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.”
The complete record
Every one of 3,625 lines we hold for Simon Hamilton, in date order, each linked to its source. Free to read, in full, without an account. Page 33 of 73.
“<BR /> <BR />Recently, the outgoing Commissioner for Older People highlighted her concerns about the domiciliary care sector at the Health Committee and in her report 'Domiciliary Care in Northern Ireland'. First, I assure Members that my Department is committed to providing a high-quality domiciliary care service to support our older people to remain in their homes. Although I was disappointed by the way in which the report was published, it is, as we have discussed today, clearly a crucial area. The Department recognises that the domiciliary care sector faces significant challenges, as so many sectors do. To address those issues, the Health and Social Care Board has published its report entitled 'A Managed Change: An Agenda for Creating a Sustainable Basis for Domiciliary Care in Northern Ireland'.”
“The intention is to ensure that any relocation will be managed with minimal disruption to them, that they are able to remain as close to the original location as possible and that there will be no additional financial implications created by the move. All the organisations that I mentioned, including the owner of the homes involved, are committed to ensuring that there is clear, regular communication with residents and their representatives to address any concerns that may arise. I assure the Member and the House that, as Minister, I will, as far as I can in respect of a decision made by a private company, ensure that that is done as well as is possible.”
“However, he raised particular concern about what would happen to the residents in the seven homes that are proposed for closure. The board is working closely with my colleagues in the Department, the RQIA and the health and social care trusts. They are working together and will continue to work closely with Four Seasons to ensure that there is regional and local coordination in managing the process of moving people away from the homes that are earmarked for closure. <BR /> <BR />I also want to put it on the record that the continued well-being of residents will be the priority in dealing with any future transition to alternative care arrangements.”
“I have been keeping developments under constant review, and, as a consequence of those growing concerns and further negative developments today regarding plans by Four Seasons Health Care to close seven homes across Northern Ireland, I am asking the Health and Social Care Board to halt and review the proposed closures of statutory residential care homes. Given that many of the proposals are predicated on spare local capacity in the independent sector, it is only right and proper to pause, reflect and give careful consideration to issues arising in the independent sector. <BR /> <BR />Mr McGlone raised issues around the 250 or so people who would be affected, never mind the 300 or more staff who would be affected.”
“<BR /> <BR />I am aware that Members have in the past and this evening raised concerns about the proposed closure of statutory residential care homes in their constituencies, including the proposed closure of the Westlands nursing home in Cookstown. Trusts have been engaging in consultations, with three already complete and two still outstanding. When concluded, those proposals are to be forwarded to the board for consideration before they come to me for a final decision. To date, none of them has made it as far as the Department. In spite of what Mrs Overend said, I have not closed any homes. <BR /> <BR />I have been increasingly concerned about a range of pressures facing the independent sector and particular problems facing one of the largest independent providers of residential care in Northern Ireland.”
“<BR /> <BR />We have also established 17 integrated care partnerships (ICPs), which all have agreed action plans in place as well as funding for a range of service change initiatives. The initial focus of ICPs is on frail older people and those, regardless of age, with certain long-term conditions such as stroke, diabetes and respiratory conditions. Alongside the review of care pathways, they are engaged in risk stratification work to identify patients in the priority areas — stroke, diabetes, respiratory conditions and frail elderly — who are at significant risk of poor outcomes because of their condition. That work will enable GPs to identify patients who are at risk and therefore require proactive case management to help them to manage their condition effectively and to avoid unnecessary acute admissions.”
“Projects directly addressing the need for services designed to meet the needs of older people include the adoption of a regional approach to the delivery of reablement services that help people to remain independent at home for longer; reviewing domiciliary care provision, linked to the work on reablement, with the aim of providing a consistent service across Northern Ireland; and the promotion of self-directed support, which empowers service users and carers to exercise more control over their social care services by giving service users as much control as they want over their personal budget, the amount of money identified and allocated by the health and social care trust to meet their assessed needs. That enables service users to make informed choices about how and when services are provided.”
