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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“From June to October 2012, the Department and the Northern Ireland Social Care Council undertook a joint consultation on the proposals to reform the model of conduct used by the council. From November 2012 until January 2013, the Department and the care council undertook a further joint consultation on proposals to provide for more flexible methods for the recognition of the required standards of proficiency in social work. <BR /> <BR />Respondents to both consultations included registrants, employers, trade unions and key stakeholders from the statutory and voluntary sectors, as well as the professional body, professional organisations and universities. The responses indicated a strong level of support for implementing the proposed changes.”
“The proposed amendments in the Bill will extend the council's powers so that it can recognise learning achieved by social workers to improve their knowledge and skills through a wide range of approaches to learning and development, such as academic courses, in-service training provided by employers, and e-learning and distance learning programmes. <BR /> <BR />The formal recognition of social workers' learning by the care council provides an assurance to employers, service users and the wider public that social workers are not only maintaining but continuing to expand their skills and knowledge throughout their career in the health and social care sector in Northern Ireland. <BR /> <BR />It is important to say that all the proposed changes in the Bill have been subject to public consultation.”
“The wider range of sanctions will enable the council to address deficits in an individual's performance and thereby improve the quality and safety of care provided. <BR /> <BR />The second set of proposed amendments seeks to extend the council's powers to give formal recognition to the learning achievements of social workers. Registration with the care council requires that registrants maintain and keep their knowledge and skills up to date in order to be accountable for the quality and safety of their work with vulnerable people. <BR /> <BR />At present, the legislation allows the care council to award certificates to social workers for the successful completion of formal professional training courses approved by it.”
“<BR /> <BR />The General Medical Council, the Nursing and Midwifery Council, and the Health and Care Professions Council have a broader range of sanctions available to them for the disposal of cases of misconduct that allows them to place conditions on a registrant, such as a training condition to address an issue of competence. Recently, the legislation relating to the Pharmaceutical Society of Northern Ireland was amended to provide the society with a range of powers and sanctions similar to those regulators I just mentioned. <BR /> <BR />The sanctions available to the Social Care Council within its current model of conduct include admonishment, suspension and removal. It is proposed to introduce the additional sanctions of undertakings and conditions.”
“The current range of sanctions allows the Social Care Council to take appropriate action against registrants through admonishments, suspension from the council's register and, the most serious sanction, removal from the register. In comparison with other healthcare regulators, the range of sanctions available to the care council is limited and restricts its ability to respond flexibly and proportionately to cases where there are concerns about an individual's practice. That is particularly so where there are issues regarding health or competence.”
“I also want to ensure that the care council can continue to promote high standards in practice through the formal recognition of learning that social workers achieve through a broad range of methods, including the use of e-learning. <BR /> <BR />Specifically, the Health and Personal Social Services (Amendment) Bill aims to achieve two things. First, it will modernise the council's model of conduct and extend the range of sanctions to dispose of conduct cases. Secondly, it will extend the council's powers to formally recognise the learning achievements of social workers. <BR /> <BR />The existing conduct model is based on a determination of misconduct.”
“<BR /> <BR />It is important that the conduct model used by the care council is fit for purpose, efficient, cost-effective and commands the confidence of service users, the wider public and the social care workforce. The council's current conduct model has been in place since 2003, and whilst it has been robust and has ensured that those unsuitable to provide care have been excluded from the workforce, it needs to be updated to keep pace with best-practice developments in regulatory practice in Northern Ireland and across the United Kingdom. <BR /> <BR />My aim is to build on the strengths of the existing model while ensuring that it is modernised and reflects best-practice models used by other workforce regulators, particularly those used by professional healthcare regulators.”
“I am pleased to open the debate in the Assembly today as I believe that this is important legislation. By way of background, the Northern Ireland Social Care Council (NISCC) is responsible for the regulation of the social work and social care workforce in Northern Ireland and for the regulation of professional training courses for social workers. <BR /> <BR />Regulation of the workforce is one element of the overall framework established by my Department to strengthen safeguards for service users and public protection. It makes a key contribution in providing independent assurance to the public that those responsible for the delivery of social care across Northern Ireland will be held to account for their conduct against agreed standards of conduct and professional practice.”
