Proposed reorganisation of health services

2025.02.25

3.14   Deputy J. Renouf of St. Brelade of the Minister for Health and Social Services regarding a lack of public consultation in his proposed reorganisation of health services (OQ.52/2025):

Further to his response to Written Question 18/2025, will the Minister explain why he does not plan to hold a public consultation on his proposed reorganisation of health services?

Deputy T.J.A. Binet of St. Saviour (The Minister for Health and Social Services):

I thank the Deputy for his question. I have to confess to being a little confused, because I think my response to the Written Question 18/2025 is particularly well detailed, so I am not at all sure what it is that the Deputy considers should be put out for public consultation. It may be helpful to me to be able to answer the question comprehensively if he would be kind enough to explain exactly what form that would take.

Deputy J. Renouf : Sir, I …

The Bailiff :

Yes, the question has been allowed in its current form. It may be easier, but are you not in a position to answer the question as put, Minister?

Deputy T.J.A. Binet :

Well, are we really going to go and consult with 100,000 people about internal changes? I have tried to make some inquiries as to similar situations, and in similar situations to this it would not go to public consultation. That is why I simply ask whether the Deputy would be kind enough to explain, given that I did answer the written question comprehensively, what part of that he thinks is appropriate to go to public consultation. We have 2 pieces of work. One is work that we have already done, and it seems to me to be perfectly in order to have done, and that is transferring policy and certain other areas into the health service. We have looked to appoint a director of finance and digital services and H.R. (human resources) and hopefully, in time, procurement. What part of that should we be taking to the public? We are looking to put a board in place; a partnership board. I am just mindful that, under the previous Government, we introduced an advisory board, and I do not recall Deputy Renouf standing up and saying that that should go to public consultation. Perhaps the Deputy would be kind enough to explain what it is about this scenario that is different to the last.

The Bailiff :

No, Minister. It is not for the Ministerial responder to ask a question unless it is an obscure question in the first place. As the Chair is speaking, perhaps do not speak at this moment.

Deputy T.J.A. Binet : Sorry.

The Bailiff :

It seems to me that what you are in effect saying - and please correct me if I am wrong - is that, in your view - and it is backed up by the information that you have provided in answer to the written question - there are no areas which you think would be appropriate for public consultation. Is that a correct characterisation of your answer, or is it not?

It is indeed, and I apologise for not putting it as succinctly as you have, Sir.

1. Deputy J. Renouf :

The reason I think that we would want this to go to public consultation is that it is the most fundamental reorganisation of health service delivery, certainly that I can remember, and therefore it might be appropriate. In particular, it might be appropriate because on 31st July 2024, the Minister wrote to the new Hospital Review Panel saying that, and I quote: “It is anticipated that these proposals for structural reform will be published for public consultation in Q4 2024.” Six months ago, a consultation was planned, but now it is not. What has changed?

Deputy T.J.A. Binet :

I have to give the Deputy points for finding that; I do not know how I came to have said that there was going to be a public consultation. It was probably an error to have said that, for which I apologise, because I cannot see an instance why I would have suggested that. But I make the point that it is not appropriate for public consultation, and if I made an error in saying that, perhaps what I was meaning to say was it would be there for public consumption rather than consultation. Because I cannot think of a point in time at which I would have thought that it was an appropriate course of action.

2. Deputy I. Gardiner of St. Helier North :

At the same public hearing to the Public Accounts Committee from the chief executive … I am reading through the transcript. “It is a policy under development, the organisational concept in which we try to integrate health services.” Does the Minister consider this work, as the chief executive considers, policy under development?

Deputy T.J.A. Binet :

It is under development until such time as it is all through. You do not reach a point in time where you suddenly make an arbitrary decision to stop talking to people; so it is constantly under development and it is going through various stages, so that is correct.

3. Deputy I. Gardiner :

Thank you to the Minister for confirming that reorganisation of the health service is the policy under development. According to the guidelines, any policy under development within the Government of Jersey when public money is involved requires public consultation. Does the Minister agree with the Government’s guidelines, or would he like to change them?

Deputy T.J.A. Binet :

Without access to those guidelines, as we speak, I cannot say that that is not a fact, but it is not appropriate under the circumstances. I can certainly take a look at those guidelines and see where we go from here. I still do not think it is appropriate.

3.14.3   Deputy J. Renouf :

The Assembly would usually regard it as entirely unremarkable for there to be a public consultation on matters that are so fundamental to the delivery of health services in the Island. The Minister has confirmed that he has not asked his former chief officer about these changes, even though he is paying him quite a lot of money to be an adviser. He has not read the Government’s guidelines on consultations, and yet he is absolutely sure that he should not be holding a public consultation. Will he please review his attitude to consultation and consider whether the public might have an interest in hearing more about this and involving themselves in the consultation process?

Deputy T.J.A. Binet :

I would like the Deputy to withdraw his comment that I have not consulted with the former chief executive. That is not correct, and I do not think it is fair to say so. In terms of reviewing my approach to this, not at all. What I will be doing … I phoned the Policy Department after the question from Deputy Gardiner and suggested that we organise another briefing, because there seems to be a relatively small number of Members that seem unable to get their head around what is being proposed. What we are actually doing is just trying to support health professionals to provide a better service. The nature of the questioning this morning, you would think that there is something criminal about what is happening, not that we are trying to improve things for patients. I do intend to organise another briefing for Members so that we can get matters a lot clearer, but I do not intend to change the course of events going forward.

The Bailiff :

Very well. That brings all the questions to an end. There were 2 questions deferred to the end for Deputy Ozouf ; he is not present in the Assembly. Once I close the question period, that must bring the matter to an end. And as if by magic. [Laughter] Morning, Deputy . Are you ready to answer the 2 questions …

Deputy P.F.C. Ozouf of St. Saviour :

If I may just have a few moments to collect my things, Sir. Please, if I may. I am not ready at this …

The Bailiff :

I could quite happily look at my papers for a minute or 2, if Members would agree. Deputy P.F.C. Ozouf :

I apologise, Sir; I am one of those people that deals with some of the health issues that have been referred to earlier. Thank you for the forbearance of you and the Assembly, Sir.

The Bailiff :

We are now starting with Question 1 on the Order Paper. Deputy P.F.C. Ozouf :

Yes, if I may.

The Bailiff :

Yes, please do ask your question.