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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“The inquiry asserts the obligation on Government to do their utmost to protect all children and young people up to the age of 18. As children become older and are able to exercise more practical autonomy, the task becomes more difficult. However, the duty to care for and protect remains, alongside the child's right to be cared for and protected. It is incumbent on all of us with responsibilities for the care and protection of young people to prioritise their right to be protected.”
“That is already being considered by the Health and Social Care Board and the trusts. <BR /> <BR />Importantly, the inquiry challenges the view that children have an unqualified right to autonomy, which some have suggested disempowers staff to act with appropriate authority or to set clear standards and expectations for behaviour. The inquiry suggests that a holistic view on the spectrum of children's rights, including their right to direction and guidance, can assist in identifying ways that balance the care and control required to keep young people safe while respecting their rights and evolving capacities and independence. <BR /> <BR />The inquiry helpfully explores how the issues of CSE can be addressed within the human rights framework and challenges the misconception that children's rights are a barrier to taking action to help them.”
“<BR /> <BR />On the use of physical restraint and secure care, the inquiry is firmly of the view that those must not be regarded as everyday responses to manage risk in children's homes, although there will be some situations in which their use is justified. <BR /> <BR />The inquiry sums up the challenge in finding a solution to young people going missing from care as follows:”
“It also heard that many looked-after children felt stigmatised by the media coverage of CSE in September 2013, and we should be mindful of that as we discuss the report and its findings. It is important that the messages about the threat of CSE to all our children and young people are not masked by an undue emphasis on those in residential care. In Northern Ireland, 7% of all looked-after children, which is about 200 in total, are in residential care. It is the explicit policy of my Department that as many looked-after children as possible should experience and benefit from a stable family placement with kinship or foster carers. The welfare of all looked-after children is a priority, but there is undoubtedly an issue with the care and control of young people who go missing repeatedly despite the best efforts of staff and foster carers.”
“The inquiry also acknowledges that the debate about missing children and their vulnerability to CSE can be skewed by the fact that there is available data about children in the care system, whose activities are closely monitored and recorded. <BR /> <BR />The inquiry obtained figures from the police on reports of missing children over two 24-hour periods, one at the weekend and one midweek. The figures show that, over the weekend, more than twice as many people were reported to police as missing from family settings as from looked-after settings such as foster care. Going missing and the risk of CSE is not just a problem with looked-after children. <BR /> <BR />The inquiry acknowledges that many young people have good experience of residential care.”
“On victim support, a range of general and bespoke services to support the recovery of victims is identified in the report. The inquiry identifies the need for services to support victims of CSE who come forward in adulthood, as well, of course, as younger victims. <BR /> <BR />The inquiry was asked to look specifically at safeguarding looked-after children, given the concerns about those who go missing from care, sometimes repeatedly, and the associated risks of CSE. The inquiry acknowledges that not all children who go missing experience child sexual abuse and that some who experience CSE may not have gone missing or stayed out late without permission.”
“Holding offenders to account is primarily the responsibility of the Justice Department, and I pledge to support Minister Ford in whatever actions he may decide to take forward in this regard. <BR /> <BR />The inquiry notes the importance of cooperation amongst agencies and the sharing of information. It states that, while there have been improvements, more can be done. It also states that it heard a view that there are too many partnership arrangements involving the same people and leading to duplication of efforts. Those are matters that, I accept, need further consideration.”
“Perpetrators must be held to account. The report highlights long-standing concerns about the low rates of securing prosecutions and convictions of those who prey upon children and young people for sexual purposes. Not enough is known about people who sexually exploit children and young people. This is a serious gap that has been identified in other reports. While there have been some specific groups of men identified in some reports regarding CSE, the National Crime Agency suggests that perpetrators are mostly solitary offenders and could be from any part of the community. Understanding offenders’ profiles and predispositions, their motivation, mindset and how they operate are key to helping us better protect children and young people.”
