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Health President on the spot over charges and waiting lists

Health President on the spot over charges and waiting lists

Wednesday 23 November 2022

Health President on the spot over charges and waiting lists

Wednesday 23 November 2022

The President of Health & Social Care has defended changes to the out of hours charging policy for cancer patients, telling the States Assembly that it improves “equity” for those with other chronic conditions by reducing their charges.

Deputy Al Brouard (pictured above) did not mention the recent introduction of charges for cancer patients outside of Bulstrode Oncology Unit’s operating hours in his President’s update statement, which he gave to the States this morning, and which triggered questions from several deputies and Alderney Representative Steve Roberts.

Deputy Brouard said the system is “neither fish nor fowl” with a “complex” and shifting line between which services are free and which are charged. He also bemoaned some “extremely poor” media reporting which did not understand the responses provided by HSC. 

“For a lot of people, we have reduced their charge… for those people who have kidney failure, heart failure, respiratory disease… everyone now pays the medical fee for the medical services that they are provided, and nobody pays the attendance fee for going to hospital. 

“If you have been to hospital and you’ve had one of these treatments, within 48-hours after the treatment, again it’s all free at the hospital” he said, highlighting this includes children and those receiving income support.

He said waiting lists for many treatments are not sustainable, but public-private work with the Medical Specialist Group is a “partnership” with responsibility and blame for facilities and staff falling on either side.  


Pictured: Express reported today that HSC has suspended tests for a screening bowel cancer due to a backlog of gastro patients. 

Deputy Rob Prow wondered if the Committee would review that charge policy. Deputy Brouard reiterated that fees for other conditions have been reduced by the recent measures, and the policy will not be reviewed as a priority. 

“Your secondary health care for your cancer treatment, or your bowel treatment, or your leg is all free at the MSG - that system is what we pay for through our taxes,” he said.

Mr Roberts, who receives treatment for cancer at Bulstrode House, suggested that additional charges for patients may not be prudent “at the darkest time of their lives”. 

Deputy Brouard noted that “a lot of people have darkest times” and that individuals would only pay a consultation fee, up to £380, should they not have insurance, at A&E. He added that “unfortunately that’s the reality of the system we have".

Deputy Andrea Dudley-Owen, another cancer patient, said: “There seems to be an increase in younger females taken out of the workplace and having lost their jobs as a consequence or having to step away. 

“I’d like to have the President’s view on whether it's fair - it's equitable - to levy additional charges on people who are not in the workplace as a result of treatment that they have just received such as chemotherapy which may preclude them from continuing that treatment”. 

“That is exactly the dilemma we have”, said Deputy Brouard, adding that “no-one was shouting” for those with non-cancer conditions who suffer the same issues: “We are trying to put a level equity into the system… this came from the professional people on the ground who felt this was an unfair anomaly”. 

Deputy Heidi Soulsby said reducing waiting lists and pressure within the system is best achieved through “prevention and intervention” and asked for confirmation that the bowel cancer screening programme is “working to plan”.

Deputy Brouard said testing has been suspended so that “those who are symptomatic are being seen” since health services “just can’t process the numbers” to get through the backlog “fast enough”.

Deputy Al Brouard

Pictured: HSC President Deputy Al Brouard.

Update statement

Deputy Brouard, in his general update to States members, said preparations are underway to prepare “for what is antanticipated to be a potentially challenging winter” with variants of covid-19 and other respiratory viruses under surveillance.

Services, “particularly on our waiting lists for surgery” continue to be hampered by the pandemic, with Deputy Brouard comparing Guernsey’s situation to the UK’s where “7.1 million people are on the waiting list for treatment”, especially in respect of gastroenterology and orthopaedics

He said the opening of the new de Havilland unit will go some way to tackling waiting lists for orthopaedic surgeries, and that two full-time locums are on-hand for December to help serve additional patients as the Medical Specialist Group seeks to recruit a new gastroenterologist.

Looking further forward, Deputy Brouard said the first phase of the hospital modernization plan, due to open in early 2024, “will increase hospital capacity and directly help to improve waiting times”. 

“Whilst work to develop the facilities and systems that HSC has available to it continues to progress well, it must be emphasised that these projects are nothing without the skilled staff who know how to make these things work

The position is quickly becoming unsustainable, with staff vacancies adding further strain to our existing workforce.

“It has been a busy few months as it always is in Health & Social Care, and I do not doubt that it will also be a busy winter and beyond. But we have been able to put measures in place to tackle some of the key issues despite the challenging environment we are all working in, and I do not doubt that our ever-dedicated staff will continue to do all they can over the coming months to provide safe and effective health and care services. 


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Out of hours charges for cancer care "a huge backwards step"

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