Transcript - Quarterly Hearing with the Minister Social Security - 7 March 2019

Health and Social Security Scrutiny Panel Quarterly Hearing

Witness: The Minister for Social Security

Thursday, 7th March 2019

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.A. Martin of St. Helier , The Minister for Social Security

Deputy G.P. Southern of St. Helier , Assistant Minister for Social Security 1 Deputy J.M. Maçon of St. Saviour , Assistant Minister for Social Security 2 Ms. S. Duhamel, Head of Policy

Mr. I. Burns, Director, Customer and Local Services

[14:00]

Deputy M.R. Le Hegarat of St. Helier (Chairman):

Good afternoon and welcome to the Health and Social Security Scrutiny Panel's quarterly meeting with the Minister for Social Security and Assistant Minister. Firstly, I will ask people within the room to introduce themselves. I am Deputy Mary Le Hegarat , Chairman of this panel.

Deputy K.G. Pamplin of St. Saviour :

Deputy Kevin Pamplin of St. Saviour and the Vice-Chairman of this panel.

Deputy C.S. Alves of St. Helier :

I am Deputy Carina Alves and I am a member of the panel.

Deputy T. Pointon of St. John :

I am Trevor Pointon, Deputy of St. John , and I am a member of the panel also.

The Minister for Social Security:

Judy Martin, Minister for Social Security, Deputy for St. Helier No. 1.

Assistant Minister for Social Security 1:

Geoff Southern , Assistant Minister for Social Security.

Deputy M.R. Le Hegarat :

What we will ask is rather than go round the room, if somebody does contribute anything, we will ask them at that time to identify themselves so that the public know who is speaking at that particular time.

The Minister for Social Security: Okay.

Deputy M.R. Le Hegarat :

I will just remind people that obviously this is a Scrutiny Panel and therefore it works under the rules of the States Assembly. We have already obviously had a quarterly hearing with the Minister for Social Security, and we are going to obviously ask some questions about how much progress has been made since we last had a hearing. When we met at our previous quarterly hearing you set out a number of priority areas that you were working on. These included reviewing the Social Security Fund, improving access to primary healthcare and local workplace pensions. What progress have you made on these priority areas?

The Minister for Social Security:

The first 2 we have made quite a bit of progress. There is quite a bit of work in the transition plan and I will sort of jump a bit because you will also ask a bit later on what my Assistant Ministers do. We have already ... I think there are some different personnel at Health to get this actual meeting set up and working across Health and looking into primary care. We have had 2 meetings, have we not, but there are going to be lots of G.P.s (general practitioners) involved. It is clear you have concerns in your own report about mental health. That was mentioned already around the table, so workstreams, how it is going to be costed, who is going to deliver it, where it is delivered, and Deputy Southern will be ... and they need to be as quick as ... there will be lots of meetings to get in the diary. I physically could not do it and Deputy Maçon has 4 panels already, so you are taking that on for him, are you not, Deputy Southern ?

Assistant Minister for Social Security 1:

Yes, and we have already made quite a bit of progress in terms of defining the fact that currently now and in the short term many people in our society cannot afford ... say they cannot afford to go to a G.P. That we have to act on to deal with now, but that then combines with a longer-term measure of how we restructure to make sure that services remain affordable, because affordable is the starting point. If you cannot afford to go there, then the whole policy falls down without that central plank. We have already started talking about some of the numbers and some of the areas that we might want to start on in terms of getting better, more affordable access to G.P.s and their ancillary services, because it is also ...

The Deputy of St. John :

I think the question was about pensions and the Social Security Fund and primary healthcare, which is ...

Assistant Minister for Social Security 1: That is what I was talking about.

The Deputy of St. John :

Of course, but we need to look at the broad picture, I think.

The Minister for Social Security:

Oh, the Social Security ... well, the Social Security, there was 2 big Social Security reviews. They have all been printed out. There was lots of little workstreams or big workstreams that come under that, and it is looking at short-term care, long-term care, how it is best delivered, are we getting the right people at the right time, is it a short-term mental illness and you are not getting ... because you can stay on the short-term sick for a year and have no interaction really with a lot of people. So we have had all the presentations on that. We have set out a workstream for at least the first 2 or even hopefully 3 years, but with all the Government plan, with all the work that is already ongoing, to be realistic, some of these things will be delivered this year, towards my policy ...

The Deputy of St. John :

Where are you specifically, Minister, in relation to developing a workplace pension arrangement?

The Minister for Social Security:

It is very early stages. We have had a discussion with Treasury. They know the problem. It is priority and politically it was ... when we said put in a few priorities that we want to see, that one came out top on myself, Deputy Southern and Deputy Maçon's list, but it is not one of those things that can be done that easily. It is a lot of consultation. It has not gone out to consultation. Where do you set it? Where do you benchmark it? Do you make it compulsory? Is it an opt-in, opt-out, like Guernsey are doing and the U.K. (United Kingdom)? Some people are saying there is not even enough money, so we are already asking ... it is people who will be paying this. We are already going to ask them very shortly to pay 0.5 per cent at least for long-term care again, so you have to take your audience with you as well. Sorry if I misunderstood. So, as I say, the key objectives were in the transitional plan. Again, I am not jumping, but we have not completed the family-friendly employment, but we have lodged it. What I did not add ... I know obviously Deputy Maçon - because Deputy Maçon is a master of Scrutiny - said to me: "Why do people ask at the quarterly hearing what is coming forward?" You want to know what legislation, you want to plan your work, and obviously as quick as we can we will ... anything that is coming forward I will let you know. Just on that, legislation is already being drafted for the ... it is not necessarily your panel, but because Deputy Alves is here, it is the mesothelioma regulations. That is already out there, but it may fall under your panel, probably would do. Yes, if you want to obviously look at the regulations, as soon as they are there, you will see them.

Deputy M.R. Le Hegarat :

So would you be able to expand on the new models that you will be looking at in relation to primary care and dental care?

The Minister for Social Security:

Honestly, it is good, and we are where we are. You would not start from there. Geoff, we have had the 2 high-level meetings. We were really pleased it is including the look across mental health and dental. This is where it is starting. Where it finishes and where we get to, providing more things out in the community and not necessarily through your G.P., it could be a nurse, it could be pharmacies, it is very high-level, I would say, so far.

Assistant Minister for Social Security 1:

On a slightly lower level, what has been recognised is that we do not have any form of contract with the G.P.s and their practices. So effectively, while we do subsidise and contribute £20.28 towards consultation costs directly to the doctors, that does not involve a contract. They can charge their customers, their patients, what they like. So even if we were to raise that, to double it, let us say, to £40 with the intention of that bringing the cost to the patient down, it would not necessarily happen because it is not on a contractual basis. So what we are looking at on the short term is finding some form of contractual basis and agreeing it with the G.P.s and their practices, their fellow professionals, not just G.P.s, because we are looking at pharmacies and practice nurses to deliver some of the issues. They would not necessarily - they do not have to - bring their prices down. They could carry on charging £40. If they want, they could double it. They are completely private businesses. So as we look at both the short term and the long term, the essential thing is to alter the way in which we issue payment so that we have a contractual agreement with the doctors and we can share the aims that we are all keen on of making sure that what we do is make the service affordable so that people can get there early and we can do some decent preventable work to prevent long-term illness. So it is an invest to save in the longer term.