“It depends. I know that the Member has taken an interest in the issue because he tabled a question for written answer to me about it. <BR /> <BR />Our job is to work with others, including Four Seasons, to get appropriate accommodation for residents. We will seek to find similar accommodation in the vicinity so that people can move with a minimum amount of disruption. As I mentioned in my response to Mr Middleton, it may be the case that, out of personal choice, some residents want to go somewhere that perhaps has a different or higher standard of care and, as such, attracts an additional payment. That is a matter for residents and their families to decide on. The assurance that I am giving is that, where they are moving to similar suitable accommodation, people will not be out of pocket as a result.”
“If the trust finds a resident a new placement, it will not cost them any more than their current placement. However, personal choice is always a key element of decisions about where people want to go. Residents remain free to make their own arrangements about their new placement, though this may have financial implications for them. If they move to similar accommodation, we will certainly ensure that they are not out of pocket any more than they already are.”
“Obviously a tariff is paid and many residents and their families pay top-ups over and above that for a higher or different standard of care. One of the things that I said last week — and just to try to take away some of the concerns that may well be there from this week — is that I gave an assurance that residents will not be financially disadvantaged by any move that they might make. That is because it will be difficult enough for residents and their families to deal with the situation that has unfolded in the last week without having that added pressure and burden of worrying about the fact that they are moving from one accommodation to another and there might be slightly more to pay. It is important that we dealt with that last week. That is why I gave that assurance.”
“That is why I have asked for a piece of work to be done to review the state of the whole sector in Northern Ireland with the impact of the range of challenges that they are facing, whether that is around the national living wage, the availability of nurses or indeed the payments that are made to them by government. What I am doing is getting that overall snapshot and picture of where the sector is and how stable or otherwise the market currently is, not a review of the tariff itself.”
“I have not got that figure to hand, but I will provide it to the Member and copy it to other Members. I am aware that the independent sector, principally Four Seasons itself, as one would expect, has been making all sorts of suggestions about the suitability of the tariff. We have looked at and compared the tariff to other local authorities elsewhere in the United Kingdom, and it compares favourably. I am not saying that it is the highest or that others do not pay more in some cases, but what we pay compares favourably to what is paid by local authorities across the water. Independent sector care providers may make some suggestions about the level of the tariff and the impact that that is having. I do not think that we should take what they are saying at face value.”
“Again, we are looking to the trust to work closely with the board, the regulator, the Department and indeed Four Seasons to minimise the disruption that will inevitably take place.”
“Working backwards; we will be looking primarily to Four Seasons to provide other employment opportunities for its staff. That may well be, as the Member says, elsewhere within that organisation or indeed there may be a possibility, given the staff shortages that there are in different homes in different parts of Northern Ireland, for people to move into other jobs with other providers. I cannot give him a categorical list of what communications the Southern Trust has had. I will write to the Member about that. The Southern Trust, like the other trusts, is involved in the joint working group that I outlined in my original answer and indeed the multidisciplinary teams that will be set up, so there will be involvement by the Southern Trust, particularly given the impact on the Member's constituency with the home in Armagh.”
“That is why I think it is important to emphasise that we want to see these residents get the appropriate care that they need — in most cases, that will be nursing care — and to try to get that as close to their current location as possible. That is certainly what we will be working to, but it is not going to be a matter of moving people who have complex nursing care needs into residential care homes. That would not be right for them, and it would not be something that we could stand over with regard to quality.”
“The Members is right; there is an important distinction. It is important that we follow that distinction through in terms of the question that he has asked about moving people with complex nursing needs into a residential care home. That would not be appropriate, particularly for those who have very, very complex needs. They would not get the standard of care that we all want to see them get. So, we need to be careful and mindful of the fact that the statutory residential care homes are not a solution for those who have complex nursing care needs. However, that does not mean that there may not be opportunities elsewhere in the state sector, or, indeed, the independent sector, to look after those who have complex nursing needs.”
“I know that that will be challenging, but that is certainly the aim, and it is certainly what I will be ensuring that officials from my Department, and others within health and social care, ensure happens.”
“Unfortunately, I cannot give the assurance on jobs that the Member is looking for, because they are not my jobs to save or rescue in the way that he is asking me to do. These are people who are employed by Four Seasons. I look to Four Seasons to act as a compassionate employer in such circumstances and to do its best to relocate the staff to jobs elsewhere in the group. I think that it has made some indications that that is the intention. Staff are, primarily, the responsibility of the employer, but I think that we all would want to see them treated with dignity and respect. Equally, we want to see residents treated with dignity and respect and, as I said in response to other Members, moved, with minimal disruption, to appropriate accommodation close to where they currently live.”
