Proposed Government Plan 2023-2026 (P.97/2022): twentieth amendment Hospital funding

STATES OF JERSEY

PROPOSED GOVERNMENT PLAN 2023- 2026 (P.97/2022): TWENTIETH AMENDMENT

 HOSPITAL FUNDING

Lodged au Greffe on 28th November 2022 by the Council of Ministers

STATES GREFFE

2022  P.97 Amd.(20)

PROPOSED GOVERNMENT PLAN 2023-2026 (P.97/2022): TWENTIETH AMENDMENT

____________

1  PAGE 2, PARAGRAPH (b) –

After the words "those revised approvals" insert the words ", except that –

1. To refer to their Act of 7th October 2021, in which they approved the funding of Our Hospital through borrowing (external financing), and to agree that such approval extends to the funding of ongoing work on the development of future healthcare facilities during 2023; and
2. in Summary Table 2, the "Borrowing for Our Hospital" should be renamed  "Borrowing  for  Healthcare  facilities",  and  the  maximum amount which may be borrowed for these purposes be set at £90,071,000, with the change to approval in Summary Table 2 amended to £- 665,929,000 with the figure in each of the columns headed 2023, 2024, 2025 and 2026 in Summary Table 2 to be amended accordingly to reflect this change".

2  PAGE 2, PARAGRAPH (c) –

After the words "of the Law" insert the words ", except that, in Summary Table 3, the transfer from the Strategic Reserve to the Consolidated Fund should be amended as follows –

1. The transfer for Hospital capital should be amended to £51,500,000 for 2023 and zero in all future years; and
2. The transfer for Hospital borrowing should be amended to £4,200,000 in each of 2023 and 2024, £3,900,000 in 2025 and £3,500,000 in 2026".

3  PAGE 2, PARAGRAPH (d) –

After the words "to the Report" insert the words ", except that in Summary Table 4 –

1. the  Total  Project  Approval  for  Our  Hospital  shall  be  amended  to £77,116,000 with the Change amended to £-727,384,000; and
2. the following row shall be added to the end of the table –

Spons  Supply  Previous  Total Project

£'000   Dept   Dept   Approval Approval   Change Healthcare facilities1  HCS  IHE  -   60,360   60,360

4  PAGE 2, PARAGRAPH (e) –

After the words "of the Report" insert the words ", except that -

1 Includes £8,860,000 spent in 2022 on Les Quennevais under Our Hospital Head of Expenditure

1. in Summary Table 5i, the Head of Expenditure for Our Hospital  – Financing Costs should be deleted and replaced with the following –

  Head of £'000  Income  Expenditure   Expenditure Healthcare  facilities  -  financing

costs  -   4,200   4,200

2. in Summary Table 5ii, the Head of Expenditure for Our Hospital should be deleted and replaced with the following –

Major  Sponsor  Supply  2023 £'000   Project   Department   Department   Estimate Healthcare facilities  M  HCS  IHE   51,500

5  PAGE 2, PARAGRAPH (i) –

Designate the existing paragraph as new paragraph (j) and insert the following paragraph as paragraph (i) –

i) "to refer to their act of 7th October 2021, in which they agreed to amend the Strategic Reserve Fund policy, so as to allow the Fund to be used to support the delivery of Our Hospital and to agree that the policy should be amended to allow the Fund to also be used to support the ongoing work on the development of future healthcare facilities proposed to be undertaken during 2023 and the borrowing costs for such work.

6  PAGE 2, PARAGRAPH (i) –

After the words "Appendix 3 to the Report" insert the words

", except that page 69 shall be amended accordingly to reflect the ongoing work on the development of future healthcare facilities during 2023,".

COUNCIL OF MINISTERS

Note:  After this amendment, the proposition would read as follows –

THE STATES are asked to decide whether they are of opinion

1. to approve the estimate of total States income to be paid into the Consolidated Fund in 2023 as set out in Appendix 2 – Summary Table 1 to the Report, which is inclusive of the proposed taxation and impôts duties changes outlined in the Government  Plan,  in  line  with  Article  9(2)(a)  of  the  Law;
2. to approve the proposed Changes to Approval for financing/borrowing for 2023, as shown in Appendix 2 – Summary Table 2 to the Report, which may be obtained by the Minister for Treasury and Resources, as and when required, in

line with Article 9 (2)(c) of the Law, of up to those revised approvals except that –

1. to refer to their Act of 7th October 2021, in which they approved the funding of Our Hospital through borrowing (external financing), and toagree that such approval extends to the funding of ongoing work on the development of future healthcare facilities during 2023; and
2. in Summary Table 2, the "Borrowing for Our Hospital" should berenamed  "Borrowing  for  Healthcare  facilities",  and  the  maximumamount which may be borrowed for these purposes be set at £90,071,000, with the change to approval in Summary Table 2 amended to £- 665,929,000 with the figure in each of the columns headed 2023, 2024,2025 and 2026 in Summary Table 2 to be amended accordingly to reflectthis change.

