By Bernard Place
LATER this year, the States Assembly will debate a proposition from Health Minister Deputy Tom Binet to refresh and expand the governance of our Island’s health and care system. Known as P.52/2025, it seeks to do two things: extend the life of the current Health and Care Jersey Advisory Board and create a new Partnership Board to guide future whole Island system-wide planning. On the surface, it sounds like sensible continuity. But is it the start of something more coherent – or the risk of something more confused?
To understand the significance of this proposal, it’s helpful to take a step back. The original Health and Community Services Advisory Board was set up by the Assembly in 2023 under P.19/2023. Its purpose was clear: to provide independent oversight and assurance to the Minister for Health and Social Services. It looked at the quality and safety of care, examined serious incidents and complaints, and brought public scrutiny to how Health and Community Services (HCS) was performing. It met in public, published its minutes, and included both executive and independent members under a non-political chair.
By most accounts it has made a quiet but valuable contribution. A review published in April 2025 confirmed that the board had helped improve transparency, raised the quality of governance, and encouraged a more open culture inside the department. Its members understood their limits – it wasn’t their job to manage services – but it was their job to ask awkward questions on behalf of Islanders. And they did.
Now, just over 18 months later, the Health Minister wants not only to keep that board going, but also to create a second board, with a broader and more ambitious scope. The new Health and Care Partnership Board is designed to bring together providers from across the system – government departments, GPs, care homes, charities, and others – to advise on integrated planning and service configuration. Its aims include improving collaboration, shaping future investment, and solving cross-cutting challenges like illness prevention, digital integration, and workforce planning.
This raises an important and timely question: is two better than one?
There is, of course, a compelling case for partnership. Jersey’s health and care challenges are complex and long term. The old model of government doing everything in-house is no longer viable, nor is it always desirable. Hospital care provides only one part of our Island’s healthcare. The proposed Partnership Board reflects a recognition that good healthcare isn’t delivered by one provider alone. We need to plan as a system. That means bringing together the different voices that make up our social fabric and letting them speak – not just in crisis, but in strategy.
But there are also risks that deserve thoughtful attention. If the Advisory Board already provides scrutiny and assurance, and the Partnership Board is now offering advice and coordination, what happens when these two groups overlap or disagree? Who has the ear of the minister? Which voice carries weight when decisions get tough?
The answer is not obvious. Both boards are non-statutory, meaning they exist by ministerial approval rather than by law. Both are advisory, not executive, meaning they offer opinions rather than make decisions. And both depend on goodwill, clarity of purpose, and ministerial follow-through to have real impact. Without careful delineation, there is a risk that these two boards could become confused in role, conflicting in message, or even competitive in influence.
This is not just a theoretical concern. During the consultation on the new board’s terms of reference, some stakeholders raised fears about executive dominance – too many senior government voices in the room and not enough independence or community representation. Others questioned how transparent the Partnership Board’s recommendations would be, or how the minister would respond to them. Would they be debated? Published? Quietly shelved? There is as yet no formal mechanism requiring that recommendations be acted upon.
At the same time, the Advisory Board’s role as the independent eyes and ears of the public could be weakened if its remit becomes blurred with the new board’s strategic functions. The whole point of an assurance board is that it stands slightly apart – able to observe without becoming entangled in the day-to-day or political crosswinds. That distance is its strength. But it only works if the lines are kept clear.
These issues may sound procedural, but they cut to the heart of how we govern health in Jersey. We have no statutory health authority and no democratically appointed local health boards. The boards proposed here are advisory only. That doesn’t mean they’re unimportant – but it does mean they are fragile. A future minister could disband them. A difficult recommendation could be ignored. An ambitious plan could fall into the gaps between multiple groups, none of them fully empowered.
So what might make the minister’s proposition stronger? For one, clarity of function. The Advisory Board should retain its assurance role, focused on how services are delivered and whether they meet standards. The Partnership Board, if agreed, should be clearly tasked with strategic planning – and only planning. Second, accountability. Recommendations from either board should be formally published, with the minister required to respond, much like a Scrutiny Panel report. That helps build trust, even when decisions go against recommendations.
Finally, thought should be given to the long-term structure of governance. If partnership and accountability are both needed, would a single statutory board with two committees – one for assurance, one for planning – offer a more sustainable approach? That might protect independence while also delivering joined-up thinking.
The Health Minister’s proposition is, in many ways, a step in the right direction. It shows a willingness to listen, to plan across boundaries, and to open up decision-making to wider input. But structure matters. Governance is not just about goodwill – it is about architecture. If we want a health system that is coherent, credible and trusted, we need to get the scaffolding right.
The Assembly debate in September offers an opportunity not only to approve or amend this proposition, but to shape a clearer future for how Jersey governs its most essential service. Islanders – patients, carers, clinicians, and taxpayers – deserve a system that listens, learns and leads. Whether that needs one board, two boards, or something else entirely, the test will be the same: does it help us make better decisions, and does it serve the people it’s meant to serve?
A registered nurse for nearly 40 years, Bernard Place has been a clinician, teacher and researcher in intensive care units. From 2012 he managed departments in Jersey’s healthcare system and from 2015 to 2019 was the clinical project director for Jersey’s new hospital.
