Recruitment of healthcare workers

21.05.11

7 Deputy K.G. Pamplin of St. Saviour of the Minister for Health and Social Services

regarding the recruitment of healthcare workers (OQ.115/2021)

Will the Minister advise what action the Government are currently taking to ensure that the recruitment of healthcare professionals such as nurses, G.P.s (general practitioners) and carers is maintained and supported, especially for the workforce needs arising out of the Jersey Care Model?

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

The workforce strategy and associated resourcing plan for the Jersey Care Model is scheduled to be delivered by the end of this year as part of the first tranche of activity within the Jersey Care Model. At that point we will know the requirements for all healthcare professions to support the model. In the meantime, the department continues to recruit to its existing vacancies, with 107 jobs actively out for recruitment at this moment. This includes 21 adverts for medical staff for the 21 vacancies currently available in medical staff, 37 specific nursing adverts, and I have referred in the previous question to the "always on" recruitment portal for nurses, of which there are 60 vacancies for nurses at the present time. I said in the previous question many of those vacancies are not just left empty, they are fulfilled by locums at the present time. The question refers to G.P.s and carers. The Government does not have responsibility for the recruitment of G.P.s or carers, but as the workforce strategy develops, any changes in the workforce to support the Jersey Care Model will be identified and shared with the relevant recruitment leads in those areas to ensure correct recruitment activity is taking place.

1. Deputy K.G. Pamplin:

I am glad the Minister touched there on the last part of my question about G.P.s because a recent study by the King's Fund, Nuffield Trust and Health Foundation predicted in 2019 that the N.H.S. (National Health Service) shortfall in G.P.s would triple from 2,500 to 7,000 by 2023-2024. As the Minister rightly said, they do not get directly involved in the recruitment of G.P.s. Will he ensure that part of the work going forward is to help the G.P.s in recruiting, when there are similar issues across not just the United Kingdom but Europe in recruiting and training new G.P.s?

The Deputy of St. Ouen :

Yes, we are working in partnership with G.P.s. We are all involved in providing health and care on the Island to ensure that all Islanders' needs are met. That is a very definite impetus in the Jersey Care Model. We are working and collaborating well with other professionals, including the G.P.s, and I am pleased to see that moving forward.

2. Deputy R.J. Ward :

In looking at our future needs in terms of the workforce, has the Minister taken into account any effect of a migration policy that could have particular barriers for professionals and for numbers coming to the Island?

The Deputy of St. Ouen :

Yes, that was taken into account when the Migration Policy Development Board was formulating its report. H.C.S. made a submission in respect of staff it needed and I am pleased to see that the final report - and indeed, this was shown in our debate on the issue - recognised that we still need to bring people to the Island based not just on their economic value to the Island, but on their social value, which might include the need for carers, the need for nursing staff, the sort of sectors where traditionally they have not been seen as high earners, but they have a real social and healthcare value.

3. Deputy R.J. Ward :

Extending that to the on-Island training and the need to train skilled workforce, will the Minister be looking at support for those; for example, nurses who want to extend their training by going off- Island and gaining that experience and therefore giving more financial support to those people who make that commitment? Because at times it is very difficult for people to go off-Island and survive in order to gain the sort of experience we desperately need on-Island.

The Deputy of St. Ouen :

Yes, I am conscious of the difficulties the Deputy has outlined. It has been an issue in the past and we are aware and we do look at those issues, but there have been steps taken to improve what is available for Island trainees. For example, it is now possible for nurses to be supported as mental health nurses and develop that specialism, and also as community nurses, so that has helped those 2 streams come along in recent times. We will always be trying to improve that position.

The Bailiff :

Very well. A supplementary, Deputy , or was that your supplementary, I think? Deputy R.J. Ward :

Honesty means that I must say it was my supplementary.

4. Deputy G.P. Southern :

I am looking forward to 5 supplementaries. Where was I? Right, as part of his action today, will the Minister commit himself to adopting the ethical charter passed by this House almost 2 years ago now and put it in place so that we can get the best terms and conditions for our carers in homes in order to recruit and retain correct staff?

