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"Important and major" decisions relating to Health and Community Services will be taken in public from early next year by a new board that is being established to make the department more transparent.
The move follows criticism from the States spending and management watchdog, Comptroller and Auditor General Karen McConnell, who said she found very little evidence of “good governance” within the department, which she described as rife with inadequacy, insufficiency and a “fragmentation of responsibilities."
She published a report in mid-September blasting the department for millions of necessary savings left unidentified, thousands spent on consultants deemed inefficient and unaccountable, and a lack of knowledge about who’s in charge.
Ms McConnell made the observation that the management of health and social care in the island was “overly complex for a relatively small health and social care system but at the same time poorly defined and communicated."
The Department for Health and Community Services (HCS) published its response to the damning report yesterday, setting out how it intends to strengthen its governance arrangements. The department’s formal response, detailing actions on 22 separate recommendations, has now been sent to the Public Accounts Committee.
Pictured: Anthony McKeever, interim Director General for HCS.
Anthony McKeever, Interim Director General for HCS, commented: “The C&AG identified various concerns about the way that the old Health and Social Services Department was run. These criticisms reflected governance structures in place as at May 2018. Since then, a new senior leadership team has been put in place and firm and swift action has been taken to correct matters.
“The criticisms contained in the C&AG report do not relate to the dedicated staff working around the hospital or in community settings. The structures and processes that were found to be inadequate related mainly to ‘back office’ functions and relationships between departments. In future, we aim to ensure these organisational structures and processes reflect the high standards clinical professionals expect of themselves."
In order to address the concerns raised by the C&AG, a new board and committee structure is being established "to provide greater transparency and accountability for HCS’ services."
The new board will be chaired by the Minister for Health and Community Services, Deputy Richard Renouf. Other members on the board will include Assistant Ministers, as well as the Director General, Group Managing Director, Jersey’s Chief Nurse and Group Medical Director.
The board should meet for the first time in early 2019. It will then meet quarterly and in public with published papers and documented decisions. The board will discuss major and strategic issues, including those that require a Ministerial Decision, a change in legislation or the lodging of a proposition. Progress made on key programmes of work will also be reported to the board.
Pictured: Deputy Richard Runoff, the Health Minister, will chair the new board.
The States assured the board hasn't been designed to make decisions independently. It is however intended "to develop and deliver system plans from both ministerial and managerial perspectives."
HCS is also developing a "governance handbook" for staff to help ensure that it becomes embedded into the department’s culture. The programme set by the States explained: "The achievement of good governance requires continuing and determined effort. Staff within the organisation and beyond need to have an understanding of what good governance looks like, their role in achieving it and how decisions should be made across the organisation."
The Director General noted: “The improvements required will take years, not months, to accomplish, and we acknowledge that progress made and the results being achieved will need to be regularly monitored. In health and social care, getting the right results - for individuals and for taxpayers - is important at every level. We want governance to become part of normal business at every level in HCS."
The Health Minister, Deputy Renouf, commented on his department's response, saying: “We want islanders to know that their health and social care services are being led properly, and that leadership and decision making is simple, transparent and well structured. I am grateful to the C&AG for pinpointing the changes required. My colleagues and I are determined to correct the organisation’s previous shortcomings and to make a fresh start.
“HCS is committed to creating a health-promoting, safe and effective service for all islanders. So we must ensure that the department is well-organised and remains resilient into the future."
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