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The new multi-site hospital: key questions that need to be answered

The new multi-site hospital: key questions that need to be answered

Friday 04 November 2022

The new multi-site hospital: key questions that need to be answered

Friday 04 November 2022


The decade-long new hospital saga took a new turn this week with the publication of a review led by Infrastructure Minister Tom Binet.

After working with an ‘expert advisor’ who has managed several hospital builds, extensions and refurbishments in Northern Ireland, Deputy Binet proposed cancelling the £804.5m Our Hospital Project – because, he argued, we can no longer afford it – and instead splitting healthcare across multiple sites, which happens at the moment.

By his own admission, the Deputy said his review did not have all the answers, and once the principle had been accepted, an ‘outline business case’, which would have far more detail, can be developed.

And there lies the conundrum: how will Deputy Binet get the go-ahead from States Members if he doesn’t have all the answers?

Some of the key questions that Deputy Binet is likely going to have to answer include: 

  • Will running a multi-site hospital be cheaper than a single site hospital? 
  • How much duplication will be necessary at multiple sites compared to one site, and has that been factored into your cost estimates?
  • Will it cost more to maintain multiple sites? Again, has that been factored in? 
  • How much of this is a step backwards in terms of consultation, planning, and finding a way to pay for everything? Is it, in effect, back to the drawing board?
  • Clinicians were critical of the previous dual-site option in 2012. How will you win them around this time?
  • Is there a danger that this new plan could end up costing more than Our Hospital Project, even if the latter would now cost over £900m, as you estimate? 
  • The previous Government said costs to maintain the current hospital will soar after 2026. Do your estimates include maintaining the current health estate until the new buildings are ready?
  • Does the £635m estimated cost of the multisite hospital include all the elements of the Our Hospital Plans, including ‘contingency’ costs. Is it a like-for-like comparison?
  • One of the principal arguments for a single-site option was ‘clinical adjacency’ – having linked services, such as theatres close to A&E. Will a multisite option compromise clinical adjacency?
  • Will patients be better off under the multisite proposals than they would have been with the Our Hospital Project?

Yesterday, the findings of the Binet Review received the official endorsement of the Government when Chief Minister Kristina Moore posted a video on social media backing the plans.

She said: “The size and scale of the previous scheme wasn’t right for Jersey. Building smaller, on multiple sites provide us with many other benefits. It avoids the risks associated with a large single development giving us greater control over the timing of construction and allows us to commit to building when it best suits the island’s finances.

“It will help us to avoid excessive changes to existing infrastructure while offering construction opportunities to local businesses, keeping more money and opportunity in Jersey.

“A multi-site approach will require less intensive development of Overdale while bringing in much needed investment into regenerating the areas around Gloucester Street and Kensington Place.

“This solution will provide Health and Community Services with essential operational resilience in the event of emergencies or a future pandemic. 

“I want to reassure islanders that the period of indecision which has long plagued the hospital is over. We’re determined that construction will start with two years, and we will see the first of the new facilities, focusing initially on mental health treatment, completed by 2028.”

Deputy Moore added: “Ministers will now be working proactively with the public, clinicians, States Members and Scrutiny over the coming weeks and months to ensure their voices are heard, their questions are answered, and we can get on with delivering a future health facility for the island.”

Do you have any questions that you feel need to be answered before the new plan is accepted? If so, please post them at the end of this story.

READ MORE ...

Our Hospital(s)? Gov review proposes multi-site solution

FOCUS: How much more “affordable” would a multi-site hospital be?

TIMELINE: When will we get a new multi-site hospital?

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Bowls club and road "likely" to stay, if multi-site hospital plan accepted

Key players share first reactions to £30k hospital review



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Comments

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Posted by Keith Marsh on
I am wondering if it is 1st April, as we now have Infrastructure Minister Tom Binet's report, that says one thing = Overdale is costly.
He has no reply to all of the very serious questions raised, let alone to the repairs to the present Hospital that are long overdue.
The current hospital does not even follow the Disabled Legislation in that most of its doors are not self-opening, making it very difficult for wheelchair / scooter users.
The total cost of two or three sites, will with inflation cost MORE that the previously agreed site.
Running Costs and Staff Numbers and Costs will increase under the multi-site proposal and worse of all , The Final Date for the completed hospital is likely to be a decade away, instead of an opening date of 2026/8
ALL this review/report does is to Confirm The First Minister's and the Author's STATED intentions, to kill the Overdale Site.
Posted by David Ng on
All these questions were answered. Any indecision was caused by scrutiny in the previous States. A clear decision was passed democratically. Funding was passed but the delay in fixing the mortgage at 2.4% was delayed by scrutiny again. And we've missed the financial boat.
I believe this political dilly-dallying is going to cost more.
The report is all about money. No mention about the impact on staff and patients. We barely have the personnel to run the current single site.
The £5M maintenance fund in the report isn't enough when to fix the sewage leak in maternity cost £9M,which had to be halted every hour for an hour to allow the new mothers and babies to remove their eye plugs and allow some rest. None of these effects of building in and around the hospital has been considered. It's all about cost. And more the delay the smaller the saving. Dithering and indecision caused by scrutiny in the previous assembly, and the current report trying to reverse 4 years (1461 days) of planning and consultation with a single expert's report written over 100 days paid for by assembly searching for independent validation to stop the OHP.
Posted by Private Individual on
Mr NG you are right, it is about the cost!

Taxpayers of Jersey are at breaking point with the cost of living and tax rises by our previous governments. We are not all paid extortionate wages such as consultants at the hospital, which are paid for by taxing us more.

This is the correct decision based on the present economic climate, so well done Mr Binet and Deputy Moore for having the courage to reassess the ridiculous notion of a hospital at the top of a hill with no access!
Posted by Esporta Johnson on
Most of medical consultants had been trained in medicine and further specialised in a particular branch of it. Only few of them have degrees in business, public finance or engineering. Their opinions should therefore matter more when discussing medical problems and of course they are entitled to their personal opinions on other matters. In the case of our new hospital it was professor Handa who advised the consultants - being a doctor and having vast experience in building many hospitals he was naturally credible to them, so some still keep defending his story. Professor Handa argued that the cost of 800M+ was not that high - he compared it to every Jersey resident paying for a Happy Meal every day for the next 40 years. We are only as good as the experts we select. With £1000 per day he was paid much more than the medical consultants so perhaps we should not use the term extortionate thinking about their salaries.
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