Health Insurance (Medical Benefit) (Amendment No. 5) (Jersey) Regulations 201-

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While there is a presumption toward publication to support of transparency and accountability, detailed information may not be published if, for example, it would constitute a breach of data protection, or disclosure would prejudice commercial interest.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 14 May 2012:

Decision Reference: MD-S-2012-0035
Decision Summary Title :	DS - Health Insurance (Medical Benefit) (Jersey) Regulations 201- Amendment		Date of Decision Summary:	11 May 2012
Decision Summary Author:	Policy and Strategy Director		Decision Summary: Public or Exempt?	Public
Type of Report: Oral or Written?	Written		Person Giving Oral Report:	N/A
Written Report Title :	WR - Health Insurance (Medical Benefit) (Jersey) Regulations 201- Amendment		Date of Written Report:	11 May 2012
Written Report Author:	Policy and Strategy Director		Written Report : Public or Exempt?	Public
Subject: Health Insurance (Medical Benefit) (Jersey) Regulations 201- Amendment
Decision(s): The Minister decided to lodge ‘au Greffe’ the Health Insurance (Medical Benefit) (Amendment No.5) (Jersey) Regulations 201-
Reason(s) for Decision: In accordance with the agreement set out in P.36/2010, the Minister is committed to increase medical benefit in line with the relevant increase in RPI .The current rate of benefit of £19.59 per GP consultation will be increased to £20.28 (an increase of 3.5%). Following the approval of P.184/2009, additional medical benefits have been introduced in respect of the taking of blood samples to allow for haematological and clinical chemistry tests. The current rate of benefit of £10 will also be increased by 3.5% to £10.35.
Resource Implications: The increase in medical benefit represents an estimated net cost to the Fund of approximately £278,000 per annum.
Action required: Policy and Strategy Director to request the Greffier of the States to lodge ‘au Greffe’ the draft legislation and to request a States debate on 26 June 2012.
Signature:		Position: Minister
Date Signed:		Date of Decision (If different from Date Signed):

Health Insurance (Medical Benefit) (Amendment No. 5) (Jersey) Regulations 201-

Health Insurance (Medical Benefit) (Amendment No.5) (Jersey) Regulations 201-

The Health Insurance (Jersey) Law 1967 collects contributions (2% in total) from employers, employees and Class 2 contributors and uses this money to pay for medical and pharmaceutical benefits and the administration of the Law. The rates of medical benefit are set in the Health Insurance (Medical Benefit) (Jersey) Regulations 2005.

1. General Medical Benefit

General practice in Jersey is provided by private businesses and General Practitioner consultation fees are set by each practice and not by Government. Under the Health Insurance legislation, the general rate of medical benefit for the provision of medical services provides financial assistance to insured people for General Practitioner consultation fees.

In accordance with P36/2010 (Draft Health Insurance (Medical Benefit) (Amendment No. 3) (Jersey) Regulations), the Minister is committed to an annual increase in medical benefit in line with relevant increase in RPI. As medical services are exempt from GST, the relevant RPI is RPI(Y), which excludes the impact of indirect taxes, including GST. The increase in the RPI(Y) index between March 2011 and March 2012 was 3.5%.

This amendment to the Health Insurance (Medical Benefit) (Jersey) Regulations 2005 will replace the current benefit level of £19.59 with a new benefit level of £20.28 from the day after the Regulations are made.

2. Medical benefit respect of blood samples for haematological and clinical chemistry tests

In addition to the general medical benefit, separate benefits are payable in respect of the taking of blood samples to allow for haematological and clinical chemistry tests to be undertaken by the Pathology Laboratory at the General Hospital.

Following the approval of P.184/2009 on 10 December 2009, these two benefits were introduced on 1 January 2010 at an initial value of £10 each. The new benefits avoided an additional cost being passed on from the GP to the patient in respect of these medical tests.

The Health and Social Services Department propose to increase this cost by 3.5%. In order to avoid this additional cost being passed on to the patient, it is proposed to increase the value of each benefit by the same amount, from £10 to £10.35, with effect from the day after the regulations are made.

Financial and manpower implications

A total of 351,268 general medical benefits were paid in 2011. The increase in benefit rate has an estimated additional annual cost to the Health Insurance Fund of £250,000.

A total of 76,541 medical benefits in respect of blood samples were paid in 2011. The increase in benefit rate has an estimated additional annual cost to the Health Insurance Fund of £28,000.

There are no manpower implications.