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STATES OF JERSEY
Health, Social Security and Housing
Scrutiny Panel
Health White Paper Review - Silkworth
Lodge
MONDAY, 30th JULY 2012
Panel:
Deputy J.A. Hilton of St. Helier (Chairman) Deputy J.G. Reed of St. Ouen
Mr. G. Wistow (Panel Adviser)
Witnesses:
Chairman, Families in Recovery Trust, Silkworth Lodge Chief Executive Officer, Silkworth Charity Group
Also present:
Ms. K. Boydens (Scrutiny Officer)
[13:30]
Deputy J.A. Hilton of St. Helier (Chairman):
Welcome to this hearing of the Health White Paper by the Health, Social Security and Housing Panel. I would like to draw everyone's attention to the code of behaviour for members of the public that is displayed on the wall and in particular to the following. All electronic devices, including mobile phones, should be switched to silent. The taking of visual images or audio recordings by the public will not be permitted. If you wish to eat or drink please leave the room. Finally, I would also ask that members of the public do not interfere in the proceedings and as soon as the hearing is closed please leave quietly. Members and witnesses may wish to make themselves available afterwards but any communication should take place outside the building. For the sake of the witnesses, may I confirm that you have read and understand the witness statement that is in front of you.
Chief Executive Officer, Silkworth Charity Group: Yes.
Deputy J.A. Hilton:
Thank you. We would like to introduce ourselves for the benefit of the tape. I am Deputy Jackie Hilton. I am Vice Chairman of this panel.
Deputy J.G. Reed of St. Ouen : Deputy James Reed, panel member.
Mr. G. Wistow (Panel Adviser): Gerald Wistow, adviser to the panel.
Ms. K. Boydens (Scrutiny Officer): Kellie Boydens , Scrutiny Officer.
Chief Executive Officer, Silkworth Charity Group: Jason Wyse, Chief Executive, the Silkworth Charity Group.
Chairman, Families in Recovery Trust, Silkworth Lodge:
Frank Laine, Chairman of the Families in Recovery Trust, Silkworth Lodge.
Deputy J.A. Hilton:
Thank you. I would like to give the apologies of our Chair who is off Island at the current time. I would like to start by asking you what services do you currently provide and how are they funded?
Chairman, Families in Recovery Trust, Silkworth Lodge:
We provide a drug and alcohol rehabilitation programme, an abstinence-based programme at the moment. It is funded partly by charitable donations and also a service level agreement which we have in place with Health and Social Services.
Deputy J.A. Hilton:
When was your organisation set up? You say you have a service level agreement with the Health Department. Have you always had a service level agreement or is that something that has just happened in recent years?
Chairman, Families in Recovery Trust, Silkworth Lodge:
The service level agreement was a result of a previous scrutiny panel review which made the recommendation that Health and Social Services engage with us to set up a service level agreement, which did happen in 2004. The actual charitable trust was established approximately 15 years ago. It grew from a one-room office in Halkett Place to what it is today.
Deputy J.A. Hilton:
Thank you. Would you like to tell us how you feel that the service level agreement is working and what your working relationship with the Health Department is like at the current time?
Chairman, Families in Recovery Trust, Silkworth Lodge:
The service level agreement is fine. The money comes through in a timely manner, apart from the last one, which was in December, which was deferred or, in my interpretation, it was cancelled. There have been no referrals from the Drug and Alcohol Department from October of last year. We rely on referrals from the Drug and Alcohol Department. This is part of the care pathway system that we have established. We also rely on referrals from G.P.s (general practitioners) and from private individuals. The States of Guernsey are one of our biggest clients. In fact we get more referrals from Guernsey Health Department than we do from the local Health Department. There seemed to be a change of policy or a change of attitude, for want of a better expression, around about October of last year. We did not take much notice of it because the facility is full and we have always got waiting lists for people coming in, but we began to notice the lack of referrals from our main source of supply. We then had a visit from the new chief of adult mental health who wanted to investigate and to get himself involved in our results. The last time we did a very comprehensive review of our successes and all the other things, which we have a copy of here, was the last time we had a service level review, which was in 2009, and this was prepared for that review. It took us a long time and it is very expensive to do this type of thing but it is very comprehensive and very thorough. They seemed to want to become very actively involved in our details and figures. My intuition told me that I would like to know is the inquiry to help us or to not help us. We have been waiting for an answer to that since December of last year. We have also asked them why we have had no referrals since last October and we are still waiting for an answer.
The Deputy of St. Ouen :
Are you aware that in the Health White Paper one of their priority service changes that they are promoting between 2013 and 2015 is a focus on alcohol?
Chairman, Families in Recovery Trust, Silkworth Lodge: Correct.
The Deputy of St. Ouen :
With regard to that then, what involvement have you had in the process leading up to the publication of the White Paper and these service changes?
Chairman, Families in Recovery Trust, Silkworth Lodge:
None whatsoever. We have not been consulted. We do not get consulted on anything. We see things in the paper, various people attending conferences, making statements about drugs. We are one of the primary providers of drug and alcohol treatment in the Channel Islands and we are never consulted. We are never asked for our experience of what we know or what knowledge we have of what is going on in the street. We never get consulted.
Deputy J.A. Hilton:
Can I just ask you, did you say that the payment was cancelled in December?
Chairman, Families in Recovery Trust, Silkworth Lodge: Correct.
Deputy J.A. Hilton:
So you have had no funding from ...
Chairman, Families in Recovery Trust, Silkworth Lodge:
We got an apology a month later but it took quite a lot of political shenanigans to make sure that the money came.
