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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“I can also report that a new resource, in the form of a pack, has been issued to newsrooms in Northern Ireland to try to encourage sensitive reporting of what are tragic events for families and communities.”
“That was updated last year, and the update took account of advances in technology, particularly around social media and the Internet, over that period. The Public Health Agency conducts media monitoring in conjunction with the Samaritans, and it looks at any reporting of suicides in Northern Ireland and identifies what might be described as insensitive reporting. The guidelines also try to encourage the media to use different, more sensitive terminology around suicides and to talk about "died by suicide" rather than "committed suicide". We can all understand that we get used to using a certain lexicon. It can be hard to change vocabulary. Occasionally, training is also provided for journalists, because some people move in and out of newsrooms, and it is therefore important to keep them updated on the guidelines.”
“I thank the Member for her question. She is absolutely right. The tragedy and the impact of suicide is particularly in our minds today after the news of the tragic death of Ronan Hughes, and I am sure that I speak for everyone in the House when I say that I pass our condolences on to his family. <BR /> <BR />Reporting suicide presents a range of challenges for our media. On the one hand, there is an important role to be played by the media in Northern Ireland in raising awareness of suicide, but, on the other hand, sensationalist reporting can distress bereaved families and can run the risk sometimes of encouraging copycat suicidal behaviour. So, it is a balance that the media has to find in reporting. <BR /> <BR />Media guidelines were issued in 2007 by my Department to our media in Northern Ireland.”
“<BR /> <BR />Suicide rates have not changed substantially since 2006, although the fact that they did not rise during the economic downturn may be an indication that prevention efforts have had some success. Provisional figures for 2014 show an 11% reduction in suicides on the previous year. That is encouraging. However, rates can fluctuate from year to year, and, given the very wide range of influences on suicidal behaviour, it is not possible to assess the impact of a single strategy on suicide rates.”
“Since the initial implementation of the Protect Life strategy in late 2006, a wide range of programmes has been put in place to prevent suicide in Northern Ireland. The programmes have been regularly updated and new programmes developed to reflect emerging international evidence of best practice. Suicide prevention services and initiatives include: Lifeline crisis de-escalation; counselling; training and awareness raising; improved in-patient safety; psychiatry services in hospital emergency departments; bereavement support; suicide cluster emergency response; local research; the self-harm registry; mental health crisis response teams; and self-harm intervention.”
“— Ambulance Service. So, there are things happening. It is certainly not dead. It is part of a broader vision for the health service in Northern Ireland.”
“I have a bid in, as I mentioned, to the June monitoring round of around £5 million to progress five Transforming Your Care projects, and £1·5 million from the Executive change fund was secured during the Budget to implement three Transforming Your Care projects. There has been considerable investment from 2012-13 to 2014-15. There was £19 million allocated in 2012-13, nearly £10 million in 2013-14 and between £8 million and £10 million in 2014-15. The spend was around or slightly above that. So, money has been spent. It has produced good results around the creation of integrated care partnerships, the roll-out of primary care infrastructure around resettlement and better care pathways for the —”
“It is something that you would expect me to reflect on personally as I have come into post. As I said in response to Mr McKinney, whilst it is a cornerstone of a vision for health and social care in Northern Ireland moving forward, it is not the only part of that vision. As I said in response to Mr Ross, there are many transformations and innovations going on across our health and social care service that we should be immensely proud of, but they are not necessarily part of Transforming Your Care. It is not dead by any means at all. It continues, albeit, as I said previously, not at a pace that perhaps I or many of the rest of us would want to see, but that is something that is affected by resources. <BR /> <BR />In the current year, we have just over £15 million in the board, which will be spent on transformational projects.”
“I cannot lay my hands on the exact figures on what has been moved from acute to community. If I cannot find that, I will provide it to the Member. There has been some discussion over the last couple of weeks about the position of Transforming Your Care, not least at the recent Committee meeting.”
