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Statement by the President, Committee for Health & Social Care

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Wednesday 15 December 2021

General Update

Thank you, Sir

It has been quite a year in the world of health and social care. Nearly one year ago to the day, on 17th December 2020, the first COVID-19 vaccine in the Bailiwick was given in the Emma Ferbrache Room at the Princess Elizabeth Hospital. 105,000 doses later and thanks to the sustained efforts of the team, there can be no doubt of the success of the Vaccination Programme in protecting our community and allowing us to focus how we can live responsibly with COVID-19, albeit that the pandemic continues to keep us on our toes.

The winter season is usually a busy period that sees an increase in the clinical activity at the PEH and for our community services, partially due to seasonal respiratory illnesses such as flu. The pressure on the whole system this year has been constant throughout 2021 no matter the season. We are fortunate that the high rate of vaccination uptake is reducing the number of people that might otherwise require hospital treatment for COVID-19.

However, as health and care systems nationally and internationally have been put under increasing strain, the operating context has changed significantly, and this is impacting our ability to recruit staff to fill key roles.  The Committee is doing all it can to think creatively about how to recruit staff for our essential services and how we can best protect our infrastructure over winter months is kept under continual review. In particular we will be increasing staffing through the use of agency and temporary staff to improve our resilience in the coming months.

We know that our efforts to prioritise urgent surgeries, to care for those 30 patients who are awaiting discharge from the PEH, while also managing the small number of admissions with a COVID-19 diagnosis in the hospital setting, is having an impact on surgical waiting lists.

Regrettably we cannot access off Island providers as we could in pre-pandemic times and now have to 'paddle our own canoe' for anything but the very urgent cases. I know that delays and postponements cause distress and upset for those affected and their families, but I am hopeful that recent decisions of the Committee - to recruit additional resources to the Community Care Teams; to extend the opening hours of the Day Patient Unit; and to increase the total number of beds in the PEH - will see a reduction in the number of people waiting for their procedures.  We can make in-roads into the waiting lists when beds are available, but this remains a significant challenge for us at this time.

I would like to take opportunity to update on other initiatives which have progressed over recent months.

With the introduction of low-cost appointments for children less than three weeks away - thanks to the reallocation of a proportion of family allowance - we're taking important strides in improving the accessibility of health care, and I would like to thank the GP and dental practices for actively engaging in this important change.

However, we know that this alone isn't enough - all islanders need to be able to access good quality health care when they need it and at rates they can afford. It has been shown that, when health care systems are configured around primary care, the system yields a healthier population at a lower cost - the system is more effective, equitable and efficient.

Work on a review of the model and funding of primary care is ongoing, and I am grateful to Deputies Roffey and Falla, along with HSC's non-voting members for their participation as members of the Working Party. We are in active conversation with Primary Care colleagues and remain on course to report to the Assembly next year.  There are no easy solutions, but I anticipate that a range of options will be presented in our final report, ranging from the cost-neutral reallocation of existing funds to provide greater value for money, right through to how we could make primary care free at the point of access.  But we as an Assembly, of course, need to be mindful to make policy decisions that create an environment that supports the wellbeing of our community.

Turning now to the Government Work Plan and to HSCs priority areas, I am pleased to report that a cross-Committee political oversight group - 'The Children & Young People's Board' - has been established to lead the Review of the Children Law. Stakeholder workshops took place earlier this week and will further inform the recommendations for changes to remove delays in determining outcomes for children, and this important piece will also be reported to the States next year.

Recognising that the festive period can be a difficult time of year for some Islanders' mental wellbeing, I announced last week that arrangements have been made to introduce additional wellbeing support over Christmas and New Year. This will be available in the evenings when other forms of support may not be readily available and is intended to help Islanders who are feeling particularly isolated or stressed. While this 'pilot of a pilot' won't initially go as far as we intended when the GWP was being put together, we will build upon this further and discussions surrounding a partnership approach with the third sector to provide out of hours 'drop in' crisis support also continue in parallel.

I would reiterate, though, that support is available for those who need it and I would encourage people to speak to their GP if they are struggling, who will refer them to the appropriate services if necessary. 

Progressing the Capacity Law is one of the top legislative priorities of the GWP and I'm pleased to advise Members that the Ordinance for Lasting Powers of Attorney has recently been approved by the Committee and will be making its way to the Assembly in the New Year. This is an important development for our community and we will be doing further work to raise awareness of this development with members of the public and with key stakeholder groups.

I am also pleased to advise that the first year of the implementation of NICE TA drugs and treatments is almost complete, thanks to the hard work and diligence of our pharmacy team.

Continuing on the theme of the GWP, and working closely with the Committee for Home Affairs, a cross-committee steering group has been established to examine alternative and non-punitive approaches to the possession of small amounts of illegal drugs for personal use. This piece of work will consider all drugs, not just cannabis. Meetings of the steering group are underway and will deliver Propositions and a supporting policy letter for consideration by the Assembly.

As a positive action for the future physical health of our population, the Committee made Regulations earlier this year to introduce a legal requirement for the plain packaging of tobacco. Working alongside our colleagues in Jersey, this legal measure will see cigarette packets, from 31st July 2022, without tobacco company branding on them so they will by and large look exactly the same from one brand to another. Experience from elsewhere suggests that we should see fewer children starting to smoke in the coming years across the Channel Islands as a direct result of this initiative.

As always, I have only been able to touch upon a small part of HSCs work in my Statement today. As we look ahead to 2022 it is important to acknowledge the good work that goes on, on a day to day basis, to support the community. I would like to take this opportunity on behalf of the Committee to thank everyone working across health and social care - in HSC, and in the private and third sectors too - for their tireless and enduring commitment this year. And finally, I would like to thank you, States Members, on behalf of the Committee, for your support with our budget, our build programme, and just being there when we need help, so thank you.  

Thank you, Sir.

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