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Health and Social Security - Approved Panel Minutes - 12 February 2015

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Health and Social Security Scrutiny Panel

Record of Meeting

Date: 12th February 2015

 

Present

Deputy R. Renouf , Chairman

Deputy T. McDonald

Deputy G. Southern , Vice-Chairman

Deputy J. Hilton [Co-opted Member item 2 only]

Apologies

 

Absent

 

In attendance

Connétable J. Refault, Assistant Minister for Health and Social Services [Item 3 only]

Mr J. Turner, Director of Finance and Information [Item 3 only]

Ms. H. O'Shea, Managing Director of the General Hospital [Item 3 only] Mr P. Andrews , Divisional Lead Operating and Support Services [Item 3 only]

Miss S. McKee , Scrutiny Officer

 

Ref Back

Agenda matter

Action

 

1.  Record of Meetings

The Panel noted and approved the record of its meeting held on 29th January and 2nd February 2015. The Chairman signed it accordingly.

 

09/02/15 Item 1

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2.  Respite Care for Adults

The Panel considered its Public Hearing with the Health and Social Services  Minister,  which  took  place  on  9th  February  2015.  It  was recalled that during the hearing the Panel was advised that it was the Department's intention for all health and social care, including short- break services for respite users, to be funded through the Long-term Care Scheme in the future. The Panel noted its concern about what that would mean for adult respite users and, in particular, how their care would be funded going forward. It was advised that the Social Security Department had offered to brief the Panel on this particular matter as it was also concerned about the information that had been conveyed to Members.  It  was  suggested  that  a  briefing  took  place  as  soon  as possible.  Subsequently,  the  Officer  was  requested  to  enact  the necessary agreements with the Department.

The  Vice-Chairman  requested  that  his  concerns  regarding  private briefings were noted. The Vice-Chairman advised the Panel that he felt that it was unnecessary to hold the briefing in private and believed that all  briefings  should  be  open  to  the  public.   Deputy  G.   Southern requested the Chairman to re-raise the issue at the next Chairmen's Committee meeting and report back to the Panel.

It was recalled that, at the Hearing, the Panel had requested to view the

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assessment  system  (FACE)  that  was  used  by  the  Social  Security Department to assess the level of respite care that an individual would require based on their specific disabilities and needs. The Officer was asked  to  follow  up  on  the  request  and  to  arrange  a  visit  to  the Department.

The  Panel  further  recalled  that  the  Director  of  Adult  Services  had offered to meet with the Panel to discuss the Department's future vision for Le Geyt Centre. The Panel agreed that, due to its busy timetable, it would be preferable for the Director to write notes on this matter and circulate to the Panel. The Officer was asked to contact the Director and advise of the Panel's request.

The Panel further requested the Service Level Agreements between the Health Department and approved providers of home care.

The  Panel received  an  update  on  the  status of  the  review.  It  was advised that the Panel had so far received four written submissions from Members of the Public. It was further advised that three private hearings had been arranged with parents whose adult children were receiving respite care for the week commencing 16th February.

The Panel identified further stakeholders that it wished to contact for information regarding its review. The Officer was requested to write to those concerned.

It was noted that, so far, little consideration had been given to respite users who were at the latter end of the age bracket that the Panel were reviewing.  In  this  regard,  the  Officer  was  requested  to  contact  the Health Department to ascertain what respite facilities were available for individuals  with  early  on-set  dementia.   The  Officer  was  further requested  to  contact  Jersey  Alzheimer's  Association  to  establish whether there were any figures available on the number of people who suffered from early on-set dementia in Jersey.

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Item 5 29/01/15

517/1/1(5)

3.  UK Patient Treatment

The Panel received a briefing from the Assistant Minister for Health and Social Services and his Officers on the Patient Travel Charges Policy.

The Panel was advised that the Patient Travel Charges Policy had last been updated in 2014 for two specific reasons. Firstly, the Department needed to ensure that the Policy dealt with civil partnerships. Secondly, the Policy's definition of Emergency Care' needed to be consistent with other jurisdictions.

