Hope House

21.12.13

13 Senator S.C. Ferguson of the Minister for Health and Social Services regarding

Hope House (OQ.244/2021):

Given that the recent independent review of the Mental Health Department included substantial criticism of the department's management, will the Minister advise whether he has considered the department's evaluation of the services which Hope House was prepared to offer youngsters and, if not, why not?

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

Health and Community Services Adult Mental Health Department has not evaluated the services offered by Hope House as Hope House is registered as a children's home under the Jersey Care Commission and therefore does not provide services that would come under the remit of H.C.S. Decisions on this service sits with C.Y.P.E.S. and the Minister for Children and Education.

1. Senator S.C. Ferguson:

Given that the Health Department know the excellent reputation of Silkworth and given that we have a very new Minister for Children and Education, does the Minister not consider that he should be working with the new Minister to give the very best of opportunities to children at Hope House rather than wait for the education do it yourself scheme to commence?

The Deputy of St. Ouen :

I share the Senator's view of Silkworth as an excellent provider of services and it is true that H.C.S. has services that it commissions from Silkworth in the adult sphere. The Senator suggests that I should and I think that is known to the Minister for Children and Education and C.Y.P.E.S. I have not had any dealings with C.Y.P.E.S or the Minister for Children and Education on this. I have not been asked to intervene in the way the Senator suggests and I cannot answer as to why this service has not moved forward.

Senator S.C. Ferguson:

Given that the Minister's own hospital

The Bailiff :

Senator, you will have a final supplementary but there are others to ask questions first.

2. Deputy R.J. Ward :

Referring to the first part of the question with the criticism of the department's management, can the Minister confirm whether any of the managers in question or any structures within that system have been involved in commissioning of mental health services to either charity providers or, more relevant, profit-making providers for mental health services, i.e. is that criticised management involved in now commissioning their services away?

The Deputy of St. Ouen :

Yes, H.C.S. has commissioned services in the mental health field from charitable providers and private providers and that would have involved those working in the Mental Health Department and the Social Services Department. Those services and that commissioning has gone through a proper process and I am satisfied all is in order.

3. Deputy R.J. Ward :

Can I just confirm with the Minister that he is confident in those commissioning services, that there are no conflicts of interest or those making decisions on commissioning that may have interest in particular groups or companies?

The Deputy of St. Ouen :

Certainly no conflicts have been brought to my attention and I am certainly not aware of any. I would not expect there to be. There are checks to make sure that those conflicts do not arise. If the Deputy has any doubt at all, any information that he wishes to bring to my attention I hope he would do so.

4. Deputy I. Gardiner :

At a recent P.A.C. (Public Accounts Committee) hearing with the director general for Health and Community Services, the director general mentioned that this service came ahead of time when we questioned if we need these type of services in the community. Would the Minister address the comment that Hope House came ahead of time and it would be very beneficial for the Jersey Care Model but not now?

The Deputy of St. Ouen :

I am sorry, I did not quite catch that. The Deputy was suggesting Hope House had something Deputy I. Gardiner :

The director general commented that the Hope House has excellent facilities but came ahead of time, too early and it would be beneficial later on in the Jersey Care Model but not now. Any comments?

The Deputy of St. Ouen :

That is a view expressed. As I said, I have not been briefed on the services that were intended to be offered at Hope House because it did not sit within H.C.S. I am afraid I cannot comment on the service that was intended.

[16:15]

5. Deputy I. Gardiner :

The director general for Health is responsible for arrangements in the hospital and obviously the director general for C.Y.P.E.S. was responsible for arrangements in the community. During the P.A.C. hearing, we questioned how the process from the hospital to the community was working and currently, from the Minister's response, it seems that there are still siloes between health and the community and the process is not working smoothly. Is that correct? Apologies, in relation to Hope House.

The Deputy of St. Ouen :

The Deputy has the advantage on me because I was not at that hearing. It is true that H.C.S. delivers services to children in the hospital, for example Robin Ward , and that C.Y.P.E.S. delivers services in the community to children of course, such as the children's mental team, C.A.M.H.S. (Children and Adolescent Mental Health Service). There are structures around that, there are memoranda of understanding as to how that operates between the 2 departments and those are always under review. I know the professionals working in those areas are dedicated to their work and are ensuring that the system flows well and works well for children. I hope that helps the Deputy .

