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Comité des Connétable s
Deputy Mary Le Hegarat
Chairman - Health and Social Security Scrutiny Panel Scrutiny Office - States Greffe
Morier House
St Helier
JE1 1DD
Our ref: DWM/srdeg/20 16 January 2019
Dear Mary
Changes to Health and Community Services Department
Thank you for your letter dated 17 December 2018 which was considered at the recent meeting of the Comité des Connétable s. The report of the Department for Health and Community Services was also discussed noting the Department stated that its aims are to "reduce our reliance on hospital- based care delivered during the working week and create new options for care closer to home" and, in particular, the paragraph regarding the delivering and funding of health services in the Parishes in the section titled "Building on our strengths".
That paragraph referred to "a local infrastructure that would be the envy of most jurisdictions" and that "our local communities stand ready to play a strong role in supporting their residents to live healthy lives" but did not elaborate on specific plans.
The Comité has had various approaches over the years, most recently in autumn 2018, when Connétable s were consulted on how the States of Jersey could directly work with each Parish to help to deliver and expand the provision of community based services. The States understood community based services to be wide ranging, from clinical assessments to exercise groups to health awareness sessions so this might be any health service that did not require specialist hospital equipment. The States wished to ascertain a list of the valuable services' the parishes currently provided and delivered (these might vary from exercise groups to talks and afternoon tea sessions/dances). On that occasion the Comité was informed that the proposals for future service delivery would address preventative health for both old and young persons and should be cost neutral to parishes.
The Comité was also asked, in 2015, whether space was available at Parish Hall s for HSS staff to work remotely which would enable staff to update records whilst working in the community.
In 2012 the Comité met with the Director of System Redesign and Delivery, Health and Social Services, to discuss the implications and impact on parishes of the proposals in P.82/2012 "Health and Social Services: a new way forward" (P.82 is referred to in 2.1 on page 3 of the "One Health and
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Community Services: Playing our part within One Government" December 2018 report). At that time concern was expressed that the States was seeking to devolve the provision of services from the centre to the parishes without the necessary resources but equally of concern was the adverse impact on volunteers should financial costs be transferred.
During our discussion, we were informed by the Connétable of St Saviour that Langtry Gardens, a development of lifelong homes for the over-55s, should have delivered shops and other amenities but, other than a community room, these were never provided – as a result that community has no easy access to a doctor's surgery etc. The Comité was also informed that the Parish of St Martin is currently seeking to develop community facilities in the former school building to include a doctor's surgery. An initial approach to the Council of Ministers was declined although we understand the newly appointed Chief Executive considered this was a missed opportunity when he toured the premises last year. Whilst negotiations are on-going with potential tenants there is still be the opportunity for the HSC to deliver a surgery in the centre of St Martin fitted out for use by its various services e.g. diabetes clinic, etc. Indeed, in the interests of closer working with the private sector, should the States fund a fully-fitted doctor's surgery it could well be of interest to local general practitioners without a base in that part of the island who might rent' space to deliver services to their patients.
In relation to funding it should be noted that we have, over the years, received a number of proposals from States Departments faced with budget cuts which would, in effect, seek to transfer costs from the States to the Parishes. You will, I am sure, understand that these have been resisted by the Connétable s. Whilst we focus on the provision of services for our own communities, it is the ratepayers who fund the running costs of the buildings owned by parishes and through which these services are provided. We of course welcome the delivery of States services in a more geographically convenient and cost effective manner for our parishioners but this should be funded by the States and not a Parish.
I hope this assists the Scrutiny Panel in its review. Yours sincerely
Deidre Mezbourian
Chairman, Comité des Connétable s