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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“So, in fact, one in five substances sold as so-called legal highs is not legal, and anyone purchasing them could be arrested for possession of a controlled substance. <BR /> <BR />Given the nature of the issue, it is difficult to get an accurate picture of how prevalent the misuse of these substances is. However, a survey in 2010-11 indicated that 2% and 2·4% of the population had taken the then legal Mephedrone and new psychoactive substances respectively. Things may have changed since then, and that survey is being rerun to give a clearer picture about the current extent of use. In 2013-14, figures from our treatment services also indicated that 15% of those in treatment reported the use of the now banned Mephedrone. <BR /> <BR />I move now to tackling supply.”
“They are marked, "Not for human consumption" for a reason, as the sellers are trying to get round our existing drug laws and regulations. <BR /> <BR />Let us be absolutely clear, Mr Deputy Speaker: taking any substance that has not been prescribed for you comes with real risks. These new psychoactive substances have not been tested, they do not go through quality assurance, there is no way of knowing what they actually contain, and, therefore, they are potentially more dangerous than drugs such as Ecstasy or cannabis. In fact, they may not even be legal. Test purchases conducted by the police and forensic services across the UK, in 2013-14, showed that almost 20% of NPS contained drugs controlled under the Misuse Of Drugs Act 1971.”
“<BR /> <BR />Worryingly, a new challenge has arisen through the availability and use of so-called legal highs, an issue that has, unfortunately and sadly, been brought to the fore again by the recent tragic death of Adam Owens, a 17-year-old former pupil of my old school, Regent House, who died in Newtownards in April. I extend my sympathy to Adam's family and pass on my condolences to them. <BR /> <BR />These are substances that have a psychoactive effect but which are not classified under the UK-wide Misuse of Drugs Act 1971. However, the term "legal highs" is misleading. We should, therefore, try as best as we possibly can to refer to them as new psychoactive substances (NPS). The key message that needs to come from the Chamber today is that these substances are not safe.”
“Thank you, Mr Deputy Speaker. I begin by thanking Mr Easton and Mrs Cameron for bringing the motion to the Floor. Indeed, I thank everyone who has spoken today. <BR /> <BR />One of the most important public health challenges facing us is the need to prevent and reduce the harm that alcohol and drug misuse causes to individuals, families and wider communities. Episodes, such as the major incident that occurred at the Odyssey last year, or, more tragically, the number of potentially drug-related deaths that have occurred recently, serve to highlight the real consequences of substance misuse. I join others in passing on my condolences to all families who have, tragically, been affected by the issue.”
“Pneumococcal vaccination programmes are in place but are targeted at specific demographic cohorts; namely, babies, people aged 65 and over and anyone between the ages of two and 65 with a long-term health condition. That is a national policy, and it is based on advice and recommendations that come from the UK Joint Committee on Vaccination and Immunisation. So, that is in place for those specific groups of people in the wider population. That is obviously then added to by outbreaks such as this, where there are clusters of pneumococcal disease and vaccinations are issued as appropriate.”
“I absolutely can give that assurance. I hope that the work that has been conducted over the last number of days illustrates that we are prepared not only to provide the necessary treatment but, as that treatment has been given, to give reassurance and explanations to members of staff as to what has been going on. We will continue to do that as appropriate, although, as I said, I hope that the operational side of our response is complete by this evening and that we will not be required any further. Should it be the case that we are required, I assure the Member that we will respond appropriately.”
“I am not in a position to make the assessment that the Member is encouraging me to make, nor would it be appropriate for me to do so. That issue, if it has any impact on the set of circumstances in this outbreak, is one for Harland and Wolff to deal with. I assure the Member and the House that the Health and Safety Executive is continuing to work with Harland and Wolff to ensure that those very issues are addressed. If there are problems associated with this outbreak in respect of equipment and the standard of it, I am sure that the HSE will be able to deal with that in conjunction with Harland and Wolff.”
