A DAMNING report that has raised questions over the government’s programme to deliver new healthcare facilities is “likely to cause a good deal of unnecessary concern”, according to the Health Minister.
Deputy Tom Binet said there was “nothing” in the 117-page document published by the Hospital Review Panel on Friday to suggest that the programme, which involves building over several sites – including recently-approved plans for the new hospital at Overdale – should be “slowed”.
The panel, chaired by Deputy Jonathan Renouf, raised concerns that the Island “may not be able to afford to build and operate the enlarged healthcare estate that is currently envisaged”.
Operating costs
One of the potential issues highlighted by the report is the ongoing revenue costs of running the new healthcare facilities, which Deputy Renouf said “seem to have been considerably understated”.
The report notes that the programme’s outline business case does not provide “cashflow projections during the construction phase and post-operational phase – particularly where operating costs increase”. It cites rises in patient activity and healthcare demand, as well as the implications of running a bigger facility with greater bed capacity.
“The OBC should clearly articulate the impact that this would have on costs, according to best practice,” the report added.
Capital costs
The panel also argued that the outline business case does not provide enough information breaking down “the scale and associated capital costs” of the new acute facility at Overdale and initial phases of other schemes – such as the planned ambulatory care centre at Kensington Place and health village in St Saviour.
“Other than in the programme plan in the management case, the OBC only provides information on the proposed capital scheme at Overdale, and the scope of the procurement strategy that was developed post-OBC submission excludes the other three sites,” the report states.
“There is therefore no evidence of any plans in place to progress the required works at the Kensington Place, St Saviour and St Ewold’s sites, which indicates the risk that the new facilities will not be delivered in time for the multi-site model to be implemented.”
Best practice
Another point put forward in the report is that the commercial case “does not align with what would be recognised as best practice for an OBC for an NHS capital scheme” and questions its compliance with UK “Green Book” guidance.
However, it later added that: “We recognise that there may have been additional work undertaken that is not reflected in the OBC and supporting documentation, however we can only comment on what information has been made available.”
Lack of transparency
In the foreword of the report, Deputy Renouf stressed that the panel was not saying for certain that the new healthcare facilities would fail to meet the needs of Islanders or that they were definitely unaffordable.
However, he claimed there was “a lack of evidence that they will meet those criteria”.
“We are left with the impression that the political imperative to build a new hospital at Overdale at the fastest possible speed has been allowed to override every other consideration. It is all very well to want to ‘get something done’, but it is equally imperative to make sure that it is the right thing that is getting done,” he continued.
“That is what the assurance process should deliver – confidence that the right decisions are being taken, based on a comprehensive understanding of healthcare needs, matched to relevant financial and estate strategies and a funding solution.
“We do not have that assurance. Instead, the lack of transparency and clarity fuels the fear that there is a funding black hole when it comes to the future affordability of the Island’s enlarged healthcare estate.”
Unnecessary concern
Responding with a statement, Deputy Binet said he would study the panel’s findings and recommendations.
But he added that, having read Deputy Renouf’s foreword and the executive summary, “it is clear that the report is likely to cause a good deal of unnecessary concern”.
“For the avoidance of doubt, there is nothing in it to suggest that progress towards the delivery of New Healthcare Facilities should be slowed and I am confident that the team will be able to address all the key findings and recommendations and assuage any public misgivings,” he continued.
“Even the chair of the panel himself says that they are not saying the new healthcare facilities will fail to meet the needs of Islanders or that they are definitely unaffordable.
“Everyone knows the new acute hospital at Overdale and other healthcare facilities are desperately needed, and having worked with the highly-competent delivery team for almost three years, I’m satisfied that sufficient information has been generated in this specific, Jersey context to justify the expenditure, and that the outline business case will be refined to a full business case in the same, appropriate way.”
