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Politicians are today being asked to back one of the most radical changes in the way healthcare in Jersey is run.
States Members will vote on a proposal to create an ‘Advisory Board’ for Health and Community Services, made up of an independent chair and up to five non-executive directors.
But how will it work? Is it a case of importing an NHS model? And will the £206,000-a-year cost be worth it?
The concept of a board came about in the wake of a highly critical review of the running of the Health Department published last August.
It concluded that current management arrangements were not succeeding and that improved governance was needed at the hospital, and recommended the creation of an independent board to oversee the running of the service.
The Health Minister denies that the creation of a board was a simple adoption of an UK NHS model, but a system used by health care systems around the world.
The board – which will have no legal powers, at least initially – will be responsible for advising Ministers and making recommendations of what changes should be made to the health service.
Pictured: The non-statutory Health Advisory Board will report to Health Minister Karen Wilson.
The Chief Officer at Health – currently Chris Bown, who is on a 12-month contract following the unexpected resignation of Caroline Landon at the end of March – will remain accountable to the Government’s Chief Executive for the management of the department and its finances, and accountable to the Minister for the delivery of policy.
“Rather than the Chief Officer alone, the experience of the NEDs will bring much needed skills and expertise to provide the oversight of complex, high-risk services; they will understand the questions to ask; recognise what good looks like and be trusted to provide credible advice and support to me as Minister,” Health Minister Deputy Karen Wilson said.
She said that it was important to have good systems in place to ensure the quality of healthcare being provided to islanders.
“Health care is an inherently complex business and I know, from years of direct experience working as a nurse, complexity is best addressed by having systems in place to ensure that the quality, safety and effectiveness of what clinicians do every day leads to good health outcomes for patients and maintenance of high standards.
The oversight of this is critical and that is why I propose the establishment of the Health and Community Services Advisory Board to work for patients on this basis by ensuring the healthcare system is governed well.”
The Government is spending around £750,000 on setting up the board.
While its set-up costs in the first year will be greater, it is then expected to carry a £206,000 annual cost.
This includes £70,000 a year for the Chair, working 48 days a year, and £15,000 each for the five non-executive directors.
The current chair will get paid £172,800 this year for working three days a week to get the board set up and recruited.
Some islanders argue that.
The Our New Hospital pressure group’s Chair, Mary Venturini, previously commented: “There are plenty of questions to ask about [the board] – its cost is estimated at £343,000 in the first year and £206,000 in the subsequent two years of its three-year life.
“This comes on top of the £800,000 now being spent on the turnaround team, which is looking at the same problems in secondary healthcare as the proposed Board.
“Shouldn’t we save this £755,000 [three-year cost] at least until the turnaround team publishes its report?”
The Minister has since accepted an amendment to her proposals which would mean the Interim board only runs for 18 months in the first instance.
The Health Minister, Deputy Karen Wilson, argues that the £206,000 cost would be worth it because it “will save millions of pounds a year which is currently being spent on inefficiencies and poor quality”.
She commented: “In the context of a £242m service, the Board will cost £206,000 per year… Poor clinical governance leads to failures that are costly, not only to the individual but to the taxpayer.
“For example, the frequency with which we have had to rely on expensive external reviews to identify what went wrong; the lost working hours due to stress in the workplace; and the cost of responding to complaints.
“In all of these areas the Board will be in a position to advise me how we can improve.”
If States Members agree, that ‘interim’ board will be in place for 18 months, with Professor Hugo Mascie-Taylor as Chair for 12 months.
A report explaining the Health Minster’s proposals, which will be debated by States Members this afternoon, said: “The interim Board’s remit is restricted to services provided by the Department, including hospital, mental health, and adult social services. It does not include ambulance services (which are the responsibility of the Minister for Home Affairs) or Child and Adolescent Mental Health Service (CAMHS) and Children’s services (which are the responsibility of the Minister for Children and Education). It is envisaged that the Board’s remit may extend to these services at or before the [end of the interim period], pending discussion and agreement with the relevant Ministers and the States Assembly.”
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