“Statutory agencies — social services, the police, health, education and youth services — cannot tackle CSE on their own. They need the support of children, parents, communities and third-sector organisations. It is reassuring that all those who provided evidence to the inquiry indicated their willingness to take part. It is particularly reassuring that young people want to be empowered to resist CSE, and they can only do so by knowing more about the risks. Parents, who are the first line of defence against the exploitation of their children, want to be treated with respect and supported by agencies in their efforts to do so. <BR /> <BR />Concerns were raised in the report that there is too much emphasis on the behaviour of victims and calls to restrict their liberty rather than punishing and locking up perpetrators.”
“<BR /> <BR />While we do not know the full extent of CSE in Northern Ireland, we can say that there are no findings in the inquiry that point to the type of organised exploitation seen in Rotherham or Rochdale; nor does it have the same ethnic-minority dimension. There is no evidence in the report to suggest cover-up, corruption or a lack of commitment on the part of agencies or individuals. Indeed, the report states that, in Northern Ireland, senior managers expressed a commitment to taking CSE seriously. While that may be the case, there is no room for complacency, and the inquiry report counsels vigilance in the face of changes in social attitudes and in the cultural make up of Northern Ireland society. <BR /> <BR />I turn now to what the report says about preventing, tackling and supporting recovery from CSE.”
“The report states that the first step in tackling CSE is to recognise that it exists and suggests that more cases will be identified as awareness increases, and there is a recommendation linked to public awareness-raising. <BR /> <BR />A shared understanding about CSE and improved information collection and analysis are considered by the inquiry to be prerequisites to better identification, reporting and a more accurate assessment of the prevalence and nature of CSE. However, it is important to bear in mind that we already know that all forms of child abuse have a hidden dimension and are significantly under-reported and, as a result, there will always be a gap between actual prevalence and what is known to social services.”
“The report states that it was not possible for the inquiry team to identify the prevalence of paramilitary links, but perhaps that is not surprising, given that some stated that they feared for their lives if it became known that they had spoken to the inquiry. <BR /> <BR />The inquiry identifies a number of groups of young people who are potentially more at risk of CSE than others. The risk and vulnerability factors identified include: neglect, deprivation, domestic violence, drugs and alcohol, peer pressure, advances in technology, an increasingly sexualised society, cultural attitudes to women and going missing overnight. The inquiry concludes that available data can only provide a rough idea of the extent of CSE and it is likely to be a significant underestimate.”
“Girls may feel that they can gain status through cooperating with those powerful individuals, and that may be tolerated by some families. Others fear threats to their families if they do not succumb to the abuse. <BR /> <BR />The inquiry also heard that some young men look to those powerful figures as role models and aspire to be like them. The inquiry was told of families that had endured generations of exploitation. The kind of power that such individuals exert means that they may be involved in all types of CSE. However, specific to them are the pubs and clubs operated in some areas where there may be lock-ins involving young girls who get the tap on the shoulder to stay behind.”
“However, the inquiry found the witness testimonies about potential paramilitary links with CSE to be powerful and persuasive. A number of individuals expressed an ardent plea that the inquiry should speak up about the paramilitary dimension to CSE. <BR /> <BR />Some described how CSE could be associated with organised drug dealing. More commonly, it was a case of individuals believed to be members of, or linked to, paramilitary groups who used the authority and fear that it engendered to exploit children and young people. Those individuals have access to alcohol, drugs, guns and violence. They were described as people to whom you cannot say no. They regard themselves as beyond the law. <BR /> <BR />The inquiry was told very clearly that paramilitary influence may cause and facilitate CSE. In communities, it can build up loyalty and fear.”
“<BR /> <BR />The inquiry states that there is an increasing risk of peer-to-peer abuse, attributed by Kathleen Marshall to an increasing sexualised society, assisted by advances in technology and changing cultural norms in our society. <BR /> <BR />The inquiry concludes that while there is some level of organisation to CSE in Northern Ireland linked to groups who coalesce around young people, for instance, in party houses, it does not constitute organised crime as understood by the National Crime Agency. <BR /> <BR />Considerations about the organised nature of CSE took the inquiry to consider possible links with paramilitaries in Northern Ireland. The PSNI view is that organised paramilitary involvement in child sexual exploitation has not been established.”
