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Health and Social Security Scrutiny Panel Quarterly Hearing
Witness: The Minister for Social Security
Thursday, 18th October 2018
Panel:
Deputy M.R. Le Hegarat of St. Helier (Chairman) Deputy K.G. Pamplin of St. Saviour (Vice-Chairman) Deputy C.S. Alves of St. Helier
Deputy T. Pointon of St. John
Witnesses:
Deputy , J. Martin, Minister for Social Security
Deputy G. Southern , Assistant Minister for Social Security 1 Deputy J. Maçon, Assistant Minister for Social Security 2 I. Burns, Director General, Customer and Local Services S. Duhamel, Policy Director
[14:02]
Deputy M.R. Le Hegarat of St. Helier (Chairman):
Just so that people are aware, this is being live streamed so is everybody settled before we turn it all on? Perfect. Good afternoon everybody and welcome to the Health and Social Security Scrutiny Panel. This is our first opportunity in this new States Assembly to speak to the Minister for Social Security. I am Deputy Mary Le Hegarat of St. Helier and I am the Chairman of the Health and Social Security Scrutiny Panel.
Deputy K.G. Pamplin of St. Saviour (Vice-Chairman):
I am Deputy Kevin Pamplin. I am Vice-Chairman of this panel.
Deputy C.S. Alves of St. Helier :
I am Deputy Carina Alves of St. Helier .
Deputy T. Pointon of St. John :
I am Deputy Trevor Pointon of St. John .
Deputy M.R. Le Hegarat :
I would also like the people opposite me if they would not mind to also introduce themselves in order that the public know who they are.
The Minister for Social Security:
I am Judy Martin, the Minister for Social Security, Deputy of St. Helier No. 1.
Assistant Minister for Social Security 1: Geoff Southern , Assistant Minister.
Assistant Minister for Social Security 2:
Good afternoon, everyone. Deputy Jeremy Maçon of St. Savour, District Petite Longueville, Assistant Minister.
Policy Director:
Sue Duhamel, Policy Director.
Director General, Customer and Local Services:
Ian Burns, Director General of Customer and Local Services.
Deputy M.R. Le Hegarat :
Thank you very much. Just for you to note that this session is covered by parliamentary privilege, as it is a proper session. Thank you. We will start now. We have a number of questions and each of the panel will ask some questions. A lot of it will be based obviously on Social Security's recent report. In your speech when you were elected as Minister you highlighted the importance of a culture of customer service. Four months into the job what do you think of the culture in Social Security?
The Minister for Social Security:
Are you talking about what has been delivered at Social Security?
Deputy M.R. Le Hegarat :
I think what is being delivered but also the culture of Social Security itself would be helpful for us to understand as well. Thank you.
The Minister for Social Security:
What is being delivered in the building that just used to be Social Security is a few of new things, it will be tax, passports and planning is the last branch to come down. I think it is around 5th November. When I went for the job and spoke to Ian Burns and Sue Duhamel it was one of my hopes that I could get us there because for probably 5 or more years, I would say, it has been: "Tell us once, you know, one stop shop" and it does not seem to have happened. They showed me this diagram and said: "This is this what you are on about?" Also going to out to the communities and work with the community base and with the parishes. I think it is very early days, the building seems to be working well. A third of the customers at the front desk are dealt with there and then. When they are trying to get their ticket, they do not need a ticket, just a general question. The man who put all this together, who went well, not all around the world, but he is the Director General for Customer and Local Services and has brought all this together and the system that you will see, if you want to talk a bit more about it?
Director General, Customer and Local Services:
Yes, I can do. Over the last few years at Social Security we have been trying very hard to provide an improving service through staff training, through improvement to processes and we have also been asking our customers for feedback. We have been working really hard to improve service and our satisfaction surveys have been promising and good but what we are doing with the change to customer and local services is trying to make it easier for our customers by moving services to one place initially in La Motte Street. That will mean that people will have to travel to less buildings to see people who they would have seen in 3 or 4 different buildings. Then we need to start looking at how we improve those services to make greater connections with things that customers want to do with Government, they need to do with Government but also moving things online as well because many customers want to transact with us online. We had a survey done earlier in the year that nearly three-quarters of customers wanted to be able to transact with Government online rather than coming in face to face. So this is the first move, it is not the end game by any means, but we need to improve the way we work, move things online, improve processes, make time for those customers who do need help and make sure we do it in a professional way and hopefully starting from Monday. We have changed the layout downstairs in La Motte Street, we decluttered it to make it clearer for what customers want to do and we introduced a new role called Welcome Host which the Minister mentioned, which means that many people are just in and out even faster than they were before. Customers who do need to wait know exactly how long they have to wait and they will then see the right person or people if they need more than one service. We have a long way to go but it is a promising start for Monday. We have been trying out this new approach with existing social security
activity over the last few weeks, so we have tested it out and it is working well so far. But tax move to us on Monday and it is really important we have been running a campaign to ensure that we minimise as much as possible any customers going to the wrong building from Monday. There is further media activity in the next few days to help push that message across so that we avoid someone turning up at Cyril unnecessarily.
Deputy M.R. Le Hegarat :
Thank you. This is for the Minister. What are your personal priorities for the next 4 years?
