“Difficult choices” ahead as HSC focuses on a “sustainable” future

Health and Social Care (HSC) has promised islanders “high quality, sustainable health and care services”, with a loaded warning that the States “must agree a delivery and funding model” before the end of this term.

As HSC published its work plan, the committee’s President, Deputy George Oswald, said its priority was “to ensure islanders continue to have access to high-quality health and care services, both now and in the future”.

The work plan shares eight priorities for the next three years.

While some of the priorities won’t surprise anyone, including promises to support children and older people, and a focus on early intervention, HSC has also set its sights on “strengthening” and “modernising” our healthcare services.

“This work plan sets out an ambitious programme for the political term, centred on creating a more sustainable health and care system, without compromising health outcomes,” said Deputy Oswald.

“Delivering it will require difficult choices, as well as close partnership working across government and with healthcare providers, charities, staff and the wider community.

“By investing in prevention, supporting people to live independently and modernising our services, infrastructure and technology, we can build a system that is better equipped to meet the changing needs of our islands.”

‘Difficult choices’

HSC warned that significant pressures were facing health and care services, including changing demographics, increasing demand and rising costs.

The committee said it “aims to ensure services can continue to meet islanders’ needs” through its eight priorities”.

It says the work plan will help ensure those services continue, “while putting health and care on a more sustainable footing for the future”.

The difficult choices Deputy Oswald referred to include the States needing to agree a delivery and funding model for health and social care provision which is more cost effective than the current model.

The new model must meet the funding challenges “without compromising health outcomes”, HSC said.

The new model will see changes to health and care services in both Guernsey and Alderney.

Why is change needed?

The changes are needed because of the continuing challenges caused by the Bailiwick’s changing demographic, HSC explained.

This has “significant implications” for health and social care systems due to people living longer, with multiple health conditions requiring ongoing medication, treatment or care.

HSC warns that if health and care systems are not reformed, they will absorb an increasing proportion of the States’ total resources.

To meet this funding challenge, HSC said it is going to review all current health and care systems, and their history, to see how they have evolved, and what gaps, challenges, and pressures there are.

This will help HSC create a vision of how health and care could change in the future to make services more financially sustainable.

This could include changes to how some services are provided, with some moving to a primary or community setting rather than being based at the hospital.

Pharmacy services, the secondary healthcare contract, and off-island care will all be included in this review.

Other changes could be led by the promised increased focus on prevention and early intervention.

HSC said this work will be developed during the first half of the political term, with a new delivery and funding model needing to be agreed by the end of this States (2029).

This suggests more details will be made public over the coming months as deputies reach the mid-way point in their current term since the June 2025 election.

The implementation of any new health and social care model is likely to be delivered in future political terms.