The government has accepted the majority of the recommendations from a report which found that the pot that helps pay for GP visits and prescription medicine is “not sustainable in its present form”.
Comptroller and Auditor General Lynn Pamment’s review warned that rising healthcare costs, an ageing population and increasing demand are placing growing pressure on the Health Insurance Fund.
In its formal response to the watchdog’s report, ministers agreed to act on nearly all proposed reforms – including recommendations to tackle medicines waste, improve prescribing practices and strengthen oversight of pharmacy services.
“The pressure on the fund is acknowledged publicly and politically,” the response said, acknowledging that “government will need to make a clear policy decision on how healthcare services will be funded” in the future.
But a key recommendation to establish whether pharmacies are being paid the correct amount for dispensing drugs has been put on hold.
The report warned there is currently “no objective evidence” that the cost of medicines and dispensing fees reflect the true cost for local providers – raising the risk that pharmacies could either be underfunded, threatening access to medicines, or overcompensated at taxpayers’ expense.
Despite this, the government has decided to defer the review until electronic prescribing is introduced, with the current system described as reliant on “outdated” paper-based processes.
“As part of the Digital Health Plan, Jersey will have the opportunity to move to electronic prescribing, at which point the processes and costs associated with dispensing will be entirely revised,” the response said.
The C&AG’s report highlighted the danger of medicine waste and inconsistent prescribing, warning that inefficiencies could lead to “poor use of public funds” and potential impacts on patient outcomes.
But the government said steps are already being taken, including monitoring prescribing patterns, using approved medicine lists and planning a public campaign to reduce waste later this year.
The government otherwise broadly backed the auditor’s findings, which included overhauling how the fund is managed to avoid “duplication leading to inefficiencies”, introducing a minimum balance to ensure there is a clear “trigger point” for action, and developing a long-term plan amid warnings the fund could otherwise be “depleted”.
Ministers also agreed to improve transparency around GP fees, amid concerns pricing could be “inaccurate or inconsistent”, and to review whether recent spending on GP and pharmacy services has delivered value for money.
One proposal – to require stronger business cases for all new spending decisions – was only partially accepted amid concerns that it could “disproportionately increase bureaucracy” and place additional strain on resources, while limiting the ability of States Members to bring forward policies.