Deputy C.S. Alves :

Is there anything, any ideas with regards to dental care then? So you have mentioned there G.P.s.

Assistant Minister for Social Security 1:

Again, I will start with the problems and say where we are with them, I think. The problem is that dentists fall into 2 groups. There are those who are good with children and like doing children's dental work, and those who do not like dealing with children because they make a bigger fuss than adults, or they tend to. So it is becoming obvious that we have to deal in terms of dental fitness, the old dental fitness scheme, and we could reinstitute something that was very similar, or we could change it to more be effective. We certainly need some more accountability in there. But it would not necessarily ... it would be, I do not know, a proportion, 40 per cent, let us say, of dentists on the Island that would be happy to incorporate that and to do what effectively is a dental fitness scheme and to restart that. That would need some funding, but again it is funding to save in the long run because dental health is very costly.

The Minister for Social Security:

Sorry if I did not make that clear. I think we were both very pleased around that table that was one of the issues was dental. As I say, Health have a very big budget for the under-11s. In the hospital is not ... I have always maintained, why would you want to take your child to the hospital? It is normally a consultant dentist who is doing it, who is going to be doing real different operating things the next day and they are not necessarily the best people to have that experience with. So all that is on the table, Health's budget, our budget, who delivers it. As Geoff said, it may not even cost ... if it is done right, get the right people around the table, the right dentists, it may not need any more money. It needs Health's money to do it. That will be another conversation. We are not taking it all on, but it is now looking at this money: "There is money. You are paying that in the wrong area on the wrong people delivering it, really." They are doing a great job, I am not knocking the people, but it does not need the high-level consultant dentist to do your first child check-up and say you have great teeth, or you have not.

Deputy M.R. Le Hegarat :

The next question we asked of the Minister for Health and Social Services as well a couple of days ago when we had a public hearing with them. Is there any mechanism currently to allow people

requiring attendance at the exercise referral scheme to benefit from financial support if they are unable to afford the seasonal fee?

The Minister for Social Security:

Yes, I did watch that. I could not hear the answer completely because ... and I was confused because I think the Deputy asked ... there is the Active scheme and you are referred through Health if you need one-to-one for so many weeks. Then it is you take it on after. I think he said there was not and from ... I have asked at Social Security and no, there is none at the moment. There is no subsidy. Apparently there was a good few years, not even under this system, Government since 2005, but we have checked. No, only the corporate package and I think it is about £30 to join Active if you are working in a corporate ... you will get a corporate ...

Deputy C.S. Alves : Discount, yes.

The Minister for Social Security: Yes.

The Deputy of St. John :

The question I asked was about financial discrimination.

The Minister for Social Security:

Yes, you asked if there was any ... if they discount or we do and the answer is I have checked and we do not, no.

The Deputy of St. John :

So it means that there a number of people who are not going to be able to access that programme because they cannot afford to access it?

The Minister for Social Security: After they have had the free part?

The Deputy of St. John : No, there is not a free ...

The Minister for Social Security:

I thought when you are referred to Health and the occupational ... I thought Active ...

Deputy C.S. Alves : It is a discounted rate.

The Minister for Social Security: Oh, it is a discounted rate.

Deputy C.S. Alves :

But not quite as discounted as corporate.

The Minister for Social Security:

Oh, I am sorry, I may be wrong, but is Active ... well, no, you would not know.

The Deputy of St. John :

It is called the exercise referral scheme. It is run ...

The Minister for Social Security:

There is an Active rate for pensioners. There is because I see some of the pensioners up there.

Deputy C.S. Alves : Yes, there is.

The Minister for Social Security: They love it, yes, absolutely.

Deputy C.S. Alves :

There is a different rate for the exercise referrals as well, which are run through the G.P.s, which is not quite as discounted as the corporate rates, but it is still discounted compared to the normal rate. But even then it can be deemed as unaffordable to some.

The Minister for Social Security:

Yes. So if we looked at a scheme ... I mean, we have not put it on our priorities, but you would be ... we would have to look and see if it would be income or age or both, a combination. I mean, some of those are the same people but ... yes. No, there is not any at the moment.

Assistant Minister for Social Security 1:

We could take a look and we could examine whether it would qualify for a special payment under the income support scheme. Somebody who was eligible for income support, could they claim a special payment in order to participate in this healthcare thing?

[14:15]

The Minister for Social Security:

If it was needed for health I would have thought, yes.

Assistant Minister for Social Security 1:

It would be something that we could consider, certainly.

The Minister for Social Security:

Something we could look at, individual, but that is not ... what you are asking us to do is to think about at least where we would put this in our priority list.

Deputy C.S. Alves :

I think it is because it is coming from a G.P. as opposed to somebody self-referring. If it is coming from a G.P., then there needs to be that facility to ...

The Minister for Social Security: That they can carry on doing it, yes.

Assistant Minister for Social Security 1:

If that is the direction we are taking, prevention rather than cure ...

Deputy C.S. Alves : Exactly, prevention, yes.

Assistant Minister for Social Security 1:

... that is the sort of thing we ought to be looking at. That sounds like a short-term issue that we could examine how we solve it.

Assistant Minister for Social Security 2:

Yes, apologies, Chairman, thank you for allowing me to join. I was just at the Planning Committee, so apologies for being late.

The Minister for Social Security: Now introduce yourself.

Assistant Minister for Social Security 2:

For the transcript, I am Deputy Jeremy Maçon of St. Saviour .

Deputy M.R. Le Hegarat : Thank you. Not a problem at all.

Deputy K.G. Pamplin:

Can I just go back to the dental care plan, because it is curious because I know this borderlines on Health, but the Community Dental Service waiting time for a first appointment is still 55 weeks and just reading testimony from parents here, the wait time to have an appointment has gone up to 5 years. Do you think there ...

The Minister for Social Security: Sorry?

Deputy K.G. Pamplin:

Five years for actual treatment, waiting.

The Minister for Social Security: Oh sorry, yes.

Deputy K.G. Pamplin:

Taking that into context, you mentioned that Health have a big budget for dental care, but if there is a waiting list of 55 weeks, does the impact of not having a dental care scheme to provide people with affordable dental care, do you think that is a contributing factor to the waiting lists?

The Minister for Social Security:

Some people who know the scheme is there, they put their baby down at birth so by the time ... it is what it is. Not always ... again, this is not ... you will see everybody from all walks of society in that dentist. When they reach 11 they go to a different dentist. So are these people stopping the children that really need to be seen because they cannot afford it anywhere else? This is a big piece of work. The budget is that much because again they are funding the dentists of a consultancy to see your child first, but just to assess the teeth. I did not realise it was ... and then after that if they need work it is a 5-year wait.

Deputy K.G. Pamplin:

It can be as well, so that was the point I was getting to. If we have an affordable dental care plan that the dentists buy into, much like G.P.s, then surely the impact would be the waiting list and people could be treated and that would bring down the waiting time.

