Simon Hamilton
Strangford · Democratic Unionist Party · Northern Ireland
“I have emphasised to the Member and the House before, that, whilst I accept that those are not good enough — that is why we have been developing the plan — there are alternative technologies in place that can present opportunities for those who just cannot get acceptable speeds.”
“I thank the Member for his intervention. There are some initiatives that I believe will help and act as a driver to improve broadband access. One such intervention is the broadband universal service obligation (USO), which is being taken forward by Her Majesty's Government.”
“I thank the Member for his question. However, he is conflating two issues. I wrote to his party leader, and indeed to all Assembly party leaders, before making the announcement that I did last week about wanting to publish the details of the businesses in receipt of the non-domestic RHI scheme. It was my intention to do that tomorrow.”
“<BR /> <BR />The Chancellor, in his autumn statement, made some more funding available for telecommunications, and my Department is studying that and seeking to avail itself of that to the fullest possible extent.”
“In addition, my Department is managing a contract for the delivery of the superfast rollout programme, which, by 31 December, will provide access to superfast broadband with speeds of at least 24 megabits per second to a further 38,000 premises, both business and residential, across Northern Ireland, including in the Newry and Armagh cons…”
“I signalled the intention to do this a few weeks ago. The Member and the House will know that inspections of all installations would have taken place over the 20-year lifetime of the RHI scheme.”
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“The Member will know that there have been issues across Northern Ireland, particularly sometimes in the Western Trust, in getting the requisite staff to look after the various services that are provided. It has been a challenge to get the appropriate numbers of staff, particularly at consultant level, into Altnagelvin to be able to look after the radiotherapy centre properly. My understanding from the Western Trust — I will clarify it with the Member if I am inaccurate — is that it has been running a fairly aggressive recruitment programme — indeed, it is an international recruitment programme — to try to get people in to staff the radiotherapy unit. From speaking to the chief executive of the trust a few weeks ago, my understanding is that that has been successful.”
“I am not aware of any, but I will contact the Member with any particular details to clarify that. Indeed, if the Member is aware of any projects or potential projects where charities or others are working in that space and think that there is an opportunity, he should please let us know, and we will certainly get them in contact with the right people to try to take forward their ideas.”
“We have a very vibrant research and development sector in health and social care and in partnership with our universities. Our universities are very clued in and switched on to the potential, particularly around health and social care, of availing themselves of some of the vast amount of Horizon 2020 funding that is out there.”
“That is why the two projects that I highlighted to Mr Buchanan — project MAGIC, which is looking at stroke care; and project NEPHSTROM, which I think I said was with Queen's University but is actually with the National University of Ireland at Galway, but it involves the Belfast Trust, and it is looking at kidney disease — have acquired nearly €10 million between them. There is also another project — project MErCuRIC — which is led by Queen's University. It partners with the Belfast Trust and the Royal College of Surgeons in Ireland, and that got €6 million to research bowel cancer. <BR /> <BR />A lot of projects from FP7 and Horizon 2020 are working their way through the system. My message is that I think Northern Ireland is exceptionally well placed to benefit from Horizon 2020 funding.”
“I am looking here for information. I do not think that I have the precise numbers. I have figures for INTERREG Va but I do not have the full figures for Horizon 2020. I am happy to come back to the Member in writing with more specifics around that. <BR /> <BR />I recall the figure of around 12% of a success rate for applications that have a Northern Ireland lead, which, the Member will appreciate, is a reasonably good success rate. Even though it sounds like quite a low figure, the Member will know that these are hugely competitive funds and you need to be at the top of your game to get anything out of them.”
“<BR /> <BR />The Member asked specifically how many people from Northern Ireland will benefit from the centre. It is estimated that around 1,150 or so patients from Northern Ireland will use it annually. Around 385 patients from the Republic of Ireland will also benefit from the facility. I think that it is an absolutely great project. It is a good example of us working in a practical way on a cross-border basis for mutual benefit, and it will significantly improve the standard of cancer care for patients in the north-west of Northern Ireland.”