“<BR /> <BR />On the nature and extent of CSE in Northern Ireland, the inquiry concludes that it is not new and takes different forms in Northern Ireland, as it does throughout the United Kingdom, but there are particular Northern Ireland dimensions to it. <BR /> <BR />The forms that CSE takes here include: online exploitation; what is described as the party house scene; exploitation by older boyfriends; prostitution; trafficking, and forced marriage. The inquiry has not been able to establish actual numbers of young people being exploited, though it references official figures for prostitution, trafficking and forced marriage, all of which are in single figures.”
“On behalf of my ministerial colleagues, I thank Kathleen Marshall and those who assisted her for their efforts. Throughout my statement, I will refer to child sexual exploitation as CSE for ease of reference. <BR /> <BR />All forms of child abuse, including CSE, are totally unacceptable. I want Northern Ireland to be a safer place for children and young people and the most hostile of environments for those who abuse or exploit our children and young people. I want to take Members through what Kathleen Marshall has found, her recommendations and my initial response, and I want to emphasise that it is an initial response.”
“Last year, my predecessor, on behalf of my Department and the Departments of Justice and Education, commissioned an independent inquiry into child sexual exploitation in Northern Ireland. The inquiry was led by Kathleen Marshall and is now complete. It was charged with the following matters: establishing the nature and extent of child sexual exploitation in Northern Ireland; examining how effective cross-sectoral child safeguarding and protection arrangements are in preventing and tackling child sexual exploitation; and considering how well we are safeguarding and protecting looked-after children. The inquiry was asked to make recommendations on future actions. <BR /> <BR />All three Ministers have now received the inquiry report.”
“He also said that, to balance the books, the health service in Great Britain requires £8 billion. The Barnett consequentials of that for us would be £240 million. If I had an extra £240 million, we would not be having this debate today. That would be more than enough to cover the pressures on my budget. If England, Scotland and Wales are facing exactly the same pressures, why are you blaming it on the previous Minister?”
“— I will have been explicit in telling them that a full consultation exercise must be carried out.”
“Trusts have a clear statutory obligation and have to provide assurances to my Department that they are meeting their obligations as part of the governance framework. Should any of the temporary measures outlined in the trust contingency plans be proposed to be made permanent —”
“In 2012-13, £11·4 million was shifted from hospital-based services to community-based services. The figure for 2013-14 was £13·6 million. Nonetheless, it is clear that more has to be done, and we are doing everything we can to meet these very challenging targets. I assure the House that the transformation process will continue to be a priority for my Department over the coming years. <BR /> <BR />Equality screening did not get much of a mention in the debate, even though it is a significant part of the motion. It is a statutory responsibility of the trusts to undertake equality impact screening of all policy proposals and to undertake assessments when indicated. My Department has been in contact with each of the trusts to seek an assurance that they are meeting all their equality scheme responsibilities in their contingency plans.”
“The TYC report by John Compton estimated that £70 million was required for such transitional activities. When John Compton drew up his report, which I am still totally committed to, he could not have foreseen the financial difficulties that we, the Northern Ireland Executive, are in today. I have to say that we have not achieved all of the finances that we required to implement TYC, but, between April 2012 and August 2014, despite the difficult financial circumstances in which we find ourselves, the Department has been able to invest close to £30 million in the delivery of TYC and make significant progress on a number of fronts. For instance, we have 17 new integrated care partnerships, which have been up and running since June 2013, and they are making good progress on developing their action plans.”
“I will certainly look at that situation on behalf of the MLAs in North Antrim. It is one that I was just made aware of today, and I think that it needs to be looked at. The Member knows that next week in the House there will be a major debate on the issue that he will take part in. That will give Members an opportunity to articulate the views of their community and enable me to report on the consultations that I will have between now and then. What he cannot say to me is that I have not been consulting every stakeholder in the community about the decision. It will be consulted on to the nth degree, I assure him. <BR /> <BR />TYC came up in the debate. My predecessor always made it clear that the speed of transformation would be dictated by the availability of transitional funding.”
