Alex Easton
North Down · Independent · Northern Ireland
“I, too, want to raise the issue of Bright Sparks Preschool, which is a feeder preschool for Crawfordsburn Primary School. Last Wednesday, the Education Minister visited Bright Sparks to hear about its excellent work and see all the pupils in the preschool.”
“<BR /> <BR />My annoyance is that I have met the Education Authority with Bright Sparks many times over the past several years, and there has been a lack of effort by the Education Authority to find a solution for a building that it owns.”
“The map shown in the consultation included the entire Newry, Mourne and Down District Council area, which has nothing to do with the South Eastern Trust area. <BR /> <BR />We therefore know that the consultation and the equality impact assessment were a farce and a foregone conclusion.”
“<BR /> <BR />The South Eastern Trust proceeded to say what its plans were. Closure, with the announcement of a new minor injury unit at the Ulster Hospital site, was the only option.”
“How accurate my prediction was: the Bangor minor injury unit never reopened its doors. It was stripped of its equipment even before the consultation was finished.”
“I quote two Alliance councillors, who said that the units had not been "of any use". If they were of no use, why did 22,000 people use the two minor injury units at their height? <BR /> <BR />Over 20,000 people signed a public petition opposed to the closure of the units.”
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“Those amendments will see a number of sections of the Human Tissue Act becoming non applicable to Northern Ireland, and restrictions will be put in place where consent is required. <BR /> <BR />The sponsor of the Bill undertook an extensive public consultation over 16 weeks on the policy objectives and proposed approaches of the Bill. A total of 1,366 responses were registered, from which it is said that a sizeable majority agreed with the objectives of the Bill. The majority of respondents stated that they believed that legislation and the introduction of a soft opt-out system would make a greater number of organs available for transplantation and therefore increase the chance of saving lives.”
“It is proposed that the Bill will seek to increase the availability of organs for the purpose of transplantation through a consent process requiring affirmation after death unless the person has already taken their name off the organ donor register. <BR /> <BR />At the moment, human transplantation is governed by the Human Tissue Act 2004, which is a piece of law that applies to England, Wales and Northern Ireland. It is stated that, if the Bill becomes law, it will fit into the general framework already established by that Act. Some parts of the Bill repeat the provisions of that Act and make them apply to transplants under the Bill. Some parts follow the approach taken by the Human Transplantation (Wales) Act 2013. The Human Transplantation Bill will result in consequential amendments to the Human Tissue Act 2004.”
“The Human Transplantation Bill makes provision concerning the consent required for the removal, storage and use of human organs and tissue for transplantation and connected purposes. It must be enacted by the Northern Ireland Assembly and assented to by Her Majesty The Queen. <BR /> <BR />Under the Bill, the Department of Health, Social Services and Public Safety must promote transplantation. It must also provide information and increase awareness of transplantation and inform the public about the circumstances where consent to transplantation is deemed to have been given and the role of relatives and friends in affirming that deemed consent. That also includes a duty to promote a campaign informing the public at least once a year. <BR /> <BR />The Bill contains 22 clauses and one schedule.”
“What type of feedback has the Minister had on his announcement from the people who really matter?”
“I thank the Minister for her answer. I note that the Minister said that, when work on the west stand starts, it will take about a year. Is there a rough idea of when that project could start?”
“I believe that we want the same things and the same outcomes. Let us show that we can unite on this very important issue. The amendment, I believe, strengthens the motion.”
“<BR /> <BR />That brings me, finally, to my amendment, which urges broad support for the urgent implementation of the world-class mental trauma service announced by the Health Minister in September. What will it do? It started with discussions in the Stormont House Agreement implementation group, which considered proposals to implement the agreement's commitment to establish a comprehensive mental trauma service in the health service. That was discussed by all the political parties that were in the Executive at that time. If agreed fully, it will lead to a better joined-up service that will provide opportunities for Departments, organisations and groups across sectors to share expertise and resources, ultimately benefiting service users. <BR /> <BR />I urge the House not to divide on the issue.”
“To reduce stigma, the Public Health Agency is working in partnership with the Northern Ireland Association for Mental Health (NIAMH) to deliver a future wide-ranging, three-year anti-stigma programme. There is also cooperation at cross-departmental level, with the ministerial coordination group on suicide prevention. The Department is working with DARD and DCAL on a joint initiative on awareness and help-seeking behaviour through rural networks and sporting organisations. That is Departments working together. We also have the Mental Capacity Bill, currently at Committee Stage, which sees the Justice and Health Departments working together in partnership.”
