A NEW hospital, one of the biggest building projects in Jersey’s history, will inevitably command massive attention and engagement in the realm of public health, but other opportunities to improve lives will also be pursued.
One overarching aim of Big Plough will be the urgent adoption of internationally agreed measurements of wellbeing, tracking not just economic output but also the community’s physical and mental health, quality of life and general happiness.
Once again, revitalised parish hubs should be acknowledged as full partners in this holistic approach. The voluntary sector and community spirit in which Jersey people rightly take such pride has not always been properly valued by the more bureaucratic States administration and that must change. Parish communities represent the best of the Jersey Way
and can have an even more important role in future, not least in combating loneliness.
We will continue to support new initiatives to promote preventive medicine, healthy lifestyles and education in nutrition.
All public places, policies and projects should be designed to be dementia-friendly, disability-friendly and child-friendly. Jersey’s hybrid health system should be reviewed to ensure that no Islanders are excluded from GP and dental services on the grounds of cost. States-subsidised health insurance schemes will be considered as an addition to the range of funding options.
France, our near neighbour, is widely acknowledged to have the best health services in Europe. As in many other areas of Island life, we should take advantage of our unusual degree of independence and look there for ideas, role models and collaborations, as well as to the UK.
FOR years the agenda has been dominated by the perceived need for a new hospital. Advance Jersey recognises that, though some parts of the offering are satisfactory – for instance we have a relatively new day surgery unit – others are no longer fit for purpose and some facilities, while technically satisfactory, are poorly housed. We support the need for new hospital facilities, but believe the current proposals are grossly over specified. We will draw a line under the work to date, take from it what value may be gleaned and move forward with a new plan which is proportionate to the need.
Too much time has been wasted on a new hospital building and not enough on the interface between medical professionals and patients. We believe too much of the Health budget is directed towards administration and not enough towards clinical activities. Recognising the need to recruit and retain qualified doctors and nurses, in addition to employment terms we will look at the importance of providing them with the good-quality, modern accommodation at an affordable cost which is presently lacking.
We understand the challenge facing the least well-off with the cost of seeing a doctor; a GP makes a charge simply for writing a prescription, but the medication is provided free of charge to everyone. We will reintroduce a nominal fixed charge for dispensing prescriptions, exempting those on the lowest incomes, and apply the savings to further reduce the
cost of doctor visits for those least able to pay.
HEALTHCARE poses one of the biggest challenges to policy makers and the States Treasurer. Treatments are becoming ever more effective, but equally costlier and more complex. Patient expectations are often sky high. Meanwhile, many of us aren’t taking good enough care of our health: smoking, drinking and narcotics, obesity and other lifestyle conditions brought on by sedentary occupations – coupled with an ageing population – are placing increasing strains on healthcare delivery. If we don’t do something soon, the mismatch between demand and supply will become unsustainable.
An important part of the answer is to ensure that each of us takes proper ownership of the lifestyle choices we make – and their consequences. In return for having universal access to excellent healthcare that is free (or heavily subsidised) at the point of delivery, it’s only fair that those of us who are careless about our fitness – or simply take unnecessary risks – must shoulder part of the burden of increased costs. This could be done by levying a supplementary health charge. And we must learn to compromise over issues of location and timing – when and where we’re treated. For end-of-life care, we need to build on the brilliant success of Jersey Hospice. We want everyone to enjoy good health from childhood to old age, and this means ensuring we all have access to the treatments needed to keep us that way. But it also means a new deal between our health service and its users, with maximum emphasis on preventative medicine and a willingness to use outsourced facilities where these can provide a better or more cost-effective solution.
Meanwhile, as with education, the administration of our health service has become bureaucratic and top-heavy. There are cost savings to be had from thinning out the management layers, and further gains from giving a greater say to senior doctors, surgeons and other medical staff. ‘Consultations’ with these groups – in particular over the new hospital plans – have often been nothing of the sort: ‘briefings’ would be nearer the mark. Instead, we will tap into this expertise.
The interminable process to find a location for the new hospital has been a fiasco, and its conclusion is a farce. Redeveloping on and around the current site is a recipe for years of dislocation and an unmanageable budget.
We will stop this nonsense in its tracks and look afresh at alternative
sites, with a likely preference for the waterfront.
In the longer term, changes in medical technology could radically alter the interface between patients and clinicians. And this is likely to have a direct bearing on the size and specification of the new hospital.
Despite the large sums already spent, we’re not satisfied that enough care has gone into planning this highly expensive replacement for the existing facility, and in government we will consult further with health professionals and futurologists to make sure we get it right.
