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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“They are going to take forward the administration of the independent living fund in Scotland and Northern Ireland, and we continue to work to ensure that all the apparatus is in place so that everyone who currently receives independent living fund payments continues to do so.”
“The Member raises a very timely issue. There was some media coverage over the weekend of the decision by the previous coalition Government to do away with the independent living fund in England. The objective of independent living fund payments is, of course, to keep people with severe disabilities and conditions in their own home with a degree of support that is paid for. We in Northern Ireland have taken the decision to continue with the independent living fund and are working in partnership with our colleagues in the Scottish Government, who have taken a similar decision.”
“It will be informed by a case study carried out by the OECD, which is doing a public-governance review of the whole of the Northern Ireland public sector. Its work is focusing in particular on the commissioning system, which it will examine, assess and benchmark against best practice in other OECD member countries. I entirely agree that a properly functioning commissioning system is at the heart of a reformed, transformed and more innovative health and social care system.”
“I do. Very early on in my tenure, I attended the second annual regional workshop for integrated care partnerships (ICPs) in Northern Ireland. One of the points made to me was that our current commissioning system is a barrier to innovation in the system. I think that we all accept that we need to be increasingly innovative in our delivery of public services, not least in Health and Social Care. I am concerned when I hear people in integrated care partnerships, who are at primary care level and thus at the coalface, describe commissioning as a barrier, so we need to take action to remove that barrier. <BR /> <BR />The Member may be familiar with the review of the commissioning process in Northern Ireland that was launched by my predecessor.”
“That will require, however, a degree of courage and political consensus that, unfortunately, has not always been evident in the past when grappling with the issue of reform.”
“There is some fantastic work going on there and some world-leading research is taking place in the Cancer Centre. That is the sort of world-class vision that I have for the health and social care service. I think that we can have that right across a number of disciplines and specialisms.”
“I agree with the comments made by the Chief Medical Officer in his annual report, which was published a few weeks ago. They flow from comments made by many people who have talked about the reconfiguration, reform and transformation of our services. I made similar comments in a speech in the Northern Ireland Cancer Centre in Belfast City Hospital where I outlined not just my vision for a world-class health and social care system in Northern Ireland but the need, allied to that, to continue to reform, transform and reconfigure services. <BR /> <BR />As the Member will be aware, the Cancer Centre is a very good example of where, when services are regionalised, we can have the highest standard of care, not just in this part of the world but right across the world.”
“I appreciate and accept that it is an incredibly challenging time for all trusts. I have no reason at this point to believe that the Southern Trust will struggle to meet its pressures. It is worth making the point that I expect all our trusts to be at worse than financial break-even point at the end of the year.”
“Ambitious savings targets of around £160 million are in place this year. That adds to the two thirds of a billion pounds that has already been saved over this Assembly term through efficiency savings. I accept that those targets are, and continue to be, challenging for all in the health and social care system, but a significant amount of money has been saved and has been redeployed into front-line services. <BR /> <BR />The Member is right to identify concerns that might exist about where those savings are made. I want to see front-line services protected as much as possible. I want to see savings made in administration and procurement — areas not on the front line. It is incredibly important that trusts focus their attention on those areas rather than on front-line services.”
“I can provide the Member with a precise figure of the pressures across my Department, including all the trusts, the boards' pressures and my Department's core pressures, including the Fire and Rescue Service; the pressures on our budget are somewhere in and around £35 million to £40 million. I am sure that the Member agrees that that figure is not insubstantial. I await with bated breath the outcome of the June monitoring round, as I have submitted bids totalling £89 million. I hope to receive positive action on all those bids. If that does not happen, we will have to take decisions on the basis of whatever the outcome is, because, at this stage of the financial year, we need to give some certainty to trusts and others.”
“I will assure people in the Ards and north Down area that I will look at the evidence thoroughly before any final decision is taken.”