The Minister for Social Security:
Well, we worked together on the Strategic Plan and we did it all in groups and so the priorities I have at the moment are things that underpin that plan and work that is being done or we need to more work on the whole Social Security fund that collects money, taxes from employers and employees. We need to look at the contribution rates and the value of the States grants, and the range and value of benefits that the fund pays out. It has got a lot of money in it at the moment but it still has to be paying out. Do you want me to go on to my next one or do you want to ask questions on the fund itself now? It is entirely you can ask me I am easy whichever way you want
Deputy M.R. Le Hegarat :
One of my colleagues might have some questions they want to ask.
The Minister for Social Security: Of course. Of course.
Deputy C.S. Alves :
What I was going to ask, you mentioned there the States grant component because that has been frozen for 4 years so what do you envision is going to be done to supplement that?
The Minister for Social Security:
That is in talks. We have money coming in to cover 2019 so it will be in the new business plan for 2020. We are still in talks with Treasury, my 2 Assistant Ministers and I were there the other day, how do we do this? It is in the plan, we know it is a problem and we know it has to be dealt with to try and make it as fair as possible.
Deputy M.R. Le Hegarat :
How do you aim to achieve your priorities?
The Minister for Social Security:
Again, Deputy , I have done Assistant Minister before but this scheme of working this plan and then working into streams, it is so far across and one of my priorities down here I am working with the Minister for Education, we are looking at the skills area. That is why I have Jeremy as well because he sits across 3 but for me we are looking at back to work schemes, Skills Jersey, trackers, N.E.E.T. (Not in Education, Employment or Training), we are looking at vocational work, again, with Education. Do we have it right? Vocational areas from discussion with the Minister for Education and the Minister for Children, one day of work and 4 days at school. Looking around it could be a much better mix. Maybe 2, 3, which way, just so if that is there interest they still have to do their math and English, especially if they are taking a course, they need it, but you get them at 14 in their interests and they are going to stay. We want to move this one as quick as possible. We do not think it costs a lot of money, it is just making sure that we can get them while we have them. Then there is a scheme also because we do not know what they do when they leave. They do not come to us if they do not need any money. We do not give anybody any money under 25. If their family is not in the income support they could out there and we just do not know about them. So, Education, again, have a scheme now, it might not hit the ones just left but they are looking at seeing how they can find them, asking permission before they leave: "Can we keep a check on you, to help you?" It is just they do not want them to go and sit at home, get totally disillusioned. How long does it take a 16, 17 year-old to get disillusioned and not work? Then they are not going to work. There is work to be done but those things will not necessarily take that long. There will be a cost.
Assistant Minister for Social Security 2:
I do not mean to be rude, Chair, but if I could just be excused for 5 minutes.
Deputy M.R. Le Hegarat : Yes.
The Minister for Social Security: Of course.
Deputy M.R. Le Hegarat :
Can I just ask, in relation to some of these priorities will there need to be any legislative changes?
The Minister for Social Security:
Yes, I mean the big one coming will be the next family friendly the next piece of legislation that is going to go through the States, you mean going to come to the States?
Deputy M.R. Le Hegarat :
Yes, I meant with any of your priorities, whether there will need to be any legislative changes. For example, if you take children out of if you change how they are educated, will there be any need for any legislative changes for that to happen?
The Minister for Social Security:
The Minister for Education is literally looking at that at the moment. As I say, there probably will be changes because the law says you will be in education and the vocation is the other way around at the moment but they do not want to be at school 4 days when they really love the one day so maybe 2 or 3 and just they still have to keep attaining or they cannot do the course. The Minister for Education has done some research across the U.K. (United Kingdom) and this is how it works. It is good, we are always up in that office and chatting. This is working really well. Just to pass knowledge on is working well. I have just left the Minister for Planning up there, that does work well that we are all in the same building.
Deputy M.R. Le Hegarat :
How will you measure and monitor your progress towards achieving your priorities? How will you measure that you are getting there, if you like?
The Minister for Social Security:
We know where we want to go we need to note none of these will be done probably in the first year or 2 and there will be some that even probably will not be done it will be about priorities. If this is what I set out to do and then this is where I get to, to me that is I would measure it by that. Not everything is going to, I would imagine I do not know, everything that I want to get to is if I pick the vocational training and I find that we have 30 now and we put everything in place and then in the next 2 years that 30 is 60 and then it is 90 and they all go on work, to me that is how I would measure that. But if you are thinking of anything else, I am not sure.
[14:15]
Policy Director:
In general terms, the Council of Ministers will be producing a Government plan next year and past that so that will replace the Medium Term Financial Plan, so we currently run to a 4 year cycle, which is primarily the financial cycle, there are some indicators in there but it is not embedded within the document itself. This Council of Ministers is very keen to have a much more holistic view of policy development and use of resources and development into policies. There will be lots of performance indicators and outcome measures incorporated into the Government plan next year so the Ministers will be working on that over the next few months. That document is due to be available in draft form from March next year onwards. There will be plenty of time for people to see the ways in which Government will measure itself over the next 4 years, meaningful outcomes. For example, outcome indicators where you are not measuring how much of something you have done for what impact it has had on the target audience. How many people have we helped get into jobs not how busy the staff have been. So indicators based much more on the outcomes to the population.
Deputy K.G. Pamplin:
Just a bit of context before my next question. As new Members we were invited to go to Social Security as an introduction to the department back in the end of May, where we met officers, and to give us an understanding of the feel of Social Security and its aims and its changes. Again, as part of our scrutiny process we have had that privilege only recently to sit down with officers with an update, you could call it, of where we are on changes. We have had meetings on various legislation and stuff. I am curious from taking all that on board and to hear from you, how you view what progress has been made from you coming in as a new Minister on the changes, particularly the Department for Social Security into the Department for Customer and Local Services and the Department for Strategy, Policy, Performance and Population. It is a lot of change. How do you view it coming in to this new role, the progress so far, as you see it?
