Future Hospital: rescindment of Gloucester Street as preferred site (P.5/2019) – comments [P.5/2019 Com.(2)]

STATES OF JERSEY

FUTURE HOSPITAL: RESCINDMENT OF GLOUCESTER STREET AS PREFERRED SITE (P.5/2019) – COMMENTS

Presented to the States on 12th February 2019 by the Chief Minister

STATES GREFFE

2019  P.5 Com.(2)

COMMENTS

As  Chief  Minister,  I  welcome  the  proposition  of   Deputy  R. Labey  of   St. Helier (P.5/2019).

I have been consistently clear that the newly-elected Assembly should take the decision as to whether to proceed with delivering the new Hospital on the existing site, as approved by the previously Assembly, or to opt for a different path.

Many of us have been closely involved with this project for many years, and most of us will  have  had  constituents  approach  us  expressing  concern. We therefore  have  a responsibility to consider the issues carefully, whilst at the same time also ensuring that the current Hospital is funded and fit-for purpose, throughout the life of the project.

For  myself,  I  have  been  involved  through  Scrutiny,  commissioned  the  Policy Development Board, and now, having received the second planning application refusal, we need to look at other sites as part of a new, open and collaborative process. This does not mean a significant delay to the project. Our aim is to speed up the process of site selection, re-using existing work where possible, and to ensure that the future Hospital project is delivered in a timeframe in line with the existing project.

I therefore support the proposition of Deputy R. Labey of St. Helier . Background

To inform this decision, one of my first actions on assuming office was to establish the Future Hospital Policy Development Board, compromising Connétable s C.H. Taylor of St. John (Chairman) and R.A. Buchanan of St. Ouen ; and Deputies R.J. Renouf of St. Ouen , C.S. Alves of St. Helier , T. Pointon of St. John , and R.E. Huelin of St. Peter . The Board's report was published in November 2018 and concluded that they had " not been assured that the evidence supports the current site as the optimal site – although it could deliver an acute general hospital facility provided the full range of health strategies are fully funded and proper mitigations put in place around patient safety."

The Deputy of St. Ouen , as Minister for Health and Social Services, dissented from the findings of the other Board members, and produced a minority' report which concluded that " the site for the hospital was properly evaluated and sufficient and accurate information was provided".

What is clear is that all of the Council of Ministers, and the Policy Development Board, fully support the provision of a new Hospital.

In any event, and whatever the merits or otherwise of the decisions of the previous Assembly,  matters  have  progressed,  as  in  January  2019  the  Minister  for  the Environment refused the outline application for the scheme on the site approved by the previous Assembly. In doing so, he concluded that " this application site is not quite large enough to comfortably accommodate the proposed scheme. A different application may overcome these issues.". The Minister for the Environment was also unable to conclude that there existed an overriding public interest benefit providing sufficient justification for making a decision which is inconsistent with Island Plan policies.

As such, we now need to consider the next steps for the benefit of our Island.

This means not just moving forward with the existing site – this Assembly, and the Public, understandably, need more assurance given the importance of the project and the money involved. We need to do this constructively, working together and valuing the contributions we each make.

With this in mind, this Council of Ministers is committed to the following actions:

1. Facilitating a new, transparent site selection process

This will be done in an open and transparent manner, re-using previous studies where appropriate, but not relying on conclusions reached by previous reports. This is why I have lodged a minor amendment to Deputy K.F. Morel of St. Lawrence 's amendment to the third amendment (P.5/2019 Amd.(3)Amd.(2)), just to ensure that matters are clear, and that work can progress thoroughly, efficiently, and in a timely fashion (see P.5/2019 Amd.(3)Amd.(2)Amd.).

In  developing  the  site  selection  process,  we  will  work  with  States  Members  in workshops,  and  in  consultation  with  healthcare  staff  and  other  stakeholders,  to determine which sites should be appraised, seeking to focus on a small number of deliverable and supported sites.

To be clear, approving the proposition does not exclude the existing Gloucester Street site, it merely rescinds the decision to proceed on the site – essentially leaving a blank slate as to where the Hospital should be. The only Assembly decision remaining would be P.82/2012: "Health and Social Services: A New Way Forward" and its commitment to a new Hospital.

