Monday 28 October 2013
The Health and Social Services Department has released a review of efficiency at the Princess Elizabeth Hospital, but does not agree with some of the report's findings.
The Review says that there are significant inefficiencies in the delivery of specialist medical services. It says that the services cost between £6m and £9m per year more than they need to because of the structure.
The HSSD Minister, Deputy Mark Dorey, says:
"The review is critical of HSSD in a number of areas, so we wanted to give the public confidence that we are responding to these concerns. On the other hand, the Board are also worried about the many inaccuracies in the report, and we felt it was important to comment on those.
"For example, the report suggests that HSSD could manage beds more efficiently and still keep De Sausmarez Ward closed. In the past 10 months, while the Ward has been closed, we have had 153 cancellations. We have also lost private income as a result of using most beds in Victoria Wing for non-private surgical patients. The reality of the situation is that the PEH does not have enough capacity now, and certainly will not have enough in the future. We must reopen De Sausmarez Ward, and that's what we are doing."
A spokesperson for HSSD explained why they think the report is flawed:
"The review was carried out by comparing the PEH to a 'benchmark hospital' in the UK, using a statistical model based on NHS hospital data. While comparison with NHS hospitals is of interest, and sometimes of use, Islanders generally expect higher levels of service at the PEH.
"Added to that, the statistical model was not fully adapted to Guernsey - for example, it assumes that we can employ junior doctors, which is just not possible here. Junior doctors are in the course of training as Consultants. They have to be working in a hospital of sufficient size and covering the range of services necessary to be accredited as a teaching hospital. Because we can't have junior doctors, some of the organisational changes suggested in the report simply can't be made in Guernsey.
"The reviewers also acknowledge that they have used incomplete or unreliable data, because of the very short timeframe for the review. This means that, while the review does flag up some potential concerns, it is difficult to rely on any of its conclusions with any great confidence."
HSSD has published the review online, together with a summary of highlights from the report and its own response to them.
HSSD discussed the results of the review with the Medical Specialist Group and with Primary Care. Both organisations were equally critical of the data and analysis. However, both agreed that there were areas which should be followed-up and will be doing so with HSSD. These include increasing the use of Day Patient Surgery instead of in-patient, implementing enhanced recovery programmes, reducing expenditure on off-island treatments and looking at reducing referral rates from GPs to specialists.
Deputy Dorey adds:
"We accept that there are areas for improvement, both within the HSSD organisation and in our contractual position with key partners, including the MSG and Primary Care doctors. We have released the review in a spirit of openness to give the public a more comprehensive picture of some of the challenges and opportunities in Guernsey's acute health services."