“<BR /> <BR />TYC made the case that preventative approaches can deliver better outcomes and set proposals on supporting older people, including home as the hub of care for older people, with more services being provided at home and in the community; a major reduction in statutory residential accommodation for older people as a result of a focus on promoting healthy ageing, individual resilience and independence; and a diverse choice of provision to meet the needs of older people, with appropriate regulation and safeguards to ensure quality and protect the vulnerable. <BR /> <BR />Despite the financial pressures that have slowed the transition to the model of care envisaged in TYC, steady progress has been made in transforming health and social care service delivery.”
“While, of course, it is a significant achievement that people live longer than ever before, it is essential that government in Northern Ireland faces up to the challenges presented by an ageing population. <BR /> <BR />The process of reform to meet the challenges confronting the provision of health and social care in Northern Ireland did not start with Transforming Your Care. However, TYC identified in a single comprehensive document the serious pressures facing the health and social care system going forward. The review set out a very strong case for change, recognising that no change was simply not an option, and made proposals on where service changes would have most impact on those challenges.”
“<BR /> <BR />The continuing growth in demand for services for our older people should not be and is not underestimated by my Department, and I believe that we are taking steps through Transforming Your Care and other initiatives to provide and improve those services. The growth in demand was also one of the main reasons why I recently outlined the need to significantly reform our health and social care system <BR /> <BR />It is widely recognised that Northern Ireland, like many other countries, has an ageing population, something that is very good. Projections from the Northern Ireland Statistics and Research Agency (NISRA) indicate that the population aged 65 and over will increase by 26% — 71,000 people — by 2022.”
“I begin by joining others in passing on my condolences to Mrs Overend and her family on the recent loss of her grandmother. <BR /> <BR />I thank her for proposing the Adjournment debate. I have listened to the range of views expressed by Members — the hardy few who are in the Chamber at this time — and I will do my best to respond to most of the issues raised. I would also like to take the opportunity to outline and highlight some of the work being undertaken by my Department, the Health and Social Care Board and the trusts to provide care for older people across Northern Ireland.”
“I beg to introduce the Health and Personal Social Services (Amendment) Bill [NIA 68/11-16], which is a Bill to make provision about the Northern Ireland Social Care Council and other provision about social care workers.”
“I must be privileged, Mr Principal Deputy Speaker. The Member stated my view. Does she accept the important letter that I read into the record, which will be available on the Department's website and in the Assembly Library. It states that it is the view of the clinicians and consultants in the transplant centre at the Belfast Trust that we should be cautious, wait and see and view the Welsh experience before moving forward in Northern Ireland? Does she accept that that is their view?”
“Strong views on either side of the argument clearly exist in the Chamber, just as they will exist in our community. As we move forward with the issue, I caution that those who oppose the Bill today are not pilloried as being against organ donation. Quite the opposite is true, I am sure. Concerns about the state overreaching or adding stress to bereaved families at a very difficult time are entirely legitimate and should be respected and not characterised as being against organ donation or opposed to more donors. <BR /> <BR />It is an incredibly important issue, deserving of mature debate and careful consideration. I urge the House to debate the issue intensely but without rancour and to carefully consider the issues raised today.”
“If the Member for Upper Bann illustrates a willingness to work with me and my Department to make the legislation workable and reflect the fact that the experience of elsewhere must be taken into account before full operation, I will not stand in its way today. However, if the legislation put before the House at a later stage is still concerning clinicians, I will revisit my position.”
“There are too many elements of the Bill that are too unclear and uncertain in such an incredibly important and potentially controversial piece of law. Just a few days ago, the British Medical Association, which had been supportive of the Bill, wrote to all MLAs expressing concerns about clause 4, stating its belief that the current drafting "could lead to confusion". Whenever supporters of the Bill are sounding notes of caution, we should respect that and reflect it in our scrutiny. <BR /> <BR />I believe that it is critical that we take our time, consider the clinical evidence and get this right.”
“She exhibits a willingness to accept the need expressed by the team of consultants at the renal transplantation centre that waiting and seeing is the best course of action. If she is willing to embrace the need to reflect this in her Bill by way of an amendment, in spite of my serious concerns, I am prepared to work with the Member and make resources from my Department available to craft the Bill into one that is workable and that reflects the need to consider the views of clinicians, the evidence available and the experience in Wales, should the Bill pass Second Stage today. <BR /> <BR />For our part, my senior official who is leading on this issue has already met Mrs Dobson to indicate my Department's willingness to engage with her because, believe me, this Bill needs some work.”
