Heidi

Businesswoman, wife, mother and daughter, not necessarily in that order. I love Guernsey and care about the Island and its people. That is why I am standing as a candidate in the forthcoming Guernsey elections.

Hospital modernisation

In March 2019, HSC presented a policy letter to the States of Deliberation setting out its proposals for the modernisation of the PEH. It was unanimously supported by the States and we now embark on an exciting new chapter in its history.

Sir, It was in 1949 that our future Queen officially opened the building that was to bear her name, the Princess Elizabeth Hospital. In those intervening 70 years the hospital has played an increasingly important role in the protection, promotion and enhancement of the health and wellbeing of islanders. The work undertaken 24/7 behind its walls has contributed in no small way to residents having amongst the highest life expectancies in the world. 

The hospital, or as we all know it, the PEH, has had such an important part to play in our community since it was opened. It is where life begins and ends. It is where lives are saved or improved, it is where we learn what it is to be a mortal human being and who and what are most important to us. 

We should be proud of having such a facility on such a small island. There must be very few places in the world that could boast a hospital providing such a range of services for such a small population. There is a tendency to take it for granted but we should not. We are very lucky indeed.

And that is because over the years previous Boards and Committees in various guises have seen the need to adapt it in an ever changing landscape. New innovations in medical practice, advances in scientific understanding, medical research and technology, have all helped to improve outcomes but they have also put increased demands on the physical infrastructure.

There has probably not been a time when the need to expand and adapt the infrastructure of the PEH has not been either discussed or implemented. Now a few months back I read a piece about post war period of health care in Guernsey written by the much respected Dr Brian Seth-Smith who spent a lot of his working life working at the hospital and who sadly died in January. In this article he talks about Plans for Phase 1A and B to create a new Children’s Ward, operating theatres, central sterilisation department, pharmacy, post-mortem room and supporting service area which were first drawn up in 1966. Apparently, these were thrown out by the then States as being too grandiose, with one speaker stating that he didn’t want a mortuary, as he didn’t see why we should spend money on the dead. 

But, plans were eventually accepted in 1971 and that first phase of development was completed 15 years later. Dr Seth-Smith made the comment though that, whilst an excellent design, it was unfortunate that x-ray and receiving room were at the Vauquiedor end, far from the theatres and wards.

The most recent developments covered off the new clinical block completed 9 years ago now, and the Oberlands Centre that was opened in 2016. 

Just as it has been a focus for our community over the last 70 years, the PEH Campus has a big role to play in the development of our new model of care – the Partnership of Purpose. We see it as the backbone of the system, with the long term intention that it should be the focus for the delivery of secondary health care, including the acute hospital, mental health services and diagnostics.

However, we are struggling with what we have now. The design is inflexible and makes it difficult to implement new technology and new ways of working. Some of the areas are very dated and costly to maintain. Just recently we had to close a theatre because of a water leak into the air filtration system which followed a more serious leak last year. Added to that there are the problems with asbestos in various areas which mean that when repairs are needed, say in the plant room under theatres, staff have to wear full protection gear and the whole process takes much longer than if it was a benign environment. 

We are unable to meet various building regulations and standards because of the layout and parts of the site do not support those with a disability, nor provide the best working environment.

The 10 year modernisation programme that we are presenting to members today is an essential catalyst for change enabling greater integrated patient centred care in a modernised hospital that is safe, flexible to meet future needs and which ultimately will improve patient experiences and outcomes.

The programme is divided into 3 phases to minimise the impact on the delivery of services. At the same time it spreads the capital cost over a number of years and should benefit the local construction industry. Details are provided in the policy letter and I won’t repeat all that is said in there.

However, I think it is important to focus on a few points relating to Phase 1 for which we are seeking funding approval today.

Various reviews, including that by the NMC in 2014 into maternity services, have highlighted the issue of the distance of Loveridge, the maternity ward, from theatres. At the moment staff have to undertake drills to ensure they can get women who need an emergency caesarean section from to the ward within 20 minutes. The main risk area being the fact Loveridge Ward is on a different level to the theatre block and therefore a lift is needed. The plans seek to address this issue.

However, this won’t be just a simple lift and shift of Loveridge and Frossard, the children’s ward, but address other limitations of our current offering. This includes a dedicated area for children and young people presenting with mental health issues, space that is more suitable for adolescents and a means for treatment away from the wards. 

Now, the backlog with regard to orthopaedics is well known and thanks to support from ESS and P&R and an incredible amount of hard work by HSC staff, we are now actively tackling it. However, a key limitation to us and what needs to be tackled if we are to minimise the risk of this happening in the future, is the infrastructure.  A real pinch point that is impacting on the number of operations that can be undertaken and causes a higher numbers of postponements than we would like is the number of critical care beds. This is an increasing problem as the age of those we operate on rises. Whilst in the past we may not have operated on 70 and 80 year olds, this is becoming more and more common. Those patients are more likely to have other underlying health conditions which means they need more care post-op in the critical care unit beds. We currently only have 7 such beds, which means we are very vulnerable to any emergency or trauma cases that arise. The plan is to create enough space that will enable us to start with 10 beds and later to 12. 