“Members write to me or complain in the House or to their local press, but those who are inhibiting the welfare reform legislation from passing would do well to reflect on their part in our inability, as a Department, to deliver services at the level that they or, more importantly, their constituents want.”
“<BR /> <BR />There is an understanding and an acceptance that we are under financial pressure, and that is not helped by the fact that we are continuing to lose £9·5 million a month because of the inability of some in the House to move forward on welfare reform. Even in the four weeks that I have been in post, there is hardly a Member who has not written to me about the need for some service development, including several Members from his party, who want more for this and more for that. The ability of the Executive as a whole to do more is inhibited by the fact that we are losing cash to the tune of £2 million a week because of the welfare reform fines.”
“I heard the Member talk about decommissioning and I thought that we had gone back in time in this place. <BR /> <BR />A commissioning plan is being brought forward by the Health and Social Care Board. I believe that it is due to come forward this week, and it will outline what is being commissioned for this year. There are well-publicised pressures that my predecessor and I acknowledge the Department is under. We are short of roughly £30 million to £40 million to enable us almost to keep going on the previous year's position. That is after having made savings and is predicated upon making roughly £157 million of savings in year, but we are still short of that £30 million to £40 million. Understandably, that will result in pressures and perhaps people not getting the services that they want within the time that they want them.”
“— I have made a bid through the June monitoring round for more funds to develop and roll out more of TYC.”
“He will know and understand the difficulties around the budget and the availability of finances. Whilst we have been able to invest a considerable amount in TYC over the last number of years, it has not been enough to do everything that we want, and, on that basis —”
“The point about a published and funded timeline for TYC comes from the recommendation along those lines in the Donaldson report. The Donaldson report is being considered and will be responded to in due course. It is not fair — I appreciate that the Member did not say this — to say that TYC has not been rolling out. There are many examples of where Transforming Your Care has been implemented in various areas such as new pathways for care through the Northern Ireland Ambulance Service, the establishment of 17 integrated care partnerships and the commencement of the roll-out of primary care infrastructure. There are other examples. So things are happening. Would I like to see more happening? Absolutely, but he hit the nail on the head when he talked about the budget.”
“There has been a significant spike in the number of people presenting themselves to the emergency department, yet it is still making progress in trying to reach that four-hour target.”
“I thank the Member for his oration; I think that there were a couple of questions included there. He is right about Antrim Area Hospital. I would not be content, and nor should any of us be, with the figures of four-hour waits in Antrim Area Hospital. It is still short of the target. However, improvements are being made, and I think that many of those improvements are down to the innovations that have been taking place in the Northern Trust and in Antrim Area Hospital. We should welcome those innovations, which are having an impact. <BR /> <BR />Interestingly, however, they are making those improvements at a time when the number of people coming to the ED at Antrim Area Hospital has risen annually from around 70,000 to around 75,000 in the last year.”
“I am not aware of the specifics of the issue that the Member raises. I see Mr McGimpsey rising in his place. He might be able to advise me if he gets called by the Deputy Speaker. I am not aware of the specifics, but I commit to examine the issue and to return to the Member. I will see what is happening, what the current position is, and whether something can be done. The Member knows that I seek always to do my best about these matters. I am happy to look at it and see what is possible.”
“<BR /> <BR />As a new father, I am sure that the Member would be impressed with the new children's area in the emergency department. I hope that he never has cause to use it, but having had cause to use emergency departments before with children, particularly late at night, it is very good to have a separate area where they can be treated differently and separately. I was also impressed with the telemedicine that is being used there, particularly for stroke patients. <BR /> <BR />There are a lot of impressive reforms and innovations going on in our health and social care sector. Mr McKinney mentioned Transforming Your Care. Not all of those will be branded or badged as Transforming Your Care, but they are things that are happening day in and day out, right across the health and social care sector. They should be welcomed and celebrated.”
