Health insurance fund 'not sustainable'

Planned spending from Jersey's health insurance fund (HIF) is not sustainable, the States auditor has said.

The fund provides financial benefits for medical and pharmaceutical services to people with health insurance. Over recent years, more money has been taken from the fund to help reduce GP fees and make healthcare more accessible.

However, in a new report on the fund, the Comptroller and Auditor General said these additional benefits and contracts had put "additional pressure on the sustainability of the HIF".

The Government of Jersey said work to assess long-term funding options were "already well-advanced" and had been a "key government priority throughout 2025 and into 2026".

In her report, the Auditor General, Lynn Pamment CBE, wrote: "In recent years, there have been a number of changes to the medical benefits funded from the HIF.

"As a result of these changes and other pressures on the HIF related to the ageing demographic, the Budget 2026-2029 is that the HIF will show a deficit for each year of the budget period," she said.

"By the end of 2029, the balance in the HIF is anticipated to be £61m which is less than one year's expenditure."

The report said "no clear plan of action has been developed for the HIF since 2021 actuarial review, despite the clear indication from the actuary that the fund is not sustainable".

It said: "Instead, a number of additional benefits and contracts have been funded through the HIF since 2021, causing additional pressure on the sustainability of the HIF.

"The current funding and expenditure model for the HIF is not sustainable without intervention."

The Budget 2026-2029 said "increased expenditure against the health insurance fund means that the fund will be exhausted during the early 2030s unless action is taken soon".

This is different to the position reported in the Government Plan 2023-2027, which forecast a surplus for each year of the plan and concluded that "the fund remains in good health over the medium-term".

The government said ministers had been clear in the 2026 budget and beyond action was "needed to address long‑term pressures on health funding caused by increased treatments and enhanced support with health care costs".

"Significant preparatory work has already taken place, and several of the C&AG findings and recommendations are already under way," it said.

"This includes consideration of reform of the Health Insurance Fund as part of a whole health care system approach, rather than viewing the Health Insurance Fund in isolation."

It said the new Health and Care Partnership Board would also assist in considering options to help inform future budgets.

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