“I am not sure; I am not familiar with the precise detail of the consultation paper or whether the beds were considered on a like-for-like basis or in totality. The trust has communicated its belief that it can deal with the closure of Northfield House and the loss of the 14 intermediate care beds there by arranging more care for people in their homes, as consistent with the vision set out in Transforming Your Care. However, as I said, this has not yet arrived on my desk. I can assure the Member, and, more importantly, people in the north Down and Ards area who are affected, that I will look at the evidence thoroughly before any final decision is taken. <BR /> <BR />I am sorry; I should have said Ards and north Down to be strictly correct and to be able to get home safely in the evening. See how it just naturally tripped off my tongue?”
“<BR /> <BR />The point that I made to Mr Cree three or four weeks ago was that, whilst I could see superficially why a connection might be made — it was a connection that I made in my own mind — the profile of the people in the GP referral beds is very different from those in the intermediate care beds in Northfield House. Whilst in many respects it may look like the same issue, we are talking about very different types of people and patients.”
“I am mindful of the Member's point. When the preferred option for Northfield was identified by the trust, I was obviously aware that the option for the closure of the GP referral beds in Bangor Hospital was dependent on having, I think, 14 intermediate care beds in Northfield House. That was the subject of a question for oral answer last month from Mr Cree. Like the previous question, these are matters for the trust to decide, and decisions have yet to be taken. If the final decision is that the trust is to close the referral beds, that will come to me for a final say-so, and I will look at all the evidence that is presented to me.”
“<BR /> <BR />I do not want to get into the process that is going on or the whys and wherefores in judging the merits of a previous contract with something that might replace it. Suffice to say that I would want to ensure in any trust area — Western, Belfast, South Eastern or wherever — that the highest standard is achieved and is always done with an eye to ensuring value for money.”
“I am tempted to say that you almost answered the question. That is ultimately a decision for the trusts, in the circumstances in which they find themselves. The Western Trust in particular has been under significant financial pressure over the last number of years and continues to be so in this financial year. <BR /> <BR />The trust has the best-placed people to decide what is in the best interests of people in their area who need community meals. They have to take that decision, factoring in a range of issues, including ensuring the quality of the service. In the current circumstances, they will also clearly have to have an eye to the cost of current contracts and what the cost of a replacement contract might be.”
“I do not know the specifics of the outcomes. I know that the Western Health and Social Care Trust is in the process of taking forward new contracting arrangements for its community meals service and has held consultation sessions with clients who receive the service and with service providers. Feedback from those sessions will help to inform the new contracting arrangements.”
“I feel as though I am almost being scolded by the Member. She was not alone in writing to me of course about ADD-NI or indeed many other organisations that were affected by, at that stage, no decision in respect of core funding. Many Members asked me to meet them. I made it clear that I was meeting NICVA on behalf of the voluntary and community sector. I had that meeting, and a decision was taken that ensures that ADD-NI and, indeed, the other 66 organisations that receive core funding will receive 100% of what they would have expected in-year. I am sure that ADD-NI and others that received that money, and that will receive that money pending successful applications this year, will very much welcome that.”
“Again, I think that has been well received by NICVA and, indeed, other individual organisations, some of which will be members of NICVA and some of which will not. I look forward to working with them and anybody in that sector to develop the new scheme and ensure that it is in place for the start of the next financial year.”
“I met NICVA around 10 days ago. At that very useful meeting — certainly, from my perspective, it was very useful — we discussed the issues that surround the existing scheme and why I did not feel that it could continue in place and why I felt that we needed change. I think that that point was accepted by NICVA on behalf of its member organisations. I think that it has been accepted for some time. It certainly has been flagged up and indicated by previous Ministers that the core funding scheme for £4·7 million that was going to these 67 organisations would be wound down and done away with or moved to some other platform. I have taken the decision in the last week to move to this new health and social care innovation fund model.”
“<BR /> <BR />One of the reasons and motivations for setting up a fund like this has been that, from my experience in previous jobs and this one, if you want to encourage innovation and focus on things like early intervention, prevention and encourage collaboration across the system, you need dedicated funds. Everybody agrees with wanting to encourage innovation right across the public sector in Northern Ireland. Trying to find the resources from existing budgets to do that can be incredibly complex and difficult, particularly in times like now when we are under severe financial pressure. Ring-fencing and having objective-specific funds that are focused on innovation will obviously produce more innovative ideas and ensure that that important element of how we continue to deliver services does not fall to the bottom of the pile.”