The plan is for a new theatre block, to include critical care unit to be built that will enable the latest technology including robotics to be introduced, whilst reducing the problems we are currently experiencing in terms of maintenance.

As part of phase 1, work will be undertaken to identify the most suitable location for MSG staff and consultants. This will then enable any building works to be undertaken in phase 2 and within the 7 year deadline when their current leases expire. Having consultants on site will be conducive to greater integrated and patient-centred care.

Throughout the programme we will be building in better support for those with a disability. This will include signage that will support those with conditions such as dyslexia and dementia, as well as new facilities such as changing places toilets.

The overall anticipated costs for the programme are between £72.3m to £93.4m. The first phase, due for completion by 2021, will cost between £34.3m to £44.3m. It’s probably worth noting that Jersey has spent a similar sum just trying to identify where to put their new hospital. We are fortunate with the site we have.

It is for phase 1 that we seek funding support for now. We will be coming back to the States In respect of Phases 2 that will cover orthopaedics, day patient unit, relocation of MSG, equipment library and private wing, and Phase 3 which will include pathology, pharmacy and emergency department as the programme progresses.

Finally, I can’t finish without mentioning transport and parking. The Committee understands the frustrations for those visiting the PEH who find it difficult to park. It impacts us as we don’t have dedicated spaces and our friends and families. Seventy years ago the PEH had 20 parking spaces. 50 years ago it had 120 spaces. Today there are 750 parking places across the Campus. Those are the official ones, not including people parking across grass verges and down side roads. And still it’s apparently not enough. Whilst at peak times we are around 50 spaces short, outside of those times there are plenty of spaces going spare. 

We will shortly be adding 80 additional temporary parking spaces that will help as works get underway. However, we can’t just look at pouring more tarmac over the site. History has shown it just doesn’t work and is not value for money. Thanks to the support of E&I a travel strategy has been developed for the Campus and the Committee will receive the report very soon. We hope that this, combined with the development of new staff changing facilities which is currently underway, will help in the creation of a more sustainable long term solution.

Sir, in summary, the overriding aim of the hospital modernisation programme is to improve the experience of anyone needing our services. From the moment that they arrive on the PEH Campus, get the care they need when they need it and leave. We want that experience to be as stress free as possible and with the best outcomes as possible. But more importantly we want it to be a joined up part of an overall seamless experience of community care for all. 

Health & Care Regulation

In February 2019, HSC presented its proposals to the States of Deliberation on the future regulation of health and care. These were overwhelmingly supported. This is my speech opening debate.

Sir, As members will know, a key aim of the partnership of purpose is proportionate governance: ensuring clear boundaries exist between commissioning, provision and regulation. In the policy letter setting out the new model of health and care, the Committee for Health & Social Care stated that it is likely there will always be some overlap between those who decide what kinds of services should be provided and how they should be paid for, those who provide these services and those who regulate the services to ensure safety. However, there needs to be, in particular between commissioning and regulation, a framework which is proportionate to the size, resources and requirements of the Bailiwick, to ensure appropriate separation.

This Assembly supported that policy letter and the proposals in front of members today support that key aim as well as being a priority of the Policy & Resource Plan.

The current system of regulation is fragmented and has evolved over many years. What we are seeking to do is not destroy it and put in a huge great regulatory structure in its place, but build on it and develop a more robust independent regime. There are areas where there is a lack of professional regulation such as in domiciliary care, lack of systems regulation – such as for the majority of States services, a lack of flexibility to respond to evolutions in health care provision, insufficient emphasis on safeguarding and a lack of regulatory independence. These are what we are seeking to address.

As Prof Dickon Weir-Hughes states in his report for the Committee, the subject of regulation in any sector often gives rise to concerns about cost and proportionality, especially amongst taxpayers. However, as he says, ‘one of the key benefits of providing health and social care in a relatively contained island community that is not burdened by the bureaucracy of larger jurisdictions is the opportunity to develop regulatory approaches that are both world leading and proportionate.’

Now, when we say world leading, we don’t mean gold or platinum plated. It is not about how much money you throw at it and how complex you make it, but how effective it is. Those are not necessarily the same thing as the 2008 financial crash showed.

Fundamentally, the Committee was determined that such regulation should be appropriate and proportionate to the size of the Bailiwick. What does that mean?

Well we did not believe that replicating the regulatory system for the financial services industry would be appropriate and neither did we believe adopting the hugely complex system in the UK would be proportionate. Ultimately we need to consider proportionality in terms of risk.

And in doing so, we don’t want to reinvent the wheel. There are a wide range of internationally accredited schemes, such as CHKS for GP practices and Magnet for hospital services that exist around the world. We will evaluate those that make sense for our community and adopt where necessary. Where there are no ready-made schemes seen to appropriate we will set our own, again taking an appropriate and proportionate approach.

