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The provision of healthcare needs to evolve across the globe, as most communities face the problem of ageing demographics. Often referred to as a ‘time-bomb’ it’s more like a creep.
The problem is essentially here already. We’ve seen it in Guernsey with black alerts, bed blocking and ever extending waiting lists for simple surgeries. The demographic shift is well on its way, and this will be felt acutely in Alderney.
38% of the population is above the age of 65 and the community continues to struggle in drawing a younger crowd to the island. It’s this position that continues to drive Alderney’s approach to healthcare, to ‘prevention and early intervention’. It's the trigger behind the Integrated Care Strategy, a long-awaited piece of work that promises a cohesive, forward-thinking approach to supporting the island’s medical needs.
So, how did we get here?
In 2022 concerns were raised about access to primary care when the island's only GP practice was put at risk of closure.
The owner announced his decision to close the business with the States of Alderney and Guernsey jointly working together to come up with a solution to ensure GP services could continue in the short term initially, and with "a sustainable and robust healthcare service in the long term".
Island Medical Limited was bought by the islands' governments later in 2022, with the focus now on developing a model to provide the services needed in a sustainable way.
Depleted ambulance staff also saw St John Ambulance Guernsey step in to operate a ‘more resilient’ service.
Pictured: The Island Medical Centre.
2022 also saw the formation of the Alderney Care Board, which was formed to explore how health and care provision in Alderney could evolve, taking into account transferred services and on-island experience. It’s a joint initiative between the States of Guernsey and Alderney which shares ‘expertise and knowledge between the Islands’.
That work is continuing with the joint Guernsey and Alderney political forum and the Alderney Care Board overseeing discussions about health and care provision in Alderney.
One of the first administrative decisions was to bring in someone new to oversee that work, with Will Pierce appointed Head of Alderney Care.
This leads us into the Integrated Care Strategy...
Alderney’s Policy and Finance Committee received a report in 2023 that outlined a plan to bring together all the island’s care providers. This included the Island Medical Centre, the Mignot Memorial Hospital, the Connaught Care Home, the ambulance service and the pharmacy.
This plan would be implemented over a five-year time frame and also include plans to extend the pharmacy service and incorporate mental health support.
“The programme will create a collaborative culture across Alderney’s health and care system, developing and maintaining vital relationships between all providers at a time of great challenge and change,” said the Chair of P&F, Nigel Vooght.
“Obviously there are many hurdles to overcome along the way, including public consultation, but we are excited by the vision of this report.
“We look forward to the next steps in this integrated approach vision which PFC is convinced will deliver an enviable standard of health and social care involving all stakeholders working together collaboratively and will be the envy of other jurisdictions like ours.”
Pictured: Mr Vooght.
While the plans remain in development, some in the community continue to raise concerns about what the plans might entail.
These concerns include a suggestion that the privately owned Boardman’s Pharmacy could be moved to the Mignot Memorial Hospital, and that the Connaught Care Home could be put in a position where its charitable status is in jeopardy.
In February this year the owner of Boardman’s Pharmacy, Paul Durston, responded to the debate surrounding the Integrated Care Plan and the pharmacy’s space within it.
“I have had limited discussion with Alderney Carer regarding the pharmacy moving to the Mignot Hospital,” he said on Facebook
“I made it clear that it was not a viable proposition as far as I was concerned. I was therefore surprised to see the comment that the pharmacy services would be moving there,” he said in response to a statement in the Alderney Journal.
“Boardman’s Pharmacy is a privately owned business and I have no intention of moving the business to the Mignot Hospital in the foreseeable future.”
When his concerns were put to the States of Alderney, Express was provided the following comment from a spokesperson:
“As for the pharmacy, this is a private business. The States has simply agreed to proceed towards the provision of a health and social care model, in which all parts of the overall provision collaborate and work together to provide a seamless and high-quality Care System, and report back.
“No decisions have been taken. At this stage the objective is simply to examine the pathways and governance of such a model. This will be drafted and then put to public consultation before agreeing the resulting blueprint.”
The real point of contention with the future of healthcare in Alderney remains the Connaught Care Home and its governance. A reshuffle of the Board of the Connaught Care Home was instigated by the States in line with the development of the Integrated Care Strategy.
The Board is appointed annually, four members were not re-appointed this year and one didn’t “return their form of willingness”. The Company Secretary also joined the outgoing board members by handing in her own resignation earlier this year.
All five former board members have now been officially removed from the company register and it’s understood that Judy Craske – the only remaining board member – has become the charity’s resident agent (a staff member who receives all legal and official documentation).
The States of Alderney subsequently installed Will Pearce from the Island Medical Centre and States member Kevin Gentle as new directors.
Pictured: The Connaught Care Home.
The reshuffle was met with distress and concern from the outgoing members, with Barbara Benfield going as far as to read a statement out during a States meeting.
“I am here today to address you on some very important issues that relate to the wellbeing of Alderney,” she said during the March meeting.
“I will start by stating that in all of the years I have lived in Alderney I have never felt the need to address the States at a Chief Pleas. However, I am hoping that the result will be at least one of you will listen and take on board some of the points and questions raised.”
She claimed that she had been lied to throughout the process of appointing the new board members.
You can read the full statement ONLINE.
Speaking after the reading, States member Boyd Kelly said: “Barbara is a well-respected member of the community, and I think she deserves rather to be listened to.
“I personally would like to encourage her to go back on the Board because I think the island needs her experience and expertise.”
Pictured: Ms Benfield spoke at a States meeting in March.
The Chair of P&F said that the committee’s wish was always to have Ms Benfield remain on the Board, and in response to the statement Mr Vooght said: “In January, we made a clear operational decision to appoint a Care Home Board that would share the vision of collaboration across all parts of healthcare in Alderney.
“It was our wish that the Connaught manager, Liz Bowskill, and Barbara Benfield of Age Concern would continue as Board Members with their valuable expertise and experience, but that, sadly, was not to be. Additional directors can and will be appointed.”
Concerns were also raised that having two paid States employees on the Board would jeaopardise the care home’s charitable status, to which Mr Vooght said:
“On the matter of the Connaught’s charitable status, the Royal Connaught Residential Home Ltd is a company registered under Alderney Companies Law and its articles clearly state its charitable objectives. This remains the same and has not changed. As far as impartiality is concerned, each director has a fiduciary duty to act in the best interests of the company that they represent.”
Healthcare provision, much like education provision, will always hit upon the emotional core of a community. It highlights contentious, emotive issues that are integral to how a community operates.
It’s no surprise then that the development of a future plan for integrated healthcare would draw out important and direct conversation.
The States say ideas about a strategy have been raised ‘both internally and externally’ and a review is now underway to develop the concept, which will then be discussed with all stakeholders. A date for that public consultation hasn’t been set yet.
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