I made this speech during Phase 1 of the Policy & Resource Plan.
Sir, I can’t say that the thought of developing CHSCs P&R plan gave me a warm feeling inside. Our overriding purpose over this term is to lay the foundations for the transformation of health and social care after all. That is our overriding objective and we are all completely behind it. However, I have always supported the concept of a Policy and Resource Plan. Anyone who read my manifesto in the last election will know that. The theme of my manifesto was focus – and how the States needs to focus on its priorities and work together to achieve them. That is fundamentally what the P&R Plan is all about. It is OUR manifesto.
Yes a year into this term, but this is the closest we have come to being a joined up government and every Committee has worked towards it far more than any previous one has done and for that we should give ourselves at least a small pat on the back. If we don’t now one else will lets face it. No we’re not there yet, we need to develop the overarching priorities and link that to funding but we shouldn’t beat ourselves up about that. I would’ve though other jurisdictions would be looking enviously at what we have achieved right now and so they should. The fact States terms are too short for our system of government is another matter of course. It does not mean our system of government is weaker than anywhere else. Recent events in the big Island north of us have shown that to be the case. Bigger aint necessarily better.
But the thought of being able to develop a P&R Plan for HSC within a year of the election and whilst we were still developing the business case to even to begin to look at a new model of care, when at the same time we were trying to arrest a spiralling overspend did make me slightly twitchy.
However, I really do have to thank my Committee and staff for what we have put together and what you see in this Plan. Teamwork has been key here.
So, what is the CHSC’s plan all about then?
HSC needs to keep pace with the needs of an aging population, the changing burden of disease, and rising patient and public expectations. But spending more doesn’t necessarily equate to better results. We need to think differently and work differently.
The next 4 years are critical for HSC. The most significant priority is the responsibility for the implementation of the future operating model. The primary purpose of this model is to ensure services meet the community’s changing needs and in the most sustainable and equitable way. This is not just about how the States of Guernsey organises itself, but the structure of health and social care across Guernsey and Alderney.
HSC needs to re-design the existing model to achieve best value for money and to be aligned with the principles of the 2020 Vision.
Integration between the core elements of the existing system are essential – primary care, secondary care, community services, 3rd sector and various private and commercial businesses. We talk about our health and social care system but we don’t really have a system at all. The focus is on putting the patient at the centre of truly coordinated and integrated care between the many organisations and services concerned with meeting the needs of islanders.
The work being undertaken will place greater emphasis on key principles of future services including amongst other things:
- Patient centric care;
- Delivering more care in the community;
- Partnership and engagement;
- Treating mental health with equal consideration as physical health;
- Better use of technology; and
- Prevention and early intervention
Key outcomes will be a system that is appropriate, flexible and sustainable
The HSC submission for the P&R plan sets out the policy priorities for the Committee, demonstrates how these priorities and link with the emerging guiding principles for the future operating model which include;
Looking after yourself to prevent illness in the future
Having treatment packages that are centred around you.
Ensuring fair access to care and not allowing the poor to be priced out of good health.
Commissioning services to enable equal access and proportionate governance and regulation.
Improving access and reducing duplication.
Providing care closest to home
Measuring and focusing on results.
Clear care and treatment packages.
Working with others to help achieve the best results
And last but not least, inspirational leadership and empowered staff.
All these points run through our Plan and are at the heart of our new model of care.
At the same time we have been putting together our Plan we have also been working with KPMG in developing the new operating model that will come to this Assembly later this year. I know I corrected Deputy Brehaut yesterday regarding our relationship with them and it may have seemed pedantic at the time but it truly has been a partnership and not just with KPMG I have to say. I have been truly delighted by the level of engagement I have witnessed since we began this work in April.
I don’t just mean senior HSC staff, who have been 100% behind this project, but the engagement we have had from staff across the organisation, representatives from the primary care sector, secondary care, third sector, other health and social care professionals and the wider community. We have held a whole series of events with health ans social care professionals and the general public to get to the heart of what works, what doesn’t and more importantly, how we could really make a difference for outcomes for the people of the Bailiwick.
Change is a difficult thing. It can be a frightening thing. We know our health and social care system needs to change or we will end up breaking the fiscal rules we have debating all this week quite spectacularly. That’s the reality.
What we need to do is take people with us and we do that by working together, listening to each other, challenging each other and developing a new model of care together. I have to say before we started this process only a couple of months ago I was nervous how things would pan out but the positivity I have witnessed as we have gone through the process has been incredible. Yesterday lunchtime I closed the last event with health and social care professionals from across the sector before we start putting our policy letter together. And what I emphasised was that the new model wasn’t the Committee’s model but their model and that of the people of the Bailiwick. We will all need to own it to make it a success but that by working together we really can make great things happen. So, with the Committee’s Plan isn’t really just our plan. To make it work we need to work together make it happen. And that also means with CESC, With ESS, With CHA, With P&R, With E&I and With CED. Every one of our plans has an overlap somewhere.
I would just like to finish on a personal note. Today is the 30th June. It is an important date to me. It was my Mum’s birthday. She died last year but would have been 82 today. It is also my daughter’s birthday. She is 18 today and finished her A levels yesterday. Yippee.
The last 6 months of my Mum’s life were not easy for her, my Dad or the rest of the family as dementia destroyed the person we all knew. I saw first hand all the problems associated with the illness, being a carer and getting support.
I thought long and hard about taking on this role but one of the reasons that made me decide to put my name forward was because I could see things could be better and perhaps more importantly I knew those working in health and social care wanted things to be better. I mentioned my manifesto earlier. what I didn’t say is I wrote it in the last days of my Mum’s life but it wasn’t about her. It was about my daughter and son for that matter. The next generation. Those going to their end of school proms right now with their lives ahead of them. I didn’t need the amendment we passed yesterday to say we would consider the impact on future generations when designing policy, it was why I wanted to do what I am doing and why I believe passionately that we need a new model of care.