Alderney health reform 'stalled'

Various models of primary health care provision were suggested in the Wilson Report, released two years ago in the aftermath of the Dr Rory Lyons inquiry, and aspects of health care causing concern to the public were highlighted.

However, despite subsequent reports on health care in the Bailiwick, there has been little or no progress on the matter.

The comments were made in a joint speech by Policy and Finance Committee chairman James Dent and member Graham McKinley.

One of the key issues is the extent to which primary health care should be a business or service and whether competition should be encouraged.

There is currently only one GP practice on Alderney.

‘Two years ago I was hopeful that this question was about to be addressed. As with most difficult questions, I am now finding it has been pushed into the long grass,’ Mr McKinley said.

A formal, less ‘ad hoc’ consultation process than used in the Wilson report should be established to look at the way forward, with more information on each option’s costs. It was the States’ belief, he said, that a policy document should be agreed between the States of Alderney and Guernsey which pinned down where the latter’s needs and capabilities differed to those of the former.

Mr McKinley suggested that they would include ensuring safeguarding regulation was not ‘overburdensome’, recognition that solutions for Alderney had to reflect the island’s small size and of the greater appetite for risk that those living on Alderney may have compared with other jurisdictions.

He added, however, that if people believed the system was not actually broken, then the States should be ‘very reluctant fixers’.

The Island Medical Practice’s clinical director, Dr Sally Simmons, has highlighted medical issues in need of urgent fixing.

The first was visiting consultants – a greater proportion of specialist appointments should be in Alderney.

‘Rheumatology is a prime concern,’ said Mr McKinley. ‘People with rheumatism find it extremely difficult and painful to get into a Dornier. The IMP would also like to see a cardiologist come here – there are many referrals to that service.’

The second was the issue of medevacs. At present there is no overnight medevac provision and Aurigny could not provide a plane at 11am for a medevac last week.

Over the past month there have been several medevacs performed by the UK Coastguard and the island’s lifeboat.

Twice this year, a retrieval team has visited from Guernsey.

‘There is a clear risk of someone dying as a result of an accident or illness because we cannot get them promptly off-island,’ said Mr McKinley.

He added that the IMP was confident that with better trained doctors and nurses on-island, it was in an improved position to care for the seriously ill.

He reported that two medevac specialists had approached the States about the possibility of providing the service.

One was Capital Air, which provides medevacs to the UK from Guernsey and Jersey, which had held discussions with the IMP. However, said Mr McKinley, the runway would need to be extended to accommodate their aircraft. The newly-constituted States is tasked with taking the matter further.