And it is possible that some measures, such as no longer providing pensioners with free prescription medicines, whatever their income, may be brought in sooner rather than later. That is the blunt warning from the island’s Health president.
But Deputy George Oswald stressed that there will be no return to the days when local families were financially crippled by big bills for secondary healthcare. He said that keeping the present funding model would be both unfair and unaffordable.
The prospect of charging for some hospital services was raised at the end of last year and was immediately knocked back by islanders.
Deputy Oswald points out that if healthcare is paid for out of taxation alone then the rising demand for care, driven by an ageing population, will largely have to be funded by the reducing percentage of islanders who are of working age – and he did not believe that such inter-generational unfairness was sustainable.
The findings of a planned major review of healthcare funding mechanisms are unlikely to be debated until near the end of this term because that review will follow on from three other pieces of work.
The first of these will consider the funding of social and nursing care – known as the Slaws project. Firstly HSC and ESS want to fully implement reforms agreed at the end of the last States term, and then move on to proposing more radical solutions, to make the funding of social care more sustainable in the long term.
That will be followed by reviews of community pharmacy services, and of primary care. And only then will work be focused on the future funding of those health services currently paid for from taxation.
But the HSC president admits that some targeted measures will be needed sooner than that to allow his department to deliver the 1% per year savings target agreed by the States at the end of last year.
He said that he was hopeful that in year one this might be achieved through efficiency savings, but said that after that some changes in approach will be required.
Deputy Oswald said he had three specific measures in mind but did not want to reveal them until they had been fully discussed by his committee. However, he confirmed that removing universal free medicines for pensioners was one of the three, and has previously flagged up the prospect of charging for hospital stays, effectively paying for ‘board and lodging’, in cases of elective surgery.