The Minister for Social Security:
The new role to put the plan together has been working across departments, policy areas and all different Ministries. Now, the building - if you are talking about the building - still has whatever it had before that was delivered by Social Security, it just has a lot of add-ons. Population control sits in there. But if you are asking if they do something there would it affect me, we will work that all out together. That is the way I see it. Is that what you are asking?
Deputy K.G. Pamplin:
Yes, it is just your opinion of coming into the role itself and seeing is the progress going well, are there areas where you feel maybe that can go quicker or maybe that needs a bit more review. Just to get your stamp of authority on the new role.
The Minister for Social Security:
To be fair, coming in I thought I knew - like Geoff thought he knew - in 17 and 18 years of doing things around Housing and Social Security, we are learning a lot in different areas. I think the staff are excellent, they give us great briefings. I can ask what I like and, you know, it gets done. Geoff is always there as well and Jeremy when he can, because he has 3 hats with the Health and Education and Planning, and P.P.C. (Privileges and Procedures Committee). He mainly does not make it. But, no, it feels like a long time from the election and then we got elected in these roles in June and there was loads of work over the summer on the C.S.P. (Comprehensive Spending Plan), real good workshops. I sat on 2, I was with Sam and Tracey on the children's one. I was with
Richard Renouf and Steve Pallett on the well-being. Geoff sat on the what was the one called, Geoff? Yes, low income, looking at low income and that, and Jeremy was on the one which was skills really. Yes, under E.D. (Economic Development). But they have all come along. It gives you much more insight. People might think it is going slow but we all know where we are going and I would rather know where I am going, but I do not think we are going slow.
Deputy K.G. Pamplin:
That is interesting, because as you referenced you both have had long distinguished careers in the States and for the last few Assemblies it would be fair to say you have been very vocal and very forthright in your views on how previous Assemblies were are going. Has anything changed your view of how the department is run and where it is heading, how you may have thought differently sitting outside Government in last Assembly? I will ask that of the pair of you.
The Minister for Social Security:
Where the department is going? Instead of 3 Ministers with 3 under people trying to sort out customers and local services, they gave Ian the job of director general to sort out local and customer services. He has managed to do it. When we used to have: "You talk to your Minister", "You talk to your Minister" then it was: "Oh, we do not really want to do that. I do not suppose we would like to go down there." Well, this is where it is. It is not about you, this is about the customer and this is the best place and how to do it. Been told it for years: "I have to go that end if I have to sort our tax out." Most people who need social security or income support have lost their job. The next thing they have to go and sort out is their tax because they have been paying tax and probably last year. So they have to go and speak to them. The welcome people are going to be saying - I might be putting words in their mouth - "Look, you are here for income support, did you think you ought to get a ticket and maybe talk to tax." Because you are stressed. I think it is going to work fantastically and I think it is moving forward well.
Deputy K.G. Pamplin:
What are the next steps you see for the continuation of the reorganising structure? What for you is the next steps in the reorganisation as you see it?
The Minister for Social Security: The reorganisation of ?
Deputy K.G. Pamplin:
That is continuing over the whole department, yes.
The Minister for Social Security:
The whole department. Well, I know Ian has been talking to the Constables and putting what cannot be delivered or maybe can you get out there how many days a week. I think you ought to speak as you know exactly what you are doing. It sounds good.
Director General, Customer and Local Services:
Yes. The Minister mentioned the fact that she came to speak to us before she stood for election as the Minister for Social Security, and indeed one of the key things she said at the time was she was keen that we were to get out into a wider outreach almost to the community around the services that Government can offer. The new one,gov structure that we are working to implement across all the new departments includes a drive to work closer with the parishes and closer with the voluntary and community sector. So that is a piece of work which is, I think, going to take awhile because there is a lot of relationships there to build and an understanding of what services are better delivered out in the community. But I think it is a stream of work where there is a general willingness to move forward. We had voluntary and community sector workshop the other day. I think you were there representing a group there. That was trying to look at how that relationship can move forward between Government and the voluntary community sector and it will take a little while but we can make it start to make a difference in terms of the services we have and how some of these services are delivered to customers. So the one front door bit, which is from Monday, is just the beginning of a whole series of things which will hopefully improve service and also help improve access to customers.
Deputy K.G. Pamplin:
On that note, do you still think, Minister, there is a perception of culture or attitude towards the department from the public. You are a Deputy , I am a new Deputy , what struck me is when you talk to people about their issues and their problems there is a perception of negativity out there towards them. Do you think there is still a bit of work to do on that perception so we can get people in to experience some of these new changes and the attitude that is changing between how the experience is as a customer? Do you think there is still a culture of negativity that we have to break through? I am just interested in your opinion.
The Minister for Social Security:
Are you talking about, what, Social Security?
Deputy K.G. Pamplin:
Yes, the public's perception of going to Social Security and the attitude.
The Minister for Social Security:
Deputy , over the years I have helped a lot of people who have had an issue with Social Security, had an issue with Housing, mainly things like that. When I have been able to help and get to the right staff, never a problem - and taken the heat out of it, say - mainly everything has been resolved. I think you are talking about a perception and in reality we have about 5,500 people getting some of it and I think that is without contributions, and pensions.
