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STATEMENT TO BE MADE BY
THE CHAIR OF THE NEW HOSPITAL FACILITIES REVIEW PANEL ON TUESDAY 18TH MARCH 2025
The Chair of the New Hospital Facilities Review Panel will make a statement regarding the recent Review of the new Healthcare Facilities Programme.
Sir, I am pleased to have this opportunity to make a statement regarding the New Hospital Facilities scrutiny panel report, published on February 28th.
Last year in various debates relating to the new hospital, two messages came through loud and clear. Members wanted to get on and build a new hospital and they also wanted the scrutiny panel to continue to scrutinise the project. We have respected both of those imperatives.
We too want the hospital at Overdale to be built. However, the New Hospital Facilities Project - the NHFP - remains the single largest Government funded capital project in the Island's history, with significant implications for ongoing Government expenditure and future affordability of health delivery. Therefore, it needs scrutiny. It cannot be the case that "hospital fatigue" means that "anything goes". The implications of getting it wrong are just too serious.
Members will be aware that the government has moved from the single site "Our Hospital" project to a phased approach, aiming to deliver multiple facilities over a longer time period. We do not question the principle of that approach. However, the panel has uncovered a number of major issues with the implementation .
A key area of focus for the Panel has been on the Outline Business Case - the OBC - for the first phase of the NHFP, including the delivery of an acute facility at Overdale and "meaningful progress" on the non-acute elements of the NHFP. The OBC was shared with the panel in confidence.
The Government has stated that the OBC was developed in broad alignment with UK Treasury guidance and best practice - the so called "Green Book". However, following the Panel's own scrutiny and its engagement with an expert advisor, we believe that the OBC is far below the required standard. On multiple key issues it is not compliant with the Green Book, and therefore with best practice. It is important to note that this was the conclusion of the panel's expert advisers. The advisers own report, which we published as an appendix to the panel's report, lays bare the extent of the failings. The government argues that where it has not been compliant with the Green book, it is because some elements are not relevant to Jersey. Given the multiple failings identified in our report, this simply doesn't wash.
Therefore, at the most fundamental level, the Panel is not confident that the capital costs required to construct the proposed facilities will be met within the existing, agreed funding envelope for the NHFP. There is also a lack of detail about key aspects of the NHFP, particularly in relation to the proposed Kensington Place Ambulatory Facility.
Running costs for the NHFP appear to have been understated, particularly regarding staffing costs, which will have a significant impact on future affordability of the NHFP. The Panel has not seen evidence of a workforce strategy or health and care strategy and is therefore unclear about the decision-making that has informed key parts of the OBC, including whether the NHFP will match the future healthcare needs of Islanders.
The Panel has also not seen evidence of a mental health strategy to inform the proposed St Saviours Health Village and does not believe that a compelling case has been made for this facility.
The Panel is concerned about the extent to which the NHFP proposals have received sufficient internal challenge, including oversight by the Treasury and Exchequer in relation to the weaknesses of the OBC that have been highlighted by the Panel's review. It should not be left to a Scrutiny Panel to identify such fundamental failings with the OBC.
The Panel's report contains 34 Key Findings and 20 Recommendations.
I would particularly draw members attention to Recommendation 3 which asks the minister to confirm the intended uses for the Kensington Place Ambulatory Facility.
Also, Recommendation 15 requests that the minister provides information making clear how the ongoing revenue costs of the new hospital facilities will be afforded.
And Recommendation 18 points the way forward by asking the government to address the deficiencies regarding the OBC when they produce the Full Business Case - the final document prior to working beginning on construction at Overdale.
In terms of what we hope happens next, our report has outlined serious risks around whether future healthcare facilities will meet the health needs of the islands and whether they will be affordable. We therefore hope that the government looks closely at our findings and recommendations, and in particular takes steps to ensure the full business case does not suffer from the deficiencies of the OBC.
Finally, I'd like to take this opportunity to thank the minister and his team for their engagement with the panel. I'd also like to thank panel officers for their dedication and hard work in putting the report together. And I'd like to thank my fellow panel members for their work and their support for me in my role as chair.
I will now take questions on the report from Members.