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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“<BR /> <BR />It is worthwhile to remind ourselves that, every year in Northern Ireland, there are over 48,000 cases of food-borne illness, resulting in 450 hospitalisations and, unfortunately, 24 deaths. That comes with an equivalent total cost of £83 million to the Northern Ireland economy. I believe that this Bill will be an important tool in helping to reduce this financial burden. <BR /> <BR />I want to highlight a couple of very important aspects of this legislation. First, the public will now be able to see the hygiene ratings of establishments that they frequent and from which they buy food. They will no longer have to make a special effort to discover the ratings because they will now be readily available in front of them at the establishment itself.”
“I am pleased to move the Final Stage of the Food Hygiene Rating Bill, which seeks to make it mandatory for food businesses to display information to consumers about hygiene standards based on inspections by district council food safety officers, with the overarching aim of reducing the incidence of food-borne illness. Not only will the Bill allow consumers to make an informed choice regarding where they choose to eat or shop for food but it will provide an impetus for businesses to achieve and maintain compliance with food hygiene law. It will, therefore, be a key mechanism for driving up the food hygiene standards of food businesses across Northern Ireland.”
“Mr Speaker, thank you for the opportunity to move the Second Stage of the Bill, and, again, I thank Members for their support, which I hope will be ongoing throughout the passage of the Bill.”
“If I missed anything substantial, I will come back to Members in writing, but I am sure that a lot of the issues that have been raised will be ironed out in the course of the Committee's consultation and scrutiny. Once again, I am grateful to everyone who has contributed to the debate on what will be, I think, a very important piece of legislation. While I am aware that we have only a short time to progress the Bill through the Assembly in the current mandate, I believe that, by working cooperatively on the issues that are in the Bill and, indeed, those that we want to introduce into the Bill, the Health (Miscellaneous Provisions) Bill can pass into law before the end of this mandate.”
“I am open to debate. I hope that I have always shown a willingness to be open to debate and discussion, but I do not think that we should be rushing or doing anything other than considering and deciding this on the basis of evidence. <BR /> <BR />I was very interested in the point that Mr McKay made on hypothecating the tax for health. That is interesting, but even though it is an obvious attempt to persuade the Health Minister to back something like this, I am not persuaded by that alone to support, at this stage anyway, the introduction of a levy on sugary products or a sugar tax. I do, however, take on board what the Chair said, and I will reflect on that as promised. <BR /> <BR />There may have been other points raised.”
“If it were very low, comparatively speaking, what would be the health, or indeed, taxation benefits from that? You might not raise a terrible lot to justify doing it, given the other impacts it would have. If the tax were high, what would be the impact on low-income families and small businesses in Northern Ireland? <BR /> <BR />We therefore need to consider the matter carefully. I take on board the point that the Chair made.”
“Although we have implemented a lot of measures, and those have changed attitudes around smoking, there is still too high a number of people smoking in Northern Ireland, even given the amount of tax that there is on a packet of cigarettes. We would have to iron out issues of legality. I suspect that, if we were to plough ahead with this, it would be open to challenge. No doubt there would be some legal challenge to it. We would have to consider what the cost impact would be on small businesses, particularly, say, on the hospitality trade. We would have to consider at what level we should introduce something like this for it to be effective in dissuading people from consuming sugary products. If it were a few pence, would that really dissuade people? I suspect that it would not.”
“Sorry, Mr Speaker. My apologies if that remark was partly in your direction. <BR /> <BR />Moreover, if we are going to levy a tax on sugary products, what about fatty products? What about fast food? It opens up a swathe of other issues. There may be a glint in the eye of the Chair at the mention of other opportunities to levy tax on other things out there. However, we have to be mindful of the fact that, if we are going after obesity, we have to be clear that going after it in this way would work and have a substantial impact. <BR /> <BR />A lot of the focus in the debate on the Bill has been around smoking.”
