Jim Wells
South Down · Democratic Unionist Party · Northern Ireland
“On a point of order, Mr Deputy Speaker. In November 1982, I made my maiden speech in the Chamber, and, here we are, 40 years later, and I am making my last speech in the Chamber as a DUP MLA. I was the last person in the Public Gallery when the Assembly collapsed in 1976.”
“<BR /> <BR />Mr Deputy Speaker, I thank you for your indulgence and for your patience with me over many years. Unfortunately, Mr McGlone has just left the Chamber; I was about to thank him. I have enjoyed my 27 and a half years in this Building.”
“I wish that I could, but I have only five minutes. <BR /> <BR />That was so that a very small number of Irish language zealots could go in and register their marriage or civil partnership in Irish or in dual language: £261,000. Did anybody stop to think about whether there was a more cost-effective way of doing that?”
“We are all perfectly happy with a genuine expression of people's culture. That is fine. However, when the language is so cynically used by militant republicanism, unionism has difficulties. Why, for instance, is there no translation into Irish of the words, "United Kingdom", "Londonderry", "Northern Ireland" or "Her Majesty The Queen"?”
“The Member has made the point for me. The official who came to the Committee made it absolutely clear that £261,000 had been spent already. It was farcical to bring that before either the Finance Committee or the Assembly, because the money had been spent and the processes had been set up.”
“If they want the unionist community to accept the Irish language as a genuine cultural expression, they should get rid of the political baggage and extremism, and stop using the Irish language as a political weapon to try to subjugate unionism.”
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“I wish that other drink companies were as responsible. I am also waiting to hear from the small number of supermarkets in Northern Ireland that are still selling alcohol as a loss-leader: maybe at 35 pence or 40 pence a can.”
“Indeed, I concur with that comment. I got a very supportive letter from the managing director of Tennent's Northern Ireland immediately after the announcement of MIU. Therefore, I would like to think that MUI — sorry, whatever it is, and that is me only on water.”
“<BR /> <BR />I ask pubs, clubs, off-licences and supermarkets to get their act together and introduce a voluntary minimum unit pricing structure, so that no one is being undercut, and to try to act responsibly. They should do that rather than sending lots of mainly young people out on a Saturday night with vast quantities of drink that they will consume through pre-loading or "prinking" as it is called — pre-drinking — and then go out to clubs or pubs afterwards. It simply cannot be accepted any more that we allow our young people to destroy their lives by binge drinking. We also have a huge increase in liver cancer as a result of that. To me, it all points in one direction: either the industry self-regulates and introduces minimum pricing or I, with the Department for Social Development, will do it for them.”
“It is an awful pity that we have had to go towards the implementation of minimum unit price legislation. It is very sad that the supermarkets and some club owners have not voluntarily decided to step in and say that enough is enough and that they are causing huge problems. <BR /> <BR />When we realise that, over Christmas, 80% of those who report to A&E at weekends after midnight are under the influence of drink and are there because of drink, we can see the huge problems that that is having for our health service. We then wonder why we have difficulty in getting middle-grade doctors to staff those late-night shifts, when they have to deal with the abuse that they receive from those who are intoxicated.”
“That is an ongoing part of our policy. However, I can assure the Member that, this year, none of the charities will notice any difference and will get exactly the same funding as in 2013-14.”
“We will have a fundamental review of how we fund the voluntary and charitable sector in Northern Ireland. It has grown up over the years with various ad hoc requests for funding. Various Ministers, including Mr McGimpsey and Ms de Brún, have acceded to various requests, but there has been no coherent policy to see how that is delivering the best value for money on behalf of the state. I believe that we give something like over £4 million every year. <BR /> <BR />Some of the organisations are large British-based charities with Northern Ireland offices and have quite high levels of resources and others are small charities that are entirely based in small communities in Northern Ireland. We have to decide what is the best use of a significant amount of taxpayers' money to complement the work of the Department.”
“I think that I know the direction in which the honourable Member is taking the question. I must say that she asks very incisive questions for written answer of me very regularly and has ruined many a Saturday night as I tried to deal with her answers while watching 'Match of the Day'. <BR /> <BR />I am sure that she is concerned about the fact that, until this week, no decision had been made on the funding of the 68 voluntary bodies that are funded by my Department. I am glad to tell her that the decision has now been taken. Funding will be reinstated and all those groups will be paid in exactly the same way as in previous years, and they can expect to receive the remainder of their payments very soon. That indicates just how important I see the role of the voluntary sector within health and social care delivery.”