“I do not have a comparator for other UK regions. She is right, and I join her in congratulating the PHA for its response to this outbreak. It was able to respond quickly when it became clear that a cluster was developing and get on the ground in Harland and Wolff, in conjunction with the management there and working with the Belfast Trust and others, to ensure that the 450 people, which is a sizeable workforce, have received antibiotics and vaccinations. That that has been completed over a very, very short time is testimony to the good work that the PHA is able to do in instances like this. I hope we do not have many more examples where we can test our readiness for this, but this has been a very good example of where the PHA has been able to do the job that we ask of it and do it very well.”
“<BR /> <BR />The Department, the PHA and the health protection service have shown that, in this unfortunate outbreak of pneumococcal disease, they have the capacity and capability to respond appropriately to problems such as this and do a very good job.”
“I understand that the source is the metal fumes. As I said in my initial response, there is an accepted and acknowledged heightened risk to welders of getting this disease from metal fumes. That is believed to be the source of this outbreak. <BR /> <BR />We have been taking this matter incredibly seriously. One role of the Public Health Agency is to lead the response to clusters and cases of outbreaks of infectious diseases such as this. The health protection service within the PHA has been working with the Belfast Trust, Harland and Wolff and others to prevent further cases. Having identified those at risk, they have, over the weekend, been ensuring that workers were vaccinated and provided with antibiotics.”
“<BR /> <BR />Obviously, we will continue to monitor the situation, but as I pointed out in response to the main question, a lot of the work from here on will be carried out by the Health and Safety Executive to ensure that, with the heightened risk to welders of contracting pneumococcal disease through metal fumes, whatever preventative work needs to be done with Harland and Wolff's occupational health service and health and safety processes will be carried out. I am sure that the Minister of Enterprise, Trade and Investment will ensure that that is provided to Harland and Wolff.”
“I join the Member in commending the Public Health Agency and its health protection service on their rapid response. The fact that they dealt with 450 workers over the weekend and into today shows the extent of their work and their skill. <BR /> <BR />I am content to give an assurance that, should it be required — I hope it is not — the PHA will be there to assist Harland and Wolff and its staff as appropriate. Hopefully now that these measures have been taken, with vaccinations and so forth, there will be no further incidences of this disease.”
“<BR /> <BR />The PHA led a risk assessment process at Harland and Wolff, which identified the workers at immediate risk requiring public health intervention. They are being offered antibiotic prophylaxis and pneumococcal vaccine. About 450 workers were given antibiotics and vaccine over the weekend, with a further 150 being seen today. The Public Health Agency expects to complete this work at Harland and Wolff by 9.00 pm today, and that no further clinics will be needed. <BR /> <BR />Vaccination may reduce the risk of invasive pneumococcal disease but it does not replace measures to prevent or reduce exposure. Ongoing prevention is primarily a matter for Harland and Wolff's occupational health department, with support and guidance from the Health and Safety Executive of Northern Ireland.”
“The Public Health Agency (PHA) has been coordinating the response to the cluster of cases of pneumococcal disease at Harland and Wolff. There have been four confirmed cases, with onset dates between 28 April and 6 May. All have been treated in hospital. <BR /> <BR />It has been recognised for some time that there is an increased risk of invasive pneumococcal disease associated with welding. The green book, which is the UK's authoritative guidance on vaccination, provides specific guidance about protecting those at risk of frequent or continuous occupational exposure to metal fumes, including welders. The key preventative measures are pneumococcal vaccine, prophylactic use of antibiotics and measures to limit exposure to metal fumes and dust.”
“In February, my Department launched a new 10-year strategy for home accident prevention. The strategy's vision is that the population of Northern Ireland has the best chance of living safely in a home environment in which there is negligible risk of unintentional injury. <BR /> <BR />The strategy sets out four main objectives, which I will share with the House, each of which is supported by a set of strategic priorities. The objectives are to empower people to better understand the risks and make safe choices to ensure a safe home with negligible risk of unintentional injury; to promote safer home environments; to promote and facilitate effective training skills and knowledge in home accident prevention across all relevant organisations and groups; and to improve our evidence base.”
