Increase in patient fees charged by the GP Co-Op Out of Hours Services.

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While there is a presumption toward publication to support of transparency and accountability, detailed information may not be published if, for example, it would constitute a breach of data protection, or disclosure would prejudice commercial interest.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 (11/01/2008) regarding: Increase in patient fees charged by the GP Co-Op Out of Hours Services.

Decision Reference: MD- H SS-2008-002
Decision Summary Title :	GP Co Op; Proposed Increase in Out of Hours Fees		Date of Decision Summary:
Decision Summary Author:	M. Littler Directorate Manager of Medicine		Decision Summary: Public or Exempt?	Public
Type of Report: Oral or Written?	Written		Person Giving Oral Report:	NA
Written Report Title :	GP Co OP; Proposed Increase in Out of Hours Fees		Date of Written Report:	9th January 2008
Written Report Author:	M. Littler Directorate Manager of Medicine		Written Report : Public or Exempt?	Public
Subject: Increase in patient fees charged by the GP Co OP Out of Hours Service.
Decision(s): The Minister for Health and Social Services supported the proposed increase in fees as set out in the attached report charged by the GP Co Op Out of Hours Service with effect 14th January 2008.
Reason(s) for Decision: The proposed increase in fees charged by the GP Co Op Out of Hours Service:- has been increased in line with the methodology agreed with the Jersey Competitions Regulatory Authority; has been agreed with the Jersey Competition Regulatory Authority on 17th December 2007; is deemed to be reasonable.
Resource Implications: There are no resource implications for Health and Social Services.
Action required: Subject to the Ministerial Decision, it is proposed to implement the decision with effect 14th January 2008.
Signature:		Position:
Date Signed:		Date of Decision (If different from Date Signed):

Increase in patient fees charged by the GP Co-Op Out of Hours Services.

HEALTH AND SOCIAL SERVICES

GP CO-OP – PROPOSED INCREASE IN OUT OF HOURS FEES

In setting up the GP Co-Op, one of the objectives of the Health and Social Services Department was to ensure that the GP Co-Op was set up on good professional lines and that the Department had the means to rectify anything that could question its investment in the delivery of an out of hours General Practitioner (GP) service.

A case in point concerns the up rating of fees charged to prospective patients. Part of the Agreement between the Department and GPs requires any prospective increase in fees to be agreed with the Department and the Jersey Competitions Regulatory Authority (JCRA).

The current fees were set in April 2006 and agreed with the Department and the JCRA.

Now that the GP Co-Op service has reached a degree of stability and comprises effectively all of the Island’s GPs, it is now appropriate to review the fees charged by the GP Co-Op.

The mechanism agreed with the JCRA by which the out of hours fees are increased is relatively complicated and based on actual specified costs incurred by GP practices in delivering their day time services per consultation and proportioned to each consultation/visit pertaining to the GP Co-Op. This figure is adjusted to include any legitimate extra costs attached to the GP Co-Op in delivering that service (e.g. to reflect an increase in the GP’s proportion of the total cost of the driver service).

The proposed increase in fees has been agreed by the JCRA in an email to Dr Bryony Perchard dated 17th December 2007 and strictly in accordance with agreed cost increases in delivering the service allows for an increase in fees of approximately 4.4% to 5.1% with effect 14th January 2008 depending on the service delivered. The changes in the GP Co-Op fee structure are given below:-

Service Provided	Current Fee with effect 3/4/06	Proposed Fee with effect 14/1/08
Evening Home Visit	£80.16	£83.77
Night Home Visit	£100.72	£105.13
Surgery/Clinic Consultation	£40.00	£42.04

As a consequence of the above, it is recommended that the proposed increase in fees is supported by the Minister and Chief Executive of Health and Social Services, and that the decision is communicated to J. Doc without delay. This will allow the increase in fees to be implemented in line with normal increases in GP charges (i.e. with immediate effect) and allow for an implementation date of 14th January 2008.

Also in line with normal practice, the GPs (through J. Doc) will:-

notify the Employment and Social Security Department of the increase in fees (who will subsequently and retrospectively publish the new fees in April 2008); and,

ensure that the new fees for the GP Co Op are displayed in all GP surgeries and the GP Co OP.

M Littler, Directorate Manager of Medicine 09/01/08