very keen to get women’s health right, but we will need more money.

3. Deputy L.M.C. Doublet :

Does the Minister agree to ensure that the money that is available is targeted towards those who have the greatest  need and, in  some  respects, single parent  households and single pensioner households again were highlighted in this report? Could the Minister ensure that his funds are targeted to the greatest need?

Deputy T.J.A. Binet :

As a general statement, I think that is fair. They will always go to the greatest need and I have to say that is not an easy task because there are ... my inbox is full of very, very compelling stories and it is not easy. But as a general statement, I am very happy to support that.

4. Deputy K.L. Moore of St. Mary , St. Ouen and St. Peter :

As the political leader of his organisation, how does the Deputy demonstrate the behaviours that show a good example and encourage others to break down gender inequality?

Deputy T.J.A. Binet :

Could I just ask to qualify what that question means? The Bailiff :

What I think is: do you lead by example and how do you show people that they should break down gender inequality? Is that fair, Deputy Moore ?

Deputy T.J.A. Binet :

I do not think I make any particular effort to do that because I like to consider that my conduct is reasonable in all respects. I do not think I have a particular problem in that area, and like I say, I could list you half a dozen areas where I want to put a particular emphasis on conduct. Sorry if that is not the right answer, but no.

The Bailiff :

There is no right answer, there is only your answer, Minister. Deputy T.J.A. Binet :

Let us hope that is right, Sir.

5. Deputy K.L. Moore :

Perhaps the next question should be then: has the Deputy taken any time to consider a gender- sensitive approach to his policy-making, or does he perhaps consider that he may need some training in this area?

Deputy T.J.A. Binet :

I do not know what to make of that at all. Do I need training? I am afraid I do not think I do. I think I take a civilised approach to things and I find that question actually quite tasteless. That is just a personal opinion.

Deputy K.L. Moore :

Sir, I do think it would be good if the Deputy would take back that statement. I think he is suggesting a Deputy should not ask a reasonable question.

The Bailiff :

I think the position simply is I think the comment on the quality of a question. If I have allowed it I have allowed it, and that is the end of it, Deputy . Any adverse comment should be withdrawn I think. If you would like to withdraw your observation that it was tasteless that would be welcome.

Deputy T.J.A. Binet :

People are busy, I will withdraw it. I do have to say I do not really feel that I should, but we want to keep things moving.

The Bailiff :

Well you have withdrawn it, so let us leave it at that. Deputy T.J.A. Binet :

I shall withdraw it.

The Bailiff :

Thank you very much indeed.

6. Deputy L.K.F. Stephenson of St. Mary , St. Ouen and St. Peter :

Does the Minister accept that Jersey, like many other western systems, has a health system built by men for men, and that the service he leads continues to take a male-as-default approach?

Deputy T.J.A. Binet :

I think that perhaps may have been the case historically. I do not think that is where we are now. We are working well with the Executive Leadership Team, they are all very, very balanced people, and I think they are all very keen to take a balanced approach to delivering a health service. I do not think that is a problem that we suffer with currently. I mean there might be issues still to address in terms of gender equality but I think that the people that are leading the organisation now do not have a problem with that at all. They recognise it and they are very keen to deal with it.

7. Deputy L.K.F. Stephenson :

What practical kind of on-the-ground examples can the Minister give to back up that position that we do not have a system built by men for men that continues to take a male as the default approach?

Deputy T.J.A. Binet :

I have a number of females in key roles. I cannot think of any particular example and I do not know why I would. As I say there is a balanced team of people taking a balanced view of things, recognising that there are gender inequalities and doing their best to resolve them.

8. Deputy H.M. Miles of St. Brelade:

Could the Minister please tell us specifically what he is doing to improve the confidence of women in Jersey’s maternity services?

Deputy T.J.A. Binet :

On a personal level absolutely nothing, but there is a team of people. We have got somebody new running the maternity service who I have a great deal of confidence in, and she is busy doing her job. I cannot go around prioritising every single area of health. There are lots of areas of health that require particular attention, and I am trying to deal with them in an even- handed and balanced way across the piece. No, I do not do anything specific, it has to be said.

9. Deputy H.M. Miles :

The Minister is on record as saying that to reinstitute the home birth service, women would have to pay for that service. Is that still the case?

Deputy T.J.A. Binet :

I have no recollection of making that as an absolute statement. I have suggested that we are under financial pressure and that we are going to be looking at that as we are going to be looking at an awful lot of things. Like I have said, we are under huge budgetary pressure. There is only so much we can do with that money. I intend to have a consultation with the public to point these things out, to let them know where we are, to ask them what sort of health service they would like and ask them how they are going to pay for it. I can think of a number of very, very pressing areas that require money so I have not made a statement to that effect - an absolute statement - but I have made it plain that we would be looking at all areas of healthcare and deciding which areas are priority and which are not.

Deputy K.M. Wilson of St. Clement :

Could I first of all raise the défaut on Deputy Ozouf ?

The Bailiff :

Yes that was your question though. [Laughter] Yes, the défaut is raised on Deputy Ozouf . Deputy K.M. Wilson :

Shall I ask it in a different way, Sir?

The Bailiff :

Please ask your question.

10. Deputy K.M. Wilson :

Could I ask the Minister for Health and Social Services what particular health outcomes he would like to see for women in contact with our health service?

Deputy T.J.A. Binet :

Good ones.

11. Deputy K.M. Wilson :

As part of the health strategy work, could Minister explain what has been done to assure himself that there is a focus on meeting women’s health needs?

Deputy T.J.A. Binet :

I think everybody is aware that there is a particular focus on women’s health needs and we have got a very public meeting coming up only next week with Scrutiny. I think it is very, very clear that there is a focus on women’s health needs at the moment. I do not think there is much more that I can say.

12. Deputy J. Renouf :

The Minister referred earlier to needing more money to be able to make effective change, but some of the issues identified in the Strategic Needs Assessment were to do with “dismissive and misogynistic attitudes leading to stigmatisation of women’s health issues.” What is he doing to address these cultural issues within his department?

[10:00]

Deputy T.J.A. Binet :

I think that the leadership team are aware of a number of issues that need to be addressed, and they are addressing them through the management system from the top down. I think racism has been another one that is in need of address, and that is being addressed too. As I say, I do not have an executive job in the health service. To an extent, I have to have trust in the people that are leading the organisation and I am comfortable they are doing all the right things.

Deputy J. Renouf :

Could I ask just a clarification on what is he doing to address these problems, which is what the question was?

The Bailiff :

I think the Minister has answered that question by saying personally he has to have faith in those who are conducting things on an executive level and the main management team is fully aware of these issues and being addressed through them. That is as I interpreted the Minister’s answer. Is that fair, Minister?

Deputy T.J.A. Binet : Absolutely correct, Sir.