We are proposing that regulation will be the responsibility of an independent commission. This is important to ensure there is no political interference and it can equally hold the public and private sector to account. But, perhaps more importantly, having that independent function will support continual improvement.

We are not proposing that the Commission will have a heavy inspection system but one that ensures compliance with standards and schemes, but that it will have the power to step in and inspect or take other action where concerns have been highlighted. Neither are we proposing it will employ a large team of people. The complexity of the system would not justify it. Instead, there will be a core team that will bring in expertise as, and when, required.

The aim will be to develop an Enabling Law to establish the Commission and give power to the States by Ordinance to prescribe or authorise adoption of designated accreditation schemes or local standards and other appropriate regulatory measures.

After that, the individual standards will then be set and approved by the States, with a focus on those with the highest priority, being the unregulated domiciliary care workforce and acute hospital services.

We have been working closely with Jersey in the development of this policy letter, and whilst they wish to adopt a more heavy inspection system and have other priority areas in terms of regulation, we both believe there is an opportunity to share the Commissioner function and will continue to work with them if this policy letter is approved to ensure that our Enabling Law makes a shared Commissioning function possible and how we can put it into practice.

No one really likes regulation. And I have stood up in this place more than once raising my concerns. Most recently on Data Protection. But, it does seem to me that there are some who, possibly understandably given the extent of regulation that has grown over the years, lost sight of a core purpose – to protect people from harm – be it financial, social, environmental, physical or mental. Surely nowhere is regulation more justified than in matters of life and death. 

I’d ask those who think this is just another piece of unnecessary regulation, are they happy that anyone, without any police check or any qualification, can enter the home of their frail and vulnerable mother or father to provide very personal care? Are they happy that their 14 year old daughter can get their eye lids lifted or lips botoxed from a hotel room? Are they happy that their depressed wife or husband can get self-styled counselling from someone with no recognised qualifications?

There are some who think we don’t need it for ‘an island of our size’. Does that mean we don’t need finance regulation too? Or is money more important than our people? An island of our size wouldn’t have a general hospital the size of the PEH. Are those same people saying we ought to close it down? To those who believe a priority should be a sound foundation for health and later life care’, I would say, it is difficult to think of a sounder foundation than ensuring appropriate standards  through professional and systems regulation in the health and care sector.

Now, we estimate the total costs will be around £368k, although not all the costs are new. How this will be paid for and how much those who will be licenced will have to pay will be the subject of further engagement but I would point out to those who believe this is too much to spend on regulation, it pales into comparison with the extra £800k members supported for another regulator only a few months ago – the Data Protection Authority and represents 0.2% if the total health and care spend.

It’s also worth pointing out that the lack of an independent regulatory regime was a stated concern of the NMC when they undertook their review in 2014 and with whom our nurses and midwives are registered. They expect that their members to be working in a regulated environment. Were it to be decided today that we do not a proportionate and appropriate system of regulation, that we are happy not to protect our workforce then at the very least, it will not be looked on favourably, at worst, they may consider nurses may not be revalidated whilst working here. Not only that, it could mean that we are no longer able to provide on-island training of our nursing workforce. These are very real risks.

Let’s also not forget that this is also welcomed by those in the health and care sector, with whom we have had extensive engagement. Regulation may be seen to just add to bureaucracy but it can have benefits. And one particular area is in terms of post-Brexit preparedness with the European Commission, having recently published a report on the increasingly important role of health care assistants and with it, the importance of having an overview of the knowledge, skills and competencies they need. As they say, such an overview can help patient safety while at the same time facilitating professionals’ mobility.

So, sir.

I understand those who say, not more regulation. But let me ask those naysayers, if you had a list of all those areas that are currently regulated, would you say care regulation is less important than all of them? If you do think this is one piece of regulation too many, then is it not better to repeal those pieces of regulation that you believe are unnecessary red tape?

Appropriate and proportionate care regulation is about the Bailiwick being a mature, credible and economically attractive jurisdiction. 

It’s about people getting the service they need not stifled by bureaucracy or wary of punishment so they don’t innovate.

It’s about people knowing what to expect and what is expected of them.

It’s about promoting quality, minimising harm and strengthening trust in the health and care service.

Our proposals are innovative, cost effective, sustainable and most importantly, have the potential to improve health and care across the Bailiwick.

For all those reasons I ask members to support this policy letter.

Welcome

Hi there. I’m Heidi Soulsby and I was re-elected a People’s Deputy for the South East at the 2016 General Election. I was first elected to the States of Deliberation in May 2012 and during my first term I served as Chair of the Public Accounts Committee, Deputy Minister of the Health and Services Department and Member of the Scrutiny Committee, Constitutional Investigation Committee and Commerce and Employment Department.

In May 2016 I was elected as President of the Committee for Health and Social Care, under the new machinery of government. I am also Vice Chair of the Commonwealth Parliamentary Association Guernsey Branch Executive Committee and a Governor of the Board of The Ladies’ College.

