Questions to Minister without notice Health and Social Services

5.  Questions to Ministers Without Notice - The Minister for Health and Social Services

1. Deputy M. Tadier :

I did ask a written question - number 17 for reference - regarding the Four Seasons Nursing Home. One of the parts of that question was whether the private care homes, including the Four Seasons one, have been properly vetted and police checked in regard to their staff. The answer given by the Minister lower down says that: "There is currently no requirement in the law to enable or require police vetting of staff. However, in this particular case of respite I can confirm that appropriate vetting and barring procedures are in place." I would like to ask the Minister, first of all, if she wrote that answer or if it was provided to her, because I believe that answer is factually incorrect. I would ask her to investigate because I believe that procedure is not in place. There are not appropriate vetting and barring procedures in that place because I know for a fact that staff members have been employed without even so much as a simple background check.

The Deputy of Trinity (The Minister for Health and Social Services):

I stand by the answer that I gave and everything is provided by the department that regulates the care homes, which consist of residential care and nursing homes. I am concerned about what Deputy Tadier has just said and if he has any concerns about this care home then I would be very happy to speak to him about it, as would be the regulator of care in that area.

5.1.1 Deputy M. Tadier :

A supplementary if I may: would the Minister advise whether she has been made aware that the Four Seasons Nursing Home is pending an investigation? There is an investigation being carried out at the moment. Is she also aware that, as I have stated previously, there are not currently vetting and barring procedures taking place and also, as she said, they are not required to be under the law?

The Deputy of Trinity :

Yes, I am aware of an investigation taking place. It has just begun and it would be totally inappropriate for me to make any further comments regarding that. As regards the vetting and barring, if it is not under the law then it might come under the service level agreement that we have not only with this care home but with every other care home that provides care to Health and Social Services.

2. Deputy K.C. Lewis :

Will the Minister update Members regarding the provision of peritoneal dialysis at the general hospital?

The Deputy of Trinity :

I know that Deputy Lewis has been very concerned about this. He has been lobbied by many of his parishioners and the Kidney Association, along with Deputy Lewis and Deputy Martin, have spent quite a few hours in the Renal Department trying to get reassured and I am sorry that the Deputy is not reassured yet. Nurses are in place. Can I just briefly say that this relates to continuous ambulatory peritoneal dialysis. It does not relate to hemodialysis, which continues. This is a very specialised, highly technical procedure which involves a cannula into the peritoneum, which is part of the abdominal body, and it is only used really for ambulatory patients. It is highly skilled and needed to be highly trained and for the people who receive it - and at present there are 5 people receiving this type of peritoneal dialysis - it is not an easy thing to undertake because they have to be on the ball; it is a treatment they have to do to themselves every 6 hours, 24 hours a day, 7 days a week. Obviously, cleanliness, infection control and to be able to understand how to do it is very high priority. That is why the nurses that need to be trained are highly specialised and it is difficult to get nurses with that specialised training. We have succeeded in getting the nurses, they are being trained up and we hope to be able to have new patients on the ambulatory peritoneal dialysis programme by the beginning of January. As I said, this is a very highly specialised area.

3. The Deputy of St. Martin :

Could the Minister inform Members of the annual funding given to Family Nursing and also outline the governance arrangements in place re the States funding to Family Nursing who identified a £172,000 deficit at their A.G.M. (annual general meeting) in May this year?

The Deputy of Trinity :

I have not got the exact figure; I am sure the Deputy has. I think it is in the region of £6 million and it is done by a service level agreement. Officers within my department liaise very closely with the Chief Executive of the Family Nursing Services, as I do with the Chairman and the Chief Executive, I think on a 6-monthly basis. I know the Family Nursing Services have got a deficit, I was there at that A.G.M., but they are looking at new ways of doing the service as they move forward, as we all need to look at our services that we offer, especially in looking at the area of our ageing population.

5.3.1 The Deputy of St. Martin :

Could I just ask a supplementary and ask the Minister was the deficit really related to the lengthy and costly suspension of the former Chief Executive Officer?

The Deputy of Trinity :

I think that is a matter for the Family Nursing Services and the committee.

The Deputy Bailiff :

That is not within your responsibilities.

The Deputy of Trinity : No, it is not.

4. Deputy G.P. Southern :

The Minister has stated that the voluntary redundancy scheme will be considered for implementation at the beginning of 2011 and in accordance with the States-wide scheme at that time. Has the Minister seen the proposals for the new voluntary redundancy scheme in 2011? She also then says: "In all such cases employee representatives have been involved to date." Can she detail the involvement of employee representatives: who attended, how many meetings, when and where?

