Workplace reform, call centre and waiting list reductions in Arias-Vasquez budget address

The Minister for Health, Gemma Arias-Vasquez, highlighted measures across the GHA, including a workplace reform, smoking ban, reducing waiting lists and a new 24-hour call centre.

Mrs Arias-Vasquez delivered her budget speech for close to five hours on Thursday, detailing key points across her portfolios which account for roughly half the government spend.

The GHA and ERS accounted for £202.6m of the Government spend, marking an overspend of £20.3m.

Mrs Arias-Vasquez said this money is “not disappearing into a black hole” and of the GHA’s expenditure, approximately £95.5m relates to personal emoluments, £104.6m to recurrent expenditure, and £2.4m to capital expenditure.

“It is the cost of paying staff, running services, purchasing medical supplies, maintaining operations and continuing to invest in the infrastructure and equipment that a modern health service requires,” Mrs Arias-Vasquez said.

She highlighted improvements across the GHA such as increased theatre usage, which now stands at 82.3%, reduced waiting times at A&E, and appointment non-attendance rates at St Bernards Hospital have also declined.

She announced a new 24-hour call centre at the GHA that is currently under development and is expected to be completed by the end of this year or early next year.

The new call centre is set to operate as a single central point of contact for the public and will be the place where people phone to manage their appointments, make cancellations and make general enquiries.

In practice, Mrs Arias-Vasquez said, this means the new call centre will not only transfer calls, it will be able to deal directly with a range of issues, including changing appointments, and will therefore provide a much more useful, responsive and joined-up service to the public.

She added that the Primary Care Centre appointment line has improved and that, over the past year, appointments were available on average until 12:49pm, and on 98 of those days the line did not close at all.

Mrs Arias-Vasquez said a workforce reform is underway as this marks the largest component of GHA spending.

“It is about building a workforce model that is firstly fair, secondly sustainable and thirdly fit for the future,” she said.

“That is why work is ongoing with stakeholders to develop a locally sustainable Agenda for Change framework, alongside progress on parity banding discussions for Allied Health Professionals.”

“These are important reforms. Because a modern health service needs modern workforce structures. It needs fairness. And it needs reform that staff can understand and trust.”

She said the Government was serious about recruitment and retention, morale, and long-term resilience at the GHA.

“If we are serious about the long-term strength of our GHA, then we must also be serious about creating opportunities for our local people, whose university grants we fund, to build careers within the GHA,” she said.

Mrs Arias-Vasquez added that the GHA needs professionals from abroad where there is not that expertise locally.

Nurse Management now falls under the remit of Workforce, and a requisition process has been introduced to ensure that cover is properly mapped against staffing shortfalls.

“That more disciplined approach is already helping to reduce agency hours across St Bernard’s hospital wards and forms part of the wider work to make staffing arrangements more sustainable and better controlled, and ensuring higher standards are maintained whilst continuing to protect the Government’s policy of bringing more Gibraltarians into the service wherever possible, without losing sight of the fact that there will always be areas in which external expertise remains necessary,” she said.

A new purpose-built Ambulance Station is being developed and has a revised completion date of late September 2026.

“Unfortunately, there is a manufacturing shutdown during the last week of July and throughout August, and those delays are entirely outside the control of the GHA, because I am advised the delivery of elements of this project depends on third parties,” she said.

There was also a significant increase in community-based end-of-life care provided by the GHA, increasing from 210 in 2024 to 400 in 2025, and Mrs Arias-Vasquez highlighted investment in health provisions.

The Cath Lab activity service, which become fully operational on a 24/7 basis from April last year, has undertaken over 90 primary life-saving coronary interventions and over 425 procedures have been carried out since it opened in December 2024.

“That is a remarkable figure,” Mrs Arias-Vasquez said.

“And it is worth pausing on what it means.”

“It means over 90 people received emergency treatment here that would previously have depended on external referral pathways.”

“It means lives have been saved through local capability.”

“It means 425 occasions where patients have been able to benefit from this service locally, supported by our own GHA teams, without the same need to travel abroad for care.”

“It means delays have been reduced.”

After two full-time audiologists and the appointment of a permanent consultant otologist were appointed, the waitlist has dropped from over 12 months to around two months.

This reduction in waiting times has meant that the GHA has achieved a near-zero paediatric ENT surgical waiting list and children requiring surgery are now routinely scheduled within one month of their clinic appointment.

Full paediatric hearing assessments are now also delivered locally.

Between April and October 2024, 55 children were referred to University College London Hospitals for hearing assessments.

During the same period in 2025, that figure fell to 13, marking a 76% reduction.

Surgery procedures have risen from 3,883 in 2023/2024, to 4,043 in 2024/2025, and now to 4,249 in 2025/2026.

The median waiting time for all surgeries has fallen substantially in recent years and, at April 2026, it had reduced from 23 weeks in 2022 to nine weeks.

Over recent months, the GHA’s surgical teams have undertaken the first local robotic surgery cases in General Surgery and, Mrs Arias-Vasquez said, the programme will now expand progressively into Urology, Colorectal, Upper Gastrointestinal and Gynaecology specialties.

Mrs Arias-Vasquez said the Government has transformed ERS care with a budget of £27.2m.

Development of the Daphne Alcantara Acute Dementia Ward is underway at Ocean Views, with the expected completion date for the works being mid-September.

This new Acute Dementia Ward will comprise 14 beds across seven rooms and will be staffed by professionals trained in Positive Behaviour Support, a compassionate and evidence-based approach to understanding and responding to behaviours often associated with dementia.

It will also increase the provision of respite beds for individuals living with dementia, helping families who are caring for loved ones in the community.

This development is a key part of the National Dementia Strategy and will provide a purpose-built environment for the right care to be delivered in the right place.

Designs for Gibraltar’s new Community Mental Health Hub at Joshua Hassan House have now reached an advanced stage and have gone to the Development and Planning Commission as part of the planning process.

Mrs Arias-Vasquez also set out plans for a smoke-free Gibraltar.

She said the Tobacco and Vapes Bill “will be one of the most important public health interventions that we will make for future generations” and will prohibit the sale of tobacco products to any person born on or after January 1, 2009, with those provisions coming into force from January 1, 2027, when those born on or after that date begin turning 18.

“This is not about criminalising smokers,” she said.

“It is not about blaming those who already smoke.”

During the last 12 months, Mrs Arias-Vasquez said the Public Health team has developed physical activity guidelines for Gibraltar, which she launched during her budget speech.

The National Physical Activity Guidelines aim to support and empower the population to become more active by providing clear and practical advice on how and where to incorporate physical activity into everyday life, taking into account the local context and culture.