Social Security Minister denies ‘arrogant governance’

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Deputy Judy Martin said that any suggestion that she was ‘involved in arrogant governance’ was unjustified and that the use of the Health Insurance Fund was ‘fully compliant with the laws that control them’.

The minister was responding to comments made in yesterday’s JEP by Ann Esterson, who was the chief officer at Social Security from 1996 to 2006.

Mrs Esterson described the government’s attitude to financial governance as ‘cavalier’ and said this was driving up the cost of GP visits. Much of Mrs Esterson’s criticism centred on the Health Insurance Fund, which was first set up in the 1960s, partly to meet the cost of patients’ appointments. The HIF includes a system of rebates for GPs. However, the rebate figure of £20 per appointment has not been increased since 2012. GP appointment fees have increased in recent years, with some set to rise to £50. Mrs Esterson also said that rather than being ringfenced, in line with the principle on which it was established, the HIF had been dipped into for expenses other than primary care, such as a hospital IT system and the ‘bureaucracy’ needed for the Island’s new health system, known as the Jersey Care Model. The minister rejected the claims in a letter of response published in today’s paper.

‘I strongly refute the suggestion that I am involved in arrogant governance or defective decision-making, or that the use of the fund is, in any way “cavalier”,’ Deputy Martin said.

She added: ‘I take the governance of the Social Security funds extremely seriously and I can confirm that the use of the funds is fully compliant with the laws that control them and the Health Insurance Fund remains ringfenced to support the provision of health benefits and services.’

While acknowledging that the rebate had not increased, Deputy Martin cited several alternative ways in which patients were supported as a result of the HIF, including:

  • A total of £1.7 million in additional income for GP surgeries through the Quality Improvement Framework, which uses a range of indicators aimed at improving care.
  • Free cervical cancer screening, as well as free and subsidised flu vaccinations and free diabetic supplies.
  • The Health Access Scheme, for which up to 12,000 Islanders were eligible, providing free surgery consultations for children up to the age of 17 living in an income support household and capped fees of £12 for an adult surgery consultation for those in the same group.

The minister admitted that the HIF was under pressure and would have been likely to use up all its reserves by 2034 without the plans to improve the Island’s health system, including the new hospital and the Jersey Care Model, and the way in which services are funded.

Politicians involved in Scrutiny have pledged to continue their efforts to monitor the government’s plans for healthcare.

Deputy Mary Le Hegarat, chairperson of the Health and Social Security Panel, said members of her panel had been asking questions regularly and would continue to do so. And Deputy Inna Gardiner, chairperson of the Public Accounts Committee, said: ‘We understand the comptroller and auditor general will be reviewing the Long-Term Care Fund later this year and we will undertake a wider review of the sustainability of all the Social Security funds. In the meantime, we will be monitoring closely the demands on the funds to ensure the public is aware of how its money is spent by those entrusted to spend it.’

  • Deputy Martin’s letter is on page 12 of today’s JEP.
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