Government of Jersey

Information about the publication of Ministerial Decisions

A formal published “Ministerial Decision” is required as a record of the decision of a Minister (or an Assistant Minister where they have delegated authority) as they exercise their responsibilities and powers.

Ministers are elected by the States Assembly and have legal responsibilities and powers as “corporation sole” under the States of Jersey Law 2005 by virtue of their office and in their areas of responsibility, including entering into agreements, and under any legislation conferring on them powers.

An accurate record of “Ministerial Decisions” is vital to effective governance, including:

demonstrating that good governance, and clear lines of accountability and authority, are in place around decisions-making – including the reasons and basis on which a decision is made, and the action required to implement a decision
providing a record of decisions and actions that will be available for examination by States Members, and Panels and Committees of the States Assembly; the public, organisations, and the media; and as a historical record and point of reference for the conduct of public affairs

Ministers are individually accountable to the States Assembly, including for the actions of the departments and agencies which discharge their responsibilities.

The Freedom of Information Law (Jersey) Law 2011 is used as a guide when determining what information is be published. While there is a presumption toward publication to support of transparency and accountability, detailed information may not be published if, for example, it would constitute a breach of data protection, or disclosure would prejudice commercial interest.

A decision made 18 January 2010 regarding: Loss of reciprocal health agreement - transfer of funds from Treasury and Resources to Health and Social Services.

Decision Reference: MD-HSS-2010-0006
Decision Summary Title :	Reciprocal Health		Date of Decision Summary:	14h January 2010
Decision Summary Author:	Director of Finance & Information Services		Decision Summary: Public or Exempt? (State clauses from Code of Practice booklet)	Public
Type of Report: Oral or Written?	Written		Person Giving Oral Report:	N/A
Written Report Title :	Loss of Reciprocal Health Agreement Income		Date of Written Report:	14th January 2010
Written Report Author:	Director of Finance & Information Services		Written Report : Public or Exempt? (State clauses from Code of Practice booklet)	Public
Subject: Loss of Reciprocal Health Income
Decision(s): The Minister approved the transfer of £861,360 non-recurrently in 2009 to Health and Social Services to fund the removal of the Reciprocal Health Agreement income by the UK Department of Health with effect from 1st April 2009.
Reason(s) for Decision: Funding is required to reimburse Health and Social Services for the removal of the Reciprocal Health Agreement income by the UK Department of Health for period October to December 2009.
Resource Implications: Recurrent funding for this has been adjusted for in the 2010 cash limit.
Action required: Request the Minister of Treasury and Resources to action this transfer as a non contentious transfer of funds from Treasury and Resources to Health and Social Services.
Signature:		Position: Minister for Health and Social Services
Date Signed:		Date of Decision (If different from Date Signed):

Loss of reciprocal health agreement - transfer of funds from Treasury and Resources to Health and Social Services

HEALTH & SOCIAL SERVICES

Summary Report re: Loss of Reciprocal Health Agreement Income

The following analysis shows the income that has not been generated in the 4th quarter of 2009 as a result of the removal of the Reciprocal Health Agreement income by the UK Department of Health from 1st April 2009.

Details	Period Apr to Sep 2009	Period Oct to Dec 2009	Total Claim 2009
	£	£	£

Income not received from DoH	1,950,000	975,000	2,925,000
Recurrent HSS income budget set for overseas visitors	15,100	7,550	22,650
Actual income received from overseas visitors (less bad debts written off)	(248,070)	(132,210)	(380,280)
Cost of additional staff taken on to identify treatment costs and raise invoices for overseas visitors	20,150	11,020	31,170


Total	1,737,180	861,360	2,598,540

As per the funding agreement the Accounting Officer confirms the following:

The claim is necessary
That this loss of income can not be met from existing resources
That all possible measures (within current systems) had been taken to secure payment by visitors from the UK and their insurers.

Recovery of Overseas Patient Income

Systems have been developed in H&SS that identify patients as UK/overseas visitors at the earliest opportunity, usually upon admission depending on the patient condition. Once identified, they are met and interviewed by the Overseas Patients Officer who attempts to discover the exact circumstances and status of the patient. During this initial discussion the Overseas Patients Officer explains how Jersey is not part of the UK NHS system and informs them of the likely costs that will be incurred.

An important part of this discussion is that the Overseas Patients Officer attempts to obtain a consent signature that confirms they have had the situation explained to them and hence they are aware of the potential charges.

At this point it is usually identified if the patient has appropriate insurance. If they do then the Overseas Patients Officer liaises with the insurance company to confirm the level of cover and to gain the agreement that charges will be met. Alternatively, if the patient is not insured for the specific circumstances or is not insured at all, then the patient is informed they are liable.

This can be a highly emotive interview and is always approached with tact and respect for the patient’s condition. Important to clarify is that no patient is ever refused essential emergency treatment, but it is made clear that if the patient is uninsured they are liable, regardless of their status or ability to pay.

Once the patient episode is completed then the costs are fully identified and forwarded to the insurance company for payment. For uninsured patients an invoice is issued to them personally.

After an appropriate time period and after reminder letters have been issued etc., if the debt remains outstanding a UK debt collection agency is used to attempt to recover the outstanding income.