Public Accounts Committee Legacy Report

On the last day of the last States meeting of the 21012-2016 term I presented the legacy report of the Public Accounts Committee. I have been proud and honoured to represent the Committee for 4 years and believe it is in a better place than at the start of the term. My speech is below.

 

Sir, I am pleased to present the legacy report of the PAC for this term. It is not my intention to go through the contents of the report given this late hour both in terms of the time of day and with respect to this meeting. It is a comprehensive record and members are only being asked to note it after all – and more on that later.

What I will do is focud on just 3 aspects of the report and then look to the future.

 

The present Committee had only just put its feet under the table when we were informed of a fraud committed against the States of £2.6m. In fact it was just a month into this term. This States has often been blamed for that event. However, sa I stated at the time the Committee published its report into the states of financial controls and risk management at the time, this was an incident waiting to happen.

Reports produced int he past, including those of previous PACs has, for whatever reason, been ignored. I am pleased that this States has acted on the findings of this PAC’s report which reflects the understanding particularly of the CM and PSD Minister of the time and the T&R Minister, in particular, as to the seriousness of the issue, as well as the pressure from the Committee to ensure our recommendations were acted upon.

Our second report on financial controls demonstrated the improvements made. However, the Committee is concerned that the focus on risk management will be lost as attention turns to public service reform. It is therefore critical that the Scrutiny Management Committee monitors developments closely.

I would no like to turn to the FTP, which has dominated much of this term. The Committee ha spent a considerable amount of time reviewing progress, or otherwise, of what was one of the most significant programmes of work ever undertaken by the States of Guernsey. The Committee took various approached in order to cover off various aspects of what was a complex area.

The Committee on a regular basis called in the T&R Minister and officers for updates as well as having a direct input on improving reporting for the Policy Council. The cost/benefit review which looked at the largest projects in the FTP acknowledged that savings has been made and found evidence of some excellent initiatives but expressed concern over some of the calculations and, more importantly whether certain savings would indeed be sustainable. And in addition, the Committee fought vociferously and successfully against the payment of commission to the consultant in respect of a transfer of £650k from general review to the Guernsey health service fund as it did not represent a saving to the taxpayer.

Finally, in relation to the FTP and subsequent to this report, the Committee held a public hearing where it questioned the T&R Minister and States Treasurer principally on the legacy of the programme and lessons learnt. More particularly on the transformational aspects.

I would like to thank the Minister for his openness at that hearing and I would recommend that the Hansard record be read by those involved in the Public Service Reform, both politicians and officers. I want to see public service reform work. I think we have a great opportunity to make it work but we need to understand lessons learnt.

Much of the Committee’s work as, by necessity, to be undertaken behind the scenes, this has included developing a more robust annual audit and accounts production process, providing greater value for money for the taxpayer as well as providing advice and recommendations which have considerably improved the States of Guernsey’ financial and resource management policies and procedures.

The last are I would like to focus on is post implementation reviews. Sir, recent headlines implied that projects undertaken by this States has been wasteful. However, I think it is important  to make clear that several projects we looked at took place in the previous term and one, the airport terminal , over a decade ago. There has been a significant improvement in the management of projects since then. However, it is true that lessons do still need to be  learnt and money is still being spent unnecessarily. It is for that reason that the Committee recommended that the Policy & Resources Committee in the next term look at placing PIRs in the public domain.

Before ending, I would like to leave a message for the future SMC.

 

  1. Firstly, work together as a team. It has been a pleasure working with a bunch of intelligent people who have worked together, can have robust conversations, but listen and respect each other’s views and come to a consensus. The PAC has certainly demonstrated that it can be done. We live in a consensus system and it is as important for the SMC as it is for every other Committee of the States. I just hope that continues in the next term.
  2. Secondly, don’t follow your own personal agenda. This will be even more important to be aware of where the whole scrutiny function is concentrated in just 3 Deputies and 2 Non-States Members; and
  3. Thirdly, Remember that what you want is to make government perform better. That can mean a balance between making a quick headline and working behind the scenes to make things happen. A recent report into the effectiveness of Westminster select committees in the last term stated that whist some committees took the big bang approach, they did not necessarily produce long term improvements. In fact it can lead to the bunker syndrome. A balance needs to be struck.

 

Sir, finally, and without wanting to make this sound like an Oscar acceptance speech, I would like to thank all those members of the Committee during this term. It has been a realtievely stable committee with changes only arising from the untimely death of Alderney Rep Paul Arditti and the departures of Deputies James and Le Clerc for an easier life on HSSD. I thank everyone for the positive contribution they have all made.  I have been honoured to represent you in this Assembly.

There is an old adage that says, It should be noted that if you have something to note, then note it. Do not note that the item you wish to note should be noted. With that in mind, I ask members to note this report.

Policy for Gifted and Talented Children

I laid a successful amendment to the Education Department’s report on Secondary Education in March 2016. My speech is below.

Sir, I did think I heard a collective groqn that another amendment would be laid but hopefully this won’t be a mammoth debate as I believe the Education Department will not oppose it. As I mentioned in earlier debate, this amendment is relevant whichever way we voted on selection. However, I do believe it will fit in very well under the non-selective system that has been approved this week.

