Costa highlights GHA budget controls

GHA spending was at £120.4m in the last year, which is nearly £10m less than the £130.7m anticipated, Health Minister Neil Costa told Parliament this week.

In his budget speech, Mr Costa pointed out that historically, GHA spending increased by nearly 9.10% year on year. However this year’s expenditure saw an increase of 1.25% from the previous year.
He added: “The GHA continues to strive to improve processes that will deliver better budgetary control and financial balance.”

“I am pleased to note that financial projections indicate that the GHA will this year keep within its allocated budget, which, in my opinion, is a fair and reasonable allocation to our health services.”

Mr Costa said what his GHA teams have achieved is “nothing short of remarkable”, adding that over the past financial year, clinical staff levels had increased, more services had been repatriated, there had been no cancelled surgeries due to a lack of beds, surgery waiting lists had decreased and a high level of bed availability had been sustained at St Bernard’s Hospital.

Mr Costa explained that staffing levels had also gone up by 223.5 posts, with 92.5 more nursing staff and 65.5 more medical and Allied Health Professions since 2011.
Primary Care Centre

A new primary care centre is being built on the grounds outside St Bernard’s Hospital, where a total of 30 GPs, seven dentists and specialists will run their clinics.

The Children’s Centre will be located next to it, and will combine the full range of children’s medical health services.

Secondary Care
Some of the new services introduced at the hospital include a flagging system to notify staff of any serious medical conditions and an advocacy council for healthcare users with additional needs.
Sponsored patients

Mr Costa said there has been a marked decrease in spending for the first time in 11 years on sponsored patients.
Many services have been repatriated to Gibraltar, including vascular surgery, renal replacement, keyhole bariatric and colorectal surgery, specialist shoulder and ankle surgery including replacement shoulder and ankles, urology and haematology.
Sponsored patients’ daily allowances have increased to a flat rate of £25 per day.

Clinical governance
Referring to the formal complaints in the Ombudsman report in 2017, Mr Costa said: “Many of these complaints could have been resolved quickly and efficiently by the GHA, and we failed our patients in not having done so. For every time we failed anyone, I sincerely apologise.”
From January 2018, the GHA Patient Advocacy and Liaison Service will handle all complaints, with the aim to provide a positive outcome before a formal complaint is filed.

School of Health Studies
For the first time ever, the GHA will introduce a BSc Mental Health Nursing programme and a BA (Hons) Social Work degree via the Care Agency.

Mental health
A crisis and outreach service was introduced in July last year within the community mental health team, which provided support outside office hours.
Mental health patients now have the ability to live independently in the supported accommodation initiative.
A locally available Clinical Psychology for Children and Families is being set up to address the mental health needs of children and their families.

Care Agency
During the last financial year, adult social services has received 847 referrals for social work assessments and support, an increase in 220 from the previous year.
Domiciliary care continues to be provided to assist vulnerable or elderly people at home, and a new reviewing system is in place to ensure care is provided to those in need.

Two social workers and a social work assistant at St Bernard’s Hospital has resulted in 83 patients having been discharged with packages of care to support their rehabilitation and recovery.
Safeguarding awareness continues to increase, and in the last year 41 referrals were received and assessed of a range of different alleged abuse of vulnerable people.

The adult social service team has received training in working with partners of individuals who commit sexual offences, who can help reduce the risk of reoffending.
Training has been provided to working with people with learning disabilities who are at risk of being sexually exploited.
The Child Protection Committee has been working to generate awareness on the dangers of sexting to help with children’s safeguarding.

Disability Service
Both St Bernadette’s Resource Centre and Dr Giraldi Home have undergone several refurbishments to ensure the safety and wellbeing of its service users and staff.
Elderly residential services

A consultant geriatrician and three GPs form part of the Elderly Services Medical Team. In addition, an occupational therapist was employed to ensure the residents’ needs are being met and the quality of life and independence is improved.

An additional floor at the John Mackintosh Home will increase the capacity from 54 to 70 residents.
Hillsides Residential Home and Bella Vista Day Centre are now running at full service.

Royal Gibraltar Police
The RGP has now embedded its structure, yet continues to reconfigure itself to meet existing and emerging challenges such as those posed by terrorism, Mr Costa said.
Another area of concern is cybercrime, and Mr Costa lends his full support to the RGP.

The RGP has introduced the Economic Crime Unit, which is also developing terrorism financing investigation capabilities.
The government has spent £165,000 to purchase Livescan equipment and software that scans fingerprints electronically and helps in exchanging information with other law enforcement agencies.

Gibraltar Law Courts
The Rt Hon Sir John Laws was appointed as a new Justice of Appeal, increasing the complement of the Court of Appeal from five to six members.

A legal profession supervision officer was hired to work with the Registrar of the Supreme Court, primarily on anti-money laundering and countering terrorist financing issues.
Legislation

New legislation was introduced in the last financial year, including the Public Health (Human Tissues, Cells and Organs) (Amendment) Regulations 2018 makes provisions for Gibraltar residents to be able to register as organ donors.

The Law Commission is examining the eligibility for parole licences which is usually possible after one third of a served custodial sentence, and whether the maximum sentence available for certain offences should be amended.

The thresholds for financial eligibility has also increased, raising the £5,000 limit for earnings to over £14,000 and increased the capital amounts that may be held by applicants from £500 to £10,000 and allowing the first £50,000 of equity a person has in their property to also be disregarded when working out capital owned.

HM Prison
Mr Costa said: “Prison management remains committed to the ongoing rehabilitation of offenders, with a view of breaking the re-offending cycle and successfully reintegrating offenders back into society.”

Prisoner numbers have fallen from 53.37 prisoners in 2016/2017 to 46.99 prisoners in the last financial year.