Deputy K.G. Pamplin:
That is 5,500 households claiming income support?
The Minister for Social Security:
Income support. So then you have pensioners. I hope it is not a big perception. You will always get people who do not understand something so something would have gone wrong or something has gone wrong because we have the wrong information from them and it has to get sorted out. No, I think with the new way forward they will be seen the people who do not need to be seen for that long will be in and out, the people like Ian said who need that little bit of extra will now get a bit of extra time and their problems should be sorted out. You know, some things go wrong, that is just the nature. It is unfortunate but it does.
Deputy K.G. Pamplin:
Sure. Final one from me before we move on. Where are you based currently? Because part of the change is there has been a lot of change of where people sit, where are you based?
The Minister for Social Security:
I am based in Cyril, mainly with all the other Ministers on the sixth floor. The Minister for Education is there, the Minister for Planning is there, usually the Minister for Children/Housing is there. John is only 2 floors down, he is up and down. Ian Gorst was there yesterday afternoon. I work there every day. I used to come here every day but I go there every day now, although I have to come here sometimes.
Deputy K.G. Pamplin:
That is a good way of working because there has been so much change within the building, of course, what is your relationship coming back and forward? How do you break up your day? Spend some time in the department meeting the team, people on the ground?
The Minister for Social Security:
The team, I have come down there. Sue is now based down there. She used to be in La Motte Street. The team that work in Social Security, policy officers work there, a couple of them are there today. I see the team but I think the great thing about me not sitting in my tower up there and the Minister for Education sitting up at Highlands you know, the Education building, it is not Highlands, next door. We are all there and you talk a lot. You would be surprised well, you know, you can talk about the policies and this and this and this and it does not come as a surprise because you are just having a general chat. I think it works.
Deputy C.S. Alves :
We know that the Social Security fund is currently in a healthy state but what impacts do you think the increase in, for example, the number of old age pensioners will have on the fund in the medium to long-term?
The Minister for Social Security:
Do you mean the long-term care fund or the pension because they are both pensions, yes. Well, this is what we have to look at. As it goes up you are going to have more people being able to take out and not the same as even we have now putting in. It is going to be a problem. When we look at the next 4 years this is what we have to start thinking about. We are all right, I think, for how many years? We think if it all stays the same about 7 years.
Policy Director:
No, we have 7 years' worth of we could pay out of our reserves 7 years' worth of benefit without any extra income coming in at all but that is not the
The Minister for Social Security: Not the fund.
Policy Director:
Yes, we are not in any trouble in 7 years' time. We have significant reserves built up and we have high level contributions which are currently funding our pension costs. But, you are absolutely right, pension costs will go up in the future. We are currently undergoing an actuarial review of the Social Security fund. That work will be done by the end of the year and that will give us projections going forward 60 years. They are very long-term projections which will show the full bulge of the baby boomers going through the population and out the other side. That will give us very useful information to help plan the policies going forwards, which the Minister is already doing with the Minister for Treasury and Resources.
Deputy C.S. Alves :
So what are you currently doing - if you could go into a bit more detail - to mitigate any of those future impacts? Is something like, for example, revising the higher earner's cap something you have considered for maintaining that fund?
The Minister for Social Security:
Everything is in at the moment, Deputy . I could not say: "Oh, yes, we definitely do that." You are right, we need to look at the fund, we need to make it as fair as possible. As I say, initial talks we had with the Minister for Treasury and Resources to do it this way, to do it that way. We have to make it fair first, but it still does not mean that the contributions will not need to go up. It might be a double whammy.
Deputy C.S. Alves :
Can you give us an update on your progress on the Social Security review?
The Minister for Social Security:
The Social Security review? Under which part? The family friendly or ?
Deputy C.S. Alves : It is the review that
The Minister for Social Security: There. I thought I had already said that.
[14:30]
Deputy C.S. Alves :
Do you still aim to complete the review by 2019?
The Minister for Social Security:
Oh, absolutely, yes. That is right, is it not? Yes, the review has been completed.
Policy Director:
Shall I just explain? The review started before this current Minister was in office obviously and there have been some consultations over the last couple of years. This year one of our main focuses has been on the actuarial review. So all 3 funds had an actuarial review. That is quite a significant piece of work in itself. That puts us in a very good position for next year. So next year the Government plan will create a 4 year combined policy and financial plan for the States as a whole. So we need to make sure that the Minister and the Minister for Treasury and Resources have the opportunity to feed into that plan appropriate actions that need to take place for the short-term sustainability. But the review itself looks more at the long-term sustainability of the fund and that is absolutely about demographics. It is also related to population policy, which is another area that obviously does not
fall under this Minister but for the Chief Minister to look at, so there will need to be co-ordinated actions across the various Ministers to resolve those kind of issues. The review itself, one of the areas where the Minister is very keen to make progress in the next year is around looking at the way the incapacity benefits are provided so that is not necessarily worrying about the cost of things but more the way in which a service is provided. So the assessment of long and short-term incapacity, working with doctors and other health professionals to try and develop a more modern assessment method that run across benefits in a much more coherent way than what we have at the minute. The Minister has also asked us to look at home carer's allowance and various other aspects of the benefits we have at the minute. So there are a variety of different workstreams going on. Some of them will finish next year but some of them will carry on through. The important point is to get the work that needs to go in the Government plan done in the next few months so that feeds into the Government plan next year but inevitably there will be more work to do over the course of this 4 year term to look at incapacity in lots of detail. Maternity benefits: the previous Minister was interested in introducing a more modern approach to parental benefits, so perhaps having benefits available to fathers as well as mothers. That is something that this Ministerial team would like to look at. So there are many things to do, they do not all cost a lot of extra money, they are just perhaps reorganising existing funding. So there is a mixture of long and short-term actions to be taken.
