Health and Social Services Minister, Senator Andrew Green, made the following speech to the States Assembly on 13 December 2017 in debate on P107/2017:
SIR,
When preparing for today’s debate I couldn’t help but reflect on the journey to get here.
It’s been both emotional and demanding, there have been highs and lows in the process.
As Minister I have been supported by some fantastic officers across the three Ministries as well as Ministers and my own assistant Ministers
Sir we hear all the time about silo working. This project team and Political Oversight Group (POG) have broken down those silos worked together to delivery an investment not only for the short term but for many generations to come.
What a fantastic opportunity,
how lucky we are as a community to be able to afford a new hospital
To be able to provide the infrastructure for our aging population
the infrastructure our Nurses, Doctors and medical teams need to work in.
The infrastructure which will provide both patient dignity and clinical excellence.
We are indeed a fortunate community.
Let us all embrace this opportunity.
Let us go forward together putting our political differences behind us for the good of our island.
Sir Just over a year ago, I stood in this place and proposed the preferred site for the future hospital.
I’m pleased to say Members voted overwhelmingly for a new hospital on the current General Hospital site (34-3).
Now we have reached another significant point – seeking members approval of the outline business plan and the funding for the preferred scheme
A preferred scheme which will deliver modern, safe, sustainable and affordable hospital services on the agreed site.
Given the decisions already made by this Assembly, I do not propose to dwell on the reasons why we need a new hospital or to repeat the particular merits of this site. These have been well rehearsed.
The outline business case goes into great detail about our preferred scheme.
Throughout this year, I have engaged with States Member as we have developed this detail.
I do not believe there is a member in the Assembly who has not had the opportunity to address any concerns they have about the Preferred Scheme or to clarify any matters of detail.
There have been many workshops and opportunities to share information including Briefings on the 17 October and 17 November
In these workshops and deliberations the site options were discussed, at members request Warwick Farm and Overdale were further reviewed.
In both cases there were challenges but the biggest insurmountable challenge with both sites was that planning permission could not be achieved which would allow either site to be developed in a way which would meet the clinical needs of a future hospital
In essence the buildings in both cases would be on top of a hill and considerably above the sky line which was and still is unacceptable to planning!
Sir the clear consensus from States Members was that the future Hospital should remain in town and that there was no better site than the current one. This conclusion concurred with the view of the majority of the public
Members were advised that it would mean a big building higher than the current one but lower than the current chimney and that’s what we have in front of us today.
Sir, it’s worth exploring why member came to this conclusion? It wasn’t one factor but a number of factors. For example 40% of those to attend the hospital either to visit or attend clinics walk in from their home or place of work.
Members also said that within reason the needs for a new hospital (the Planning Minister might not like this Sir) should trump planning considerations and that the suggested development on the current site was justified.
Sir, they went on further to say that the Hospital is a special place, where special life events happen and a new hospital should be easily accessible in town.
In addition to the workshops, members had the opportunity of meeting with me, my ministerial team as and project team members. I’m grateful to members for both their input and the time they gave us.
Sir, The Future Hospital Scrutiny Panel has examined the proposals. It appointed technical advisers to assist it during their review.
The Panel’s advisors Concerto Partners undertook an assurance review of the outline business case the OBC).
Its overall view of the OBC was that ‘it is fit for purpose and presents that it presents a sound enough basis for decision making by the States Assembly’.
Concerto rates the project as amber/green because there is sufficient contingency, in terms of time and cost allowances, to cope with the various risks that face it.
However In terms of the short-term objectives of the project, Sir, (the planning approval, approval of this proposition and the appointment of a main contractor), Concerto rates this phase as amber-red - which means that if we don’t make this decision today - the successful delivery of the project in the short-term period is in doubt.
And why do Concerto say it’s in doubt – because of the risk of further delay
Members can by approving P107/2017 today help to remove one of the major risks that would cause such delay.
- Today is not the time for further delay
- Today is the day for approval,
- Today is the day for action
Sir, my colleague, the Minister for Infrastructure, will say more about the planning process, and I am sure the Treasury Minister will say more about the funding,
but I will just comment that the Environment Minister in making his decision on whether to grant planning approval,
will be informed by the Planning Inspector’s recommendations,
the inspector will not be deciding whether the new hospital is built on the site – this site is earmarked for such a building –
but will express a view on the exact make up of that building. Of course, some changes may be required to gain planning approval, but a hospital, a good hospital can and should and must be built on the site.
The funding of the project should be divorced from the decision to agree planning permission as we discussed.
Any decision from the planning process, may well have financial implications, but these must be contained within the agreed budget.
Sir, the inspector’s report may or may not recommend certain courses of action, or modifications.
These will need to be considered by the Environment Minister and, subsequently, any decision will need to be considered by the project team.
In every scenario, Sir, funding will be required to either progress the current outlined scheme, or progress with an amended design change. Another reason why we cannot delay today.
States Members have said repeatedly we know we need a new hospital and we know we need to pay for it.
May I remind Members respectfully, Sir, that the Planning Inspector’s remit is to consider the outline planning permission for the proposed hospital to be built on the preferred site.
The preferred site this Assembly has agreed.
My primary concern is about safety when people use our services.
