Guernsey Press

Guernsey’s great health divide

The health of a community tells you much about how inclusive it is. And, says Richard Digard, the latest research shows how fractured and divided we’ve become in just a few short years

Published
Last updated
(Image by Shutterstock)

FORGET your age for a moment and consider this.

In the scheme of things, 70 or 80 years isn’t a long time. Given the planet is around 4.5bn years old and humanity has been energetically screwing it up for just the last 300,000 of them or so, the interval between Liberation in 1945 and today is fleetingly brief.

Yet in that time the Bailiwick has gone from government by jurats, clergy and parish constables, to near starvation under enemy occupation and the use of slave labour, to full democracy and unparalleled wealth and employment opportunities created by the finance industry.

Unlike the difficulties Prince Charles finds himself in, we weren’t at all squeamish about accepting cash in suitcases because the island was truly dedicated to the process of building back better and eradicating (bunkers excepted) the last traces of enemy invasion and rule.

Now, just 77 years later, we find ourselves with a government that couldn’t be bothered to take the lead in celebrating Liberation Day – the one day a year when we should give thanks for the remaining freedoms we have and for not being like Russia – and a society that is probably as fractured and divided by wealth and privilege as when the Royal Court was the de facto ruling body.

I say this with some confidence because we now have a fifth of the island on at least £80k a year (7% on more than £120,000), while a fifth have to exist on less than half that. A third of the island is either retired or doesn’t have to work, and approaching half (41%) own their own home outright. A further 7% either pay no or minimal rent thanks to family or friends providing accommodation.

What of those excluded from this sweet spot in life? Well, a further third are trying to buy a home and raise a family with a mortgage and all the associated financial strain that implies, and 18% are renting in the private sector, with all the cost and insecurity that also entails. Government help, through partial ownership schemes or social rental, is minimal at 5%.

So what does this mean for the individuals concerned? Not much for the majority. Well over half (62%) could meet an unexpected bill of £100 with no problem at all. You’re probably thinking that many States members spend that a couple of times a month on a nice dinner or two, but I wouldn’t personalise it that way.

Instead, the latest research shows that 9% of islanders couldn’t find a hundred quid in an emergency and a further 28% – that’s 15,680 individual islanders by the way – would struggle to do so.

Hang on. We’re a wealthy island. Everyone in a ‘tax haven’ is rich. We’ve got gold-plated public services and money’s so freely available we’re thinking of making people pay to recycle and stick another 8% on food and fuel bills through GST to cover government’s past excesses. An odd sort of levelling up.

The reality is that there’s a massive excluded sub-group here and it’s affecting the health of the island. Fully one-third say they have health concerns they’ve not seen a doctor about, and the main reason for that for nearly half of them was cost. Unsurprisingly, the percentage of people who said the price had stopped or delayed them seeking care was notably higher in people who were:

. aged 25-54 compared to older age groups

. women

. living in States’, private rental or other housing compared to home owners

. without private health insurance

. more financially vulnerable (those who said they could not afford £100 or else it would not be easy to do so).

The survey, by Island Global Research on accessing primary health care services, was commissioned by CareWatch, an independent panel made up of individuals and organisations from the community, and sponsored by Health and Social Care.

The gap it reveals is 52% of us pay for our own GP appointments while 22% are lucky enough to have the cost covered by their employer, while another 22% can afford insurance themselves.

It also found the island significantly affected by stress – with the same divide between those who own their own home, are older and can afford health insurance and those who don’t or can’t. Broadly, two-thirds of the population suffer from large or moderate amounts of stress, which seems incredible for an island that not so long ago had the pursuit of happiness as official policy.

Dig into the figures further and work, money and health are the biggest areas causing stress. It’s a particularly cruel irony that anxiety over how you or your loved ones are is made much worse by not being able to pay the doctor to make things better.

If you have a job and are renting, you’re more likely to be pressured by work issues, while those in social or private rented property are more likely to be anxious about money and financial matters.

So while the research was commissioned as a snapshot of primary healthcare, it also provides a vivid reminder of where we are as a society and what – basically, possession of wealth and property – divides us.

The other point to make is this also affects the children of the excluded. And the situation is getting worse. As the report notes:

. 31% of people said their health was very good in 2018. The equivalent statistic is now 18%.

. 8% of people said they had a health concern they had not seen their GP about in 2018. That is now 31%.

These are simply appalling statistics and heading in totally the wrong direction.

I got a bit of flack the other week for suggesting one of today’s problems is that States members have stopped caring about us as individuals. From the above you might, if being generous, conclude that at the very least they’ve taken their eye off the ball over what’s really important – making lives better, more financially secure and healthier.

Instead, we have a significant number of islanders stressed, with unresolved health issues because they can’t afford a doctor and worried because if they lose their job they can’t pay the rent and face eviction.

And it’s getting worse – before the cost of living crisis really takes hold.

It’s not the sort of progress those fighting to build back a better Guernsey had in mind in 1945.

The gap’s actually widening

Richard Digard’s column was written before the island’s cost of living survey was published. This new research shows that:

. 6% cannot afford costs and often have to go without essentials

. 11% said they could not afford an unexpected but necessary expense of £100

. 35% would struggle to afford a £100 per month increase in living expenses

. 49% found it difficult to meet living costs in the last 12 months

. 79% expect the financial position of their household to get worse in next 12 months

. 54% think inequality in living standards will get a lot bigger in the future

This indicates, he says, that the wealth and property divisions he writes about here are actually worse than generally understood – and are getting more severe.