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Tomorrow will mark the start of a new chapter in the long-running hospital saga.
It will be when Infrastructure Tom Binet publishes his review of the Our Hospital project, which he has carried out with Health Minister Karen Wilson and Assistant Health Minister Rose Binet.
They have been helped by ‘Principal Expert Adviser’ Alan Moore, a chartered surveyor who was responsible for delivering a £1bn capital investment programme across several hospitals in Northern Ireland.
The review, which was launched by Chief Minister Kristina Moore not long after being elected to the top spot in Jersey, has assessed the affordability of the current £804m project.
It has also considered the state of the existing hospital and associated heath and care facilities, the measures currently being undertaken to improve and transform Jersey’s health service during this period, and examined different options for an alternative plan.
The group’s remit was to focus on Overdale, the current Gloucester Street General Hospital and neighbouring sites, including Kensington Place. However, it also included looking at ways to bring in secondary sites to complement the principal ones.
It was also charged with seeing if a longer-term phased approach might work, instead of building everything all at once.
In order to preserve Kensington Place as an option, ministers halted work on the redevelopment of the former Revere and Stafford Hotels for social housing.
Developer Dandara had demolished the hotels and was due to start work on building a five-storey block providing 106 flats for Andium Homes.
Pictured: The Revere and Stafford hotels have been demolished but their redevelopment into flats has been halted by the Government.
The properties and land were bought by the taxpayer-owned housing provider last December for £7.8m.
Ministers have not been clear on whether Dandara is eligible for compensation should the housing project be shelved.
Returning to the review, Deputy Binet appeared to dismiss the chance that the current Our Hospital project could be endorsed unamended when he said in July that it was no longer affordable.
His justification was that rapidly rising inflation and interest rates meant that the £804.5m agreed price tag is no longer viable.
Also, the presumption that borrowing at a fixed rate of 2.5% - which last year’s funding calculations were based on – was also no longer possible.
The inflation rate last September was 2.9%; it is now 10.4%.
Tomorrow’s report will reveal how actively ‘Stick with Plan A unamended’ was considered.
It is possible, however, that a trimmed down single-site-at-Overdale version – perhaps without the adjustments to Westmount Road or the separate Mental Health Block, Knowledge Centre or multi-storey car park – will be a viable alternative.
Pictured: The controversial widening of Westmount Road could be proposed to be shelved by the Binet Review.
Or possibly these could be added at a later date.
Sticking with Overdale in some form also retains compatibility with the Bridging Island Plan, which specifically earmarks the site for health-related activities. It was a major reason why Plan A was approved in May after an extensive planning inquiry.
However, Deputy Moore did successfully amend that part of the BIP to make it easier to return to a 'dual-site option' should Overdale, or parts of it, be no longer needed for healthcare.
Proponents of Plan A say that there is no point building a hospital on the cheap: buy a quality shirt and it will last years, but go for a low-priced option and might not survive the first wash.
They also argue that the value of land assets that might be released by Health departments consolidating at Overdale has not been factored into cost calculations.
Therefore Plan A has more value than is presented on the current balance sheet, they say.
They argue that the fact that everything is under one roof means that clinicians will operate more efficiently, and this means there will be time and money savings. It also means that patients will be closer to multiple disciplines, especially important if anything goes wrong.
The suspension of home building in Kensington Place makes it clear that the development of the currently hospital site is being actively considered.
Redeveloping Gloucester Street, and expanding onto neighbouring land, was the preferred option of the Government in 2016 but it was twice rejected after failing to be supported by an independent planning inspector following inquiries in 2018 and 2019.
The first incarnation was described by inspector Philip Staddon as a “grossly out of scale, an over dominant, obtrusive and alien structure.”
Pictured: Previous plans to build a single hospital in Gloucester Street have twice been rejected at the planning stage.
For the second attempt, he wrote: “What I can say is that the current scheme is far superior to the first scheme. The Applicant’s team has worked hard to produce a calmer, more sophisticated and refined proposal, but, despite the progress, significant Planning harm would still result.”
If the Binet review proposes a single site option there again, the Government will be hoping for third time lucky at Gloucester Street. However, listening to the mood music, it seems more likely that Overdale will feature in some shape or form.
The single-site Gloucester Street option was costed at £466m in 2017, with £275m of that being borrowed.
There is also the ‘dual-site' option – with acute services in one hospital and outpatients and other day services in another.
This also has been proposed previously. In 2013, then Health Minister Anne Pryke proposed this split solution, costing £297m, with all the money coming from the Strategic Reserve.
Could the Binet Review propose flipping this around, with wards and theatres being built at Overdale and outpatients remaining in town?
One thing we do know is that if the current Government wants to stick to the Plan A timetable of any new hospital being finished by the end of 2026, they need to get their skates on, especially if new planning permission is required.
So far, the Our Hospital Project has cost £76.8m of taxpayers' money. The last rejected incarnations had cost around £44m, meaning that around £120m has been spent since 2012 with little to show for it, although some money – including property purchased (£25m) and work done that can be applied to whichever project is successful – will not have been wasted.
The project team, which has so far cost £3.7m, is costing taxpayers around £55,000 a month, as they wait to start work on the final approved project.
Meanwhile, work continues on the £15m redevelopment of the former Les Quennevais School into a temporary hospital on the basis that whatever final project gets the green light, services will have to move out of Overdale and Gloucester Street at some point.
Tomorrow, immediately before or after the lunch break, Deputy Binet will stand in the States Assembly to make a statement about his review, which will be followed by 30 minutes of questions.
All Members, the media and the wider public will then be able to pore over the detail of what he, his team and their expert adviser are proposing. Former Our Hospital Project political head Deputy Lyndon Farnham – now a backbencher – will be especially keen to see what has changed and could try to fight the Government, if he thinks any deviation from Plan A is unjustified.
Islanders can expect another period of intense political activity in the days and weeks ahead.
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