VOTING… FOR A BETTER LIFE
WE are fortunate to live at a time of major advances in medical care and technology. In the near future, a patient will expect to receive medication that has been specifically formulated to match his genetic profile or to have an operation to replace a deceased organ with a replacement organ generated from his own DNA. Against this background of improving healthcare, people are living longer and this trend is set to continue.
Unfortunately, modern life also has some health disadvantages. Jobs are often sedentary and diets based on processed food, with calorie intake far in excess of actual need. The government should place far more emphasis on health promotion to help everyone adopt a healthy lifestyle. Lessons should be learnt from countries such as Japan, where there is a much higher awareness of the importance of exercise and a balanced diet.
Schools and workplaces should ensure that there is time put aside every day for physical exercise. Sessions should also be freely available for pensioners and others based at home, such as parents of young children. Healthy eating should be much more prominent in government policy with good, nutritious food
provided in schools, offices and community centres.
Building a new hospital is the single largest investment the States will ever have made. The current Health Minister is blindly pursuing an inferior option and this poor decision should be robustly challenged by the next States Assembly. Health is essential to everyone and our only hospital should be a matter of pride to the community rather than a hotchpotch of compromises squashed onto inappropriate sites.
There is still time to establish a health quarter based around Westmount and Overdale. Creating a single large campus site would have significant advantages. The Emergency Department would be located just off Victoria Avenue at the George V homes, parking built into the hillside and the main hospital buildings provided at Overdale.
The site would have good road connections and regular bus services from the North, East and West. Purpose-built key worker accommodation would be included to ensure that we can attract high-quality nurses and doctors to work in the new hospital, with opportunities for health-related businesses to be located nearby. The setting at Overdale would help patients
recover with access to gardens and sea views.
It would also be ideal as a basis for establishing medical tourism, offering patients a combination of high-quality healthcare and a beautiful environment. This could be a valuable area of diversification within the local economy, particularly if hotels were to offer complementary therapeutic and recuperation facilities. It would also be of benefit to local residents who would gain access to world-class specialists providing services in Jersey.
Whatever the location, a Jersey hospital will never be able to provide all the specialist services of a major medical centre. There should be much more emphasis on establishing strong and regular connections with both French and English centres of excellence, with appropriate transport links providing quick and easy access.
Jersey has a wonderful outdoors culture, a beautiful environment and it’s a rich island. All the conditions are in place for healthy, productive and happy lives. And, indeed, Jersey scores well on many health indicators, including average life expectancy.
Yet there is still much to be done. In particular, there is a sharp divide in health outcomes between the well-off and the poor. In addition, demand for health care will rise as the population ages.
Investing in health is an investment in all our futures. It improves quality of life, increases productivity, lengthens our productive lives and reduces healthcare costs.
We need a two-pronged strategy. First, ensure that health care in Jersey is properly funded. And second, take action to improve the health of the population.
It’s impossible to talk about health in Jersey without talking about the new hospital. The process of choosing a site and planning the project has been a fiasco. However, we have to accept where we are today. Jersey Together believes that the new plans for the current hospital site should be allowed to work through the Planning system. If they are deemed satisfactory, then let’s get on with it.
The tax rises already outlined in this manifesto will mean that we can properly fund health care in Jersey. This includes ensuring that nurses’ pay and conditions are sufficiently attractive to prevent recruitment problems, and the over reliance on (expensive) bank shifts.
We will ensure that public health in Jersey is benchmarked against the best in the world. In areas where Jersey scores badly, we will design strategies to close the gap. This will allow us to set measurable goals against which we can be held to account.
Alcohol-related ill health is a major issue. Most problems are caused by heavy, ‘binge’ drinking. It is well established that this kind of drinking is encouraged by cheap alcohol. At the moment it is possible to buy alcohol at around 20-30p a unit, meaning that it is possible to get drunk for around £2 to £3. Jersey Together proposes a minimum price per unit of alcohol, to be set at around 50p per unit. It is worth noting that this would have no effect on the cost of most drinks. For example, a bottle of wine costing more than £5 would be unaffected.
Obesity is also a significant issue. Our children are more obese than in the UK. We will work to encourage active lifestyles. In the UK a ‘safe routes to schools’ campaign has significantly increased cycle and pedestrian journeys among children and could be replicated here.
We support the introduction of an asbestos-related disease compensation fund.
Finally, we will achieve improvements in public health by other measures in this manifesto that reduce poverty. We will increase the medical provision in income support, so the least well-off are not deterred from visiting GPs because of cost.