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A new watchdog report has savaged the methods used by the review that led to the scrapping of the £800m plan for a new hospital at Overdale – and suggested that the Government’s new project timeline isn’t realistic.
Published today, the critical review by Comptroller and Auditor General Lynn Pamment also estimates the money already written off on previous hospital projects in the island at more than £38 million – and warns that this could rise even further.
The Government based its decision to abandon the previous administration's single-site project at Overdale on a £30,000 review led by Infrastructure Minister Tom Binet, and Expert Adviser Alan Moore, who did not face any competition for the role, having been appointed after carrying out previous work for the Government.
Pictured: The Comptroller and Auditor General, Lynn Pamment.
That review was the result of a pledge by Chief Minister Kristina Moore in her '100 Day Plan'and led the Government to conclude that it would instead build health facilities across multiple sites as part of a new project called the 'New Healthcare Facilities Programme'.
In her report, Ms Pamment said it was hard to see how the review "could have been expected to uncover new and meaningful information". She said there was a "lack of clarity" around the new plan.
She also described the checks and balances around the previous £800m 'Our Hospital' project as "strong", whereas she said the new project approach lacked rigour and queried the timelines it had set out.
She also highlighted significant gaps in information and costed plans available to ensure that the New Healthcare Facilities Programme could be "right-sized" from the start and sufficiently future proofed.
Pictured: The checks and balances around the previous £800m 'Our Hospital' project were described in the report as "strong".
The C&AG expressed particular reservations about a number of aspects of the review conducted last year, noting that, while some of the success factors it used to assess proposals cover the same ground as those used for the Our Hospital project at Overdale, others had not previously been identified as priorities.
"It is not clear how the critical success factors for the review were decided on and the appraisal process demonstrates some limitations," the report states.
Ms Pamment was also critical of the consultation process used in the latest review. It involved 25 meetings with 60 stakeholders, most held over a three-day period.
She said the meetings "acted more like communication meetings than open consultation".
Following the C&AG's comments, Infrastructure Minister Tom Binet defended his review as a "necessary but rapid appraisal of the Our Hospital project".
"I am mindful of the Comptroller's comments that the review was 'over ambitious', but I remain convinced that we needed to set out a clear direction for the project team and islanders that we would deliver the facilities they need, while appropriately managing the risks and impact on both our finances and the environment," he said.
Pictured: Infrastructure Minister Tom Binet defended his review as a "necessary but rapid appraisal of the Our Hospital project".
Addressing concerns over timelines, he added: "The team have been working hard to meet the timeline that Ministers have set, and I will be ensuring they are given appropriate time to develop and consult on the Feasibility Studies and functional brief, as recommended by the Comptroller."
Health Minister Deputy Karen Wilson previously acknowledged that health staff lacked enthusiasm about kickstarting the hospital project for a third time.
Following the C&AG's report, she said: "Effective and open consultation with clinicians and other healthcare staff is essential to producing a robust functional brief and delivering the healthcare facilities that the Island desperately needs.
Pictured: The Health Minister previously acknowledged the lack of enthusiasm about the hospital project among health staff.
"I will work with my Ministerial colleagues to ensure that while we pursue a strict timeline and cost-effective project delivery, the needs of patients and clinicians remain foremost in the minds of all involved in the Programme."
As part of her review, Ms Pamment made several recommendations to improve governance around the project.
Chief Minister Kristina Moore said this morning that many were in the process of being implemented. In a statement, the Government confirmed:
"The Health Minister will be developing, in consultation with non-governmental providers, the framework for Jersey’s future healthcare services. This work will inform the development of facilities for healthcare staff and patients and support the ambitions of the Government to provide high-quality and cost-effective care into the future.
A series of critical success factors have been developed as part of the draft Strategic Outline Case for the new healthcare facilities, and these will underpin the Feasibility Studies and ongoing monitoring of the Programme’s performance. These success factors will be presented to Governance Groups, Scrutiny, States Members, and the public on completion of the Feasibility Studies in May 2023.
The Ministerial Group overseeing the NHFP have established a strong governance framework to ensure that there is rigour in recording and reporting cumulative expenditure, as well as any exemptions and breaches that occur. The Government will be publishing the financial position of the Programme on a monthly basis.
A programme of regular engagement and consultation has already begun with clinicians and other staff across Health and Community Services. The options for multi-site healthcare delivery have been discussed with staff in workshops, drop-ins and via online videos and digital signage at the General Hospital. The preferred option identified by staff has directed the work of the NHFP in producing the Feasibility Studies."
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The cost of restarting the NHF project, and restarting is what it is, can only escalate with not a brick laid. The (un)feasibility study will only look at building (capital) costs and not running (revenue) costs. I have asked the NHF team to add this to the study, but the politicians have ignored this. Instead, they want to tax us knowing that the running costs for a multi-site are going to be greater than a single site. They have also ignored the staffing issues. Once again, I state, there are not enough staff to run the current single site !!
The hospital staff are fed up with "engaging", notably when the questionnaire did not include, a "single site" option, and only a tiny percentage bothered to answer it. It was "hot" and "cold" sites or "acute ambulatory sites" knowing the latter is more expensive to run but is also safer.
I predict the CM target statement on Channel TV of laying a brick within 2 years will be missed. And the cost will be a further £50M+.
Those who wasted this money SHOULD be vicariously liable!