The Minister for Social Security:

I know, but then you have to make the political decisions that you will. At the moment everyone under 11 is free at the hospital, big budget, wrong dentists, in my mind. Then you decide we want everyone to do this amount for their children under 11; we will not discount these people because they are on mega-money. It is still their children, but they are not earning money. Or we do it out in the community with the same budget and we could probably do it with less out in the community. The other problem with dentists, they are not as organised - as we have found around the table - as G.P.s, where they get together. You have the officers work with the G.P.s so you have ... sorry, the dentists have a clique over here, some over here, and then there is a few in the middle that are doing great work, but you just ... we would like them to get more organised and have some more serious conversations and, as you say, get to everybody. Children's teeth, you get it done right first of all and they sail through the rest of their life and they are not scared either.

Deputy K.G. Pamplin:

You touched upon our mental health report yesterday. That is what we proved with the statistics that we provided that the waiting times cause issues in mental health. You talked about the G.P. fees. In our research we noted that G.P.s would assess the patient and they would make a personal judgement to not charge them the full whack, but that is not a sustainable model, surely, for the G.P.s.

The Minister for Social Security: No.

Deputy K.G. Pamplin:

So they need some guidance to say: "Here is the criteria to what a child ..." and if somebody has to keep going back to receive mental healthcare because of the waiting list to be seen by a psychiatrist, they have to keep coming back and paying out £50. There need to be tough, stricter things in place.

The Minister for Social Security:

I know, and there are 2 issues there. I noticed, as you say, how does somebody know what you are going through the door for? Is the G.P. the right place? Quickly, I noticed in one of your recommendations you want to train all G.P.s. I am not saying all G.P.s, I am just doing the recommendation from memory, give them training in mental health. Because I think in the recommendation, in the text, you are saying they are getting a service from some G.P.s better than others which ... you know, so again this would be discussed. These are all things on the table. Would that be better if we had a group of G.P.s with specialism, absolutely specialised in up-to-date treatment of mental health, at a price? Again, we have to get rid of this: "We are a business, we

need to run this, we will do that." It is all on the table, but it is really ... Deputy Pointon challenged me at 6.00 p.m. last night if I had read it and I was out last night so I had to get up at 5.00 a.m. I have read it to the last little bit ... I am sorry if I am scanning it, but I have read it, honestly. I have made a lot of notes on it.

The Deputy of St. John :

I announced to her this morning that we were not going to ask serious questions on mental health.

Deputy K.G. Pamplin:

Cannot help herself. We will move on.

The Deputy of St. John : So she lost sleep over it.

The Minister for Social Security:

No, I did not, I just got up early. [Laughter]

The Deputy of St. John :

I wanted to ask a supplementary about the way that you are going, the direction you are going, in relation to G.P. funding. I wondered whether you had given any serious consideration to a capitation version of funding.

Assistant Minister for Social Security 1:

Capitation, by which you recruit a large number of people?

The Deputy of St. John :

By which you say to the G.P.: "For every patient you have on your books we will give you so much money per year."

The Minister for Social Security:

That word was discussed around that table and there were other ways of doing it.

Assistant Minister for Social Security 1:

My reaction to that is that in the U.K. it is certainly already coming into question because doctors are just getting as many basically fit, middle-class customers as they can on their books and just watching the capitation add up, knowing that these people do not require a great deal of services.

The Minister for Social Security:

You gave that answer around the table, so yes, we have discussed it.

Assistant Minister for Social Security 1:

It is an issue. It is one of the things that is on a sheet to say we should be considering other ways of rewarding ...

The Deputy of St. John :

There is a real issue in relation to the current system of rewarding G.P.s and that is that if a person ... there was a system called H.I.E. (Health Insurance Exemption) and that meant that the individual holding an H.I.E. card was exempt of charges.

The Minister for Social Security: Yes, I think that was on illnesses.

The Deputy of St. John :

In my experience in residential homes and nursing homes, I discovered that those people that were H.I.E. status were visited very much more frequently than those people who were not by their G.P.s, maybe every 2 weeks rather than every 6 months. When I first came to the Island I was shocked when I did some private work in people's homes to discover that the G.P. would play up on the individual's anxiety about their state of health and visit every 2 weeks simply to do a blood pressure and to take a temperature and collect the fee, thank you very much, from a private patient. So the thing was working at both ends of the scale and the G.P.s were pulling in all sorts of unnecessary visits and consultations in order to enhance their income. I am not saying that goes on all the time.

The Minister for Social Security:

The G.P.s used to be a lot more one-man bands, 2-man bands. They have got into really good practices now. I cannot think of the name of it. There is some test they have to reach. A lot of that has gone and the H.I.E. has gone as well and the card has gone.

The Deputy of St. John :

One of the other things they do not do currently, notoriously I think, for some people who are especially in work and need the G.P.'s certificate, they hold on to them rather than referring them on to the hospital because if they refer them on to the hospital for investigations, they lose the face-to- face contact, which is the source of income.

The Minister for Social Security:

That sounds worrying, but I have not heard of it.

That sounds worrying.

The Deputy of St. John : Anyway, these are just things ...

Assistant Minister for Social Security 1:

This issue about the perverse nature of the way in which we reimburse the private sector doctors is that it encourages more visits rather than fewer, so it is a perverse incentive. That I think goes back to that short and long term, looking at how we restructure that so that we get what we need, which is the prevention stuff done and people going to the doctor as appropriate rather than leaving it because they cannot afford it. Again, we come back to how do we best do that, not to build in some perverse incentives into what we are doing.

Deputy K.G. Pamplin:

How does that work into the charges? Because we are just talking about going to the doctor. The average price of calling a doctor to your house in the daytime is £70 to £80.

The Minister for Social Security: It is £180, I think.

Deputy K.G. Pamplin:

Then after 11.00 p.m. it goes up to £100. So if you have a sick child and you know you just need a G.P. or whatever the situation, you do not want to go down to the hospital, you might not be able to, you are a single parent, cannot get down there, but the cost of that goes way up. So is that being factored in?

The Minister for Social Security:

Yes, we talked around the table about that figure and how we deal with that, that bit of time, as you say, up to then and then after midnight to 6.00 a.m. or 8.00 a.m. in the morning when a lot of doctors will be around. I thought we were quoted £180 for an evening between that time. Again, we know that is not sustainable. We know that doctors, the majority, do not want to do it on a regular rota or anything, so again, is that your specialists? You know you are going to do one week in the year. There are enough doctors to do it, or even ... do you see what I mean? Or it can be whenever you do do it, you do your callout. We are starting ... there is nothing off the table. We are where we are. A lot of the older doctors, they have invested in ... sorry, that sounds ageist, but they have been here longer. They have invested in a lot of properties. They have now grouped together. They have some really great facilities. My old doctors have joined a big practice. I can go to 3 different places,

or 4, I think, to go and see them, which is convenient more for me, parking not always in town. They are doing some good things and they are really much more regulated, and they do get money, and if my other officer was here she would know, but Sue would probably know. If you want to ask more about that, we can talk about it later, how they are regulated.

Assistant Minister for Social Security 1:

But suffice it to say that at that meeting there was a representative from the out-of-hours service there flagging up very strongly about how we go forward with the out-of-hours service and the essential nature of what it delivers.

Deputy K.G. Pamplin:

Good. We will move on. Also in the written response to the panel in November you stated that there is an emphasis on skills and vocational training in the Common Strategic Plan: "I will work closely with the Minister for Education to support skills for all ages through close co-operation." What close co-operation mechanisms have been established so far with the Minister for Education's department to facilitate this aspiration? I am guessing Deputy Maçon ...

