'I am hugely supportive of the private patients vision, and I hope it might just be the beginning'

Dr Chris Edmond

By Dr Chris Edmond

IN the past year, topics for this column have included the need for vision, collaboration, whole-system working, innovation, healthcare as an export, attracting the brightest and best to Jersey and optimising the health of the working population to improve productivity.

And so it was that I read the government’s recently published Private Patients Strategy with some excitement – even being a political enthusiast it’s not often I get to say that about such documents.

Whilst it was released with little fanfare, you may have read in the JEP coverage that the strategy lays out a five-year plan to double private patient income from around £12m to £24m by 2028. I am hugely supportive of that vision, and I hope it might just be the beginning.

I am sure the sceptical among you (I am often in your number) will be wondering why the enthusiasm? Well, let me be clear that I will not benefit personally – I don’t do hospital private practice and I have no vested interest, other than as a citizen wanting to see the best for our island.

And having worked in the General Hospital for the past 13 years, I am in no doubt as to the challenges facing the health system in terms of governance, staffing, modernisation, and the need to develop an overarching healthcare vision within the current environment of financial restraint.

I also typically lean somewhat to the left of the political centre, and don’t have access to private medical insurance myself. However, I am also a pragmatist and recognise we need to take the best ideas from across the spectrum to address the major challenges of our time.

So let me give a bit of background as to why I think it’s a good proposal that we should get behind.

Whilst the specific figures are difficult to come by, we have known for some time that Jersey has a higher proportion of citizens with access to private medical insurance (PMI) than most comparable countries (30%, compared to 12% in the UK). And whilst you may think PMI is just a perk of the finance industry, it is actually provided as an employee benefit in an expanding range of industries including construction and utilities in Jersey.

However, one of the oddities of working here in healthcare is that when I ask people if they have private insurance before referring them for treatment, often they won’t know. Or more worryingly they will have insurance but not know how to access it, or not see any benefit of using their insurance rather than going via the public system.

Working in occupational health, it is vital that we can get our patients access to the healthcare they need as quickly as possible, to support their return to work as soon as they are able – this benefits the employee, their employer and the wider economy. If you aren’t sure personally, do check your employer’s healthcare offer and, most importantly, consider using it if available.

As well as people not using their insurance, we know that private patients are often choosing to travel off-island for their care, taking their funding with them. Many Jersey citizens can also self-fund their private care and have a choice of anywhere in the world in which to be treated. Wouldn’t it be amazing if our health system could meet their needs without them having to travel, and if we could keep those financial flows supporting our health ecosystem locally?

Now, moving on to what I find so impressive about the strategy itself. Importantly, for a government document, it stands out as having a unifying vision, a measurable target and a clear plan – laying out specific actions over three phases that are necessary to deliver the central aim to double private patient income over five years. These include improved private patient facilities, better governance and service quality, gaining clarity over the use of facilities shared with the public sector (for example, operating theatres), better contract management with insurers and clinicians, improving referral pathways, and all round a more commercial focus on exploring the opportunities available. I think this sort of commercial thinking could benefit many areas of our public service if I’m honest.

The strategy also takes a whole-system view – it really is a strategy with winners all around:

  • Private patients benefit from improved care locally, public patients from increased income to the health system as a whole and shorter public waiting lists when other patients choose to use their private provision.

  • Staff benefit from an attractive earning opportunity, particularly for clinicians keen to innovate and provide the best care possible. We must recognise that we are competing on a world stage for talent (consultants don’t need to go far to earn more than ours – the starting salary for medical consultants in Ireland was increased recently to over 200,000 euro).

  • The organisation benefits from increased income at a time of financial strain, allowing us to truly focus on developing a healthcare system fit for the future, with investment into new facilities and staffing that benefits all patients, whether public or private.

  • Businesses benefit by providing PMI for employees, and with access to excellent care on the Island available they will be able to keep their workforce healthy and engaged.

  • The Island economy benefits both through growing the healthcare industry, with the potential to attract health tourism in specific areas, and improving the health and productivity of staff across all sectors.

I know other commentators have challenged the fairness of improving private care whilst we have lengthy public waiting lists, and the sensibility of addressing a niche area when general services are so challenged. I would push back, however, and suggest that the strategy – if delivered as planned – rather than being a niche distraction really could be a win-win for public and private patients by providing increased funding and driving improved care standards for all.

Finally, I have always said that we need to lay out a compelling vision for the future at the same time as fixing the problems of the present day. This is the crux of leadership – if we never lay out a bold vision, and never try to achieve it, we will likely just circle down the drain. I believe that this strategy may be the first in a long time to strike the right balance, and I sincerely wish the team the best of luck in making it happen.

  • Dr Edmond is the founder and medical director of WorkHealth (CI) Ltd, a dedicated Jersey-based occupational health provider. He is also a director at Jersey Sport and Jersey Recovery College, and adviser to the Jersey Community Foundation. He writes in a personal capacity.

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