At present the use of Gifted and Talented programmes is variable across schools and there is no central policy. The purpose of this amendment is to ensure that there is a co-ordinated policy across schools, something which I think makes complete sense and works very well under a comprehensive system. It is something in which I have taken a good deal of interest in the last few years.

So, what are Gifted and Talented students and why does there need to be a policy for them?

Dr Francois Gagne,  who was a leader in the field on this area made the following definition;

Gifted students are those whose potential is distinctly above average in one or more of the following domains of human ability; intellectual, creative, social and physical. Talented students are those whose skills are distinctly above average in one or more areas of human performance’.

The key word here is ‘Potential’. That a child needs support and guidance to achieve his or her gifted potential. It is estimated that approximately 5% of students in a mixed ability school will gifted & talented but that is not set in stone and will vary, and should.

So, why do gifted & talented students need to be considered separately? Well,  the normal curriculum may not be sufficiently interesting, motivating or straetching for the most able. They often need more challenging tasks if they are to maintain their enthusiasm, develop independence and reach their potential. Some exceptionally able students may have weaknesses which need specific attention if they are not to undermine outstanding abilities in other areas.

Extremely able students can become bored, unhappy or disaffected if their potential is unrecognised or neglected.

Gifted and Talented Education or GATE, is a broad term for special practices, procedures, and theories used in the education of children who have been identified as gifted and talented.

At present, schools approach gifted and talented students in different ways and to a greater or lesser extent. There is no overriding policy approach. St Sampson has details of their GATE for years 7,8 and 9 on their website. However, there is no policy in terms of the identification of gifted and talented, aims and objectives and measurement of outcomes. The purpose of this amendment is to fill that gap.

In a recent review of gifted and talented provision in Scotland, the author suggested that the focus on equality of opportunities and reluctance to consider selction in the Scottish education system meant that the needs of gifted and talented pupils had largely been ignored. I don’t think we can afford to ignore our giftes and talented ppils. Failure to identify such students risks damage to individuals who are so tuned off by rigid education that they opt out, sitting well below the attainment radar on their way to dropping out.

In turn, that damages our society and not letting them reach their potential means we are not maximising the potential value to our economy.

Sir, this is a common sense amendment, I understand the Education Department will not oppose it and I urge members to give their support.

One schools 4 Sites v 3 Schools

Following the decision of the States to end the 11+ at the March 2016 States’ meeting, attention turned to the number of sites that should be retained. The choice was between the Education Department’s preferred model of one school across four sites, with the concept of a ‘hard’ federation, versus a 3 school model. The latter succeeded. My speech on the matter is below.

 

Sir, Deputy James said the other day, a long long time ago, how that she felt she had fireworks going off in her head. WEll I don’t know if she’s like me and after 4 days of debate those fireworks have turned to jelly. Much of what Deputy James has said in this debate resonated with me. That might well be because I have more than once expressed to her my disbelief at the Education Department’s hypocrisy when it comes to their report now and their arguments made to close St Andrew’s School.

We were told a reason for closure was falling pupil numbers. That there would be a peak and then numbers would tail off. Here we are told we need 4 sites due to rising pupil numbers.

They want to retain 4 smaller schools rather than have 3 bigger schools but a reason for closing St Andrew’s was that large schools meant better education outcomes and help teacher recruitment.

We were told during the St Andrew’s debate that closing a school would not result in large schools in the UK sense but a size to ensure better educational outcomes. And to hear Deputy Sillars earlier quote a report supporting smaller schools seems so, so, ironic. And hearing others quoting the advantages and disadvantages of smaller schools gives a huge feeling of deja vu. It does, however, support the point I made the other day that you can find an educationalist to support any argument you want.

Now, Deputy Parkinson said he’s like to see 4 schools and have each one specialise, say int he arts or sport. Well, how will that work given the decision made yesterday which would result effectively in selection by catchment area?

All that aside I think I should comment on a term used both in the run up to debate and today and that’s value for money. It’s been quite disappointing hearing some comments about value for money which have demonstrated a real lack of understanding as to what it means. Value for money is at the heart of public service reform and quite rightly so.

On page 30 of that document is a diagram showing 3 interconnecting circles representing cost, quality and need and in the middle it shows that where those circles interconnect we get value for money. Value for money is not cost. Deputy Gollop, this debate is not about cost. It is about cost, quality and need.

Now we are told we shouldn’t be bothered about value for money when it comes to education, health and social care. But, this represents a complete misunderstanding of value for money. You just can’t throw money at something regardless of whether it is needed or the quality of provision. This is an irresponsible use of funds. That way leads to financial meltdown.

And I remind members yet again that in the the consultation on the personal tax and benefits review, respondents said overwhelmingly that they weren’t prepared to keep on funding these services. Frankly, this report makes it impossible to determine whether the Department’s proposed solution is value for money. It sets out little in the way of figures, little on outcomes and how this will lead to a better educational system. That’s the problem.