“Hopefully, I have explained how I feel in the uncomfortable position of having to deliver these cutbacks, but I have no option about carrying a debt over into 2015-16. First, I cannot do it, and, secondly, it would be a cowardly way to deal with it because you are simply carrying that debt and storing up trouble for the next financial year.”
“Again, it was interesting that, in the monitoring round discussions, no one suggested for one moment that we did not need £140 million; that was never the issue. The issue was this: did we have the cash to come up with enough money to make the trusts continue their good work to the end of the financial year? All the trusts have been asked to develop and implement a range of contingency plans to secure break-even. It is a painful and difficult decision for all of them. Nobody, including me, wants to be in this position. <BR /> <BR />I faced the folk from Moyle earlier today on the steps of Stormont. It was, I must say, a very polite conversation, but it was also a difficult conversation. They have every right in a democracy to come up and make their views known.”
“The honourable Member for North Antrim will take it from me that that letter is a consideration in any decision. I accept that. I had not seen that letter until today, and I am certainly taking it into consideration as part of the overall decision-making process. The Member cannot deny the progress made under the ministership of Mr Poots, and no one in the Chamber has stood up to deny that any of the facts that I have stated this afternoon are indeed true. <BR /> <BR />I very much regret the measures that are necessary and facing my Department to obtain the £70 million that is required under the contingencies. I regret that, in the monitoring round, we did not get all of what we asked for.”
“<BR /> <BR />There is more bad news for the detractors opposite: despite the predictions of a reduction in staff by 4,000 from 2011 onwards, including compulsory redundancies, let us hear the facts. Between March 2011 and March 2014, the number of qualified nurses and midwives increased by 800. That is an increase of 5·7%. The number of medical and dental consultants increased by almost 200, which is 15%. The message is very clear: the previous Minister made a very stressed budget go an awful lot further than any previous Health Minister in Northern Ireland's history. What is he getting? He is getting condemned.”
“Members opposite will not want to hear the statistics that I am about to cite because they do not want the facts to get in the way of a good story. There was, for instance, a 22·8% reduction in the number waiting over 13 weeks for inpatient appointments and a 65% reduction in the number of patients waiting for specialist drugs for conditions such as arthritis. The waiting times for anti-TNFs, for instance, were dramatically reduced. The number of patients waiting longer than 12 hours in A&E was more than halved. As was said, the number of clients receiving domiciliary care has increased by 5%, and the number of hours provided is now 250,000 hours per annum. Outcomes for patients and clients have improved, with life expectancy continuing to rise for males and females.”
“The Finance Minister was speaking as the Finance Minister. That is his role, and he has many difficult conversations with all the spending Departments. I understand his role, but I also think that anyone who can land a £5 billion budget within 0·3% must have been doing a lot of things right. The motivation for that slight overspend, of course, was to continue with the elective care of individuals who needed hips, knees and elbows treated as a matter of urgency. <BR /> <BR />In managing a particularly challenging financial position over this period, the House should be aware that the investments made by my predecessor played a crucial role in improving the health and well-being of patients and clients.”
“That sum is bigger than the combined sum for four of our smallest Departments, which indicates the significance of the savings that we expect the trusts to achieve — more, for instance, than the entire budgets for DCAL, DOE, OFMDFM and Finance.”
“<BR /> <BR />There is one fact that no one in the Assembly can contradict: all the stats show that demand for health service provision is rising at about 6% per annum and that the resources allocated by the Assembly for health care and social services is 2%, so there is a shortfall of four percentage points. We should not be surprised, therefore, that the stress began to show in year 3. In autumn 2013, all the trusts told me that things were getting really tough indeed. We all came to the same conclusion, and we all know the stats. It is hardly surprising that the pressure began to show, but it is also important to highlight that the Department has reported significant savings over the Budget period: £490 million from 2011-12 to 2013-14 and a further commitment of £170 million in the current year, which is a total of £660 million.”