The Deputy of St. Ouen :

For my part, I wholeheartedly support the ethical care charter and I remember those lengthy discussions with the Deputy , but of course Government does not employ domiciliary care workers, it is private sector employment, and the regulation of them is with the Jersey Care Commission, who I understand is very much aware of the ethical care charter. Indeed, the whole ethos of the Jersey Care Commission is to ensure that those industries that it regulates treat its employees in the best possible way, fairly, and ensures that their professional training and standards are upheld.

5. Deputy G.P. Southern :

Could the Minister commit himself then to talking to the Jersey Care Commission in order to work out what aspects of the ethical charter - which, as he keeps saying, has been passed by this House - can be adopted now or in the near future?

[11:30]

The Deputy of St. Ouen :

Yes, I will again talk to the Jersey Care Commission about that. There is one limitation the Jersey Care Commission has, in that it cannot set employment law, so of course there must be a parallel discussion with the Minister for Social Security with regard to any employment issues or terms of employment relating to carers. The Jersey Care Commission will do all it can within its remit and then I think it is for us, as States Members and Ministers, to ensure that employment law practices are followed.

6. Senator S.C. Ferguson:

I assume the Minister is aware that we are advertising for 17 new civil servants costing £900,000 a year or thereabouts to plan the commencement of the Jersey Care Model, which means we have more civil servants in the Health Department than we have G.P.s in the Island. Does he think that this is a constructive recruitment policy and does he perhaps need to take a step back and look at the proper organisation of his department?

The Deputy of St. Ouen :

This was the Senator's question last week, but I am happy to address it once again. Of course a department with approaching 3,000 staff may well have more administrative help than the 100 or so G.P.s that are in the Island, so that certainly does not surprise me. With the remit of H.C.S., I would hope that it is fully managed and resourced correctly, but we must bear in mind that the term "civil servant" also includes our allied health professionals, such as physiotherapists, occupational therapists ...

Senator S.C. Ferguson: No, no, no. [Laughter] The Deputy of St. Ouen :

The Senator may interject, but they are classed as civil servants, so if the Senator is concerned about numbers, she should know that our pharmacy staff, our lab staff and any therapists are presently classed under our system as civil servants and paid on the civil service paygrade. Just finally, I have received criticism that the previous iterations to try to change the way we care for people in the Island have just not been progressive under the previous management and administration. The present recruitment is to ensure that we have a system in place that will work for Islanders that will ensure we deliver the change that is necessary to embed the best ...

The Bailiff :

Minister, I am afraid I do have to draw your answer to a close. It is well over the one minute 30 seconds that is normal.

The Deputy of St. Ouen :

I have finished.

7. Senator S.C. Ferguson:

No, because the productivity of the Jersey Care Model compared to the current productivity in the hospital will go down. Really this is something that should be looked at properly. We do not want a Jersey N.H.S. which is an utter disaster, so ...

The Bailiff :

Is there a question, Senator? Senator S.C. Ferguson:

... please will the Minister look at the productivity of the sector and of the aftercare services that are going to be provided in the Jersey Care Model and just apply a bit of common sense?

The Bailiff :

Did you wish to respond, Minister?

The Deputy of St. Ouen :

I would be interested to know where the Senator gets her data around the reduction in productivity. I have seen no such data. The work surrounding the Jersey Care Model is being thoroughly planned and it is for that reason we can expect that the care of Islanders will improve and will be modernised and come up to the very best healthcare standards because of the recruitment of the particular posts that the Senator is concerned about. We are embedding this work so that there will be no split. The best healthcare will be delivered and I am confident that that work is being done.

The Bailiff :

Thank you very much. I have Senator Mézec , then Deputy Morel , Senator Pallett, Deputy Higgins, Deputy Le Hegarat , then the final supplementary. I will not take any more questions on this one. We are running - surprisingly, even with the allowances - relatively tight in time. There have been some extremely long questions and some equally long answers and one or 2 of the questions had begun to stray outside the parameters, even broadly interpreted, of the question. Therefore I would be grateful if Members could bear those factors in mind when they come to ask their questions, and Ministers and others answering questions, bear those in mind when they answer them.

