Comptroller and Auditor General Karen McConnell has identified a number of weaknesses in the process and made various recommendations that she said the States should consider when making other major decisions, not just about the hospital.
Her review focused on the period from March 2012 to February 2016, when the decision was taken not to proceed with the People’s Park site.
And while she praised the improvement in processes in the time since, and the way officers have taken on board her previous comments, she said there were still further changes that needed to be made – some of them urgently.
The Health Department has welcomed the CAG’s report and said that it had already addressed the issues it highlighted.
‘The States have to make decisions on major and often controversial projects on a regular basis,’ said Ms McConnell. ‘I am concerned that arrangements for making decisions on the siting of the future hospital were poor and that the decision took too long. Through this work I have identified a number of areas where urgent change is needed if better value for money is to be achieved.’
She added: ‘Elements of structures, roles and responsibilities may not have been developed adequately to reflect the requirements of ministerial government.
‘The roles of ministerial and officer groups have not been sufficiently clear. Progress was hampered by what was at times a confused and poorly documented process.
‘Although the interaction and accountabilities between ministers and officers at departmental level was clear, there was confusion where projects cut across departmental boundaries.’
She also expressed surprise that consultants had been engaged to advise on site selection without an acute service strategy, which she says was an essential underpinning for the specification of the new facility, in place, and said that the accounting officer structure whereby the chief officer of the Infrastructure Department has ultimate responsibility for the site selection could be a barrier to effective leadership and decision-making.
As the project progresses she has now recommended a continued focus on:
- Effective programme management.
- Effective and meaningful consultation with clinicians and other stakeholders at appropriate times.
- Securing and taking into account advice on potential changes in medicine, technology and workforce models.
She added that to ensure effective decision-making in future the States needed clear structures, roles and responsibilities in place, the right resources, tools and approaches, and improvements in basic operational areas.
Responding to the report, Health Minister Andrew Green said: ‘Jersey’s clinical professionals made very clear to Assembly Members in a briefing last week that there must be no further delays to this project, and all our focus is now on ensuring that we get approval so we can start work in early 2018 to build a modern hospital that will serve our Island for generations to come.’
