Diagnosis tricky without knowing all the symptoms

INFORMATION flow from the States is usually akin to a dripping tap.

Last week was a classic example as slowly more and more information was released about the King Edward VII hospital – usually accompanied by words designed to distract from the core issue of whether the facility, at £3m. a year, is providing value for money.

It speaks volumes that the deputy trying to extract information on costs from the Health and Social Services Department, Mike Hadley, had to go back because it had not provided adequate answers in the first place.

And still we are only a little wiser as to why a facility which the department voted to close in 2009 – a fact that emerged only on Friday – is still open.

Minister Mark Dorey did not open his mouth on the issue to any meaningful extent until an interview with this paper on Friday, but that was not before a statement in which he went on the attack about the upset this newspaper's coverage of the spending had caused staff and patients.

This from a new minister of a department that will make dispassionate, life and death decisions daily.

There is still missing information about the costs of the facility, such as how much is spent on GP visits or the MSG contract, or even the bed occupancy rate.

What is troublesome about the whole affair is that the information is not at the department's fingertips already.

Remember, this is the same Health and Social Services that argued no stone had been left unturned as it tried to deal with its estimated £2.5m. overspend.

Well, very little has been said about the future of the KEVII in any of the documents where you might expect it to be explicitly mentioned, such as the Financial Transformation Programme or the department's own 2020 vision.

The latter document comes to the States for debate at the meeting that begins tomorrow in the form of an update report.

Again, members will be left debating an issue partially in the dark.

When 2020 was released in 2009, it had 58 target dates for different elements on its roadmap.

So how has it done? A question you would clearly like the update report to tell you.

It does not, short of a small footnote to say that more information – which will include an updated roadmap – 'is in the process of being made available' on www.gov.gg.

In the six weeks since this report was published, and remember it would have been compiled months in advance of that, nothing has appeared online and deputies have no more information.

Just take the example of the older people's strategy (now bizarrely renamed the supported living and age well strategy). It has taken on the status of some great mythological creature, so often is it referred to in the past few years without materialising.

HSSD hints at delay in the update document, talking of 'an ambitious four-year roadmap' and the document reflecting a new approach 'which is responsive to the scale of the work and accommodates the fact that resources have been, and continue to be, quite rightly needed for other critical States priorities, such as the Financial Transformation Programme'.

The note attached from Treasury and Resources to the 2020 vision report is telling in what it does not say: 'As there are no resource implications identified in this report, the Treasury and Resources Department has no comments to make.'

The report will be criticised for not having any costings – no doubt HSSD will argue it is a high-level strategy document.

This lack of information is disappointing because it leaves too many loose ends in a document that will be central to shaping the island.

It includes so much that should be a force for good – such as ensuring people are more healthy to start with and that a radical overhaul of health care is delivered.

'The health system is delivered through a range of partners and independent providers, including HSSD, MSG and the island's GPs. There is, however, no overall governance and direction and thus no guarantee that the best outcomes are being achieved. The system is not financed in a coherent way and this can create unhelpful and counterproductive barriers to better outcomes,' the report stated.

That is about as explicit a criticism you can get.

Certainly more explicit than talking about prioritising major decisions about developments and 'disinvestments' – the latter presumably means closures and service cuts, but the department did not want to upset anyone.

Health and Social Services is by no means the only department that is afflicted with an apparent desire to say as little as possible.

Sometimes the States may not have the data, which is just as worrying.

Sometimes the States just does not trust the public, or realise the importance of what it holds.