I made the following speech in debate and focused on health and social care.
Sir, I will focus on a couple of aspects related to health and social care. As members will be aware and as President of P&R and myself mentioned during the budget debate, significant funding for H&SC for Guernsey and Alderney comes from ESS, both through GHS and LTCF.
The LTCF funding is not sustainable and, with an ageing population, the restriction in the funding ie for support in residential or nursing care homes needs reform. I’m not going to go into great detail on that now as it is clearly set out in the Supported Living and Ageing Well Strategy. However, I have to say that, from a CHSC perspective, this is an area that needs to be given priority.
The fact that funding is not available to support people in their own homes but rather serves to delay discharges from hospital until suitable care home beds are found is a significant issue, as is the fact people can wait until they get a space at their home of choice, rather than where a bed is available. This has direct knock on effects on the general revenue budget of Health and Social Care. Not only is it costly keeping people in hospital, but health outcomes are affected by the longer people stay in hospital. We need to restructure the LTCF to enable funding for care in the community, which supports the findings and recommendations in SLAWS.
Moving onto the GHSF. I would refer to paragraph 2.2.11. Whilst the policy letter states that the current contribution rate is adequate to ensure break even through the projection period, there is a projected increase in the break-even rate in the early years due to an increase in consultants at the end of 2014. 3 scenarios are given with 45, 50 and 55 consultants from 2017. The problem is the number of consultants never has remained the same year on year. When the contract began there were 19. Now there are 46 authorised posts for which the States pay £382k each. The fact is we can’t continue with the model we have, something Geoffrey Wood made clear the other week. That is why it is crucial that the model of secondary healthcare has to change and why any new contract has to enable that change to happen.
In relation to medical grants, it is apparent that the £12 grant for GPs and £6 for practice nurses no longer serve the purpose for which they were intended. Such universal benefits are not targeting resources where they are needed. We need to think differently in how we address access to primary health care to help improve outcomes and facilitate prevention and early intervention.
Finally, on a positive note, members may be aware that HSC has been piloting video-teleconferencing to enable remote consultations for the people of Alderney. It has been estimated that up to half of consultations could be undertaken remotely. It is hoped that this can be expanded to Southampton which should help reduce the travel costs to the States that are charged through the Health Service Fund.