“That will be used to improve our understanding of the current challenges, and it will be used as a platform for developing our policy and operational responses moving forward. It is incredibly important that we undertake that work. <BR /> <BR />Given the issues with Four Seasons and the concerns that have been expressed elsewhere in the independent sector, it is only right that we get a view and an analysis of where the sector currently is.”
“I think that it is important that we go further than that and get a better picture. Given what has happened with Four Seasons, given what representatives of the sector have said in the media, without any substantiation, I might add, but worth listening to nonetheless, and given the issues that are looming around wages, a national living wage, and, indeed, the provision of appropriate nursing staff, it is only right and proper that we reflect on the current market position within residential and nursing care. As a result of that, I have asked officials to bring forward a detailed report on the care market in Northern Ireland, with an emphasis on the economic outlook and the longer-term sustainability of the current arrangements.”
“There are obviously concerns created by the particular circumstances of Four Seasons that raise issues around the current volatility in the sector. That is why it was important that I decided last week to halt and review the consultations in respect of statutory residential care homes.”
“We want to minimise the disruption and ensure that they are moved to appropriate accommodation as close to their current location as possible. I appreciate that that will be tricky in some cases, but the Member, the House and, more importantly, the residents have my categorical assurance that we will do our very best.”
“Mr Boylan has changed somewhat in the last number of days. He may have become a ventriloquist, using somebody else and throwing his voice. I am sure that that is the question that Mr Boylan would have asked anyway. <BR /> <BR />I appreciate there will be difficulties in doing this. It is not an easy undertaking to move 254 residents in pretty short order. It highlights the difficulties that have arisen because of a decision taken by Four Seasons to do this for its own commercial reasons. All that I can say is that I will ensure that everything that can be done to minimise that disruption is done. It is in nobody's interest to have residents, who are vulnerable people, being caused confusion and anxiety by the fact that they have to move. Nobody wants to see them traumatised any further.”
“A tariff is worked out on annual basis with the Health and Social Care Board and the sector. It differs between residential care and nursing care: £470 per week is provided for those in residential care and £593 per week is provided for those in nursing care. While there are perhaps some differences in other UK regions and some local authorities paying a little bit more, my understanding is that the rates compare pretty favourably with those provided across the United Kingdom.”
“I do not think that anybody would want to see them in accommodation or homes that are not suitable for them or are not good homes providing good standards of care.”
“I know that the Member has an interest in that home. He has corresponded with me about it, and, I think, he met a previous Health Minister — I cannot remember which one it was — about it. Obviously, we want to see standards of care in all our residential homes and nursing homes, whether in the statutory or independent sectors, at the highest possible level. I want to see the 254 residents affected by the seven closures in the most appropriate accommodation for them, which is obviously accommodation of a high standard. I will look to my officials, as they work with Four Seasons, to ensure that the residents get the most appropriate accommodation and that that accommodation is as close to where they are currently located as possible.”
“What has driven the firm to announce these closures and other closures across the UK is the fact that it is a heavily indebted private company that is having to take these decisions to ensure its longer-term survival.”
“<BR /> <BR />In answer to the questions about the impact of wages and a shortage of nurses on this decision, I think that it has been minimal. The reality of the situation with this provider is as I have outlined, with well-publicised media reports on its indebtedness and the impact that that is having on its profitability, which gives us some cause for concern. <BR /> <BR />I do not for a second denigrate or seek to diminish the issues that the Member raises about the availability of nurses or about wages and the impact that a national living wage may have on this and other sectors in health and social care, but the direct impact on this issue has been minimal.”
“I have not yet met Four Seasons. The Department has been aware of issues with Four Seasons for some time and will continue to discuss them with the company on an ongoing basis, particularly the impact of closing the seven homes. The Member is right to highlight the impact that it has on very vulnerable individuals and the concern that that will cause their families; she is also right that it is a particularly difficult time of the year. That is why I want to see my Department working very closely with others in the health and social care family and directly with Four Seasons to ensure that the disruption that there will be is minimised and that people can be accommodated in suitable accommodation as close to their current location as possible.”
“Whilst we are very concerned about what is happening with Four Seasons and are keeping a watching brief on it, there are others in the independent sector who see opportunities in Northern Ireland.”