“I firmly believe that my Department’s policy of increased public awareness, education on the key issues, promoting the new organ donor register and the further development of transplantation services through UK-wide action is the best way forward for organ donation in Northern Ireland. <BR /> <BR />I believe that it would be better for this Assembly to wait and see the impact of the introduction of the statutory soft opt-out system in Wales next month. As it stands, this legislation would come into full operation on 31 May 2018, regardless of the Welsh experience or the clinical evidence available between now and then. I do not believe that either can be ignored. <BR /> <BR />I will listen very carefully to Mrs Dobson as she concludes the debate.”
“<BR /> <BR />My predecessors and I have previously stated that making a decision on any legislative change for organ donation is not one to be taken lightly, just as an individual's decision to go on the organ donor register should not be taken lightly either. The last place we want to be is, in seeking to do the right thing for the right reasons, actually doing the wrong thing. That remains my position. It also appears to be the view of clinicians. <BR /> <BR />The new organ donor register also needs time to establish public awareness of the additional registration options. It is hoped that the new register will encourage more people to donate their organs and to make their wishes clear.”
“I said at the start of my speech that I share the aim of the Member for Upper Bann to see many more of our fellow citizens who need an organ to improve their health, and, indeed, in many cases, to save their life, receive that organ at the earliest opportunity. The debate around this Bill has made me think about the issue in ways that I had not thought about it before. It has provoked not just my own thinking, but conversations in my family. I have, for the first time, signed up to the organ donor register. While I may have some misgivings about the Bill, it has at least made me see the merits of voluntarily signing up to the register.”
“My Department would therefore need additional resources to implement this Bill. <BR /> <BR />I think that legitimate questions exist about the human rights compliance of this legislation, and I will be seeking the Attorney General's view about that important aspect. I hope that the Assembly will see from my comments that, if this Bill passes to Committee Stage today, the Committee will need to ensure that the content of the Bill is clear and leaves no room for ambiguity in its interpretation if it becomes law. <BR /> <BR />I have raised some important points of caution. I have also set out the views of clinicians as they have conveyed them to me. I want to set out my own position on the Bill.”
“That estimated cost would cover new investment to set up and maintain the infrastructure required to operate a statutory soft opt-out system of organ donation. The costs would include business and system changes, the processing of opt-out requests, public communications and evaluation. In addition to the new investment in infrastructure, costs would also likely be incurred from any increase in the number of organs retrieved from deceased people and transplanted. Those are variable costs that will differ by organ type. Currently, my Department contributes in the region of £2 million annually to NHS Blood and Transplant, including for the retrieval and transport of organs given by donors in Northern Ireland that are clinically suitable for patients awaiting an organ in the rest of the UK.”
“In 2012, the Welsh Government estimated that the cost of implementing similar legislation in Wales would be £8 million, discounted over 10 years. On a population-proportionate basis, the estimated cost of implementing the Bill in Northern Ireland is therefore £5·3 million when inflation is taken into account.”
“<BR /> <BR />Clause 1 in the Bill places a duty on my Department to promote organ donation in a campaign at least once a year that informs the public about the circumstances in which consent to transplantation is deemed to be given and the role of relatives and friends in affirming deemed consent. The campaign should also increase awareness about transplantation. My Department has estimated that the annual recurrent cost of that campaign could be in the region of £250,000. <BR /> <BR />I understand that the Member for Upper Bann has said — indeed, she repeated it today — that information available to her indicates that the cost of implementing the Bill is likely to be between £2 million and £5 million.”
“My Department believes that it will be essential for it also to produce a code of practice to ensure that guidance on the new transplantation policy proposed by the Bill is available for healthcare professionals, patients and their families — guidance that they can easily understand and apply at hospital level. In addition to the codes of practice, there are other important operational matters that will require careful consideration. Those include an assessment of the impact on critical-care capacity in our hospitals of an increase in the number of donors.”
