Recruitment of Health and Care workers

21.11.02

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

recruitment of Health and Care workers (OQ.222/2021)

Is it the Minister's assessment that there is a recruitment crisis for health and care workers that is affecting service delivery; if so, will he state what steps he is taking to address it; and if not, will he explain why not?

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

There is no recruitment crisis in H.C.S. (Health and Community Services). The organisation has a vacancy rate of 5.3 per cent currently, which is not unusual for an organisation of that size. However, we do have areas in some specialties in which recruitment is a challenge as we are competing in a highly competitive labour market, and of course Members have asked me about the issues in many previous questions. As to what is being done, much could be said of the various training programmes run by H.C.S. but I have limited time to do so. In the last 3 months we have recruited more staff than leavers. Wider than H.C.S., we do need to recognise the pressure in the residential and domiciliary care sector for staff that support homecare, residential and nursing care. This is a topic that has been covered in a previous question. There are similar pressures in that sector to the pressures we see presently in hospitality. Many staff appear to have left the Island, perhaps as a result of Brexit or COVID. It is also pertinent that in primary care, G.P.s (general practitioners) are working exceptionally hard in the face of increased attendances and surgeries and they report difficulties in attracting G.P.s to work in the Island. I hope that helps.

1. Deputy M. Tadier :

Focusing particularly on the part of the answer the Minister gave about the residential sector, would he explain what he thinks are the main pressures or problems with recruiting and what he thinks is the job of his department, if anything, and the Council of Ministers to mitigate those problems?

The Deputy of St. Ouen :

Pressures: that it is a tough job. I believe the people who work in care are very special persons and are rare enough that they have become crucial to the sector. We are trying at the moment to increase the numbers of people working by the help-at-home initiative. Members may have seen the publicity given to that. Money has been released as part of the fiscal stimulus with the aim of recruiting 100 new staff and upskilling 50 existing staff in the sector. That money is to fund their salaries while they are training because that is an issue for some of these providers who have to train new entrants. They have to be taken on to the books but while training they cannot offer their services as carers.

2. Deputy R.J. Ward :

Does the Minister have concerns over the level of skills of those who are being attracted or entry into the care sector given the vulnerability of those that they are caring for?

The Deputy of St. Ouen :

I have not been alerted to any risks as a result of a lack of skills. There is a robust training programme in which those entering can move through the ranks and qualify at different levels and achieve different skills. Indeed some move through the levels of qualification as a carer to move on to a nursing degree. The question of whether care is being delivered in an unskilled, inappropriate way would be dealt with by the Jersey Care Commission. But as a general rule, I believe our care delivered in the Island is of an excellent quality.

3. Deputy R.J. Ward :

Is there a concern that because there is such a need - you mentioned 100 people needing to be recruited - and some care workers are starting at quite a low level of skill - I cannot think of a better phrase - but thrown into the industry immediately and really put under pressure from day one? It does put them in an almost impossible position with low wages and a very difficult situation. That is the issue we have with recruitment and retention.

The Deputy of St. Ouen :

I do not know the details on how a carer is trained but I do know that a carer who is just entering the sector is not permitted to work on their own. They have to work with an experienced carer until such time as they have acquired the requisite level of skill and qualification. There are safeguards around this. There are robust training programmes, everyone who applies for a job has to enter a training module, and this is standard. As to salaries, the present help-at-home initiative is offering a starting salary of £12.75 per hour, which of course is over the living wage. I think carers can move through the different levels to a higher degree than that.

4. Senator S.C. Ferguson:

There are certain areas in health where there are long waiting lists and expensive equipment, which his sitting idle for half the time. Why does the department not employ additional temporary staff to reduce the lists?

The Deputy of St. Ouen :

They appropriately do employ more staff and we attempt to move through the lists as quickly as we can. There is a constant view on how we can get through our lists but of course sometimes it is even difficult to recruit locum staff. But that certainly happens and we do employ them.

5. Senator S.C. Ferguson:

Why does the department not put its mind to it? If you employ staff to work overtime and utilise the equipment for 24 hours instead of 12 then you could reduce the waiting lists very quickly. It would be a temporary measure and then once you manage to reduce the waiting lists you could keep on top of it. It would be cheaper in the long run to employ people to clear the waiting lists rather than this half-hearted approach. Why does the department not put its mind to it?

The Deputy of St. Ouen :

I do not agree we have a half-hearted approach. We do employ locums to catch up on work. We employ teams sometimes that come over just to move into the list and get things done. We do offer overtime where appropriate, but it is not possible to run the health service on a 24/7 basis without having to increase staffing levels massively if we have to supply services around the clock. That is all I can say to that.

6. Senator K.L. Moore :

Is the Minister aware that many families are struggling and ever-approaching crisis points in their attempts to care for their loved ones in their own homes due to the current lack of staff available for domiciliary care? What does the Deputy propose to assist those families?

The Deputy of St. Ouen :

Yes, I am aware of the challenges, very much so, as are the social care team who makes very effort to help in this respect and we will prioritise resources to make sure that as much care is given. But it is the case - we have seen in other sectors, hospitality being one - that at present there are pressures because so many of the staff that used to work in these sectors are just not available. Whether that is a temporary situation or whether it is for the longer term, the whole administration and Government needs to work through. But at the moment we are going out with the help-at-home initiative to local people and telling them that a career in care can be very satisfying and rewarding, and that is running with the help of the fiscal stimulus funding to ease these difficulties.

[10:15]

7. Deputy G.P. Southern :

Will the Minister commit himself here and now to working with the Minister for the Environment to ensure that the terms and conditions under which home carers are recruited and retained put up no artificial barriers and make the process as easy as possible?

The Deputy of St. Ouen :

I will co-operate with my fellow Minister. We want to make sure that the sector is effective in delivering in care but of course I have no powers in terms of fixing the employment terms and conditions of private businesses.

8. Deputy G.P. Southern :

I am hearing the tale coming back again. Does the Minister accept that his predecessor's decision to transfer homecare services into the private sector, away from the Jersey Family Nursing sector who provided the best training and the best service at the time ... does he think that his predecessor's decision to transfer away from that particular service was a mistake and will he seek to reverse that mistake?

The Deputy of St. Ouen :

I think the Deputy needs to realise that homecare has moved on since that time in that there is far more care being delivered in people's homes than there ever was and we have far more providers to do so. It is not possible to reverse and we do not want to; we wish to ensure that all the care that is needed is available and the private companies with their high training needs and programmes are in a position to do that.

9. Deputy M. Tadier :

The Minister talked about the job being a difficult one. Is he aware, whether itinerant or peripatetic, care workers who go from home to home to provide care are still not being paid their travel time? If he is, does he think that is a good practice that will incentivise people to work in the sector?

The Deputy of St. Ouen :

I am aware that different companies operating in this area have different rules. Some pay for travel time, some pay an allowance for the use of a vehicle. It is important that staff feel that they are properly remunerated and that they are not bearing the burden of having to move around from client to client during the working day. Exactly how that is done is perhaps a matter for discussion with their employers.