New hospital hampered by ‘public sector silo culture’

New hospital hampered by ‘public sector silo culture’

Karen McConnell, who is leaving her post at the end of the month, said that States Members were ‘not experts within particular fields’ and needed the civil service to provide them with sound advice and evidence on which to base political decisions, particularly for large-scale and complex projects.

Having recently said that the public sector needed a drastic culture change, Mrs McConnell said that its disjointed nature, where departments acted as a series of silos with different working cultures, had meant this presentation of advice and evidence was not achieved for the hospital project.

Last year £27 million had to be written off the cost of the future hospital project after a series of U-turns and confusion surrounding the location of the new facility.

Mrs McConnell said that she had some sympathy for the politicians involved because of the lack of information provided.

‘One of the things I want to make clear is if you are in a democratic organisation, within a political structure, the politicians are not experts within particular fields,’ she said.

‘They employ officers who are experts within those fields or, if you need specialist expertise because it’s not something you have ever done before, you simply buy it in for a period of time. One of the things that I think hasn’t been effectively put in place is assuring that elected Members get that right level of support to help them make those decisions and that was one of the points I was making in one of the earlier reports.’

She added: ‘Being very blunt about it, I have sympathy for elected Members. They do not have background in some of these core areas.

‘What they need is proper effective advice coming through from the civil service. But if, within the executive, you have a structure that doesn’t very well allow working across departments and where you don’t build up all the necessary information that you need in order to make a capital project flow, then you already have a real problem.

‘If you put that information in front of elected Members, who have never done this before and they have no benchmark against which to know what they should expect, then they are going to have a problem making that decision.

‘What needed to happen, and is beginning to happen, is you are getting a better framework for drawing that information together. You should not be asking States Members to make a decision based on something while not giving them the information they need to make that decision.’

Mrs McConnell pointed out that she had made a series of criticisms of the hospital project in reports she has published, and one of her key findings was that the process was initiated badly.

‘If you are going to build a hospital, you need to understand what services you are going to provide so you need a strategy and you need to set out what acute services you are going to have,’ she said.

‘That dictates all sorts of things – how many beds you need, the size of the hospital, how the patients flow through. When the first work began on the site for the hospital, the acute-services strategy wasn’t there.

‘So the first set of consultants were brought in to develop something when the basic building blocks to do it weren’t there.’

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