“There is some suggestion that those who would be hardest hit are those who can least afford it; that is, those in lower-income families. Although it might appear to be a good thing, would it substantively work? There is a complexity to the issue of obesity. It is not driven entirely by our consumption of sugary products at all. It is as much about a lack of exercise. There might therefore be an argument that we should tax a lack of exercise or a sedentary lifestyle. We should maybe tax ourselves, as being an MLA is one of the most unhealthy jobs that you can do. A tax on MLAs might actually be quite popular out there. It might also deal with the age-old mint problem. Mints might become too expensive to have at the top Table.”
“I am happy to consider that and take it away. I will do that in the spirit that it is offered. We should not rush to implement something such as this. There are many reasons why we should not rush to pass something that significant. I will certainly consider and reflect on it, and I will come back to the Chair on perhaps commissioning a piece of evidence in Northern Ireland, building on the work that Public Health England has already done on the issue. That should consider these issues: the evidence; the view among clinicians; and the view of other allied health professionals who are expert in the area. It should also consider the cost-of-living impact. We have to be very mindful of that. Who would be hit hardest by a sugar tax?”
“That goes to the heart of many problems. I understand that having a sugar tax seems to be in vogue, with many bandying it about as a solution to the problem. However, there is no consensus that it is a solution to the problem. There is also no substantive analysis of its impact, particularly in Northern Ireland. I hope that I have been consistent in saying, from the day and hour that I came into post, that, if we are to make policy changes or take policy in a different direction, particularly in an area such as health and social care, we should always seek to be guided by the evidence that is available to us, particularly when that evidence comes from clinicians.”
“She said that there was no evidence that reducing sugary, sweetened beverages in adults reduced body weight. If we are not buying full-fat Coke — apologies for the product placement — what are we buying instead? A packet of crisps.”
“I cut out a story from 'The Times' a number of weeks ago when the debate was raging across the water, with the Prime Minister saying that he was opposed to bringing in a sugar tax after a Public Health England report said that it should be considered. 'The Times' report contained comments from a lady called Catherine Collins from the British Dietetic Association. On reading the report, I initially thought that, if any organisation was going to be in favour of a sugar tax, it was probably the British Dietetic Association, but her comments were also cautionary. She warned against becoming "fixated" on a tax, saying that it was wrong to single out sugar when a bit of everything and not too much of anything remained the best advice. She went on to ask whether it would make people lose weight. No, it would not.”
“Fundamentally, I think that people need to take better responsibility for their lifestyles and diets. Like Mr McCallister, I am fully aware that I am preaching that but not necessarily always practising it. Although I do my best, I fail miserably virtually every day. <BR /> <BR />I urge caution for several reasons, however. I genuinely raise these issues in the spirit of good debate, which I am sure is what the Chair and her party want to engender. The first point is that there is no clear consensus. Some have expressed support for the introduction of a so-called sugar tax; some have been lukewarm; and others have been downright opposed.”
“You will not get any disagreement from me about the impact that our diet or poor dietary choices as a society have on public health and, by extension, the impact on the health service. <BR /> <BR />Almost from the day and hour that I have been in office, I have cited the need to reform our system. I talked about that in the context of a range of challenges that we face, such as the growth of our ageing population and technological advances. I have always talked about how the unhealthy lifestyles that we lead and our bad dietary choices present problems now. We see that particularly in the rise in type 2 diabetes but also in the long-term problems that are presenting for public health, which will make the problems that we experience now seem timid by comparison.”
“The issue has been well discussed. There should be — I sense that there is — general and broad support for an amendment, so I do not expect any problems. I will try to furnish Members, through the Committee, with a draft of the amendment as quickly as possible, so that the Committee can debate, discuss and have its view. If the Committee has suggestions, we can seek to accommodate them. I thank the Chair for her support for an amendment on the subject. <BR /> <BR />The issue that dominated the debate was not what was in the Bill but what was not there, but it was not the issue that I did not foresee not being in the Bill. That is a sort of Rumsfeldian riddle, but what I mean is a sugar tax or a levy on sugary products.”