“I thank the Member for his question. It is an issue that I know he is very close to. In fact, the Member and I visited the construction site just before Christmas. We got our hard hats on and looked around what is going to be an absolutely fantastic facility for people in that part of the world. As the Chair said earlier, it is impossible for us to make it easy for people to get cancer treatment; it is a very difficult time in their lives. However, the fact that so many people have had to travel so far for so many years to get the treatment that they need will now be addressed by the fact that we are opening this absolute state-of-the-art radiotherapy unit at Altnagelvin. We should be proud of having taken that forward in this Assembly mandate.”
“The Member will be aware that standardised packaging will roll out right across the UK in May 2016. The transposition of the EU tobacco products directive that I talked about means that a range of measures will be brought into domestic law, including our own law. Those are things like a ban on flavours of tobacco, an increase in the size of the health warnings that appear on cigarette packets, a minimum size of 20 in a pack and the regulation of e-cigarettes. The Member will be familiar with the Health and Personal Social Services (Amendment) Bill — I think that I have got that right — which is going through the House. It contains clauses to regulate the sale of e-cigarettes in Northern Ireland. That is an example of how we are putting that directive into practice here.”
“I begin by thanking the Member for his words of thanks on the package of additional funding for autism services in Northern Ireland. That is another area in which there has been work on a North/South basis in the past, and I hope that the additional £2 million of funding that I announced will go some significant way towards reducing the unacceptably long waiting times that have developed over the last number of years. <BR /> <BR />The knock-on impact that tobacco use has on health and social care is an issue and a problem that has afflicted every region and state. In Northern Ireland, it is estimated that we spend around £160 million a year — I think that that is a very conservative figure — on treating tobacco-related illnesses.”
“Whether it is INTERREG funding or Horizon 2020 funding, there are huge opportunities for Northern Ireland and the health and social care system here, working in conjunction with our universities and, indeed, the private sector to avail themselves of the sizeable funding that is out there.”
“A project to provide mobile assistance for groups and individuals in the community — project MAGIC — has received €3·6 million and is focused on improving after-stroke care. It works in conjunction with other European regions, but Northern Ireland is very much taking the lead. Another one, project NEPHSTROM, looks at novel stromal cell therapy for diabetic kidney disease. I think that Queen's University has been involved in that project, which has received €6 million. Northern Ireland is doing well with Horizon 2020 funding. <BR /> <BR />There is a suite of funding through INTERREG IVa as well, with around €50 million available for health and social care projects, particularly those focused on older people, disability and R&D. The first call for that received some 21 applications.”
“As the Member knows, Horizon 2020 is a huge fund. I think that around €80 billion is available across the whole of the European Union, and aspects of that are available for health and social care. So far, Northern Ireland has had a pretty good success rate in converting applications into successful bids. I think that about 12% of bids are successful. That might not sound like a terrible lot, but it is up there with the best conversion rates for turning applications into successful bids. Long may that continue, and hopefully it will. Some very good projects are getting through and getting Horizon 2020 funding, and Northern Ireland is taking a lead on those. <BR /> <BR />I was at the launch of one such project a couple of weeks ago at the Ulster University, Jordanstown.”
“That issue was raised formally with the Irish Health Minister at the NSMC meeting, and he indicated that they hoped to make some positive progress in the not too distant future. It is still moving forward. I commend all those who have been involved in the work, particularly the board and the work that it has been doing to try to make this a reality. I am still hopeful that it will be up and running very soon.”
“It was received in the Department around 1 February, but we need, in particular, to develop sufficient intensive care unit capacity in Dublin at Our Lady's Children's Hospital in Crumlin for the approximately 140 Northern Ireland patients who would have to use those facilities annually. <BR /> <BR />There has been an issue, I understand, with opening up two further beds in the intensive care unit. I understand that the beds and the attendant equipment are there, but the issue is the staffing complement. You need six nurses for each bed, and, at this stage, there has not been the ability to provide them. If they were provided, that would allow us to move the next cohort of patients: 30, 35 or 40 urgent cases per annum could move there.”
“That is another very good example of cross-border cooperation having practical benefits for people from Northern Ireland. The Member will be well versed in progress over the last number of years on the decision to set up the network and the funding that has been provided for it, particularly, in recent years, through the Executive's change fund. It is fair to say that the progress has probably been slower than many of us would like in getting the network fully established. That has not been for any want of trying on this side of the border. I can update the House that we recently received a costed implementation plan and business case for the full establishment of the network.”