3. to approve the transfers from one States fund to another for 2023 of up to and including the amounts set in Appendix 2 – Summary Table 3 in line with Article 9(2)(b) of the Law, except that, in Summary Table 3, the transfer from theStrategic Reserve to the Consolidated Fund should be amended as follows –

1. The transfer for Hospital capital should be amended to £51,500,000 for2023 and zero in all future years; and
2. The transfer for Hospital borrowing should be amended to £4,200,000 ineach of 2023 and 2024, £3,900,000 in 2025 and £3,500,000 in 2026".

4. to approve each major project that is to be started or continued in 2023 and the total cost of each such project and any amendments to the proposed total cost of a major project under a previously approved Government Plan, in line with Article 9(2)(d), (e) and (f) of the Law and as set out in Appendix 2 - Summary Table 4 to the Report, except that in Summary Table 4 –

1. the  Total  Project  Approval  for  Our  Hospital  shall  be  amended  to £77,116,000 with the Change amended to £-727,384,000; and  
2. the following row shall be added to the end of the table –

Spons  Supply  Previous   Total Project

£'000   Dept   Dept   Approval Approval   Change Healthcare facilities2  HCS  IHE  -   60,360   60,360

5. to approve the proposed amount to be appropriated from the Consolidated Fund for 2023, for each Head of Expenditure, being gross expenditure less estimated income (if any), in line with Articles 9(2)(g), 10(1) and 10(2) of the Law, and set out in Appendix 2 – Summary Tables 5(i) and (ii) of the Report, except that

–

in Summary Table 5i, the Head of Expenditure for Our Hospital – Financing Costs should be deleted and replaced with the following –

  Head of £'000  Income  Expenditure   Expenditure

2 Includes £8,860,000 spent in 2022 on Les Quennevais under Our Hospital Head of Expenditure

Healthcare  facilities  -  financing  

costs  -   4,200   4,200

6. in Summary Table 5ii, the Head of Expenditure for Our Hospital should bedeleted and replaced with the following –

Major  Sponsor  Supply  2023 £'000   Project   Department   Department   Estimate Healthcare facilities  M  HCS  IHE   51,500

7. to  approve  the  estimated  income,  being  estimated  gross  income  less expenditure, that each States trading operation will pay into its trading fund in 2023 in line with Article 9(2)(h) of the Law and set out in Appendix 2 – Summary Table 6 to the Report;
8. to approve the proposed amount to be appropriated from each States trading operation's trading fund for 2023 for each head of expenditure in line with Article 9(2)(i) of the Law and set out in Appendix 2 – Summary Table 7 to the Report;
9. to approve the estimated income and expenditure proposals for the Climate Emergency Fund for 2023 as set out in Appendix 2 – Summary Table 8 to the Report;
10. to refer to their act of 7th October 2021, in which they agreed to amend theStrategic Reserve Fund policy, so as to allow the Fund to be used to support the delivery of Our Hospital and to agree that the policy should be amended to allowthe Fund to also be used to support the ongoing work on the development of future healthcare facilities proposed to be undertaken during 2023 and theborrowing costs for such work.
11. to approve, in accordance with Article 9(1) of the Law, the Government Plan 2023-2026, as set out at Appendix 3 to the Report, except that page 69 shall beamended accordingly to reflect the ongoing work on the development of futurehealthcare facilities during 2023,".  

REPORT

Background

The Council of Ministers does not dispute that there is a compelling case to replace the existing health estate. It is recognised that buildings are deteriorating, and that the standard of these facilities may, over time, start to compromise the delivery of health services.

The Council stands together in acknowledging that new, modern and fit for purpose health and care facilities are needed, and high-quality, safe facilities should be delivered as soon as is reasonably practicable. In addition, there is a strong consensus that whilst any new facilities are being delivered, the delivery of safe health and care services in the interim should not be compromised.

