Monday, 19 November 2018

Hospital Site: Was there political interference in the choice of site?













Hospital Site: Was there political interference in the choice of site?

Finding: The Board is assured that the site selection process undertaken by Gleeds was sound, however, due to the political reasons to drop the Waterfront site, the majority* of the Board members are not assured that the available evidence in relation to the decision of the previous States Assembly supports the proposal of the Council of Ministers that the new hospital be located on the existing site.

I’ve put together below a timeline gleaned from key facts which have come to light from the recent future hospital report.

Looking at the timeline and discussions - it is clear that Ian Gorst and Philip Ozouf were instrumental in making sure the Waterfront was off the table, first when Atkins said it was a good site, and secondly when Gleeds also said it was a good site.

This was not based on considerations of the best site for a hospital, but on the loss of site area for the Jersey Development Company. There was a clear conflict of interests between the two, and anyone conflicted should have recused themselves, but instead they took the political decision to shift the Waterfront out of the occasion. This was not brought before the States but instead took the decision within the Council of Ministers, behind closed doors.

Richard Renouf is the ONLY dissenting voice. Pretty well all the reports findings are disagreed with by him, including this one.

The other members are: Connétable Christopher Taylor (Chair), • Connétable Richard Buchanan, Deputy Richard Renouf (Minister for Health and Social Services), Deputy Rowland Huelin, • Deputy Trevor Pointon, • Deputy Carina Alves.

Richard Buchanan has a strong background in financial services. He is no one’s poodle. If he didn't dissent, he gives serious weight to the report, in my view.

Rowland Huelin also has an impressive CV: "my career involved thirty years in the fast-paced Information Technology industry where I was involved in major sales and contract negotiation with banks and service companies on a global basis. I am used to the highly pressured life of corporate America."

Trevor Pointin brings a clinical POV: "Before moving to Jersey in 1990, I had been a Health Service Nurse Manager and then a Management and Commissioning Consultant to businesses setting up Residential and Nursing Homes in the private sector. Once here I continued with this work. In the mid 90s I became the General Manager for The Shelter Trust, moving back to clinical practice at the General Hospital in 1999. "

Leaving aside Chris Taylor and Carina Alves as perhaps more likely to be critical of decisions made, I do not think it is easy to brush aside the heavyweight experience of the others. These are clever professionals who are taking an independent and critical view. That they agreed with all points raised signifies serious issues with the decision making over the last two governments, which as the report shows, has been shown to be motivated in part at least by political expediency.

Richard Renouf is an advocate of the Royal Court, and with the greatest of respect, I don’t think he has as wide a portfolio of experience as either Mr Buchanan or Mr Huelin, while Mr Pointin brings a much needed medical oversight of the findings.

In particular continually moving the Waterfront off the table twice against the reports proposals as the best site shows the worst case of political considerations of a very narrow kind taking precedence over what is best for the Island itself, and against advice given.

I think Richard Renouf will have to very seriously consider his position as this finding is completely indisputable from the minutes and letters relating to site selection. I look forward to seeing a detailed explanation from him on why he dissented from the findings. 

As he expressed dissent from revisiting site selection as Health Minister even before the Board, I think he should explain what findings of fact he acknowledged, and why he felt they made no difference to site selection.

Timeline

Dec 2012: Atkins had been instructed to undertake the long-listing process

Feb 2013, MOG, Letter from MD of SoJdC

Discussions on letter from SoJDC over concerns of developing waterfront option as it could “compromise funding streams” for the JIFC

Further Letter: Serious concerns about the risks of indirect and direct losses of income from the JIFC should waterfront option be progressed.

“IG indicated in his view the States of Jersey could not afford to lose the JIFC and there would be strong public criticism if the work to develop a new hospital compromised such a development in the current economic climate. PO explained that he had attended the recent SOJDC Board meeting where the matter was discussed and the Board was very strong in its view that pursuing option 14C was likely have a serious impact on the JIFC, in particular to its ongoing efforts to attract a key tenant for a major part of the scheme. In his view this meant the site should not be considered further. “

April 2015:

In accepting Recommendation 12 of SR.10/2014, Gleeds were commissioned to review the four options, publishing a report in April 2015.This concluded that the Waterfront option scored significantly better than all other options and continued to do so under several levels of sensitivity testing. Full details are included within CRO04 Report.

CR004 Report: "UK Treasury Green Book recommends that, at this strategic stage, the differential value offered by different options is compared by calculating the quantum of Net Present Value required to secure each benefit point. On this basis Option ‘D’ being the Waterfront scored significantly better than all other options and continued to do so under several levels of sensitivity testing. On the basis of the evidence established within the report it is clear that Option ‘D’ is the optimal location to be taken forward to detailed design."

