WHEN Health Minister Tom Binet sits back to reflect on his time in government, his verdict is unsurprising – not least because he was the minister who brought the previous Council of Ministers down.
“The new government is a happier place,” he said. “I didn’t enjoy the first round very much. This experience has been much more positive.”
In January 2024, Deputy Binet resigned as Infrastructure Minister and lodged a vote of no confidence in then–Chief Minister Kristina Moore.
He initially intended to stand for the top job himself, only to make an embarrassing miscalculation prior to the deadline for nominations about how many fellow members were supporting his candidacy.
He subsequently backed Lyndon Farnham – now Chief Minister – as part of a shared commitment to finally deliver a new hospital.
His appointment to Health followed soon after.
“In a way, I wanted health,” he said. “I’ve been very lucky. I’ve got three Assistant Ministers, and having my sister there, from a strategic point of view, has been vital. We’ve worked together for 50 years.”
“It’s definitely been a happier, more relaxed environment,” he added. “Health is a big strain… but if you get it right, the rewards are directly related.”
Two years in, he said the team now had “a pretty good grasp” of what needed to be done. “It’s been a progression…We’ve laid a number of foundations,” he said.
Unfortunately for Deputy Binet, he will not have the faintest idea who’s going to be elected where when he puts his own name forward.
Although he stopped short of fully committing to standing, he indicated that he would be interested in continuing as Health Minister if re-elected and if the political environment allowed.
“The hospital construction is about four years. It should be delivered, commissioned and in use by the end of the next electoral period,” he said.
“We’ve set an ambition to get the health service in as good a shape as the new hospital. It would be great to be part of that right till the end.”
The desire to see it through to the end is partly due to how Deputy Binet has been involved with the hospital project since his time in Infrastructure.
“I’ve been working on the hospital since I came in,” he said. “I’ve been very, very lucky indeed and landed on my feet insofar as the team were in the background in the last iteration. They’re now in charge. Extremely competent, hardworking, efficient.”
The government recently named Bouygues UK as its preferred contractor for the Overdale project – despite the company recording pre-tax losses of more than £30 million last year and £62 million the year before.
“They’re a big, effective company… part of a group of companies. They do have a parent company that’s extremely profitable,” he said.
He said Bouygues Construction – the parent – had injected capital into the UK business over recent years and confirmed that a parent-company guarantee would be in place when the contract was signed.
A big challenge for Deputy Binet in the meantime, he said, is getting through the next four years with a hospital regularly at capacity.
“We’ve got to make things run for another four years. Bed management is a real problem,” he said.
He pointed to work underway to make better use of existing beds – reducing delays in discharge and improving how patients move through the hospital – as well as expanding “step-down” options – meaning rehabilitation and intermediate-care beds for people who no longer need acute treatment but are not yet ready to go home.
“There’s a bit of creative work going on at the minute,” he explained. “It might mean that we’ve then got to invest a bit in community care so that people can leave the hospital earlier… that will then free up hospital beds.”
When asked about the Island’s consultant model, where doctors can split their time between public and private patients, the minister explained: “The more private work you do, the more money you get in. But the more private work you do, the less public work you do – and waiting lists get worse.”
Deputy Binet later clarified that consultants had been asked by the leadership team – with his endorsement – to carry out “slightly more private work with a corresponding reduction in public work” in an attempt to “help reduce the deficit in the health budget”.
He described this as a “dilemma”.
Consequently, he said tackling waiting lists would be “top of the agenda” in the programme of work for next year, including discussions with department heads about setting realistic targets, improving efficiency and, if necessary, changing how internal resources were allocated.
“A year and two-year waiting list is not acceptable,” he said. “We have to understand that.”
Days before the States Assembly is due to debate the Government Plan, Deputy Binet also sought to correct what he described as a misconception about the scale of Health’s Budget increase.
The proposed Budget for 2026 includes £381m of spending on healthcare – a rise of almost a fifth on 2024 – but Deputy Binet said that much of it relates to new services being brought under his department.
“There’s a lot of talk about £60 million, but it’s not 60,” he said. “£22 million alone is the transfer of the ambulance service from Home Affairs. We’ve moved 40 people out of digital services, central government across various areas, HR, procurement, finance, and public health.
“All of those areas have been transferred back to health because we want a holistic health service… another chunk of it is for all of the previous years where there have been overspends.
He went on to reject the idea that Health was chronically overspending – saying the department had simply been underfunded for years.
“I would relabel those [underspends] as an underfunding situation, and every year the government has made up that underfunding,” he said.
While saying he was grateful for the extra funding, the minister described the allocation as the “bare minimum” needed to close the department’s long-running deficit – currently around £12 million – and to maintain essential services.
The department hopes to break even next year by finding £9 million in savings, which would leave about £15 million in net new funding.
Of that, £12 million will be ring-fenced for health prevention initiatives and improvements to digital systems – which Deputy Binet descirbed as the only genuine areas of new investment.
“If you take all of it, boil it all down, we’re getting the money for digital and the money for health prevention, and that’s it in terms of real new money,” he said.
The department’s prevention programme will receive £4 million a year – a third of its original £12 million bid – to fund early-intervention and screening measures.
Deputy Binet said the figure was reached after a summer of negotiations and reflected what could realistically be delivered in the first year.
“It was a much bigger programme. My wings were clipped — that’s politics,” he said.
The digital plan – which aims to improve systems so staff can share patient information more easily, send prescriptions electronically, and keep all health records in one place – will receive £8m a year, after its original £70m five-year proposal was reduced to about £40m.
“We’re rated at zero on a scale of one to seven in terms of digital connectivity,” he said.
“We can’t even get people into appointments properly. Some people are getting an invitation to go to an appointment a week after the appointment date.”
“These absurd things are because we’ve got no connectivity at all. Lots of information falls between the gaps, between the GPS, between the hospital, between the charitable health services, all that’s got to stop.
“That’s going to be a game changer.”
Deputy Binet confirmed he would accept Scrutiny amendments calling for formal plans on prevention and women’s health.
“They basically reflect what we’re doing… they want it formalised. I’m quite happy,” he said.
However, he strongly criticised other amendments, including a proposal to redirect assisted dying funds and one from Deputy Kristina Moore seeking to cut £57 million from the Health Budget.
“I find it staggering,” he said. “I cannot dream of anybody going to face the electorate and their family having taken £57 million away from the health service.”
High levels of sickness and stress-related absence remain a concern across Health – with 761 mental health-related absences in the Department last year alone.
To address the issue, Deputy Binet said he was leading a “major” programme on occupational health and wellbeing across the public sector.
“If people feel valued, looked after and supported, we want to get those numbers well down.”
In previous years, reports have raised concerns about poor workplace culture, with some staff reluctant to report bullying or harassment for fear of repercussions.
But Deputy Binet said he believes that morale is improving.
“When we arrived at Health, the culture was, I think, really poor… I think it’s on the way up. I genuinely feel a sense of optimism.”
