Implementation of the Child and Adolescent Mental Health Service including supplementary questions

3.6   Deputy S.Y. Mézec of the Minister for Health and Social Services regarding the implementation  of  the  Scrutiny  Report  into  the  Child  and  Adolescent  Mental Health Service:

Let us see how we do with this one. Following the publication of the Scrutiny Report into the Child and Adolescent Mental Health Service, what action, if any, will the Minister be taking to implement these recommendations?

Deputy A.E. Pryke of Trinity (The Minister for Health and Social Services):

Members should have received this morning a letter from me in which I have outlined my actions and, importantly, set out a clear vision on the way forward. I will be responding formally in more detail to the Health, Social Security and Housing Scrutiny Panel before the last sitting of the Assembly. Meanwhile, I am happy to outline my initial response to this Assembly today. Firstly, I want to thank the front line staff at C.A.M.H.S. (Child and Adolescent Mental Health Service). I and my Ministerial team met with them last week and I was incredibly impressed by their hard work, professionalism and dedication in supporting young people and their families. I accept and they accept that the service needs to change and I know that C.A.M.H.S. front line staff are up to this challenge. Some of my key early commitments and actions I will ensure are taken forwards as a matter of urgency. They will cover leadership, governance, vision and communications. In addition, I intend to accelerate the development of an adolescent unit on Robin Ward . I have already increased the capacity in C.A.M.H.S. to respond to the unprecedented increase in demand and I am in the process of strengthening both management and clinical input for the specialist C.A.M.H.S. service as a whole. I am also strengthening the leadership across children's services. As my department takes this ambitious programme forward, my officers will ensure that relevant States Departments, in particular Education, voluntary and community sector organisations, young people and their families and carers are fully involved. We know it is vitally important that their voices are heard.

[15:15]

It is also critical to the success of children's services that other departments and partner agencies are involved and support our efforts because nothing is more important than protecting and caring for vulnerable children. Finally, I would like to thank the Scrutiny Panel for providing comprehensive support and I hope this Assembly will acknowledge my department's and my commitment to respond effectively to its findings and support me and my department in taking these things forward.

1. Deputy S.Y. Mézec :

One of the criticisms in the Scrutiny Report is the lack of action that was taken after the 2006 Young Minds charity recommendations, most of which have not been implemented. How can the Minister assure us that this report will not end up on the scrap heap like the last one and has she pre-emptively asked the Minister for Treasury and Resources for more funds to help her accomplish some of these changes that young people in Jersey desperately need?

The Deputy of Trinity :

Documentary evidence provided to the Scrutiny Panel review shows that of the 17 recommendations made to the Young Minds report 15 have been acted upon following publication. It is recognised that the Young Minds report was published in 2006 and there has been significant change in this area since. The climate is not the same: cyber-bullying, increased pressure. It is a fast-moving world and we need to react quickly to it. My department has been in contact with the States Treasury to look at funding, especially for Robin Ward , but it is not only about resources, it is having a clearer vision and a positive way forward.

2. Deputy M.R. Higgins:

One of the main criticisms in the report was the lack of any assistance to families after 9.00 a.m. until 5.00 p.m. Will the Minister tell me has she brought in measures now to correct that and is there now a service for people outside normal hours so they can get the help that they need? If not, when?

The Deputy of Trinity :

There was a clear pathway but that pathway even needs to be clearer. If someone is accessing service after 5.00 p.m., if it is an acute episode it needs to be done in a proper way through A. and E. (Accident and Emergency) and into the Robin Ward if that is appropriate. That is one of the actions that we are going to look at very shortly. Regarding timescale, I cannot give the Member the exact timescale for that.

3. Deputy J.A. Hilton of St. Helier :

In the letter sent to States Members this morning, the Minister for Health and Social Services alluded to a fundamental review for the independent mental health issues and also in her penultimate paragraph in that letter that that review will be undertaken. Could the Minister tell Members when that piece of work is likely to commence?

The Deputy of Trinity :

Members would appreciate that a lot has happened in the 2 weeks. Things I have put in place have been very firm and swift action. Regarding the review, it will take longer but, as the experts' action plan said, within 3 months. When I give the detailed report back to Scrutiny within the next couple of weeks that will be detailed.