“When that is happening, is it any wonder that our A&Es are clogged up on a Saturday or Sunday night by people who are heavily intoxicated? I believe this is a no-brainer. I believe the statistics show that we must do something about this, and I am depending on Members backing me on a policy that may not be particularly popular but which will bring real health and social benefits and, of course, help our police service in Northern Ireland.”
“The licensing of alcohol establishments and licensing policy fall between the Department for Social Development and the Department of Justice, but it is quite clear that it is possible to enact legislation that will make it a condition of one's licence, be it for an off-licence, a supermarket, a pub or whatever, that all promotions and all activities that sell alcohol below the minimum price, be it 45p or 50p or whatever, will be in contravention of their licence. <BR /> <BR />When one understands that 20% of the drinkers in Northern Ireland consume 70% of all the alcohol sold, one understands that there is something seriously wrong with a society that allows that — and also allows alcohol to be sold significantly cheaper than bottled water, or a two litre bottle of cider to be sold for £2.”
“If I had that £240 million that is being wasted in dealing with alcohol abuse in my budget, my position would be much stronger today, and I would not be having all these painful questions being asked of me. Therefore, I welcome the report; it gives a scientific basis, and I am working with the Department for Social Development to ensure that we can implement a discussion paper to go to the Executive and then to public consultation on minimum unit pricing for alcohol in Northern Ireland. My colleagues in the Republic of Ireland, Scotland and Wales, all looking at the same research, have made the same decision.”
“The survey is very timely and important. It shows that alcohol abuse in Northern Ireland is costing the Assembly and Executive £900 million a year; that £240 million of that is levied on the health service; that over 12,000 admissions to our hospitals every year are as a direct result of alcohol abuse; and that, sadly, 230 people die as a result of alcohol abuse in Northern Ireland. But much more shocking, I think, is the fact that alcohol is now 62% more affordable today than it was 30 years ago. We simply have to do something about the outbreak of binge drinking in Northern Ireland, which is leading to all these problems. <BR /> <BR />We as a society cannot afford to continue to pick up the bill for alcohol abuse.”
“Now that it has been drawn to my attention by a number of Members, I will take a personal interest in it, but, as I said, at the end of the day, it is the trust's decision as to what is best for these highly vulnerable children and to make certain it has the best provision for them. I thank the Member for raising the issue, because I think it is very timely.”
“I do not know whether the lady has been invited or not; that is entirely in the hands of those who called the meeting. She may be aware that the Cottages is a six-bedroom facility, but it has only four beds that are deemed suitable for children with complex needs. Avalon House, which is an alternative provision, has an eight-bed facility. <BR /> <BR />The trust is currently consulting staff at the Cottages, and that consultation will end on 17 December, so it would not be proper for me to make known any views about the service apart from the fact that many have indicated their high level of satisfaction with it. The trust will also be engaging with individual families and has been engaging with families over the past week. We are very much in that important consultation period.”
“Coupled with providing services within the commissioned level of funding and the increase in demand, the trust is reviewing its respite services. <BR /> <BR />I am aware that this is a very difficult issue in the north-west and that a lot of folk are concerned. I became aware of it only very recently and am very keen to hear the views of MLAs, including the Member, as a representative for Foyle, on the issue. I see today's meeting as being the first of several dealing with this very important issue.”
“I am very aware of the situation at the Cottages facility in Londonderry. Indeed, I have been lobbied by several MLAs and will have an emergency meeting this afternoon with MLAs, led by Mark H Durkan, to discuss this very important issue. As the Member will know, it is a six-bed unit that provides regular short-term respite for children aged five to 18 years with varying degrees of learning disability and associated conditions. The honourable Member for East Londonderry Mr Campbell has paid tribute to the work undertaken there. <BR /> <BR />The Western Health and Social Services Trust has advised that the nature of respite provision to families is changing and that new personalised provision is needed to meet specific and unique needs. To ensure this, the trust has to make certain that these services are designed accordingly.”
“I am delighted to say that new registrations added to the organ donor register for residents in Northern Ireland increased by 1,300 in the last 12 months. At the end of September 2014, we had 597,144 people registered, including me, which represents an increase of more than 100,000 compared with five years ago. Real progress is being made, and I thank those who made the decision to allow their name to be entered on to the register. However, I say to all those people and to those who have not registered, make your views known to your family now so that, if the worst happens, you can provide life to others. Progress is being made, but we still have a lot to do, and there are still people dying needlessly in Northern Ireland because a donor is not available. We have to do everything that we can to overcome that situation.”
“He had made his wishes clear to his family, and six of his organs were taken for donation. Two of those organs saved lives, and the other four enhanced lives. It was a traumatic situation for his family, but at least they had some reassurance of knowing that the loss of their loved one had meant so much to many others.”