This was when they went for a Split Site: "SD reiterated the view that, whilst it had not scored as high technically, Atkins believed that Option 1E was a solution that would work and would provide what was required for a new hospital for Jersey. "

[I have no idea who "SD" is – despite names being placed alongside initials, there is no “SD”, which suggests an earlier stage of redaction removing their name, but missing the initials]

Philip Ozouf proposes Dual Site October 2013. This effectively removes the Waterfront from public gaze. Notice that the proposal comes from him as Treasury Minister, and Ann Pryke, as Health Minister, is effectively shunted onto one side – a contrast with the later proposal which was brought by Health Minister Andrew Green. It is another confirmation of political interference in the site selection.

Sept 2014: Scrutiny: The HSSH Scrutiny Panel issued a report, SR10/2014, reviewing the transformation of Health Services. The report raised concerns that both the public and employees were concerned about the dual-site proposal, the length of time it would take before the hospital was completed and that the States Assembly had not been involved in the decision making process.

New election Andrew Green revisits options with Gleeds assessment. "A new Health Minister was appointed who had “grave” concerns about the dual-site proposal."

Looking at Gleeds Table with weighted measures:

Option A – Dual Site (Existing General Hospital and Overdale) – New Build and Refurbishment (2.432.05)
Option B - Overdale Site and adjacent property – 100% New Build Option (1,720.52)
Option C - Existing General Hospital Site and adjacent property – 100% New Build Option (1,466.87)
Option D - Waterfront Site - (14C Zephyrus, Crosslands and Jardins de la Mer) – 100% New Build Option (1,056.71 )

MOG received the outcome of the Gleeds Site Appraisal Report CR04. The report concluded that the Waterfront option scored significantly better than all other options. The dual-site option scored very poorly.

The Waterfront stands out and this must have been something of a nightmare for those on the COM, such as Ian Gorst and Philip Ozouf, who wanted it off the table.

July 2015

MOG requested a further review to consider additional sites of Parade Gardens and People’s Park. Gleeds’ initial findings noted that Parade Gardens was not suitable to progress past the long-listing process but that People’s Park was worthy of further short-list.

When you don’t get the desired result, try some other options! This was when the People’s Park came onto the agenda, although at this stage, it was concealed from the general public as an option until leaked by the JEP.

October 2015

The Council concluded that it was apparent that, on the basis of all the evidence available, there was a compelling case that the People’s Park site was clearly the preferred option and the Council accordingly endorsed the People’s Park as the Preferred Site Option.

Having neatly removed the Waterfront, Andrew Green defended the decision for the People’s Park as the preferred site. Collective responsibility means that dissenting voices, such as St Helier Deputy Rod Bryans, are effectively gagged, although once it becomes public knowledge Constable Simon Crowcroft and all the other Town Deputies are unanimous in opposition.

February 2016:

P3/2016 was a proposal by the Constable of St Helier to remove People’s Park from the list of sites for consultation. The Health Minister subsequently confirmed its removal as a potential option. Ministers entered a period of reflection on the project’s objectives.

This decision, like many others, was made because of political factors. Opposition to the People’s Park had been increasing both within and outside the States, and the count from emails expressing lack of support for the Council of Ministers meant that it was very likely the proposal would be won.

It was clearly felt to be less humiliating and damaging to take the People's Park off the table – perhaps with a Health Minister overboard. It also meant there could not be a healthy debate on site selection, something the Council of Ministers - or some of them - clearly wanted to avoid at all costs.

June 2016

The Council approved the concept of utilising the existing General Hospital site and adjacent areas to be purchased. It was agreed that the Minister for Health and Social Services should make a statement in the States on 14th June 2016, which would include reference to the intention of proceeding with a report and proposition in due course in relation to the preferred site and outline timetable, but not details of any funding proposals presently under consideration by the Minister for Treasury and Resources.

As we know, the first plans ignored advice given by planning on height, and appeared to present mock up designs which showed a much lower hospital that was the case. These were rejected and new plans submitted in the run up to the election.

The Planning Inspector had been given a very restricted brief not to review other sites, safeguarding the Waterfront being placed back on the agenda, and meanwhile Andrew Green signs off a lease for hemp production on Warwick Farm, another potential site, moving that more or less out of consideration.

In conclusion, the timeline shows political considerations – rather than finding the best site- played a dominant role in site selection, in such a manner that the results were skewed away from the Waterfront, and then later from any other options. This is the stuff of “Yes, Minister”, but unfortunately not half as funny.

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