“— or those who need nursing home care or physiotherapy.”
“There are no more needy and vulnerable people than those on the waiting list for hip or knee operations —”
“<BR /> <BR />Where one could argue that it is having an impact is that we are needlessly losing £9·5 million each and every month because of our failure to move forward on welfare reform. I think that we have sometimes glossed over or forgotten the impact of the loss of £114 million this year, which is the total fine, and the £100 million that has been lost to date. If that £9·5 million was received by my Department, it would allow me to help to provide 1,800 hip operations or 2,100 knee operations. It is the cost equivalent of 900,000 prescriptions items, 264,000 GP consultations, 16,000 weeks of nursing home care or 233,000 physiotherapy treatments. I hear some argue, in this place and in the media, that, by resisting welfare reform and incurring these penalties, they are helping the needy and the vulnerable in Northern Ireland.”
“That was teased out a little in my response to Mr Boylan. It is not having an effect on this year's health budget yet. A Budget is in place, and all Departments are operating to it. However, that Budget will unravel very quickly if the finances and flexibilities that flowed from the Stormont House Agreement are not secured. <BR /> <BR />The House will probably be most familiar with the £200 million for the voluntary exit scheme. My Department, like many Departments, is relying on making pay bill savings in-year through the use of that £200 million to let some people exit the system early. If that does not happen, we will be into a crisis situation, not just with my Department's budget but with the budgets of every Executive Minister.”
“<BR /> <BR />I have read Sir Liam Donaldson's report and, indeed, the comments by the Chief Medical Officer today, and it is very clear that, in many respects, Northern Ireland has the capacity to have a world-class health and social care service. We talked previously about coronary care, which is a really good example of where we have a world-class specialist service, and there are other examples. In many respects, we are very good, but I want us to be good in everything and to be world class. We need change to achieve that, but the point that I want to make is that, whilst we face change, and change is inevitable in our health and social care sector, it must be always be change for the better. That is what I want to lead on and ensure that it becomes a reality during my time in office and beyond.”
“The one thing that I will prioritise in my time in office is what I referred to in my previous response to the Chair of the Committee: the need for transformation, reform and change in our health and social care system. <BR /> <BR />We have just had a discussion about statutory care homes. I know that talk of change can be frightening for many and that people have emotional attachments to facilities. That is understandable: I have many such attachments, and I am sure that everybody here does as well. However, in the time that I have in office, I want to move on the need to transform our health service.”
“I do not think that I have sufficient time in two minutes to outline the full extent of the challenges that face the Health Department. I thought that I had a hard job until I moved into this one. There are many issues. My first week in post has highlighted the multitude of challenges that face the health and social care system in Northern Ireland. Those challenges are not unique to Northern Ireland and are faced by states, countries and nations right around the world.”
“Whatever decisions are taken by the board, I want the matter to be handled with appropriate sensitivity and care and better than it was previously, and to ensure that all people who are affected understand that they will reach their own personal decision about where they want to be and whether they want to remain in a home or to move to other residential care. No one — not me or anybody on the board or in the trusts — will tell those people that they should move out of their homes, because those are their homes. We will always want to do what is best for people in residential care.”
“I am not aware of the details of the case that Mr Beggs raises, but I am happy to look at it and communicate with him. I accept his point that there is a role for statutory care homes in step-up and step-down provision in the multifunctional use of care homes. It is important to remember that. That service will continue to be provided. We sometimes focus too much on structures without concerning ourselves with the important services that are meant to be provided and recognising patterns of care. Many citizens want to remain in their homes a lot longer and live their lives out in their own properties. We want to continue to support that sort of independent living. <BR /> <BR />As I said, the issue has caused concern in the past.”