However, it cannot be overlooked that current cost estimates in respect of the proposed single-site single-phase scheme at Overdale are in excess of the budget approved by the States Assembly for delivering the project. Indeed, that excess is assessed as being significant – between £70 million and £115 million more than the approved figures and so not affordable within agreed limits. Using a phased approach gives us more flexibility and resilience, allowing us to proceed with each phase only when we know we can deliver it, and afford it.

Project review

In response to the current global context of increasing prices of materials, labour and volatile  financial  markets  as  a  result  of  the  currently  unpredictable  geo-political situation and the stark fact that the scheme as proposed is not affordable, the Chief Minister commissioned a review of the Our Hospital project as part of her 100-day plan upon taking office. The full review can be found here.

The review, presented to the States Assembly as R.154/2022, provided advice to the Assembly  about  whether  changes  can  be  made  to  deliver  a  more  affordable  and appropriate alternative. The review concluded changes to the project could be made, most notably with respect to increasing affordability by reducing exposure to risk at any one point in time.

In summary, at a very high level, the review concluded that this could be achieved by delivering new healthcare facilities with a phased approach over two or more sites, including Overdale and areas of Kensington Place:

• To  mitigate against  the  risk  of  entering  into one single,  significant  value contract. Instead, smaller work packages for smaller elements of the project could be commissioned at times when they were considered more affordable in their constituent parts. In turn, it was concluded that local construction firms could  have  greater  opportunity  for  involvement  in  these  smaller  works packages, therefore better supporting the local economy.

• To  mitigate  against  the  risk  of  exposing  Jersey  to  high  levels  of  debt  at unfavourable rates of interest – an alternative financing model could allow phases to be financed in associated tranches. This would reduce exposure at any one point and enable the Government of Jersey to be opportunistic in taking advantage of moments to borrow where interest rates are more favourable. However, the financial model is not set. For example, the Minister for Treasury and Resources has identified other funding opportunities for the programme of

work,  such  as  income  received  above  income  forecasts  and  utilising underspends from other areas.

• To  reduce  the  degree  of  environmental  or  infrastructure  impacts,  when compared to a single-site scheme. Jersey has successfully operated multi-site healthcare for many years, in diverse locations and of an appropriate size for our Island. This will deliver a more appropriate service provision – to ensure that given our island context, the broad range of services delivered by Jersey's Health and Community Services continue to be delivered safely on-island.

• To deliver elements of the programme quicker - a phased solution means shorter construction times. As a result, some healthcare facilities, and where possible those most needing replacement, should be operational in a similar timeframe to the existing plans.

Why amend the Government Plan 2023-26?

The proposed Government Plan 2023-26 includes funding to deliver the single-site single-phase Overdale scheme. In recognising that the scheme is no longer affordable, the conclusions of the review, and the anticipated changes in project direction, the States Assembly must note that previously anticipated expenditure on the project will not be as it stands in the proposed Government Plan. Therefore, it must be amended.

Funding will be required to:

• update  feasibility  studies  that  will  be  required  to  deliver  a  new  delivery framework and programme with better time and cost certainty, with a view to minimising  the  risks  outlined  above.   These  will  require  expenditure  on Government of Jersey team and professional services to develop a revised brief, early designs and a project programme and plan.

• continue the development of the former Les Quennevais School into a health and care facility, into which services can be relocated from Overdale during construction of that site or for other healthcare services. Although no future direction has been settled, there is an opportunity to retain this site as a delivery space for health and care services in the longer term beyond the construction of new facilities at Overdale, which may fit into a future model of care for Jersey.

• transfer  the  land  at  Kensington  Place  from  Andium  homes  as  a  strategic purchase to enable the delivery of a multi-site facility.

Further to these initial activities, it is intended that further Propositions will be brought forward by the Council of Ministers asking the States Assembly to consider substantive financing and funding models to deliver new health and care facilities for Jersey as part of a programme of works, supported by designs and a robust case for delivery.

Finances and borrowing

The required changes to the Government Plan are set out below. The revised Summary Tables reflecting the amendment are included at Appendix 1 to this report. In addition, Appendix 2 to this report sets out the revised wording in the Government Plan (page 69) for the hospital project, including revised financial tables.

