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.

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