REPEATED attempts to ensure the long-term sustainability of the Health Insurance Fund were missed by the Assembly, the head of the States spending watchdog has said.
Public Accounts Committee chair Deputy Inna Gardiner said that amendments had been brought to each of the past two Budget debates which could have gone some way to safeguarding the future of the fund, but were ultimately rejected.
It follows a recent report from Comptroller and Auditor General Lynn Pamment which concluded that while recent changes have removed cost barriers and broadened services, they have also piled pressure onto a fund now forecast to fall into annual deficit.
The HIF – which subsidises GP visits, prescriptions and other primary care services – is expected to shrink to £61 million by the end of 2029, less than a single year’s expenditure. The Budget 2026–2029 warns it could be exhausted in the early 2030s without intervention.
Reacting to the report, Deputy Gardiner said: “The Comptroller and Auditor General’s report confirms concerns that have been raised for some time about the sustainability of the Health Insurance Fund.
“Rather than introducing measures to restore balance, additional commitments have been made without consistent long-term financial modelling or clear value-for-money assessments.
“Rising health expenditure is placing sustained pressure on the fund, yet no comprehensive plan has been set out to secure its long-term stability.
“During the past two Budget debates, amendments were brought forward to limit and better control the use of the Health Insurance Fund to protect its long-term sustainability. I supported those amendments because the warning signs were already evident.”
In a final note, she said: “In light of this report, it is clear that the Assembly chose not to put stronger safeguards in place at the time — and we are now seeing the consequences of that decision.
“It is not something I say lightly, particularly given the pressures of an ageing population and growing healthcare needs.
“However, following repeated warnings and now the independent findings of the Comptroller and Auditor General, it is my responsibility as the Chair of the Public Accounts Committee to place these concerns clearly on the public record.”
In the report, Ms Pamment said: that the HIF is “not sustainable in its present form” and added that there had been no “tangible plan” for primary care and that the government does not “routinely assess value for money from new initiatives”.
However, in a statement reacting to it, a government spokesperson said that work to assess long-term funding options is “well advanced” and has been its “priority throughout 2025 and into 2026”.
It added: “Ministers have been clear, including in the 2026 Budget, that action is needed to address long‑term pressures on health funding caused by increased treatments and enhanced support with healthcare costs.”
