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By JULIE GARBUTT, Chief Executive, Health & Social Services Department


Significantchanges expected in health care


Our health and social services are at a crossroads. Working with our care staff, and taking your views into account, we have a unique opportunity to make services fit for the future.


When I arrived in Jersey over a year ago, I was struck by how closely health and social services work together. This is different to the UK, where health and social services are run separately. I was also impressed by the dedication of the staff and teams, and by the strong community links within both the parishes and with the “third sector”, which includes charities.


Jersey is a great place to live, but, like other countries, we know that we face some challenges – now and in the future. So we have asked ourselves whether we have enough resources, in the right places, organised in the right way to be able to continue providing Islanders with the high quality health and social care we are used to.


These are our challenges. In Jersey, just like in most other countries, we have an increasingly older population. This will continue to grow, and by 2040 the number of people aged over 65 will have doubled. Our older people make a valuable contribution to society, but they also tend to need more services, and there will be fewer


Page 24 Health - Helping yourself


adults of working age to support them – including funding health and social services.


Our staff are also growing older; more than half of our doctors are due to retire in the next 7 years, but medical training has changed so that, for example, surgeons are now specialists whereas in the past a general surgeon would have been able to perform more varied surgery. This means that we might need to replace one retiring ‘generalist’ doctor with two or three ‘specialist’ doctors. Even if we could fund this increase in medical staff, with our population size there isn’t enough work for them to do to keep their skills at the level required, and we often have problems attracting staff to work in Jersey due to our high cost of living. This impacts in particular on our nurses and other care staff.


Some of our buildings have outgrown their usefulness. For example, our General Hospital will need to be either extensively refurbished or rebuilt in the next ten years. This will cost millions of pounds. Other accommodation, such as our children's homes, mental health wards and group homes will also need to be upgraded.


When people need care in Jersey, we often treat them in the hospital. This can be expensive and,


sometimes, unnecessary – in some cases people could have been cared for at home, in an environment that is familiar to them, surrounded by their family. This is especially the case at the end of life where, again, people tend to be admitted to hospital to die rather than being given a choice to die at home. This also affects children, because we only have a limited number of foster carers, some children who cannot live at home have to live in a children’s home instead of with a foster family.


So with all of these challenges facing us, we need to change the way our services are organised and delivered. The good news is that, by making these changes in the next few years, the right services will be in place ready for when they are needed.


We need Islanders to be aware of these challenges, so earlier this year we held a three month long public consultation. In our Green Paper "Caring for each other, caring for ourselves" we set out three options. Whatever option we choose, one thing is certain; the cost of providing health and social care will rise because our demands will rise. We were clear that however much the cost rises, and what services we can provide for the future, would depend on the option chosen.


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