The Minister for Social Security:

This is why Jeremy is here, so over to Deputy Maçon.

Assistant Minister for Social Security 2:

Yes. The issues ... obviously that is why I am here. It is what we have been doing. We have already been working with the Back to Work team looking at the synergies between the different services because what Skills Jersey does, what the Back to Work team do in some aspects, there are some similarities. We are doing an analysis about is there a duplication of service, would it be better if the Back to Work team sat in Education or should it stay where it is. Those types of discussions are going on at the moment, and certainly through our wider things about in the future what we might consider, it is something which I have been promoting both on Education and Social Security is we need a retraining strategy. How do we support people if they want to retrain? Do we need to do that through the income support system or is there something enhanced we need to do around that? So it is certainly different strands that we are pulling on in order to do that, but of course at the moment it is very much developing bids, developing proposals at the ideas stage. Sorry, I cannot give you anything more concrete.

Deputy K.G. Pamplin:

So what you are saying is nothing has been established, but there has been a step down the road to look at pulling things more closely together?

Yes.

Deputy K.G. Pamplin:

Has there been any blockages though why those mechanisms have not come any closer? You have seen departments not working closely together? Is the Minister for Education being sidelined? Is there something going on that is not making this go more urgently and quickly?

Assistant Minister for Social Security 2:

I would not say that there was a problem in the relationship between the Ministers or the different departments. I would say that what has happened is the issues around the Target Operating Models about being able to meet the needs of the funding gaps that we have. That has promoted perhaps greater thinking and challenging between the 2 departments about where the services should sit, about that being more lean. That work is obviously being done in the background by officers when they are analysing it. So I would not say there are any blockages. I would say perhaps the circumstances that we find ourselves in are encouraging greater working together.

The Deputy of St. John :

Right, we will move on to delivery of services. You told us last time that you want to see services delivered in the parishes and we were wondering what particular services you would like to see delivered in the parishes.

The Minister for Social Security:

I notice as well you had Paul McGinty in here, and we had a briefing by Sean McGonagall, who is literally working together ... they are quite late to the game and they are doing a fantastic job. They started on 1st March out in Communicare and somebody gave me a very small ... all the things that are being delivered. So they are going in there first. We want to see the take-up. Thank you. This is all the Health things obviously, which ... oh, just before I go on, we thought - and I think Richard did as well - it was too much to bring Sean or Paul, but they are quite willing to sit with you for half an hour and go in real more detail on who will be coming in. So if ...

[14:30]

The Deputy of St. John :

We got a very decent impression of what Health were doing in terms of developing ...

The Minister for Social Security: I could not hear his answers.

The Deputy of St. John :

We need to hold the next session in this room, I think. What we are concerned about here is what Social Security is doing to, if you like, disseminate services to parishes.

The Minister for Social Security:

This trial, if it works, will go as far as it can. It might be 4, north, south, east and west. It might be in every parish that can accommodate it. Again, it has to be obviously somebody in my ... we have talked about we want to put somebody ... could be like the other way around where community police are coming into La Motte Street an afternoon a week, it could be - as long as it is well- advertised, who our target audience is - looking at people: "Are you getting enough pensions; is there a gap somewhere; are you in that bracket where you get the pension but you do not pay tax; are you getting all the help you need?" Mums. Our Communicare is a great place. If you do not want to come into town, cannot park, if you are halfway along you can go ... it covers quite a good area, so that would be the services and any form of benefit service. There will not be somebody sitting there every day, it could not work like that, but as long as it is well-advertised, but we have been told and we have been briefed a couple of times by the 2 who are implementing this, let us go along and let us see how this works. They think you are never going to recreate ... it is a most fantastic facility, Communicare, everyone knows it, everyone loves it, and everyone goes to it, but there is possible chances. There is the parish halls. There are lots of benefits that could go out there that somebody with a laptop can deliver and that ...

Assistant Minister for Social Security 2:

I think, to answer your question, at the moment it is largely a Health-led initiative, but there is great working dialogue going on between Social Security and Health and it is at pilot stage at the moment, so while at the moment it is largely Health-led, if it is a success, what we are hoping to do, through Social Security, is to provide those services. But to answer your question: "What are you doing at the moment from Social Security?" I do not think it is a huge amount at the moment, but we are working together behind the scenes.

The Minister for Social Security:

No, but to be fair, it was at all of the hustings - and you were there, you were at the hustings - all on the election tower. That is when the third sector and the community said: "We are not listened to by Government." These 2 people, I think Paul has been in post late July and I do not think Sean came over until about September/October. They are pulling these people together, they are finding out what they are all delivering, where there is gaps and everything. I am just really impressed how quick we have got something in. They said: "We are having a soft launch next Friday", this is like

for the first ... I am like: "Oh right, okay. Good luck." I said: "You have done all this?" So I am very impressed. It is what I wanted to see.

The Deputy of St. John :

What Jeremy has just said crystallises where you are at, that you are at the beginning of a journey and they are a little way along the journey, so you will be joining them at some stage in the relatively near future to get some of your services out into the community.

The Minister for Social Security:

They are constant talks with Ian Burns of what could go in there and what they are proposing. I am saying ... do you launch everything at once? This is their advice, these are the experts. They have told us: "We do it this way and then we will be adding and bolting on" but we have known, and we have been kept up, but it happens to be mostly Health. But yes, you are right, in my election speech for this job, I want more out in the community. It is the C.S.P. (Common Strategic Policy) and everything as well.

Deputy K.G. Pamplin:

Can I just ask, as somebody who works in the charitable sector, much like in the hospital, every Friday they have a session for G.P.s at 1.00 p.m. on a Friday, where they bring in various people. This week it is the Recovery College and Mind Jersey to talk about where their strategies are with mental health. Have you looked at an opportunity to brief the Social Security staff team, for example, representatives from Headway can come in one lunchtime and brief all staff about what Headway Jersey specifically are doing for patients, just to educate what they do, what they provide - for example, Headway do not give people money and we do - just so that the frontline staff in Social Security, if you do get somebody who comes to the department saying: "I have had a head injury" and you said: "Right. This is the services that Headway do, letters of referral" so that joined-up thinking? Is there work going on? I know I was at the event earlier in the year with the voluntary sector, because it is all well and good putting things in place, but it is the information and the pathway and the referrals I think is key. Is there something like that?

The Minister for Social Security:

I think, from memory, there is a direction now that Citizens Advice could be in there. As I say, these people have come to us. There is no "no", if it can work, we will say ... they did not really want to advertise that Community Savings were going in there an afternoon a week, community police, and I went: "No, this is really good news." It is how you accommodate, and why would that not happen? Again, this is early. We are getting more and more people that have got to be accommodated. I cannot see why that would not happen.

Deputy K.G. Pamplin:

So it is something you would do? Because I know the charity sector would love the opportunity to bring staff.

The Minister for Social Security:

The service, as explained to me, and it is what I have wanted and we have all been aiming for, it is designed around the customer, the client, the people of Jersey, so anything we can do to help facilitate that. There are no "nos" from us.

