Review slams 'potentially unsafe' Jersey health service

A damning new report has exposed a series of failings in the way Jersey's health service is run - including allegations of bullying, a lack of accountability, and managers being unclear of their roles.

The independent review, which was carried out by Professor Hugo Mascie-Taylor, found in some cases patients were not receiving proper care while the culture was 'potentially unsafe' for workers.

It also highlighted numerous issues that had been raised by staff who feared they were more likely to lose their job for sharing these problems than they were confident the points would be resolved.

This contributes to what Professor Mascie-Taylor said was an overall culture of a lack of accountability within the way the department is run, as well as an unwillingness to change. Many staff members described it as 'the Jersey Way'.

He explained: "A striking number of interviewees, including some doctors, described a longstanding culture in which there is an unwillingness to manage and hold to account powerful and well-connected minorities, the presence and influence of undisclosed networks, and a lack of openness and transparency."

Professor Mascie-Taylor also raised the issue of obstructive behaviour from some members of staff, saying they have 'too great an opportunity to exercise a veto or to enjoy undue influence beyond their legitimate sphere'.

He wrote that Health and Community Services (HCS) 'over-relies on individual competence, personal autonomy and goodwill' to ensure patients are kept safe, rather than formal processes and good governance.

The Professor added: "HCS and particularly some of its employees approach to safety is to over-rely on individual competence, personal autonomy, and goodwill – some firmly rejecting any movement towards systematisation, standardisation, and good governance that has been widely and successfully embraced elsewhere.

"The culture of the heroic individual, rather than the effective team, is supported by some in HCS more assertively than the author has encountered elsewhere in the world."

Staff members interviewed by Professor Mascie-Taylor said that private patients are unfairly prioritised - being seen by consultants more frequently, placed first on waiting lists, and treated more urgently than public patients with the same conditions.

He has made 61 recommendations to improve conditions within the department.

The new Health Minister has committed to turning things around, announcing plans to establish an independent health board to provide extra oversight.

Deputy Karen Wilson said: “I will ensure that urgent, clear and direct action is taken to address the report’s recommendations.

"Our health service must become an exemplar of safe and effective care, be of good quality, and its performance accounted for in an open and transparent way.

“In light of this, I will bring forward plans to establish an independent health board, including experts in health care provision, to drive reform, improve governance and address the cultural, structural and practice issues affecting the quality and safety of the care provided.

“Alongside that board, I will strengthen policy functions to determine government policy across the whole health system.”

The Minister ordered an immediate turn-around plan to be developed for the hospital while the new board is established.

This will have to be done by the end of next month and will be overseen by the government's CEO Suzanne Wylie.

There will also be a follow-up review in one year’s time to track progress.

Caroline Landon, Director General for Health and Community Services, commissioned the review and said: “Now that the report is published, and the issues are known, we can set about improving our clinical governance arrangements in order to advance the quality and safety of our services.”

The HSC Executive Team added: “We recognise that we cannot tackle all of these issues on our own many of which are long-standing and historical and involve a change of culture.

"We require the support of Government to put in place the structural change needed to implement the recommendations in full.

“Our values are very clear. No kind of behaviour which makes another colleague feel devalued or upset is acceptable, irrespective of their title, grade or length of service.

“The improvement will be led by the staff in the services, it is their culture. This needs to be supported by clear lines of accountability, which will allow clarity of roles and responsibilities. We will have clear expectations of professional standards and conduct that will be required in the organisation.”