8. Senator S.Y. Mézec :

In answer to a previous question, the Minister pointed out the Government not recruiting G.P.s and carers, that they are not falling within their responsibilities. My question is why not? If there are shortfalls occurring for G.P.s and carers, will there be scope in the Jersey Care Model for the public sector to step in to directly fill the gap?

The Deputy of St. Ouen :

The reason why not is because simply Government does not fund primary care to the extent that it would run G.P. surgeries. That has not been the position in the Island, as the Senator will know, and similarly with domiciliary care workers, Government have not operated in that sector and that remains the case.

9. Senator S.Y. Mézec :

I guess I reiterate the question: why not? Just because that is the way it has been in the past does not mean that needs to be the way it is in the future. If it became clear that it is in Jersey's interests to have publicly employed G.P.s and carers to meet the health needs of the population who we represent, why would he not do that? Is he being advised that it would be a bad thing to have publicly employed G.P.s and carers to fill that need or is he being advised that it could be a useful way of filling a gap when the private sector is not capable of doing so?

The Deputy of St. Ouen :

I do not believe there is any gap in primary care. Other services outside of the public sector are being delivered and Islanders' healthcare needs are being met to the best extent that we can, but these things are continually under review. If there was seen to be any failing and the inability to provide a primary care service, then I am sure that Government would need to step in. We have excellent providers in those services and at the moment there are no plans for Government to step in and take over all these services.

The Bailiff :

A supplementary question, Senator Mézec , or have I already given you one? The Deputy of St. Ouen :

I think he has had his supplementary. Senator S.Y. Mézec :

I would love a third, but I probably will not.

The Bailiff :

No. Sorry about that, I will try and keep better track.

10. Deputy K.F. Morel :

Workforce is one element of tranche one of the Jersey Care Model. Other elements include detailed planning, foundations, acute, community and intermediate care and communications. These are all aspects of tranche one to be delivered in 2021. Would the Minister for Health and Social Services advise the Assembly whether he believes that all aspects of tranche one are currently on course to be delivered this year?

The Deputy of St. Ouen :

Yes. The information I have at the moment, the answer is yes. Deputy K.F. Morel :

Could he repeat that, because I could hear that answer?

The Bailiff :

Yes, if you could repeat that. You were rather muffled there, Minister. If you could say that again.

The Deputy of St. Ouen :

I apologise. Yes, to the best of my knowledge, the information I have is that all those workstreams will be delivered within 2021.

11. Deputy K.F. Morel :

As part of the debate on the Jersey Care Model that took place last year, close liaison with Scrutiny was required through an amendment. Could the Minister confirm that such liaison is taking place?

The Deputy of St. Ouen :

It is, and the Scrutiny Panel is aware of the steps being taken to establish the overarching board which was agreed as an amendment put forward by Scrutiny and accepted by me. Recruitment to those posts and the chair of those posts is taking place imminently.

12. Senator S.W. Pallett:

There has been a difficulty in attracting and indeed retaining staff. I mean, some of that I think has been down to housing costs to some degree and I have seen that within the mental health service personally. What will the Minister be doing in regards to providing support packages to attract staff to the Island and will he be looking to improve on those packages if recruitment becomes more difficult?

The Deputy of St. Ouen :

Yes, we will seek to improve on any packages should recruitment become more difficult. We are in a better position now to offer housing, as one example, with better accommodation, a better quality and a better range of accommodation, with the new facilities open at Hue Court and Pleasant Court for doctors and other staff.

13. Deputy M.R. Le Hegarat of St. Helier :

What risk assessment has been completed in relation to the Jersey Care Model should Jersey be unable to recruit sufficient G.P.s in order to deliver those services?

The Deputy of St. Ouen :

That is a risk assessment that needs to be undertaken with the primary care body, so I think that is something that will be developed in time. I cannot say that it is totally completed at the present time. The risks, we are aware of them. In the past though there has been good recruitment for G.P. positions in Jersey and I hope that will continue.

The Bailiff :

Deputy Pamplin has indicated he does not wish a final supplementary question.