Deputy K.G. Pamplin:

The only thing I would say on the Community Savings Bank, having had many dealings with them, is it is a very ... it is a big step to go and ask, if you are in financial peril. Basically you are bankrupt or you need assistance, that is a private affair, and if you do big banners in the community, people will look and say: "Oh look, they have gone in to get some help because they have got no money" so what I would suggest is there has got to be a balance between advertising the services there but protecting the privacy, that somebody walks into a public place like the parish hall, so ...

The Minister for Social Security:

I am not saying I wanted to shout: "This is Community Savings."

Deputy K.G. Pamplin: No, I am not suggesting ...

The Minister for Social Security:

What I wanted to get out there, that they are going in there. As you say, you do not know what you are seeing, but again, all our services are trying to be aligned, so it is the experience of the customer and wrapped around the person when they come in.

Deputy K.G. Pamplin:

That is the point of the parish hall, it is such a public place. Anybody, one of us, could walk into that parish hall and go: "Oh look, there is so and so, talking to so and so." That is something, it is just the delicate way that that can be managed and that is what I think we are going for. So the La Motte Street building, been up and running for a couple of months now with the new initiatives. We had a briefing with Ian a couple of weeks ago and he gave us a little overview. Where are the successes since the changes and where does the work still need to be done to make the successes in the future with the changes of one Government and the frontline desk?

The Minister for Social Security:

As I said, there is more and more people that are in there. The training is going to be changed for ... I can only talk about ... you see, I am not the Minister for Customer and Local Services, but I can talk about the services that are in the building. But in my service, if you need this help here, people are being trained across the levels, so you will not need to go over there and find this out. A lot of people are trying to get online, it is much more straightforward. It will then free up the more experienced or higher trained people to really sit down with the vulnerable and say: "What can we do? Oh, you need this as well and you need that." As somebody said at the beginning - you, Deputy Pointon - we are at the beginning of the journey. I cannot believe ... I know people are: "Oh, it is the wrong place. Oh, if they go to tax ..." everyone knows and everyone that has gone has said: "Oh, I could go and get my passport. I was in there" and everyone says to me, because we are this age: "I want to find out what pension I will be due" and I say: "Yes, when you are there, find out what tax you are on, if you are going to have a year back liability and what you need." "What, in there?" "Yes." I find it absolutely fantastic that we can do this in one place for the people of the Island.

Assistant Minister for Social Security 2:

I think if you are asking about some of the successes, one of them that we have been briefed on is, for example, if there is a peak workload in a certain area, which might be a different department, officers are working together to help manage workloads. For example, we knew there was a high demand in passports, and they were getting lots of phone calls, and it was other staff were managing to then cover the phone calls so that the staff could process the passports and deliver the service that way. So I would say that one of the successes is the service kind of working together where there are peaks and troughs in the workflow, which has got to be a good thing.

The Minister for Social Security:

Yes, apparently there is a high demand, because there is a bit of a panic, because people do not yet ...

Assistant Minister for Social Security 2: Because of Brexit.

The Minister for Social Security:

It is a Brexit thing and it was a couple of straightforward answers, but when you are ringing and ringing and the passport people are dealing with the passports, the customer services telling them: "No, you do not need a new passport by 27th or 29th March", whatever it is. People are panicking.

Deputy K.G. Pamplin:

I guess the test - and I have talked about this before - is when the rush to get your income tax form, as we have always seen over the years at Cyril Le Marquand House and the long queues and

rushing the envelopes through, is forward thinking and planning ahead to reassure there is enough staff in place, the separations are obvious, where you are going for tax. I guess are you aware of that pre-preparation and what is the preparation that you can tell us? Because I guess I used to see people driving down, parking outside and rushing in and rushing off and we know where the Social Security building, that is not straightforward. So any little tweaks, any little things that are going to make the process smoother?

The Minister for Social Security:

We did have some in the States, that we could have levered people to get their tax in on time, you might get a percentage instead of a £200 fine, but other than that, no. Obviously, as I say, I am not the Minister for Treasury, tax and everything, but I totally see where you are coming from. Customer and Local Services, yes, they know that it is about managing your time, managing your staff and if everyone went out in January, returned in and then they got a bit back, I would like to do it sort of alphabetically or something. Look, I am joking, but we are always ... we know there will be a bulge and it will be in that last week, but I think people are trying to get their returns back. Nobody wants a fine, really.

Deputy K.G. Pamplin:

No, and that all may change next year with online tax, when it comes online, but with any sort of new customer service, that might be the first time people have come into the new setup, so they might come in and go: "While I am here, I am going to go and talk about my passport with Social Security." It is just mitigating, that staff are prepared and there is enough frontline staff to take people and go: "Oh right, you need to talk about Social Security while you are here? Let us take you over here."

The Minister for Social Security:

Absolutely. What has worked brilliantly is the welcoming people who say: "Can I help you? What are you here for?" and sometimes people do not need to go any further and that is quite a bit of that percentage, at least half, or maybe ... I think it is a higher figure than that, so you have got 10 people, they can deal 7 and it is only the other 3, whereas you remember the old desk, standing there and ... I used to stand there just to tell the Minister that I have arrived, because it just was not ... it is really working well, really good.

Deputy K.G. Pamplin:

Have you got any data collectible maybe we could bring in for here on comments, feedback from people that have been in there, wait times gone up and down, any feedback on parking? Have you got any data provided since the changes have come forward?

Do we have ... and would you like Ian to answer this? Because as I say, I am not ... it literally is across the board, passports, planning and things. If Ian could ...

Deputy K.G. Pamplin: Yes.

The Minister for Social Security: Yes, thank you.

Deputy K.G. Pamplin:

Seeing we are in the process of a public hearing, it would be good to get it out.

Director, Customer and Local Services:

Good afternoon. Ian Burns, Director of Customer and Local Services. Yes, various information has already been published. We had some F.O.I. (freedom of information) requests on wait times both before and after. Broadly we are getting about 700 people a day coming into La Motte Street. About 100 of those are doing more than one thing, as an example, and in addition to that, a couple of hundred people are being looked after, as the Minister said, by welcome hosts, so they are just being dealt with and can just turn around and leave the building straight away. Wait times overall, it is about 10 minutes, but for many activities, it does vary very much between activities. It is a couple of minutes for some things. I think tax for the period we measured for the F.O.I. request, it was a bit longer than that, but they are also of course in a peak time. I think that period covered January, where people were getting their tax returns and therefore it was a bit of a peak for people coming in and querying around that. Also in December people got their I.T.I.S. (Income Tax Instalment System) rates, so that was also quite a popular time to come in and change your I.T.I.S. rate. We are working with Tax to look at this period up until May and as well as of course utilising social media and so on. Of course if we are seeing 700 people a day, there are 700 chances a day to prompt people and nudge them along to completing their tax return and coming in to check it out and get answers now rather than wait until the end of May. People will get a much better experience if they come in sooner rather than later, and I hope everyone listening at home has completed their tax return already. I think that is the point, if the majority of people have, then that will be very helpful indeed in terms of getting the paperwork completed, getting the support people might need to complete the paperwork, but also avoiding any real peaks in May.

Deputy C.S. Alves :

You mentioned there the experience and waiting times and things like that, but what about the actual outcomes for people requiring help? Has that been improved? It is great that obviously waiting

times are down and everything, but if they are still putting that form in and it is still taking longer than anticipated or whatever to get the outcome that they require, are those kind of things being measured?