Capital costs

As an interim step, this Government Plan includes a new head of expenditure for healthcare facilities to replace the previous head of expenditure for Our Hospital. This will allow work on revised plans for new healthcare facilities to continue during 2023,

in advance of substantive financing and funding models being brought to the States Assembly. The new head of expenditure covers the following areas of expenditure:

The amendment also changes the total Major Project approval for Our Hospital, to reflect the costs to completion of that project in 2022. The overall expenditure on Our Hospital up to 2021 was £63.3 million. A further £22.7 million is forecast for 2022, meaning total expenditure of £86 million (including £8.9 million on Les Quennevais).

Revenue costs

The Revenue Head of Expenditure for "Our Hospital - financing costs" is replaced with a  new  Head  of  Expenditure  called  "Healthcare  facilities  –  financing  costs".  The proposed Government Plan included financing costs of £3.05 million for Our Hospital, increasing in future years in line with the profile of spend and borrowing. This is amended to £4.2 million in 2023 and in future years, reflecting changes to the profile and cost of expected borrowing for the proposed 2023 capital works and the borrowing to conclude the work on Our Hospital up to the end of 2022. In line with previous decisions, these costs will be met by transfers from the Strategic Reserve.

Financing

The capital costs in 2023 (£51.5 million) will be funded through short-term borrowing initially utilising the existing and a new Revolving Credit Facility. A longer-term funding strategy will be brought to the Assembly as part of the development of revised proposals for the hospital project. The amounts borrowed will be kept to a minimum by utilising underspends. In line with the previous funding strategy, the borrowing will be credited to the Strategic Reserve and then transferred to the Consolidated Fund.

When added to the borrowing for the Overdale Scheme under existing approvals in 2022, the total borrowing requirement in 2023 is £90 million (which includes £38.6 million borrowing up to the end of 2022).

Conclusion

The single-site Overdale scheme, as proposed, is no longer affordable within approved budget limits.

The Council of Ministers and the States Assembly have an opportunity to adopt a prudent risk management approach to deliver a more affordable project through a different financing model, and by spreading commitment to spend over a longer period, rather than progressing a single large-scale and high-cost scheme with cost estimates for construction outside the forecasts within the Outline Business Case.

As the Minister for Infrastructure put forward in his review, It is time to put aside the public discord of the past and progress at pace, alongside a constructive dialogue with Health-care  workers,  Clinicians,  Scrutiny,  Assembly  members  and  all  Islanders, including neighbours and interest groups.

Appendix 1 – Revised Summary Tables

Summary Table 2 - Borrowing for 2023

Existing  Change to  2023  2024  2025  2026 £'000  Approval  Approval  Approval  Proposed  Proposed  Proposed Costs of Covid-19  208,520  (208,520)  -  -  -  -

Fiscal Stimulus  29,641  (29,641)  -  -  -  - Refinancing  of  past-

480,000  (3,000)  477,000  477,000  477,000  477,000 service liabilities

Housing Bond  250,000  -  250,000  250,000  250,000  250,000 Total  Approved

Borrowing  (before  Our  968,161  (241,161)  727,000  727,000  727,000  727,000 Hospital)

Consolidated Fund  Climate Emergency Fund  4,400  4,400  4,400  4,400

Strategic  Reserve  (Pensions

Consolidated Fund  1,790  2,192  2,605  3,028

refinancing)

Health Insurance Fund  Consolidated Fund (Revenue)  6,100  4,100  -  - Health Insurance Fund  Consolidated Fund (Capital)  6,350  5,705  -  - Criminal  Offences

Consolidated Fund  1,811  777  -  - Confiscation Fund

Social  Security  (Reserve)

Social Security Fund  89,000  -  -  - Fund

Consolidated  Fund  (Hospital capital)

Strategic Reserve Strategic Reserve

Consolidated  Fund  (Capital repayment)

Consolidated  Fund  (Hospital borrowing)

Strategic Reserve

Summary Table 4 - Major Projects

Spons  Supply  Previous  Total Project

£'000  Dept  Dept  Approval  Approval  Change Infrastructure  Rolling  Vote  &  Regeneration

IHE  IHE  -  14,715  - Including St. Helier

Sewage Treatment Works  IHE  IHE  86,235  88,635  86,235 Learning  Difficulties  -  Specialist

HCS  IHE  9,350  9,350  9,350 Accommodation

Ambulance, Fire & Rescue Headquarters  JHA  IHE  24,403  24,403  24,403 Oakfield and Fort Regent Decant  IHE  IHE  9,402  9,402  9,402 Office Modernisation  IHE  IHE  3,923  3,923  3,923 Inspiring Active Places - Sports Strategy  IHE  IHE  814  3,914

