The People’s Healthcare Charter
A public agreement on what healthcare must deliver — timely care, better outcomes, and clinical services protected from bureaucracy.Healthcare should never be a source of fear, uncertainty, or endless waiting.
This Charter sets out what the public is entitled to expect — and the standard the health system must be judged against.
The Dual Approach and the People’s Healthcare Charter
The dual approach to healthcare recognises all available capacity across the system — ensuring that when one part is under pressure, other capacity can be used to protect patients.
But structures and labels are not what people actually care about.
What matters is simpler:
Will I be seen in time?
Will my condition be taken seriously?
What happens if the system cannot cope?
The People’s Healthcare Charter defines what patients are entitled to receive.
The Dual Approach ensures the system has the flexibility to deliver it.
Care comes first.
Administration exists only to support it.
The Dual Healthcare Model
The Dual Healthcare Model recognises that healthcare must be structured clearly in order to deliver effectively.
Under this model, the system will be divided into two defined entities: Clinical Care and Administration.
Clinical Care
Clinical Care includes every role directly required to diagnose, treat, support, and enable patient care.
This includes:
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Doctors
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Nurses
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Healthcare assistants
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Therapists
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Porters
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Catering staff
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Cleaning staff
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Technical and support personnel essential to safe treatment
If a role is necessary for a patient to be examined, treated, monitored, or safely cared for, it forms part of Clinical Care.
Clinical care is the core function of the healthcare system.
Administration
Administration includes all roles responsible for coordination, management, governance, reporting, and system oversight.
This includes:
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Appointment and booking systems
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Management structures
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Secretariat and reporting functions
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Policy, governance, and oversight roles
Administration exists to enable clinical care — not to replace it.
Structural Separation and Transparency
These two entities will be clearly defined, costed separately, and reported transparently.
The public will be able to see:
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How much is spent directly on patient care
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How much is spent on administration
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Whether administrative costs remain proportionate to clinical need
Clinical care comes first.
Administration must justify its cost by enabling it.
Clinical care comes first
Clinical care must always come first.
Doctors, nurses, and clinicians exist to diagnose, treat, and care for patients — not to manage paperwork or defend waiting lists.
Under the People’s Healthcare Charter:
Clinical judgement leads.
Administration exists only to enable care.
Bureaucracy must never delay treatment.
Early treatment leads to better outcomes
Early examination and treatment reduce harm.
When problems are identified and treated sooner:
Patients recover faster.
Complications are reduced.
Fewer conditions become emergencies.
Early care improves outcomes for patients — and avoids the far greater cost of delayed or crisis treatment later.
Clear access to care
People should not be left waiting without clarity or reassurance.
The People’s Healthcare Charter sets clear expectations for access to care — because delay harms patients and worsens outcomes.
Where care is needed, the system must respond. Waiting without explanation or end point is not acceptable.
Access standards exist to protect patients — not to manage queues.
If care cannot be provided locally
If the Island cannot deliver care within an acceptable timeframe, delay is not an option.
Under the People’s Healthcare Charter:
Care must follow the patient.
This may mean treatment provided elsewhere, or additional clinical capacity brought in.
The patient must never carry the burden of system failure.
Administration exists to enable care
Administration has an essential role — but a limited one.
Separating clinical care from administration protects medical services and ensures that clinical decisions are made by clinicians.
Administration exists only to:
Enable clinical action.
Support clinicians.
Remove barriers to treatment.