“While some might wish to use this example of a firm that has had well-publicised difficulties to have a go at the independent sector and say that it is not the best way to provide care for our elderly people, I understand from media reports in the immediate aftermath of the announcement by Four Seasons to close the seven homes that other firms have indicated a desire to look at them, take them over and run them as a viable business. That has certainly been in the public domain. I have also met other independent providers who are not in the Northern Ireland market but are expressing an interest in being in it. Whilst there has been an issue with one provider and its viability, there are others expressing an interest in the seven homes and in coming into the Northern Ireland market.”
“There was probably very little that I could have done to arrest that. <BR /> <BR />In respect of reopening admissions, some of the consultations undertaken by the trusts on statutory residential care homes recommended that some of those homes be kept and reopened for admissions. I want to see that proceed, but I am open to the idea of reopening admissions in particular areas if that is the appropriate thing to do. It is not something that I can say authoritatively is the best thing to do in every case, but it is certainly something that I would like the board and the trusts to reflect on in the current circumstances with the volatility that there is in the market. If it is the right thing to do, I hope that they will do it.”
“I do not accept the premise of the first point about a failure by me or my predecessors. The issues with the particular provider that is closing the seven homes developed over the recent while. Although we have been aware of difficulties that it was facing, we were not aware until very latterly that, specifically, it was to close the seven homes indicated last Tuesday. I do not accept that there was much that I could have done, as Health Minister in a devolved region, to bail out a company paying over 10% on its debts and in such a difficult financial position.”
“<BR /> <BR />The Member's point about the care provided in the public sector is right, in that the public sector provides a very high standard of care, whether nursing or residential. However, that does not mean that the standard of care provided in the private sector is any less high quality. Unfortunately, debates such as this can sometimes be seen as knocking the private or independent sector. The Member is shaking his head, and I appreciate that he does not perhaps mean or seek to imply that, but we should acknowledge that our independent sector plays a vital role in providing care, whether residential or nursing, for many older people across Northern Ireland. It will continue to do so into the future. Many great people work in that sector to ensure that our older people get the quality and standard of care that they require.”
“Let us not conflate the issues. The homes looked at more recently by various trusts were, of course, residential care homes. These homes are more on the nursing care side, where a very different level of care is provided to meet the needs of residents. Last week, I took a decision to halt and review consultations on the potential closure of some statutory residential care homes. It was only right to do so in a period of obvious volatility in the market, when the biggest provider in the independent sector in Northern Ireland is in the difficulties that it is. I think that it was only right that I paused, reflected on and carefully considered the whole range of circumstances.”
“Particular issues with the company's finances and debt led it to take this decision. <BR /> <BR />My job is to work with Four Seasons as best I can and ensure that the whole health and social care family, as I outlined, works with the company to minimise the disruption that will be faced by the 254 residents and get them appropriate new accommodation as close to their current location as possible. I will make sure that the trusts, the board and the regulator all work together and closely with Four Seasons to make sure that what is a very difficult period of uncertainty and anxiety for those residents is not made any more difficult.”
“I am aware that there are concerns expressed by the sector about the impact, for example, of a national living wage, which has not been implemented yet and therefore had no direct bearing on this set of circumstances. <BR /> <BR />I was and am aware of the issues pertaining to this particular provider. That is why pointing the finger of blame in my direction, as the Member has sought to do, is completely baseless. A recent media report highlighted the fact that Four Seasons is a particularly indebted company, which, according to a recent report in 'The Guardian', is paying more than £50 million a year in interest on debts of £500 million. Paying over 10% on your debts is an incredibly high rate for any firm and makes it very difficult for a company of any size to deal with, even the biggest care provider in the UK.”
“Given the fact that it is an incredibly serious issue that affects 254 residents and their families, and, indeed, over 300 staff, it is disappointing that the Member, in his opening comments, chose to make a baseless political attack on me. It is absolutely disgraceful that, on such an important issue, the Member seeks to do that without any justification whatsoever. <BR /> <BR />I am aware that there is a range of issues facing the sector. The Member mentioned some of them around staffing issues and a shortage of nurses, which is something that that sector, all sectors in health and social care, and, indeed, all parts of the United Kingdom and far beyond, are facing.”
“Staffing is a matter for Four Seasons Health Care as their employer.”