4. Deputy R.G. Le Hérissier:

Notwithstanding the Minister's welcome memo, can the Minister explain to the House further why her recommendation involves that there be an expert running or monitoring the whole of the Children's Service as opposed to C.A.M.H.S., which was the focus of the Scrutiny?

The Deputy of Trinity :

Because under the Children's Service we need a wide range because it is a multi-agency response. That is the most important thing that I need to get over. It is not just C.A.M.H.S., it is not just Children's Services. C.A.M.H.S. is a specialist mental health service and we need to involve Education, all Children's Services, Home Affairs, the voluntary sector, and schools, too, have a big part to play with this.

5. Deputy R.G. Le Hérissier:

Why then have all the previous reports come to naught? The Deputy of Trinity :

I totally disagree with that. As I said about Young Minds, 15 of the 17 recommendations have been in place. With the Williamson Review, there have been firm recommendations which have been put in place. There is strengthening. Children's services - C.A.M.H.S. services - is a very complicated issue and we must address these issues as highlighted in the scrutiny report.

The Deputy Bailiff :

Deputy , although that was a factual answer being sought, it was a point-scoring question and I was hoping we were going to avoid those.

6. Deputy M. Tadier :

One of the findings states that the majority of the recommendations from the Young Minds report in 2006, already 8 years ago, have not been fully implemented. Does the Minister think that this is acceptable?

The Deputy of Trinity :

I just thought I had already answered that. I can say it again: 17 recommendations made in the Young Minds report; 15 have been acted on following publication of the report. Young Minds was back in 2006, so how many years ago? Eight years ago. The climate has changed. We know that and we must react quickly to the effects of cyber-bullying, bullying, pressure that these young people are under.

7. Deputy M. Tadier :

Is the Minister saying that the finding is wrong then? Because it clearly states that the majority of the recommendations had not been implemented. Is that not correct?

The Deputy of Trinity :

I shall repeat what I just said. I cannot say it any more than that ... Deputy M. Tadier :

I do not wish her to repeat. I just wish her to answer the question. The Deputy Bailiff :

I think she did answer the question, Deputy . She does not want to add anything further. We are going to move on. This is not a debate about the C.A.M.H.S. report today. It is Question Time.

8. Deputy S.Y. Mézec :

The Minister mentioned expanding Robin Ward as one potential thing that can be done. I would like her to just say exactly how that is going to work. Is it going to be Health Department staff down there? Is it going to be C.A.M.H.S. staff down there? Could she just give us a bit of an idea of exactly what that means?

The Deputy of Trinity :

Within Robin Ward we have already identified that we need a secure unit. As in most of our hospitals in the States, some of it is just out of date full stop. We have identified that. We recognise the problems. It will be a specialist unit within Robin Ward and, yes, if it needs to be staffed by specialised paediatric mental health staff, then that is something that is in the Business Plan and we will try and bring it forward as swiftly as we can.

Senator P.F.C. Ozouf :

May I raise a point of order? In the earlier question, Deputy Higgins said: "I wonder why he bothers to turn up" in relation to the Solicitor General. I have read Standing Orders 104 and I believe that that statement would be contrary to Standing Order 104(2)(b), insulting language or improper motives. I am surprised you did not rule it out of order and I just wondered why the Solicitor General should be subjected to such an inappropriate comment that is clearly in breach of Standing Orders, in my view.

The Deputy Bailiff :

Senator, I am grateful for that point being raised. In my view, you are correct that it was out of order. I did say to Deputy Higgins it was unnecessary. I probably should have ruled it out of order, but I am afraid it comes from a lifetime of experience as Attorney General and Deputy Bailiff that the Crown appointments unfortunately have to put up with things being said in this Assembly which frequently should not be said.

Senator P.F.C. Ozouf :

Then if it is in breach of Standing Orders, would you ask the Deputy to withdraw the statement that he made? I would like an expression of the rest of the Assembly that we do not agree with that statement being made. [Approbation]

The Deputy Bailiff :

I am grateful. I do think it is in breach of Standing Orders. Deputy , would you be prepared to withdraw it?

Deputy M.R. Higgins:

I am quite prepared to withdraw it and thank the new Speaker of the House for bringing it up. Senator P.F.C. Ozouf :

That was imposing improper motives.

The Deputy Bailiff :

I think it was possibly doing that if you take a very firm view of it. I am not going to take that view because we are under time pressure. We are going to keep moving.