Deputy J.A. Hilton:
So the financial arrangement is back in place at the current time ...
Chairman, Families in Recovery Trust, Silkworth Lodge: It is, yes.
Deputy J.A. Hilton:
... but you have had no referrals from last October, which is about 9 months ago?
Chairman, Families in Recovery Trust, Silkworth Lodge: Nine months ago.
Deputy J.A. Hilton:
From a taxpayer point of view, that has got to be a matter of grave concern. With the level of alcohol and drug problems in this Island, one has to ask what on earth is going on.
Chairman, Families in Recovery Trust, Silkworth Lodge: Where are they going?
Chief Executive Officer, Silkworth Charity Group: What is being done?
Chairman, Families in Recovery Trust, Silkworth Lodge:
There is 600 or 800 people go through that department in a year and we have not seen one since last October.
Deputy J.A. Hilton:
Do you know where they are going?
Chairman, Families in Recovery Trust, Silkworth Lodge: We do not.
Chief Executive Officer, Silkworth Charity Group:
We have no idea and we have asked the question more than once.
Chairman, Families in Recovery Trust, Silkworth Lodge:
We have asked the question of the people who are in charge and we have asked the question of this new lady who has come on board and we have had them around to Silkwood and we have asked the question of the Minister, but we cannot get an answer.
Deputy J.A. Hilton:
So nobody has answered that specific question?
Chairman, Families in Recovery Trust, Silkworth Lodge:
Nobody has given us an answer to why we are not receiving people from the Drug and Alcohol Service.
The Deputy of St. Ouen :
Are there any other organisations, apart from yourselves, that are providing services to support those with alcohol and drug addiction on the Island?
Chairman, Families in Recovery Trust, Silkworth Lodge: No.
The Deputy of St. Ouen :
So, just to be clear, there is no other organisation that is providing the service that you currently provide and yet we have a Health Department that seems to have chosen not to consult with yourselves in one of the particular areas that they have chosen to focus on within the White Paper?
Chairman, Families in Recovery Trust, Silkworth Lodge: Correct.
The Deputy of St. Ouen : Thank you.
Deputy J.A. Hilton:
I am stunned. You said you have spoken to the Minister. You have asked the Minister yourself?
Chairman, Families in Recovery Trust, Silkworth Lodge:
We have had correspondence with her, which is available. We have had correspondence with the chief of the adult health. We have had correspondence with the lady who has come on board who was part of the KPMG review.
Deputy J.A. Hilton: Rachel Williams.
Chairman, Families in Recovery Trust, Silkworth Lodge:
We have had no response. They will not give us a definitive answer.
The Deputy of St. Ouen :
Has the Health Department raised any concerns with you about the current services that you have been providing over the last 20 years?
Chairman, Families in Recovery Trust, Silkworth Lodge:
Nothing at all. We are regulated 3 times more than any U.K. (United Kingdom) facility. We have an inspection from the U.K. It is paid for by the Health Department. They come over, they do a thorough examination of what we do and what we provide. Every one of them we have been told that we would be one of the top 3 treatment centres in the United Kingdom if we were in England.
The Deputy of St. Ouen :
Have any complaints, to your knowledge, been made about your facility or the way you provide your services over the past 3 years?
Chairman, Families in Recovery Trust, Silkworth Lodge: No complaints.
Deputy J.A. Hilton:
You mentioned that you get more referrals from Guernsey than you do from Jersey. How did you first establish a relationship with Guernsey? How did that come about?
Chairman, Families in Recovery Trust, Silkworth Lodge:
That came about many years ago. They have always had a serious problem, the same as we have here, and they were referring people on to the Priory in Southampton, Marchwood Priory. It is expensive. The Priory and any other facility of that nature would be a minimum of £5,000 a week. We provide the same programme that you would get at the Priory for £600 a week.
Deputy J.A. Hilton: That is a big difference.
Chairman, Families in Recovery Trust, Silkworth Lodge:
That is why Guernsey came to talk to us. We have also established a support group in Guernsey and we go over there once a fortnight. One of our counsellors goes there and we have a big aftercare group, probably 30 or 40 at a time. Some of these people are now 8, 9, 10 years into clean and sober from drugs and alcohol. So we have big support there. All the health people from Guernsey have been to Silkworth Lodge. They are very excited about what we do, the results that we get.
Chief Executive Officer, Silkworth Charity Group: They want to engage with us.
The Deputy of St. Ouen :
Can I just pick up. I want to understand a little bit more about the service level agreement, because you say there is a service level agreement in place. How long does that service level agreement go out for?
Chairman, Families in Recovery Trust, Silkworth Lodge: The service level agreement is a 12-monthly arrangement.
The Deputy of St. Ouen : Twelve months?
Chairman, Families in Recovery Trust, Silkworth Lodge:
Twelve months. I have written to all of the people involved and told them that constitutionally and morally it is incorrect. We employ people on term contracts. We have to interview them, we have to go through all the process that everybody else does. We have to offer people, like Jason and like other people involved in the charity, proper term contracts with salaries. They then base their life on that. They go out, take a mortgage, educate their children. They have responsibilities. These people could come along, like they did at Christmas, and withdraw our service level agreement. That would put those people out of work.
The Deputy of St. Ouen :
Are you aware of other charities that have similar sorts of length of agreements?