The Inspector’s remit is not whether we should build a hospital, or where to build it, or how we should pay for it. That is a matter for Members
Sir in approving the OBC and funding there are other benefits for our Island. Our construction industry will receive a multi-million pound boost from the building of the new hospital.
We will have main contractors partnering with local firms, but without approval to move forward we cannot confirm arrangements.
The Chair of the Jersey Construction Council has stated his desire for a positive outcome today to avoid further delays in the start of work.
We know that major construction activities like this one – Jersey’s biggest ever infrastructure project – depend on plans being made well in advance so contractors can commit to certain work and turn down other work.
Further delay and uncertainty may mean they make other plans and commitments and they will not be available when we require them. I doubt they will wait for us.
However, Sir, as Health Minister my primary concern is about the safety and experience of Islanders when they use our health and social services.
While our current hospital is safe,
- it’s old
- its deteriorating
- it cannot provide the modern clinical facilities that Jersey needs.
The pressures on the current General Hospital are already upon us. And further delays will make matters worse.
Sir, Jersey’s General Hospital is creaking. Demand is rising for both emergency and planned care beds.
This year, as in previous years, beds are being closed because of norovirus or similar infections.
Small numbers of operations this year, have already had to be cancelled because of the demand for surgical beds and insufficient operating theatre capacity.
Of course staff will always do their utmost to keep patients safe. They will do so despite the fact that the building is ill-suited to the needs of modern medicine.
Despite the fact that this winter may well again see the signs of the pressure on the general hospital –
Despite the fact we have a growing ageing population and with more complex illnesses related to their age.
Not just my view, Sir, but one confirmed by senior Clinicians.
And before moving on I would like to pay tribute to the hard work of staff in the hospital and the wider health services who continue to provide such a good service in increasingly difficult circumstances.
But Members make no mistake – with further delay we will reach a stage very quickly, where our amazing staff will not be able to manage.
This will sap their morale. And make further recruitment more challenging who will want to come and work in a hospital crying out for renewal?
The future hospital will be the right size for the Island. As I have said previously, there will be no bells and whistles as part of the new build General Hospital,
- but it will be one
- that is safe,
- that is sustainable,
- that is affordable.
A general hospital is not just about the building. It is as much about the range and quality of services safely provided within it.
I am particularly passionate about the fact that our future hospital will have more single ensuite bedrooms and therefore it will provide opportunities for the kind of privacy and dignity that patients and their families should expect.
Where they will be able to talk privately and share their last moments without being overheard by strangers in adjacent bays. For me, this cannot come soon enough. Let’s not delay it even further. This cannot come soon enough.
Members will be aware that senior clinicians have echoed this concern about multi-bedded bays and voiced their concerns regarding an inadequate future bed base, poor configuration of the current building and failures in the infrastructure.
They also raise concerns in relation to the lack of provision of single rooms, Sir, for patients receiving end of life care – would members want this for their family?
No, as professionals, they do not want it for their patients.
Clinicians desperately want and deserve an up-to date, fully-specified new hospital by 2024.
As our Chief Nurse says: ‘We want a hospital that thrives, not survives.’ That’s why we need to support this Proposition today.
At this stage of such a large and complex project, we now have sufficient certainty to be able to proceed to the next stage.
The next stage will provide more certainty. (we will be able to procure a main contractor which we cannot do without approval today).
We will have recruited substantively members of the Project Team to provide the very resilience the Scrutiny Report asks for.
But we cannot do any of this without approval today.
We will have set up the necessary governance structures to manage the contingency sums associated with this project. But we cannot do this without approval today.
Most importantly we will be able to start the enabling works to provide the capacity and capability for the General Hospital to meet the healthcare challenges facing the Island between now and 2024 when the New Hospital is scheduled to open.
This will provide certainty to staff, to patients and to the public that not only do we have a plan but that plan is now in action.
It will enable us to operate the current hospital safely during the construction period.
And much of what we are doing in the enabling works period forms part of the permanent solution – it provides investment that brings forward many benefits for patient and staff well ahead of the main scheme opening in 2024. But we need approval today.
In practical terms, the Scheme will stop without a decision today. The Project Team funding will run out by the end of February and the ability to procure the enabling works and main contractor will be lost.
By then we will be facing at least 12 months delay as the new COM and possibly new HSSD, Infrastructure and Treasury Ministers familiarise themselves with the work done so far.
To be clear, Sir. Delay will mean additional costs, additional uncertainty and potential loss of goodwill, particularly from stakeholders such as doctors, nurses and other staff who have contributed a considerable amount of their time at countless meetings, and from constituents who will wonder what we are waiting for.
Let’s be quite clear. We have the support of the majority of clinicians,. They have not been gagged. There are some who think if we day No today they cab go back to People’s Park. that is not the case, the People’s Park is gone.
This is probably the only site. It is the right thing to do.
The decision we make today will have a profound effect on the thousands of Islanders in this and future generations.
Generations who will benefit from a new build general hospital. But, in the short term, delay will affect all Islanders who require healthcare in what is rapidly becoming an inadequate environment.
Together lets embrace this opportunity.
Together let’s do what the majority of Islanders are urging us to do.
Together let’s get on with it.
I commend this Proposition to the Assembly, Sir, thank you.
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