“Points were made about smoking in public places. At the time, I was not entirely convinced about a ban on smoking in public places until I went to the United States in 2004 and saw it in operation in Massachusetts, and I was immediately convinced that it worked. It completely changed the environment in pubs and restaurants and breathed new life into them. I have been persuaded on that issue. <BR /> <BR />Mr McCallister asked how we will deal with this: I will discuss in detail with officials how we can best do it. I want to table a pretty clear amendment that is not convoluted and gets the job done. Over the last number of years, the issue has been well aired and well discussed in the Chamber. To be fair, it was not included in the original Bill, and that has sparked some debate over the last number of months.”
“I am sure that my children would look back at the television campaigns of the 1980s and think it ludicrous that people did not wear their seat belt as a matter of normal practice.”
“It is about making smokers even more aware, if they are not aware already, of their responsibilities to others and of the damage that their actions can do to others. It is not about a big, heavy-handed nanny state intervention, with the police lying in wait and trying to catch people specifically for this; it is about trying to get the message out that we need to do things differently and change that culture. <BR /> <BR />Look at other interventions, in cars or elsewhere, and the implementation of legislation that was, at the time, probably similarly defined as nanny state-ish: that has produced positive outcomes. Seat belts were mentioned, and I remember, as a young man, the campaign in the early 1980s. It seems ridiculous now.”
“I am always very conscious, on philosophical grounds as much as anything, of that accusation. It is not my preference always to intervene with the heavy hand of the state or government and legislate to solve a problem. People need to take greater responsibility for their behaviour and their life, and I will go into that in greater depth on another issue in a moment. The difference between this and some other nanny state proposals is that I do not envisage our police service enforcing a law on this in the same way as it enforces the law on speeding. It is hard to lie in wait and catch people who smoke in cars carrying children, but the police may catch people as a result of stopping vehicles for other misdeeds on our roads. In my view — I have been persuaded of this —this is about changing the culture.”
“My view is that anybody who smokes in a confined space, such as a car carrying children, is an idiot, given the multiplicity of evidence on the damage that smoking does to the individuals themselves and the well-established knowledge and information about the damage that second-hand smoke can do to others and particularly the impact that it can have on young children because, as others have said, their lungs are still developing, just as they are developing and growing. Why anybody cannot see the stupidity of smoking in such a confined space is beyond me. In that sense, we should not have to legislate for this, but I accept the argument that there is a need to do so. <BR /> <BR />A couple of Members, including the last to speak, mentioned the concern about this being seen as a nanny state intervention.”
“I expected the debate probably to centre on things that are not in the Bill, particularly smoking in cars carrying children. Virtually every Member who contributed to the debate raised that issue, and I welcome the support that many expressed for my proposal to table an amendment at Consideration Stage to address that. This is one of those areas where I do not think that an amendment or a change of law should be necessary.”
“I begin by thanking all Members who have contributed to the debate. As I said at the start, the Health (Miscellaneous Provisions) Bill is a Bill of two Parts. Part 1 deals with provisions for the sale of e-cigarettes. It is clear from those who commented on that subject today that, while e-cigarettes may have a place — I believe that they do — in helping smokers to give up tobacco, they are not products that we wish non-smokers, particularly children and young people, to use. Therefore, I look forward to the progression of the Bill through the Assembly to enable my Department to introduce regulations at the earliest opportunity to prohibit the sale of e-cigarettes to under-18s. <BR /> <BR />I do not think that anybody talked about Part 2 at all.”
“Sometimes, I think that we do not view nurses as being innovators in that sense, but the ability, the skill and the capacity that they have to implement change and to bring forward new ideas are truly impressive. I see them as critical to implementing the reforms that we need across our system.”