“That care has now switched to around 60% in the community and 40% in institutions, which is a positive move. <BR /> <BR />I noticed a report over the weekend that was aired by the BBC about mental health spending across the UK. It is interesting to note that the only country in the United Kingdom that has increased expenditure on mental health in each of the last two years is Northern Ireland, where we increased it by 1% last year and by around 2·5% or 2·6% this year. All other jurisdictions in the United Kingdom have not been able to increase that expenditure over the last two years. The Member knows the pressures that the Health budget faces, and the limitations and many demands on that spend, but he and the House have an assurance from me that I am deeply committed to promoting better mental health.”
“I noticed the comments from the Secretary of State for Health and NHS England on increasing mental health spend in England. We still have a lot of work to do to get our emphasis right on mental health versus physical health. We have had lots of debates and discussions on that in the Chamber, even in my time as Minister. There is a record of good improvement from the Department over the last number of years, particularly post publication of the Bamford report. That saw not just a 25% increase in the amount of funding for mental health in the subsequent years, with more than £250 million a year being spent on mental health, but a shift away from such care being provided mostly in institutions, which, in many cases, were inappropriate and not helpful, to a more community-based type of care.”
“That started to break down with informal contacts, and I have asked officials to formalise that more so that we can try to develop a corridor between Belfast and Dublin to increase the opportunities for human transplantation right across the island of Ireland.”
“It is estimated that around 500 patients will receive catheterisation in the cath labs in Altnagelvin. <BR /> <BR />There is scope for further development, and there are opportunities in two areas. One of those is deep brain stimulation for Parkinson's patients, which we are very good at in Northern Ireland, and there is an opportunity for us to provide that support for patients from the South. Another area that was discussed at the North/South Ministerial Council meeting was human transplantation. There are two transplantation centres, one in Belfast and one in Dublin, which have operated with very little contact between each other over the last 25 or 30 years.”
“I was also at Altnagelvin Hospital just before Christmas and saw for myself the 24/7 cath lab, which is providing primary percutaneous coronary intervention (PCI) and coronary care for patients in the Western and Northern Trust areas, and in other parts of Northern Ireland. It will not be too long before it is also providing support for people from County Donegal.”
“I thank the Member for her question. Some see North/South cooperation as something for the optics or just for the sake of it. It does not necessarily need to be of any substance. I have to say, with some pride, that the area of health is full of substance in what we have developed on a cross-border basis. It is absolutely not the case in health that we are doing things just for the sake of it or to say that we are doing them on a cross-border basis. There are lots of positive and practical examples of both jurisdictions working together to identify and meet need in a way that is mutually beneficial. <BR /> <BR />The Chair of the Committee mentioned the good example of the radiotherapy unit at Altnagelvin, which will be on-stream towards the end of the year, we hope, treating patients from both sides of the border.”
“Sporting organisations, including the GAA for example, have been raising awareness among their members on both sides of the border. As with many issues in health and social care, we have services in place to deal with the particular problems in Northern Ireland. While there is, perhaps, a higher prevalence in some communities than others of people taking their lives, we will always have to target our resources and attention at those. There is certainly no monopoly on wisdom and ideas to deal with suicide in this part of the world. We will learn from, and share with, others, including the Government of the Irish Republic, any good practice we have, and seek to learn from their best practice as well.”
“I thank the Chair of the Committee for her question. This is an issue that, sadly, affects Northern Ireland, the Republic of Ireland and, indeed, all countries and regions. We have particularly seen the shadow cast by suicide in this part of the world in recent times. Even though the number of people taking their lives has fallen, we are still by some distance the region with the highest number of suicides in the United Kingdom. From talking to counterparts from the Irish Republic, I know that they are having similar problems, if not, perhaps, at the same level. <BR /> <BR />The Council acknowledged and supported the work being done by some organisations that have an all-Ireland focus. For example, the four main Christian Church denominations have been working through the Flourish project.”
“The Council noted the Safefood chief executive officer's report and, in particular, the launch of Safefood's weight-loss app. The Council also noted the Safefood annual report and accounts 2014 and approved the appointment of four new members and one reappointment to Safefood's scientific advisory committee, as well as the appointment of Professor Margaret Patterson as chair of the committee. <BR /> <BR />Finally, we agreed that the next NSMC health and food safety meeting will be held in the autumn.”