Chairman, Families in Recovery Trust, Silkworth Lodge:
We have engaged with people who are the primary providers of alcohol and drug services in the U.K., which is called Action on Addiction. They have been our external supervisors for all of our staff and everything that we do there for many years. All of the U.K. service level agreements are with a 3-year contract, which is normal. The British Government have spent thousands and thousands of hours working their way through this. That is the most honourable and sensible way of doing it. If at the end of 3 years people do not want a service you have a controlled exit, a respectful exit for everybody involved in it. The people that get into recovery need to know that we are still there. Part of the recovery is knowing that there is a facility that can help them. They can come back, their families know, their bosses know, the teachers know that the parents have now got some help. It takes the pressure off the teachers, off the police. Our facility is not just about the drug addict or the alcoholic. It is the extended community, the wider extended community. A large part of our work is to educate the families as to the illness of whoever it is and that takes a lot of time. We have now just been accredited with the Investors in People. So it is a quality organisation, it is well structured, it is trimmed to the bone.
[13:45]
My background is I run businesses and I run them successfully. My reputation does not run to backing nags or to wasting money. This charity is well structured and well run.
The Deputy of St. Ouen :
What is the split on funding, roughly, that supports Silkworth?
Chairman, Families in Recovery Trust, Silkworth Lodge:
When we started we were heavily reliant on the service level agreement. It is now about 50:50. We were 90 per cent dependent on it at the beginning but we have built up a reputation where we are now getting referrals from people who have the wherewithal to pay properly for this treatment. Six of the beds we charge properly for and for the other 6, which are allocated for the States, we get £600. We can get £2,000 for them privately if they have got the money, but no one has ever been turned away from Silkworth Lodge in all of the 15 years because of lack of money.
The Deputy of St. Ouen :
One of the things that the White Paper particularly focuses on, they speak about alcohol and, as you rightly point out, there is equally the issue of drugs and it is sometimes difficult to separate one from the other. Do you believe that there should be a greater focus on or inclusion of drugs within those service changes that they are proposing within the first 3 years of this plan?
Chairman, Families in Recovery Trust, Silkworth Lodge:
My personal view, and I have been in this field for almost 40 years, is that behaviour- wise there is a difference between drugs and alcohol but addiction-wise and damage- wise in my opinion there is no difference. An addiction is an addiction. Whatever the chemical used to get to that particular point is none of our business. We treat people with drugs and with alcohol with the same programme. There is the same recovery process. The only thing different is drug addicts have a different mentality. They think differently because they have to do what they have to do to find the drugs, but the actual damage done to the families and to the children and to the wider community is very similar.
The Deputy of St. Ouen :
Your facility is able to provide for both?
Chief Executive Officer, Silkworth Charity Group: For both.
Chairman, Families in Recovery Trust, Silkworth Lodge:
One of the points we have asked the other people is what does it cost for the methadone programme. They will not give us an answer to it. How much does it cost? It is not in the White Paper. There is no mention of it in the White Paper. Methadone and the other substitutes are very, very expensive drugs. I know from the website there are over 600 people on this drug but there is no mention of how much that has cost or how many are getting it or how long are they on it.
The Deputy of St. Ouen :
I presume methadone is supposed to be a substitute to help an individual move from drug addiction in what we would commonly know as class A drugs right through to sort of being clean?
Chairman, Families in Recovery Trust, Silkworth Lodge:
Correct. We have had people in Silkworth who have been on methadone for 14 years.
The Deputy of St. Ouen :
Fourteen years? Would that be considered normal in the U.K.?
Chairman, Families in Recovery Trust, Silkworth Lodge: I think I had better read this again.
Deputy J.A. Hilton:
I think you said you provided 6 beds to the Health Department. When they were sending you referrals what was the split between drug dependent and alcohol dependent?
Chairman, Families in Recovery Trust, Silkworth Lodge:
I would have to check that out but I would think it was probably 50:50.
Deputy J.A. Hilton:
Have you had much contact with the head of the Drug and Alcohol Centre at Stopford Road?
Chairman, Families in Recovery Trust, Silkworth Lodge: Only very limited.
Deputy J.A. Hilton:
Very limited? Interestingly you made that comment about having somebody who had been taking methadone for 14 years. I have had discussions with the head of the Drug and Alcohol Service to try and understand the methadone programme, because it seemed to me that people were being allowed to take methadone for a very long period of time and I could not really quite understand why and I still do not really understand why. So it is truly alarming to hear that you have had somebody, who was presumably referred from the drug service to you, having been taking methadone for 14 years. Bizarre. Notwithstanding your previous comment, and I think you said that you had not been consulted with regard to the White Paper, what are your thoughts on the White Paper? Have you read the paper? We would be interested to hear what you think.
Chairman, Families in Recovery Trust, Silkworth Lodge:
My personal view is that it is a lot of words but there is no substance and I cannot tie it all together. We have also run it past our people in Action on Addiction who are a primary provider. They made the same comments.
Chief Executive Officer, Silkworth Charity Group:
I would agree with those comments as well. I think the White Paper itself, there is words in there but there is nothing backing up what is going to happen, what are the cost implications, et cetera. I think particularly around alcohol there is not enough there to go into how we are going to work in the community. We need to get that right now before we do these sort of things, and no mention of drugs as well which I think is ...
The Deputy of St. Ouen :
I think you raised an important point there because generally the people we have spoken to find it very difficult to necessarily disagree with the direction of travel that the White Paper is highlighting but that there is further detail that they would like to understand, especially around money, because ultimately that is the case. With regard to this move towards more services being provided within the community, what role do you see organisations like your group playing in delivering those services and what would you need to see happen for that to become a reality?