6. Deputy K.G. Pamplin:

The building used to be in the hands of Health and Community Services, it is now in the hands of the charity but the charity's remit is to help teenagers with alcohol and drug problems, an issue that does affect Health and Community Services when dealing with those young people in the hospital. Given the Minister's response about knowing the charity, will he seek to sit down with all relevant Ministers to look at why this service is not being used to benefit young people, because that is one of the main remits of those they hope to help?

The Deputy of St. Ouen :

That question should be referred to the Minister for Children and Education, if the Deputy wants to know why the service is not being used to benefit young people, because it is not a service that H.C.S. would commission or would come under my remit. I am afraid I cannot provide the answers. The question needs to be asked elsewhere.

7. Deputy K.G. Pamplin:

I was also just prying on to the Minister who mentioned he was aware of the charity's work, that he would take that forward to sit with the other Ministers and look at what referrals could be put in place with his understanding of the charity's work, because there is linkage between all the services, and that is the point of the Jersey Care Model.

The Deputy of St. Ouen :

I undertake to have a conversation with the Minister for Children and Education, as that seems to be the wish of the Deputy . There will be organisations that work across Government and will be involved in various departments, and because one department does not commission services I do not think it is for another department to persuade. But I will have that conversation with the Minister for Children and Education.

8. The Connétable of St. John :

It is a little like déjà vu because at the P.A.C. hearing that Deputy Gardiner referred to, the director general of Health and Social Services confirmed that they provided resource for children and education. It was confirmed by both director generals that neither were responsible but both were responsible. Is Health responsible for this service?

The Deputy of St. Ouen :

No. Health was never asked to commission this service. The discussions, I understand, around Hope House have always been with C.Y.P.E.S. and the Minister for Children and Education.

9. The Connétable of St. John :

Could the Minister update us on where the memorandum of understanding between his department and C.Y.P.E.S. currently is in the provision of services on their behalf?

The Deputy of St. Ouen :

There is a memorandum of understanding relating to the delivery of services within C.A.M.H.S. and that exists.

10. Deputy L.M.C. Doublet of St. Saviour :

Given that Silkworth provides services for those affected by substance misuse and dependency, does the Minister agree that these issue are a health issue and therefore should sit under his remit?

The Deputy of St. Ouen :

The decision was taken before I came into office to establish a Ministry for Children. I would guess the Deputy might have supported that. This is to support children whose lives are affected by substance misuse and clearly the Ministry of Children have that within its remit. There is an overlap with Health, of course, but there is an overlap between many Ministries. This service clearly falls within C.Y.P.E.S. remit and all discussions have been with C.Y.P.E.S. I am sorry I have not been able to answer these questions in detail because I have never received a briefing and never expected a briefing, and it was never suggested I would be briefed. It was always going to be a service provided and commissioned by C.Y.P.E.S. if agreement was reached.

11. Deputy L.M.C. Doublet :

Just on that, does the Minister agree that our actions relating to drug misuse and dependency should take a harm reduction model, which I believe is what Silkworth advocates?

The Deputy of St. Ouen :

I am sure that is right. A harm reduction model would seem the most sensible but I am not immediately aware of all of Silkworth's statements of purpose, for example. But if the Deputy says that is within it, I can understand that.

12. Senator S.C. Ferguson:

Will the Minister discuss, over coffee perhaps, the extremely competent service provided by Silkworth and suggest to the Minister for Children and Education that he should visit the organisation himself and seek verification of the comments that have been made to him by his in- house staff? As Professor Reagan said: "Trust, but verify."

The Deputy of St. Ouen :

I have said I would embark on a conversation with the Minister for Children and Education but I am not going to do so with any preconceived ideas in telling him what to do because is clearly the lead on this, so I would wish to listen to what he has to say. I will speak to him of our relationship in H.C.S. with Silkworth when delivering services for adults and we will see where that leads.