Letter - Open Letter to Deputy Chief Minister - 18 March 2021

States Greffe: Scrutiny

Senator Lyndon Farnham Deputy Chief Minister

By Email

18th March 2021

Dear Deputy Chief Minister,

Ongoing Scrutiny Our Hospital

The Future Hospital Review Panel is writing this open letter to you in relation to our ongoing scrutiny of the Our Hospital project to seek clarification on a number of issues and to highlight our concerns about comments made in the media regarding this Panel's work.

The Panel also notes the publication on Friday 12th March of the Chief Minister's response to our Review of the Future Hospital Site Selection Process (S.R.9/2020). The Panel will discuss and comment on the response to its recommendations in due course.

The Role of Scrutiny in holding Government to Account

You will recall the Council of Ministers lodged a notice au Greffe requesting an additional meeting of the States on 1st February 2021 to debate Our Hospital: Preferred Access Route' (P.167/2020). The Panel was made aware of this on 28th January 2021 and this revised timeline forced the Panel to bring forward its report at a critical time at almost no notice and as a direct consequence, resulted in important due processes in the production of Scrutiny reports being significantly compromised, or in some cases, regrettably not implemented at all. The Panel was unable to adequately set out and analyse the evidence gratefully received from a range of stakeholders, or even include important issues such as information discussed at the recent public hearing and additional background in order to present its report in time for the debate. The Panel's advisers' reports were similarly compromised and were forced to be submitted in advance of their due date. It was not possible for the Panel to hold the anticipated meetings with the advisers to consider both reports. This compromised situation caused by the Council of Ministers is an extremely concerning precedent on many levels, not least the reputational damage to the States Assembly – especially but not limited to those members of our  community  who  have  engaged  with  the  Assembly's  Scrutiny  process.  It  was  quite avoidable and the benefits of bringing the debate forward a week earlier remain unclear.

We would also take this opportunity to express our concern about comments you made to ITV Channel prior to the debate in February in which you claimed that Scrutiny had been disingenuous' and uncooperative'. This Panel, and indeed all Scrutiny Panels, takes its role extremely seriously and is focused on scrutinising Government policy and decisions on behalf of the electorate and in the best interests of governance. The Future Hospital Scrutiny Panel has been elected to hold the Council of Ministers and the Deputy Chief Minister to account for this hugely important project and we will continue to do so. We have always followed the

States Greffe | Morier House | St Helier | Jersey | JE1 1DD Tel: 01534 441080 | Fax: 01534 441077 | email: scrutiny@gov.je

Scrutiny process in line with Standing Orders and the rules of the States Assembly and we refute these comments unreservedly.

Update on the OH work timetable

You may recall we recently wrote to you asking if you could provide an update to the OH work programme. We have yet to receive this and would be grateful if you could provide this as soon as possible. In addition, we were recently made aware of a briefing which took place providing an update on the modifications of the access road, showing proposed changes to the original plan. The Panel is disappointed it was not offered the opportunity to join in this briefing and would like to receive the same briefing as soon as possible. The Panel is aware of the Community Consultation website https://ourhospital.je/community however, to receive this information when it is in the public domain we believe undermines the trust of the Review Panel and is discourteous to the work of Scrutiny.

Government meeting the terms of the Panel's amendment

You will be aware the terms of the Panels amendment to P.123/2020 Our Hospital Site Selection; Overdale makes reference to request the Council of Ministers to present a report to the States prior to lodging any proposition seeking the Assembly's approval of the Outline Business Case. We understand the Outline Business Case is not due to be lodged until May 2021 however, there is reference within our amendment to include an obligation for the Council of Ministers to bring a report back to the States Assembly by March 2021. Could you provide the Panel with this report by the end of March 2021 in line with these terms.

Provision of Services

We have been made aware that some services, currently carried out free of charge at the existing site, may move to user pays' once the new site is in use. Could you provide a list of any services that are proposed to be user pays' at the new site. We have also been made aware that some services, currently carried out at the existing site, may be moved to out of town locations once the new site is in use. Could you also provide a list of the services that will no longer be carried out at the existing site and may be moved to other locations. We would also be grateful if you could provide details of how these relocated services will be funded, if not carried out at the new hospital under that budget.

Overdale decant to Les Quennevais

The cost of moving the services from Overdale to Les Quennevais is due to come from the existing budget for the new hospital. Could you provide the Panel with an updated cost and timescale for the decant of services from Overdale to Les Quennevais. Could you also provide us with an update on progress since your announcement in the media advising of this plan on 18th January 2021. We note from your media announcement that facilities will be moved back to the new hospital site when it opens. Could you confirm this is still the case or if any services will continue to be carried out at Les Quennevais.

