Treasury and Resources
Ministerial Decision Report
TRANSFER OF £6.131M FROM THE HEALTH INSURANCE FUND TO THE CONSOLIDATED FUND FOR HEALTH AND SOCIAL SERVICES INCOME TO FUND PRIMARY CARE SERVICES
- Background
The savings and growth proposals from Health and Social Services were considered by CoM as part of the 2011 Business Plan process and early phase of the CSR. The levels of growth required exceeded the funding available within target cash limits. It was suggested that as the longer term pressures on healthcare are likely to require an expansion of the use of the Health Insurance Fund (HIF) then an early transfer from the available surplus may provide a solution.
The proposals in the 2011 Business Plan were to fund £4.9 million of necessary growth in Health and £0.93 million of the department’s required savings from the HIF. This increased to £6.131 million as an alternative to introducing a £0.3 million user pays proposal in 2011 in respect of diabetic supplies and dietary, oxygen and continence products.
2. Business Plan 2011 and P125/2010
The proposal for a £6.131 million transfer was included within the 2011 Business Plan and an amendment from Senator Ferguson resulted in a debate on whether it was appropriate for such a transfer to take place ahead of a full review of primary healthcare services. The amendment was defeated with reference being made to the debate of P36/2010, and more importantly P125/2010 from the Minister for Social Security which proposed an interim arrangement for two years until such time as a full review of primary healthcare services and use of the Health Insurance Fund could be completed. This review has now been completed as part of the Strategic Review of Health and Social Services.
During the debate of P125/2010, the Minister for Social Security clarified that the actual transfer of funds would be for primary care services, currently provided by Health and Social Services, which would free up funds within the department’s cash limit to fund the necessary growth and balance of savings and user pays which were required. The report to P125/2010 included a schedule of the likely primary care services to be claimed.
The Minister for Treasury and Resources committed to manage the transfer from the HIF to the Consolidated Fund and to only release funds on receipt of evidence from Health and Social Services confirming expenditure in respect of primary care services.
P125/2010 was approved on 3 November 2010, subject to review by the Scrutiny Panel. However, the Scrutiny Panel decided on 16 November 2010 not to undertake a detailed review. Amendments to the Health Insurance Fund (Miscellaneous Provisions) Law have been approved by the Privy Council.
The Health Insurance Fund (Miscellaneous Provisions) (Jersey) Law 2011 permitted the States to approve a further transfer in 2012 on a proposition brought by the Minister for Social Security. The 2012 transfer was agreed by the States in the 2012 Annual Business Plan (P123/2011) on 15th September 2011 and P185/2011 on 18th January 2012.
3. Process
A similar process is used to monitor this expenditure as has been operated with both Pandemic Flu and Fiscal Stimulus. All of these have involved a review by Internal Audit to check the evidence of expenditure claims.
Health and Social Services have identified a schedule of primary care services and estimated spend during 2012. This schedule has become the template for an invoice for the provision of services and is attached as Appendix A.
Internal Audit have reported on the accuracy of the evidence to support the expenditure and have confirmed that the amount is valid.
- Recommendation
The Minister for Treasury and Resources is recommended to agree:
- the transfer of £6,131,000 from the Health Insurance Fund to the Consolidated Fund for use in funding primary care service delivery by the Health and Social Services Department
- that the Health and Social Services Department is able to spend the additional income received on primary care service delivery.
- Reason for Decision
The proposal for a £6.131 million transfer was included within the 2011 Business Plan. Further, during the debate of P125/2010, the Minister for Social Security clarified that the actual transfer of funds would be for primary care services, currently provided by Health and Social Services, which would free up funds within the department’s cash limit to fund the growth and balance of savings and user pays which were required. The report to P125/2010 included a schedule of the likely primary care services to be claimed.
The Minister for Treasury and Resources committed to manage the transfer from the HIF to the Consolidated Fund and to only release funds on receipt of evidence from Health and Social Services confirming expenditure in respect of primary care services.
The Minister for Social Security and the Minister for Health and Social Services both agreed the process.
£6.131 million was transferred in 2011. The Health Insurance Fund (Miscellaneous Provisions) (Jersey) Law 2011 permitted the States to approve a further transfer in 2012 on a proposition brought by the Minister for Social Security. The 2012 transfer was agreed by the States in the 2012 Annual Business Plan (P123/2011) on 15th September 2011 and P185/2011 on 18th January 2012.
- Resource Implications
This decision will reduce the Health Insurance Fund by £6,131,000 and increase Health and Social Services income by an identical amount
Health and Social Services will have the permission and ability to spend the additional income transferred.
Report author : Head of Financial Management, Accounting and Reporting | Document date : 8th November 2012 |
Quality Assurance / Review : Head of Financial Planning | File name and path: L:\Treasury\Sections\Corporate Finance\Ministerial Decisions\DSs, WRs and SDs\2012-0100 - Transfer from HIF to Consolidated Fund in 2012 - KH\WR - Transfer from HIF to Consolidated Fund in 2012 - KH.doc |
MD sponsor : Treasurer of the States |
Appendix A
Areas of Primary Care Services currently funded by Health and Social Services Department