Deputy C.S. Alves :
Does that include things like avoiding increasing the retirement age and cutting benefits in light of the increasing pressures with people living longer and things like that? So are those the kind of things that you will be looking to avoid?
The Minister for Social Security:
You mean benefits in old age and you also asked about working longer?
Deputy C.S. Alves :
Yes, are you looking to avoid increasing the retirement age, for example, to help fund that or ?
The Minister for Social Security:
It is already going up. I think we have a plan so many years, 68, is it? Sixty-seven.
Policy Director:
Some time ago now the States agreed the State pension age, so it is not retirement age, it is the old age pension rather than a retirement pension. The State pension age will start to increase in 2020, it will increase 2 months a year each year for the following 10, 11 years, so it would reach 67 by 2031 and that is where we are at the minute, so we are in the average of other countries. Many countries have made that kind of change. It is a nice gradual change, it is two months a year so
there is no big jumps in the programme. Past the review we will need to look at whether there should be further increases. Recent evidence suggests that life expectancy is not increasing as fast as it has been in the past so that is something to take into account because up until now there has been this relentless kind of increase in life expectancy. There is evidence that may be slowing down now. So there is quite a lot to think about. But, basically, we have a timetable through to 2031 so we do need to take another decision but there is no suggestion that we would go faster within the next 10 years, it will be 2031 onwards we will be talking about. So we have plenty of time to plan for that.
The Deputy of St. John :
Minister, thank you for coming along today. I want to add some questions in relation to social security. We are currently going into a period when there is going to be a greater dependence by this society on community services for a certain development that is going on at present. It is clear that community services, primary care services, are sometimes not taken up by the public, especially people on low income but who fall outside the support track. Are you thinking of putting any funding into review of dental and G.P. (general practitioner) treatment?
The Minister for Social Security:
On the stream that I was on, the well-being with Richard Renouf and Steve Pallett, dentistry and access to G.P.s, both accessibility in a place - it does not have to be in hospital - and also affordability for different people. Some people can just go. Again, the dental piece, I mean, in my opinion, the Minister for Health has a lot of money that is in the dental scheme. Can it be done better? Is the best place to take your 4 year-old, 5 year-old child for the first time they go to the dentist in a massive hospital? It is a high priority, Deputy , and all priorities are bumping against money. We know we need more money and it is how we feed it. We have to save some money to change things and then we will find some money. It is very high on my priority and I would say high on Health's priority, and their Assistant Ministers - and Jeremy is one
Assistant Minister for Social Security 2: Could I just
The Minister for Social Security: Yes, of course.
Assistant Minister for Social Security 2:
I think it is a really good question but it not just about raising perhaps the subsidies towards G.P.s and dentists, it is also looking at who can deliver a service. The classic one, for example, is looking at pharmacists. Pharmacists can quite easily deliver skincare, you do not necessarily need to go to your G.P. in order to pay for that service. So some of the work that is going on in Health is looking at: "Well, who is best placed to deliver this service?" Of course the implication for Social Security then is who has access to the H.I.F. (Health Insurance Fund) funding. That work is going on but it is not just about looking at who we can subsidise in order to attract more people to do it, it is also looking at who is best placed to deliver the service. One of the pressures, of course, is always is a nurse practitioner a better way of delivering the service. So to take blood does your G.P. need to do it or can a nurse within a practice do it, for example. To answer your question, it is not just about looking at subsidies, it is also looking at about how best a service is delivered and can that be done in a cheaper way.
Assistant Minister for Social Security 1:
But it is essential, I think - if I may add to that - that we do make sure that we have joined up thinking and we get people to the G.P., if that is necessary, early so that we save money in the long run. What is happening at the moment is some people, poorer people, are finding themselves unable to afford to go to the doctor and that defeats the aim of trying to keep us all a bit healthier as we age. That has to be essential, I think, and some measure of how well we succeed in that we should be looking at.
The Deputy of St. John :
Which is one of the reasons I asked the question, I wanted to see where progress had got to in relation to developing additional funding for G.P.s, dentists and so on.
The Minister for Social Security:
Also preventative, making sure you can go when you need to go. It is very high up there on the well-being across the board with policy officers from Health.
The Deputy of St. John :
It brings us on to where do we go when we are discharged from hospital and have a dependency, on to the long-term care scheme. The last scrutiny panel produced a report, do you have a response to that report, or how have you responded to that report?
Policy Director:
There has been a response, yes.
The Minister for Social Security:
It was very weird because the main players in the report were Deputy Renouf and Deputy Southern . By the time the responses were signed off, they were Minister and Assistant Minister. But it would have been the same answers because I was in the room as well. Have scrutiny not got where we are? Have you not got where we are?
The Deputy of St. John : No.
Assistant Minister for Social Security 1: The response was given in SR4 of 2018.
The Minister for Social Security:
There were, I think, 25 recommendations and we accepted 23. They are mainly ongoing, some have been completed. Do you want me to go through them? I can.