“I thank the Member for his question. As I have indicated already, the focus of any new scheme will be innovation. It is encouraging that that element of the proposal has been well received by community and voluntary sector organisations so far. As I have said, I am keen to sit down, co-design and co-produce what that scheme might look like during the consultation period, which will run in the autumn. The focus will be very much on innovation and trying to capitalise on and encourage further the innovation that already takes place across the community and voluntary sector in Northern Ireland.”
“I really want to work with that sector to develop a grant scheme, which will be progressively put in place over the next number of financial years, that they can work with, we get benefit from and, more importantly, society as a whole gets a better outcome from.”
“I think it is incredibly important that, as we develop a new replacement scheme, which will be open to all community and voluntary organisations, we take particular cognisance of the fact that there were 67 organisations receiving this funding; by no means the full extent of community and voluntary organisations in Northern Ireland. In fact, there were many who did not receive funding. It is incredibly important that we work with the entirety of the sector to develop a replacement scheme, which, as I have outlined, will be focused on innovation. There is a tremendous amount of innovation within the third sector in Northern Ireland, not just in health but right across the board. I want to encourage that.”
“I thank the Member for his comments and his question. He is right: it is a decision that, since the announcement last week, has been warmly welcomed right across the community and voluntary sector, not least by some of the 67 organisations that benefit from what has been described as core funding and will continue to benefit from it — fully in this financial year but in diminishing chunks in the following two financial years. I am keen to work with the community and voluntary sector to develop the new fund that I outlined in the initial response, which we will consult on in the autumn.”
“The new scheme will focus on health and social care innovation, and it will be open to all voluntary and community organisations to apply.”
“Mr Speaker, with your permission, I will respond to questions 4 and 13 together, as they deal with core funding provided to voluntary and community organisations. <BR /> <BR />The 67 organisations that my Department provides core funding support to will receive the same level of grant in 2015-16 as they received last year. Applications have been issued to all organisations, and I have asked officials to deal with the first payment promptly, once the application is received and all relevant checks have taken place. The voluntary and community sector plays an integral role in delivering care that meets the changing needs of the population here, and it is important that it is supported appropriately. That is why my Department will consult on proposals in the autumn for a new grant scheme to be launched in 2016-17.”
“They include continuing with the development of a regional children's hospital at the Royal Victoria Hospital; a new critical care building; new maternity facilities at the Royal as well; new primary care centres in Ballymena and Banbridge and the continued progression of the new primary care centres in Newry and Lisburn; phase B at the Ulster Hospital radiotherapy unit; the redevelopment of tower block 5 at Altnagelvin; and Omagh local hospital. There are lots of capital projects that continue to progress in the 2014-15 financial year, in spite of the fact that we are short of what we would ideally like, but then that is the story in every Department. What we are doing with that £213 million is making the best use of it to ensure that the highest standard of facilities is provided for people right across Northern Ireland.”
“The capital budget for the Department for the current financial year is £213 million. We estimate that that is around £30 million short of what we absolutely need in-year — I am sure that we would ideally like to have a lot more than that — and therefore necessitates some difficult decisions around the phasing and implementation of various capital projects. Even though it is short of that £30 million, that does not mean that we are not able to proceed with some significant capital projects that will benefit service delivery across Northern Ireland.”
“I think we would all agree that, on paper, they are good outcomes, but I appreciate that there is that emotional attachment to having a service in a local area. I understand, though, that the proposed new model will allow patients from the Newry and Mourne area to receive ongoing rehabilitation at Daisy Hill from day 16 under the care of the local staff there with stroke expertise and from a specialist stroke rehabilitation team. There is still a service being retained in Daisy Hill, but it is for that rehabilitation phase rather than the early stage.”
