Monday 11 February 2019

Fourteen Reasons Why the Revised Plans for Jersey’s Future Hospital (JFH) will not Work

This isn't mine, it is part of the material from a recent FOI request, but ahead of the debate. Curiously it appears on a Google Search as a PDF dated 22 January 2019 but I've not seen the datat on the list of FOI requests for that date.

Incidentally the Scrutiny panel attacked the past bias of Hospital Board Review members based on what they had said, but had nothing to say about Richard Buchanan or Carina Alves - and yet we are presumably to believe they were led by the nose into not dissenting from Christopher Taylor.

What would be extremely interesting - and far more use - would be to ask why they agreed when Richard Renouf disagreed - I notice they don't go through his record for all his past support for the Gloucester Street site which shows how selective they are in their criticism.

To be really fair, they should have cited any statements they also made so we could see their own bias on choice of hospital site, for instance:

"I am concerned that the argument over the location of the hospital is distracting from the more important issue of how our health care is managed. I want to change this." Kevin Pamplin

So clearly on his own argument on bias, the Chairman of the Scrutiny panel was never going to agree with Chris Taylor's report. The argument from bias can be played all ways! What is more important is the argument from facts, and here Scrutiny seem to have been as selective as those they criticise.

An interesting question: If there are only two really independent members, why did they agree 100% with the review findings?

So what can we see in Richard Buchanan's CV:

"I have had over 40 years’ experience working in the Jersey finance industry most of which has been in a very senior capacity"
"Experience in running large and complex business, employing staff and developing and managing budgets"

In fact, just the kind of independent whose opinion should carry weight, especially as he looks into another large and complex business, that of the new hospital. Yet there is not one single reservation from him in dissenting from the views of the others. Are we really to believe he would not have cast a critical eye on all the findings?

Fourteen Reasons Why the Revised Plans for Jersey’s Future Hospital (JFH) will not Work 

1. The current plans do not meet the States requirement from 2012:  that a new hospital should be on a single site that accommodates all the facilities currently provided by the General Hospital. The current plans will be on 6 sites; will cost too much; does not put patients as the top priority; will take too long to build; has no room for expansion and are not liked by the clinicians who will work there.

2. Site Selection: the ‘Ministerial Advisory Group’ skewed the overall site selection process in favour of the Gloucester Street site without any explanation in the Outline Business Case (OBC) of October 2018 by removing the two green field sites in States ownership (Warwick Farm and St Saviour’s Hospital) from the shortlisted sites.

3. Cost: The cost is budgeted at £466 million. In April 2015 Gleeds assessed the cost at £626 million. The Care Inquiry was budgeted at £6 million with an outturn of £23 million. Will the ultimate cost of the new hospital be any different?

4. Paying for the JFH: Meanwhile, taken together with the Andium bond for new public housing, the annual interest payments will be £16 million for over 40 years.   The OBC estimates the total cost of this bond as £626 bringing the full cost of the JFH to over £1 billion.

5. Lack of Professional Consultation: There has been strong pressure on clinicians and nursing staff not to express doubts about the 'preferred site', but the unanimous view expressed in informal contacts is consistently against the present plans.  A confidential vote by the clinicians should form an element in making a final judgement on the site.

6. The Site is too small: Trying to squeeze a quart into a pint pot will not work. It is impossible to put all the existing facilities and departments into a smaller site, which is compromised by Planning height restrictions in St Helier. As a consequence the revised plans have multiple treatment floors rather than a single 20,000-m2 ground floor, as specified in the 2012 brief, with existing Departments made smaller to fit the site, rather than the clinical need.

7. There is no Room for Future Expansion: The site is constrained by the four roads within which it sits. Hoping that future advances in medical technology and practice will allow expansion and new facilities is naïve. Between 1950 and 1987 the Nurses Home (now Sir Peter Crill House) Gwyneth Huelin and 1980’s blocks were built in order to accommodate necessary expansion as medical advances and the population grew. Why would that requirement not be replicated in the 60-year life of the new JFH?

https://www.gov.je/Freedom%20of%20Information%20library/ID%20FOI%20Fourteen%20Reasons%20Why%20the%20New%20Hospital%20Plan%20Will%20not%20Work%20280818%20%20ref%20email%20%202%2020190122.pdf

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