MS Foundation  COO  COO  11,446  10,871

Cyber & Cyber ORI  COO  COO  14,970  16,358  14,970 Integrated Tech Solution Release 1 & 2  COO  COO  54,740  54,740  54,740 ITS Release 3 & 4  COO  COO  6,500  6,500  6,500 ITS Release 3 Additional  COO  COO  1,281  1,281  1,281 Digital Care Strategy  HCS  COO  16,185  16,185  16,185 Schools Estate  #N/A  #N/A  -  -  -

Jersey Opera House  ECON  ECON  -  11,731  - Community Fund  T&E  T&E  -  7,000  - Revenue Transformation Programme  T&E  T&E  9,425  9,425

Summary Table 5i - 2023 Revenue Heads of Expenditure

Head of £'000   Income   Expenditure Expenditure

Departmental Expenditure

Cabinet Office  2,780  70,116  67,336 Children, Young People, Education and Skills   21,220  210,908  189,688

Customer and Local Services  10,452  105,755  95,303 Infrastructure, Housing and Environment  31,177  86,682  55,505 Health and Community Services  26,207  274,089  247,882 Jersey Overseas Aid  -  17,700  17,700 Justice and Home Affairs  4,530  39,700  35,170 States of Jersey Police  234  27,342  27,108 Ministry of External Relations  290  3,378  3,088 Department for the Economy  -  40,264  40,264 Treasury and Exchequer  3,355  70,743  67,388 Past Service Pension Liability Refinancing  174  13,956  13,782 Departmental Expenditure  100,419  960,633  860,214

Non-Ministerial and Other States Bodies

Bailiff 's Chambers  68  2,192  2,124 Comptroller and Auditor General  80  1,158  1,078 Judicial Greffe  2,382  11,509  9,127 Law Officers' Department  237  11,118  10,881 Office of the Lieutenant Governor  107  946  839 Official Analyst  53  738  685 Probation  88  2,732  2,644 States Assembly  68  8,814  8,746 Viscount's Department  826  2,928  2,102 Non-Ministerial and Other States Bodies

3,909  42,135  38,226 Expenditure  

Covid-19 Response  -  25,211  25,211 Departmental  and  Non-Ministerial

104,328  1,027,979  923,651 Expenditure  

Reserves  

Reserve for Centrally Held Items  -  43,506  43,506 General Reserve  -  29,187  29,187 Reserve Expenditure  -  72,693  72,693 Healthcare facilities - financing costs  -  4,200  4,200 Revenue Heads of Expenditure Total  104,328  1,104,872  1,000,544

Summary Table 5ii - 2023 Capital and Other Projects Heads of Expenditure

Major  Sponsor  Supply  2023 £'000   Project   Department   Department   Estimate Feasibility   T&E   T&E   1,830 Estates

Land Acquisition  IHE  IHE  - Oakfield and Fort Regent Decant  M  IHE  IHE  5,000 Inspiring Active Places - Sports Strategy  M  IHE  IHE  1,300 Office Modernisation  M  IHE  IHE  460 Crematorium  CLS  IHE  - Vehicle Testing Centre  IHE  IHE  100 Orchard House  IHE  IHE  449 Other IHE Estate Projects  IHE  IHE  1,700 Jersey Opera House  M  ECON  ECON  6,270 Elizabeth Castle  M  ECON  ECON  2,027 Learning  Difficulties  -  Specialist

HCS  IHE  1,700 Accommodation  M

Health Services Improvements Programme  HCS  HCS  5,000 In-Patient/Support Services Refurbishments   HCS  HCS  749 New School and Educational Developments   CYPES  IHE  3,504 Upgrade to CYPES Estate  CYPES  IHE  13,621 Ambulance, Fire & Rescue Headquarters  M  JHA  IHE  800 Army and Sea Cadets Headquarters  JHA  IHE  960 Magistrates' Court conversion  JG  JG  750 Firearms Range  SoJP  SoJP  1,775 Dewberry House - Sexual Assault Referral

SoJP  IHE  2,851 Centre

Prison Improvement Works  JHA  IHE  2,985

52,001

Infrastructure

Infrastructure  Rolling  Vote  and

IHE  IHE  14,715 Regeneration Including St. Helier

Sewage Treatment Works  M  IHE  IHE  11,966 Countryside Access & Wellbeing  IHE  IHE  - Planning Obligation Agreements  IHE  IHE  - Road Safety  IHE  IHE  - Other Infrastructure  IHE  IHE  2,950

