Guernsey: ‘Why we cant have the same health deal as Jersey’

Guernseys HSSD yesterday explained why it has not reinstated a reciprocal health deal with Britain

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Residents of the Bailiwick of Guernsey – that is, people who live on Guernsey, Alderney and Herm – pay for more of their own healthcare than do residents in the UK, the Isle of Man or Jersey, a statement by Guernsey’s Health & Social Services Department (HSSD) said.

For this reason, if Guernsey were to implement the same type of reciprocal health agreement (RHA) that Jersey and the Isle of Man now have, new systems would need to be put in place to look after any UK visitors who were to require medical care on Guernsey for free, since Guernsey residents in the same situation would pay themselves, the department statement added.

It said HSSD staff are in the process of gathering information on the "financial and other implications" of restoring an RHA with the UK, and this information, in the form of a report, will eventually go to the States Assembly, for possibly consideration as part of the States Strategic Plan in October.  

As reported here yesterday, Jersey reinstated its RHA on Friday, while the Isle of Man did so last year, after having a temporary agreement in place for six months.

‘Guernsey… last’

Explaining Guernsey’s seeming lateness in dealing with the matter, and its apparent willingness to wait until HSSD staff are able to compile a report, the statement noted that when the UK agreed to hold talks with the Crown Dependencies about reinstating the agreements it said it would do so “separately and in the order of Isle of Man first…and Guernsey last”.

“Guernsey has therefore not been tardy in attempting to negotiate a new reciprocal health agreement – we have simply been waiting our turn as requested,” yesterday’s HSSD statement said.

Previous agreement involved money

The problems Guernsey now has in trying to come up with a new reciprocal health agreement with the UK did not arise under the previous scheme, which existed from 1976 until the end of March 2009. This is because under that arrangement, “the three Crown Dependencies and the UK [were required] to pay each other for the treatment given to their respective citizens taken ill or injured while in the other’s jurisdiction”, the HSSD said.

It was the increasingly lop-sided nature of this arrangement, which saw the UK having to pay more and more to look after the healthcare needs of Crown Dependency residents, that led the UK to end the agreements two years ago, the HSSD pointed out.

“The UK Government…felt the agreements that it had with the crown dependencies were no longer providing ‘value for money’ for UK taxpayers.”

‘Provisional talks have taken place’

The Guernsey HSSD statement stressed that talks are under way to possibly set up a new reciprocal health deal with the UK – which, it noted, has made clear that it will insist on an arrangement “whereby any of its citizens visiting the Crown Dependencies on business or pleasure will receive healthcare entirely free of charge for ‘immediate and necessary treatment’".  

The UK Government has also “made it clear that it will not entertain any reciprocal health agreement whereby any funds are exchanged between the jurisdictions”, the HSSD said. 

The bottom line is that waiving ambulance, A&E and GP visit fees for visitors could cost the States somewhere between £500,000 and £1m per year, the HSSD statement noted.

Even if a new RHA were to be introduced in Guernsey, it would be unlikely to include the costs of repatriation, the HSSD said, noting that neither the IoM or Jersey reciprocal health deals provide for this.

Residents of Sark, meanwhile, the smallest of the inhabited islands surrounding Guernsey, were never part of the old reciprocal health agreement and have always had to pay for all their healthcare costs, whether at home in Sark or visiting Guernsey or the UK.

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