“<BR /> <BR />I appreciate the concerns that the Member and many of his constituents in the Newry and Armagh area have about moving stroke services away from Daisy Hill. However, my understanding is that the proposal will bring about greater flexibility in the way that the Southern Trust delivers its stroke services and will mean that there will be improved levels of stroke care in line with national recommendations, so raising standards. There will be a dedicated medical nursing and allied health professional team within a specialist acute stroke unit; direct access, which is important as well in taking pressure off emergency departments, to a specialist ward on first admission; and better long-term outcomes. That is the objective of the changes that have taken place.”
“I am aware of the removal of some stroke services from Daisy Hill Hospital. This is one of the most difficult issues that I deal with in this job — not this issue particularly, but this type of issue. Trusts and the board take decisions to move services in the interests of better standards of care for our patients and with patient safety at the forefront of their mind, and that is something that we should all agree on. Sometimes, that brings about decisions whereby services are shifted and reconfigured. There are obviously many long-standing emotional attachments to services being delivered in a particular area, as well as the convenience of having those services delivered in a locality. At all times, those decisions should and will be taken on the basis of raising the standard of care.”
“<BR /> <BR />I do not have the information about whether a paediatric trauma centre will form part of the centre of excellence, and I will come back to the Member and identify whether that is the case. It is certainly a good news story for Daisy Hill Hospital and its long-term sustainability. More importantly, it is a good story for the Southern Trust area and paediatric services in that trust.”
“I thank the Member for his question and welcome him back to talking inside a democratic institution for a change. He is right: this is an important development. It assists with the sustainability of Daisy Hill Hospital and ensures that paediatric services in the Southern Trust area are linked up. What is proposed for the centre of excellence at Daisy Hill will link in very clearly with what is happening in Craigavon Area Hospital as well. My understanding is that there will be inpatient services, ambulatory care and outpatient services at the Daisy Hill Hospital and that, unlike the Craigavon Area Hospital, it will have a dedicated paediatric theatre.”
“It is anticipated that the paediatric centre of excellence at Daisy Hill will be completed by August 2017.”
“No one will be forced to leave their home, and no pressure will be placed on anybody to leave their home. I am very clear on that and want to make sure that that is absolutely the case. <BR /> <BR />The ban on new admissions has probably flowed more from common sense. Given the decisions that were pending on those care homes, it would not have been the wisest thing to have new admissions, only to then take a decision to close a home and have potential difficulties arising from that. A common-sense decision was taken. Nineteen homes were reviewed. The majority of them will either change their use or will remain in place with admissions opening up. That will mean that, in many cases and in many places across Northern Ireland, the doors will be open very soon and people will be admitted to those homes again.”
“I do not think that I can go any further than making a guarantee in writing to each resident, including the three permanent residents in Northfield House in Donaghadee, to make it clear that none of them will be moved against their will as long as their needs can be safely catered for in Northfield House. Obviously, the needs of individuals will change over time. Some may want to move elsewhere, or their care needs will alter and they might be better looked after in a different environment. However, as long as they want to remain where they are and it is safe for them to do so, that is where they will be. That is the guarantee and the promise that I can give. That follows on from what my predecessors put in place, and that is what is there.”
“I do not mean just in the closure of statutory residential care homes, which is a reflection of a reduction in overall demand for places, whether in the statutory or independent sector. That is because of conscious decisions that people take as they get older to live in their own home environment for as long as they can and as long as their needs can be catered for there. That is something that we should want to see, and most of us would want to take that decision. The system is certainly trying to encourage it, particularly through the implementation of the vision laid out in Transforming Your Care, which is to look at the home as a hub for people and to look after people's needs in the home environment as best we can.”
“I am sorry; I did not quite hear the end of that, but I can give the same assurance to permanent residents in Slieve Roe. It is a blanket guarantee, a promise across the board to all residents. That is why I took the decision not only to uphold the commitment made by predecessors but to write to each of the 80 or so residents who are affected by possible closures to make it clear to them all that none would be moved against their wishes as long as their needs could be safely met in their current care home. That stands, and I hope that it will in the future, no matter who is in this role. <BR /> <BR />On the general issue, we have to recognise — this relates somewhat to the question asked by the Member's colleague to his right — that the whole area of residential care homes has changed dramatically over the last number of years.”