“I have to say that the new emergency department is, aesthetically, a very impressive building that has been designed to alleviate some of those problems. I was particularly impressed with several innovations taking place in and around the emergency department. Probably the most impressive was the acute assessment unit, which is located in the old emergency department, where GPs can speak directly to staff, get advice, and arrange for a referral to the acute assessment unit for diagnostics and management. That can help to alleviate pressure on the emergency department because, where people might traditionally have gone directly to the emergency department, they can now go, through their GP, instead to the acute assessment unit. They can even be referred to it from the ED, which helps to relieve pressures.”
“I thank the Member for his question. I visited the emergency department at the Antrim Area Hospital last week. Although it is not in the Member's constituency, many of his constituents avail themselves of the services provided out of that hospital. We are all well aware of the much-publicised problems that the old emergency department, in particular, at Antrim Area Hospital had in the past.”
“The Chief Medical Officer was also, rightly, very clear that "no" and "slow" are not acceptable options in response to the drive for transformation.”
“The focus of our reforms must remain the delivery of person-centred care, with home as the hub of care wherever possible. To deliver that vision, we need to ensure that organisational boundaries do not limit the effectiveness of care, and we must continue to ensure that people take responsibility for their own health. That was the vision of care set out in Transforming Your Care in 2011. Those remain my priorities for reform. <BR /> <BR />The Chief Medical Officer and I are in agreement about the need for reform. His comments reflect the findings of reports like Transforming Your Care and, more recently, that by Sir Liam Donaldson. His report is clear that reform of health and social care services is required to meet the future health and social care needs of the citizens of Northern Ireland.”
“With your permission, Mr Deputy Speaker, I will group questions 2 and 15 together. <BR /> <BR />There can be no doubt that our health service needs reform. Rising demand for services, a growing and ageing population, an increase in chronic conditions, technological advances and scarce resources create serious challenges for health systems across the world. Addressing those challenges requires innovation and transformation. We need a health and social care sector that constantly challenges itself to be better. I want to make it much easier for health and social care staff to promote innovation, whether it is big or small. To enable that, I have established a new strategic leadership group to help support and drive the culture of change and innovation that we need.”
“I want to see that enhanced and increased, because it is responding appropriately to the needs of the person, and analysis of people's views in our changing population has shown that that is what people want. That is where people want to be looked after and taken care of, and it is clearly, as I pointed out in a slightly different way in response to Mr Easton's question, a more cost-effective use of our resources. It is not always the best use for the person, but, where it is appropriate, I think that that is what we should be going for. That is certainly a vision that I want to see rolled out and progressed as we go along. As I said, Transforming Your Care set that vision out very clearly and it is still something that I want to see achieved progressively over time.”
“Transforming Your Care still represents the cornerstone of my vision for health and social care in Northern Ireland. The Member has been a great supporter of Transforming Your Care in recent times. It is something that he wants to see pushed forward, and I agree with him. I think that he appreciates the resource constraints that I am placed under and my inability to roll out Transforming Your Care at a pace that he, I and others want to see. <BR /> <BR />The vision of care being wrapped around the patient and the person or service-user being looked after in their community or in their home, with the home as a hub for their care, is something that I very much subscribe to.”
“Some of that cost could not be recovered, but there is an anticipated saving of around £840,000. So on those figures — I appreciate that obviously it is not just those figures that we look at — on a pure value-for-money analysis, it is very clear that the greater use of independent beds is cost effective. If you were procuring more independent sector beds, you could obviously reduce that price further. On a pure value-for-money analysis, the independent sector is obviously much more cost effective. However, it is not just that that is considered; it is a factor, a considerable one, but not the only thing that will be examined.”
“The 105 intermediate beds that I mentioned in response to Mr Cree's question have an element of use and greater use of the independent sector, which is quite strong in the Ards and north Down area. The average cost per bed, per annum in the independent sector is just over £30,000. The weekly cost of a bed in Northfield House is £808, which equates to roughly £42,000 per bed, per annum. By contrast, the 20 GP beds in Bangor Community Hospital cost nearly £1·5 million, which equates to roughly £75,000 per bed, per annum. On a direct contrast, you can see that it is considerably more expensive to provide a bed in Bangor Community Hospital than it is in the independent sector. I must point out, however, that the closure of the 20 beds in Bangor Community Hospital would not recover all of that £1·5 million.”