“The very first event that I attended when I became Minister was at the Ulster Hospital around nurses, and one of the first formal events that I attended thereafter was the Nurse of the Year awards. At both, I pointed out that I view nurses not just as one of the cornerstones of the health and social care system but as pivotal to implementing the reform that I think we all know we need across health and social care. <BR /> <BR />One of the things that I recall clearly from the Nurse of the Year awards was that all the nominees and all the recipients of awards were receiving those awards and the acknowledgement of their peers because of changes and reforms that they had initiated across the system.”
“To get a better picture of what is going on in the independent sector, I commissioned work to look at the market, what capacity there is in it and the pressures that it faces, to give us a better independent view of what is happening in adult social care and nursing homes so that we are better informed in the decisions that we make, rather than jumping to what somebody says we should do over here or over there. We will take evidence-based decisions with a full and complete understanding of what is happening in the social-care market.”
“I appreciate the concerns that remain about the operator that has been mentioned. I have no intelligence to suggest that there are others in a similar position. Of course, that is not to say that there are not pressures being faced by other operators; I understand that. When I listen to representatives of the independent sector, they articulate the pressures that they face and express concerns about future viability. Because of that and because of the uncertainty, I did a couple of things in the immediate aftermath of the Four Seasons announcement. I halted and called for a review of the closure of statutory residential care homes because of the volatility in the marketplace.”
“The announcement on Friday past that two of the homes are to be sold to other private-sector operators in the Northern Ireland market somewhat undermines the argument put forward by some that this was entirely about a failure on my or my Department's part to give enough money to those operators. I am not for one second suggesting that there are not challenges facing that sector with the national living wage or the recruitment of appropriate staff, but the fact that other operators have been prepared so quickly to step in to take over those businesses — I appreciate that they are still going through their various processes — suggests that there is a profit to be made, contrary to what has been argued by some others.”
“I think the Member's analysis is close to being spot on. There have been some who have, no doubt for political reasons, sought to blame the Department of Health for not giving sufficient money to the Four Seasons business to keep it going, through the tariff or whatever, as the reason for its failure — or, indeed, issues about the recruitment of nurses. The fact is that we have a substantial business that still provides a lot of much needed care in Northern Ireland, but its extensive, well-publicised debts, requiring over 10% of its money in interest payments, have put considerable pressure on the business.”
“If that requires me to meet people from the area to discuss their concerns, I would be content to do that.”
“I will consider any and all of these sorts of decisions where there are changes to services. I fully understand, as the Member articulated, the concerns they can raise within local communities, particularly when the possible benefit of a change has not been articulated as clearly as we would like. This is why I think it is incredibly important that trusts, when making changes to services, present local representatives or the local community with the benefit that a change will make. Clearly, in circumstances where that is not obvious, you would meet the sort of opposition that the Member is talking about. I will approach any and all of these sorts of decisions that arrive on my desk by carefully considering all the evidence presented to me, and I will seek other evidence as appropriate.”
“Obviously, decisions of this nature will have to be made by the trust and then be approved by the board before they come before me. At this stage, they have not arrived on my desk.”
“I am aware of the issues that the Member raises, not least because party colleagues as much as anybody have raised them with me. I think the Member will understand the pressures that the Western Trust is facing with its budget and in the redesign of services that people are facing. Sometimes some changes can be seen entirely through the prism of making budgetary savings in difficult circumstances. Very often, what gets forgotten is that some services will change to provide better outcomes for people. In that sense, we all need to look at these with an open mind sometimes. That does not mean that we should be supporting them willy-nilly or just because the trusts are coming forward with them. <BR /> <BR />Certainly, I am aware of the concerns that are there.”
“I do not think that we should dismiss it because it is not the same, but I am certainly keen to examine it a lot more closely to see how it relates to what the National Screening Committee is doing and to ensure that we learn all possible lessons from it, including those issues that the Member talked about, so that we can iron out any problems and wrinkles there might be.”
“I am aware that the National Screening Committee (NSC), from which our Administration and, indeed, others across the UK take guidance on issues like this, has been running its own pilot. It is due to report next year, and I will look at that evidence as well. The reason why I said that I will come back to the Member is that I am aware of what is happening at Daisy Hill through the Southern Trust. That is a different trial to the one that the National Screening Committee is doing.”