“I hope that, whatever decision the board takes, it will be treated with the sensitivity and respect that it deserves and that that important assurance that I have given, which my predecessors put in place, that no one will be moved out of their home against their will, will be received and understood by residents and their families.”
“Whatever decisions are made — we await the outcome of tomorrow's board meeting — the message that Edwin Poots gave when he was in post, which was reiterated by Jim Wells and which I am happy to reaffirm today, is absolutely critical: no resident of any statutory care home that is earmarked for closure at any point in the future will be moved out of their home against their will. It is incredibly important that, when this debate happens, as it inevitably will at some stage in the future if not in the next number of days, current residents of those care homes understand that they will not be moved out of their homes against their will. <BR /> <BR />Unfortunately, a lot of things were said in the past that scared people and caused grave concern. I accept that the issue was not handled well.”
“Before coming in for the commencement of the previous debate, I heard the Member speak in the debate prior to that on funding for voluntary and community services. I cannot remember exactly what he said, but he was talking about the difficult decisions that are going to be required in the current environment that we are in. This is one such area in which difficult decisions may be required. <BR /> <BR />I am well aware of the sensitivities about statutory care homes. I thank the Member for raising the issue, because it gives me the opportunity to make one particular point clear.”
“I am not saying that I would get all the £114 million that we are paying out in penalties or that my Department would have got all the £100 million that has been lost already because of welfare reform penalties, but I think that a Department like Health, which is everybody in Northern Ireland's first or second public spending priority and which has consistently been the priority of the Finance Minister and others in the House, would have received the lion's share of that money. It could have been invested not just in primary care but in mental health, Transforming Your Care or a raft of different areas, which would have provided much-needed care, support and help for people across Northern Ireland.”
“I do not disagree. I am glad that the Member welcomed the £15 million investment, and I hope that GPs and primary-care practitioners also welcome it. I am sure that they will. That money is there to help them to modernise their services and to provide better support and care for our communities. <BR /> <BR />I would love to have more money to invest in a range of services. However, as the Member will be aware, that is inhibited not only by the broad, general Budget situation, whereby our spending as an Executive has not kept pace with inflation over the last number of years, which is set to continue for at least another two or three years, but by the fact that the Assembly is losing £2 million a week — £9·5 million a month — because of our failure to move forward on welfare reform. That is not our failure; rather, it is Sinn Féin's.”
“I think that that investment is a clear signal of the esteem in which we hold GPs, the work that they do and the vital role that they perform in meeting everyone in Northern Ireland's current and future needs.”
“I am well aware of the issue. If I was not aware of it, I am becoming increasingly aware of it. I was lobbied, like many Members, by local GP practices on the issue over the last number of months. I am well aware of and recognise the current challenges that primary care across Northern Ireland faces. I am supportive of the critical role that our GPs provide as a front-line service to our citizens. My Department and I remain committed to working with the British Medical Association and others to identify opportunities to address the current and future challenges that primary care faces. <BR /> <BR />By way of our commitment to primary care and the work that GPs do in their surgeries across Northern Ireland, up to £15 million has been invested in primary-care services this year. That was announced at the start of this financial year.”
“We must ensure that patients have an assurance that the blood being provided to them is safe, wherever it comes from. I will, as I said and will repeat, be guided by the science and the medical evidence. There is an emerging body of evidence on this, particularly from Great Britain. I will monitor, examine and carefully look at that and take my decisions accordingly.”
“As I tried to point out in my initial response, the original judgement in the case means that it is not my job to decide on the matter: the jurisdictional responsibility rests with the Secretary of State for Health in London. That is in part why an appeal has been taken: to try to establish authority in the Northern Ireland Assembly and in my hands. If the appeal is successful and establishes that I am responsible, I have made it clear so far in post that the science and medical evidence guides me, and will guide me, in the matter. <BR /> <BR />I disagree with the Member. It is not an equality issue. In fact, I agree with the Irish Minister for Health who, whenever the Léger judgement was made public, pointed out, rightly, that it is a matter of patient safety, and only of patient safety.”