“It has not yet come to me in the Department, but I am happy to place on the record to the Member that I will rigorously and robustly examine the proposal, particularly in light of the issue with Northfield House. I am told that the trust believes that those 14 beds can be dealt with through domiciliary care and by keeping people in their homes and out in the community. Whilst it is a factor in the overall mix, it does not have a direct bearing, because the type of patient in the Northfield beds would be very different to those in the 20 GP beds that were previously in Bangor Community Hospital. As I consider the issue, I am happy to examine the evidence that comes forward rigorously and robustly and whatever determination or recommendation the trust makes to me.”
“I was pretty sure that that issue would come up in this context, because, as the Member will be aware, the consultation on the closure of the 20 GP beds in Bangor Community Hospital was set, as I said, in the context of a wider need to provide 105 intermediate beds across the north Down and Ards area. Fourteen beds had been identified in Northfield House in Donaghadee. A consultation on its proposed closure is due to start soon. Those 14 beds were identified as part of the mix of 105 intermediate care beds. I can understand why the Member wants to raise that in the context of the GP bed situation in Bangor Community Hospital. Bear in mind that the consultation has been completed only recently.”
“The South Eastern Health and Social Care Trust’s public consultation on the future of intermediate care in north Down and Ards closed on 29 April 2015. The trust is analysing the consultation responses. <BR /> <BR />The trust's preferred future option is to provide up to 105 intermediate care beds across the area. That would not include the 20-bed GP unit in Bangor Community Hospital, which is temporarily closed. In deciding whether to approve the implementation of that proposal, my Department will take into account the extent to which the proposal is consistent with my priorities as set out in the commissioning plan direction; the impact of the proposal on the quality, sustainability and accessibility of services and assurance on adherence to established standards of service; and the views of public and local community representatives.”
“I beg to introduce the Mental Capacity Bill [NIA 49/11-16], which is a Bill to make new provision relating to persons who lack capacity; to make provision about the powers of criminal courts in respect of persons with disorder; to disapply Part 2 of the Mental Health (Northern Ireland) Order 1986 in relation to persons aged 16 or over and make other amendments of that order; to make provision in connection with the Convention on the International Protection of Adults signed at the Hague on 13 January 2000; and for connected purposes.”
“<BR /> <BR />In conclusion, I can assure Members that I am committed to ensuring that the best possible support is provided to carers and that I recognise the importance of providing age-appropriate, accessible and flexible short-breaks services for carers and their loved ones.”
“<BR /> <BR />The Health and Social Care Board has been leading a regional adult short-breaks development group. That involves all the trusts and my Department, and it incorporates carer representation and community and voluntary representation. The aim of the group is to improve access to adult short-breaks provision, increase the range of services available to carers and increase the number of carers regionally who are supported by the Health and Social Care system and its partners. Needless to say, those are challenging aims, particularly in the current financial environment, but I look forward to receiving its conclusions and recommendations.”
“That is one reason why we are encouraging the promotion of direct payments and self-directed support for children and families assessed as requiring services. That can be particularly useful for families in rural areas. Such payments give parents more flexibility about how they use the payment for their child. Domiciliary care services are also used for families when community options are limited, and the worker can provide support to a child in or out of home. <BR /> <BR />The Southern Trust has informed me that it appointed a short-breaks manager within children's disability services in April of this year to progress a review and a development plan for services. The matter of children living in rural communities will be a particular area of focus in that post.”