“<BR /> <BR />I know that the Member has a particular interest in this issue, and he is absolutely right to continue to push for improvements in the service for young children who have heart defects and problems and to ensure that it improves on an ongoing basis. That is something that I am committed to. I met the Children's Heartbeat Trust recently, and we discussed some of the issues that children and service users are facing. I am certainly committed to doing my best to take the service forward to ensure that the excellent service in Belfast continues and that we put the all-island network in place as quickly as possible.”
“I have become aware of the trial only recently. We all realise and acknowledge that innovation will solve many of the problems in our health and social care system that we have been talking about. It comes, sometimes, at considerable cost. That is why we are not always able to bring innovations and changes through the system as quickly as we would like. Sometimes bureaucracy gets in the way of that too. I am aware of the trial that the Member is talking about. I have to say that I am not fully apprised of it and, therefore, do not want to say too much about it at this stage. In fact, I was discussing it with colleagues in recent days, and I am keen to look into it a bit more. I will certainly do that, and I will update the Member with our views on how it is going and the impact it might have.”
“One of the reasons why I did not go down the route of a specialist fund was that I did not want to put a particular figure on it. I wanted to have clinically led decisions, made through the regional scrutiny committees, as to what was appropriate need. <BR /> <BR />I am disappointed that we have not been able to reach agreement on the reintroduction of modest prescription charges, and, therefore, this additional cost will have to be covered from elsewhere in the Health and Social Care budget, and that all, of course, puts some pressure on a budget that is already considerably challenged. However, for the reasons that the Member has outlined, which I appreciate, and I am sure others do too, I think that it is the right thing to do.”
“The Member and I have discussed the PPRS before. While I do acknowledge that we get money back in as a result of it, much of that is used annually to cover the increasing cost of drugs elsewhere in the system. So, we are not quids in or sitting with a lot of additional cash as a result of that; it is merely covering some of the costs that are there. The Member is mouthing the figure of 40 million quid — £40 million, rather; I should not use unparliamentary language such as "quid" — but it is not over and above the increasing cost of drugs right across the system. <BR /> <BR />I hope that the Member recognises, as I am sure most people will, that what I have announced today will substantially increase access to specialist drugs for people, who will have clinically-led decisions.”
“Whilst that will not help in the case that the Member raised or, indeed, some others, I hope that the Member, the House and those outside will recognise that this is positive progress in improving access to specialist drugs in Northern Ireland. <BR /> <BR />I have not agreed to move forward on the creation of a specialist drugs fund or the introduction of prescription charges because of a lack of political agreement around that issue. However, the lifting of the 95% exceptionality and the creation of the regional scrutiny committee will, I believe, substantially increase access to specialist drugs for cancer patients and others.”
“I thank the Member for raising the issue. I did not know Mr Withers, whom he mentioned, but I am sure that the Member will pass on my sympathies and condolences to his family. The Member may be aware that, today, I announced my conclusions, views and recommendations in respect of the consultation on the individual funding request. I have agreed to proceed with three of the recommendations. I have agreed to remove 95% exceptionality, which, I think, everybody in the consultation agreed was far too restrictive. I have also agreed to establish a regional scrutiny committee, which will have a much fairer, more consistent and more clinically led approach to the issue of access to specialist drugs. I am going to start work on revising guidance on individual funding requests.”
“That is not a route that I wanted to go down, and I stopped that from heading down that direction. Hopefully, that gives some assurance to nurses. However, I do think that there are issues particularly around the retention of nurses after they qualify, and I am keen to look at that. There are changes that perhaps we can make that I am sure everyone can agree with. If we are investing in fees, in bursaries, in nurses and in nursing students, I think that we want to see the benefit of that investment in the health service here in Northern Ireland. That is something that I am keen to look at.”
