From women’s health and an ADHD hub to diabetes services and PFAS tests, there is not a single spare penny in the Health Department pot, according to the Minister.
In the space of two days last week, Deputy Tom Binet addressed fellow politicians at the Health Scrutiny Panel and members of the public at a meeting on PFAS contamination – and described to both audiences how a tight budget flows is impacting all aspects of his department.
“We can scarcely keep the operating theatres and the wards running”
Asked about blood tests for PFAS levels, the Health Minister claimed that he had paid for his own test “because everybody else has paid for their blood tests”.
Deputy Binet added that, if everyone got a free test costing £20 per person, the total cost for 100,000 people would “cripple the health service”.
“I have to make a point to you about health funding,” he told the meeting.
“We’re so tight on budget at the moment that we can scarcely keep the operating theatres and the wards running.
“That’s how tight the budget is, because over the last 50 years, our life expectancy has gone up by 12 years, and people live for a lot longer.
“They’ve got a lot more complaints and they require a lot more money.”
“Not a single penny” in the pot
The Minister’s comments to the Health Scrutiny Panel on Wednesday echoed the same theme.
Deputy Binet last month rejected a recommendation to set up a dedicated ADHD hub for patients – which was suggested in a report from the Health and Social Security Scrutiny Panel about how ADHD medication is prescribed to adults.
He said the department was “not in a position to fund” the hub and cited worldwide staff shortages.
Last week, scrutineer Deputy Jonathan Renouf asked the Minister: “There was a recommendation around the dedicated [ADHD] hub that was rejected on the grounds of cost.
“I think your words were: ‘it’s going to cost a hell of a lot more money, and in any event, we need more staff’.
“Was there any kind of costing model produced, or was it just a general kind of this is going to cost money?”
Deputy Binet replied: “Unfortunately, when you look in the pot and there’s not a single penny, you can’t leave the starting blocks.
“That doesn’t mean that we won’t look to try and do this as things go forward.”
The Minister added: “We need to have a fundamental rethink about health funding.
“I think when you pay 20% tax and year on year, you get health provision that is more and more complicated, more and more expensive, you then have to have an honest discussion with the public about what sort of health service they want and how much they’re prepared to pay for it.”
“We cannot shift a single penny from where we are”
In the same Scrutiny meeting, the Minister was asked about plans to prevent diabetes.
Daniela Raffio, the Deputy Director of Public Health Strategic Commissioning, described how the department was “working actively” on a diabetes prevention service.
She said this would involve a local pilot scheme with a focus on changing behaviours, including physical activity and weight management.
But Deputy Binet said that “we cannot shift a single penny from where we are”, adding that the department would need more money to continue the diabetes prevention measures.
“You certainly can’t utilise that same money because you haven’t got enough of that to keep doing what you’re doing,” he said.
“What this requires is new money, and it needs upfront money, and that’s going to be quite a long-term investment.”
The hearing also touched on plans to focus on six areas of women’s health – including healthy behaviours from childhood, gynaecological and reproductive care, and working with different demographics among women.
But Deputy Binet said it would be “simply a case of doing as much as we can in each of those categories with the money that’s available”.
“A fundamental review of health funding”
Deputy Binet suggested that his controversial plans to completely overhaul the Health Department – and his own remit – would also include changes to the way Health is funded.
Talking about the way that the Health Insurance Fund is administered, he said: “There’s an enormous amount of complex complexity that could be streamlined, and all we’re looking to do is transfer a fund in its current form with exactly the same purpose from one department to the other.
“It seems to be a very good idea to us, and the Social Security Minister feels the same way.
“I don’t see any contention in that.”
He added that in the future, the department has to “be prepared to look at everything, and we have to have a fundamental review of health funding”.