“As we deliver services that are recovery-orientated and move away from reliance on drugs towards providing people with access to psychological and cognitive behavioural or talking therapies, we see that the Health and Social Care Board (HSCB) and the Public Health Agency (PHA) are delivering joined-up services on how mental health services, GPs and other primary care providers and hospitals can get better at making earlier interventions and moving people from long-stay hospital wards to community-based arrangements. <BR /> <BR />The Department published a stepped-care service model for child and adolescent mental health services (CAMHS) that promotes a more consistent, person-centred approach to mental health service delivery for children and young people.”
“As Bamford has been rolled out, we have seen improvements in how we treat, handle and help those with mental ill health. In 2014, the Department launched the regional mental healthcare pathway, You in Mind, to commit the health service to delivering care that is more personalised and improves the experience of people with mental health problems. The trusts provide a range of services — including psychology, psychotherapy, cognitive behavioural therapy (CBT) and trauma therapy — that promote mental health and well-being.”
“<BR /> <BR />The Bamford review set in motion some of the most significant changes ever seen in mental health services. Those changes have transformed how we care for people with a mental illness and have significantly improved outcomes for many. The Bamford vision is to treat people in the community, close to their friends and family, and for inpatient care to be provided only for acute cases in which someone needs to be detained for their own safety and well-being. At the time of the Bamford review, we were spending 60% of the mental health budget on hospital services and 40% on community services; we now spend 44% on hospital services and 56% on community services. That is what Transforming Your Care is all about: care in the community.”
“I thank the proposer of the motion for bringing it to the House for debate. <BR /> <BR />It is widely recognised that Northern Ireland has higher levels of mental ill health than any other region of the United Kingdom. It is estimated that one in four adults across Northern Ireland suffers from a form of mental ill health at some stage of their life. Mental illness does not discriminate, as it affects many people from all walks of life. Despite better outcomes from treatment for mental illness, there is still a stigma attached to it that prevents people from coming forward for help. More needs to be done to do away with that stigma and to encourage people to come forward, as well as to find and deliver the best services that we can to tackle mental ill health.”
“I thank the Minister for her answer. How many posts will be lost by the 2015-16 period and what are the expected pay bill savings?”
“Will the Minister outline the range of major capital projects that he is taking forward?”
“I thank the Minister for that answer. If Northfield House closes, what will be the effect on staff?”
“This will allow Northern Ireland Water to set the standards to which private sewers, including any necessary sustainable drainage system, must be constructed, and an appropriate security, which is a bond, will have to be paid. If all the standards are met, connection may not be refused by Northern Ireland Water. This protection is good news for those who are purchasing or renting a new home, as they can now be assured that the sewerage connection to their home will be up to the appropriate standard. I support the Bill.”
“Clause 4 will see further powers given to Northern Ireland Water to enable it to adopt infrastructure and to enter into agreements about adoption. It will also give powers to ensure that those constructing any new builds construct sustainable drainage systems as a condition of adopting a drain or sewer. That makes practical and economic sense. Clause 5 adds lack of sustainable drainage to the reasons why Northern Ireland Water can refuse connection of surface water to its network. If a drain, sewer or SUDS system does not meet the standards set down, connection can be refused. This is an important protection for the ratepayers and for Northern Ireland Water. <BR /> <BR />Clause 6 introduces a requirement to enter into a sewer adoption agreement.”
“The Bill allows the Department to extend existing arrangements to allow it to pay subsidies to Northern Ireland Water to ensure that there are no household charges for homeowners — in other words, that there will be no water charges. This is allowed up to March 2017 and is welcomed right across Northern Ireland. <BR /> <BR />Clause 2 will put in place measures to amalgamate water resources management plans and drought management plans into an overarching plan. That will reduce bureaucracy and is welcomed. Clause 3 will remove the requirement for Northern Ireland Water to install water meters in new-build domestic properties. That will create savings of around £135,000 per annum, and I believe that it is a sensible way to save money.”
“I thank the Minister for his update. Will he agree that Denroy is a world leader in its field? Can he maybe tell us how much investment went in from Invest Northern Ireland and the company itself, and what benefits that will have for the population of north Down?”