“It may form a resolution from some people's perspective, but I do not consider it to be a satisfactory resolution of a situation that would ensure that a contract that has been agreed by all sides previously as being not fit for purpose remains in place. That is why I want to see a negotiated settlement around this issue, and I encourage all sides to negotiate. <BR /> <BR />I am aware of the announcement that was made in the Chancellor's autumn statement on nursing bursaries. The Member will be aware that that does not impact on Northern Ireland because of devolution. When I entered the Department back in May, some work had been done by officials in looking at the issue of nursing bursaries and also at nursing fees, which, in most circumstances, I think, are paid for by the Department.”
“There are two issues, which I will try to deal with in the time available to me. On the issue of junior doctors' contracts, as I said, I welcome the fact that both sides — the Department of Health/NHS employers and the junior doctors' side — are now engaged in discussions within a short, limited time period. That is what I wanted to see from the start and I think that that is the most likely way to reach the conclusion that I want to see, which is an agreed contract for the whole of the United Kingdom. The Member said that there had been a "swifter resolution" in Scotland and Wales. I do not accept the terminology that it was a swifter resolution. Scotland and Wales took a particular decision not to impose a contract. I did not take that decision because I wanted to encourage both sides to go back into negotiations.”
“I recently made a statement indicating that I have no desire to impose a contract on junior doctors in training but that my preferred way forward is through negotiation. I welcome the outcome from the ACAS discussions between the Department of Health and the BMA and that all parties are willing to explore how best to deliver together on a new junior doctors' contract. I see this as a great opportunity, and I am optimistic that these discussions will lead to an agreed way forward. I therefore think that it would be pertinent to await the outcome of these exploratory talks before making a considered decision for Northern Ireland.”
“Actually, he did not allow it to go to 350. In 2010, which was during Mr McGimpsey's tenure, it started off at 436 members of staff, considerably north of 350 and a lot higher than the 250 that he envisaged. I presume that the people whom he was talking about, crying and wailing, were civil servants, who he told me at the Committee could not run the health service. It is pretty clear that they could wrap him around their little finger and get him to do whatever they wanted, because he nearly doubled what he wanted to start off with in the board. It is interesting to point out that, over the same period, the number of staff in the Department decreased from 670 to 446, so down 224. That is considerably more than the number of staff by which the board has increased.”
“Interestingly, when Mr McGimpsey gave an interview recently to the 'Belfast Telegraph', he said that he wanted the board to be a lean organisation. Mr McGimpsey said:”
“It is wrong to start off with Health and Social Care reforms of this nature on the basis of saving money. If we can save money — I expect that we will — that is an advantage and something additional that we should welcome. However, to reiterate the points that I made to the two Members who asked questions previously, the whole purpose of this is to create a system that gets the best out of the staff who operate in Health and Social Care across Northern Ireland. As a result of the reforms that were taken forward by the Member's colleague Mr McGimpsey when he was Minister, I do not think those staff have been given a system that maximises their talents, skills and abilities. <BR /> <BR />I accept the point that he made about the size of the board growing. Since its inception in 2010, it has increased by around 160 members of staff.”
“This is not being done with savings in mind. That is not one of the criteria that I want to see as a result of the reform. It is about reforming and transforming the system and giving our staff the best system possible in which to do their work. I envisage that some savings will be made. The budget for the board is currently around £30 million, so even a 10% saving will release £3 million. Whether it is £3 million, £2 million or £1 million of savings, I can assure the Member and the House that those will be redeployed into the front line to ensure better care for our citizens.”
“I do not envisage there being any compulsory redundancies. That is not to say that there will not be a need to get rid of some posts, but that will not be as a result of a compulsory redundancy process. It is worth emphasising the point again, given that he has raised it, that this is about getting an appropriate system in place for our staff to work in so that we can get the best from them. I do not believe that the current system is getting the best out of our staff, and the talents, skills and abilities that are there are not being optimised in a system that has far too many layers for a very small region such as ours. <BR /> <BR />What was the second question?”