Health Minister Richard Renouf has confirmed that he will lodge a proposition in October seeking approval for the new Jersey Care Model, which underpins the design brief for the new hospital.
The model will raise again the question of how the cost of primary care is apportioned between the government and Islanders. Deputy Renouf rejected the idea that the vision involved ‘nationalising GPs’ – as was suggested by one States Member recently – or threatening the current role of the profession.
‘That is quite the wrong language to use. The Care Model doesn’t envisage that,’ he said.
‘It envisages the professionals working as they are, as independent practices, but in close collaboration in an integrated system. We value our GPs in Jersey and we don’t want to move to a UK model – that’s clear. We don’t want these long waiting lists to see your GP which occur in some parts of the UK, so that relationship and ready access is important and must be preserved.’
Deputy Renouf added that the States would be asked to address the broad principles of the care model – which seeks to move many non-acute services away from a centralised hospital setting into the community – but that the detail, including the operation of the controversial Urgent Treatment Centre, would be a matter for further discussion.
The treatment centre was introduced as a temporary measure at the start of the Covid-19 pandemic, but the principle of such a facility, seeking to reduce pressure on the specialist Emergency Department, is a key element of the new model. The temporary centre closed last month and an agreement with some GPs to work from the hospital has now expired. Many are understood to be unhappy about the arrangement.
However, Deputy Renouf said that it was important to distinguish temporary measures introduced in response to Covid-19 from the new model which they wish to roll out in consultation with all those involved in health and social care in the Island.
‘It has been a difficult time, but it was very much an emergency response and done quickly – but it wasn’t the care model. We shouldn’t think that we’ll be lifting that experience and exactly replicating it in the care model.
‘We’re going to talk it through with GPs and everyone involved in the services as to how that might work best for Jersey. The detail hasn’t been worked out. It’s the subject for discussion which we haven’t got to yet because the care model hasn’t been agreed with the States and we haven’t got the money through yet,’ Deputy Renouf said.
The draft brief for the new hospital is strongly influenced by assumptions made in the Jersey Care Model, particularly in relation to capacity, which makes its adoption by the States significant for the project. However, the minister pointed out that the brief also included the potential for expansion, if necessary.
‘But I sincerely hope that States Members will see the huge benefits of adopting the care model and they have been very supportive thus far. I want to emphasise that what we are trying to do is all about delivering the right care to Islanders in the right place and at the right time – patient centred. It’s not about a building, or a profession, or hospital management. It’s about us,’ the minister added.
The care model vision, set out in public presentations last November and December, is that the interests of patients are best met by a system capitalising on a range of expanded community-based services, including those provided by pharmacies, GP surgeries, the parish system and voluntary organisations.
For larger organisations like Jersey Hospice, Family Nursing & Home Care and the Island’s mental-health charities, there was what the minister described as a ‘tremendous role’. He said that his department would negotiate longer-term agreements with shared governance and oversight arrangements.
‘We’ve got the opportunity to develop something for Jersey, to create what we want and need,’ Deputy Renouf said.