Issues recently highlighted by Les Amis in relation to staff shortages and their consequential effects

2019.03.12

4 Deputy M. Tadier of the Minister for Health and Social Services regarding the

issues recently highlighted by Les Amis in relation to staff shortages and their consequential effects: [OQ.73/2019]

Will the Minister explain what steps he is taking to resolve the issues highlighted by Les Amis in relation to staff shortages and the consequential effects of them ceasing their community outreach and short breaks services from 31st March 2019?

Deputy R.J. Renouf of St. Ouen (The Minister for Health and Social Services):

Health and Community Services is aware of the situation with Les Amis and the 12 adults, who are affected following the decision of Les Amis to cease its community outreach and short breaks service. Multi-agency procedures were implemented immediately upon notice being received from Les Amis. All agencies came together quickly and are presently working together to ensure the best outcomes for service users and their families, in transitioning to other arrangements. Those service users, who did not already have a case co-ordinator, have been allocated one and the agencies involved are meeting on a weekly basis, for the foreseeable future, to monitor progress and address any issues. It is my understanding that other providers can step into the place of Les Amis and no adult client of Les Amis need be left without alternative arrangements for outreach, or short breaks being put in place with as little disruption as possible.

1. Deputy M. Tadier :

The last sentence, I think, was key. The Minister said that other organisations can step in and that no client need to be left without respite care. But, can he given an assurance that this will be the case? Will the Minister also give an added reassurance - he will know some of my constituents, who have used and struggled finding sustainable and stable respite in the past, he will know that through his time on the Scrutiny Panel - will he give all those families the reassurance that, if necessary, his department will step in to ensure sufficient respite care?

The Deputy of St. Ouen :

At the moment, there are assessments being carried out by the agencies concerned. So, I cannot predict the results of those assessments and therefore I, as Minister, cannot give a categorical assurance that all the required procedures would be met, but I do not anticipate difficulties. It is my understanding that there is capacity in other providers and subject to those assessments, which are a very necessary part of the service, there is no need for adult clients to be left without their respite.

2. Deputy G.P. Southern :

Does the Minister consider that the position we have got to today is a direct consequence to his predecessor's privatisation of the care industry and introduction of competition? We were always going to find a shortage of care workers in this particular area and this has manifested itself as a result of the policy.

The Deputy of St. Ouen :

That is an extremely wide-ranging question. Jersey decided long ago to introduce a long-term care scheme, which clearly envisaged that independent providers would be providing care to the vulnerable in the Island and did not envisage government provision. That was not a decision of my department, or my predecessor. That was a decision of this Assembly. The system works well. We have a good care system and a thriving commercial market, which has grown over recent years in order to put into place care for our community. There are always pressures in a market and there is competition amongst care providers, but I think Jersey can be proud of the fact that it has produced a care system and we can look across the water at the U.K. and see the struggles they are encountering. We are not in that position.

3. Deputy G.P. Southern :

Does the Minister not accept that we are endangering the level of the service we can provide? What measures does the Minister have in place to ensure that all care workers, in this particular area, are fully trained?

The Deputy of St. Ouen :

What has happened here is that the managing director of one charity has said that he cannot continue to provide part of a service that they have previously provided and the Deputy seems to think that this means that the whole of the care sector is endangered. I do not believe there is any evidence of that. As to what steps I take to ensure that carers are trained; that is a matter for regulation of care and the Jersey Care Commission. It is a requirement that carers are properly trained and qualified.

4. Deputy K.F. Morel of St. Lawrence :

While the Minister is not directly responsible for rates of pay at the organisation in question, Les Amis, does he accept that in a sector where long-term relationships between staff and their patients are critical, that a race to the bottom on wages is only going to result in Jersey shooting itself in the foot and losing care workers from across the sector?

[10:15]

The Deputy of St. Ouen :

I wonder to what extent that question is hypothetical, because I have seen no evidence on wage levels and whether there is a race to the bottom. In fact, I think in many cases, because of the competition involved, care workers are in a good position to move between providers for better wages. I note that we have not had, it does not appear, I am not aware of any industry representations, concerning pressures on the care sector. Merely the announcement from this one provider.

5. Senator S.C. Ferguson:

Given that the lessons learned in the Children's Department of Health and Community Services are not being communicated to the complementary adult section, is this not a cultural defect, which his department needs to address?

The Deputy of St. Ouen :

I am not sure what the Senator is alluding to. First of all, the Health and Community Services does not, any longer, have a Children's Department. That is managed under the aegis of the Minister for Children and Housing, as the Senator will now know. If the Senator is asking about transitions and communications, then that is a process that has been addressed and we always attempt to ensure proper transition when people are moving between children's and adult services.

6. Senator S.C. Ferguson:

The lessons that have been learned by the Children's Department, or the children's section, are not being communicated to the complementary adult areas that are contiguous to the treatment dealing with the disadvantaged adults and so on, the lessons are not being communicated within the working sections. Is this not something the Minister will investigate and just get to work, rather than just saying: "Oh well, I do not know"?

The Deputy of St. Ouen :

I have not been advised of any failure to learn lessons. If the Senator wishes to help me with that, I would very willingly meet with her and I will investigate, I will ask questions of the department, as she requests.

Senator S.C. Ferguson:

I would recommend that he also reads the Auditor General's report.

7. Deputy M. Tadier :

The Minister talked about a thriving commercial sector within the care industry, which will no doubt be of little solace to Les Amis and their clients, who are affected by the service cuts. Does the Minister agree that for care workers generally who do some of the most worthwhile and perhaps hardest work in our society, they often get paid the lowest wages still with precarious work conditions where they are often not even paid, for example, for travel time? Hence the more general issue that we and he need to get to grips with is making sure that care workers are valued and want to do the job valued, both philosophically, but also in monetary terms for the work they do. Will he take steps to make sure that issue is resolved and not simply leave it to the thriving free market?

The Deputy of St. Ouen :

I concur with much of what the Deputy has said. We need to value care workers. These are people who are looking after very vulnerable people, sometimes people who are doubly incontinent, who are unable to communicate, they really have a tough task and we must commend them and thank them for all their work. Yes, there have been issues and there may be issues around the use of vehicles and not being paid for travel time, et cetera. Some carers may feel underpaid, but these are private operators and it is not for government to intervene beyond setting the minimum wage and beyond ensuring that there is proper regulation of this sector, which there is.