The Deputy Sloan/Deputy Helyar amendment to the Tax Reform 2026 policy letter proposes to limit any future budget increases to inflation only for the next three years, unless the States expressly resolves that exceptional circumstances justify a departure from that principle.
The amendment poses a significant risk to health and social care services. Restricting budget growth to inflation would create real-terms cuts to the Health & Social Care budget at a time when costs and demand are increasing faster than inflation.
Off-island care is just one example of a pressure that can rise unexpectedly and requires us to respond quickly. Under this amendment, there would be little flexibility to manage these kinds of unavoidable costs. The result would not be greater efficiency, but cuts to services and reduced capacity to meet the health and care needs of islanders.
Guernsey is fortunate to have a healthcare system that delivers a wide range of services on island. However, some specialist treatments can only be provided in larger centres with access to specialised facilities, equipment and expertise.
Every year, around 2,000 islanders are referred to the UK for healthcare that cannot realistically be provided locally. This includes highly specialised services such as cancer treatment, organ transplants, complex heart procedures, spinal surgery, specialist mental health care and advanced care for newborn babies and children. It would not be practical or affordable to provide these services on-island.
That is why our partnership with the NHS is so important. It helps ensure islanders can access the care they need throughout their lives, whether that care is delivered in Guernsey or by specialist teams in the UK.
As those responsible for safeguarding healthcare services, we must look beyond today’s challenges and prepare for future pressures. A key part is understanding the risks that could affect healthcare costs and access to services in the years ahead.
One of the main pressures is the rising cost of off-island healthcare. In 2025, spending on off-island treatment reached £19.6m., compared with £18m. in 2024, an increase of 9%. This increase is being driven by growing demand as people live longer, treatments become more advanced, and healthcare needs become more complex.
These pressures are not unique to Guernsey.
The majority of off-island treatment costs are covered through reciprocal healthcare arrangements agreed with UK partners in 2023. These arrangements have worked well, helping Guernsey manage costs while maintaining access to important specialist services. However, healthcare organisations across the UK are facing significant financial pressures.
There is no immediate indication that the UK’s reciprocal healthcare arrangements with Guernsey are changing, and no NHS trust has proposed any major changes to existing agreements. However, the arrangements are due to be reviewed by the end of 2027.
We need to ensure Guernsey is prepared for future pressures. The Sloan/Helyar amendment, as it stands, which limits any budgetary increase to inflation only, hinders the committee in our preparations for any such change and puts access to local health and social care services at risk.
The good news is that Guernsey has strong, long-standing relationships with NHS partners. Organisations such as Southampton University Hospital continue to provide excellent care for islanders, and these partnerships deliver significant benefits for patients and families.
Healthcare demand is continuing to grow, and new treatments are allowing people to benefit from care that would not have been possible a generation ago. These advances are welcome, but they come with increasing costs.
Discussions about healthcare funding cannot be separated from wider conversations about the island’s long-term finances. Decisions taken today will affect our ability to maintain and improve services in the years ahead.
Guernsey’s healthcare system has much to be proud of. By planning ahead, managing risks responsibly and maintaining strong partnerships, we can help ensure islanders continue to have access to the healthcare they need, now and in the future.
Deputy George Oswald
President, Committee for Health & Social Care
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