“We also received updates on the work of the US-Ireland R&D Partnership and on the ongoing work of the All Ireland Institute for Hospice and Palliative Care. <BR /> <BR />Ministers noted that the child protection work programme agreed at the NSMC meeting in July 2012 continues to be progressed and that a review of the current child protection work programme will be reported at a future NSMC meeting in that sector.”
“The Council received an update on the ongoing collaboration to maximise the drawdown of EU funding in the health sector and noted that our respective officials continue to seek to identify opportunities to collaborate on the drawdown of EU funds. We also welcomed a presentation from the Health Research Board on Horizon 2020 funding streams in the health sector. The Council was informed that legislation to introduce standardised packaging of tobacco products and to transpose the EU tobacco products directive is expected to come into force in May 2016. <BR /> <BR />Ministers welcomed the update on suicide prevention initiatives in both jurisdictions. The Council noted that construction of the radiotherapy unit at Altnagelvin hospital is on target and that it is planned that the unit will open and be in operational use by late autumn 2016.”
“I wish to make a statement on the twentieth North/South Ministerial Council (NSMC) meeting in the health and food safety sectoral format, which was held in the NSMC joint secretariat offices in Armagh on Wednesday 20 January 2016. Minister Michelle O'Neill MLA and I represented the Northern Ireland Executive at the meeting, while the Irish Government were represented by Leo Varadkar TD, Minister for Health, and Dr James Reilly TD, Minister for Children and Youth Affairs. Minister Varadkar chaired the meeting. This statement has been agreed with Minister O'Neill, and I am making it on behalf of us both. <BR /> <BR />We agreed that our respective officials will progress deliberations on potential additions to the current work programme and noted that officials have already commenced a review of the child protection agenda work programme.”
“I heard the Member's comment or criticism, in fact, about guidelines not coming forward from the Department of Health. Will the Member reflect on the fact that, when new guidelines on the termination of pregnancy were issued by me in December 2015, one of the Ministers who replied to those guidelines was his party colleague the Minister of Justice, who said that he did not support those guidelines? Perhaps he will reflect on that fact when he is standing in the Chamber chastising me for not bringing guidelines forward.”
“If there is a lack of clarity as to how it might operate and there may be inadvertent consequences, surely we are better taking our time to get it right. I make the offer again that the Department will work with the Committee to try to include in the regulations some way to strengthen the opt-out provisions that does not have unintended consequences. I am happy to make that offer if the House will accept it. However, I will put on the record that, if the offer is not accepted, I will oppose amendment No 2, which is on the Marshalled List.”
“Incidentally, I would have been content to accept amendment No 1, which has not been moved by the Committee Chair, and not accept amendment No 2. However, in the spirit of trying to accommodate the Committee's concerns, I am prepared to have regulations to ensure that the Committee is given its place and that other aspects of the Bill have to come forward to the House at a future date via draft affirmative resolutions and legislation. I am prepared to make a commitment that the Department will work with the Committee to seek to strengthen opt-out provisions via secondary legislation. <BR /> <BR />I have some concerns about this amendment. I understand the intentions behind it. As evidenced by the debate, it is not entirely clear how it might operate.”
“I am not saying that I do not understand the points that the Committee is making or that I do not have sympathy with its desire to reinforce people's ability and capacity to opt out of having their information shared.”
“I get that; that is easy. Let us say that a cancer charity requests the information. How does it know that it is excluding the right person? There could be several people of the same name on a list, so the charity would need to be absolutely certain that it was excluding the right person. You would have to give the charity the name to tell so that you could tell it to exclude it from the list. This is information that is not to be identified to the charity. <BR /> <BR />What I am saying is that I have concerns about how this has been drafted and what might be its unintended consequences.”
“To do that, you would have to provide the requester, with whom the individual does not want their information to be shared, with identifiable information on date of birth, where they live, when they have had treatments and all that. You would be starting to get into the realm of breaching the Data Protection Act. You would, potentially, be giving away personal information to people whom the subject of the information did not want it to go to in order to stop them getting other personal information. I am not clear as to how you would otherwise exclude them or make sure that mistakes do not happen. Surely, we do not want mistakes. The risk is that, by attempting to protect people's personal information, you actually start to reveal their personal information.”