“I am a very enthusiastic supporter of Organ Donation Day, which is due to be held on 11 December. This is a tremendous idea, and I was delighted to be at the launch last week. This is part of our Speak Up and Save a Life campaign, which encourages people to talk to family and friends about their organ donation wishes. I urge every Member of the Assembly and anyone who is listening to the debate to have that discussion with your family on 11 December. If you are minded to leave your organs for donation to help others, make that decision very clear to your family so that, should the worst situation occur, they are very clear about your decision. <BR /> <BR />I will give the example of a young gentleman from Coalisland who died in tragic circumstances in a car accident several years ago.”
“The draft Budget for 2015-16 is out for consultation, but, as things stand, my Department will need to deliver challenging efficiency savings of £160 million to meet the existing costs of service provision.”
“Those will have to be addressed next year. I do not think that Members really understand that, if you get £60 million in the October monitoring round to meet needs, that £60 million does not continue into the following year; it meets the need for that financial year, and you start from scratch the following year to find more resources to get the same £60 million in that year.”
“I thank the honourable Member for South Belfast for asking that question, because it is very topical and requires a public airing. <BR /> <BR />I accept that many of the savings proposals that are required to be implemented to secure financial balance in 2014-15 are counter-strategic. However, they represent the measures that are capable of being delivered on the ground in the remaining months of the financial year. I would not normally support such measures, but there are simply a limited number of areas where cash savings can be extracted from the system at such short notice. Indeed, I mentioned those areas earlier. <BR /> <BR />Many of the pressures in 2014-15 are also being addressed through non-recurrent means, such as monitoring round funding, which means that we roll forward those unmet needs into 2015-16.”
“Somebody has to deliver those fundamental changes in the structure of health service provision; it cannot be done by volunteers. <BR /> <BR />I am content that, in many cases, we have the right numbers. Equally, I am certain that the permanent secretary will reveal areas where savings can be made. Even if those savings are radical, they will not meet the fundamental shortfall that we have next year from carrying forward £160 million of unmet need. We have no money, but we require about £110 million for the development of new services. Administration expenses are not the golden bullet; they are not the savings that can bring about a radical increase in available resources. We will have to look at much more fundamental issues.”
“The permanent secretary's study goes across the board, as it were, through all the organisations. Three years ago, the Health Committee decided to look at the administrative costs of the five trusts. We went in with great enthusiasm, and I remember — at the time I was the Chair — expecting to find vast layers of administration that we could take out of the system. When we looked at the figures, the position was not as it had seemed. We came up with a figure of 4·1% as being the average percentage of administrative expenses in the five trusts. That compared very favourably with trusts in the United Kingdom and throughout Europe, so the huge savings that we had anticipated were not there. We continue to pile on extra responsibilities — for instance, through Transforming Your Care.”
“If you were to make any radical change in administration, it would mean voluntary redundancies. We have to have a system in place that allows that to happen. Even if the permanent secretary's report recommends fewer staff, it would be three years before we made any savings, because we would have to pay the affected staff their redundancy packages. That is our difficulty, particularly with administration. It is not the quick fix that most people think it is, because, under the present Civil Service and trust arrangements, asking people to leave is difficult and expensive.”
“We are placing quite a high expectation on the permanent secretary. We want his study to run parallel to the consideration of our final budget for 2015-16, allowing its findings to be factored into my determination of how funding is allocated to bodies in the health and social care system. We are talking about three or four months, which is extremely demanding. <BR /> <BR />Before we come back to the House with our views on the HSC budget for the incoming year, we have to be able to stand over the levels of administration. If there are too many layers of administration, we need to make proposals to deal with that. I remind Members that administration is 90% personnel. The vast majority of costs involved in administration come from the people who sit at desks carrying it out.”
“However, it is a legitimate question, and I would want to satisfy myself, after the permanent secretary's report is issued, that all the administration that we have is money well spent. I would rather see that money going to the Fire Service, domiciliary care, the cancer centre or to all sorts of other procedures where there are so many competing demands for that income.”
“That is a legitimate question. The problem is that it is only seven or eight years since we had the last fundamental review of structures in health. We had the reduction from 18 trusts to five, we reduced the number of boards to one and we had the PHA, so we have had major change. I do not know whether it is an appropriate time to initiate another major structural change after such a short period. One argument that could be made is that the present structures have not had time to show whether they are an efficient model. We have to be fair to all concerned. Therefore, whilst it is vital that we look into the administrative costs of the board and other organisations, I do not think it is the right time for another fundamental review of the system, particularly with budgets being reduced so dramatically.”
