POD: Health MD denies ‘NHS-ification’ of service

Monday 11 October 2021

The health service is not overrun by ‘managers’ behind desks, and there are no attempts being made to “NHS-ify” it, according to the service’s Managing Director.

Rob Sainsbury made the comments on the latest Bailiwick Podcast, following recent concerns raised by politicians and pressure groups around the service’s ongoing restructuring.

In August, the Friends of Our New Hospital called out in a report what they saw as too many managers being recruited to the Health Department, when the focus should be on dealing with the “worryingly high” vacancy levels among clinical and nursing staff. 

But Mr Sainsbury said that there was a misunderstanding of what a “manager” was in a hospital context, saying that many of those in positions of responsibility were not sat behind a desk, but already clinicians with experience on the ground.

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He further argued that the service’s restructuring had led to a less hierarchical structure – contrary to what some had claimed, saying: “I’ve been here for four years and it did strike me that there is a real draw on hierarchy in Jersey – it was a real strong chain of hierarchical command. You had to ask somebody permission – you couldn’t seek to do something yourself. A lot of our routine things that would be routine to me felt to be quite complicated and involved lots of different people giving a nod – some of those people in quite senior quite powerful positions.

“That is not the leadership style that we want as an Executive Team in Health - we want involved leadership, we want teams to be self-leading and empowered to do so.”

Elsewhere in the interview, Mr Sainsbury sought to rebut suggestions that Health leaders were seeking to turn the island’s service into an island ‘NHS’ by stealth. 

Describing Jersey’s relationship with the NHS as “strange” and “complex”, he emphasised that the island was “inevitably” intertwined due to its reliance on the NHS supply chain for equipment, drugs and even covid vaccinations. 

He also highlighted that “nearly all” local Health service staff come from the UK, and that Jersey’s medical training schools and regulatory functions were also UK based.

“We wouldn’t want to not be part of that… But that doesn’t mean our organisation has to be like the NHS,” he said.

“The Benefit we have is that we can look at what happening in the UK, NHS and beyond and look at what’s good and what’s not and wouldn’t want to do,” Mr Sainsbury continued, noting that there was an “awful lot” he would never want the island to replicate “because there are parts of the NHS system that really aren’t working.” 

“I feel that in Jersey we’ve got the unique opportunity and ability to really harness the good but to do it in our own way – so we’re not trying to NHS-ify the system, we don’t have the same constitutional standards, we don’t have the same framework, and our services aren’t provided in the same way. There’s a different island context.

“But we want to keep our links with the UK and we don’t want to use that education and workforce flow – I think that’s really important for us.” 

He went on to explain that he would not wish to change the island’s Primary Care system. 

“…Our GPs are a real strength to Jersey… They’ve really demonstrated during the pandemic that having a familiar GP and somebody who knows you and understands you gives good continuity of care is incredibly important. 

“There is so much evidence if you were seeing a locum GP and its three weeks between your appointment and it’s a different GP every time, you’re not going to see as good an outcome.” 

He added that Jersey was in a “better place” than the UK as a result, with local GPs doing a “good job” at stopping islanders from “flooding the doors of A&E” – Jersey’s A&E growth was less than 3% compared to the UK’s 10% - and supporting those with long-term conditions.

Elsewhere in the podcast, Mr Sainsbury addressed the findings of a damning report leaked to Express, which revealed how bullying and leadership issues were impacting the care of patients undergoing surgery, the challenges of the current hospital, and ongoing recruitment problems.

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