Director, Customer and Local Services:

We do survey customers, and have done in fact, as we were at Social Security.

[14:45]

We do regular exit surveys with people after they have had a service and leave the building and also phone people up and also get responses on email, actual measurement of customer satisfaction, and we have been doing that as we have added on services. I do not have those figures with me today, but our performance in 2018 was around 90 per cent, so I would be expecting that we would continue a good performance. That is someone giving their view about their experience, so whether they have waited a long time, it could be 2 minutes, but it could be 2 minutes too long for that individual, they would give us a response accordingly. We have been getting quite a lot of positive feedback more generally as well as the customer satisfaction surveys we have been completing.

Deputy K.G. Pamplin:

Just the thought process on the F.O.I., that has come as a cost, so given how we have Health giving us their waiting times, is there an argument here that we could start or you could start publicising these numbers so there is not a need for an F.O.I., all the data is there: "Here is our waiting times" and it is like a live updated thing, so people can see, then we do not have to keep ... I just think that would enhance the public ...

The Minister for Social Security:

Honestly, I think that would be fine, and then you make sure you collect the data in the right way, and it is a regular thing and it is just there for people to look at.

Deputy C.S. Alves :

And the processing time as well.

The Minister for Social Security: Yes, the processing.

Deputy K.G. Pamplin:

Is that easy to achieve? Is that easy to process online or ...

I think we have the vision to want to be able to publish our historic times. I do not think we have got the capability at the moment to have it live, publicly published, but that is something I can look into.

Deputy K.G. Pamplin:

Even if it is updated every quarter or every 3 months or something.

Director, Customer and Local Services:

That is what we were aiming to do, or every month, something frequently that we can have it, that there is a record. I think the issues around application turnabout times is slightly more challenging, because there is a broad range of different functions, effectively, so passports is one area, customs is another area, tax is another area. I think that could be more of a challenge to get that together, but I am all in favour of being upfront and making sure that we publish data when we can publish it on a frequent basis, without obviously creating a huge industry about keeping it up-to-date. That is the other thing, it will take away from processing applications and that is the balance we have got to try and find.

Deputy K.G. Pamplin:

Okay. We look forward to hearing about that.

Deputy C.S. Alves :

What progress has been made on changing the department from the Department for Social Security to the Department for Community and Local Services?

The Minister for Social Security:

What do you mean? It is Customer and Local Services.

Deputy C.S. Alves :

Yes, so you have mentioned some of the things there, so I think there is ...

The Minister for Social Security: Sorry, Carina, I really did not understand.

Deputy C.S. Alves :

No, it is okay, it is fine. I think there is this perception that things like data-sharing agreements are in place and things like that. Is that currently in place?

The Minister for Social Security:

I do not know the answer. Ian might have the answer.

Deputy K.G. Pamplin:

That is an operational question.

The Minister for Social Security: Yes, Ian would know the answer to that.

Director, Customer and Local Services:

Yes, we do have data-sharing agreements with different services and obviously under the G.D.P.R. (General Data Protection Regulation) we are compliant with all the requirements to handle customers' data and we train staff on handling customers' data and we have appropriate privacy notices in place and so on. So we are working with ... even though we have different areas in the building, of course we seek to ensure that customers' data is used appropriately and with their permission and that people are aware of what we use it for.

Deputy C.S. Alves :

So obviously there has got to be a cost involved here as well with the change, so do you know what budget that is coming from and how that is being funded?

Assistant Minister for Social Security 2: That is operational.

The Minister for Social Security:

It is operational, but the budgets, it must have been brought together. Is there a savings? I do not know. Ian can answer that, but I do not ...

Director, Customer and Local Services:

The cost of setting up La Motte Street, those funds were used by agreement from our underspends in 2018, so where we had an underspend, for example, on staff administration costs, not benefits, we used that to invest in the refreshing of the La Motte Street area of the ground floor, where we removed a lot of the clutter and made things simpler and improved the waiting areas. We are also implementing  the  customer  flow  system,  which  helped  give  us  the  times  around  how  many customers may be waiting, how long and so on. That was the major investment in the building to make those improvements, so they came out from effectively taxpayer money.

The Deputy of St. John :

When you say you made the savings in administration, where did they come from precisely?

Director, Customer and Local Services: I did not say we made any savings.

Deputy K.G. Pamplin: The underspends.

Director, Customer and Local Services:

Oh, from underspends, that is it. As part of the M.T.F.P. (Medium Term Financial Plan), the second one, M.T.F.P. 2, the Department of Social Security was needing to make savings of approximately 21 per cent over that period, a 4-year period, and when we are making those savings in advance, we generate underspends, so if, for example, we needed to save £945,000 from 1st January 2019, and to make those savings, they were making those savings over the year, and as we made savings in 2018, we had surplus funds which we were able to invest in things that would make us more savings, or in those, to help launch and get ready to be the one front door for Government. The reason we were pushing to try and get that in place for October/November time was because the original plan was that we would be moving out of Cyril, out of South Hill and into a central building, so we needed to close those buildings and move people into La Motte Street at that time. Obviously Broad Street eventually will open up slightly later, but that was the original timeline we wanted to get things done.

The Deputy of St. John :

I know we have just had a session on this.

The Minister for Social Security:

That is fine. You are finished on customer access. Yes, thank you.

The Deputy of St. John :

You recently lodged an amendment to the employment law to introduce more family-friendly employment rights. A spokesman for the Chamber of the Commerce, and I quote: "We feel the financial burden to be put on our businesses is too great." I have a sort of open letter from the Chamber. In the last paragraph: "Given the burden on our businesses and the unknown economic impact to our Island, we would urge that further time is sought to provide clear analysis and data before bringing proposition P.17 to the States Assembly." Any comments?

The Minister for Social Security:

This letter came literally ... I was chasing up the road so I could get a copy to each of us, but to be fair, we met the Chamber on Friday and some of the comments that are in here ... and I am glad they published this, because it was a private meeting and I could not probably talk about it and I could not talk about it at the gender pay gap on Monday because it had been private. I did not know the letter was coming, but it got to me and States Members and the media. This was consulted upon in 2017. There is nothing new that has not been thought about. The only thing in the recommendations ... every recommendation is what they went out, they discussed with every size business and employees. If you look at their consultant, the Employment Forum's - sorry, I did not mean to jump - consultation document says that they had X amount of employees, employers. I mean, there was Unite, which is all right for employers, there was Chamber, Institute of Directors, and all the people they represent, the Farmers Union. All these people, we met with the Employment Forum, who told us in some of these cases, especially family-friendly, they really have a great engagement and some of these bodies like Chamber even do their own little questionnaire to different-sized businesses. Whether this was done, I do not know. The recommendations came back, and we are trying to catch up with the rest of the world. We brought in a tiny bit in in 2015. In 2017 we brought what the forum had said: "You need all of this, but if you cannot do half in 2018, do all of it in 2019." When it was looked through by the last Minister and the officers, there was quite a few easy wins that they could do and still extend fathers' rights, because fathers today can have 26 weeks, from 1st September, and they can take it in 3 blocks, but only over one year, so it is in the first year of the baby's life. Then there was breastfeeding rights, a completely new law, parental rights, which has now overtaken maternity and paternity leave, there is parental right leave of 52 weeks for the mum or the dad. We have sat down with Chamber on Friday. I think they did not understand some of ... they have put their letter out, but people do not pop every so often and say: "I want a few weeks' leave." They have to sit down with employer 15 weeks before the baby is born and decide who is going to take the leave. Well, you probably decide it with your partner first, then you sit down with your employer and say: "This is what ... I am going to take leave." Again, it is all about who can afford to take this leave. It would be lovely if everybody could, because that is what we are trying to encourage, trying to encourage mum at home as long as she wants to be at home. Some women do not want to stay at home, some people do not want to breastfeed. Dads are sometimes really cut out to be the better carer. The law did not allow that, so I am looking to Chamber. It is being scrutinised by a different panel, I think, now or is being scrutinised anyway, so hopefully they can have a good look at it and see what Chamber are saying. I can move the debate a few weeks and hear ... obviously call in. I did ask Chamber for the industries or the size of the businesses and that is not in this letter, but they said they were going to do some more research and try and come back to us.

