Jersey’s Health Minister has been accused of making islanders “the subjects of an experiment for which he has no evidence” as he brings in sweeping changes to the Health Department’s structure with no public consultation, cost-benefit analysis, or looking for a comparable model elsewhere.
Deputy Tom Binet faced pushback in the States Assembly this week against his reorganisation of the Health Department, which sees sectors like Public Health move into the same system as the Hospital and Mental Health Services.
There has not been a cost-benefit analysis for the proposal, nor had he looked if similar models elsewhere worked, he admitted.
The Health Minister made the proposals last year.
But although Deputy Binet told the States Assembly that the Council of Ministers supported the projects, it emerged that Ministers haven’t voted on it.
He said: “The proposed reorganisation of the Health Service relies on the evidence obtained by talking extensively to a wide range of health professionals, patients, charities and health service providers, then, in conjunction with my assistant ministers, applying a combination of commercial experience and common sense.”
Deputy Binet added that the “combined and, I believe, sensible approach” would make Health – now referred to as ‘the Health Service’ rather than the old ‘HCS’ – more efficient.
The Minister told the Assembly that Health wouldn’t be an arm’s-length organisation.
Asked further what type of entity it would be, he said it would be better for more work to be done by specialists in health settings.
Deputy Binet said: “Under the old system, an awful lot of the affairs of health were taking place in central government, and it’s my opinion that they weren’t really receiving the right amount of focus.
“They were being done away from a health setting.
“And I believe some of those decisions are better off made by people specialising in those areas.
“I would refer particularly to finance. I think we’re spending well over £300 million a year.
“We’ve now got a finance director appointed who specialises in health finance, and I think that’s to our advantage, having just paid half a million pounds to KPMG to try and sort the finances out.
“I think going forward, we require that function to be done in a health setting.”
He added: “Similarly, digital health, a number of other areas, procurement and HR – I think that focus needs to be within a health setting, ultimately running through government, but actually all the data they start being taken care of by people who specialise in that area.”
Asked whether he had found examples of places with a similar model, Deputy Binet said: “No, and I have to confess, I haven’t looked elsewhere.
“I’ve just spent quite a lot of time taking a look at what seems to be wrong, and I’ve done my best to put it as straight as I can.”
He added that he had consulted “probably hundreds of people” about the model, with none arguing against “these essential principles”.
“So perhaps I should have spent a little bit more time looking at other jurisdictions, but there’s a job to do, and I think the Health Service requires improvement, and we’re moving as quickly as we can,” he said.
Deputy Jonathan Renouf cited the lack of cost-benefit analysis, public consultation, examples of similar models elsewhere, or alternatives considered, and asked: “Is the Minister comfortable that he is essentially making us all the subjects of an experiment for which he has no evidence?”
Deputy Binet argued that health professionals were all in agreement about the restructure.