JERSEY’s health system has “demonstrated a clear lack of safety”, the former interim chair of the Health Advisory Board has said.
Professor Hugo Mascie-Taylor told the Health and Social Security Panel he had been concerned about safety when he wrote his critical 2022 report on the health system.
But he said that when he took over as interim chair of the board “a number of specifics began to emerge that demonstrated a clear lack of safety”.
Prof Mascie-Taylor was one of three experts who delivered their verdicts on the state of Jersey’s healthcare system this week.
Tom Hayhoe, who was previously chair of the advisory board, said Health and Community Services felt like a service he would have seen in the 1980s “compared to what I expect with modern medicine”, while Professor Simon Mackenzie, who was clinical lead in a five-person “change team”, said his experience was “bookmarked” by consultants repeatedly rejecting findings from Royal College of Physicians reports.
Prof Mascie-Taylor highlighted the number of lone practitioners, a lack of multi-disciplinary team working, a welcoming of isolation, the lack of clear lines of accountability, weak appraisal systems, a lack of openness and transparency and, among some, “a fierce rejection of guidelines”.
He said he discovered that the things exposing organisations to risk were “there in number”.
“That didn’t mean that it was definitely unsafe but it did mean that I couldn’t assure anyone that it was safe and I was deeply concerned that it might not be; and I suppose that was then evidenced as I moved into the next role [interim chair of the Health Advisory Board] where a number of specifics began to emerge that demonstrated a clear lack of safety,” he said.
Commenting on the reception of his report in Jersey, Prof Mascie-Taylor said most readers told him it captured “the state of the nation” so far as the health service was concerned but some “clearly didn’t like it and rejected what I’d said”. Referring specifically to the issue of adopting appropriate clinical guidelines, he said: “At organisational and political level that modern practice was embraced years after it had been everywhere else but I wasn’t convinced, by the time I’d left, that there was an acceptance of it among all; in fact, I’m quite sure that there was a fierce rejection of the use of guidelines by some.”
Explaining the need for guidelines that were accepted elsewhere, he said they provided security for patients.
“I think Jersey should aspire to the highest standards of care not mediocrity,” he said.
Prof Mascie-Taylor endorsed the idea of a link with a major health centre outside the Island both because this meant that patients with more “esoteric conditions” could receive specialist treatment but also because, using multi-disciplinary teams, cases could be discussed by groups of clinicians not just by an individual.
“The benefits are potentially enormous in those two regards. Equally, I think if it’s going to carry on with the current lack of engagement with a major centre – which I’ve not seen anywhere else in the world that I can think of – then I think the risks are substantial,” he said.
Questioned about the funding gap that currently exists in the Island’s health system, he said that higher costs for health care could be expected in a small island because of its scale but that the challenge was to get the best care for the least cost.
“I really can’t sit here and say I can suggest a way you will spend less on health care but I do think I can say you’d get a lot more for your money if you did some of the things I’m suggesting, and that every report I’ve seen has suggested,” he said.