In response to Deputy Gollop’s accusations against the members of T&Rwho supported retaining selection and now support the 3 school model. But the fact is you could have a 3 school option under selection as Deputy St Pier said in his opening speech. It would probably require more work and the criteria for selection would need to change to make it work but the point is it could work.

Sir, how can I as Chair of the Public Accounts Committee, faced with this report and at the same time seeing the potential for greater value for money do anything other than to vote for the 3 site option. I can’t and will be supporting amendment B2.

Secondary Education Report – 11 Plus

Probably one of the most divisive subjects that we have had to debate this term. It formed part of the Education Department’s policy letter proposals for secondary education. I thought it a very disappointing report with little in the way of evidence or desired outcomes. Financial information was sparse and the public consultation was totally ignored. The accompanying letter from Treasury & Resources was scathing. In fact the whole situation was unacceptable, with 2 Departments unable to reach consensus over 2 years. That can’t be allowed to happen again.

It was no wonder that the report was heavily amended. It had to be. A decision on the 11+ was needed before deciding the structure of schools.

Here is my speech on the 2 amendments which set out whether or not the 11+ should continue. The States voted to get rid of the 11+. This was followed by a subsequent amendment to retain selection through a combination of assessment and tests. I supported it, but this too was defeated.

 

 

Sir, as expected, there are many here who have strong views about the 11+, both for and against and these positions have been expressed well yesterday and today.

It’s hardly surprising, given that there is an abundance of material on the matter and that anyone can provide evidence to support their point of view. Indeed, I believe there is a whole industry dedicated to providing information to support a particular viewpoint and I think many educationalists have done very well indeed out of such debate over the years.

And really that’s the point. There is no overwhelming evidence either way to say whether the 11+ is better or worse than no selection at all.

So, as someone who has not nailed her colours to the mast of the 11+ or alternatively said scrap it altogether, I have found it very difficult to determine the best thing to do. Perhaps that reflects my experiences. I was brought up by a teacher who often made it clear she believed it should go, someone who attended a Grammar, which at the time I was there has the teachers working to rule, oh the delights of the late 70 and early 80s, and having a child at the Grammar school who has blossomed there.

I hear what my good friend Deputy Le Clerc said but I don’t think we should look at personal experiences but rather what is in the best interests of the Island as a whole.

For me, how I vote focuses around 2 claims. The first is the limitation and long term impact on children and the other about the shortcomings of the exam itself. I am going to focus on the former.

EQUALITY OF OPPORTUNITY

So, firstly, the big buzz word is that the 11+ does not provide equality of opportunity. This was said by all those not in support of the 11+.

The reasoning seems to be around restriction of access to the curriculum. That sounds reasonable. I mean if you can’t get access to the course you want, then that is not equality of access.  However, I have been scratching my head as to why and how that means the solution is to scrap the 11+.

Will it be possible to offer all subjects under the system Education proposes? I do wonder the logistical nightmare of managing a timetable across 4 separate sites. I suspect there may well be a call for some new software to enable that to happen.

SOCIAL HOUSING

Now, I have been trying to get to the bottom of why there are such low numbers of chidlren from social housing that go to the Grammar and Colleges. We are told they are low, but no explanation. However, it is an argument made to demonstrate inequality of opportunity.

 

Now this is looked at in paragraph 7.8 where it states that in a 3 years period, of the 230 children in social housing only 3 went to the Grammar. Just over 1%. That is low.

BUT it goes on to say that the teachers only assessed 31 out of the 230 as being capable of going to either the Grammar or Colleges.  So that is just 13%. However, the top 25% from any year go there.

I’ve not heard anyone today explain that difference and why it is the 11+ that is to blame.  Doesn’t that demonstrate the equality of opportunity exists before Year 6?

Is it the primary school system? We hear they are wonderful, and they’re mixed ability, no one has a bad word to say for them. Or is it the family circumstances of those children? Is this something which demonstrates the importance of the 1001 days programme? We need to sort things out before the children even get to school?

I do see that the numbers from social housing are less than those in private sector. But is it the 11+ concept that is at fault?

SETTING

I do understand that setting can be a solution, althought the report is vague on this and should this amendment be passed I would be happy to second an amendment referred to by Deputy St Pier, to ensure that it is.

However, there will be a fundamental difference between setting students across 4 mixed ability schools than setting under a selective system, which exists now in core subjects. I know it does at the Grammar

Taking the top 25% of a distribution and setting that gives you much tighter ability levels in each set rather than the comprehensive model that takes the whole distribution and divides it up into sets, resulting in much wider ability levels in each set. Of course the alternative will be to have more sets and perhaps that is a solution.

 

GEOGRAPHY

Now, one issue that hasn’t been clarified is whether results will be published by campus or as one school?  Frankly I think the public will demand it by campus. Well, I think the Housing Minister might quite like that as it could well stimulate the housing market with parents moving to the most desirable catchment area. Something that has been done in respect of primary schools. Of course, those in social housing aren’t able to make those same choices.  So we will have selection, but based on geographic accident, or perhaps not,  of where your parents are, rather than ability

 

MENTAL HEALTH

Finally, Another commonly cited problem, is that the 11+ can cause mental health issues. I can understand that a child who does not get a Grammar school place may, wrongly see themselves as failures. It is hard not getting what you want and looking like you are not as good as someone else.

