We can’t simply outsource our health services to save money

) to the funding crisis for healthcare, specifically secondary care, by advocating the outsourcing of much of the elective work currently carried out on island, to the UK.

This process has, in part, already been enacted through waiting-list initiatives, most notably in the recent ‘cataract plan’ (well thought-out and planned, based on a day case procedure), but also in an option for joint replacement (now finished) off-island. This latter initiative illustrated the problems for such a move to off-island care, many of those eligible were not fit to travel for elective work of this nature, and of those who were offered the trip, a substantial proportion turned down the opportunity because of reluctance to undergo major procedures away from home. Other more radical plans have been aired at many times in the past, but all dismissed because of the practical difficulties involved. NHS hospitals, despite their wish to earn money from jurisdictions such as ours, are not exactly queuing up to offer their services, because of the capacity and waiting list issues they also have.

Mr Camp recognises the need to maintain emergency services on island, to cope with trauma and sudden unexpected illness. Care in such circumstances will extend beyond the emergency department to substantive in-patient treatment. But to attract, recruit and retain the personnel able to achieve a successful outcome would be impossible if all that was available to them locally, professionally, was a ‘treat and transfer’ service.

A third of us will get some form of cancer at some stage in our life. Many will require courses of treatment requiring expert attention and monitoring. Would any of us really wish to travel to the mainland for chemotherapy, with all its potential consequences, on a regular basis? Furthermore, if you were a company wishing to relocate to the island, or to expand their business if already here, would you wish to do this in an environment without a fully functioning secondary healthcare sector?

Mr Camp is right in saying that ‘we have been relying on the UK for specialist services for years’. There are well- established protocols to allow Guernsey residents to access services unavailable on island, and undoubtedly in the future, the list of off-island provision will expand to suit the changing local needs. But I find his comment ‘if you need serious surgery you’re not going to wait around for a bed at the PEH. You’ll hop on a plane and get treated in a mainland hospital …’ insulting. All very well for the third of the population that has access to private insurance, or the substantial funds necessary, but a slap in the face to, not only the two-thirds of islanders reliant (currently) on the States provision, but also to the dedicated staff working to achieve outcomes comparable to, and in many cases better than, similar interventions carried out elsewhere.

Among the homely aphorisms and metaphors in his article, there is one recommendation he makes that I do agree with. We do need a ‘full overhaul, belt-and-braces approach to how we fund healthcare’. And we should not forget that healthcare is not just for those at the age spectrum which I suspect Mr Camp and I share. Worrying trends in the health of our young people are becoming apparent (shortly to be revealed in the publication of the latest Guernsey Wellbeing survey), mirroring difficulties already recognised in other jurisdictions. Failure to tackle these issues will have profound effects on the financial wellbeing for the island in the future, let alone the development of our young population. Something for our next States to bear in mind…

DR G OSWALD BSc MD FRCP

Retired consultant physician, and ex chairman, MSG

non-voting member, HSC