The Deputy of St. John :
I would like to hear it, please, because we do not have your documentation in front of us.
The Minister for Social Security: Will I go through the 25?
The Deputy of St. John : Just give us the broad brush.
Policy Director:
Do you want me to summarise?
The Minister for Social Security:
Yes, I was going to start with one that I know that is number 2, yes. Because they do repeat a lot but we will make sure you get one, sorry. I thought you did have one of these.
Policy Director:
We did circulate the leaflet.
Deputy M.R. Le Hegarat :
We probably do have it, it is just it may have just slipped under the radar.
Deputy K.G. Pamplin:
I think also the point you just made as well is the transitional period we found ourselves in is that - and using another example - Deputy Renouf responded to the heart organ donation scheme as Minister for Health to his own report. I guess what we are looking for is, as you are the new Minister, obviously just to add something extra from yourself to the report in your own words as opposed because of the transitional changeover is what we are looking into.
The Minister for Social Security:
Unfortunately I was not on the scrutiny and there are a couple that are joined, and this one just for me. So they asked: "If you were assessed and you were quite ill when you had already gone through an assessment on the income support PC care levels and you could have one, why would you go for it again?" That would make sense. A lot of the concerns were not enough respite and that we did also try and get and they have told us that there is something being done, it is being worked up and should have something by I think for the timing is pretty good because it will be by the end of the year. That seems to have moved pretty quick, because this was the last scrutiny report before the May elections. So it is one of those. But the scheme
Policy Director:
Shall I just summarise it then?
The Minister for Social Security:
Yes, if I have missed anything, because as I say it really was not my report.
Policy Director:
Scrutiny seemed to confirm that the long-term care scheme, as a scheme, was a well-planned scheme, well-organised scheme, it was quite complimentary about the design of what they were trying to do. It did have some criticisms on some of the operational aspects of the scheme. It was a very new scheme and we are very happy to accept the fact that it did not work brilliantly in the first couple of years. Many of the recommendations referred to more administrative type issues which the Minister would not necessarily get involved with directly, but many of these things have been addressed by operational teams since the review has come out. There has been a lot of communication, so you have a much simpler, more attractive booklet which helps people who come to the scheme for the first time. We still do have the longer booklet which is much more detailed, it is not really to read from cover to cover but it is there for reference purposes and it still performs that function really well. Some of the recommendations were around the way in which claims are processed. There has been lots of joint working between the Health Department and the Social Security Department, Social Security teams, on the way in which the information flows between the 2 areas, so that is easy for people to do. We do have, as the Minister alluded to, a process whereby an income support claimant can access long-term care very simply with very little paperwork involved at all because we have already got information through the income support scheme. We are interested in hypothecs, the way in which you claim a loan, that process is quite straightforward and we think that is okay. There is more work to do on the computer side of things. The panel were asking for online applications, that is something we will do. It is quite a low volume benefit compared to other benefits and therefore it will not be given priority over some other areas but we will be looking at that next year.
[14:45]
Ditto the ability to get automatic statements out so we can produce those on demand and that seems to satisfy people's needs at the minute. There will be some work done next year on a more automatic system for that. These are more small incremental changes, settling down changes. The scrutiny panel asked the 2 departments to look in more detail at some areas of for young adults, for respite and the way that one of the assessment tools was working, the computerised assessment tool was working. That work has been commissioned by the Health Department and an independent expert is looking at it at the minute. As the Minister says, that work will be finished towards the end of the year. The Minister for Social Security has not been involved in that directly, that has been organised by the Minister for Health. As I say, I am very sorry you have not had the published report but we will get you that straight away.
Deputy M.R. Le Hegarat :
I think we have had it. There might just be a bit of confusion as to how the question I think it was more about asking for an update on where you were at as opposed to where is the report sort of thing. It was more about you have accepted this, this and this, where were you at. You have obviously explained that, I think that was just a confusion.
The Minister for Social Security: Thanks, Deputy . Thank you.
The Deputy of St. John :
That has clarified. Do you think the L.T.C. (long-term care) fund is robust enough to see us through in its current form?
The Minister for Social Security:
The fund is designed as a fund, it is a very young fund and we have sent out the actuarial report. It should not have gone out until next week but I knew I was seeing you and because we have got the team over next week on Wednesday, we have a States Members' briefing because it should be our lunch hour but obviously I still hope you come. Obviously the scheme says the money has to go up. Personally I have been involved in the scheme even before Social Security, myself and Deputy Alan Breckon, as he was before he was Senator, and Roy Le Hérrissier and there was a fourth. We literally went out, we found Professor Forder and he had looked at say there was 5 schemes in the world at that time and he said you can get the best scheme if you take a bit from there, there, there and there. I think we did that. The amount of people that lost everything, they had to pay for their care, their house taken away, they had everything taken away from them. So it does do 2 things. It provides funds for your old age but it also saves the house you have struggled to buy for most of your life keeps quite a good chunk if it is under 430, is it, Sue? £430,000, you keep the whole, anything above that is what you can keep. Before this came in it was everything. I just did not think that was fair. Apparently the rest of the world would like our scheme but it is only in a few places. It does have to be paid for, though. It is only going to be a gradual increase. We always said that. Gradual, gradual. Some of these figures in here are talking about 2043. I do not know where I will be then.
The Deputy of St. John :
Are we looking at increased contributions in the near future?