“<BR /> <BR />I still accept the Member's premise that we need to look at every aspect of administration in the health and social care system. Mr Eastwood alluded to the painful decisions that will have to be made in the Fire Service. We have also heard about the stresses of domiciliary care. It is incumbent on us, when we are doing that, to make certain that the board provides the best possible value. We will look at every level of administration to see if there are efficiencies that can be made. I would say, though, that the Health and Social Care Board has accepted a budget that will lead to a delivery of £600,000 of savings for 2014-15.”
“I thank the Member for his supplementary question. For his benefit, I will read into the record the whole-time equivalents because I think that is the best way to compare like with like: 2008-09, there were 621; 2009-2010, 522; 2010-11, 427; 2011-12, 458; 2012-13, 483; and 2013-14, 549. In that, there are 80 temporary positions on fixed contracts. Once those contracts and work have been carried out, those individuals will leave the board's employment. When you factor in those numbers, it is not as dramatic as it seems. Indeed, the board has kept within its admin budget throughout the CSR period. We also have to be fair to the board and say that new projects such as Transforming Your Care, the integrated care partnerships and other functions have been transferred to the board, which is new work that has to be carried out.”
“A particular focus of this work will be on the relationship and avoidance of duplication between the Department, the Health and Social Care Board, the Public Health Agency and the trusts.”
“I thank the Member for raising the question, because it brings to the fore issues that have been mentioned in the media and by other MLAs. The Member will be aware from my previous correspondence with the Health Committee that the increase in staffing levels in the HSCB, as commented on in the media and by the Committee, is of concern to the Department. When our front-line health and social care services are under pressure to identify significant savings, it is imperative that the administrative support given to those services be subject to the same degree of scrutiny. For this reason I announced last week that I had asked my permanent secretary to conduct a fundamental review of the administrative structures in our health and social care system.”
“Again, this is only in relation to the minor injuries unit. I received quite a large amount of lobbying on the issue from Members right across North Down. One of the issues that I took into account was that, if we kept the MIU in Bangor available, that could relieve the midwinter pressures on other hospitals; for instance, Ards Hospital and the Ulster Hospital. It was done for that reason. However, I have to make it clear that the South Eastern Trust still has to find the savings outlined in the contingency plans. Therefore, the difficulty remains of finding the money that would have been saved through the temporary closure of the MIU. That money has to be found from somewhere.”
“I hate to sound negative in answering the Member's legitimate questions, but, as he is very aware, the issue is before the courts. Anything that I would say on that specific question might be used by one side or the other in that court debate. Therefore, on this occasion, I will have to present what is, in cricketing terms, a very straight bat and say that I cannot go any further on that specific question than the answer that I have already given.”
“As the Member is aware, I have allocated £5 million additional funding to address winter pressures in delivering unscheduled care. The money will be used to improve patient flow from emergency departments and to expand capacity as required over this winter period. The South Eastern Trust has taken steps to mitigate any impact that the temporary closure of the GP wards in Bangor Hospital might have. In addition to improving efficiency and increasing community services, the trust continues to monitor closely the impact of the contingency plans. The trust has been progressing plans to improve unscheduled care over the winter period and has started a review of the model of care for older people. The trust is also working, as part of an integrated care partnership, to develop new models of care in line with Transforming Your Care.”
“Keep Belfast as well. <BR /> <BR />I have also asked the trust to keep the option of access to beds at the Bangor site under constant review. The trust has a range of intermediate care options available, but, clearly, if additional capacity is required in the future, reinstating beds in Bangor is one option that could be considered. I trust that the Assembly will understand that I am mindful that the matter is before the courts, and that limits very considerably what I can say.”
“Bangor. Sorry. I have also asked the trust to keep —”
“As the honourable Member for North Down knows, I announced on 28 November 2014 that I have asked the South Eastern Health and Social Care Trust to ensure that the minor injuries unit (MIU) at Belfast community hospital remains open —”
“In my constituency of South Down, it is proving more and more difficult, particularly over the Christmas period and the July holidays, to get staff to cover shifts. That issue is being taken seriously by the trusts and the Department.”
“The honourable Member makes a sensible comment. We are experiencing staff shortages in parts of Northern Ireland. A current study has shown that we could be 500 staff short of what we need to provide domiciliary care in the next 10 years. Attention is being given to increasing training opportunities to encourage people to come into the domiciliary care market. <BR /> <BR />In most boards, about two thirds of provision is carried out by private contractors and firms that provide it on behalf of the trusts. It is surprisingly difficult, given that we are in a very difficult recession, to attract people into that essential service. We are looking at that as part of the review. It is a very important issue. As the economy hopefully continues to improve in the foreseeable future, it will become more difficult.”
