Friday 21 March 2025
General Update
Thank you, Sir,
Before I deliver my final statement as the President of the Committee forHealth & Social Care, I would first like to express my appreciation to States Members for the support that you have provided in this challenging role over this term. Thank you for that.
My most sincere thanks must go to the other HSC Committee Members, both past and present. In addition, I would like to thank our non-voting member, Dr George Oswald, whose knowledge and experience in the medical profession has provided invaluable insight. Finally, I want to thank all the dedicated staff who work tirelessly to deliver our health and social care services.
We shouldn't forget that at the beginning of this term the Committee had to respond to the significant challenges that arose from the Covid-19 pandemic. Indeed, I gave my first update statement as President in December 2020, the day before the first COVID vaccine in the Bailiwick was administered, and I think about how far we have come since that time. This was the biggest challenge the health and care system had faced in living memory, but it also showed our health and social care systems at their very best; the dedication and skill of staff, the flexibility of providers to work beyond traditional organisational boundaries and the ability for the whole island to come together to protect our health and wellbeing.
Whilst the extended period of disruption to health and care cannot be underestimated, it is pleasing to note that the subsequent investment into a series of recovery initiatives, such as the establishment of de Havilland Ward dedicated to elective orthopaedic procedures, an endoscopy initiative in gastroenterology and in ophthalmology have had a noticeable positive impact on reducing waiting lists.
The States Assembly's decision to upgrade the hospital site through Phase 1 of the Our Hospital Modernisation programme was essential to meet and future-proof islanders' health and care needs, both now and in the future.
We hope to officially open the Post Anaesthetic Care and Critical Care Units within the next few months. We had hoped to open in April so naturally we're disappointed, but it's crucial that we get this right for patients and staff given the benefits that the new units will bring and that is our focus.
Turning now to the next phase of the Hospital Modernisation Programme. We are planning to refine our business case for the next phase of work. This is predominantly new build construction and will address key issues, including providing much needed additional theatre capacity, the development of a Neonatal Intensive Care Unit/Special Care Baby Unit and improvements in maternity services, as well as improvements to wards and outpatient services.
The Committee will bring this business case back to the Assembly later this year. While I wouldn't have predicted this at the time, the phased approach to hospital modernisation will ultimately lead to better outcomes for both patients and clinicians.
The Electronic Patient Record replacement programme continues to receive positive clinical feedback for the significant transformational benefits it will bring. Work is now moving into the phases of testing and preparing for the initial go-live this summer. This process includes testing with all the other integrated hospital systems, building training materials, and rehearsing for the swap over from existing systems.
As I have previously advised, this is a complex programme, and the programme team continue to actively monitor timelines, progress and risks. This includes providing regular progress reports to both the Governance Board and the Committee. There continues to be some challenges with both resources and complexity. Whilst we now expect a short delay to the initial go-live date of approximately one month, the current projection remains for overall programme delivery as planned in June 2026, within the funding provided.
Moving on to 'Our Community Services' projects. As Members will be aware it is our intention to redevelop Raymond Falla House and co-locate existing Community Health & Social Care services to provide a Children & Families Hub. This will provide an improved environment for the multi-service delivery for children and their families, in addition to increased efficiency in our estate utilisation. We anticipate that that the Business Case for this redevelopment will be presented early in the next political term.
La Vieille Plage is the specialist residential development currently being built by the States of Guernsey, the Guernsey Housing Association, and local Construction Partners to meet the needs of members of our community living with varying levels of learning and physical disabilities. I'm pleased to report that construction has progressed well and is currently on track for delivery this summer.
I now wish to highlight the significant progress made to deliver some key policy and legislative workstreams during this political term.
Through the Government Work Plan, the Strategic Portfolio for Health and Social Care has been established, building on the strategic vision set out in the Partnership of Purpose, and we have continued to lay important foundations for the long-term transformation of health and social care.
Early in the term, the Committee finalised the new 'opt out' arrangements in respect of organ donation, implemented new arrangements to give effect to an updated Abortion Law and, working closely with External Relations, we also implemented the new Reciprocal Health Arrangement with the UK.
In support of our ongoing commitment to prevention and early intervention and the delivery of the Combined Substance Use Strategy, the Committee has implemented new legislation to improve community health and wellbeing, particularly for our younger generations. For example, we have introduced legislation making it a criminal offence to smoke in cars carrying children and worked with the States of Jersey to introduce regulations to implement plain packaging of tobacco products with appropriate health warnings.
Further, in deliverance of our commitment to establish a framework to define and regulate vapes, the enabling law on vaping products was presented to and approved by the Assembly in November 2024.
When elected, I made it clear that health is a cross-Committee responsibility and in fulfilling our promise to work together, we have completed a cross-committee piece of work to complete a full refresh of the Children and Young People's Plan that sets out how the States and partner agencies will support children and families across the Bailiwick.
With regards to the introduction of the Capacity Law, the much-anticipated Lasting Powers of Attorney was successfully brought into effect in 2022 and work has continued to progress the phased introduction of this Law.
With your support, we have also reached a key milestone in establishing a new framework for Care Regulation. I'd just like to mention that one of my regrets is that the States has not made more progress in relation to the provision of key worker housing.
I am also pleased to advise of the forthcoming publication of the 2024 Key Performance Indicators report in relation to the Secondary Healthcare Contract. This positive report highlights the progress undertaken and ongoing efforts for continuous improvement to deliver a high standard of care. I would like to recognise the contribution of our many partners, key stakeholders and volunteers who make an essential contribution to the health and wellbeing of our community.
As you all know, demand for health and social care provision is increasing and there will be continuous and considerable pressures to manage the provision of the necessary services within limited resources. By way of example, in 2024 there were 24,500 emergency department attendances which represents a 21% increase in attendances between 2021 and 2024 - that is just on our watch. In addition, in 2024, 1,500 full-time equivalent nurses, and other staff on agenda for change contracts, provided approximately 2.5 million hours of care.
Finally, I would like to make some comments for the record. The budget for Committee of Health & Social Care is not out of control. The pressure on the budget reflects the ongoing and increasing demand for health & social care services. This in turn is driven by the demand for new drugs, acute care, better regulation and the Bailiwick's changing demographics. Those Members who are looking for a quick fix or pretty soundbites need look elsewhere.
Health and Social Care services will continue to need to expand and will continue to require increasing resources, as is reflected in other western economies. The real issue is who pays and what services are provided free at the point of access. I sincerely hope that we don't get to a position where islanders will have few options for their care - demand is going to continue to rise, who pays is the question.
Whilst I have mentioned just a few highlights, I hope that Members will agree that the Committee has made some real and tangible progress during this political term. It has been a privilege to serve on the Committee and I look forward to answering, or taking away, any questions Members may have.
Thank you, Sir.