Chairman, Families in Recovery Trust, Silkworth Lodge:
My personal wish would be that we were treated honestly and openly as to what people are intending to do and a consultation would not go amiss. If I am doing something in any other business I am involved with the first thing I engage with is the other people and ask them their opinion and then between us we build up a strategy which is respectful to all parties. If this facility is no longer required in the community, we would be more than happy to walk away from it. We have no other hidden agendas as to what we provide. This is purely for the people. We identified the need many years ago. The last scrutiny panel highlighted it and made strong recommendations as to how they would like to see Government engage with us on this. None of those recommendations have got very far. In fact I do not think any of them have actually been achieved. I think everything is still as was recommended, apart from us. We have gone on and developed a facility.
The Deputy of St. Ouen :
I would just to read you a little section on page 16 of the White Paper which talks about the focus on alcohol and it talks about "Detox/relapse service enhanced". It says: "Based on 2010 figures, it is estimated that the hospital spends approximately £2 million on alcohol attributable conditions per annum." That is quite clear. "Non- hospital detox is less costly and can be more effective than hospital detox as it takes place in non-institutionalised settings. To increase the investment in non-hospital detox and relapse management, individuals will receive care provided by a multidisciplinary team to help them achieve and maintain abstinence." What do you understand by those words, given the comments you have just made?
Chairman, Families in Recovery Trust, Silkworth Lodge: Well, who is going to do it?
The Deputy of St. Ouen :
If we challenged you and said: "Are you able as an organisation to provide these services?" what would your answer be?
Chairman, Families in Recovery Trust, Silkworth Lodge:
Yes, we could. We would be more than happy. In fact, we had identified a property to open a detox unit and we have a very comprehensive document that we had agreed with the previous head of the department, who has now left. This is a detox- plus which was agreed many years ago and we have repeatedly attempted to engage. It sets it out. We even identified a property in New Street and we had it adapted to our requirements. We could not get the Health Department to engage with us in a meaningful manner to help us to establish it. The biggest trouble with us is if we get someone who wants to come into treatment we have to refer them to the Drug and Alcohol for them to detox, a home detox, or we have to pay for them in a nursing home or somewhere, which is expensive. Most of the people cannot afford it and we cannot afford it. They will go for an appointment but they will be given an appointment 3 weeks from now. The family or the boss or whoever has got them to that crisis point throw their arms up in the air. So we have been continually for 4 or 5 years attempting to get this off the ground. We were almost there and then Stuart Brook left and then these other people are not interested, so we have to give the property back to the States.
Deputy J.A. Hilton:
So discussions basically came to a halt on the idea of a detox centre?
Chairman, Families in Recovery Trust, Silkworth Lodge:
We have the programme. We have not been consulted on this. So it is in place. We have got reams and files. This is the setup. We set up the care pathway. This man I had at the time was the head of the Priory. He was the chief addiction counsellor for the Priory Hospital group and he worked for me for 2 years and we did all this work.
The Deputy of St. Ouen :
Just to be clear, because that was one of my questions, who has prepared and presented these reports for you? Have they been experts in the field?
Chairman, Families in Recovery Trust, Silkworth Lodge: Oh, yes. You will not find better.
The Deputy of St. Ouen :
Yet there has been a reluctance to engage.
Chairman, Families in Recovery Trust, Silkworth Lodge:
To engage with us in a meaningful manner. There is plenty of talk but it does not go any further than, yes, it is a good idea.
The Deputy of St. Ouen :
Have you seen a variation in funding over the last 5 years, apart from the fact that they stopped funding you in October?
Chairman, Families in Recovery Trust, Silkworth Lodge: I do not understand that, sorry.
The Deputy of St. Ouen :
From the department, have they been continually supportive of your facility by maintaining consistent funding allocation?
Chairman, Families in Recovery Trust, Silkworth Lodge:
The funding has been out of their hands really because it comes from the Treasury who we have built up a good relationship with. They provide our account in a timely manner and it is paid on time, apart from that last one which we understood the chief of the mental health had our file in his car. This was the excuse we got. I do not think it was a reason, I believe it was an excuse. We have had an apology saying it was an oversight. I personally do not think it was an oversight.
The Deputy of St. Ouen :
Can I just pick you up on that. Again, we have been led to believe that a majority if not all of the services provided by third sector, charitable organisations linked to Health are funded from and through the Health Department budget. Are you suggesting that is not the case with yours?
Chairman, Families in Recovery Trust, Silkworth Lodge: I do not know. Who do we ...
Chief Executive Officer, Silkworth Charity Group:
We present our accounts to the Finance Department so when we are asked to provide numbers or accounts we send them straight through to Finance.
The Deputy of St. Ouen :
The Finance Department of the Health Department?
Chief Executive Officer, Silkworth Charity Group:
I think it is just the Finance Department I send them through to.
The Deputy of St. Ouen : What is the name?
Chief Executive Officer, Silkworth Charity Group: Sarah Pergal(?).
Mr. G. Wistow:
Just for completeness, you said you were inspected regularly by people from the U.K. Who carries out that?
Chairman, Families in Recovery Trust, Silkworth Lodge: It is under the public health nursing.
Mr. G. Wistow:
Is it C.Q.C. (Care Quality Commission)?
Chairman, Families in Recovery Trust, Silkworth Lodge:
They employ an outside consultant whose sole job in the U.K. is inspecting treatment centres and they pay him to come out here every 6 months and he goes through the place for 2 days. He inspects everything, all our files, everything to do with it, and he does that every 6 months. In the U.K. it is probably once every 2 years.
Chief Executive Officer, Silkworth Charity Group: It is in line with a C.Q.C. inspection.
