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2024.05.21
Deputy J. Renouf of the Minister for Health and Social Services regarding improving the clinical
standards and governance in the delivery of health services. (OQ.95/2024)
Will the Minister provide an update on any plans he has to improve clinical standards and governance in the delivery of health services?
Deputy T. Binet of St. Saviour (The Minister for Health and Social Services):
Following the release of the Mascie- Taylor report and subsequent Royal College reviews, a great deal of effort has been expended by H.C.S. (Health and Community Services) to improve clinical standards and governance. In June last year, they implemented a policy that mandated staff to follow N.I.C.E. (National Institute for Health and Care Excellence) guidelines and Royal College guidance. A good deal else is going on in this area so, in answer to the Deputy ’s question, I have to report that I have not added any further requirements to this already substantial body of work. Given all of the other pressures involved in catching up with a long period of underinvestment and a leadership that has not kept pace, I did not think that would be helpful. What I am trying to do is to ensure that the organisation is properly resourced and that it is provided with as much support as possible to implement the objectives that are already in hand.
- Deputy J. Renouf :
It has been reported this morning that the clinical lead of the turnaround team has resigned. This is surely a significant blow, coming as it does after the departure of the chair of the board. So can the Minister outline what concrete steps he plans to take now to improve clinical standards?
Deputy T. Binet :
I genuinely do not think I have got anything to add to what I have already said. There is a great deal of work going on within an organisation that needs a fair amount of attention and some restructuring. I think the body of work that they have got - that they are involved with now - to implement the governance that they have chosen to adopt is going to be a job in itself, so I am certainly not planning to add anything to that.
- Deputy L.K.F. Stephenson :
During a debate on P.20 last month, the Minister stated: “I am afraid to say that for me it is all about money and precious little else.” Today we read on the front page of the J.E.P. (Jersey Evening Post) that the clinical lead for the turnaround team has left, citing a lack of support from the Minister and his department to improve standards. Does the Minister believe such a narrow focus on money risks him failing to prioritise improving clinical standards and governance within his department at what is a critical time? If not, can he provide examples of how he is working to stop it doing so?
Deputy T. Binet :
There is quite a lot in that in that question. I have said that it is all about money, because at the end of the day without money you can do nothing; I stand by that. If you have not got money, you cannot. The Deputy herself at the last Assembly proposed I.V.F. (in vitro fertilisation) treatment and that is going to add something in the order of £1 million to the bill. There are a huge number of pressures of a financial nature and without money we can do nothing. But it would be wrong to say that I am only focusing on the area under discussion; I am also doing a lot of work with Public Health on illness prevention and I hope to come back to the Assembly on that in due course. Of course, dealing with the £18 million deficit and the additional expenditure that we keep laying on to the health service has to be dealt with. The digital situation at the moment requires a lot of attention because we are trying to bring digital up to date and make it suitable for working with the new hospital facilities. It is a big body of work in itself. On looking at it, I think there is some restructuring of the entire health service that needs to be done. There is a lot of work going on apart from governance.
- Deputy L.K.F. Stephenson :
I am pleased to hear that £1 million will be invested in I.V.F. healthcare. It is certainly almost double the figures I have heard being talked about, but £1 million would be excellent, thank you, Minister. Can the Minister therefore state what is his number one priority for health during his term of office? Is it balancing the budget or is it improving clinical standards and governance?
[10:45]
Deputy T. Binet :
I would suggest it is a combination of both.
- Deputy H.L. Jeune :
Could the Minister explain the reasons for the departure of the clinical lead and how the Minister intends to improve clinical standards in the absence of this lead in the turnaround team?
Deputy T. Binet :
I am not entirely sure, if I may, that that relates to the nature of the question, what am I doing to improve clinical standards and governance? But if you would like to allow the question, I am ...
The Deputy Bailiff :
I think it is relevant to the question and it is a development which is relevant to the question, so I allow the question.
Deputy T. Binet :
I have to say I am quite bemused by the departure of this particular individual with whom I have only had one proper meeting at his request. There were 5 people in the room at the time and the other 4 are equally bemused, so I really do not know what lies behind his decision. I would be perfectly happy for him to stay on; I have offered to meet him on Friday for that purpose. The offer has been refused. He was planning on reducing his hours, in any event, because his contract ends at the end of the year and he wanted less time. We will simply be looking to replace him.
- Deputy H.L. Jeune :
Could the Minister provide some words of comfort to the remaining members of the turnaround team and their H.C.S. board that he has confidence in them to deliver the necessary improvements in clinical standards and governance, and does he have full confidence in the board - executive and non-executive members - to do this?
Deputy T. Binet :
Yes. I think I said at the last Assembly that I had a full confidence in the board and the board opened their last meeting by confirming that they had full confidence in me after the departure of the short-term chairman. Yes, I think relations are good with the remainder of the team. Only time will tell - we are only 16 weeks in - but I have to say at this point time, yes, I am comfortable.
- Deputy I. Gardiner :
The Minister mentioned the deficit and the finance of the department. What work is ongoing to deliver the financial recovery plan that could deliver vital savings while maintaining clinical standards?
Deputy T. Binet :
There is a great deal of work going on, and I make the point that I know 16 weeks might seem like a long time, but it is not, so I spent a considerable amount of time with the people dealing with the finances trying to build with them a complete picture as to where the deficit arises from. The truth is, if we make the £18 million worth of cuts that we would need to meet the budget at this point in time I think it would do severe damage to the health service. I think I will be coming back to the Assembly at some point in time to address that, but it is early days.
- Deputy I. Gardiner :
Thank you to the Minister for his reassurance that he is working on the recovery plan. He mentioned early days - we have 3 months - and when will the Minister be able to share with the Assembly recovery plans or any other plans that he has in place? But they should be practical ones for clinical standards and financial recovery.
Deputy T. Binet :
I think that will have to be done in stages over the course of time. It is a big body of work and I cannot certainly put it ... in terms of where we are complete with the finances, I can only come back to the Assembly when we are ready to do so, and I will make that as soon as possible.
- Deputy J. Renouf :
The Minister has several leadership posts to fill in H.C.S: the chair of the board, of course, the H.C.S. interim H.R. (Human Resources) director also left recently and now, of course, the clinical lead. They are all critical to improving clinical standards and governance. What would he say to prospective applicants to attract them to these roles, to reassure them that they will find working with the Minister a rewarding experience and that their professional opinion will be respected?
Deputy T. Binet :
I do not think there is anything particular I could say, other than that we are in exciting times and there is a good collection of people working together with a determination to improve matters. I would just remind Members that one or 2 people might leave over the course of time, but I deal with dozens of people, possibly hundreds, and by and large I get on very well with them. I do not think there is a systemic problem of any sort.