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Changes at Jewish Home raise questions about healthcare provision

A change in the management of the Jewish Home has raised questions as to whether it amounts to privatisation that could result in inferior access to healthcare for its elderly residents.

The issue arose following an interview with Sir Joe Bossano on GBC earlier this week that led to a string of exchanges probing the change and what it means in practice for its residents, which currently number six.

It also prompted conflicting statements as to whether the Jewish Community had been properly consulted on the change.

Historically the Jewish Home operated outside the public healthcare system but when the building required significant refurbishment some 15 years, its residents were moved into an elderly care wing in St Bernard’s hospital.

Since then, residents were looked after within the government set-up, most recently under the care of the Elderly Residential Service.

The building has finally been refurbished and the residents, six in total, have returned to those premises.

In the move, the management of the facility has been taken on by the Jewish Community, which has contracted a company called Surgimed to provide care to the residents, the most economical of three tenders submitted.

Sir Joe told GBC the relocation had been at the request of the Jewish Community and in full consultation with them, adding the building had been refurbished by GBIC, a joint venture between a Chinese-government owned company and the Gibraltar Government, at no cost to the taxpayer.

He dismissed any suggestion of privatisation, insisting that in addition to the six beds in the Jewish Home, six beds had been released in St Bernard’s alongside additional space allowing for a further nine beds in the hospital.

“When you privatise something there is a minus on one side and a plus on the other,” Sir Joe said.

“This is a plus on both sides.”

Sir Joe later added: “We’re restoring what they always had.”

But Sir Joe’s statements were questioned by Together Gibraltar, which said it was “categorically untrue” that families and carers or “the wider Jewish Community” had been consulted about “this very sensitive and drastic policy change”.

For TG, the key issue is not the relocation back to the Jewish Home – which historically had been donated by the John Mackintosh Trust, which also gifted the Mount Alvernia building – but the change in healthcare provision.

TG said residents of the Jewish Home were also residents of the wider community of Gibraltar and should enjoy the same rights and standards of care as everyone else, adding they should have been consulted.

“For Sir Joe Bossano to say that the Jewish Home is not being privatised because the six beds they occupied in the hospital are not being shut down is simply bad spin,” said TG Leader Marlene Hassan Nahon.

“Elderly care is not a hotel service and the Government is not a provider of beds. it is a provider of care, and the reality is we now have six people who used to be cared for in public premises by government contracted workers and under public care standards, who will now be cared for by the cheapest company that applied for the tender.”

“We would also like to enquire as to the credentials presented by Surgimed, a company that has been entrusted with the care of some our most vulnerable citizens.”

“What is its track record in the care industry? Were the advantages of hiring their services simply lower costs? The party would like more information on how a contract was awarded to a brand new company with practically no experience in the field.”

“While it is true that the Jewish Home was historically independent of the Government’s elderly care provision, this does not mean that this situation was an optimal arrangement.”

“Things have changed significantly, particularly with regards residents living within the hospital’s ERS wing.”

“These residents enjoy benefits like the participation of on call GHA doctors, something that doesn’t apply to the Jewish Home with the new setup.”

“A proper process of consultation would have allowed all stakeholders to review the situation and figure out the best course of action for all involved.”

The statement from TG drew a reaction from the Managing Board of the Jewish Community, even while it cautioned it would not get involved in what it described as “party political discussions”.

In the statement, the Managing Board appeared to echo Sir Joe’s statements that the Jewish Community had been consulted on the relocation, though it made no comment on the concerns raised about healthcare provision.

“The Community was the prime mover of the relocation of its elderly care facility to the original premises it occupied for over 50 years at Line Wall Road,” the statement said.

“We continuously sought support from all political parties at successive general elections to achieve that aim.”

“That ambition was only recently achieved, with the full involvement of the Managing Board of the Community.”

“It has been widely welcome in the Jewish Community as a whole.”

“We are very grateful to the Chief Minister, Sir Joe Bossano and HM Government of Gibraltar for their assistance in this important move.”

But the concerns surrounding the change were also echoed by the GSD, which last night said Sir Joe’s comments raised questions about the financing of the new arrangements and the quality of care that was now being offered to residents of the Jewish Home outside the usual government provision.

Roy Clinton, the GSD Shadow Minster for Public Finance, said he had quizzed Sir Joe in Parliament in May and had been told the home would not be privatised, though it would be taken over and run by the Jewish Community.

“It is now evident that the service has effectively been privatised despite Sir Joe arguing to the contrary,” Mr Clinton said.

“Of particular interest to me is how the refurbishment has been financed by private capital which to me is disguised borrowing.”

“I would like Sir Joe to advise who is providing the financing, how much the refurbishment cost and disclose the terms upon which the financing is to be repaid?”

“It is also questionable as to why the Chinese 50:50 Joint Venture GBIC was used for the refurbishment project when the Government has a 100% owned construction company in the form of GJBS.”

“In this respect Sir Joe’s National Economic Plan makes no monetary sense.”

Elliott Phillips, the GSD Shadow Minister for Health, added his voice to TG’s concerns about the quality of healthcare now enjoyed by residents of the Jewish Home.

“While we note that there may have been discussions with the Board of the Jewish Community, it is important for the Government to assure people that the effective privatisation of the service is not going to jeopardise the integrity and the quality of care afforded to the residents of the Jewish Home,” he said.

“We ask the Government to set out in detail how it has arrived and what reassurance the Government can provide that Surgimed can meet the same high clinical standards enjoyed by elderly members of our community at Elderly Residential Services given that the minister made clear in his GBC interview that the Government had influenced the decision as to who should be awarded the tender on purely economic and not quality of care grounds.”

‘Dismay’ over Sir Joe’s ‘thoughtless’ comment on mental health

The Gibraltar Mental Welfare Society and Opposition parties expressed “dismay” at comments made by Sir Joe Bossano during a GBC interview in which he implied that people who thought the Gibraltar Government was hiding the changes at the Jewish Home had “serious mental problems”.

During the interview, Sir Joe was asked what he would say to anyone who believed the Government had made the changes “in the background”.

Sir Joe chuckled and shrugged off the question, replying:

“If people think that in a £2.5bn economy and in a government budget of £500m, doing a home for six people is something that we are hiding in the background, then I think there’s a place which is not this home but is another home for people that have serious mental problems, which is the next one we need to be looking at.”

For the GWMS, the comment was “totally inappropriate” and reflected “ignorance of and disrespect for mental health problems”.

“To begin with it is totally inappropriate to suggest that people who criticise Government procedures have ‘serious mental problems’ at the same time as it is a very demeaning comment to those on who genuinely suffer from these conditions,” the society said.

“The thoughtless comment made by the minister has rightly upset many people in the community who feel it shows a total lack of understanding of the very real suffering which poor mental health brings with it.”

TG’s Marlene Hassan Nahon echoed that sentiment.

“It was regrettable to witness the minister indulge in a cheap jibe about the mental health of those who do not agree with his creative explanation of this deal,” she said.

“It is disappointing to see a man of Sir Joe’s stature descending to a kind of humour that propagates stigmas and mocks the suffering of those with serious mental health conditions.”

The GSD too said Sir Joe’s comments were “shocking”.

“We have spent many, many years as a community, attempting to raise awareness and remove the stigma around mental health and to have Gibraltar most longstanding parliamentarian, Sir Joe Bossano, make highly disrespectfully and mocking comments about mental health provision is shocking and entirely unacceptable,” said GSD MP Elliott Phillips.

“I call on Sir Joe to unreservedly retract this most offensive comment.”

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