However, as Deputy Minister of HSSD, when I heard that children were damaged by the system I did think it was beholden on me to find out more.  The response I got from the mental health service was that they have come across children over the years who have attributed low self esteem ,anxiety and low mood to failure at the 11+ but often there are many other factors which contribute to the development of children’s mental health disorders so it is difficult to say there is a direct link .

Interestingly though, they are  seeing a rise in the number of young people  presenting with low mood ,anxiety , self harm and eating disorders as a result of exam pressure around GCSEs and A levels. I would hope that the initiative under the CYPP that we debated 2 weeks ago will help alleviate this.

 

However, clearly for some it will be upsetting to not get to the Grammar  or Colleges. I know that many like Deputy Duquemin consider this a very important point. Deputy Brehaut’s comments that it’s the only test you can only take once, it is all or nothing, but that is true of other tests. Going for a job, you either get it or you don’t. And degrees, post-graudate qualifications are limited, if not by the institution, certainly in terms of money.

 

INHERENT ISSUES

So, finally and more briefly, turning to the argument on the  structural problems of the 11+ we do hear that in the last 2 years there are more girls than boys at the Grammar School, a minority from social housing and that many children are coached. Can’t these issues be dealt with through changing the structure rather than getting rid of it totally?

 

On this I thought I’d look at my old school’s website. It is still a Grammar, but now has the benefit of being a locally managed Academy School, with Humanities College status, which was rated as outstanding by Ofsted at its last review. I was interested to find out all its policies are published on the website and that included its equality objectives. These are based around equality of access, equality of provision and equality of outcome.

In relation to the former it have the following policies;

  1. To give preference to students on free school meals in the admission border zone.
  2. To ensure the 11+ reading test does not have a ‘middle-class’ bias.
  3. To set a test that restricts the benefit of an 11+ tutor.

These policies have increased the proportion of childnre on free school meals who attend the school from 6% to 8% in 2015. So, it can be done.

I suppose to me the most important issue is not about equality of opportunity but fairness, which is part of the criteria that the department are said to have considered. Is it fair that every child gets the same education rather than the education that its them? We don’t have a failing system. All the schools are doing very well, or so we’re told.

So, why would we want to throw everything up in the air and hope that a bespke untried system will work better, when we don’t know what better is? That is the issue for me. I don’t have a strong ideological viewpoint, but I wish I did as it would make it so much easier. I just don’t see that getting rid of the 11+, or selection generally, will lead to Nirvana.

For that reason I can’t support Amendment 1 but will support Amendment 2.

Deprivation of Liberty Safeguards

HSSD presented its proposals for a new Capacity Law at the last States meeting. Included within this were recommendations for deprivation of liberty safeguards (DOLS) to protect the most vulnerable in society. It was subject to an amendment to delay until the UK has decided what it was going to do to amend its legislation. The amendment was defeated and then there were calls from the proposer of the amendment to take it out completely. I set out below my speeches urging members not to support the amendment and then in main debate, to support the policy letter in full. The policy letter ended up being passed fully and without amendment.

Speech – main debate

Sir, this isn’t a health issue at all, although it’s more applicable in health and care settings. It’s a human rights issue. It’s about how we protect the liberty and dignity of those citizens among us who are most vulnerable to having their freedom of choice taken away.

I think HM Procureur has made it very clear that this policy letter has been written to be human rights compliant. Just taking out the DOLS will just lead a coach and horses through it. It is the flip side of the same coin – the capacity law results in giving powers over someone without capacity. DOLS gives that person without capacity protection. It’s as simple as that. That is why it is required. That is why, if we don’t include DOLS, the Privy Council are quite likely to throw it back. That is the risk.

Now to cost. Comments made yesterday by Deputy Dave Jones just exemplify why mental health services have been the Cinderella of our services for so long. So much easier to spend money on drugs and operations that you can see.

Of course, we would like more investment in community nurses and social workers. It is needed, but it must not be a binary choice between one or the other, because that’s simply not he reality.

This is, as Deputy Perrot has said, a good news story, and I urge members to support this policy letter in full.

Speech – amendment

Sir, Deputy Hadley is nothing if not consistent. Here he is laying yet another unnecessary amendment. This policy letter is the result of extensive consultation with those professional concerned. Deputy Hadley references a meeting with 2 psychogeriatricians and I think I need to make it clear what actually happened at that meeting.

At the Board meeting where this policy letter was discussed, Deputy Hadley said that a couple of psychogeriatricians did not like it the DOLS and therefore he couldn’t support it. Following that meeting, I agreed to meet with them and Deputy Hadley, together with the States’ consultant psychiatrist of adult mental health, head of older adults services, director of communities and the law officer involved.