29,631

Information Technology

MS Foundation (M)  COO  COO  1,300 Cyber & Cyber ORI  M  COO  COO  5,000 Integrated Technology Solution Release 1 &

COO  COO  9,778 2  M

ITS Release 3 & 4  M  COO  COO  2,300 ITS Release 3 Additional  M  COO  COO  17

Other Government Wide IT Projects  COO  COO  3,399 Revenue Transformation Programme (Phase

T&E  T&E  3,105 3)

Digital Care Strategy  M  HCS  COO  5,300 Jersey Care Model - Digital Systems  HCS  COO  1,050 Next Passport Project  JHA  JHA  250 Combined Control IT  JHA  JHA  567 Electronic Patient Records  JHA  JHA  191 Regulation Group Digital Assets  IHE  IHE  1,252 Replacement LC-MS system  OA  OA  - Probation/Prison Case Management system  Prob  Prob  440 Pride Software  JG  JG  - Phoenix Software  Visc  Visc  300 Court Digitisation  JG  JG  1,639

35,888

Replacement Assets and Minor Capital

Replacement Assets and Minor Capital  IHE  IHE  3,930 Fisheries  Protection  Vessel  &  Auxiliary

IHE  IHE  -

Vessels

Replacement Assets and Minor Capital  CYPES  CYPES  250 Replacement Assets and Minor Capital  HCS  HCS  3,755 Replacement Assets and Minor Capital  SoJP  SoJP  200 Replacement Assets and Minor Capital  JHA  JHA  162 Replacement of Aerial Ladder Platform  JHA  JHA  768 Replacement Assets and Minor Capital  COO  COO  3,000

12,065 Community Fund  M  T&E  T&E  1,000 Reserve  for  Central  Risk  and  Inflation

T&E  T&E  8,100 Funding  

Total Project Head of Expenditure  140,515

Appendix 2 – Revised Government Plan section

Hospital Project

The review of the Our Hospital project (R.154/2022) was presented to the Assembly on 1st November 2022. The review provided advice to the Assembly about whether changes can be made to deliver a more affordable and appropriate alternative. The review concluded changes to the project could be made, most notably with respect to increasing affordability by reducing exposure to risk at any one point in time.

As an interim step, this Government Plan includes a new head of expenditure for healthcare facilities to replace the previous head of expenditure for Our Hospital. This will allow work on revised plans for new healthcare facilities to continue during 2023, in advance of a detailed budget and financing strategy being brought to the States Assembly.

The budget for healthcare facilities included in this Government Plan enables the project to:

1. update feasibilities studies that will be required to deliver a new delivery framework and programme with better time and cost certainty
2. Continue the development of the former Les Quennevais School into a health and care facility, into which services can be relocated from Overdale during construction of that site or for other healthcare services.
3. transfer  the  land  at  Kensington  Place  from  Andium  homes  as  a  strategic purchase to enable the delivery of a multi-site facility.

The capital costs, finance costs and borrowing included in the Government Plan are sufficient to enable the above activities to progress in 2023. A full funding strategy will be brought to the Assembly in due course.

A new head of expenditure for development of healthcare facilities is included in the Government Plan and designated as a Major Project.

In line with previous decisions, the borrowing will be held in the Strategic Reserve and transferred to the Consolidated Fund as required. The financing costs will be met from the Strategic Reserve (also in line with previous decisions).

Hospital project

->2022  2023  2024  2025  2026 Estimate  £'000  Estimate  Estimate  Estimate  Estimate

Revenue Expenditure

500  Financing Costs - Revenue Expenditure  4,200  4,200  3,900  3,500 500  Total Revenue  4,200  4,200  3,900  3,500

Capital Expenditure

8,860  Healthcare facilities  51,500

77,116  Our Hospital - Capital Expenditure  

85,976  Total Capital  51,500  0  0  0

Strategic Reserve Transfers

Strategic Reserve to Consolidated Fund -

(500)  (4,200)  (4,200)  (3,900)  (3,500)

Financing Costs

Strategic Reserve to Consolidated Fund -

(38,571)  (51,500)

Our Hospital  

(39,071)  (55,700)  (4,200)  (3,900)  (3,500)

Strategic Reserve Borrowing Proceeds

38,571   Borrowing Proceeds   51,500   38,571  51,500  0  0  0

Table 34: Our Hospital