“The extent of the pressures became known from the summer of 2013, and the Chair of the Committee admitted that to be true. Since that date, the Department has explored and implemented all available opportunities to curtail and control expenditure, in line with my predecessor's priorities. That has included extensive engagement with all the key stakeholders, including the trusts, the board, the PHA, DFP, the Health Committee and policy leads in the Department. Substantial bids were submitted in the 2013-14 monitoring rounds as the Department sought to address those pressures. No stone was left unturned.”
“It is important to note that, in 2014, the pressures facing health and social care were significant and unprecedented. They included a wide range of service areas: domiciliary care, acute services, safety and quality, ED, unscheduled care and children's services. In addition, the Department has had to manage substantial pressure in relation to clinical negligence settlements, which, again, few people have taken into consideration. Those cases were before the courts, and there was a backlog of complex cases. Many of them were settled in that year, and they led to large-scale payouts that could not have been predicted and put a significant burden on the health service budget. <BR /> <BR />Let me make it clear that the Department did not sit on its hands and do nothing in 2013-14.”
“As Ms Bradley said, never let the facts get in the way of a good story: it was not mentioned that underspends in the first three years were between 0·1% and 0·3%, from 2011 to 2012-13. We carefully landed that large spaceship called Health and Social Care on the postage stamp of an economic balance, but did anybody get any support for that? Not a bit of it. In 2013-14, we were overspent by £13·7 million, which is 0·3% of the budget and is a tiny amount, given the £5 billion allocation.”
“I have to be honest, as I was honest with the MS Society: if there are 4,000 MS suffers — I do not underestimate how difficult a condition that is — I would expect more than 69 individuals to be using the service and the bed occupancy rate to be higher than 32%. Those facts have to be taken into account. Equally, I have been lobbied intensely by many of those 69 on the impact that closing Dalriada would have on their life. I am looking at both sides of the argument. <BR /> <BR />My Department has a strong track record, under the control of Mr Poots, of managing budgets within exceptionally small tolerances, all against a backdrop of rising service pressures and demand.”
“The Member over-eggs and exaggerates things somewhat. The cuts do not affect front-line A&E services, they do not affect GPs and they do not affect clinics and other areas. They do not affect everyone, but I accept that, for the communities concerned, it is a very painful experience. Also, throughout his period —”
“It is entirely for the First Minister to make that assessment. There was no question of anybody being removed or sacked. It was simply the fact that he was going extremely well and had many important issues to deliver on, so, quite rightly, the decision was taken to allow him to continue.”
“Such was the confidence that the First Minister rightly had in Mr Poots that he extended his career as Minister substantially so that the split became two thirds to one third. One could hardly call that a demotion or a sacking.”
“I have listened carefully to the contributions of Members throughout the debate. I do not accept that there was maladministration by the previous Minister. If Members are waiting to hear me in any way criticise the performance of the previous Minister of Health, Social Services and Public Safety, they will have a very, very long wait. I watched the Minister for three years and four months. I was Deputy Chair of the Committee, attended many events with him and had many briefings from him. Would I have done anything differently had I been Minister of Health? Absolutely not. Mrs Dobson suggested that the previous Minister was asked to move. That is interesting because, as you know, my party leader made a commitment to share the ministership equally in this dispensation: half for Edwin and half for me.”
“I thank the Member for giving way. He raised a valid point. Those petitions opposing the closure of Dalriada were removed in error and forwarded to the trade union office in the Causeway Hospital. I can tell him that the trust has now provided an area inside the main hospital entrance where people can sign the petitions if they wish. We have no intention of gagging people on this issue. If they want to sign them, they are free to do so from now on.”
“Indeed. Three years ago, the Southern Trust won the award for the best telemedicine service in the United Kingdom. The then Minister, Mr Poots, and I held a function here in Stormont to congratulate it, and there was not the slightest interest about that good news among the media. In Northern Ireland, we are already leaders in the field in the British Isles, and there is a huge degree of potential in using telemedicine to make our services more efficient and more responsive to the needs of patients. Again, that is a long-term process. My difficulty is that none of that will help me balance the books by 31 March 2015, but there may be Members here who know better than me and will help me do that.”