At that meeting it was clear that the psychogeriatricians has been led to believe that this policy letter was actually the law. They were advised this was not the case. It was also clear that there was a lack of awareness as to the legislative process here and that we would have little ability to develop a law different from the UK. The final concern was with regard to the term Deprivation of Liberty. It is a phrase that is tainted due to the system that has been put in practice in the UK.

It was explained that the term comes from Article 5 of the EU Convention of Human Rights, which Guernsey has incorporated into its law through the Human Rights (Bailiwick of Guernsey) Law, 2000. Article 5 states that;

“Everyone has the right to liberty and security of person. No one shall be deprived of his liberty save in the following cases and in accordance with a procedure prescribed by law”. Therefore, in order for our law to be compliant with the convention we have to use the same phraseology.

However, that does not mean this has to be used as the standard term, merely that it is made clear that wahtever term is used it has to be referenced to the term Deprivation of Liberty. I believe the proposals suggested by the Law Commission when they went to consultation included changing the term in the UK to ‘protective care’.

It was made clear at that meeting that no-one wanted to follow the UK. We wanted a balanced and proportionate law for Guernsey. In fact this is an opportunity for Guernsey to be ahead of the UK and set the benchmark, not follow. AND, AND, we could do that and would do that through working with the professional to develop the legislation, regulations and subsequent codes of practice. There is nothing in this policy letter that says this will be anything like the UK.

At the end of that meeting the professionals, just note, the 2 profesioanls with concerns, were assured. Deputy Hadley said that he was, if they were. Great! It was a good meeting. Then, 2 days later, we heard Deputy Hadley wasn’t happy and couldn’t support the policy letter – again!

Sir, the problem here is, I’m afraid with Deputy Hadley, not this policy letter. Sir, Deputy Hadley is alone on this and I urge all members to reject this amendment.

States Welfare and Benefits Investigation Committee Report

A major policy letter that hit the meeting of the States was that produced by SWBIC. Here is my speech.

 

Sir, This is a good report. It is well-balanced, which I think reflects the diverse make up of that Committee, which I mean in a positive way. I would just like to comment on one aspect of the report and that is in relation to the implications of moving people from rent rebate to supplementary benefit.

On page 1956, paragraph 161 it states that the proposed unification of the system will potentially bring an additional 930 households, comprising 2,275 individuals, into scope of free medical and para-medical cover.

Now, I don’t want Members to think I believe that wrong. Quite the contrary. The report published a year ago by CICRA on the primary healthcare market stated that 50% of those respondents to their consultation has been put off going to the GP because of the cost. We don’t want that. All that means is people aren’t treated in time which in the end can result in more serious long term conditions and proportionately more expensive treatments.

However, I think it is important that Members are made aware of the impact that this might have on health services, at least in the short term, before things settle down, as we see increased demand arising from referrals from GPs. We don’t know the impact at this stage but it is not rocket science that it will result in greater demand.

I had drafted an amendment on this area but decided that, after discussing this with Deputy Le Lievre, that it was sufficient that I just make my concerns known for the record. However, I do believe that the future Committee for Health and Social Care with that of Employment and Social Security will need to keep this under review, possibly at the same time as addressing the recommendations of the CICRA report in relation to charges for GP consultations in general.

Having said that, it makes complete sense to me merging the rent rebates into supplementary benefits. It results in greater transparency and that has to be a good thing. So, finally, I would say well done to SWBIC and hope everyone supports these proposals.

Campaign post

Hi there. I’m Heidi Soulsby and I was elected as a Deputy for SE District in Guernsey’s general election in April 2012 and I am standing for re-election in 2016.

When I first stood for election, I said that I wasn’t a typical politician. I hope that what you have seen over the last 4 years has demonstrated just that. Through my roles as Chair of the Public Accounts Committee, Deputy Minister of the Health and Social Services Department and the other positions I have held, I have strived to make a difference through common sense, drive and passion.

In my manifesto I want to demonstrate not only what I see needs to be addressed in the next term, but also how what I say can be backed up by what I have done in the last 4 years. We have seen lots of strategies developed recently, with many fine words, but what we need now is action. However, I believe we have to be realistic. I could produce a long list of all the things that should be done, but what we really require is a States of Guernsey that is focused. Unless we establish priorities, expenditure could easily spiral out of control, leading to growing demands for tax rises to pay for everything. This must not be allowed to happen.

That is why the theme of my manifesto is focus. We must focus on where Government can, and must, make a positive difference. This includes long overdue action on housing, essential public service reform and support for economic growth. However, above all, it means transformation of our model of health and social care. That is why, if I am elected, I will seek to lead the new Committee for Health and Social Care to ensure that the positive work done, since the last Board took office in October 2014, can continue without delay.

Welcome to my website. Here you can read my manifesto, hear about my life in the States and other matters, as well as sending me feedback and your ideas.

To download the printed version of my manifesto please click here

Manifesto-link



Mobile: 07781 139385

Email: heidi@heidisoulsby.com