“Then, if somebody makes a request for information and is told, "We do not want Joe Blogg's or John Smith's information to be shared", it is not sufficient just to say, "We don't want Joe Blogg's information to be shared" — or Maeve McLaughlin's or Fearghal McKinney's or Kieran McCarthy's or Simon Hamilton's as the case may be. People might be very grateful that there is only one of us, but I suspect that there are others in the country who have our name. <BR /> <BR />You would need to be crystal clear that, in excluding my information — or the Chair's or Mr McKinney's or Mr McCarthy's — you are excluding the right person's information.”
“It was never the intention that the committee would have access to individuals' identifiable information, and this amendment — I am happy to give way to the Members if they can explain it better — would require, as I and my Department read it, the committee to obtain, hold and maintain identifiable information and to share it with data controllers and requesters who may have no previous relationship with the individual concerned. Sufficient personal information would be required to enable data controllers to identify the individual and to ensure that they do not process the individual's confidential information should they hold it. <BR /> <BR />Let me explain my concern by way of an illustration. The committee's starting position would be that it does not want personal information shared where people do not want it to be shared.”
“I am just trying to work it out and highlight some of the problems associated with it, because it is not clear to me, from reading the amendment, exactly how it would operate. However, the individual could register a generic opt-out with the committee that would then be actioned as each application was considered. That is one way in which it could be done. <BR /> <BR />The objective of the Bill was to establish a clear statutory framework with robust and stringent safeguards to enable the use of identifiable health and social care information for health and social care purposes in the public interest without the consent of the individuals whose information may be used.”
“You are asking me about it, but I am trying to interpret your amendment. It is not my amendment that has come forward, so you tell me how it operates. I am trying to look at ways in which it might operate. The point I am making is that you could have a generic opt-out. An individual could register a generic opt-out for their information in every set of circumstances. That is obviously much simpler to administer than someone saying, "I don't want my information about this condition that I had treatment for to be used, but I am happy otherwise." There might be crossover in some areas; treatments might have been simultaneous. <BR /> <BR />This is not my amendment; I am not trying to explain how it would operate. I am happy to give way to the Chair or to the Member if either wants to explain exactly how they see it operating.”
“I think it is fair to say that that might pose bureaucratic problems, because if you need to do that, it is going to involve some degree of hassle for the individual, unless they have, of course, a blanket opt-out for all their information to be shared. However, in some cases it might be that they say, "In this area, I do not want it shared, but in that area I am perfectly content for it to be shared." That will have to be clarified.”
“<BR /> <BR />Amendment No 2, as far as I understand it, seeks to compel the committee — I do not mean the Assembly Committee, but the committee that will be established by regulations through an amendment that was passed to that effect at Consideration Stage — to exclude an individual's information from any authorisation given in response to an application to access health and social care information if that individual has asked the committee not to process his or her information. <BR /> <BR />As far as we understand from the amendment, its operation would require the individual to be aware of each application that is made to access his or her health and social care information, so that they could register an objection to that information being disclosed or processed.”
“The argument goes that people are unaware of the capacity to opt out under the Data Protection Act and that inserting any sort of clause or amendment to this legislation will suddenly mean that everybody is aware of their right to opt out. <BR /> <BR />If my maths is right, I think that there are 13 of us in the Chamber at this moment in time. I am not sure how many of the other 90 or so Members understand that there is this ability to opt out, and I am sure that there are probably not more than 13 other people watching proceedings. So I am not sure how awareness is increased by including any amendment on this, but I understand completely the points that Members are making.”
“Most of the debate on the amendment centres on the ability and absolute right of people, consistent with the Data Protection Act 1998, to opt out from their information being used and shared. Nothing in the Bill has ever sought to move away from that principle, which is contained and enshrined in the DPA. <BR /> <BR />I understand and, in many respects, agree with the concerns that the Committee has. We have to be very careful that information about people is not shared inappropriately, inadvertently or unwittingly. I do not accept the argument made by some that, given that there is the capacity to opt out in the Data Protection Act, somehow, by inserting anything on an opt-out to this piece of legislation, will suddenly make people aware of that right.”
