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Politicians will decide this week whether to commit the island to 40 years of debt – totalling at least £1.2 billion – to pay for a new general hospital at Overdale.
The States Assembly meeting, which begins today, will decide on a cap on how much the new hospital will cost.
The Government wants it at £804.5m, while a Scrutiny panel set up to specifically look at the new hospital is calling on it to be £550m.
Whatever the amount, only the States Assembly will be able to approve funding above that upper limit.
How the new hospital will be funded is the second main feature of the debate. Ministers want to borrow £756m of the £804.5m in the form of two £378m bonds, lasting 35 and 40 years.
The interest cost on that £756m loan is expected to cost £460m, taking inflation into account, taking the total cost of the hospital over £1.2 billion. However, the Government argue that the gains in the Strategic Reserve over that period will be more than the interest and capital repayments.
Therefore, borrowing is a better option than paying for the hospital upfront, argues the Government.
Pictured: Around 100 people protested against the location and cost of the new hospital on Saturday. Another one is scheduled for today in the Royal Square.
Scrutiny also suggests borrowing for their lower cost hospital but propose that only a maximum of £400m is taken out as a loan.
They argue that costs can be slashed by reducing the overall size of the hospital, the number of wards, the size of the multi-storey car park, the amount of land bought and by delaying building the nearby ‘knowledge centre’.
The location and cost of the new hospital – the most expensive capital project that the States of Jersey has ever undertaken – have caused deep division in the community, and there was a protest held in the Royal Square on Tuesday lunchtime by those against building it at Overdale.
It is the third attempt to build a new hospital after two attempts to construct one on the current site in Gloucester Street and the Parade fell at the Planning stage, when independent inspectors rejected the applications.
This time, however, the Assembly is being asked to approved funding for the project before planning approval has been granted.
It is something that the now Chief Minister John Le Fondré voiced caution about in 2017, when the Assembly agreed to spend £466m on a new hospital in Gloucester Street, before planning permission.
This would have been funded by £275m of borrowing and be open in 2024.
Pictured: In 2017, before he was Chief Minister, Senator John Le Fondré voted against approving funding for a new hospital before planning permission had been granted.
At the time, Senator Le Fondré said: “Surely it is not unreasonable for just under half a billion pounds to say: “Actually we should know whether we can build it or not.”
But this time, the Chief Minister is not prepared to wait.
In comments published this morning, in response to Scrutiny, the Council of Ministers say: “Delaying or descoping certain elements of the project does not represent a legitimate economy - those elements are likely to need to be provided or enlarged at a later date and require further investment.
“They are also critical to the running of the facility.”
Pictured: Scrutiny argue that the hospital should be smaller, and therefore cheaper.
Ministers add: “A significant majority of senior clinicians and nurses employed by Health and Community Services are in support of the current plans for Our Hospital. These key groups have publicly expressed their support for the current project plans.
“Reducing the budget by over 30% would undermine the work put in by clinicians in developing design solutions and risk design solutions that are not considered by clinicians to be appropriate for Jersey and its island context.
“There would be significant risk of disengaging and disenfranchising clinicians from the Our Hospital Project. Losing clinical support for the project would be a significant risk to the deliverability of this project, as has been experienced during previous iterations of the project.”
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