This site selection process will be based on the current brief for a new General Hospital, but in the spirit of thinking afresh, the consultation with States Members will raise issues such as the specification for the General Hospital, and what this might mean for the site selection process.

The contract to undertake the site selection process will be subject to competitive tender, applying  the  appropriate  professional  standards  to  the  selection  of  advisers  in accordance with Government of Jersey procurement processes, as part of delivering a fresh approach.

2. Considering public interest issues and increasing assurance around a future planning application

The Chief Minister, and Ministers for Infrastructure and Health and Social Services, will explore  with the  Minister for the  Environment  how  we  can provide  greater assurance that any future application is in the public interest – so that we reduce the chances of a future refusal, having spent more time and public money.

The Minister for the Environment, in particular, believes that greater assurance can be secured  by  way  of  increased  stakeholder  engagement  (extensive  pre-application consultation on major schemes is a routine requirement in other jurisdictions).

The Minister for the Environment is also exploring other options to support the future planning applications process. This includes amending subordinate legislation so that the States Assembly can be asked to consider the public interest of a specific scheme that might challenge Island Plan policies, before any planning application determination is made by the Minister. The Minister has considered the introduction of new legislation to enable the provision of significant public infrastructure, and initial advice is that such legislation is likely to result in longer planning determination timescales than currently exist.

3. Committing to maintaining a good standard of care for patients

Until such time as a new Hospital is delivered, we must ensure that the current Hospital receives sufficient investment. Work is currently being undertaken to review and deliver a programme of works to enable the existing Hospital to continue to work safely until a new Hospital is  developed.  This will be  developed for consideration in the next Government funding cycle, as outlined in the Comments presented by the Minister for Treasury and Resources (P.5/2019 Com.).

The Council of Ministers commits to keeping the current Hospital fit-for-purpose throughout the life of the future Hospital build, with funding put in place to enable this to happen.

4. Review, producing and publishing an indicative timeline for site selection

The  timetable  published  as  part  of  the  report  of  the  Policy  Development  Board (Figure 1) will be reviewed to identify whether the delivery of a new Hospital can be expedited, while still going through proper processes, including substantial engagement with States Members, consultation with staff and the Public, Scrutiny, and debate in the Assembly.

Figure 1: programme of works comparing the existing States of Jersey approved site and a potential new site

This timetable is being reviewed and will need to be adjusted – notably, proceeding with the existing site will now take longer, as a new application is now needed; and the time and cost of site selection will depend on specifications, length of shortlist, and depth of analysis. The staging should also not be forgotten, in so far as the existing site was designed to deliver some operational areas before full completion.

Nevertheless, based on all the information received, a new Hospital, whether on the existing site or a new site, can still be completed in the late 2020s, and before 2030.

5. Publishing an explanation and outline of costs

Inevitably, on a project of this size, which has taken as long as it has, and had so many inputs, costs have been considerable. The Minister for Treasury and Resources has presented  Comments  (P.5/2019 Com.)  outlining  these  costs,  as  well  as  the  costs associated with winding down the current scheme if the proposition is approved.

As to future costs, to undertake site selection, and to progress thereon, the Minister for Treasury and Resources will need to lodge a new proposition to secure funding, as the Hospital Construction Fund expenditure was linked to the approved scheme (and cannot be spent on a new scheme without a new permission from the Assembly). How much is needed in the initial stages is dependent on the scope of the site selection, as outlined in point 2 above.

Conclusion

When the Minister for the Environment refused the latest planning application, he said the current site was not big enough, and that public interest did not justify going against the Island Plan. At the same time, any site would have its own challenges, and we need a new Hospital.

So we need to bring people together – and much as we should value all the work and contributions to date, we need a fresh start to achieve this.

This will involve assessing a shortlisted selection of sites, considering the public interest issue, maintaining a good standard of care at the existing Hospital, and considering how we can speed up site selection, while still going through proper processes. Deputy R. Labey 's proposition is an important first step toward this.

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Statement under Standing Order 37A [Presentation of comment relating to a proposition]

These comments were submitted to the States Greffe after the noon deadline as set out in Standing Order 37A in order for final review processes to be completed.