“The aim is to ensure that any relocation will be managed, with minimal disruption to residents, and that they are able to remain as close to their original location as possible. The continued well-being of residents will be the priority in dealing with the transition to alternative care arrangements. <BR /> <BR />My Department has established a joint working group with the Health and Social Care Board, the RQIA and the trusts to monitor developments and oversee the resettlement of the residents affected by the closures. Within the trusts, multidisciplinary teams have been established to work through the detail of all the moves to identify new placements and to manage the terms of all the moves. You will appreciate that that is a complex and difficult task, and team members will therefore be drawn from across the trusts.”
“First, I should say that Four Seasons Health Care has taken a business decision to close those homes. That decision was taken independently of the Department and the Health and Social Care Board, and we had no input to the analysis conducted by Four Seasons that led to the decision. <BR /> <BR />I fully appreciate that the closure of seven nursing homes by Four Seasons Health Care will impact on many residents and their families, and will cause great anxiety and uncertainty for those directly affected by the closures. My Department is working closely with colleagues in the Health and Social Care Board, the health and social care trusts, the Regulation and Quality Improvement Authority (RQIA) and Four Seasons Health Care in developing plans to manage the transition to alternative care arrangements.”
“I thank the Members who contributed very briefly to the debate. In particular, I thank the Committee and the Chair for accepting the amendment and for the support that has been shown. As I indicated previously, the reason for the amendment is to provide clarification on notification under the provisions of the Bill, which will facilitate district councils in effectively and efficiently implementing the food hygiene rating scheme. I ask Members to support the amendment.”
“It has also been noted that section 24 of the Interpretation Act would require the notification of a rating to be sent by registered post, which would not be a practical or cost-effective method for district councils to adopt. The issue has been addressed by proposing this amendment to clause 17, which is entitled 'Interpretation' and provides clarification on notification. I trust that Members will appreciate the need for the amendment and will understand that, from an operational perspective, it makes good sense. I ask them to give their support to the amendment.”
“However, it has been established that it would be open for a food business operator to argue that the reference in clause 3(4) to when the notification is received more naturally suggests actual receipt and, therefore, raises a contrary intention sufficient to disapply section 24(1) of the Interpretation Act (Northern Ireland) 1954.”
“The proposed amendment is a purely technical one that relates to clause 17. Through engagement with district council officers, who will be responsible for implementing and enforcing the provisions of the Bill, an issue was identified with regard to clause 3(4), which has the potential to cause district councils operational difficulties in the effective and efficient operation of the scheme. <BR /> <BR />The issue relates to a food business operator receiving a notification of a rating under clause 2, which is deemed to have taken place when the conditions in section 24(1) of the Interpretation Act (Northern Ireland) 1954 are fulfilled.”
“I beg to introduce the Health (Miscellaneous Provisions) Bill ) [NIA 72/11-16], which is a Bill to regulate the sale of nicotine products and tobacco, to amend the Health and Personal Social Services (Northern Ireland) Order 1972 and the Health (Miscellaneous Provisions) Act (Northern Ireland) 2008 in relation to the provision of health care; and for connected purposes.”
“I hope that Members can see from what I have said that, as Minister, I am aware of the concerns not just of those who are present today but of our older people and the people who care for them, whether they are family or friends or professional health and social care staff. I am also aware of the pressures, financial and other, on our statutory bodies and the independent sector, which provide important, valuable and professional services to our older people. Finally, I put on record my appreciation to everyone who provides support and assistance to our older community, as, without their dedication, a lot of our older people would be worse off.”
“It highlights evidence of a global shortage of nurses at present and emphasises the need to retain newly qualified nurses to work in Northern Ireland. One of the recommendations of the workforce review is that all employers review their recruitment processes and work to make their organisations employers of choice to encourage the retention and recruitment of nurses. A number of initiatives outlined in the workforce review are being considered to support the independent sector. A career pathway for nursing and midwifery in Northern Ireland has been developed and is intended to encourage nurses to see Northern Ireland as a place of opportunity. It has a section devoted to the independent sector. <BR /> <BR />In conclusion, I thank everyone for their contribution.”
“It is intended that the review will shape the future of domiciliary care provision, taking into account the financial and other challenges facing the sector. My officials, in conjunction with colleagues in the board, are reviewing both reports, and I look forward to receiving their recommendations on the way forward. <BR /> <BR />My Department is aware that the independent sector providers are experiencing recruitment and retention difficulties as their need for registered nurses increases to meet the needs of a growing complexity of care in the sector. The Department recently completed a nursing and midwifery workforce review that included the independent, voluntary and private sectors, and officials are considering its implementation.”