02 Health

Members of New HSC Committee

President: Dr George Oswald 7613
Vice President: Aiden Matthews 7312
Members: Jennifer Strachan 6683, Munazza Malik 6215, Sally Rochester 7119

View Previous Committee’s Handover document here

It is not for the fainthearted and demands commitment.

The Health and Social Care Committee has the largest annual budget allocation and it is growing exponentially every year. There are many drivers for this growth, including our ageing demographic, a necessary reliance on Agency resources, a broadening demand for additional services and increases in the cost of various medications – for example, to provide NICE drugs. To be fair, that despite it always being the case that some individuals may not believe they had adequate treatment or advice – our local provision is by far and away a better service than can often be found in the NHS (as an example), certainly given our size of population.

But it is this latter point – our subscale size, that now has particular impact on current and future Health provision – and the necessary costs. For example, it is a well-accepted metric that in order to justify the costs of a hospital, then you need at least a population of 250,000 people. Add to that, the expanding range of services and procedures demanded by Islanders, the shortage (worldwide) of medical staff and our very high cost of living – and you have a perfect storm driving increased costs of operation. It is these factors that mean we have to make some difficult decisions about the way our current model of provision has to change – or we must accept that substantially more tax revenues need to be raised to retain it as it is.

Right now, a major challenge exists in simply finding sufficient accommodation for the increasing staff numbers needed locally and we are very reliant upon off-island agency workers to fill the hundreds of vacancies – which even with that flexibility, are not covering all the necessary posts. We have just completed Phase 1 of the Hospital Modernisation programme and have just undertaken a major review into the expected costs of the next phase(s) which have also increased substantially from when the whole development was first outlined back in 2019.

Universal entitlement

To balance what is fair for all as well as practically deliverable in the Guernsey context, the concept of Universal entitlement has to be identified. This certainly has to be within an agreed budget, but it is also important to realise that our size cannot possibly ensure that we have access to all the procedures, services and skilled resources that a much larger jurisdiction can support. Furthermore, regardless of the scarcity of skills – we cannot necessarily provide the extent of hospital footprint that can accommodate more and more procedures or treatments. To undertake the necessary review of current and expected provision – the States have identified ‘Sustainable Healthcare’ as one of the the three, strategic portfolios in the 2025 Government Work Plan (GWP). This is also proposed to be one of 5 ‘Super Priorities’ in the 2026-2029 GWP.

But it is a big undertaking and it will certainly have to consider options such as the role of Insurance, where (and how much subsidy) is best apportioned from taxation revenues as opposed to what individuals may have to contribute to their own treatments, whether and to what extent it will be necessary to partner with local and non local organisations and of course – how much technology can be brought into the provision of services to improve both quality and productivity. On this latter point, just the replacement of our current patient management programme is being developed at a cost approaching £25 million – practically 10% of our entire annual budget.

Against all of the foregoing, Islanders needed to make sure that the next candidates for the Assembly are ready to take on the work, investigate the solutions and fund the substantial costs that maintaining healthcare (across the Bailiwick) will demand. It is not for the fainthearted and demands commitment. Please read/listen to the HEALTH POSTS below which go into greater detail on all these matters before assuming that there are easy choices to be made by members of the new Assembly.

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