“<BR /> <BR />Clauses 5 and 8 are also important, owing to their ethical intent. The clauses cover issues concerning the capacity of individuals to consent and, again, need to be clear and easily understood. They also need to be considered in the context of the Mental Capacity Bill, currently under consideration by the Assembly, to ensure consistency of approach. <BR /> <BR />The schedule to the Bill proposes extensive amendments to the Human Tissue Act 2004 and the related codes of practice issued by the Human Tissue Authority. If the Bill passes to Committee Stage, my Department will need to consult the authority fully on those amendments, as its codes will provide guidance on the implementation of the Bill's amendments to the 2004 Act.”
“<BR /> <BR />In deemed consent cases, the individual specified through qualifying relationships in clause 10 will be an important reference for the necessary information about the views of the potential donor in order to ensure that the donation does not go ahead if the deceased had a known objection to organ donation. Deemed consent as described in the Bill is at the heart of some of the most difficult conversations that any family might face. We must therefore ensure that the Bill provides appropriate safeguards in that sensitive area. One aspect of clause 4 in particular concerns me and needs more consideration and is to do with the designation of a "friend of long standing" in clause 10(1)(h). Nowhere in the legislation does it detail what a "friend of long standing" is, what counts as long-standing or what constitutes a friendship.”
“<BR /> <BR />We need to ensure that the Bill gives clear direction on the regulations to be made by my Department in subordinate legislation. Those regulations are required under clause 7, which deals with express consent to transplantation activities involving excluded material, clause 8, which deals with deemed consent to activities involving material from living adults who lack the capacity to consent, and clause 9, which deals with appointed representatives to express consent for transplant activities. Clause 9 is especially important, where the individual concerned may disagree with the views of appointed representatives on organ donation.”
“<BR /> <BR />If the Bill completes its Second Stage today and moves to Committee Stage, appropriate and sufficient time must be given to scrutinising a Bill of such importance. I know that the Committee has a busy workload at present, and giving the Bill sufficient and appropriate scrutiny could mean that other legislation falls. I have heard it suggested that the Committee Stage be expedited or that all evidence sessions be held on one day. That would be a mistake. It would not reflect the seriousness of the legislation, nor would it permit proper scrutiny. It would not inspire public confidence in the outcome either. I look to the wise judgement of the Committee Chair and members to ensure that the Bill gets the most robust scrutiny.”
“Should the Bill pass its Second Stage today, that view will be more important than ever. If it does not, I am still prepared to work with our clinicians, especially as we will have evidence from Wales's experience to consider. <BR /> <BR />I will now make some comments on the detail of the legislation. If it becomes law, the Bill will have significant implications for my Department's organ transplantation policy and for everyone in Northern Ireland. We must therefore ensure that it provides maximum clarity about the donation and use of human organs in transplantation. That will be of concern to all in Northern Ireland, who in the future may be faced with making decisions on the donation of their loved one's organs.”
“So, regardless of whether the Bill passes its Second Stage, I want to carefully consider the clinical view and the evidence about an opt-out system. To that end, it is my intention to establish a working group that will do just that: consider what clinicians believe is best, and examine the available evidence about an opt-out system.”
“Clearly, they are urging caution; a wait-and-see approach, not ruling out legislation forever, but urging us to defer change. <BR /> <BR />This is undoubtedly an emotional issue, but that does not mean that we can or should simply ditch evidence. On a range of issues, I have found that, as Minister of Health, I am encouraged by others to set to one side my personal beliefs, wherever they might emanate from, and follow the science and the evidence. On an issue as potentially far-reaching and controversial as this, we would do well to examine the evidence and listen to our clinicians. Views like those recently expressed by Professor John Fabre, of King's College, London, who wrote in the journal 'Clinical Evidence' that:”
“The Public Health Agency's evaluation work found that 6% of those currently on the organ donor register said that they would opt out of the system if it became mandatory. Some 23% agreed that organ donation is a gift which the opt-out system will take away. There is a worrying risk that a sizeable number will remove themselves from the register forever. <BR /> <BR />The second significant section in the letter surrounds the consultants' and surgeons' explicit care for caution. They say:”
“I am sure that none of us, least of all Mrs Dobson, wishes to have a detrimental impact instead of a beneficial one. However, that is what the consultant nephrologists and transplant surgeons at the City Hospital fear, and that should sound a note of caution. <BR /> <BR />I understand their point about a potential negative impact. At present, regardless of the register, 100% of individuals are potential donors and specialist nurses and clinicians have to have the extremely sensitive and difficult conversations with relatives after a death. The experts fear that, if there is a level of backlash against legislation, a large number of people opting out from the outset, could limit that from 100% to, say, 70% or 75%. Clearly, that would not be an outcome that any of us would want, but it is certainly a distinct possibility.”