“That will take account of a child or young person's age, the type of support needed and the availability and accessibility of local community services to include that child or young person successfully in their services. By definition, such support should be age-appropriate and reflect an individual's specific needs and, when possible, his or her particular preferences. Short breaks or respite service options for children also include overnight care, day short breaks and other flexible support, such as direct payments and self-directed support, which parents can use to buy the particular service or assistance they need. <BR /> <BR />Nevertheless, it is acknowledged that families in rural localities, such as the south Tyrone area, are likely to have fewer choices in community options.”
“It is often the case that people are offered a combination of those supports. In the older people's programme of care, I am informed by the trust that there is adequate access to age-appropriate short-break respite opportunities in the south Tyrone area and that it is not facing any difficulties with the provision of short breaks for older people. <BR /> <BR />The trust offers short-breaks support to children with disabilities up to 18 years of age, regardless of the locality a child comes from. The level and nature of support offered by the trust is dependent on the individual needs of a child and his or her carers. An assessment of need incorporating a carer's assessment is carried out, and, if intervention or support is required, a package is developed to meet the individual needs of the child and family.”
“As part of that review, the needs of young people who will be transitioning from children to adult services are being factored into the type and number of beds likely to be required in the future for an emerging number of young people with complex conditions. <BR /> <BR />In the case of physical disability services for 18- to 65-year-olds, there are no age-specific dedicated nursing or residential facilities. After the carer assessment is completed, short breaks are offered in a variety of ways. Those include bed-based short breaks in nursing or residential facilities registered to meet the needs of young physically disabled people; out-of-area specialist facilities; day sitting; night sitting; and flexible respite, when carers can be awarded a direct payment to allow them to arrange a short break to best meet their particular needs.”
“<BR /> <BR />Demand for bed-based respite in mental health services is relatively low, and there is no evidence to suggest that the trust requires more than three respite beds. Carers who have completed a carer's assessment that has identified the need for a short break from caring can receive an allocation up to £250 to help to fund a break from their caring role. With learning disability services, the trust has recently completed a series of information sessions with carers of individuals with a learning disability to determine the needs of carers, particularly on bed-based short-break options. It will now carry out an options appraisal in partnership with carers to agree how the future bed-based needs of carers and their loved ones will best be met.”
“I welcome this opportunity to discuss the provision of age-appropriate respite or short-breaks care in south Tyrone, the Southern Health and Social Care Trust generally and across Northern Ireland. I congratulate Ms McGahan on securing the debate, and I also congratulate her and Mrs Overend on their contributions this afternoon. <BR /> <BR />Respite or short-breaks care provision is based on assessed need and can be provided in a variety of ways, such as in a residential or nursing home; through the use of day-care facilities or a sitting service; or through direct payments, whereby service users make their own arrangements. The Southern Trust is actively involved in the development of short-breaks provision as part of Transforming Your Care and is committed to working in partnership with carers to agree the best way forward.”
“We need to ensure that we continue to get the message out that taking any drug that has not been prescribed for you has real risks for your mental, emotional and physical well-being. In fact, as we have seen recently, it has the potential to have tragic and fatal consequences.”
“The new services will be tasked with addressing emerging issues including new psychoactive substances. <BR /> <BR />The PHA is working to develop the alcohol and drug misuse workforce, including rolling out training on NPS and other substances. New evidence and research will also feed into treatment models and guidelines as appropriate. <BR /> <BR />That is an overview of the work being taken forward on new psychoactive substances. However, we recognise that there are no easy answers. There are considerable gaps in our knowledge and understanding of psychoactive substances, and there will remain a range of residual and future challenges that will need to be addressed, as there is with illicit drug use. However, we remain committed to tackling this issue.”
“<BR /> <BR />We commission and provide a range of treatment and support services across Northern Ireland, from education and information, through early intervention and harm reduction, up to specialist treatment and, to refer to Mr McCrea's comments, support services. These services are detailed on the Public Health Agency website. Although none of these services deals with new psychoactive substances in isolation, they are all equipped to deal with alcohol and drug misuse generally. From a treatment perspective, while these substances are new, they often mimic existing drugs, therefore treatment services should be able to deal with those presenting under existing treatment models. It should be noted that the PHA is currently in the process of re-tendering for a range of services that are due to come on stream in July 2015.”