“The lifetime ban on blood donation applies to men who have had sex with men. It is based on sexual behaviour, not sexual orientation. In the case of Geoffrey Léger v the French Ministry of Health and the French Blood Service, the European Court of Justice concluded that the permanent deferral from blood donation may be justified in limited circumstances. In Northern Ireland, the judgement in the judicial review case on the matter is the subject of an appeal. The Northern Ireland Court of Appeal is aware of the Léger case. The appeal is due to be heard in October. In the meantime, it would not be appropriate to comment in detail on a matter that is before the courts.”
“CPR is the sort of skill that, once developed, one will always have. There is no better setting to do that than in schools, particularly with there having been so many unfortunate examples in recent years of those involved in sporting activities having cardiac arrests. CPR should not be seen as something that just adults do but something that can affect young people. Therefore, training and support, where appropriate, is a good thing to do.”
“The Member will be aware of the publication, in July 2014, of the community resuscitation strategy, the objective of which is to increase the number of people of all ages — not just adults but young people — who are trained in CPR skills. <BR /> <BR />I am aware that there was an event in the Assembly today — unfortunately, I was not able to make it — hosted by the British Heart Foundation and involving some local schools. I understand that MLAs were also being taught how to perform CPR, although hopefully none will be required in this place, but you never know when those skills might be useful. <BR /> <BR />I know that the British Heart Foundation is doing the sort of work that it highlighted and showcased in the Assembly today. It has been doing that in many schools around Northern Ireland, and I very much encourage it in that.”
“The Member is right in his prediction that I will have to provide the information in writing. He has been typically cheeky by slotting in a question about the West Tyrone constituency to a question tabled on the issue of coronary care. It is nonetheless an important question, and I will provide him with sufficient detail in writing.”
“<BR /> <BR />Around 1,060 patients have benefited from this service since the roll-out in September 2013, and we should welcome the fact that this specialist service at the sites that I have outlined, and the emergency work being done in the Belfast trust area and in Altnagelvin as well, is proving so successful, justifying the faith that was put in this service and the investment that was made.”
“The Member is right to point out that this has been a great success for the people of Northern Ireland. As I said, cardiac catheterisation labs are of enormous benefit to patients who have had a heart attack, because they can save lives, reduce complications, speed up recovery and significantly shorten hospital stays, to the extent that, whereas in the past somebody who had suffered a heart attack might have expected to be in hospital for a number of days or, indeed, weeks, they can now be out in just a few days.”
“We have also developed a community resuscitation strategy to improve the survival rate for those who suffer an out-of-hospital cardiac arrest by increasing the availability of CPR training and the number of automated external defibrillators across Northern Ireland.”
“Since September 2014, the primary percutaneous coronary intervention (PPCI) service for patients suffering the most severe form of heart attack has been provided to the entire Northern Ireland population from two centres, in the Royal Victoria Hospital and Altnagelvin Hospital. PPCI saves lives, reduces complications, speeds recovery and shortens the hospital stay. The service has benefited around 1,060 patients in Northern Ireland since its roll-out in September 2013. My Department has also invested in 10 cath labs at four sites in Northern Ireland provided by the Belfast, Southern and Western trusts.”
“For example, all 17 integrated care partnerships have agreed their action plans and submitted proposals for service changes. The primary care infrastructure is also starting to be put in place; Banbridge, Ballymena and Omagh are moving forward. Procurement processes are being taken forward for Newry and Lisburn. There is a lot of work being done. By the end of this financial year, we will, we anticipate, have driven a shift left of £45 million. It is moving forward, although perhaps more slowly than we would have liked because of resourcing pressures, which is why I will bid in the June monitoring round for funding for Transforming Your Care, so that we can continue to realise the efficiencies and, more importantly, the better standard of care that will result.”
