The official version of this document can be found via the PDF button.
The below content has been automatically generated from the original PDF and some formatting may have been lost, therefore it should not be relied upon to extract citations or propose amendments.
August 17th 2021
P/80/2021 Letter to Scrutiny
Concerns regarding the Outline Business Case and Funding for the Our Hospital Project
Thank you for the opportunity to comment on the Outline Business Case and Funding for the Our Hospital Project
Whilst acknowledging the need for a new Hospital for Jersey, the selection of Overdale as the site for the new Hospital (as a result of a skewed'site selection process, and the omission of Warwick Farm and St Saviours Hospital) has led to the following concerns:
Costs and escalating costs which will burden the Island and future generations. The initial sum was an exorbitant £550 million with a £250 million contingency. It is now £804.5 million with the contingency used up. How has this figure been arrived at, especially as the design is not finalised? An increase of £250 million in 10 months? The sum is too great. The project appears out of control. 'and would seem to be Contractor-led to maximise profit rather than providing the most cost –effective solution for the Island. We should be looking at a more reasonable alternative. £804.5 million is neither realistic (more than double that of Central London) nor affordable. We should not be contemplating such a level of expenditure or debt, especially in these uncertain times, post Brexit and Covid 19, and with the future of the Finance sector being questionable. Interest repayments will detract from the money being available for patient care. How will the Island ever repay the capital? The proposed debt strategy, making assumptions and predications of interest rates over the next 40 years, borrowing in an attempt to make money for the Strategic Reserve fund, would seem risky and unwise, akin to gambling' with the Island's finances and jeopardising Jersey's credit rating.
Bowling Club relocation Crematorium relocation
The Super Highway' and the Road alterations, including loss of parking and destruction of the perimeter of People's Park. Islanders do NOT want this, but the Project Team is insistent on ploughing ahead, without taking their views into consideration.
The loss of 14 homes c.f. the promised 3 homes. Again, costs have escalated from the £16.6 million, agreed by the States in November 2020, to £34. 3 million. Why did the Treasury Minister approve an additional £18million for the last 3 months without reference back to the States?
Problems with building on the Rondel Field and Field 1550
The decant to Les Quennevais old school - escalating costs (£5 million to £17 million) Is this where Islanders want to receive their care? Why is it proposed to knock down the Poplars Centre, the William Knott and Westmount buildings?
- How can the fixed doughnut – shape' design of the main building be expanded in the future, and what consideration has been given to a Passive Haus' type design?
- The Our Hospital Functional Brief (version 6.1) was completed by MJ Medical in
November 2020. This was without proper consultation and without reference to the needs or preferences of Islanders. Indeed, it would seem that all decisions regarding the Our Hospital Project have been made by a very small group of individuals (all Hospital Based.) The Public have been excluded.
- Despite the Jersey Care Model having been voted through by the current States Assembly, there are serious doubts as to how it will be affordable and sustainable on the Island, The Care Model and Functional Brief have impacted on the design of the Our Hospital Project, resulting in an Acute Hospital and many unanswered questions as to what services/facilities are to be provided. It is irresponsible to be knocking down perfectly reasonable buildings at Overdale and have no plan where Islanders will receive care for long term conditions in the future.
Questions:
What services will patients be able to access in Outpatients? Will we have a proper Eye Department like we have now?
Is there a Dermatology Department?
Is there a Dental surgery, so that those with head and neck cancer or facial trauma can be treated?
Why is there no Rehabilitation Ward ?
Why No Occupational Therapy or Physiotherapy Departments? Why No hydrotherapy pool?
What are the bed numbers?
What will the inside of the Mental Health Unit and the Education Centre be like?
Worryingly, we have heard that alterations to the design, currently being made, are resulting in reductions in the size of some departments e.g. the renal unit, which will no longer have the necessary number of essential isolation rooms. Meanwhile there seems much wasted' space in the design, e.g. atria, which could serve a more functional and useful purpose.
In their Amendment of p/123/2020, the Future Hospital Review Panel asked the following:
"(b) 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 for the new Hospital, to contain the following –
- the performance detail from the demand-modelling with all key demand and capacity assumptions linked to the sizing of the new hospital and how this links to the role and function of health facilities as set out in the Jersey Care Model;
- a statement by clinical specialty that senior clinical representatives have agreed and signed off their respective departments, both room areas via the Schedule of accommodation, and drawings that match the latest hospital plans;
- the proposed hospital total area including all main hospital street communication corridors, department circulation and non-roof plant, in order to provide a total inclusive Schedule of Accommodation;
- the calculations for all project cost including non-works costs, equipment costs, non- medical costs (including the whole life transport solution), inflation, optimism bias, a clear split of all project contingencies, the premium costs for materials and confirmation that all "current exclusion" are subject to at least the latest provisional sums;
- an analysis that the aligned programme has taken account of both the programme impact, Covid-19 and Brexit;
- a full breakdown of the assumptions and amounts for recurring savings supporting the overall affordability of the project for both capital and clinical/support revenue; and
- forecast Cost at Completion, broken down into components identified in Paragraph 6 of the report accompanying this proposition."
FUTURE HOSPITAL REVIEW PANEL
In view of this amendment, please could Scrutiny ensure that the above have been carried out and also consider the following:
As it stands, the proposition, P/80/2021 contains many numerical discrepancies which need correction before it is debated, together with clarification of what the budget is to pay for, what is not included in the price and a detailed breakdown of all the costs involved.
How can the States be asked to vote money when they do not know what they are paying for?
A precise specification to be made available and Public Consultation to take place to ensure that the new Hospital contains all the components that Islanders need.
When such a specification has been completed, then the Project should be put out to competitive tender.
The other two sites in Public ownership notably Warwick Farm and St Saviours' Hospital to be properly costed as comparison new build sites. If either were to be used, then all the facilities at Overdale could remain in use, with retention of the Westmount Building (and Samares Ward ) the Poplars Day Centre and the William Knott Building. The Overdale site could be enhanced for a really great rehabilitation area. Considerable financial savings could be made as the decant to Les Quennevais would not be unnecessary, no new road, no removal of the Bowling Club, the Crematorium, no alteration of the perimeter of People's Park or the inner road network.
Plans were drawn up in 2016 for an entire Hospital at Overdale, with retention of the Westmount Building, Poplars Centre and William Knott and with the Education Centre remaining at Gloucester Street. Please could these be re-examined.
Consideration should also be given to refurbishing Westaway Court for junior doctor and nurse accommodation, together with refurbishing the houses at St Saviour's Hospital as family homes for Health workers.
The Clinical Lead stated in a recent Scrutiny Hearing that the current Hospital will be unusable after 2026.' Such a comment is unhelpful, scaremongering and untrue, and puts unwarranted pressure on States members to vote through a new Hospital which will leave the Island worse off financially and also in terms of facilities and services. This project is being unreasonably, 'rushed through.'
What is proposed is too expensive and does not provide all the services and facilities that Islanders need.
P/80/2021 should be rejected. Andy Howell