“<BR /> <BR />To improve local information, we have also set up an early warning system in partnership with the PSNI, the Public Health Agency and the Department of Justice. The drug and alcohol monitoring and information system seeks to get information, identify new substances and provide advice as soon as possible. The system has been used to disseminate information about a range of substances, and the Chief Medical Officer has issued a number of alerts based on its information. It is also used to feed into the permanent or temporary banning processes and to inform policy and practice. My Department and the Public Health Agency will continue to use this information to raise awareness of the dangers of these substances and to put appropriate treatment services in place.”
“My officials and I will continue to work with the Home Office to see it brought forward as soon as possible, and I ask all parties’ MPs to support this work as it goes through the legislative process at Westminster. <BR /> <BR />As some Members mentioned, the Internet also plays a role. Although addressing sales in head shops may be only part of the solution, it would be an important step. The availability of these substances on our high streets has the potential to change social norms; therefore, stopping these sales will send a clear message that drug misuse is not acceptable and not part of everyday life. However, I recognise that we also need to work with our UK Government and other EU member states to address the issue in a broader context, including working with agencies such as Interpol to tackle international sales.”
“Its main recommendation was that the UK Government bring forward legislation to undertake a general ban on the sale of psychoactive substances, while providing exemptions for existing products, such as alcohol and prescription medicines. I understand that this proposal is similar to legislation already brought forward in Ireland. To refer to the amendment, I am content to continue to work with colleagues across the border and learn from their experience, particularly in outlawing psychoactive substances. I am pleased that Her Majesty's Government have broadly accepted the recommendation. The Home Office is working with us and the other devolved Administrations to develop appropriate proposals. I hope that legislation can be brought forward early in the life of the new UK Government.”
“This temporary banning power is aimed at tackling the threat that new substances pose to public health by responding on a cautionary basis. It has been a good first step in addressing the issue. So far, temporary or permanent bans have been imposed on more than 350 substances, and, when combined with enforcement activity, help us begin to tackle the issue. However, we have to do more. New substances continue to emerge at the rate of one new drug a week. That is why previous Ministers at my Department have regularly raised this issue with the Home Secretary, in seeking a more robust and consistent approach. <BR /> <BR />Following that lobbying, the Home Office established an expert panel to look at the UK’s legislation. The panel reported in late 2014.”
“<BR /> <BR />In 2011, following approaches from various stakeholders, including my Department, the UK Government amended the Misuse of Drugs Act to incorporate a new classification for placing drugs under temporary control for up to 12 months. It is worth acknowledging that those temporary banning powers were primarily a result, I understand, of pressure from Northern Ireland because of the prevalence of the use of psychoactive substances here.”
“<BR /> <BR />In addition, Belfast City Council, supported by a range of key agencies, has undertaken enforcement activity against so-called head shops using the general product safety regulations. That has resulted in a forfeiture order. Further action has led to an injunction against one premises selling these substances anywhere in Northern Ireland. That is to be broadly welcomed. I know that other councils have been watching Belfast’s approach, and I hope that that will encourage them to take similar action in their areas. I recognise and acknowledge reference made by many Members today to some councils and the action that they are taking.”
“As many highlighted today, the key legislation, the 1971 Misuse of Drugs Act, is a reserved matter and is led by the UK Government at Westminster. Therefore this is an area that my Department has raised through the British-Irish Council and the North/South Ministerial Council, and I will ensure that it remains on the agenda of those key groups. <BR /> <BR />The enforcement of the Misuse of Drugs Act is the responsibility of the PSNI. My Department also helps to address the issue through the enforcement of human medicines regulations. Where the sale of new psychoactive substances breaches either of those pieces of legislation, enforcement activity can be, and is, undertaken.”