The Deputy of St. John :

You just said that you could move this debate. Is it likely that you could meet their request to move the debate?

No, they are not requesting to move the debate. They are asking me to delay implementation of P.17. I am still aiming for the full recommendations to be implemented this year. It is the timing of the debate. With that 4 months' notice you have got to give employers, it has got to go through the States, it has got to go to Privy Council, it has got to still have 4 months left to be able to have that conversation I just said. It works. A 4-week delay in the Assembly would not put the whole timing out. It is a longer delay would put the timing out. They are not asking about the debate, they are asking me not to implement the changes, not when, just not to implement them. That is what they are doing. No, I think that it has been out there. We have needed this for years.

The Deputy of St. John :

If employers want to take a closer look at this - and I am asking the question, because the public have access to this meeting - who would you advise them to contact to discuss the implications?

The Minister for Social Security:

If employers or Chambers ... sorry, I am ...

The Deputy of St. John :

Employers, small businesses, because ...

The Minister for Social Security:

That is curious, because I had an oral question in the Assembly last year and there were only 2 supplementaries, which was from the questioner, and I said: "I really wish, if there was all this concern, I had been contacted." We have been contacted by 2 and nobody even after that had come to me. Apparently they are going through Chamber. That is part of the thing, if they are a member of Chamber. Chamber is the person. There are a load of other organisations who absolutely are not ... they are dealing with different industries, so come to me. But as I say, this was really heavily consulted on. It has been out there, the whole document, this is what is coming. It was printed in late 2017, the first part implemented last year, and it has never changed. If something had changed and completely different ... I think it is saying about they want paying, but in the U.K. your contributions are 13.8. They are not comparing like for like, and I know you were this morning, but 28 weeks of statutory sick pay paid by the employer, not maternity, sick, 28 weeks to cover that. We are not comparing the same.

Assistant Minister for Social Security 2:

I think to answer the Deputy 's question squarely on: "Where can you find the information about this?" J.A.C.S. (Jersey Advisory and Conciliatory Service) are already doing training courses with employers to understand the technicalities of this law. I believe those initially when they start are a

free workshop for employers, so if employers or employees have any concerns about the upcoming legislation, J.A.C.S. would be the perfect place for them to contact. If not, of course they can always contact the department and of course we will facilitate that, if that answers your question.

The Deputy of St. John : That does, thank you.

The Minister for Social Security:

Yes, if they want to come to us, yes, absolutely - I am getting it third-hand, basically - if there is a problem.

Deputy K.G. Pamplin:

I would just like to return back to the Assistant Minister responsibilities. It is just something that is creeping more and more into my vision and I asked a similar question of the Minister for Health yesterday.

[15:00]

The curious position, the way it has seemingly worked out, for example, Jeremy, you are Assistant Minister for Education, Assistant Minister for Health and Assistant Minister for Social Security. The theory the Chief Minister put forward was that the cross-collaboration that you could obviously have. But how is that working in practice?

Assistant Minister for Social Security 2:

So how I explain this to people when they ask is that my primary role is an Assistant Minister for Education. I spill into the other departments, Social Security and Health, when there is an issue where we are working with Education work. You will not be finding me getting expertise in pensions and things like that, so that is why I work a lot with the skills section, because there is that link with Education. To answer the question, how is it working, it is working because although I am across departments, it is good to be at the ministerial levels and getting that information where I can cross- compare what the different departments are doing. That is quite useful when it comes to getting involved in the portfolios of the other departments. I am very niche and very specific about what I am getting involved in, so that my primary is that of an Assistant Minister for Education. But it is useful, and especially going forward with on the Health side, where we are looking at early years, when we start working with, for example, the health visitors, looking at parental support, all that type of stuff, the link that will go to the Health Department will be useful.

Assistant Minister for Social Security 2:

That is good, because you deputised for the Minister at a recent C.O.M. (Council of Ministers) meeting, but what would happen if the Minister for Education and the Minister for Social Security were not there?

Assistant Minister for Social Security 2: The Minister has 2 Assistant Ministers.

The Minister for Social Security:

Yes, it was Jeremy, I think you went. If it is an all-day, they ask. I say: "Who can do a morning or an afternoon?"

Assistant Minister for Social Security 2: Yes, Deputy Southern has been before as well.

The Minister for Social Security:

Yes, Deputy Southern has been before as well. That never used to happen when I was an Assistant Minister. I was only ever at C.O.M. when there was something that came under the children's part, say employment law for children, I went there a few times. But this is brilliant, because they feed back and I know Jeremy cannot make all the meetings, but we are looking at all the things we want to do, we meet, and I always say to the officers: "Make sure you invite Geoff and Jeremy, because we will all feed back across." It has got to be better that you have got more: "Oh, I heard that here, I learnt this here" so ...

Deputy K.G. Pamplin:

Absolutely, the theory seems to be sound, but I am just curious, because Jeremy ...

The Minister for Social Security:

I do not how he keeps it. Honestly, no, I do not.

Deputy K.G. Pamplin:

We are a good stock of Deputies, that is clearly number one.

Assistant Minister for Social Security 2: Absolutely.

Deputy K.G. Pamplin:

But just curious, because you just said your main primary role is Assistant Minister for Education, so I am curious then - I will ask the Director - why is Geoff not more your Deputy ?

The Minister for Social Security: What do you mean?

Deputy K.G. Pamplin:

Jeremy has just said his main priority is being an Assistant Minister for Education. He dips in and out.

The Minister for Social Security:

I have never noticed that. This is what I am saying.

Deputy K.G. Pamplin:

But I am just asking the question, you say ...

The Minister for Social Security:

Yes, but I do not understand the question, sorry.

Deputy K.G. Pamplin:

Why would Deputy Southern not be your Jeremy to Jeremy's Minister for Education?

The Minister for Social Security: Well, he is. What do you mean?

Assistant Minister for Social Security 2:

How it has operated before when it has been delegated duties, Deputy Martin has done it on a rotational basis, for example, there is common stuff like that. She is available and then also ...

The Minister for Social Security:

That last one was about an hour and half, was it not? The other one when I was away - I got called away - you did the morning and Jeremy came in in the lunchtime. There is no ... I say: "Who can do this?" if I know I am going to be away. It was that I away on short notice, but other than that, there is no ... they are exactly the same.