Mr. G. Wistow:
Yes, and it is the C.Q.C. who employs this consultant?
Chairman, Families in Recovery Trust, Silkworth Lodge: It must be.
Chief Executive Officer, Silkworth Charity Group: Would be, yes.
Mr. G. Wistow:
Is the report on your service then on their website? Is it a public document in Jersey?
Chairman, Families in Recovery Trust, Silkworth Lodge:
As far as we are concerned, yes. It should be. If it is not, we would be very pleased for it to be one.
The Deputy of St. Ouen :
What do you think are the main strengths and weaknesses of the third sector on the Island in delivering services to the community?
[14:00]
Chairman, Families in Recovery Trust, Silkworth Lodge:
The third sector, in my opinion, is in a state of anxiety, the whole of the third sector or a large proportion of it. The people I speak to are very nervous and a lot of them are frightened about what is going on and the way it is being conducted. There is a lot of talk about withdrawal of service level agreement funding. There seems to be a lot of suggestions that things need to be done a certain way, with veiled sorts of threats in my opinion. There are 2 or 3 people that I know who run charitable organisations who are less than happy and they are feeling quite unique and quite vulnerable.
The Deputy of St. Ouen :
What would have to happen within the shifting responsibilities of organisations such as yours if you were, as this White Paper suggests, asked to step up to the mark and provide and improve the services within the community?
Chairman, Families in Recovery Trust, Silkworth Lodge:
It would be a wonderful thing for the Island. The people who are engaged in this charitable sector run these things through a passion. They have identified a gap that the Government cannot provide. They have put many years into putting them together. They are the best people to deal with what they are doing. What my interpretation of the directive of the Chief Minister was that these people want to help the third sector. They were to engage with them and to support them and to help them, because some of them are well-intentioned and some of them are not very well organised. Some of them do not have lots of business acumen but the principle of what they are providing is essential to the community. The community needs these. This facility, Silkworth in particular, would cost between £2 million and £3 million to put together. It has taken 20 years to get to where we are now.
The Deputy of St. Ouen :
If you were to move from now to a much better place and delivering what has been suggested in the White Paper what would you require or expect to see from the Health Department?
Chairman, Families in Recovery Trust, Silkworth Lodge:
We would need an honest relationship with a liaison officer. That would be my personal choice, if we had someone that we could say is not swayed either way, that was independent and that would work with us. The value that people get from these charitable organisations is unbelievable. I know this is not the question but I just think you need to know this. If they interfere any more they will by default take over this third sector. It will become an extension of Government by their influence and it will take 2 or 3 years after that for them to become ineffectual, loaded up with staff, and they will not provide the services they are providing now.
The Deputy of St. Ouen :
Do you think that is a possibility?
Chairman, Families in Recovery Trust, Silkworth Lodge: I am convinced of it.
The Deputy of St. Ouen :
Can you point to anything concrete that supports your view?
Chairman, Families in Recovery Trust, Silkworth Lodge:
We have a typical instance which is Roseneath, which has a very similar constitution and makeup as Silkworth Lodge and The Shelter. I was the founder chairman of The Shelter Trust and I had a co-founder who is still the chairwoman and she still runs it now. We were contacted by Roseneath when their service level agreement was withdrawn.
The Deputy of St. Ouen : By Health?
Chairman, Families in Recovery Trust, Silkworth Lodge:
By Health. We were asked if we would like to engage with them because we were the most similar charitable organisation to them which provided for this client base.
The Deputy of St. Ouen :
Can you just remind us, who did Roseneath provide for? What was the client group?
Chairman, Families in Recovery Trust, Silkworth Lodge:
It was set up years ago by the Salvation Army and there were lots of other people involved with it, and mainly they looked after people who could not get sober. It was before The Shelter. It was a bit of an attempt at getting people in and it was mainly the rock bottom end of people with drug and alcohol problems, but there was very little structure to it early on.
The Deputy of St. Ouen : It was accommodation?
Chairman, Families in Recovery Trust, Silkworth Lodge:
It was accommodation. We were asked to get involved and we went and looked at it and we decided that it was a very good opportunity for us because it would, first of all, provide us with a secondary line of people needing treatment who have got a bad residential history so they find it difficult to get a flat, so we thought this would be ideal. It would also provide us with an income stream which would make us even
less dependent on the service level agreement. So we spoke to the people involved. The first thing I did then was make an appointment with the chief executive at the Health Department, specifically to talk about our plans and our intentions, mainly because they are our partners and we wanted to explain to them and if there was anything going on that we should know. We had a meeting with them at Christmas. We told them what we intended to do and they said that was fine. I made it very clear: "If you are going to engage with them I would not be involved in a Dutch auction" because one of the houses is on a lease, a long-term peppercorn lease, but the other one is freehold, so between them there is a couple of million pounds worth of property, between £1.5 million and £2 million. The trust had £60,000 worth of debt. We scraped together, through Lloyds TSB and various other contributors, £100,000 and we said, through our lawyer, we made the offer through the lawyer, that we would settle the debt and we would just join the trustees. We would leave the charity as it was, we would leave everything in place, all that would happen is that we would become a trustee. We made a presentation to the trustees and we came away. One hour after I made my offer and having checked with the Health, one hour after we sent our letter in the Health made an offer behind it.
The Deputy of St. Ouen : For the same property?
Chairman, Families in Recovery Trust, Silkworth Lodge: For the same property.
The Deputy of St. Ouen : For the same purpose?
Chairman, Families in Recovery Trust, Silkworth Lodge: For the same purpose.
