New structure for the delivery of health services

WQ.18/2025

WRITTEN QUESTION TO THE MINISTER FOR HEALTH AND SOCIAL SERVICES

BY DEPUTY J. RENOUF OF ST. BRELADE

QUESTION SUBMITTED ON MONDAY 27th JANUARY 2025

ANSWER TO BE TABLED ON MONDAY 3rd FEBRUARY 2025

Question

"Further to the publication of the report entitled Health and Care Services Division Annual Plan 2025 and

his subsequent answers to an urgent oral question in the Assembly on 21st January 2025, will the Minister –

1. provide more detail on the intention to make the Health and Social Services Department "separate from but linked to" Government, specifically what this means in practice, and in particular, in what ways the Department will be "separate from" Government;
2. outline what existing funding will be combined to make up the "single, central fund" that is referenced, and if there is any intention for any future health funding to include a new charge or tax;
3. confirm what Ministerial Functions, if any, the Minister is proposing to delegate to the new Partnership Board and/or the new Chief Executive, over and above existing delegations;
4. advise how the Chief Executive of the Jersey Health System will have authority over partner organisations that are outside Government; and
5. summarise any plans, if any, for a public consultation on his proposals?

Answer

1. As explained at the States Members briefing on 5 December 2024, the intention is to create a more integrated approach to the development and delivery of health and care services in Jersey. This includes government lead health and care functions being delivered by a single government department – Health and Care Jersey - rather than being dispersed across other Departments, for example, Public Health and Health Policy, which have already been transferred to Health and Care Jersey.

Finance, HR and digital development functions are in the process of being delivered by Departmental Directors who are specialists in the health and care sector with their teams being drawn from central government Procurement efficiency, in order to improve.

Health and Care Jersey will be separate' insofar as central government will cease to perform the functions mentioned above; linked' to, insofar as functions will operate, at a high level, through the central government system. For example, HCJ's HR Director will be a specialist in health and care human resources, as distinct from being a generalist HR director, who will manage HCJ's government workforce in accordance with central SEB standards and policy but will also work strategically across the whole health and care system to support workforce development across the whole sector.

2. As explained at the States Members briefing on 5 December 2024, subject to agreement by the Minister for Social Security and the States Assembly, the intention is to transfer the Health Insurance Fund to the control of the Minister for Health and Social Services.

In time, the HIF may be combined into a single fund alongside consolidate funds monies and other income (such as fees and charges) but only subject to the HIF monies continuing to serve the same purpose as at present - ie. monies that fund / part fund Islanders access to primary care services.

The work to determine what, if any, extra charges or taxes may be proposed to fund health and care services is currently underway and any such proposals will be brought to the Assembly for debate and decision as and when the work has been completed.

3. As explained at the States Members briefing on 5 December 2024, there are currently no plans, to delegate any Ministerial functions to the proposed new Partnership Board or the Chief Officer, over and above existing delegations.

The Minister cannot, by law, delegate functions to the Partnership Board unless the Board is established in law to deliver delegated functions.

4. The Chief Officer of Health and Care Jersey will not have direct authority over partner organisations who are, and will remain, independent organisations.

The Chief Officer will hold partner organisations to account for delivery against contractual standards, where those partners are contracted by HCJ to deliver health and care services and, as explained at the States Members briefing of 5 December 2024, the Chief Officer will sit on the proposed new Partnership Board.

The Partnership Board will bring together partners from across the health and care system (including HCJ officers who are responsible for delivery of HCJ's hospital, mental health and community) to discuss and agree the actions required government and / or by providers across the whole system to deliver safe, effective and sustainable health and services. There is currently no forum for whole system discussion and decision-making. The Partnership Board will recommend to the Minister the actions it has agreed are required, for the Minister to determine whether to adopt the recommended actions.

The Chief Officer will be responsible for delivering the actions adopted by the Minister where those actions relate to HCJ services, and for facilitating delivery by other partners where the Chief Officer has the jurisdiction to do so (for example, the Chief Officer would, in accordance with the Minister's direction, oversee development of standards for new community based services as recommended by the Partnership Board, with independent providers determining whether to deliver those services and, where they do deliver those services, being held to account by the Chief Officer for compliance with contractual terms)

5. No public consultation is planned in relation to the establishment of the Partnership Board, the proposed shift of the Health Insurance fund to the Minister for Health and Social Services or the internal changes to staff reporting lines with Government as these are structural changes focused on supporting better decision making and partnership working. There has, however, been consultation with government and non-government providers for health and care services with the feedback report published on 21 November 2024.

In the event that new funding arrangement, services or aways of working are proposed as a result of these new structural arrangements, there would be public consultation and / or service user consultation as appropriate.