“That is fairly robust, but it is not what the Bill says. The Bill uses the term "reasonably practicable" rather than "absolutely essential"`, so there are issues with wording that need to be addressed. <BR /> <BR />Those issues were of real concern to the Committee. Some parties were reluctant to proceed with the Bill. I will certainly ask the Minister to take seriously the concerns of the Committee and for the Department to work closely with the Committee in addressing those concerns.”
“Safeguards were mentioned in paragraph 4, but very little is known of the powers under the legislation. What are we safeguarding against? There is an assertion that anyone applying to make use of HSC data will be required to demonstrate to an oversight body:”
“This will protect the service user, the holder of the information and the individual or organisation that is applying to use it by establishing a clear, unambiguous framework to govern the secondary use of information. Will the Minister outline what the penalties might be if these are breached? <BR /> <BR />In an information session with Mr Daniel Greenberg, a specialist in legislation, he raised a number of substantial issues, as did Committee members in a further information session. Some of those issues related to principles and policy objectives and others to the technical drafting. The use of the phrase "assist research" in paragraph 3 of the original explanatory note was of concern, and "social well-being" refers to quality of life, but the definition is too broad. What does that mean?”
“<BR /> <BR />The policy objective underlining the Bill is to minimise the legal challenge risk that the Department and the Health and Social Care sector could face as a consequence of using service user information that identifies individuals for purposes other than the direct care of the individual. The Bill will enable regulations to be made that establish a process that will ensure that information is shared only in very limited circumstances that are proven to be for medical or social care purposes and that will benefit health and social care or achieve some other tangible benefit that might reasonably be described as for the public good. <BR /> <BR />The process will be robust, open and transparent. It will impose conditions on the use of the information and include penalties for those who fail to comply with them.”
“The aim of the Bill is to provide a clear statutory framework that will enable the use of Health and Social Care (HSC) information that identifies individuals for medical or social care purposes that are designed to benefit health and social care or achieve some other tangible benefit that might reasonably be described as for the public good without the consent of the individuals whose information may be used. This provision will be utilised only when it is impossible or impractical to gain the consent of individuals or when information would not be achieved for the desired outcome. <BR /> <BR />There is a provision for the establishment of a committee to authorise processing, which I believe is essential for the Bill to progress. I ask the Minister to clarify whether there will definitely be a committee.”
“I thank the Minister for his answer. As he knows, I am fully supportive of what he has done here. <BR /> <BR />This project is earmarked to happen over two financial years, and he has given a commitment on the funding for the first year. Can he give a commitment that, if the money is there, the funding will continue into the second financial year? There is a possibility that it could slip into a third financial year, so can he give a commitment that those two years will be covered?”
“I want to know whether those who decide the need for the care, treatment or social welfare of such individuals, such as custody sergeants, will be trained for that purpose. Thirdly, I want to know where the money is coming from to implement the Bill. Finally, I ask the Minister to address the concern that I raised earlier about persons under the age of 16.”
“Following the consultation exercise, the Department of Justice developed a policy proposal on the basis of the responses received. The policy proposals were included in the joint consultation that was launched in May 2014. The criminal justice provisions in the Bill have been drafted in accordance with those proposals, taking into account the responses received in the joint public consultation. <BR /> <BR />I have a few areas of concern that I hope the Minister will clarify. The first is to do with the independence of the person who makes the decision to appoint an independent advocate and to ensure that they do not experience undue time and resource pressures. I also want to ask for clarification on the safeguards for those who experience mental health issues and come into contact with the PSNI.”
“However, the overwhelming view expressed in the responses to the consultation was that the Department should instead take the time to develop the single comprehensive frameworks envisaged by the Bamford review. Consequently, in September 2009, it was decided that the Department would bring together mental capacity and mental health law in a single Bill in a groundbreaking approach not attempted in any other jurisdiction. <BR /> <BR />In July 2012, the Department of Justice publicly consulted on the basis of the existing criminal justice provision in the Mental Health (Northern Ireland) Order 1986 and posed a series of questions to determine how the existing legislation could be revised to take account of a capacity-based approach.”
“The consultation closed in September 2014, having received 121 formal responses. Five public events were held across Northern Ireland as well as approximately 40 additional meetings or events organised by key stakeholders. <BR /> <BR />Initially, the Department took the view that the Bamford review's legislation proposals could be delivered through separate mental health and mental capacity legislation but with an overarching set of human rights-based principles. That was largely in line with the approach already taken in many parts of the United Kingdom and, at that time, was considered to be the only realistic way of delivering legislative reform.”
