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Dear Katherine
Thank you for your e-mail on behalf of the Scrutiny Panel with regards to the use of the Health Insurance Fund and the proposed Government Plan.
We have reviewed the Government Plan and are disappointed that funding for Primary Care and General Practice are not specifically mentioned despite the aim to implement the Jersey Care Model.
Health funding seems to be aimed at supporting secondary care which does not acknowledge the volume, intensity and increasing complexity of care already being given in the community. This is likely to increase both due to the demographics of the island but also due to the implementation of the Jersey Care Model. Whilst the much needed improvements in hospital services do need to be funded, this should not be at the expense of affordable, accessible, high quality primary care.
Despite requests to see budgeted plans for the sums being drawn from the Health Insurance Fund towards centralised projects, information has not been forthcoming and therefore we are unable to comment as to whether this provides good value and as to how this might improve wider healthcare. This is hughlighted by the lack of consultation and information with regards to the Digital Health Project and to how this integrates with community resources both at present and looming forwards.
The planned annual calls on the Health Insurance Fund exceed the annual sums paid to support patients' access to General Practice (£8,600,000 in 2019 and falling in real terms). This seems at odds with the current policy. Inevitably, this will lead to increased costs to patients to ensure that GP services are maintained. Likewise the cost of provision of other Primary Care services are likely to be passed on to the patients.
We are concerned that increased use of the Health Insurance Fund may make it unsustainable. Further consideration should be given to the proportion of funding from both the Health Insurance Fund and Treasury.
We are unaware of any plans as to how funds will be maintained. Specifically will they be raised by increased taxation or increased social security payments? Will a proportion of funds be ring fenced for Primary Care and General Practice? What funding mechanism will be instituted to protect patients whilst ensuring that Primary Care providers are maintained as viable businesses?
The decisions on public revenue generation and spend are ultimately political decisions, but proportionate funding of both General Practice and wider Primary Care is needed and should be reflected in any plan. This is not apparent in the proposed Government Plan.