The Panel was advised that, up until 6 months ago, there had been no appeals  process  available  for  individuals  to  challenge  the  decision made in regards to patient travel to the UK. Now, however, individuals were able to meet with an appeals Panel to discuss their concerns. The Assistant Minister advised the Panel that consideration was currently being given to changing the appeals process. At the moment, when individuals  were contacted about their appeal, the Department was unable to give them a set day in advance as to when they would be able to meet with the appeals Panel. It was advised that the uncertainty would cause anxiously for some patients. Subsequently, going forward

 

 

 

a particular day of the week would be set aside for appeals and the patient  would  be  advised  of  a  specific  date  when  they  were  first contacted by the Department. It was noted that the Department had not received  many  appeals  to-date.  Only  one  complaint  made  to  the Department in regards to the Travel Policy had made an appeal.

It  was  noted  that  the  Travel  Policy  clearly  outlined  the  type  of assistance patients would be entitled to based on fixed income and financial  thresholds.  However,  the  Panel  was  advised  by  the Department that on some occasions the Policy has been applied with some  discretion. For  instance,  the  Department  recognised  the problems faced by families that needed to travel back and forwards to the UK for treatment on a significant number of occasions. Instances such as these would be dealt with by the Department on a case to case basis. The Panel was further advised that on occasions clinical advice could override aspects of the Policy. For example, Consultants would sometimes ask the Department to make exemptions for their patient as a result of their health needs. The Chairman was concerned that, if discretion was not built into the Policy itself, patients could potentially miss out on free care by not applying for assistance. The Assistant Minister advised however that a cut-off point was necessary and if discretion were to be built in to the Policy the number of appeals would dramatically increase.

The  Vice-Chairman  raised  concerns  that  the  second  tier  threshold figures for a patient's household income were too low (£39,000 for a single adult). A concern was also raised as to whether the figures had been inflated since the Policy  was first developed. The Panel was advised that the Policy was reviewed every year and its next review was due in August. However, the Department was unsure as to how and  when  the  threshold  figures  were  calculated.  The  Chairman requested that the Department provided further information about when the thresholds changed and what the previous figures were.

The Panel questioned the Departmental Officers as to whether it was possible for patients to receive funds in advance of travel in case they were unable to afford to pay themselves and wait to be refunded. It was advised that new contracts had been set up with hospitals in Oxford and Cambridge which allowed free transport between the airport and hospital. It was further advised that the aim of the Department was to re-new all of the contracts it had with hospitals in the UK to include this provision. However, it was noted that in the meantime a patient could receive taxi vouchers or emergency funds from Social Security under such circumstances.

Consideration was given to whether hospitals in France could provide particular  health  care  services  for  Jersey  patients.  The  Panel  was advised that the Department had examined the possibility by visiting a hospital in Rennes but, due to factors such as a language barrier and treatment costs, had deemed it to be inappropriate.

It was noted that if a patient was unable to be seen by a UK hospital on the same day as travel the Department would pay £50 towards the patient's accommodation. However it was advised that that happened very rarely and hospitals were normally very flexible.

 

 

 

The Panel was advised that 90% of radiotherapy treatment for Jersey patients was undertaken at Southampton Hospital. It was noted that the hospital  invoice  would  be  received  directly  by  the  Travel  Office  in Jersey  and  the  Department  would  pay  the  full  cost  of  treatment. Patients would also receive three meals and day and accommodation would be provided.

The Panel was advised that patients under 18 were allowed one parent to accompany them to the UK who was then able to stay with the child on the ward in the hospital. However, the parent was required to pay for their own travel expenses and food whilst there.

 

517/1/1(6)

4.  Quarterly Hearing with the Minister for Social Security

The Panel considered the draft question plan for its Quarterly Hearing with the Minister for Social Security, which was due to take place on 19th  February  2015.  The  Panel  agreed  to  add  a  number  of  new questions to the draft and the Officer was requested to send the main question areas to the Department for its information.

The Officer was requested to circulate the Hansard from 3rd February 2015  in  which  the  Vice-Chairman  questioned  the  Social  Security Minister on Income Support Sanctions.

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5.  Sex Discrimination Regulations

The Panel agreed to request a private briefing with Officers at Social Security on the draft Regulations. It was noted that the briefing would help the Panel decide whether it would undertake a review on this subject.  Subsequently,  the  Officer  was  requested  to  make  the necessary arrangements. The Vice-Chairman advised that Panel that he would not be attending the briefing.

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6.  Future Meetings

The Panel noted that its next Panel meeting would be held on Thursday 19th February 2015 at 9:30am in the Le Capelain room, States Building.