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WRITTEN QUESTION TO THE MINISTER FOR HEALTH AND SOCIAL SERVICES BY DEPUTY R.G. LE HERISSIER OF ST. SAVIOUR
ANSWER TO BE TABLED ON TUESDAY 8th SEPTEMBER 2009
Question
Would the Minister explain the precise process that was followed in her Department to formulate the proposed programme of spending cuts which were announced before the summer break setting out clearly the personal involvement that she and her Assistant Ministers had at each stage?
Answer
The following information provides a timeline for the precise process that was followed by the H&SS Department in formulating the proposed programme of spending cuts which were announced before the summer break. The personal involvement of the Minister or Assistant Ministers is identified at the appropriate stages (Initials of Minister and Assistant Ministers present identified in brackets).
4th February – Specially convened Senior Management Team (SMT) meeting where the Finance Director presented the 2009 financial forecast and identified continuing underlying cost pressures.
19th May- As part of the formal finance report the Finance Director reiterated that in light of the discussed service risks the financial position for 2010 needed to be seriously considered and reassessed if H&SS was to mitigate
these risks and remain within its cashlimit.
All SMT members were formally requested to identify (based on their professional opinion) the ten "lowest priority service areas" with regard to risk to patient life/urgent care. These were to be forwarded to the Finance
Director by 21st May with the Chief Officer receiving the summarised information by 26th May.
23rd June – SMT meeting where it was agreed that service prioritisation would be undertaken in a workshop environment and that the Minister would be kept informed of developments.
26th June- Chief Officer informed the Minister and Assistant Ministers, by e mail, of the need to inform the States of the possible cuts in services required so as to divert funds into high risk emergency services. He
emphasised the requirement to function within budget and confirmed details of the forthcoming SMT service prioritisation workshop. (AP, EN, JM)
30th June- SMT members participated in a workshop to categorise services into:-
Those which were considered low risk (score 1)
Those where more information was required before a decision could be made (score 2) Those which were considered high risk to cease. (score 3)
The services analysed at the workshop were identified by the Directorate managers as having the least impact within their service if cut or reduced. The workshop split the SMT into teams of 3 and utilised a scoring mechanism from 1 to 3 (see above) in order to allow an objective approach to service reprioritisation. Teams were instructed to consider life saving impact, social impact and funding released before allocating a score. Scores were submitted by each team and Directorate managers could provide information but not score their own services. Where a score of 2 was given, further information was gathered so that a score of 1 or 3 could be allocated. The final culmination of scores allowed the services to be listed in rank order, with those with lowest scores deemed the lowest risk to cut.
The amount identified as possible/achievable by the SMT was, in total circa the same amount that was required to
deliver the CoM pro rata savings and provide investment for the other estimated operational risks.
6th July- Weekly Minister's meeting (meeting chaired by Deputy Edward Noel as Minister was on annual leave). The consolidated outcome of the SMT workshop was presented to the Assistant Ministers. Deputy Noel was keen
to ensure that there were no other "low priority" services that could be considered. A meeting for July 8th was arranged whereby the Minister, Assistant Ministers and Finance Director could look more closely at the workshop
outcomes. The Chief Officer highlighted how crucial the prioritisation work was in producing the 2010 Business Plan which should be explicit and transparent. (EN, JM)
8th July- Initial findings of the Nurse Staffing review presented to H&SS Minister. (AP, EN)
8th July- Minister and Assistant Ministers met with Finance Director to consider the list of lowest priority services to be disinvested in to release funds for investment to manage risks. It was identified that there were
considerable political difficulties associated with many of the proposed service reductions at that stage and further information was requested. (AP, EN, JM)
10th July- Weekly Minister's meeting- Finance Director reported difficulties in finalising the 2010 Business Plan due to financial deficits remaining even after cutting the lowest priority services. The Chief Officer advised
identifying further service cuts to ensure that the remaining services are appropriately funded but that H&SS had
to submit the draft situation to enable Treasury to prepare for the briefing to States Members on the 20th July. 10th July- H&SS submitted draft business plan cashlimit reconciliation to Treasury Officers.
13th July- H&SS submitted pages signed by Accounting Officer in accordance with business planning process. 16th July- Chief Officer provided a report for the Minister called "Reconciliation of Expenditure". This was to
support MD-HSS-2009-0041- Reconciliation of Revenue Expenditure which the Minister did not sign.
21st July- Draft Business Plan was sent to SMT members
23rd July- H&SS Chief Officer presented highlights from the Business Plan to staff and took Question and Answers.
27th July- Weekly Minister's meeting- A discussion took place regarding a timeline for service reprioritisation and the requirement for preparation for the Minister's presentation to States members on 3rd September. (AP)