Chief Executive Officer, Silkworth Charity Group: This was on the closing date of the actual ...
Chairman, Families in Recovery Trust, Silkworth Lodge:
We were given to 23rd February to make our offer. We rang up on the 11th hour on the 22nd and said: "Have you made any offers?" "No." We had the officer who was in charge in our office in Silkworth. We asked him: "Have you made any offer?" "No." We then made our offer and then the woman who was dealing with the offers rang up: "We have just had an offer in from the States." We checked with Property Services; no one had been asked to engage with them or asked them any questions. I wrote to them and said: "In the light of the present knowledge that we have, we will now be making our offer." As soon as that landed ... I see in the paper at the weekend it has been bought for £40,000 and that the charity has been disbanded and that The Shelter has taken it over. The Shelter has not taken it over, because I spoke to the chairwoman last night and she told me she has no knowledge of it whatsoever.
The Deputy of St. Ouen :
Correct me if I am wrong but earlier you said that part of the reason for Roseneath closing was actually that the Health Department stopped funding it.
Chairman, Families in Recovery Trust, Silkworth Lodge: Correct.
The Deputy of St. Ouen :
So a short time later not only have the Health Department now sought to take it over ...
Chairman, Families in Recovery Trust, Silkworth Lodge: They have taken it over, taken the property.
The Deputy of St. Ouen :
... but they are planning to run it in the same way that it was run previously?
Chairman, Families in Recovery Trust, Silkworth Lodge: That is it.
Deputy J.A. Hilton:
Yes, but not with the previous incumbents. It has been disbanded.
Chairman, Families in Recovery Trust, Silkworth Lodge:
No. The existing charity, which we were going to maintain, is being told to disband it and to wrap it up, and there is £2 million worth of property that was in the charitable sector that could have provided us with an income stream which could have helped us to reduce our service level agreement funding. It has all disappeared.
The Deputy of St. Ouen :
Just picking up and following that train of thought and expanding on it a bit. You have already told us some of the services that your company provides. What services could Silkworth Lodge provide?
Chairman, Families in Recovery Trust, Silkworth Lodge: We can provide any service relating to this client base.
The Deputy of St. Ouen :
Just to be clear, are there are any services that are provided currently by the Health Department that you would feel able and be able to take over or take responsibility for?
Chairman, Families in Recovery Trust, Silkworth Lodge:
I do not know. All I know is that the Drug and Alcohol do a job for the community and they have restrictions and they have good people working there, I am quite sure. We provide a different structure from it but we can provide anything to do with drug and alcohol addiction. We can adapt programmes, we can make programmes to fit various requirements, but we have never been asked.
The Deputy of St. Ouen :
Just to be clear, you have got independent verification that you are competent and able to deliver ...
Chairman, Families in Recovery Trust, Silkworth Lodge:
We are highly competent. The mere fact that the man from the U.K. tells us that if we were in the U.K. ... and these fellows are hard to get something out of. It has taken us 3, 5 years before he even said that there were flowers at the entrance of the door. We had to ask him to start trying ... He says every time he comes: "If this treatment centre was in the United Kingdom you would be in the top 3."
Chief Executive Officer, Silkworth Charity Group:
I think importantly as well, an organisation like ours does not get accreditation with places like Bupa Healthcare, Investors in People, the inspection reports that we get, which are first class, if we are not doing what we are supposed to be doing.
Chairman, Families in Recovery Trust, Silkworth Lodge:
There are no complaints. There is no pending ... We have a consultant psychiatrist on board who is engaged by us. We have a consultant doctor who visits every Thursday afternoon. He inspects everybody in there. These are not registration requirements. These are protocols we have put in place to make sure that the clients and the quality of service is better than you would get anywhere and these are not requirements for registration. We provide that ourselves.
The Deputy of St. Ouen :
The truth is that if we were able to rely on the words contained in this document and that we saw real partnerships being created and developed between in your case Drug and Alcohol Services and yourself, that the opportunities that would exist to help those within our community are quite substantial?
Chief Executive Officer, Silkworth Charity Group: They are huge.
Chairman, Families in Recovery Trust, Silkworth Lodge:
But you need some teeth because this is a very comprehensive document that we were engaged in and spent a lot of time on. If you go through it you can see that each recommendation in here has not been touched. That was 2004. I have been through and I have worked with various politicians, chief executives for the Health Department, through setting up The Shelter and through setting up this, through 30 years of working with people. All the recommendations in the world are no good if people do not make anything happen.
Deputy J.A. Hilton:
Can I just ask you, going back to these premises that you bid for, did you ask the Health Department after you lost the premises why they had done that when you had been ...
Chairman, Families in Recovery Trust, Silkworth Lodge:
We have only just found out about it in this paper this weekend. We did not know. Nobody told us. I wrote to Julie Garbutt and sent a long email: "We have not heard from anyone in the department, we remain at all times available to progress any matters that will enhance or promote our sector or in fact any sector that would benefit from anything we have at our disposal. An investigation at the eleventh hour that no negotiations or indications of interest had been received by you or any other States department, including Property Services. My email of 20th December was very clear as to how we would not be involved in a Dutch auction or become involved with the trust unless you were sure that it would not interfere with our partners Health." It goes on and on. We set out very clearly we did not want to get into a Dutch auction. If they wanted the property all they had to do was tell us and we would have backed away but we were led to believe and we went to the great expense of getting a lawyer to prepare the bid. This is charitable money. "Just for clarity and for our files, Julie, so that we are clear what our intentions were from the day we made our appointment here in December 2011 and all of my emails setting out very clearly what we would and would not do."
