Are those with drug and or alcohol problems automatically referred to a third sector agency or other agencies for support and guidance with supplementary questions

2.6   Deputy J.A. Hilton of St. Helier of the Minister for Health and Social Services regarding referrals by ante-natal services staff to third sector agencies or other agencies for support and guidance:

Can the Assistant Minister explain whether as part of antenatal services offered by her department, teenage mums and/or those with drug/alcohol problems, are automatically referred either to third sector agencies or other agencies for support and guidance and if not, why not?

Deputy J.A. Martin (Assistant Minister for Health and Social Services - rapporteur):

Yes, any women accessing maternity service who require additional support are always offered a referral to the most appropriate agency. This may be either in Health and Social Services or in the third sector. This will be offered on an individual basis and some women will choose to take up the offer and some women will not. The question itself does not determine between teenage mothers and/or on drugs and alcohol problems which are 2 totally different categories. Some teenage mothers - I mean those of 17, 18 or 19 - will not be able to cope on their own. Some will be in very good relationships and have good support from their extended family.

1. Deputy J.A. Hilton:

In answer to my question, the Assistant Minister referred to individuals who require additional support. The whole reasoning behind my question is that I feel that there are vulnerable people slipping through the net because there is no one single agency picking them up and no one single agency taking responsibility, and it seemed to me that all pregnant mums have to go through antenatal services and to me it seems that this was the best agency to deal with those mums. So I do not accept that all those who require additional support are getting it and, with the best will in the world, I do not understand how anyone could think that a teenage mum I accept that some teenage mums might have supportive families behind them but with the best will in the world we all know that the best outcomes are achieved by positive intervention at the time of birth and I think it is very important that Health and Social Services pick up on this. I have been told that Health and Social Services are intending to do this in 2014 so my question to you is why cannot this be brought forward to now?

Deputy J.A. Martin:

Well, hopefully the Deputy and everyone else who is attending the White Paper presentation this afternoon at lunchtime will hear this and the Deputy has been told I am sure it is going to be early intervention and it will be before birth. Again, it will be through Health but it will be involving ... we need more input from health visitors, more input from G.P.s, we are working with the J.C.P.C. (Jersey Child Protection Committee) to put this in train but again I may differ to the Deputy 's view. I think that there are some very capable teenage mums out there and some 30 year-old mums who are not as capable. It is everyone who needs the every individual case and I am sorry if the Deputy feels that people are slipping through the net. I work very closely with Brighter Futures and they go out to some of these mums and it takes about 6 or 7 sessions and not always do they get them into the unit. The help, I think, is there and we monitor it and obviously if there is any concern over child protection that then becomes a totally different issue and we try not to get to that point.

2. Deputy M. Tadier :

Would the Assistant Minister comment on I think the underlying premise of this question which deals with to what extent should the State get involved in individuals' lives, so can the Assistant Minister comment perhaps on the policy of the department about the difficulties of intervening in the private lives of individuals and in which cases it is appropriate to do that?

Deputy J.A. Martin:

Personally, I have no problem in intervening in anybody's life if they need the help or the department or the G.P. or whoever the professional is thinks they need the help. As I say, you can point people in the right direction, you can help as long as they need it and you can give them all the support. I do not have a problem with doing that but I do not agree, as referred to in even the question, all teenage mothers would need to be referred to an outside agency. I do not agree with that.

3. The Deputy of St. Ouen :

Is the department confident that they are able to identify all those in need who would benefit from support and guidance?

Deputy J.A. Martin:

As I think I said in an earlier question, people may not be picked up – teenage or 20, 21, people having their first child at 30 or older may not be picked up antenatally. It is afterwards some suffer with post-natal depression so it is all people that come into contact with these people - i.e. as I said, midwives, health visitors - we need to work and we will be introducing this programme, early identification and directing people to the right help whatever age and whatever their problem is.

4. Senator S.C. Ferguson:

But is this something that the Minister keeps talking about this is something being done by the department. Surely this is something that comes under primary care and should be dealt with at the primary care level, co-ordinated by the G.P.?

Deputy J.A. Martin:

I did say that if the Senator obviously may have missed me, but I said we do need to really work. Some people who are working only come to antenatal at the hospital for scans. They choose because they go to their G.P. for the rest of their check-ups. Now, we need to get all the G.P.s on board, which we are working with, and the G.P. has probably known that patient since they were a baby so if anyone can identify that there could be a problem they are the ones to do it and I do not have a problem with that. We are just working towards that.

5. Deputy J.A. Hilton:

I think with the best will in the world, a professional working in the Antenatal Department would have to have their head stuck in the sand in dealing with some individuals who present themselves who very obviously require some outside assistance. The Assistant Minister's own department has recognised the value of positive intervention and intends introducing this wide scale in 2014. What I want to know is will the Assistant Minister urge her department to introduce this as soon as possible and include it in the medium-term financial plan for next year?

[10:30]

Deputy J.A. Martin:

Well, the medium-term financial plan covers the next 3 years and it is in the plan. It is about recruiting, making sure we get the right systems out there and that some are done in small places, some are done in very large places but with outlying communities. I want, and I know the Deputy wants, the best scheme for early intervention that will work in Jersey. So I will try and see if we can bring this forward and do it properly because we do not want another thing that is not right for the Island, but as the Deputy says, we do not want to miss anybody.