Cancer care or museum storage?

STARK life and death decisions come up rarely in the States chamber.So when debate on the States Strategic Plan begins again on Wednesday, expect some passion.

That's because two major developments have made the case for spending money on bowel cancer screening and the lives it can save much stronger than it was last month when debate started - and in theory should have ended.

Within the last week specialist staff have been appointed and a new, more effective screening method approved - and that makes the £200,000 a year needed a sure-fire thing - or it would have done if the extra spending had been recommended as one of the States' priorities.

It was not, although other areas of health were, and instead £250,000 a year for the next four years was earmarked to improve museum storage.

Remember that? It was only in July that deputies spoke so enthusiastically about the need for improvement that it will be interesting to compare which way they fall now storage is not being debated in isolation.

Culture and Leisure faces an uphill task to make the case for museum space ahead of bowel cancer, which comes into the frame because of an amendment by Deputy Matt Fallaize.

But the department's minister Mike O'Hara will stand up and be counted. And it is Health and Social Services's £100m.-plus budget that will be in his sights.

He believes spending on a new cancer screening service should come from within the money HSSD already has.

And its predicted £2m. overspend does not give him faith in its budgeting anyway.

'You can't just keep putting more and more money into this pot, you just can't, it's unsustainable,' said Deputy O'Hara.

'You've got to have a balanced situation in this island. Part of that balance is Culture and Leisure, part police, part education, part health - at the moment it's unbalanced.'

He said that the majority of new services being recommended for funding were related to HSSD.

'It's a difficult one for everybody, but I have a duty to make sure Culture and Leisure carries out the wishes of States members, which was clear - only a few months ago it was full approval, it's something the National Audit Office and the Public Accounts Committee told us to do: we must protect our heritage assets.'

He stressed that the money was only needed for four years, while the cash for screening was a longer-term commitment.

The money spent on improving museum storage would also free up property to be sold, which could raise almost £1m., making the scheme self-funding.

Culture and Leisure failed to get priority backing last year with a bid for some £5m. and so scaled down its plans.

That it now comes down to a straight fight between the two issues potentially demonstrates the weakness of the prioritisation process - which in any event remains opaque to islanders because the scoring system and how each project is rated is not published.

'Everyone has a democratic right to change the bids, I understand that, but you can't compare looking after objects with someone dying,' said Deputy O'Hara.

'It's a shame the staff for bowel cancer screening could not have been sorted out a few years ago.'

Treasury and Resources approved funding in 2007, which was subsequently returned by HSSD because it said it could not staff the service.

Deputy O'Hara believes that if the staff had been in place when the States Strategic Plan team assessed the bids for money this time around bowel cancer screening would have been prioritised, but at the expense of other new health-related services, not museum storage.

'My worry is that if we don't get the money this time, when will we?' asked Deputy O'Hara.

Deputy Charles Parkinson leads the State Strategic Plan team and defended the process of prioritising projects.

'We've tried to introduce rationale for prioritisation. There was a staff level assessment of all projects against pre-determined criteria. That resulted in a proposed prioritisation put forward by the Policy Council,' said Deputy Parkinson.

'But, ultimately, prioritisation of public spending is a political decision, the States can choose any priorities it wants, it can turn the whole list on its head.'

He said the team was agnostic about what came first on the list as long as the integrity of it was respected.

The plan is under fire from other quarters, too, including those who say 'new' money should not be spent on additional services until it has been generated from savings. At the moment, the £2.4m. being earmarked is based on predicted savings.

Deputy Parkinson said that an intellectually purist argument could be made for that stance.

While debate began swiftly on the plan last month, it became a microcosm of some of the shortcomings of the States:

Major strategic pieces, like the fiscal and economic plan and the environmental policy plan, went through on the nod.

Micromanaging the SSP details was far more appealing - and so it is back to the chamber this Wednesday.