13th February 2021
And an acute hospital is what we are going to get, according to the Functional Brief published on the ROK/FCC website https://ourhospital.je on Monday 8th February on and scroll down to News and Updates – “Functional Brief Published”.
I have long said that the Jersey Care Model (JCM) is the biggest threat to the new hospital design and function and so it has turned out. Yet the JCM is going to take 4 years to develop at a cost of at least £17 million and will be ready just a year before the new hospital is due to open at the end of 2026.
Meanwhile, it is being implemented now, subtly, and in stages. Changes like closing the rehabilitation unit (Samares Ward at Overdale) and changing the diabetes clinic (which was based at Overdale and will now be handled by GPs) and reducing the availability of the post-operative dressing clinic. We are appalled that the new hospital will not have a Physiotherapy Department, a Dental Department or a Rehabilitation Department, to name but three, all confirmed in the Functional Brief.
The clue about what the JCM is all about is saving the Health Care Service money - £874 million by 2036, if the JCM is not implemented, but at a cost of £679 million to implement the new services and the expansion of existing hospital services over the same period, giving a net saving of £195 million between now and 2036. These are mind boggling sums and who is going to maintain the accountability needed over the 16-year period to 2036.
The plan is to transfer the funds spent on delivering services in the hospital to the Primary Care deliverers, like GPs, dentists, etc. However, there is a real danger that Health and Community Services (HCS) will fail to reach an agreement with the GPs’. This happened to the previous strategy ‘Care in the Community’ launched in 2012, as HCS cannot afford to pay the full price of the strategy to the GPs’ and instead wants to contract with them directly to take on the outsourced services currently delivered in the General Hospital, giving them a capitation fee for the treatments they require the GPs’ to deliver i.e., what happens in the NHS, hence the promise of “savings”.
This is called ‘commissioning of services’ and it is ironic that the UK Health Secretary announced a plan to do away with the commissioning of medical services in Parliament on 11th February 2021.
The Functional Brief also says: “We will see a shift in settings of care for our workforce within a virtual hub across many professions with Secondary Care doctors providing specialist advice and guidance to GPs and community health workers who are able to work to the top of their clinical licence.” Whatever that means
In short, you need to start talking now to your politicians who will eventually vote on the Functional Brief – unless you want to pay more for less public healthcare.
Brigadier Bruce Willing CBE
13th February 2021
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