Green, Sustainable Travel

We note you have recently launched a survey where Islanders are being invited to give their feedback as part of a travel survey to help shape the planning and design of Jersey's new hospital. One of the areas this Panel focused on throughout its reviews into the OH Project has been consideration of sustainable travel and a green travel plan. While this new survey is welcome, we are concerned that a green travel plan was not considered earlier in the OH process and potentially helping to inform February's debate on the preferred access route. The Panel is keen to understand what steps are being taken to ensure those travelling to and from the hospital do so in the most sustainable way possible and why was this not considered sooner?

Could you confirm if you are planning on developing a full green travel plan and if so, other than the survey, what methodology will be used and how will this be benchmarked with best practice.

Overall engagement with the Public

Within R.54/2019, Our Hospital Project; Next Steps, it is stated "Engagement to enable staff and the Public to know the progress being made and the decisions being taken on a regular basis". [1] The Panel received written submissions from members of the public for both its reviews on the OH Project and the lack of communication from Government to the public was a key theme. The Panel is aware that public consultation did take place for the site selection process, however disappointedly, all of the consultation was done during the site analysis stage with none being carried out for the access route stage of the project. The Panel listed this as a key finding within its report S.R.9.2020 - Future Hospital Site Selection Process and made the recommendation the Council of Ministers should provide a copy of the public/key stakeholder engagement the GoJ plans to undertake and that it should be publicised on the States Website/social media. Could you let the Panel know when this will be available.

The Functional Brief

Could you provide details of how the Functional Brief has been benchmarked eg does it follow HM Treasury Green Book Standards and if not, could you advise which criteria has been used in its development. The Panel would also be grateful if you could provide details of how the Functional Brief links into the vision for the future of healthcare on the Island under the Jersey Care Model (JCM), as recently approved by the States Assembly. In addition, could you provide details of how the Functional Brief was measured against the JCM.

In-patient Bedrooms

The Panel notes 75% of adult inpatient bedrooms will be single occupancy, the remainder will be configured in four-bed bays. All single bedrooms will incorporate full coverage ceiling- mounted hoists moving through to en-suite facilities.[2]. We are keen to understand how this percentage was arrived at to ensure it is adequate for the needs of the Island. Can you provide the Panel with the methodology used to arrive at this and the criteria used.

Private Patient Facility

We note within the Functional Brief there is a proposed private unit with a discreet pathway into the building being provided for private or self-funding patients. Whilst we note the escalation and expansion plans will include repurposing of the private patient facility for public patients, should it be required in the future, we are concerned tax payers money is being used, in effect, to build a private hospital wing. Could you provide us with details of the costs of building this facility, how the costs will be recouped to the tax payer and how much per annum it is likely to generate.

Schedule of Accommodation (SOA)

The  Panel  is  aware  the  Functional  Brief  is  an  outline  initial  assessment  of  the  likely accommodation required and the way in which that accommodation will be arranged however, there does not seem to be a SOA within the proposed document. Could you provide this so that we can review the SOA plans against the wording within the Functional Brief. In addition, there does not seem to be a breakdown of each of the clinical areas. Could you also provide this detail to the Panel.

Office Space

The Functional Brief states that "..Seminar/meeting rooms will be centralised within the central administration area, the central staff zones, knowledge and research areas and within reach of certain clinical departments.."[3]. It also states "..within a central administration area, two person offices will be provided for consultants and hospital clinical leadership, supported by zoned open plan office facilities for medical secretarial staff.."[4] Could you provide the Panel with a cost breakdown for the office accommodation layout as proposed versus a standard office block with a bridge link to the hospital (or similar). The Panel is concerned valuable space within the new hospital building may be taken up with office and administration unnecessarily.

Information Management and Technology (IM&T)

We note the IM&T is due to be developed by the IM&T consultants and will be dependent upon developments in technology and improvements in clinical IM&T. Could you provide the Panel with a plan of how far this has progressed in its development with the cost implications for its operation.

Cost and Maintenance of the Functional Brief

Could you provide the Panel with the maintenance programme and the ongoing maintenance costs for the Functional Brief as proposed.

We look forward to hearing from you. Yours sincerely

Senator Kristina Moore

Chair

Future Hospital Review Panel

[1] R.54/2019 New Hospital Project: Next Steps

[2] OH Functional Brief – page 67

[3] OH Functional Brief page 33

[4] OH Functional Brief page 33