Current hospital won’t be usable after December 2026

Thursday 12 August 2021

The current hospital will not be usable after December 2026, the Clinical Director for the new ‘Our Hospital’ project has said, warning that any politicians who suggest delaying it should take responsibility when there is no infrastructure to continue delivering healthcare for islanders.

Professor Ashok Handa’s comments came as the project team was being grilled about the new hospital's Outline Business Case (OBC) by the Future Hospital Review Panel.

Published last month, the OBC shows the Government wants to fund the £800m new hospital at Overdale through two bonds of £400m each - costing the island £1.4bn by the time they are paid off in 40 years.

While it explains funding requirements in depth, it doesn't propose exactly how the bonds would be paid back, noting that the "payment of the annual bond coupon is a new cost to Government and a funding source will need to be identified."

Pictured: Senator Farnham said the OBC was comprehensive enough for a political decision to be made.

The Scrutiny Panel, which is chaired by Senator Kristina Moore, launched its review shortly after the document, choosing to focus in the first phase on a “detailed expert analysis” of the OBC to ensure it met the required professional standards and provided the information needed to support the proposed cost and objectives of the Our Hospital Project.

Senator Moore questioned whether it would be best for States Members to have access to the full business case for the project ahead of the debate scheduled for October.

Deputy Chief Minister Senator Lyndon Farnham, who has political responsibility for the project, however said that the outline document was comprehensive enough for a political decision to be made.

“It covers the majority of the issues and then committed to fill in any gaps in information as it becomes available,” he said. “It covers the principles, the economic benefits and the medical benefits and the social benefits. I think it gives enough information on that for us to make a decision ,… whilst we can put some more detail around aspects of that the overarching principles and benefits are very clear.”

The Clinical Director for the 'Our Hospital' project then interjected, arguing that the decision was not only political but also clinical.

He said that the case for a new hospital had been “clearly” made and that there shouldn’t be any further delay to the project, warning that it could have dire consequences as the current hospital reaches the end of its life.

Pictured: Professor Handa is the Clinical Director for the 'Our Hospital' project.

“I’m really glad that the Scrutiny committee and the States Assembly and the Council of Ministers have all agreed that the case from the clinicians looking after the health of the island has clearly been made, and I think if we are saying we don’t have enough information now and want to delay the decision once again I think that will be something very difficult for the healthcare workers of the island to understand or indeed accept,” he said.

“On top of that, it will be the case that those who pushed that decision will need to take some responsibility when we get to 2026 and we don’t have the infrastructure to continue delivering healthcare to the 110,000 people who live in Jersey. I think that’s a very important clinical point which clearly has political implications.”

Later on in the hearing, Professor Handa said it would be “unacceptable” to continue using the hospital.

It followed questions from one of the panel advisors, Helen Pickering, Senior Director at Currie & Brown, who said that a ‘do nothing option’ should have been provided in the OBC to “prove value for money”, as is normal practice.

Professor Handa replied that the case for a new hospital had been made back in 2012 and that since then the need had become more “acute”. He also repeated that the current hospital would not be usable beyond December 2026.

“There are two issues,” Dr Handa added. “One is: ‘is it responsible of us in the healthcare to allow the infrastructure to simply fall apart?’ and we’ve given significant evidence, there is a risk register within HCS and we made it very clear at a number of these hearings that by December 2026 both the operational daily risks as well as the clinical risks are considered to be so significant that going beyond that without some reprovision is not acceptable.

"Hence, on the basis of that, we decided not to take forward 'do nothing' as an option because it’s not a realistic option in any way, shape or form, and that has been accepted by both the States Assembly and by the Scrutiny panel on more than one occasion.”

Pictured: It is currently expected that the new hospital will be completed by the end of 2026.

It is currently expected that the new hospital will be completed by the end of 2026, with Senator Farham having said in June that the team was working “very tightly to the overall target” of completing the hospital by then.

When Ms Pickering pressed for answers, arguing that the ‘do nothing’ approach should have been taken forward for “a baseline comparison”, the Clinical Director became agitated.

“I’m really sorry; what you are asking me to do is to put a price on the lives of patients in Jersey ... that’s what you are asking me to do, to say ‘what am I prepared to spend or not do for patients' lives to be at risk?’. It couldn’t be put any more simpler than that,” he said.

He then started asking Ms Pickering: “Could you tell us what number to put on the life or limb of a patient?” before being interrupted by Senator Moore, who rejected the question as inappropriate.

Martin Clark, Director of Healthcare Advisory at Currie & Brown, also noted in the hearing that while the OBC is quoted as “fully compliant” with HM Treasury Green Book - a key document setting out how governments should approach large-scale public investments – a number of elements were not fully compliant, with no explanation as to why.