“While the Department of Justice wishes to retain those powers, it also sought to create provisions that respect the autonomy of individuals who retain the capacity to make decisions about their medical treatment, while providing safeguards and protections for persons who lack the capacity to make those decisions. <BR /> <BR />The Department of Justice also considered amendments to the civil law to take account of any introduction of capacity legislation. Those changes include the introduction of a new office of the public guardian, additional powers for the High Court and the restructuring of the mental health review tribunal. A joint public consultation on the draft civil provisions and policy proposals on the criminal justice aspects of the Bill was launched in May 2014.”
“As part of that last comment, I ask the Minister why the Bill does not include those who are below the age of 16. Does that not complicate the Bill for the future? <BR /> <BR />Taking account of the interfaces between the mental health and criminal justice systems, the Department of Justice also sought to retain the existing statutory powers available within the system to transfer individuals to the health service for medical treatment. Those powers include police powers to remove persons from a public place to a place of safety; court powers to impose particular healthcare disposals on offenders at remand, sentencing or following a finding of unfitness to plead; and departmental powers to transfer prisoners for inpatient treatment in a hospital.”
“The Bamford review recommended a legislative framework that integrated capacity and mental health legislation that was applicable to all in society, including those in the criminal justice system. With that framework in mind, the review made specific recommendations on the various interfaces between the health and criminal justice systems. The Department of Justice therefore chose to draft criminal justice provisions on the basis of those recommendations. That meant the creation of a capacity-based approach to care, treatment and personal welfare for those aged 16 or over who are subject to the criminal justice system. In addition, where possible, the Department of Justice aimed to build a legislative model that did not contain potentially stigmatising references to mental disorder.”
“The report concluded that that would help to reduce the stigma associated with having separate mental health legislation and would provide an opportunity to enhance protections for persons who lack capacity and are unable to make specific decisions about their health, welfare or finances, including those subject to the criminal justice system. The report also recommended that the new single legislative framework should be based on agreed principles that have regard to the dignity of the person and provide equality in all circumstances in which a person's autonomy might be compromised on health grounds. <BR /> <BR />The objective of extending a mental capacity approach to healthcare decisions to the criminal justice system is to comply with the recommendations of the Bamford review.”
“That was one of a series of reports that came out of the review commissioned by the Department of Health of the delivery of mental health and learning disability services across Northern Ireland. That review was known as the Bamford review. <BR /> <BR />The key recommendation in that 2007 report was:”
“Those rules do not, however, apply to decisions governed by the Mental Health (Northern Ireland) Order 1986, under which there are clear statutory powers to remove and detain people for the assessment and treatment of mental disorders, provided that certain criteria are met, regardless of whether the person has capacity. <BR /> <BR />A number of factors have been driving the need for legislative changes in this area in Northern Ireland. We are out of step with other parts of the United Kingdom, and there is no mental capacity legislation in Northern Ireland. That was highlighted in the report 'A Comprehensive Legislative Framework', which was published in 2007.”
“I welcome the Second Stage of the Mental Capacity Bill, which is being scrutinised by the joint Ad Hoc Committee made up of Health Committee and Justice Committee members. The Bill has 295 clauses and 13 Parts. <BR /> <BR />While mental capacity legislation has been introduced in other parts of the UK, mental capacity issues in relation to health and welfare interventions largely continue to be governed by the common law in Northern Ireland. That provides for a presumption of capacity in persons aged 16 and over, a test of incapacity and protection from liability when intervening in somebody's life, providing that it is reasonably believed that the person lacks the capacity to consent to the intervention and it is in his or her best interest.”
“What estimate is made of the cost of beds in the independent sector compared with those in statutory facilities?”
“I thank the Minister for her answers so far. When will the new programme be open for applications for youth projects?”
“Can the Minister outline what other funding is dependent on the Stormont House Agreement being implemented?”
“I believe that savings can be found elsewhere, and I urge the Minister to look at that.”
“It is a pity that the Committee cannot get the same information from Northern Ireland Water, Translink and Northern Ireland Railways on those issues. <BR /> <BR />Yesterday, we had a debate on community rural transport, which will see a huge reduction of £2 million in its budget. That is an increase of over 30%, which is quite worrying. <BR /> <BR />If we cannot agree our budgets across Departments, there will be a £600 million black hole, and the cuts that we are seeing now, which are quite bad, will have a devastating effect on the people of Northern Ireland from everybody's community. It is important that we all try to sort out our budgets and the Stormont House Agreement.”