The Minister for Social Security:
It is a percentage of tax so it is 1 per cent at the moment, we are looking the Minister for Treasury and Resources mentioned it the other day because she had had the same report and we are not talking at the moment probably any more than another 0.5. That would be probably the life of the plan. I do not know until I have done all the figures but if we do nothing it will run out.
Deputy M.R. Le Hegarat :
Just on the back of that, we cannot collect 0.5, though, can we?
Director General, Customer and Local Services:
Yes, we can. The scheme started off at 0.5 per cent and then went to 1 per cent when it was introduced. The point you are making is the I.T.I.S. (Income Tax Instalment Scheme) rate is a whole number and so it will round up to the whole per cent.
Deputy M.R. Le Hegarat :
So we did not collect 0.5 per cent off those that pay tax, we collected 1 per cent?
Director General, Customer and Local Services: Yes, we collected
Policy Director:
We did collect exactly the right amount of money but you are right as well. When you use the I.T.I.S. rate it is a fairly crude way of collecting instalments against your tax liability. Your tax liability works out exactly to the nearest pound and that will have the 0.5s in it. Lots of people have liabilities which are whole numbers anyway. It is not just particularly an attribute of the long-term care, it is also an attribute of the marginal rate of tax, how that works as well. Yes, everybody pays up, they always round up to the next whole number which means they might have slightly over collected during the year but then that is you never lose the money. The money is credited to your account. For many people the I.T.I.S. rate is not quite right anyway so it does work out. Also for some people there is no change. The half does not make you go up, you stay within the same band, you do not go up any more.
Deputy M.R. Le Hegarat :
Is that everybody that pays tax or just those that pay maximum tax at 20 per cent?
Policy Director:
When we talk about 0.5 per cent of L.T.C. it is 0.5 per cent compared to the 20 per cent that is tax. So your tax pool will go up by 1/40th, that is the overall
Deputy M.R. Le Hegarat :
What I am asking is hypothetically if I paid 14 per cent tax, do I pay the 1 per cent?
Policy Director:
It is not 1 per cent, it would 0.5 per cent.
Director General, Customer and Local Services: I would be 0.35 in that example.
Deputy M.R. Le Hegarat :
What I was trying to establish, just from my own perspective, is that if you you will still contribute towards the long-term care regardless of what percentage of tax you pay but the percentage would be less?
Policy Director: Yes.
Director General, Customer and Local Services: Yes.
Deputy M.R. Le Hegarat : Thank you.
Policy Director:
It mirrors exactly the marginal rate system, it is in exact proportion to the marginal rate system.
Director General, Customer and Local Services:
Just to reassure the panel, when the scheme was introduced it was 0.5 per cent and these same questions came up and yet the existing tax system and computer system coped with that complexity. By 1.1.20, if that is when indeed the rate does go up, the new system will be in place and it will be much easier, much greater clarity hopefully in terms of the level of tax people are paying.
The Deputy of St. John :
In relation to the numbers of people who are paying L.T.C., does the contribution include all taxpayers, including those people considered to be of high net worth?
Policy Director:
Yes, is the answer to that. I cannot remember off hand I will find out the answer to you. They have the cap so they pay 1 per cent of £170,000.
The Deputy of St. John :
So they are included in the scheme?
Policy Director: Yes.
Director General, Customer and Local Services: Up to the cap.
The Deputy of St. John : Fine, thank you.
Deputy K.G. Pamplin:
I have a question, Minister, can you just clarify I am happy to hear from the Assistant Ministers themselves, the overview of responsibilities of your not one but 2 Assistant Ministers. Again, happy to hear from you and then they can explain their roles and how it all works.
The Minister for Social Security:
Social Security is a bit different in what it does, you have the funds and they are what they are, they play out. Jeremy likes his skills, Geoff is well, we all meet together. We try and all meet together when we are going to get a briefing on something that we are interested in and we want to look at. How does it work now? Could it work better or somewhere in the middle? I am not saying that Geoff and Jeremy do not have any delegated responsibilities but they are all working in with what we so he will add a bit, I will add a bit and then Geoff will add a bit and then we work it out to where we go. That is our priority. Working on every day stuff, when Jeremy was reporting on Back to Work, they are the figures and that is exactly what they are. He is working on that bit and being briefed on that bit because it works lovely with his young people leaving education. If I am asked a question on that, on education, I know exactly where to go and who is going help and meets the officers and everything like that.
Deputy M.R. Le Hegarat :
A different question from me. We, as you well know, are doing a review on mental health. As part of that review we have visited various locations and spoken to various people in relation to mental health matters. Something that concerned all of us, and was a bit astonishing I have to say, was that an individual was unable to receive treatment locally and therefore had to go to the U.K. for that treatment. They had accommodation and they were obviously having their accommodation paid for by Social Security. As a result of them leaving the Island for treatment, because we could not provide the treatment, not because they chose to leave, they lost their flat or their accommodation on the basis that they lost their entitlement to Social Security. Can you give us some sort of reassurance that this matter will be looked at because it is quite a concern to suddenly realise that if somebody is receiving contributions, whatever type of contributions that they are receiving, that they could potentially, if they have to seek treatment - and I assume that this would be not only for mental health treatment but any treatment - out of the Island that is withdrawn and so therefore they are unable to pay for the basic essential of accommodation so that when they return they have nowhere to live.