Deputy K.G. Pamplin:

No, sure. I am asking - or we asked this - one of our recommendations in our mental health strategy about looking for a Minister for Mental Health, much like the U.K. Government, so giving specific ... like Deputy Tadier has a definitive responsibility for arts and culture, so do you see this working in this way or would it be better if Deputy Southern had an absolute portfolio of responsibility of primary care, social care and G.P.s and dental care, Jeremy is definitely only going to work on these area and definite roles?

The Minister for Social Security:

Absolutely, but only one in that stream you just said, primary care, and the only part of primary care is paying out from here for the part-payment, so it is a big workstream. There is no title I can make up. I am delegating Deputy Southern to work on all these streams for me, report back regularly, and Social Security does not necessarily work like that. I see what you are saying and Deputy Tadier has got those titles.

Deputy K.G. Pamplin:

Yes, it is just clear in some areas and it is not so clear in others.

The Minister for Social Security: Absolutely.

Deputy K.G. Pamplin:

For the public, who ask the questions, and that is why I am asking on their behalf today, it is a clear definition of what the role is, because I still think there is a bit of confusion from the feedback. Deputy Southern , if you could, for the people listening, what is your day-to-day, what are your specific roles, what your role is as an Assistant Minister for Social Security.

Assistant Minister for Social Security 1:

As Assistant Minister for Social Security, I will be in another meeting on primary care on Monday, but overall, if you look at the way in which the department is set up, you have got basically 2 fundamental building blocks. One is the employment law and the other is the Social Security law. Both are separate, but to say that you are just responsible for employment law is to ignore the rest of the things that the department is doing, which are just as important and there is an interlinking between the 2. It is not like Treasury or somewhere like that, where you can clearly say: "There is a little area you can be responsible for, we will delegate the whole thing to you, you deal with it." Social Security does not work like that. It does not fit that sort of model, so delegation is not appropriate, but keeping your eye across the board, certainly after 17 years of experience of advising what the department does ...

The Minister for Social Security: Yes, it is invaluable.

Assistant Minister for Social Security 1:

Deputy K.G. Pamplin:

Are you happy with this set-up? Is it working for you?

Assistant Minister for Social Security 1: I am happier than I was at the beginning.

Deputy K.G. Pamplin: Could you elaborate on that?

Assistant Minister for Social Security 1: I am a man in a hurry still.

Deputy K.G. Pamplin: I hear that.

The Minister for Social Security:

Nothing was moving fast enough, so yes, and it is ...

Deputy M.R. Le Hegarat :

Welcome to our world. We are always in a hurry.

The Minister for Social Security: Absolutely. I am still running.

The Deputy of St. John :

I am just wondering, from the public's point of view - and that is the reason the question has been asked - might it be that Government produce some relationship charts, much like those that are being produced for the services being provided by Government, and that would give the public an idea of how Ministers and Assistant Ministers and others relate together?

The Minister for Social Security:

We can look into that. As I say, it is probably, unfortunately, different against departments, just to explain our department.

The Deputy of St. John : I got a wave from ...

The Minister for Social Security: Okay, it might be going on.

Head of Policy:

I am Sue Duhamel, Head of Policy for Social Security matters. The Chief Minister will be publishing a list of ministerial responsibilities, which include how the Assistant Ministers are identified, so that is part of the existing set of Jersey law that has taken perhaps a bit longer to sort out because there have been quite a lot of changes to political responsibilities, but that work is underway and is very nearly finished. So there is always a published list of who does what, ministerially as well as department.

Deputy C.S. Alves :

Just a final question. It is understood that Les Amis are currently having a recruitment crisis on their hands. They are unable to find people to fill their care worker vacancies. Is the department able to assist at all through the Back to Work scheme?

The Minister for Social Security:

I think we do a care scheme, do we not? What is it called?

Director, Customer and Local Services: Advance to Care.

The Minister for Social Security:

Yes, so we are training up people. Literally, as you say, if we can be of any assistance. I only heard on the radio this morning that they have got the ... it is the recruitment of people and the man did say though you have got finance here and some people are leaving school with not that many qualifications but still earning a lot of money in the finance. It is a very difficult problem, but yes, if there is anyone in that care, obviously we would put them in touch.

Assistant Minister for Social Security 2:

Just to pick up on that, Back to Work does work for employers, it does seek to match people to what would work with them, maybe not necessarily on a full contract initially. Sometimes they do try and take an incremental step to introduce people to different workplaces and see if there is a good fit between the person and the employer. I am sure we are quite happy to contact Les Amis to remind them of that service as well as what Skills Jersey does, which is similar.

Deputy K.G. Pamplin:

A final question from me. Have you got any legislation or any big changes coming up outside of the Target Operating Model that you can preview very briefly or anything particular?

The Minister for Social Security:

No. I have asked that question. The only thing, as I say, this is lodged, family friendly. The law drafting is happening on the mesothelioma, but as I say - you were not here - why you asked this question is because he knows from Scrutiny much more recently that you need to plan your workload. You are not the only panel who scrutinise, and Health is massive as well, so when we see it coming, you will be the first to know. That is all I can say.

Deputy K.G. Pamplin:

The review of Social Security, where was that?

The Minister for Social Security:

The reviews were finished, and they were on the website, it just there are bits that have started ... we need to look at this, have we been doing this right? Geoff will know the one. The long-term care is based ... no, long-term capacity is based on ...

Assistant Minister for Social Security 1: A loss of faculty.

The Minister for Social Security:

It is in something like Victorian times. It is an interpretation of this. As I say, a lot of these people are going off exactly what your report says. It is probably slight depression, stress, and we allow them to sit at home isolated for 52 weeks on short-term care before they go on to long-term care, if they do not have a G.P. who is really experienced. Sorry, I am going over old ground. It is all these little streams ... well, they are big streams, and this is what the whole big review flushed out and said: "You have really got to look at this, it has to be delivered." Your report absolutely sort of crystallised that, that this is where you get into people early, you do not leave them on their own for 52 weeks.

Assistant Minister for Social Security 1:

Plus the application form for it ... what is it called? The impairment test. It is very much weighted towards the physical impairment rather than mental impairment, so I think there is work to be done there as well to make sure that it does pick up properly and weight sufficiently, equally, mental illness as well as the physical illness.

The Minister for Social Security:

And getting in there early.

Deputy K.G. Pamplin:

That is a good point, because that is again in our report, that the parity of mental and physical health needs to be treated. It is not just a health issue, it is everybody's issue. It is Education, it is Social Security, it is Housing and anywhere that the legislation does not meet that standard needs to be flushed out and sorted out asap.

Assistant Minister for Social Security 1:

There are 17 questions on physical impairment and there are 5 or 6 on mental impairment. That weighting needs to be done.

The Minister for Social Security:

Again, that is very late in the stage. If you can get to somebody early, get them the right treatment and talk to the right people, you do not need sit at home for a long time and then get more depressed and more stressed and then being out of the workforce, lose confidence. That is a brilliant report. Thank you.

Deputy M.R. Le Hegarat :

Okay, if there is nothing further, thank you very much to everyone that has contributed this afternoon. Thank you.

[15:12]