“The short answer to the final question from the Member is yes: the principles of Transforming Your Care remain priorities for this Department. I am aware that, in his report, Sir Liam Donaldson recommended a timetabled implementation plan. As the Member pointed out in the first of his several questions, resourcing is a factor. I have heard the Member criticise TYC in this place before — sorry, he was against it before he was for it. He has more latterly been in support of it, his party having previously criticised TYC. <BR /> <BR />TYC envisaged an investment of £70 million and a shift left in service provision that would release savings to the value of £83 million. To date, around £26 million has been allocated to TYC initiatives. It is not that TYC is not moving forward, even if that is the perception of some.”
“<BR /> <BR />I want to ensure, as I am sure everybody in the House does, that the approximately £4·7 billion that we are investing in the health and social care system in Northern Ireland is providing people with the care they require and is not being spent unnecessarily on administration and other aspects of bureaucracy.”
“<BR /> <BR />I think that the numbers are quite impressive. Between the 2011-12 and 2013-14 financial years, nearly half a billion pounds, £490 million, of savings and efficiencies were realised across the health system. We anticipate that, in the last financial year, 2014-15, there will be roughly £170 million of additional savings. As I mentioned before, there was a commitment for the current financial year, 2015-16, to reach a target of £160 million of savings. That is roughly two thirds of a billion pounds already that has been saved, with an estimate of around £800 million by the end of this Assembly term. That is approximately double the savings that were achieved in the last Assembly term, and I think that it is an impressive record of driving efficiency through the system at a time when that system is under considerable pressures.”
“I thank the Member for his congratulations, and I know for sure that, if I do step out of line, he will be one of the first who will tell me that I have done so. I thank him as well for reminding me. Most people move from a poacher to a gamekeeper role, but I think that I am more moving from a gamekeeper to poacher role in the change of office last week. <BR /> <BR />In my previous role, I was well aware of the savings that have been made across the health system over the last number of years. I can recall from various Budget debates that, when there was criticism of the health service and of inefficiencies in our system, I was always very keen to remind the House of the savings and efficiencies that had been delivered over the last number of years. I think that they are often forgotten about: eaten bread is soon forgotten, of course.”
“I am pretty sure in my mind that, as we move forward and address the need to transform our health service and our social care system, we need to have an open and honest conversation, and we need to reach broad political consensus in this place if we are to make it work. It is no good just me coming forward with it. I can preach a mantra about the need for transformation all I want, but, if I am the only person doing it and it is not accepted by others, we will not go too far.”
“We do need to "radically review", to use her term, or the term she has borrowed from the Chief Medical Officer, if we are to ensure that the investment that the Executive have given to the Health budget, which the House has voted to support down through the years, gets the highest standard, the highest safety and the highest quality of care. <BR /> <BR />I believe that we do need to make transformations in the way we deliver the services that our citizens require. There will be change, and sometimes that change will require difficult decisions. The Chief Medical Officer's comments, following on from Sir Liam Donaldson's report will, I hope, provoke some conversation around this issue. There has been reasonable consensus across the political spectrum on the need to reform, but perhaps not always on the detail of how that reform unfolds.”
“The Health budget, as the Member, and indeed the House, knows is by far the biggest that the Executive have. At £4·7 billion, it is close to half of the total Budget. It is a lot of money. Given the Member's position as Chair of the Committee, she will appreciate, probably more than most, that while, on the face of it, you would think that spending that amount of money would be sufficient to provide the highest standard of health and social care for a population of 1·8 million, we are facing a range of pressures around an ageing and growing population, the pressure of technological advances and the rise of chronic illnesses, to name just three.”
“I am sure that everybody in the House will receive, as will I now that I am in this post, requests for service development, such as more spending on mental health, learning disabilities and elective care and so on and so forth. As things stand, I will not be able to fund those service developments because of the pressures that still exist in the budget.”