ONE of the inevitable consequences of the wide-ranging review being undertaken by Health and Social Services is that its ‘what if…?’ approach to cost control would trigger concerns among staff, patients and other health providers.

The Princess Elizabeth Hospital is currently alive with rumours – that HSSD can’t or won’t confirm – that wards are to be closed and that nurses are being offered voluntary severance. And there will doubtless be more to come.

This is an unsettling time and one that will be deeply troubling for islanders and deputies. What it doesn’t mean, however, is that the review should stop or that it is in some way wrong.

Challenging assumptions and current ways of operating is the duty of departmental boards and their professional staff and HSSD, perhaps belatedly, is the first States body to have the courage to embark on that process.

What members need is support and encouragement, for it is the consequences of any changes that matter, not the posing of the questions.

If, for example, bed occupancy was 65%, what would happen if that was increased by taking out other beds? What savings could be made in running costs, staffing and equipment and cleaning? Would patient care, treatment or safety be compromised or waiting times unacceptably extended?

Unless islanders want to be taxed to extinction, people have to accept that the underlying issue is about choice: how much do we want to pay for a given level of public services and what can be done without increasing available funding for, say, health?

But those options cannot be exercised until the costs and consequences have been identified, which is the process HSSD has embarked upon.

It is unfortunate that the department’s political colleagues in the Assembly have been too feeble to start the process themselves: Health and Social Services is probably the last area to choose as a testbed.

That said, if HSSD can do it, the other departments also branded profligate by the Tribal consultants will find they have no hiding place.

In the meantime, the department needs to complete its work before people start jumping to conclusions about how awful the ‘cuts’ and ‘closures’ are.