Madam, Members, this is the second update that I am privileged to present on behalf of the Committee for Health & Social Care.
Since my first update, much has happened. We are pleased to welcome Ed Freestone and Mike Read as valued non voting members. These appointments were made after a highly competitive process bringing valuable knowledge and experience to our Committee. Members will know my view that we should use all talents available to the Committee to enable us to tackle our significant workload.
Ed Freestone has taken on the delegated role of Alderney Liaison and has already made his first exploratory visit. Mike Read has joined the Complaints & Learning Working Group, utilising his experience from Carewatch. This Working Group is comprised of political, medical, social care, lived experience and subject matter experts who were selected from numerous expressions of interest, for which the Committee is grateful. Members will be aware of the publicity campaign which has been launched as the listening exercises commence.
An end-to-end review of the current joint HSC and MSG complaints process is also underway. The Working Group will deliver recommendations to the Committee in Q4 2026. Some members of the Assembly availed themselves of an update recently and I am grateful to Deputy Rochester for leading this work.
The work of our Committee is significant, and its remit is wide, with a significant role to play in delivering two of the Government Work Plan’s Areas of Focus, on Early Years and Families, and Sustainable Wellbeing.
The Children and Young People’s Plan is being updated and the Committee will bring forward updated legislation to support privately fostered children with a Policy Letter before the end of 2026, following a period of community consultation. We also plan to modernise our adoption law.
The Committee has a major role to play in the delivery of the Sustainable Wellbeing area of focus. Three outcomes have been identified for the States:
To deliver an improved future model for the delivery and funding of long-term care as set out in the Supported Living and Ageing Well Strategy
To agree a plan for a Sustainable Health & Care Model
To encourage increased Prevention and Early Intervention.
Of these, the SLAWS workstream is the most advanced, and States members received a briefing on this today in the lunch break. Our colleagues on ESS will shortly be presenting the legislation to implement the measures agreed by the previous Assembly to stabilise the private care home market, with the support of Members of the Committee for Health and Social Care.
The States also directed the Policy & Resources Committee, as coordinator of SLAWs, to work in conjunction with ESS and HSC to bring proposals for a new Long-Term Care Model to address the fact that the current Long-Term Care insurance scheme and Care Model will remain unsustainable in the medium to longer term. The Committee looks forward to playing its role in delivering on this commitment.
The second most developed workstream relates to Health & Care Regulation. A policy letter was agreed by the Assembly in 2019, but work was inevitably slowed by the Covid-19 pandemic. The Committee has prioritised this work for this political term and we will engage with key stakeholders before bringing proposals for health & care regulation back to the Assembly during 2027.
The ‘big ticket’ item is the work to agree a plan for a Sustainable Health & Care Model. We are required to bring this plan back to the States by the end of this political term.However, the resolution by this house to achieve real savings of 1% per annum cumulative means that some issues of possible contention will need to be brought back earlier. Secondary Healthcare, tertiary care provided in the UK, the provision of care for those with complex needs, amongst many other issues, does not come cheap.
I detect no wish to cut or withdraw services, so there are blunt questions to be asked. Who should pay?How much should the user contribute? and how? Let me absolutely be clear, we have no intention of returning to the days before the secondary healthcare contract was signed, where service users or their relatives could be subject to financial privation and hardship to pay for essential medical services. But some realistic thinking is required here, and there will be difficult decisions for this house to approve.
In addition to the above, we have separate Committee priorities, ranging from a Mental Health and Wellbeing Strategy to the very important output from the Misuse of Drugs Advisory Group (MDAG). Of particular note, will be the guidance from MDAG on the regulation of the prescription and supply of medicinal cannabis. We anticipate working closely with Home Affairs on these issues.
HSC has four major capital projects at delivery stage. I will start with the Children’s Services Hub, which would consolidate the delivery of children’s services at the Raymond Falla House site. The inadequacies of the current buildings have been explored in previous answers to both written and verbal questions in the States. A policy letter will be brought back to the Assembly by the end of this year.
Following the successful upgrade to the software for Child Health and Children’s Services in August 2025, I am pleased to report that the new Electronic Patient Record software for Acute, Mental Health, Community Services and Adult Learning Disabilities was successfully deployed in February 2026. This will bring increased functionality right across Health and Social Care. Improvements have already been seen in areas where digital referral forms have improved efficiency and patient safety.
Work to complete EPR Phase 1 will finish by the end Q3 and is projected to cost £22 million, which is within the £23.7 million of funding already allocated to the EPR Programme. Whilst EPR Phase 1 has not been delivered to the original timeline and within the original budget, its deployment is a significant milestone in HSC’s digital transformation.
Accordingly, Phase 2 will build upon Phase 1, to include the introduction of Electronic Prescribing and the digitalisation of the Critical Care Unit. While they remain a part of the expected deliverables, these cannot be fully completed within the remaining £1.7 million of budget. Following a review, recommendations will be made regarding the prioritisation and approach to delivery of Phase 2. We will also consider how efficiencies and better health outcomes can be achieved from a broader Digital Health Strategy.
As President, I am now the nominated political representative on the Our Hospital Modernisation Programme Governance Board. I am reassured that strengthened independent oversight, one of the key improvements identified following the MyGov report, is being put in place. This will help ensure the level of scrutiny and accountability the community rightly expects.
In relation to OHM Phase 1, it is an open secret that remedial works in the new critical care units to address defects are related, principally, to firestopping. I am pleased to say that, with the cooperation of the contractor, the remedial works on the Critical Care Unit are now close to completion. However, during this process, further issues related to fire protection have been identified.
This additional work relates to changes from the original fire strategy that are required to ensure full compliance with current fire safety regulations. As such, no responsibility for the need for this additional work attaches to the contractor. It is for the States of Guernsey to finance the additional work required. We intend for the existing contractor to undertake these additional works.
Unfortunately, this will result in increased costs for the project and additional delay to the opening of the units. We are not yet in a position to confirm the financial impact, but it is unlikely that the units will open before the end of 2026.
In parallel, work on the Outline Business Case for OHM Phase 2A has been progressing. However, analysis from our external cost consultants, delivered to the Programme Governance Board within the last week, has given an early indication that Phase 2A cannot be delivered within the funding previously agreed by the States.
I am not yet able to provide specific figures, as further work is required to explore these revised estimates and to fully understand the underlying cost drivers. What I can say is that the updated estimate is likely to be very significantly above the original budget. The Committee has had preliminary discussions on the implications of this major development. We will shortly meet to discuss the full impact and consequences of this latest information on the delivery of Phase 2A. We will engage with the Policy & Resources Committee regarding next steps and we will keep Members informed.
Two items of good news to finish on, La Vieille Plage, a purpose built unit which will accommodate 14 service users with physical and learning disabilities, is currently opening to service users. Each of the one-bedroom flats has facilities to promote independent living, with a communal kitchen and lounge area.
Waiting lists for orthopaedics and gastroenterology have come down appreciably but are still beyond those wished for. Without the increased theatre capacity that Phase 2 of the hospital modernisation programme will provide, waiting lists in high demand/restricted provision areas are regrettably likely to be a feature of our health care model going forward.
I look forward to answering any questions that Members may have.
Thank you, Madam