The Deputy of Trinity :

What the Deputy asked are very specific questions. I have not attended at any of the union meetings. I cannot tell you who was there, what were the exact timings and whatever but I can reassure him that the unions were involved right from the word go. They have had meetings and I understand that 3 meetings have been arranged. We do keep the unions on board and the officers meet the unions and the staff representatives very regularly. It is concerning their staff members so it is very important to keep the unions on board. Regarding the voluntary redundancy scheme for next year, no, I have not seen it yet.

5.4.1 Deputy G.P. Southern :

Supplementary, Sir, if I may. Will the Minister agree to circulate to me and to other Members in the States the details of the meetings that have taken place and their briefings?

The Deputy of Trinity :

If I remember rightly, I think this could be one of the questions that he has asked ...

The Deputy Bailiff :

I think we are inquorate, Minister.

The Deputy of Trinity :

Does my 15 minutes continue while we are inquorate, Sir?

The Deputy Bailiff :

The clock is still running. I ask Members in the anteroom to kindly return to the Chamber. Very well, Minister.

[12:15]

The Deputy of Trinity :

As the new Chair of the Health and Social Services Scrutiny Panel, he has asked very detailed questions for the Scrutiny Panel, which is fine, and my officers are working on those. I have an idea that that question could be in it but if it is not and if he wants a detailed question then please could he request it so I know exactly what is the information that he wishes and will try and help him with these answers.

5. Deputy A.K.F. Green:

First of all I would like to congratulate the Minister on the provision of the very excellent respite care that is now being provided [Approbation] and ask if she has any plans to expand the service, because clearly it still is not sufficient for people in the community. Does the Minister have any plans to expand the provision, particularly for those at home, in other words to provide respite care for people to remain in their home overnight while their carers take a weekend off or a day trip away?

The Deputy of Trinity :

Thank you for the Deputy 's comments. It is shame that only 3 States Members took up the opportunity to go and see the facilities at Four Seasons. It is excellent. It is a 2-bedroom apartment especially for respite care for young adults who have been at Oakwell and now, because of their age, Oakwell is not appropriate. This is due to the funding that the States agreed last September on an amendment by Senator Shenton and part of that money that we used is not only for respite care in Four Seasons but also respite care at home. It all went out to tender and the Family Nursing Services won that tender. Also, there is another area of respite, and for the life of me I cannot remember what that other area is, but I think it is being able to take people out accompanied. It is covering all those 3 areas and it will need to be looked at in future. We are an ageing population and respite care will need to be addressed because it is cheaper to keep people at home.

5.5.1 Deputy A.K.F. Green:

I will help the Minister very quickly. The other area is providing care in the home during the day. Will the Minister undertake to look at providing care at home overnight?

The Deputy of Trinity :

Yes, I can do because that is an important area too if we want to keep people in their own homes, which I think is where most people wish to be.

6. Deputy R.G. Le Hérissier:

Does the Minister agree with her Chief Executive's observation that in order to reform management in the hospital it will indeed be necessary to employ, at the initial stages, more managers?

The Deputy of Trinity :

I know this has added great controversy and I can understand the reasons why. Looking at the Comptroller and Auditor General's report I am surprised that most people think that the health service is over managed. In fact, I agree that it does need some more expert management, especially at times of unprecedented change and it will be a significant change in the way that we provide health and social care. The way that we are going to look to do it in the future, we may need to make sure that the advice we get and the plans put in place are correct and right for Jersey. We may need some more management skills to add that. They may come from outside or we may hopefully train up our own but that will take time. It is difficult. We are going to have 3 extra management posts. It is going to be a hospital managing director; we have got an interim one in place but that will go to a fulltime one. There is going to be a director with Community and Social Services which hopefully will be in place at the beginning of January 2011.

7. Deputy T.A. Vallois:

After taking into account the invest to save, the growth proposal and the plan B growth proposal within the C.S.R., the end result would be approximately 5.5 per cent and not 10 per cent of the Minister's budget. Could the Minister therefore explain what her vision is for a sustainable medium to long term health service?

The Deputy of Trinity :

That is a very open, big, wide question. I think it adds on to what I said before that we need to look at all the areas across Health and Social Services of where we go in the future, not only because of the savings that we have to do but as we go into the future the way we provide healthcare will have to change.

The Deputy Bailiff :

Minister, you have 30 seconds for your vision, or perhaps less.

The Deputy of Trinity :

We will continue to look at it. It is a significant change, not only because consultants have become more specialised and we will need to look at that issue and how we are going to work with it.

The Deputy Bailiff :

Thank you very much. We now come to the end of Questions without Notice.