[14:15]
Deputy J.A. Hilton:
What is really puzzling is in the outline business case that has been produced by the Health Department to back up the White Paper they talk about stakeholders, risks, issues, dependencies and enablers, and you are listed as one of the stakeholders. Then over the page it goes on to say: "Stakeholders to be engaged as the outline business case develops into a full business case", including yourselves listed in there. So I find it truly disturbing to find that you have had absolutely no contact with the Health Department over this White Paper while there are people out there in the community who could really benefit from the service that you are providing. I am at a complete loss to understand why this is going on.
Chairman, Families in Recovery Trust, Silkworth Lodge:
We have had £200,000 worth of public money for 6 beds that have not been occupied. A lot of the charities will not be brave enough to say that to you or to anyone else because they would be petrified of losing their funding. The only primary purpose we have is to provide a facility for the people that need Silkworth Lodge. If the Government or anyone else decides they do not want us any more all they need to do is tell us. Silkworth Lodge has touched thousands of people's lives
throughout the 15 years it has been in office. We are not a high profile charity. The actual nature of what we do and deal with is not a sexy charity but the public benefits, the wider benefits to the community are unbelievable. I do not think you would find anybody in the Island who has not been touched by what happens at Silkworth Lodge and we can provide evidence of that. This is the first time in the 25, 30 years I have been in this sector that I have had to come out. I very rarely have any discussions with any media or anything because Jason or the other people deal with it. This is a serious crossroads that we have come to. My business acumen tells me and a good businessman can usually see what is coming. That is why they are good at what they are doing and they usually provide for communities what they need. This is a serious crossroads as far as I am concerned for Health and not just for Silkworth Lodge but for all the charitable organisations. It appears to me to be a takeover of the charitable sector to rake in the money and then to control the charitable sector and give the ones that they think they can manage. That may not be ...
The Deputy of St. Ouen :
What do you think needs to be done to address that issue, to remove that concern, if it exists?
Chairman, Families in Recovery Trust, Silkworth Lodge:
As a charitable organisation, we are not here to fight with them or to engage with them or to get involved with it. We are here but Government controls us because that is what democracy is about. Our job is not to go out fighting and screaming and shouting. All we can do is present our case in an honest, open way. I am not prepared to engage with data. That was the last time we were asked, the one in 2009. It took us a year to put together. For someone to arrive in our office and want that lot in 3 weeks otherwise he pulls our funding is not ... but Government runs what they run. We are happy to work with anyone that can help us to get out of this or to make it workable so that the people who we have in Silkworth and any other charitable organisation can have comfort and knowledge that they are safe, that the people they employ are not going to be put out of work within a month, because come December or whatever date their service level agreement comes in that money can be chopped off. You could have 14, 15 people, 20 people out of work.
Deputy J.A. Hilton:
Your current service level agreement finishes in December?
Chairman, Families in Recovery Trust, Silkworth Lodge:
It finished last December. We had to have a special meeting with Anne and with various other politicians to ensure that our service ... I was not prepared to go another step further until I knew that we had enough money coming in to pay people's salaries. These people have responsibilities. They have children who go to school. This is not something to be played with. These are serious structures looking after a very serious problem in society. We would not be here if someone else could provide it.
The Deputy of St. Ouen :
I might have asked this question before but are you aware of other charitable organisations that are facing similar issues?
Chairman, Families in Recovery Trust, Silkworth Lodge:
Correct. I know of at least 3 or 4. They may be in a better position than I perceive them to be but I do not think they are strong enough, because a lot of these charitable organisations are run by people on a part-time basis. They have a mission. They have identified something. They are not in the corporate world like I am and I see these things probably quicker. I am sure if they felt safe they would give you a very similar explanation but a lot of them are afraid.
Chief Executive Officer, Silkworth Charity Group:
The partnerships have to be 2-way and at the moment the partnership feels one-way and that takes away trust and takes away confidence in who we are working with. At the end of the day we are only here to help the people that need our help. We are not here to battle with anybody and when we are in a position like this where we feel that we are being backed into a corner it is not fair and the trust goes. When we are helping as many people as we are helping and we are making a difference to, like Frank said, not just hundreds of people but thousands of people effectively, it makes no sense why we are sitting here like this.
Deputy J.A. Hilton:
Thank you. Gerald, is there anything else? James, is there anything else that you would like to ask?
The Deputy of St. Ouen :
Yes. I would just like to pick up on another of the proposals that we have seen included in the White Paper, which is talking about the recruitment of quite a significant number of additional health workers, nurses and the like, though Community Services. What difficulties do you see or do you currently have in recruitment and training of staff?
Chairman, Families in Recovery Trust, Silkworth Lodge:
We do not have any trouble with that. When we need staff we deal with it in a proper, professional manner. We advertise for them, we interview them and if necessary we train them. A lot of our staff are people who have been through Silkworth. We have some people who have been 10 years as ex-clients, who 10 years ago came to Silkworth as patients, clients, went out, did some work, obtained counsellor degrees. All our staff have diplomas. They are all properly trained and we spend a great deal of time. Our most valuable asset is our staff. All our staff are externally supervised as well, so we have someone from the U.K. comes in once a month and they sit with them and they download whatever is going on with their life so that they are nice and clean and fresh. It is a discipline we find essential working in this field. It would be interesting to know what external supervision some of the other people working in the field have. The burnout rate in this field is extremely high and it is very hard to detect unless it is done externally, because if you are trying to do it internally you will tell each other all your old rubbish but if you have some external person come in whose sole objective is to make sure that what you are providing is crystal clear and clean you will not have any problems. That is why the investment in people is so important because that with the external supervision makes sure they have got a healthy environment.
