Future Hospital: Review of proposed site location and costs (P.37/2018) – comments

STATES OF JERSEY

FUTURE HOSPITAL: REVIEW OF PROPOSED SITE LOCATION AND COSTS (P.37/2018) – COMMENTS

Presented to the States on 6th April 2018 by the Council of Ministers

STATES GREFFE

2018  P.37 Com.

COMMENTS

Jersey's current Hospital is outdated and can't meet the Island's future needs. If approved, this Proposition will overturn a decision made by the States Assembly to build a new Hospital on its current location. This will delay the provision of the new, modern General Hospital that is needed to serve Islanders for generations.

There's no such thing as a perfect location for a large building like a hospital in an Island as small as Jersey. There were issues with all 41 locations that we examined, and the current Hospital site is the one that best meets the criteria.

Sites in other parishes are not only more difficult to reach, but would breach more planning policies and guidelines than the current Hospital location. A low building in the countryside would have a much bigger visual impact than the latest design would in town.

The States Assembly considered the selection process when it approved the General Hospital site as the preferred location in December 2016. The site choice was informed by contributions from States Members at a series of workshops. Independent bodies have also subjected the project to repeated and searching review, and both the Planning Inspector and the Minister for the Environment agreed that the current hospital location is acceptable.

Delay

The proposed review is unrealistic and unnecessary, leading only to more money and time being spent on a process that was undertaken by Scrutiny's advisers before the December 2017 debate. Concerto, the Future Hospital Scrutiny Review Panel's adviser, remarked that the outline business case that formed a key part of P.107/2017 was fit for purpose and presents a sound enough basis for decision-making by the States of Jersey'. States Members endorsed the outline business case for the project and supported funding proposals for the scheme, which is forecast to cost up to £466 million.

To produce an estimated cost and timescale for the development of a new General Hospital on each site' would require a tailored assessment that considers all the relevant factors necessary to build a fully functioning General Hospital for each site. Based on the work undertaken on the current location, the cost will be substantially more than the suggested £200,000 budget.

If this Proposition is adopted by Members, there would not be merely a short pause' in the building project. There would be extensive delay, as the work the Proposition is asking for cannot be completed by September 2018 if it is done properly, by qualified experts.

This means we would have to redeploy the Hospital project team; relationships with advisers and contractors would be severed, and the Island would lose the opportunity to take advantage of historically-low interest rates. We would also have to keep spending money to patch up the ageing infrastructure of our existing Hospital building to keep it safe for an extended period of time.

Best option

The current location has been chosen because extensive research by the project team and associated experts has found that it is the best option.

St. Helier is where most people live and work, and it's where our road network and transport services converge. Many Hospital staff live in St. Helier and walk to work. People who work in town can walk to attend appointments or visit friends and relatives. In fact, around one third of people who attend the Hospital walk to it.

Using the current location is more acceptable to the Parish of St. Helier, Planning and Transport Authority, and it provides room to expand in future. The required utility services already serve the building, which links directly to an existing car park.

Alternatives

Comprehensive studies have been conducted on the 4 alternative sites proposed by the Connétable . The main reasons that these sites are less suitable than the existing Hospital are summarised here:

Waterfront – The scale of development required would have an enormous impact on the surrounding area, including the loss of Jardins de la Mer. There would be little room for future expansion, and there would be no space for on-site parking. The nearest place to  park  would  be  Patriotic  Street.  The  site  could  be  better  used  for  commercial development, which is more in keeping with the current buildings on the Waterfront and would also generate public funds.

St. Saviour 's Hospital – The listed buildings on the site make it too small. Some have suggested  demolishing  the  listed  buildings  and  lawns  to  create  space,  but  any application to do this would have to prove that the Hospital couldn't be built elsewhere. This is not the case, as a new Hospital can be built at the current site.

The site is reached by poor roads and junctions unsuitable for heavy traffic. A large car park would be required, as few people would be able to walk there, and ambulance journeys from the west would take an extra 9 minutes.

Overdale – This site would also need a large car park and improvements to access and neighbouring road junctions. Some people would find it difficult to walk there because of the steep hill, and development would be restricted to 4 floors. This would still impact on the surrounding area, and there would be no space for future expansion.

Warwick Farm – is in the Green Zone and development there would have a detrimental impact on the surrounding area. It, too, would need a large car park, and the nearby roads and junctions are not suitable for heavy traffic. Few people would be able to walk there.

Construction

It is understandable that some people are worried about attending Hospital during the construction  phase,  but  modern  building  techniques  have  seen  many  city  centre hospitals being developed alongside existing services with minimal disruption. For

example,  Great  Ormond  Street  Hospital  is  just  over  halfway  through  a  20-year redevelopment programme.

The plan is to build the new Hospital in phases, without affecting services in the current Hospital, and then move clinical units into the new, modern buildings.

Cost

There have been proper systems of control and effective management of the project since its inception.

Some large hospital projects in the UK have been built at what looks like a lower cost, but it is important that we compare like with like.

Building costs on an island are generally more expensive than building on a large land mass, like the UK. We have carried out detailed cost assessments, overseen by experts who have costed many new hospitals before.

We should consider what type of hospital is being built. Jersey needs to maintain the full range of services of a general hospital. Many mainland hospitals do not have such a mix of services, and do not build general hospitals. Instead they expect patients to travel an hour down the road to attend specialist hospitals for specific services. That is not possible on a small Island.

The cost of our new Hospital takes into account estimated inflation costs for the next 6 years. A comparable hospital that has already opened will have been built at the lower prices that applied at the time.

Part (c)

With regard to part (c) of this proposal, details of the costs so far incurred by the Future Hospital project have been provided to the Scrutiny Sub-Panel and are already in the public domain, following response to a Freedom of Information request.

It is accepted that the project team could publish updated information on spending and contracts signed on a monthly basis on the Future Hospital website, subject to any issues of commercial confidentiality.

Conclusion

The Connétable has lodged this Proposition in response to the Planning Inspector's refusal of outline planning permission. However, the Inspector did not criticise the appropriateness of the proposed location. He rejected the size and mass of the building proposed for the site. Detailed work has been undertaken since then to take account of the Inspector's concerns.

In upholding the Inspector's reservations, the Minister for the Environment concluded that: "whilst the location is spatially appropriate for the hospital the application site proposed is too small to accommodate a building of this size, but other combinations of land, and/or project phasing, could result in a different outcome.".

A revised planning application to build on the current site and adjoining land in Kensington Place is being finalised and is expected to be submitted later on in April.

Members are urged to consider the impact on Islanders if we do not move ahead with replacing Jersey's outdated Hospital. Agreeing to this Proposition would overturn a decision already made by this Assembly, that we should build a new, fit-for-purpose Hospital on the location of the existing building. It would delay the provision of the new, modern Hospital that Islanders need.

The Council of Ministers asks Members to reject this Proposition.