“That letter is signed by the consultant nephrologists and transplant surgeons at the Belfast Health and Social Care Trust. <BR /> <BR />They are lengthy, but powerful and important words and we should listen to them. Two sections of the letter stand out for me. First, the clinicians state, and I repeat:”
“They are a truly amazing team of professionals whom we ought to be immensely proud of. <BR /> <BR />I have given my view, but, on a subject as serious as this, it is of paramount importance that we hear loudly and clearly the views of clinicians. Whatever we feel about the Bill, they will have to operate with the legislation that we might pass. The consultants in the aforementioned regional centre for renal medicine and transplantation in Belfast City Hospital collectively as one wrote to me to express their common position on the Bill. Their views are worth hearing, so I will read their letter in full and will publish it on the Department's website as well as placing a copy in the Assembly Library. The letter reads:”
“In my time as Minister, I do think that I have met a group of clinicians more dedicated to their work and less afraid to tell you that they want to be world-class. The world-class nature of the service was clearly seen on 13 September when a record five kidney transplants took place in less than 24 hours. That falls just one short of the world record of six transplants in a day, in Texas in 2013, and equals the UK record of transplants performed in a single unit on a single day. A team of 14 doctors, 20 nurses and three scientists were critical to the effort. Notably, several operating theatre nurses came into work on their day off. I am sure that the Assembly will join me in paying tribute to their remarkable skills and dedicated service to their community.”
“If statutory soft opt-out significantly increases the number of donors and transplants in Wales, many may wish to consider legislation more favourably; if it makes little or no difference, the cautious approach that I advocate will be seen to have been prudent and sensible. <BR /> <BR />Having made clear my views on the central principle of the Bill and before I make some comments about its content, I would like to say a few words about the team that would be required in part to deliver the Bill in our hospitals if it becomes law. I visited the regional centre for renal medicine and transplantation in the Belfast Trust and met the excellent team that provides that life-saving service. They are an impressive group of professionals.”
“Previously, we could register only to be an organ donor: the new register provides options to formally register our wishes to be a donor or not to be a donor and to record the details of two representatives to make the decision for us after death. The new organ donor register has, therefore, given us the ability to voluntarily opt out and to nominate named individuals to make the decision to donate or not to donate our organs. <BR /> <BR />Let us not rush to legislate when we have the opportunity to learn from the experience in Wales and the impact of the new organ donor register in the months ahead.”
“Northern Ireland and Wales operate their organ donor awareness and transplantation service under the United Kingdom's NHS Blood and Transplant partnership, as do England and Scotland. Northern Ireland and Wales have been members of this successful partnership, which, in the past 21 years, has enabled 55,000 people across the UK to receive an organ transplant. Northern Ireland and Wales have a similar culture that shapes social attitudes towards organ donation. We also have the opportunity in the months ahead to assess the impact that the NHS organ donor register, launched in July, will have. The new register extends the choices that a person can record when they sign it.”
“I say that because we will have the opportunity to learn from the impact that statutory soft opt-out will have on organ donation in a part of the United Kingdom when this system comes into operation in Wales next month.”
“Given that the NHS Blood and Transplant strategy does not propose that soft opt-out legislation should be introduced as a UK-wide policy, I ask Members to consider whether the introduction of the Bill is premature.”