The Minister for Social Security:
So they were sent there from Health? I do not really like discussing
Deputy M.R. Le Hegarat :
They were sent there from Health and it was a matter that was brought up when we were speaking to mental health services yesterday. To be honest, I think all of us as a panel could not believe what we heard.
The Deputy of St. John :
This is not the first time this has occurred. This occurred with a young mother who had triplets and had to leave the Island because the Island could not cope, the medical services could not cope. She lost her benefit and lost her accommodation.
Assistant Minister for Social Security 1:
It is an application on the 28 day rule. You are not supposed to be outside the Island for more than 28 days.
The Deputy of St. John : That is right.
Assistant Minister for Social Security 1:
Presumably it should not apply registered medical treatments, it seems to me. But I do not know.
Policy Director:
There have been some cases some time ago now where a gentleman was in the U.K. and it drew attention to the fact that our rules did not work quite right. That was addressed at the time. There is an issue about communications, that is fair to say, that so we also talking about an income support claimant. If an income support claimant needs to be in the U.K. for medical treatment we will ensure that support continues to provide for accommodation but, as I say, the income support team does need to know about it. There is always more to do about communication between departments in the States. Deputy Southern is quite right, income support has a general rule around if people are outside the Island for more than 28 days in any 12 month period they no longer receive support within the expenses in the Island because they are not in the Island. That returns back on again when they return to the Island. If you are in the U.K. for medical reasons that part of the law is superseded by your need for medical treatment and we can also provide some support in certain circumstances to people in the U.K., particularly if you have a child and the parent is going with the child, we can sometimes provide any expenses in the U.K. for the adult outside our normal rules. We do try as hard as we can to make sure we do not get these mismatches between different departments trying to do different things. Very occasionally, obviously, in the States it will happen but we are very happy to look at the individual case.
Director General, Customer and Local Services:
Did you say it was mental health colleagues yesterday? We will take it up with them, shall we?
Deputy M.R. Le Hegarat :
Yes, if I am honest, I do not know how long ago it was but it was certainly something that they said and there are other issues as well in relation to the accommodation but the concern for us, I think, was if somebody was having to go for treatment to the U.K. and they a critical part of their well- being is going to be coming back to recovery, et cetera. It was just something we wanted to highlight.
Deputy C.S. Alves :
You mentioned that is something in law, so has the legislation changed now to accommodate does it need to?
Policy Director:
The legislation includes the 28 day notice but the income support law is designed understanding that there will always be unusual situations and you cannot write a law that deals with every particular difficult situation. Therefore, quite unusually for Social Security, the Minister for Social Security has the right to provide exceptional payments to people outside the main laws. That is, for example, how we provide support to a parent with a sick child in the U.K., because income support is primarily a benefit paid in Jersey. The law does not allow the payments outside of the Island but we do make payments to parents who are temporarily outside the Island looking after sick children in hospital. It is that part of the so underneath the law you have guidelines that are used to determine how decisions are made.
[15:00]
It is within those guidelines that you will see there is a change made following a particular case a couple of years ago around how we treated people who in the U.K. for medical treatment. That is bit that changed. You will not see it in the legislation itself, you will see it in the level down from that.
Deputy C.S. Alves :
How does that translate to the client service? Is the process for the client or customer an easy process to go through? Like you said, communication is a bit of an issue or has been
Policy Director:
That is where we try to if it is the mental health service, sorry, I am afraid I do not know the details but if it is a hospital, general hospital - as, for example, sick children will tend to be - they will get the travel organised through the hospital and therefore we work really closely now with the hospital travel bureau because then we know when people are travelling, it is very easy to find out. We know which parents are going, how long they are away for, whether they are going to come back and forward, so we have all that detail sorted out in advance, it is really easy to do. If the claimant has a sick child or something they do not want to be fussed with lots of forms. We can do most of that ourselves. As I said, occasionally things will not be perfect.
Deputy C.S. Alves :
I think in this case it was an individual that was living on their own so it was not a parent/child situation.
The Minister for Social Security:
I think what Sue is saying, if they have to go because we cannot do the treatment here but that we will fund because they have to be over there because they are ill and cannot get the treatment here, we would look at that. As I say, I do not know how long ago if you find out
Deputy M.R. Le Hegarat :
We think it was quite recent and there were other issues, but we just wanted to ask that question because it was brought up yesterday.
The Minister for Social Security: Yes, absolutely.
Deputy M.R. Le Hegarat :
You said you worked closely with the hospital now with travel and everything, is that fairly recently or is that always is that something that has been closer knit more recently?
Policy Director:
There was a specific case 2 year ago now probably, which identified the issue that sometimes things fall through the gaps
Deputy M.R. Le Hegarat : Right, okay.
Policy Director:
Say in the last 2 years from memory it has been better, yes.
Deputy M.R. Le Hegarat : Any further questions?
Deputy C.S. Alves :
Seeing as we are talking about income support. Obviously overpayments can happen quite easily, we have spoken about this before. Now, am I right in saying that the minimum repayment, if there has been an overpayment, is £21 a week, is that right?
The Minister for Social Security:
I think that is
Policy Director:
It is not a minimum, it is a standard amount that would we start it at £3 a day but in individual circumstances that number might be smaller or higher than that depending on
Deputy C.S. Alves :
Yes, that is what I wanted to know.
The Minister for Social Security:
Yes, there is discretion. There is discretion.
Deputy M.R. Le Hegarat :
Okay, I think we are pretty much done. Thank you very much indeed.
The Minister for Social Security: Thank you.
[15:03]