UK Cabinet Office expert to support hospital project

Monday 17 June 2019

A UK Cabinet Office expert in contracting with suppliers is to be seconded to Jersey to support the new hospital development, in a move the government’s Chief Executive argues will be cheaper than employing a consultant.

The news came from CEO Charlie Parker as he gave evidence before the Future Hospital Review Panel – a group of politicians tasked with scrutinising arrangements for the new build – on Friday.

Although the 20-month timeframe provided by the Chief Minister, Senator John Le Fondré, in a report outlining the next steps for the project means that any specification for the new hospital is some way off, the Review Panel heard about early efforts being made to ensure that the island has the necessary skills to deliver the project. 

In addition to the appointment of a hospital project director set out in the Chief Minister’s report, which estimated that £7million would be needed to restart the stalled project, negotiations have already taken place with the UK government about the principle of releasing a procurement specialist on secondment.

Pictured: Mr Parker said negotiations had already taken place with the UK Cabinet Office to secure a procurement specialist.

The appointment has yet to take place and the detail finalised with States Employment Board policies but, according to Mr Parker, the secondment will enable expertise to be supplied which is not currently available within government at a cost lower than a consultancy appointment. 

The secondment was one of a number of measures discussed at the first meeting between Chief Minister and Deputy Hugh Raymond, Assistant Minister for Health and Social Services and Infrastructure, and the Future Hospital Review Panel since last month’s report. They were accompanied by Mr Parker and the Director General of Health and Social Services, Caroline Landon.

Ms Landon told the Panel that the facilities required in the new hospital were likely to change as a result of the new operating model for the health service, which is currently being developed.

She added that it was likely that new approaches to delivering healthcare would influence the physical requirements for the new hospital. While some of these related to the impact of technology – she gave the example of keyhole surgery – others were rooted in the approach the island takes to its health provision.

Pictured: The Director General for Health said the service was moving away from a bed and Gloucester Street-based model of care.

The new operating model for health would, she said, result in a clearer vision of what the hospital needed to provide and what might be provided in the community – whether by GPs within the primary care system, or by closer arrangements with the third sector.

While references to possible provision in the community were not specific, Deputy Raymond referred to his experiences in the UK and to the fact that the closure of smaller community hospitals in the 1980s in favour of larger hospitals was now being tempered by the introduction of community hubs. 

Ms Landon told the Panel about the progress of three workstreams – for primary care, secondary care and the role of the third sector – which are currently underway and expected to conclude their work in early autumn. It marked a move away from what she called “a model which is bed-based and Gloucester Street-based”.

With improved data being shared with clinical experts, Ms Landon further explained that there is now scope “by harnessing everyone who delivers care” to allocate resources more strategically. She said that the strength of the third sector, which includes charities and not-for-profits, and the motivation of GPs provided a massive opportunity.

Pictured: Support from charities and GPs could be vital in the future model of healthcare, the Director General for Health said.

Panel members Deputy Rob Ward and Kirsten Morel expressed concern about the potential for privatisation of the health system and the dangers of relying upon the third sector at a time when some charitable organisations were facing reductions in grants from government.

However, Mr Parker said that discussions were already in train with the third sector to place the emphasis on outcomes and linking these outcomes with future funding arrangements. 

Constable John Le Maistre expressed concern about the planning issue of the public interest test applied by the Planning Minister to determine whether exceptional circumstances could permit ordinary planning considerations to relaxed in the wider public interest of providing the island with a suitable hospital. 

Mr Parker suggested that Planning Minister was considering whether the framework for the public interest test could be determined by discussion in the States Assembly, and that Article 12(2) of the Planning Law might afford sufficient flexibility for public interest test to be put to a three-person panel.

Pictured: Questions were raised during the hearing about the planning application process.

Responding to Panel Chair Constable Mike Jackson, who asked whether the experience of provision in France was being considered in addition to models in the UK, the Chief Minister said that he had asked officers to investigate further the health system there. 

Mr Parker added that the contract for the new hospital would ultimately be advertised internationally and expressions of interest were expected from across the water.

Pictured top: The Cabinet Office, which is to second a procurement specialist to Jersey to work on the new hospital development. (Miguel Discart/Wiki)