The Government is set to embark on an overhaul of the Gibraltar Health Authority to improve the services provided to patients and also the accountability of the Authority to the Minister, and therefore to the taxpayer. It is clear that, while there are many people who are satisfied with the service they have received from the GHA, there are also others who have not had the experience that they should. There is plenty of room for improvement in how the GHA operates, which is hardly surprising given the scale of the organisation and the huge number of people that it employs. The Government understands the magnitude of this project, and is committed to working in partnership with stakeholders towards an outcome where, acting on expert advice, things are done differently and better in a number of areas going forward.
Plans include a radical reform of the Gibraltar Health Authority to ensure that the leadership of health services in Gibraltar is able to continue to respond to the challenges of the COVID-19 pandemic whilst reinstating all pre-COVID healthcare activity and addressing the waiting lists that have grown during the COVID response period. The magnitude of the challenge facing the GHA is similar to that which faces healthcare systems around the world and this can be tackled by a two-pronged approach which builds on best practice whilst addressing areas of concern.
The Minister for Health, Samantha Sacramento MP, today announced a 7 point plan to deliver a wide ranging series of reforms to achieve the “Reset, Restart and Recover” of the GHA following the enormous impact of the COVID-19 pandemic on the GHA staff and the services provided by the GHA.
The plan announced today is a result of careful planning that has been undertaken over the last six months, and is in parallel to a number of reviews and notable developments that have already been undertaken in this period including:
- A comprehensive review of mental health services and the launch of a national mental health strategy
- Pharmacy Review
- Review of theatres and surgical waiting lists
- Implementation of an Electronic Document Management System for the hospital.
A number of key changes are being announced in today’s plan. These changes include:
- Reconfiguration of the GHA board to ensure it functions as the key strategic and oversight body for the GHA. This change will separate the functions of the GHA and the Ministry of Health and Care and will include the appointment of a new independent chair of the GHA. Professor Ian Cumming OBE will be appointed vice-chair of the GHA board. (Professor Cumming chaired the COVID-19 vaccination committee in Gibraltar). The new GHA board will be a unitary Board with 5 non-executive and 5 executive members in addition to a non-executive Chair.
- The appointment of a new post of Director General (DG) of the GHA to provide overall leadership and delivery for the GHA. The appointment process for an interim Director General will commence shortly. It is anticipated the interim DG will be in post for a period of up to 18 months. A permanent Director General will be recruited during this time, following a full recruitment process.
- There will be new accountability arrangements between the GHA and the Minister for Health, including quarterly formal accountability meetings between the Ministry and the GHA.
- The creation of three formal subcommittees of the GHA Board focusing on:
- Quality of Care
- The creation of a new Social Partnership Forum for the GHA allowing the Trades Unions and other staff groups increased opportunities for consultation and discussion over future plans.
- The appointment of a professionally qualified Finance Director to provide financial control and leadership for the largest spending area of government. The Finance Director will take a lead role in delivering new projects and ensuring value for money across the GHA.
- The appointment of five key people to a “Reset, Restart and Recover” team to work across the GHA to help deliver on quality, efficiency and productivity, innovation and prevention across the GHA, building on best practice from around the world.
In parallel, the role and function of the Ministry for Health will be developed so that it is the driver for policy development in the health sector and in turn sets the tone for recasting healthcare for the future. In order to clearly make the distinction of the role of the Ministry for Health as being the non-executive policy driver, the Ministry for Health will be relocated to premises outside the GHA in the New Year.
The Chief Minister, the Hon Fabian Picardo QC MP, said: “The COVID pandemic has been traumatic for the world and our community. The GHA has borne the brunt of the pandemic in Gibraltar and its professionals and staff have strained every sinew to deliver. We have provided the funding and the resources they have needed and our community is proud of the achievements of the GHA and its people. It is undoubtedly also true that the GHA needs to restart and recover in order to address the many challenges that public post-pandemic health care systems such as the NHS and the GHA face. To do that effectively, we have listened to the public and to the unions and professionals involved. We are putting in place new systems that are not cast in stone but are the beginning of the work we need to do in order to carve a fit for purpose future for our beloved GHA. A future in which the professionals and clinicians are in greater control of the decisions that affect the care they provide. A future in which politicians can demand accountability from a Board that does not include a minister or other politicians. A future in which the GHA always acts toward delivery of a mission statement fixed by its new Board and informed by the professionals that make it up. This will also provide a more agile industrial relations machinery that will enable fuller and more meaningful engagement with the trade unions in a more timely fashion to ensure their voices are heard in representation of their members. This is an exciting moment as we start the process of recasting health care for the future to deliver an even better service to our community. We have listened and we are listening. That is how we will best deliver going forward. I have great confidence in the work that is being done by Minister Sacramento and Professor Ian Cumming. I am sure that the community as a whole will value that work too as it takes effect for the benefit of us all. I am sure everyone will want to support these changes and support the GHA as it emerges from the pandemic.’
The Minister for Health, the Hon Samantha Sacramento MP, said: ‘The whole of Gibraltar owes a huge debt of gratitude to so many people in the GHA and elsewhere for their enormous efforts in responding to the COVID-19 pandemic to date. Although the COVID pandemic is by no means over, we do need to ensure that our efforts are now focused on “Reset, Restart and Recover” across all our services as well as continuing the ongoing battle against the Coronavirus.
‘Some of our services have seen waiting lists grow over the last 18 months, as well as there being an impact on many other aspects of healthcare. Some decisions about strategic developments in our healthcare services have also inevitably been delayed. The time is now right to take action to address all these issues and to start to develop our GHA for the future.
‘It is for this reason that it is appropriate that a new role of Director General be introduced to be the overarching leader in the GHA and this role will be critical to lead the GHA out of the pandemic and will be tasked on leading on our “Reset, Restart and Recover Programme”.
‘This plan will deliver wide-ranging changes for the GHA and for Gibraltar. I am confident that these proposed new arrangements will allow the GHA to develop to provide an affordable and comprehensive range of health care services fit for the future.
‘“Reset, Restart and Recover” will take several years to deal with all the consequences of the COVID-19 pandemic, but these changes that I am announcing today will ensure that action starts now to provide, on an ongoing basis, a healthcare system that the whole of Gibraltar can continue to be proud of.’