“The Downe Hospital is not under threat. I have made it absolutely clear that it has an incredibly important role to play in the trust area. Some in the area — maybe even the Member — might want it to provide services at a particular level, but we have to provide services of the highest quality while ensuring patient safety. I do not want to do anything that would compromise the quality or, indeed, the safety of the service that people receive.”
“I know, from speaking to trust chief executives in all parts of Northern Ireland that they make every effort to retain staff, but it is incredibly difficult to retain staff in some of our smaller hospitals that are further away from Belfast. <BR /> <BR />I do not think that that is an acceptable position to be in; you always hear this argument about it being closer to Belfast, but sometimes we have difficulty even in recruiting for the two emergency departments in Belfast as well, and we have seen some examples of that in recent times. So, every effort is being made to try to retain staff and recruit new staff into those areas.”
“I will follow up on why the Member has not been given the answer to the question that he has asked. <BR /> <BR />Sometimes, the issue of the Downe Hospital is characterised as a south Down issue because of where the hospital is located, but the Member will be well aware that it serves many constituents of mine. I have family from the area and family still in it, and I know the special place that the Downe Hospital — the old one, in particular, but also the new one — has in the hearts of local people. <BR /> <BR />The Member will be aware of the issues that there have been, not just in Northern Ireland but UK-wide, in recruiting and retaining emergency department consultants and staff. It is something that has affected other hospitals that serve his constituency. Every effort is made to ensure that we keep staff.”
“We have already got £130 million of that. I, or whoever the next Minister is, will be making bids in the June monitoring round for further moneys to go into that system. We need that level of investment to ensure that services are maintained at their current level and that we are also spending money, which is sometimes difficult to do, on transforming our services. We have some experience of that being difficult in the past, but I want to make sure that there is a ring-fenced amount of money going specifically into transformation and change every year, so that we can make the service more sustainable in the future.”
“If I, or whoever is the Health Minister in the future, goes to the Finance Minister to make a case for more money for Health, they have to do so on the basis that it is going to improve outcomes for people in Northern Ireland — that is the most important thing — and that it is also going into a system that is going to be more efficient and it will help to make that system more efficient. I think that is the sort of argument that any sensible Health Minister should be making to a Finance Minister. <BR /> <BR />Having looked at the system, looked at demand and where it is increasing and also at the need for investment in the front line and in reform and transformation, I have already been on public record as saying that, over the next five years, the Department of Health needs another £1 billion to be spent on it.”
“I think there needs to be a significant increase in expenditure in the Department of Health over the next five years, but we have to be mindful of the fact that other Departments will have to make sacrifices to allow that to happen. I see my colleague the Minister for Social Development looking at me worriedly when I talk about sacrifices in other Departments. I think we need to be mindful of that fact. I think that some within the system are not quite mindful enough of it. We can talk about demand rising by huge percentages every year, but it is very difficult to meet that level of demand without commensurate increases in resources. <BR /> <BR />We also have to be driving forward with reforms and transformation to make the system more efficient and also more sustainable; that is incredibly important.”
“For my Department to get a 3% increase means that other Departments have to make much bigger sacrifices. The Member will be well aware of the sacrifices that many Departments are making, some facing 5% reductions in their budgets. Even in those very difficult circumstances, for the Executive to agree a Budget that increases health expenditure by 3% underscores the commitment that this Executive have made to health over the last number of years, where we have seen huge additional injections of resources into the Department, at a time when there have been immense pressures elsewhere in the system.”
“I thank the Member for his question. I noticed the comments of the BMA, and I think it is probably understandable that it will always push for more investment in health. The settlement that my Department receives, which is an increase of £130 million — nearly a 3% increase in expenditure for the Department next year — is an incredibly good settlement in very challenging budgetary circumstances. Could we spend more? Yes, we could. We could spend double, triple or quadruple what we have got, but that is not the point. We live in very confined, very difficult financial circumstances.”
“I have had discussions with them, followed by discussions with the Irish Health Minister, around the possibility of opening up transplantation into something that could happen more on a cross-border basis. There are opportunities to address — I have to be careful with my language — deficiencies, perhaps, in the Irish system that could be addressed by some of the successes in Northern Ireland and to do so in a way that enhances the experience of patients on both sides of our border. Anything like that that will improve the service is worth exploring. It is something that I have already had a conversation with the Irish Health Minister about and want to see followed up at official level in the not too distant future.”