Row over health savings plan

Friday 29 July 2016

Jersey's Health Minister has rejected claims his department won't deliver £13million of savings.

Deputy Andrew Green and Deputy Geoff Southern failed to see eye-to-eye over the proposed savings during this week's meeting of the Health and Social Services Scrutiny Panel.

Deputy Green said the savings were entirely proportionate and realistic, especially in a department with a £200m budget. 

But Deputy Southern was sceptical, saying: “What happens if you miss your targets, what happens then?”

In a fractious meeting, the Minister replied that the extra £38.5million outlined for his department in the States’ Medium Term Financial Plan (MTFP) underlined the importance it places on health.  

Deputy Green said: “We are getting an extra £38.5million for health care outlined in the MTFP and with that comes a huge responsibility to ensure we do our bit to improve efficiency and reduce waste. We should also not take money that we can’t spend at appropriate times. 

“When you are dealing with a department which is spending in excess of £200m you have got to have some flexibility within that. Not everything can be delivered to exactly the time that we would like and some things become a priority that perhaps were not such a high priority at the beginning of a programme. We cannot straight jacket everybody into sticking entirely to a plan when you are spending that sort of money.

“With savings, we are talking about 0.4% of the budget. Staff are constantly talking about ideas to save money, by reducing waste and duplication. They are the best people to do that.”

Deputy Southern said: “This is about efficiencies and you don’t know what they are. Putting my cynical head on, the easiest way for any department to save money is to not make appointments when appropriate. Put that back by six months and you get six months savings by not delivering something earlier in the year. Is that not what is built into this? 

“In a word, no,” replied Deputy Green. 

“In no way whatsoever?” said Deputy Southern. 

One of the department officers said that such delaying tactics would not be a sustainable method for making savings. 

“But you have used it in the past before,” said Deputy Southern.   

Minister Green said: “You seem to have forgotten that yes, we do have to reduce waste, but we are investing £38.5m more directly into patient care to within the community.”

Deputy Southern said he doubted the department could make savings of £13m without affecting services. “What happens if you miss your targets and you cannot deliver the sum which amounts to those savings? What happens then?”

An officer replied that savings are monitored every fortnight and said the department had a good track record when it came to making efficiencies, but admitted it was “difficult and challenging.” 

Deputy Richard Renouf said: “There must come a stage when residents started feeling the effect of these savings.”

“Not necessarily,” replied Deputy Green. “I can give you one example where surgery used to be carried out in London but is now in Oxford. It’s cheaper and it is clinically as good, if not better, than we were getting in London. We are now paying less than we were, so those sort of things also happen and challenge us all the time. That’s a good example of where you can get a better service, for less. Hospitals want our custom and so sometimes we can negotiate a better price.” 

Deputy Renouf said: “You believe it is possible to make savings year on year, all the time?”

“If it wasn’t possible, it would not be in the plan,” replied Deputy Green.