“<BR /> <BR />My Department's policy is to fully implement the NHS Blood and Transplant strategy on organ donation. The strategy does not propose that soft opt-out legislation should be introduced as a UK-wide policy. The strategy aims to raise awareness and increase the number of donors and donated organs through society and individuals, NHS hospitals and staff, NHS Blood and Transplant and commissioners working together to achieve the desired outcomes. My Department is committed to working with our partners in England, Scotland and Wales to achieve NHS Blood and Transplant's overall aim, which is for the United Kingdom to match world-class performance in organ donation and transplantation.”
“While the Bill makes provision for families to have the last say in the clauses covering deemed consent and affirmation, even with those safeguards, the Bill, if enacted, will introduce a fundamental change to our organ donation policy in Northern Ireland. These are radical changes, and I fear that the proposed move to statutory soft opt-out could undermine the achievements of the last 21 years by making organ donation a controversial act rather than the act of generosity that it is today. I know that some will say that, if a statutory soft opt-out system saves even one additional life, it is a step worth taking: I would reply that the success of the voluntary system of registration over the past 21 years should not be changed without careful consideration of the potential consequences.”
“There is no clear evidence that a statutory approach will deliver significantly higher rates of donated organs than we have today. In fact, while Spain, which has been much mentioned during the debate, is recognised as having a higher number of donors than the United Kingdom, it does so without having an opt-out system. It legislated for one but never properly or fully enacted it. Going by 2013-14 statistics, Northern Ireland's donor per million figure is also higher than those of many countries around the world — like Estonia, Austria, Italy and Finland — that have opt-out or deemed consent systems. <BR /> <BR />Until this year, we have never had a statutory requirement anywhere in the United Kingdom to make clear our wishes about donating our organs after death.”
“That is why I ask Members to think very carefully about giving their support to the Bill, because it proposes that, in future, in Northern Ireland, we will move from a tried and tested voluntary registration system to a statutory soft opt-out system of organ donation. That would be a major change in our long-standing approach to organ donation. In doing so, the Bill raises important issues of ethical, legal, medical and social significance that require careful consideration by the Assembly. <BR /> <BR />Laudable as the Bill's aims are — none of us would disagree with the objective of increasing the number of donors who could help to save lives — the Bill asks the Assembly to take something of a leap in the dark, because we have no way of knowing what the impact of the Bill will be.”
“In the last 21 years, more than 55,000 people across the United Kingdom have received an organ transplant thanks to someone donating when they died. A total of 21 million people across the United Kingdom have registered to help others. At 30 September 2015, 647,237 people residing in Northern Ireland were on the UK organ donor register. That is approximately 42% of the adult population. The number of registrations per year on the organ donor register has increased from 16,657 in 2010-11 to 36,111 in 2015, so the number of people registering is rising considerably. Those are remarkable achievements, and Northern Ireland has played its part in the success of the organ donor register.”
“I am grateful for the opportunity to contribute, to respond to some of the points that were made in the debate, to set out the work that is being done by my Department and to explain my position on aspects of the Bill. I acknowledge the Member for Upper Bann's achievement in bringing her Human Transplantation Bill before the Assembly and her contribution to raising awareness about organ donation. I know that she has strived for this, and I share her aim of seeing many more of our fellow citizens who need an organ to improve their health or, indeed, in many cases, to save their life receive that organ at the earliest opportunity. <BR /> <BR />This year marks 21 years of the NHS organ donor register.”
“<BR /> <BR />It is worth re-emphasising, if I may, his commitment and that of Minister Poots when he was in post, and which I have reiterated: if a final decision is taken for closure, no resident in any of the homes that are earmarked for closure will be moved if they do not wish to move.”
“I thank the Member for his question. I know that Slieve Roe House in Kilkeel is an issue that he has a deep and long-standing interest in. As he will know, the recommendation from the trust, which went out to consultation, was that Slieve Roe should close. However, the board recognises that there are limited alternative options available in the Mourne and Kilkeel area, and it has agreed to reopen it to admissions until alternative options, in particular the proposed 12-unit supported living facility, become available in the spring of 2017. Those proposals have gone to the board, and they will come to me as Minister to ultimately sign off on. I will consider a range of factors before making my final decision.”