“<BR /> <BR />For Transport NI, we see that £10 million was moved from roads to Northern Ireland Water. It is no wonder that we see pressure on street lighting, potholes not being fixed and no grass cutting, as, in essence, we are robbing Peter to pay Paul. We can see that £40 million is needed to meet long-term public-private partnership (PPP) contractual commitments. Has the Department gone back to look at whether those costs can be reduced through renegotiation? That is the logical thing to do. It is done in other Departments, so I hope that the Minister will consider doing that. I also note that Transport NI plans to save £3 million through the voluntary exit scheme and other admin efficiencies.”
“In my opinion, something does not add up with the Translink reserves, and I believe that the Committee will need to have a closer look at what the reserves are being used for in Translink. <BR /> <BR />How much money has been saved under the voluntary exit scheme by Translink? Would this not help with the budget? Also, I question why Translink is providing company cars for 40 staff. Indeed, we found out that there were about nine company cars for Northern Ireland Railways. This is costing hundreds of thousands of pounds. Surely, this is an extravagance that, in this day and age, we cannot afford. Surely, the Minister must put a stop to this. I believe that money can be found in the areas of Translink that do not have to hurt the public. All that is needed is a bit of willpower and imagination from your Department.”
“<BR /> <BR />It is claimed that Translink is projected to lose about £14·3 million yet has assets of £55 million, although it was stated at the Committee meeting that this will be reduced to £41 million and that a further £11 million will then be lost, which will bring the reserves down to £30 million. We have been told that this will go down to £18 million of reserves left. Surely, until now, these reserves have been steadily increasing over the years and have now decreased rapidly, within the space of a year, and are being used to pay its bills. Surely, the overall budget for Translink was being used for paying its bills, not its reserves. That was stated by Mr May when answering questions from the Committee for Regional Development.”
“In the 2015-16 budget set by DRD, we can see an allocation of £152 million for the Department, £61 million for Translink, £109 million for Northern Ireland Water and EU funding of about £0·5 million. <BR /> <BR />If we look at Northern Ireland Water, we see pressures of £15 million, largely due to rates revaluations. Has the Department appealed these? Instead, we see money being moved from roads to Northern Ireland Water, which, obviously, has caused a problem in the roads budgets. Have any costings been done on the voluntary exit scheme for Northern Ireland Water? Would this have gone some way to help the Northern Ireland Water budget? I also want to ask about the selling of assets that are no longer required. Where is Northern Ireland Water on these issues? I do not see much movement on these.”
“No, not at the moment. <BR /> <BR />When we look closely at the budget for DRD for this financial year, we see that it is around £333 million, which is about £11 million less than in the last financial year, when it was around £344 million. That is a reduction of around 0·6%. Yet, DRD claims that it has a shortfall of £60 million in its budget. This was explained by the Department and the Minister in an evidence session to the Committee for Regional Development. We see that the Department has an over-reliance on in-year monitoring rounds, and I have no doubt that, during the next June monitoring round, we will see bids by DRD and other Departments.”
“I rise to support the motion at a time when money is tight and budgets are coming under increasing pressure. It is vital that Ministers do all that they can to keep within their budgets that have been set and agreed and that they look at every possible avenue to reduce risk and to ensure that services are provided and protected as best they can be and that staff employed and, indeed, the public are given the best possible services that we can provide.”
“— and the nine company cars for Northern Ireland Railways senior management. I do not believe that we should be providing those services, and that is where money can be found.”
“I believe, however, that other savings can be found; and example of that is the 40 company cars provided for senior management in Translink —”
“That will lead to higher costs for groups using private-sector suppliers, a lack of accessibility transport options and more social isolation. The impact on the mobility centres will be that lessons for drivers will no longer be provided from the person's home. Customers will have to travel to one of the three remaining offices. That could be a round trip of 60 miles for some people. The cost of a driving lesson will increase from £25 to £35. <BR /> <BR />I certainly do not envy the Minister's task in resolving this. However, it is not fair on the people of Northern Ireland when we see the games being played by Sinn Féin, the SDLP and the Green Party over the Stormont House Agreement, which might have helped our budgets.”