The Minister for Heath and Care, the Hon Gemma Arias-Vasquez, has announced His Majesty’s Government of Gibraltar’s future plans for the health service.

• Minister for Health to become Chair of GHA Board, Chief Secretary to be appointed Vice-Chair, Financial Secretary to become a member of the Board.

• Accountability Agreement between HMGOG and GHA to be published to limit Ministerial input in any clinical decision.

• Consultation commenced on whether to integrate the Care Agency into GHA Board to enhance communication and working between the agencies.

• Patient Charter to be published and enshrined in law.

• ALL contracts for provision of services at Care Agency and ERS to be tendered.

• Public Health will become an integral part of the Health Authority.

At a Press Conference, Minister Arias-Vasquez announced a significant Health and Care restructure which will take effect from September 2024.

The restructure has been specifically designed to improve services and increase efficiency in what is the largest area of public expenditure.

The Minister for Health will take over as Chairperson of GHA Board with the Chief Secretary appointed as Vice-Chair. The Financial Secretary will also be appointed as a Board member. This will provide the crucial, necessary and appropriate oversight expected from the health and care budget which is circa £200 million a year.

At a GHA Board meeting held yesterday, Prof Ian Cumming announced he would be stepping down as interim Chair at the end of his term in June, having previously discussed this with the Minister for Health. Given his exceptional knowledge and experience, the Government of Gibraltar has asked Prof Cumming to continue to support the Minister for Health and the GHA in an advisory capacity going forward at a significantly reduced cost to the taxpayer.

The Government would like to emphasise that the GHA will remain completely clinically independent and politicians will NOT interfere with any clinical decisions. This will be set out in an Accountability Agreement which the Government will publish before September 2024 – the date at which the changes announced will be implemented. The Government’s involvement, as Chair of the GHA Board, will be limited to the setting of policy and budgetary oversight.

HMGOG will also be publishing a Patient Charter setting out patients’ rights and responsibilities within health and care services. The Government is committed to enshrining this charter into law and expects to be in a position to make further announcements in this regard during the course of the Budget debate later this year.

Additionally, a consultation will be launched to determine whether the existing Gibraltar Health Authority Act should be amended to incorporate the Care Agency into what will become the Gibraltar Health and Care Authority. This will mean that the Care Agency CEO will, with effect September 2024, form part of the Gibraltar Health and Care Authority’s Board. This will allow for improved quality of care and general experience for the service user as it will enable better integration of existing services, many of which are currently working in isolation. Importantly, this will allow for the better integration of Mental Health services, to allow for seamless care between authorities.

Crucially, the Minister for Health, following advice received by the Health and Procurement Advisor to the Ministry, has instructed that all contracts for the provision of services to the Care Agency and ERS be put out to tender through the HMGOG Procurement Office as soon as possible. This will provide a modern and consistent framework which will result in better continuity of care for service users and a cost-saving to the taxpayer. This process has already commenced.

The Minister for Health and Care, the Hon Gemma Arias-Vasquez, said: “I want to be absolutely clear on why these changes are being made. I am doing this to ensure the necessary accountability, both from a political and administrative perspective, exists at the GHA. I will be publishing an Accountability Agreement shortly setting out the terms of this and I can categorically say that I will NOT be interfering with any clinical decisions as those must be left to clinicians alone.

“The Accountability Agreement will ensure that clinical decisions are not made political. Some degree of oversight on spending and policy is, however, required. The aim is to make all the services provided in Health and Care to Gibraltarians seamless, to ensure maximising efficiency and provision of care to Gibraltar. The aim of the GHA and Care Agency should always be to improve services and repatriate services whilst ensuring that the system is efficient enough to allow us to focus resources always on the patient. We are looking to further improve the patient experience and to increase multi-disciplinary workings between all aspects of health and care in Gibraltar – from Board level downwards.

“It is no secret that the cost of providing healthcare in Gibraltar for free at the point of consumption is huge; it is by far the largest area of recurrent expenditure for the Government. The Government, therefore, is absolutely committed to ensuring that our health service remains free going forward and, in doing so, we must ensure that we have the necessary budgetary and administrative oversight of our health and care services. For this reason, I have decided to appoint the Chief Secretary and the Financial Secretary to the GHA Board. I am sure they will do an excellent job in assisting the Government to implement its policy objectives for the health and care services.

“I would also like to thank Prof Ian Cumming for his work as GHA Chair and for agreeing to stay on, at my request, as a consultant to my Ministry and the GHA. Prof Cumming is very well respected and, indeed, connected in the health and care sector and will undoubtedly be of huge assistance to the Government in this regard.

“Finally, since I stood for election I was clear that I wanted the Health portfolio and I am now extremely excited to have finally been able to make these announcements, having discussed this with the GHA Director General and, indeed, Unite the Union. I am sure these carefully thought-out changes will only improve our Health and Care services in Gibraltar, both at a human and financial level.”

Professor Cumming added; “It has been a great privilege to be the Interim Chair of the Board of the GHA and to play a small part in the start of the journey of transformation for healthcare in Gibraltar. I have always said that the GHA should be chaired by a Gibraltarian and having completed my term as Interim Chair I am delighted that this is now going to be the case. It is an honour to have been invited by Minister Arias-Vasquez to advise and support the Ministry and GHA on an ongoing basis.”