The Deputy of St. Ouen :
As we come to a close, if I asked you to briefly summarise what you would expect to see happen to improve the relationship not only that you have with the Health Department but generally to instil a greater confidence in the proposals of community and partnership working, what would you expect? What would you like to see happen?
Chairman, Families in Recovery Trust, Silkworth Lodge:
I would like to see a closer, more open working relationship and a sharing of experience with each other. There is a care pathway that we set out 9 years ago which we set up, we got it going and it all dropped away. A care pathway is essential because that pigeonholes someone. If they get in touch with that department or that department or with us, the care pathway channels them to the right place. If that care pathway was in place we would not have been closed since last October. So what would you do if you did not want to put people? You would do away with the care pathway. The care pathway is clear. The recommendations of the last scrutiny panel are clear. We have spent the last 6 years refining our business, making the product better, and we are sat there with 6 empty beds.
Deputy J.A. Hilton:
It must be very disappointing for your organisation.
Chairman, Families in Recovery Trust, Silkworth Lodge:
I did not want to come here and talk about this but we have tried every other avenue. We have a series of letters here going back to December, October last year, with no response.
The Deputy of St. Ouen :
We are grateful for you to come and talk to us because obviously if this plan is going to be successful changes are going to have to happen because it is clear that the experiences of some are not necessarily conducive to improvement and greater involvement of the third sector within the community delivering the services, which is the main thrust, in fairness, of this White Paper. So one would expect that significant changes will be required and need to be made if the Island is to benefit from the proposals of this enhanced service.
Chairman, Families in Recovery Trust, Silkworth Lodge:
The third sector needs help, it needs guidance, it needs support. It does not need rubbishing and it does not need its assets taken out and then decided by Government who should have them. These properties were put together by people who put their 10p in tins or have left money to charitable organisations, not to be taken back by Government when we could have benefited from them. We could have had an income stream from people who are going back into society. We could have had an income through that which would have benefited the community as a whole by reducing our service level agreement.
Deputy J.A. Hilton:
Gerald, did you want to say something?
Mr. G. Wistow:
Just a general question really, which is about the relationship between the third sector and the States generally. Do the States of Jersey have a strategy for developing the third sector?
Chairman, Families in Recovery Trust, Silkworth Lodge: I do not know.
Chief Executive Officer, Silkworth Charity Group:
I think they do. I think they have an idea of what they would like to do, which is bring together the third sector in order to deliver what is needed and what is not being delivered, but that only works if there is transparency, if it is a 2-sided relationship, and there is open communication because otherwise the fear factor comes in.
Chairman, Families in Recovery Trust, Silkworth Lodge:
The other thing is there is an old saying: "We hear what you are say but let us see what you do." I think that is what my point is: "I hear what you say but let me see what you do. Your actions tell me." I have explained to you in the last hour the actions. You can read lots of the promises but the actions are telling me a different story. If I was fully engaged in dealing with clients I would not have the mind to be looking at this side of it. People who are working as carers are concentrating on looking after people and getting them well. They are not known as being people who look into what we are talking about and they are the easiest prey in the world. Doctors, nurses, people who are in the care ... they are simple people, they are easy to con. I am not easy. This has taken a lot of time putting it together. There is a lot of people benefited from this, from small children to old age pensioners whose children have been in Silkworth Lodge. That is the primary purpose I am here today, for those people. No other reason.
Mr. G. Wistow:
I absolutely understand that. What I wanted to just clarify in my own mind was whether departments other than the Health Department presumably are working with the third sector.
[14:30]
Chairman, Families in Recovery Trust, Silkworth Lodge: It does not appear to be that way to me.
Mr. G. Wistow:
There is no concordat governing relationships between Government and the third sector that you are aware of?
Chief Executive Officer, Silkworth Charity Group:
There is a newly formed third sector forum committee which is in the very early stages of moving forward with employing a new employee. That is very early stages and that should hopefully bring things together, but that is run independently of Government. It is not a Government agency.
Mr. G. Wistow:
There are plenty of models of concordats between the state and the third sector and some of the issues that you are talking about would be taken care of by such a concordat if it were to exist and followed through.
Chief Executive Officer, Silkworth Charity Group: If it were to be followed through.
Chairman, Families in Recovery Trust, Silkworth Lodge:
And if we had power in selecting that person. What we do not want is the Government selecting someone and then saying: "This is the person who is going to sort you out or you are going to work with them." If you are going to do it you do it together in collaboration. In collaboration is the word, collaborate with us. We are quite sensible people. We understand. Probably we have got more knowledge of it than some of the people involved with it. Collaborate with us, engage with us. We have got the time, we will spend it with you. Just as an instance, talking about other agencies, I helped set up treatment centres in Barbados, southern Ireland, in Athens and in the U.K. In Iceland the housing department of Iceland give all the property to anyone doing anything with helping others. They provide them. The property we had in New Street we were asked to pay the commercial rate, the proper rental for that property. Another property we had to pay the full rent and we were told that that was the way the States had to charge all their properties so we had to then go to another department and say: "Can you give us the money to pay the rent?" and they would not budge, not one centimetre. Sorry, I hope I have not rambled on.
Deputy J.A. Hilton:
No, not at all. Thank you very much for coming this afternoon. It has been very interesting and informative, so thank you very much indeed. I close the meeting.
[14:32]