JERSEY needs an “all-encompassing, single health system” with a board bringing together care providers from the public, private and charitable sectors and a new chief executive to deliver “a seamless service”, according to Health Minister Tom Binet.
The Deputy said that developing such a model was vitally important for the creation of the Island’s new hospital.
“It can make no sense at all for us to be spending £710m on a new hospital, only to transfer into it a fragmented service without seamless interconnections. It would be a classic case of ‘spoiling the ship for a ha’porth of tar’ ”, Deputy Binet said.
The minister was addressing a conference organised by the Friends of our New Hospital when he set out a new vision for the Island’s health system in which the different care providers would work together in a partnership overseen by a board of public executive and non-state, non-executive members.
It would bring together functions currently provided directly by the government with GPs, the care sector and charities.
“At the end of the day, when someone needs treatment, they don’t particularly care if it’s provided by a private business, a charity or a government department. As with any supply business, all the customer or patient wants is excellent, seamless service,” the minister said.
To deliver that service, the HCS chief executive role would be split to create a chief executive of the new integrated department and a post of head of hospital services.
“At present, the chief executive of HCS has an almost impossible job. He has a broad but not entirely overarching brief with much more control in some areas than others. And along with that, he has a requirement to spend about a third of his time entwined in the knotty world of Jersey politics,” Deputy Binet said.
He acknowledged that the vision was based on “initial ideas” developed with his assistant ministers – Deputies Rose Binet, Andy Howell, and Barbara Ward – and a senior member of the HCS policy team and had yet to receive formal approval.
But he said the current system did not integrate the various elements of care as it should.
“The points of integration seem fractured and in some cases there is mild hostility,” he said.
Commenting on the transformation work taking place at HCS, the minister said he believed progress was good but he said that the relationship – highlighted by Professor Hugo Mascie-Taylor in his critical report two years ago – between hospital management and consultants remained “far from comfortable”.
“Both parties appear to have valid concerns, but the fact remains that until some middle ground is established, progress including the development of good governance will remain slower than it should.”
Addressing the current £24m shortfall in HCS funding, Deputy Binet said that a new funding baseline would probably involve accepting an additional funding requirement this year and in 2025, and he said that current funding would not deliver the fully integrated system in time for the new hospital, something he said he accepted in the interests of the current Government Plan.
But he continued: “For some time now, I’ve been struggling to understand why we accumulate a large sum of money in a Strategic Reserve for others to invest on our behalf while lacking the confidence to invest in ourselves. That might be an option but that would all be for another day,” the minister said.
Joining Deputy Binet on the platform at the conference were Health Advisory Board member Dame Clare Gerarda, Dr Nigel Minihane, Rosemarie Finley, chief executive of Family Nursing, and head of Mental Health Andy Weir.