“My understanding is that 26 staff are working in Northfield to take care of three permanent residents. While staffing issues are primarily a matter for the relevant trust, each trust will have redeployment and workforce planning measures in place to ensure that staff will not lose their jobs and will be used elsewhere as needed.”
“It is worth pointing it out that, whilst it is earmarked for closure and the trust said that it wants it closed, there is a consultation, and we will listen to the responses. The consultation responses will obviously be listened to, and, as I said, I encourage anyone with an interest to make their voice heard through that consultation process. There is no imminent closure because of the promise I gave that no existing resident would be moved against their wishes as long as their needs can be safely met in their current home. <BR /> <BR />It is relevant to raise staffing, because, whilst we are, I think rightly, focused most on residents in statutory care homes that are earmarked for closure, there is obviously an impact on staff as well. We should also bear in mind the impact that this situation will have on them.”
“When the South Eastern Trust's proposals are published for consultation later this summer, I encourage everyone with an interest to make their views known through that consultation process.”
“I fully appreciate that this may be a worrying time for residents of statutory residential care homes, and that is why I recently wrote to all residents in the affected homes to provide them with an assurance that they would be able to remain in their home for as long as their needs can be safely met there. I stress that no final decisions have yet been made on Northfield or, indeed, on any of the other homes being considered as part of the ongoing regional review of statutory care home provision. <BR /> <BR />The South Eastern Trust's proposals for Northfield House are subject to public consultation, and no decision will be taken pending the outcome of the consultation process.”
“I assure the Member that no permanent residents at Northfield House will be forced to leave their home against their wishes.”
“Obviously, in the intervening period since the launch of that TYC vision, the availability of resources has become an issue. That has had an impact, but it does not lessen the need to continue to pursue TYC and other reforms and transformations of our health and social care system.”
“Even in the short term, between now and 2017, it is estimated that there will be an additional £50 million of recurrent pressures — over £200 million — on our budget. The ageing population and its impact on our budgets is assessed on an ongoing basis. That is precisely why Transforming Your Care, which the Member has a very deep interest in — certainly if the number of questions that he asks me about it is anything to go by — is in place. I accept that it has not been implemented to the extent or at the pace that we would all want, but it was always a longer-term strategy: it was always something that we were working towards over a five-year period. It was always going to be very much dependent on resources being available to us.”
“The Member is right to identify the fact that an older population is putting significant pressure on our budget. I am always very careful, when talking about an ageing population, to say that that is a good thing. It is a great thing that we are living much longer and are able, because of technological and medical advances, to deal with many conditions a lot better than was the case in the past. <BR /> <BR />Sometimes, when we talk about an ageing population, there is a perception that it is a bit of a burden on the health service, but most people are living a healthier and happier life. It is not a problem, but there has been a related rise in chronic conditions, and that puts significant pressure on our resources. <BR /> <BR />The prediction, if you go very far ahead, is that over half of our population will be aged 65-plus by 2061.”
“There were two reasons why, up to this point, I have not been able to make a similar announcement: I did not have the funds available to do so; and I had not, at that stage, agreed a process to deliver vaccines using the GP network and trusts. <BR /> <BR />I am happy to announce to the House that, just yesterday, I released funding from my budget to pay for the meningitis B and meningitis W vaccination programmes. I did so in spite of the difficult financial circumstances that I face in my budget, and at some risk, but I am sure that the whole House and community will unite around me and say that it is the right thing to do. That means that the meningitis B and meningitis W vaccinations will go ahead in Northern Ireland from September this year. I am sure that everyone will welcome that good news.”
“The Member raises a very good issue. I talked in my original answer about studying the prevalence of conditions and diseases like heart disease and cancer and using that information to project future need. Sometimes, however, other conditions and diseases can suddenly and very rapidly become problems. Meningitis W is one such disease, and, right across the UK, there has been a sudden, rapid and very worrying increase in the number of cases. <BR /> <BR />I am sure that Members will be aware of the recent announcement that the meningitis B and meningitis W vaccination programmes will proceed across England and Wales in September this year.”
“— not just the costs but the costs and benefits of taking something forward.”