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A radical change to how healthcare is run in Jersey has been approved by States Members – but the debate has exposed fresh rifts in the Council of Ministers.
Assistant Chief Minister Andy Jehan savaged the plan for an interim 'Advisory Board' for Health put forward by Health Minister Karen Wilson, while Infrastructure Minister Tom Binet claimed that the Chief Minister had tried to gag him from speaking out against it.
The board will be made up of an independent Chair and up to five Non-Executive Directors, who will advise the Health Minister on what changes should be made to the Health service.
The creation of the group was recommended last year by Professor Hugo Mascie-Taylor, the author of a damning report alleging a 'Jersey Way' within the Health service that he claimed was risking patient safety. Professor Mascie-Taylor has now been appointed as interim Chair of the new board.
While the board received States Assembly approval following a vote this morning, 16 politicians voted against it.
Among them was Infrastructure Minister Tom Binet, who claimed that Chief Minister Kristina Moore had messaged him moments before he rose to speak against the plan.
"You'll have to forgive me if I'm a little hesitant. This afternoon, I've just received a text message from our Chief Minister informing me she's going to report me to the Commissioner for Standards if I stand up to speak. Nonetheless, I'm going to do exactly that, I'm afraid," he commented, later adding: "It doesn't come easy for me to break with my colleagues."
Deputy Binet said that what "fills him with dread" about the board was that it would only feed back to the Health Minister rather than a range of politicians or Ministers.
"...We're being asked to steadily hand over to a board of professionals with no countervailing structure to provide political oversight," he commented.
Pictured: Deputy Binet expressed concerns that he would lose his job for speaking out against the proposal.
"...As far as I'm concerned, failure to set up the correct structure in the first instance is simply a careless dereliction of our duty to the people who've trusted us to look after their interests," he went on to say.
Concluding his speech, Deputy Binet commented: "I realised before I got to my feet and probably risked my job that I was on a losing wicket. But I just thought that somebody needed to say it because it needed to be said."
Responding to queries about the Minister's comments on Twitter, the Chief Minister claimed the situation was not as described by Deputy Binet.
Deputy Moore said that she had instead said that she "will ask the Commissioner for Standards to consider the description of a Minister lobbying against another and how that sits within our code (in which we have agreed to work to a consensus-based approach)".
Not correct @TheOnlyGuru what I said when answering a Q earlier was that I will ask the Commissioner for Standards to consider the description of a minister lobbying against another & how that sits within our code (in which we have agreed to work to a consensus based approach)
— Kristina Moore (@Moore4Jersey) June 13, 2023
The latest apparent spat follows a previous public clash over handling of CEO Suzanne Wylie's departure, when Deputy Binet claimed that Chief Minister had not been transparent about what had happened. The pair later said they had put the issue behind them.
Deputy Binet was not the only member of the Council Ministers to express his concerns for about the functioning of the proposed Interim Advisory Board.
Constable Andy Jehan, the Assistant Chief Minister and Chair of the States Employment Board, stated that, while he was not opposed to a board structure in general, he did not support the Health Minister's vision. He said it wasn't clear whether the board would merely advise on health matters or whether it will direct.
He also expressed concerns over cost, saying: "The proposition in front of us states the Chair's remuneration is £172,800 for three days a week.
"So what have we got for our six-figure investment? Good question. What does an Interim Chair do full-time for three days a week?"
Pictured: Constable Andy Jehan and Deputy Barbara Ward also expressed concerns.
Other politicians expressed similar concerns.
Deputy Barbara Ward echoed Deputy Binet's comments regarding the a lack of political oversight for the proposed board.
"States Members will have little or no say in the future of how Health is run or how taxpayers' money is spent... This will leave government only responsible for broad policy," she said.
Concerns were also raised that the proposed board model was simply a copy of a UK model, with Constable of St. Brelade Mike Jackson remarking that Health should instead adopt "a structure fit for Jersey, and not an emulation of the failing NHS."
This point was later addressed by Environment Minister Deputy Jonathan Renouf, who spoke in favour of the proposition.
He stressed the commonplace nature of this structure in other health services, saying: "It’s a bit like arguing that we are copying the UK in our building standards because we insist on putting foundations in all our buildings."
In a rare show of support for the Government, Reform Jersey Members voted in favour of the proposition.
Deputy Rob Ward said it was important that the Advisory Board was "given an opportunity" to prove its worth, with Deputy Lyndsey Feltham describing the Advisory Board plan as "the only option on the table".
Pictured: The non-statutory Health Advisory Board will report to Health Minister Karen Wilson.
The Health Minister defended the board plan against criticism related to cost and NHS comparisons in an interview with Express earlier this week.
Deputy Wilson said the NEDs would offer "much-needed skills and expertise" and could be trusted to provide "credible advice and support to me as Minister".
She also argued the cost would be worth it because it "will save millions of pounds a year which is currently being spent on inefficiencies and poor quality".
"In the context of a £242m service, the Board will cost £206,000 per year... Poor clinical governance leads to failures that are costly, not only to the individual but to the taxpayer.
"For example, the frequency with which we have had to rely on expensive external reviews to identify what went wrong; the lost working hours due to stress in the workplace; and the cost of responding to complaints.
"In all of these areas the Board will be in a position to advise me how we can improve."
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FOCUS: Why does the Health Minister argue we need a 'Health Board'?
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