“However, unfortunately, if anyone thinks that any of this is going to lead to alleviating the fundamental structural problem that we have with the health service budget in Northern Ireland, I am afraid that they are totally wrong. Basically, we carry £160 million-worth of unmet need into next year, and none of those proposals is going to come anywhere near to closing that funding gap.”
“I met my counterpart from the Republic of Ireland in Armagh last Wednesday. We had a very good discussion on the very issue that the Member raises. One of the issues involved the cath labs up in Londonderry in his constituency. There is a proposal that those who have major cardiac events in Donegal can use the spare capacity in Altnagelvin. Twenty-seven per cent of the renal unit patients in Daisy Hill Hospital are from Louth and north Monaghan. We have also had the decision on paediatric congenital heart disease and interventions being moved down to Our Lady's in Crumlin. I believe that there are areas where we can cooperate.”
“<BR /> <BR />When the Member was Minister, he, too, was often in the situation of having to trust his officials. I trust my officials. I think that they are doing an excellent job in terribly difficult circumstances. Over the last five years, I have had lunch, dinner and various meetings on numerous occasions with the chief executives and finance officers of every trust in Northern Ireland. For the first three years, they told me that, whilst the budget was stretching, it was deliverable and that they were going to do it with relative ease. Now, they are telling me that it is almost impossible. Exactly the same people serving the same communities are now telling me that we are in a very different situation due to demand. Do I believe them? Yes, I do.”
“The trust chief executives have given me a commitment that the decisions that they are taking, whilst painful, will not endanger long-term, sustainable, high quality care. The difficulty that I have with this is that these are some of the finest managers anywhere in the United Kingdom, some of whom have excellent records, even in a UK context. We appoint them. We trust them with the task of coming up with the least worst options. It is, therefore, very difficult for me, having been in position for 54 days — though I can tell you that it feels like 54 years — to look over their shoulder and say that I know better or that I know better because some MLA has told me that he or she knows better. We have to trust them to make clinical judgements on what is best for their area.”
“We all heard the Committee Chair's view on last year, when the Department overspent by 0·3%, £13 million of a £5 billion budget. That is the pain that we will suffer if we go slightly over budget. I cannot possibly consider a £70 million overspend. The criticism would be legion from Members. Therefore, we have to live within budget. Unfortunately, a lot of the next four months will be firefighting to try to do that rather than concentrating on what I would like to do, which is the long-term strategic planning of what is best for health care in Northern Ireland. I wish that I had time to do that, but I am really in a needs-must situation.”
“Some of the trusts, as part of their contingency savings, have outlined that, in the last few months, they are going to have to slow down the increase in packages given to the needy. Those who are in urgent need will still get a domiciliary package. For others, there will be a slight slowing down. Remember that that is in the face of an increase in the resources given to that particular sector, a 5% real increase over the last year and a commitment to provide extra money under TYC for this. <BR /> <BR />I have absolutely no doubt that individual MLAs will write to me to complain that things are not moving as fast as they would wish over the next four months. However, again, what I am saying is that these are needs-must decisions to balance the books.”
“I would certainly have had a lot fewer sleepless nights over the last 54 days if I did not have to make those decisions, in conjunction with the trusts.”
“Therefore, I am inflicting an awful lot of pain on a very small part of the budget, but it is the part of the budget that can be touched legally. If I were starting with a white sheet of paper with two years' notice and you asked whether I would make the decisions I am making at the moment, the answer, in many cases, is no. However, we simply have no option but to balance the books at the end of March 2015. There is no provision to carry over a debt; it simply will not be allowed. That is where the trusts are. They are trying to find, not sometimes the most logical decisions but the most deliverable decisions. Therefore, that affects the Member's constituents. Do I wish that I were not in this position?”