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2024.09.10
2.17 Deputy J. Renouf of St. Brelade of the Minister for Health and Social Services regarding the planned restructure of the Health and Community Services Department (OQ 159/2024):
Further to his recent speech at the Our Health in Our Hands' conference, will the Minister update the Assembly on his planned restructure of the Health and Community Services Department?
Deputy T.J.A. Binet of St. Saviour (The Minister for Health and Social Services):
Earlier in the summer I was invited to share my initial thoughts on the health service and articulate any views I had on how matters might be improved. I expressed my views accordingly and took the opportunity to share the transcript of what I said by email to all States Members. Since then, in conjunction with my Assistant Ministers and the lead policy officer, we have been in the process of refining our ideas, and recently we started to consult with more senior leaders in H.C.S. (Health and Community Services), and going forward we will be consulting with the wider health service. Once we are sure the ideas are workable and likely to deliver a more coherent service, we will look to present them to the Council of Ministers, Scrutiny and the wider Assembly before making them public. Just to put everyone's minds at rest, especially the large number of people working within H.C.S., the essential principles of the work do not vary much from what was said at the earlier conference and the incentives are mainly on creating a more inclusive and autonomous service, improving interaction with primary care, the charitable sector and public health, but the overall goal being to create a more seamless, efficient, interconnected and, perhaps quite importantly, a more contented service. I hope that helps to answer the Deputy 's question.
- Deputy J. Renouf :
Could the Minister offer reassurance that he will undertake full consultation on these proposals at the appropriate time? Could he also give a commitment that they will be the subject of a vote in the Assembly also at the appropriate time?
Deputy T.J.A. Binet :
On the first part of that question, I thought I had alluded to the fact that we have already started a consultation process. Secondly, whether it requires to come to the Assembly is yet to be defined. So it will depend entirely on the extent of any changes that are proposed. Fairly obviously, if those proposals require coming to the Assembly, then of course they will.
- Deputy I. Gardiner of St. Helier North :
Would the Minister advise what the timescale is for the proposed restructure? Deputy T.J.A. Binet :
I do not have a proposed timescale because this is work that is ongoing with other work, but we are proceeding as quickly as we can because we would like to get everything, if we can, organised, done and possibly in place within this Parliament. So we are just moving as quickly as we can.
- Deputy I. Gardiner :
We know that the turnaround team contracts will expire by the end of this year and we know that the contract for the current H.C.S. chief officer will expire shortly as well, within I think 6 months. Would the consultation be done, be ready before, and if recruitment process will take place?
Deputy T.J.A. Binet :
A little bit of a difficult one. All of those posts are currently under discussion and I think we are quite close to resolving them, but we need to be absolutely certain before we make any announcements. But they are being considered and dealt with at the moment.
- Deputy L.K.F. Stephenson of St. Mary , St. Ouen and St. Peter :
What steps is the Minister taking to ensure that he takes people - and that is staff, the public and this Assembly - with him on this journey so that all the hard work is not wasted come the next election?
Deputy T.J.A. Binet :
I do not think I can say anything more other than the fact that we have started a consultation process. We are going to be as thorough as we can and it is pointless trying to impose things on people that are not going to work or that are not going to be acceptable, so we will just work as hard as we can to make sure we do the job as well as we can.
- Deputy L.K.F. Stephenson :
What does the Minister believe is a realistic aim for him to have achieved on this matter by the end of this political term?
Deputy T.J.A. Binet :
I think I will refer to the comments I made earlier. We are looking ... the overall goal, as I said, is to create a more seamless, efficient, interconnected and more contented service, so those are our goals.
- Deputy H.L. Jeune of St. John , St. Lawrence and Trinity :
Within this restructuring, alongside that I believe the Minister in the past has promised a new strategy for health in the Island. Where is it and who is involved in the design and how does that interrelate with the restructuring and your vision that you have just outlined for what you would like to see in health?
Deputy T.J.A. Binet :
The development of a strategy is very much in its early stages. Unless you get the structure of something right, it would be a little bit like arranging the deckchairs on the deck when you have not fixed the hole at the bottom of the boat. So a strategy will emerge, but part of that strategy is designing a more inclusive and more cohesive service in the first instance.
- Deputy H.L. Jeune :
I am not sure if I would see this the same way. A strategy would be about what you would like the health service to deliver and then you would restructure according to what you would like to deliver, which would be outlined in a strategy. So I would like just to confirm with the Minister if there at least are some clear points that would come out before the restructuring so Islanders and the Assembly would know what kind of key areas for healthcare the Minister for Health and Social Services would like to focus on in his restructuring.
Deputy T.J.A. Binet :
I think this one is quite simple. We have obviously a different way of working. That would not be my approach. I have stated what my approach is. It is basically to restructure in the first instance and the strategy will evolve from there.
- Deputy J. Renouf :
Just perhaps a couple of clarifications. The last major reorganisation of the ... restructuring, rather, of the health service was P.19/2023, which was subject to a vote. The Minister availed himself of the opportunity to vote against it. So would he commit to a vote on the subsequent restructuring which seems to be implied by this? Could he clarify what will happen to the chief officer role, to the recruitment of the new chief officer if they are being recruited into a role that will fundamentally change should the restructuring go ahead?
Deputy T.J.A. Binet :
Sorry, could I just ask the Deputy to repeat the first part of that question to make sure I have it clear? Sorry to ask.
Deputy J. Renouf :
The previous restructuring was P.19/2023, which was brought to the Assembly, so would he commit to bring a similar restructuring to the Assembly?
Deputy T.J.A. Binet :
I will repeat what I said earlier. If the proposed restructuring is substantive and requires to come back to the Assembly, then of course it will. If there are only minor changes that do not require to come back, then they will not.
Deputy J. Renouf :
The second part of the question was the role of the chief officer, which might be changed quite dramatically after they are reappointed in the new year. So what contingencies or what does he have to comment about that potential situation?
Deputy T.J.A. Binet :
We are not quite at the point where we know whether that restructuring will involve one or 2 roles and I do not want to go into anything further than that at this stage. But as I said in answer to Deputy Gardiner 's question, those things are currently under review. Decisions are imminent but not yet made.