“It is, but we have no option because of the difficult financial situation we find ourselves in.”
“Sorry, it is in the Northern Trust, not her constituency. If we are unable to make the £500,000 savings there, the trust is forced to look at other contingencies, which often means looking again at domiciliary care. This is not an attack on elderly people. My Department finds itself in the very undesirable position of having to save £70 million by the end of March out of a very small slice of the Budget. Staff wages, salaries and pensions account for 63% of my budget. Another 12% is contracts that I cannot break. I am left with a very small proportion of my budget from which to find significant savings in a very short period. One of the things that can be done is the slowing down of the delivery of domiciliary care packages. Do I like being in this position? Definitely not. Is it counter-strategic?”
“I hear what the honourable Member for Strangford says. He is also campaigning against cuts being made to other parts of the budget under contingency savings. The difficulty is that, if, for instance, we were to protect Dalriada Hospital, which is in Mrs Overend's constituency —”
“As I mentioned, a review of domiciliary care right across Northern Ireland has been initiated by the Health and Social Care Board as part of TYC. I remain committed to TYC. As the Member will know, a fundamental part of TYC's recommendations is that care should be transferred, where possible, to the home, so that the home is the hub. The aim of the review is to obtain a better understanding of how the domiciliary care market operates and identify best practice in the various models of delivery to shape the future direction and operation of domiciliary care services.”
“In October 2014, 265 people in her trust area were awaiting full care packages, and 207 were awaiting part packages or transfers between providers. Funding has been sourced for all those packages, and the commissioning process is ongoing. The issue that she has raised is being dealt with. There is a commitment to help the Northern Trust through the extra allocation.”
“First of all, our commitment to the Northern Trust at the moment is to 4,778 care users, who receive 48,000 hours of care a week. That is quite a significant input. Indeed, overall in Northern Ireland, we now have 25,330 clients in receipt of domiciliary care services. That is 5% more than in the equivalent period in 2012. The commitment is very much there to continue the service. <BR /> <BR />I will answer the Member's specific question. During the October monitoring round, £8 million more was allocated to Transforming Your Care implementation for 2014-15. Those moneys will support a wide range of measures that will help to meet the care needs of our growing and ageing population. I can bring the Member right up to date regarding the Northern Trust specifically.”
“The health service is facing significant financial pressures. I think that I should put that line before every answer that I give today. It is therefore important that trusts take appropriate measures to achieve financial break-even. In seeking to deliver this very challenging objective, there is a need to make some changes in domiciliary care spend based on reassessing current needs and reprioritising services. All trusts, including the Northern Trust, are reviewing their domiciliary care provision to ensure that highest-priority needs are met within the current resources. Day-to-day implementation decisions are taken on the basis of a professional assessment of individual need and associated risk.”
“We will discuss with it how they can be done while maintaining public safety. That will be a very difficult balancing act.”
“I thank the Member for her question; I know that she is basing it on her understanding of the rural community. At the moment, the Fire Service has a budget of £74 million. I assure her that whatever is agreed will be risk-assessed to make certain that we do not introduce any form of unsafe service in Northern Ireland. I suppose that the exercise at the moment is to see how far we can take savings without straying into that territory. I appreciate that, in rural areas, the Fire Service goes way beyond simply firefighting and vehicle rescue. For instance, it goes into situations where farm accidents with slurry tanks have occurred. We therefore value that work enormously. Again, I have to keep emphasising that we do not want to be here. We do not want to be asking the fire service to make these very significant cuts.”
“The difficulty is that I have to find the £50 million, as things stand, in my budget. I have only a very limited number of arm's-length bodies that I can approach in order to achieve those savings. Unfortunately, the Fire and Rescue Service falls into that category. It will be a difficult debate and discussion between my Department and the arm's-length bodies over the next three months. I do not want us to underestimate for one minute how difficult this will be to achieve. Other organisations such as the Public Health Agency and the Northern Ireland Social Care Council are also involved here. We have great difficulties, but we simply have no option but to balance the books for 2015-16 by finding this £50 million.”
“As I mentioned in response to the previous question, I am due to meet the chairman of the Fire and Rescue Service Board this afternoon. I have had meetings with union representatives, and I intend to see other stakeholders in that sector to talk through the various options. There are suggested reductions that can be made on issues such as commercial contracts, temporary promotions, overtime and natural wastage but, beyond that, it is difficult, at the moment, to see how we can take things much further.”