Dr Nigel Minihane, a spokesman for the Primary Care Body, and former Social Security head Ann Esterson, said that a mechanism to replenish the Health Insurance Fund was needed, or there would not be enough money to cover annual spending within a few years.
Under current ministerial plans, the fund, which contained £107 million at the end of last year, will be reduced to £47 million by the end of 2025.
Annual spending from the fund, which is used to subsidise doctors’ and chemists’ bills, is expected to reach £44 million per year by that time and increase thereafter as the population ages.
Social Security Minister Judy Martin recently lodged proposals to withdraw £13 million from the HIF next year, with tens of millions more to be taken out by 2025.
The cash is being earmarked for investment in the Jersey Care Model, which will focus on delivering more ‘care in the community’, and digital health modernisation projects.
Mrs Esterson said that the issue would be exacerbated by rising healthcare costs brought about by the planned introduction of the new model.
She said: ‘All the indications are it’s a much more expensive model than the one we’ve got now. How’s it going to be funded?
‘If the government keeps using the HIF as a piggy bank, then how are people going to be able to afford health care in the future? They’re not answering any of these questions deliberately, because they probably don’t know.
‘Are they going to put up contribution rates? Are they going to make people pay even more for their healthcare? Are they going to put up taxes? Are they going to reintroduce prescription charges? There’s only so many ways of trying to balance out the fund again.
‘[Deputy] Judy Martin’s role is about affordable healthcare, it’s not about running a change-management programme in Health or paying for their IT. It’s about making sure that Islanders can afford healthcare and subscriptions.’
Mrs Esterson added that the issue had been compounded by a long-term freeze on government subsidies for GPs, which, she said, had resulted in doctors putting up prices and fewer people going to surgeries.
‘There are 14% less visits to the GP than ten years ago and we have a higher population. That tells you something,’ she said.
She explained that she had told government officials that the planned ‘raids’ on the HIF, as well as the Social Security Fund, which, if approved by States Members, would be starved of £160 million next year and in 2023, were akin to media baron Robert Maxwell’s infamous misappropriation of the Mirror Group’s pension funds in the 1990s.
‘I said to them you’d be the first to criticize Robert Maxwell for what he did and you are doing exactly the same thing. It’s robbing Peter to pay Paul and ultimately you’ve still got to pay back what you’ve robbed, or raise taxes to cover the difference,’ she said.
‘It’s a short-term lack of financial discipline.’
Dr Minihane said that he had seen actuary calculations indicating that the HIF would run out within ten to 15 years unless action was taken.
‘If you raid the HIF it’s nonsensical. If we kept the HIF at the level of £100 million and put in some extra funding, then we could live off the interest in very much the same way they say they are using the Strategic Reserve for the hospital borrowing,’ he said.
‘We have been raising this issue for the last two years and we have been ignored. They are going to need to find alternative means of funding for it or people are going to end up having to pay more for healthcare.
‘They want, under the Jersey Care Model, more healthcare to be done by GPs in the community. So they are going to need to fund this somehow.’
Dr Minihane added that going into the 2030s Jersey’s ageing population would increasingly require access to healthcare, meaning there would be an even greater need for funding.
‘By 2035 we are predicted to have the highest-ever proportion of over-85s in Jersey, so we will need the funding more than ever,’ he said.
The government was contacted for comment but had not responded at the time of writing.
