Carál Ní Chuilín
North Belfast · Sinn Féin · Northern Ireland
“To continue the theme of undermining public confidence and public effectiveness, I ask you this, Minister: why do you and your DUP colleagues continue to block the 'good jobs' Bill, particularly the measures for parents whose babies require neonatal care and, indeed, other measures that will support workers who are struggling with the cos…”
“At the end of the day, guns were used to kill Catholics — Davy Payne; surface-to-air missiles in South Africa and Paris and then some. I will give the deputy First Minister another opportunity not to deflect but to condemn her party's involvement in Ulster Resistance and with the red berets that they wore.”
“I thank the Minister for that response. I have a close family relative who is in need of a SPiMS unit in an Irish-medium school but cannot access one in North Belfast at all. Apart from access in P4 and P5, they will have to go to an English-speaking school, even though Irish is their first language.”
“You mentioned some of the issues that are important: trade union representation, the banning of zero-hours contracts and employees being able to have their tips and service charges. Anyone who cannot get behind these proposals needs to be clear — concerns for some, and hiding behind the industry for others.”
“First Minister, I know that, recently, you were in Ardoyne for the sod cutting of the new £3·4 million purpose-built youth facility for Ardoyne Youth Enterprise. Further to your response to Brian Kingston, can you give us an update on that project and, indeed, any others?”
“I agree 100%, Linda. That is something that we all agree on. We met many people. The Bill was published and was based on the report of the truth recovery process.”
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“There is a maturity and an acceptance of what is needed now and about trying to prioritise those needs. That needs to happen as soon as possible. I appreciate that the Minister said that he is waiting to see the Budget outcomes, but I urge him to do that now. It would help with his discussions and negotiations on the Budget. However, that is a political call. That is up to him. <BR /> <BR />The amendments and, indeed, the whole process of bringing the legislation, show what the legislative process looks like. All of us, particularly those of us on the Health Committee, are dealing with a raft of Bills, and there is the potential for private Members' Bills to come forward. Despite the fact that we will have a lot of late nights, long Committee meetings, no lunches on Tuesdays and all the rest of it, I welcome that.”
“Those recommendations will be critical in any new commissioning. That is why the amendments are so important. We cannot assume, and we do not assume. Those will be writ large and will be part of our scrutiny. A lot of that stuff has come back to the Assembly for affirmative resolution, and that is the other safeguard that we put in. It is not about a lack of trust; it is to make sure that we have belt and braces when we make legislation. This is a perfect opportunity for us to do that. <BR /> <BR />I am sure that the Minister already knows this: when he calls a health summit with all the health and social care professionals, he will hear a lot of conversations about what needs to happen and when it needs to happen. There will be a lot of competition.”
“<BR /> <BR />In many respects, the Bill is about hitting the reset button and giving us the opportunity to do better what we already do well, and then some. The "then some" comes from the global pandemic. Health and social care was always at a critical point. COVID and everything that came with it certainly exacerbated that. <BR /> <BR />I also want to raise the ongoing scandals in health, which predate the Minister's term in office. I have no doubt that the services that are needed will be challenged and tackled by the different public inquiries and the recommendations that come from those. However, we already have the recommendations from the O'Hara hyponatraemia inquiry. Those need to be implemented. We heard about some of that, and, although progress has been made, there is still a lot to be done.”
“<BR /> <BR />Even in the last equality screening exercise that the Minister brought forward for the Budget — we welcome the fact that there will be multi-year budgets soon — certain issues with major implications were screened out. There is a job for local commissioning to ensure that that is corrected. The issues relate to the provision for disability, older people, younger people and lots of the issues that each of us raised. More provision for oral health is needed, particularly for children and young people from deprived communities, and better dentistry is required for people with autism and disabilities. The list goes on and on, and we all have a list of those things. Local commissioning, and getting the local commissioning structures and frameworks right in the new setting, will be critical.”
“Any new commissioning that is done by the commissioning groups — commissioning is key to this — will certainly have that reflected in any plans. <BR /> <BR />The Committee heard from a lot of people on the Bill. They spoke about our health and social care trusts, right through to the need for multidisciplinary teams of family practitioners. Our GPs, district nurses and carers all said that there is a need for better service provision and a more joined-up approach. <BR /> <BR />We have an opportunity to try to set out what will happen when we come out of the pandemic — post COVID — and during the health recovery. Everyone has said that there is a need for greater investment in health. I take the opportunity to agree with that. I also welcome the Executive's support for that. However, that always comes with conditions.”
“Certainly, they are within the principles and guidance of that agreement, when we look at co-production and co-design. Integrated care partnerships and area integrated boards will lend themselves to better scrutiny. For example, when this was being discussed, no one predicted that there would be a health pandemic. We are now dealing with what people call "long COVID", and we have to make additional provision for additional services as the learning progresses and is internalised and institutionalised. It could be put into the realm of respiratory care in the primary care sector. I am sure that my colleague Órlaithí Flynn will touch on the mental health aspect. However, the impact of COVID on us physically, economically, socially and in mental health is critical.”
“I am delighted that she will not oppose the Bill, because we all appreciate the strain that our providers of health and social care are under. <BR /> <BR />There has been a lot of scrutiny of the Bill. As I said, there was recognition that transformation is key. However, my concern was that, while people had difficulties in the scrutiny of the Health and Social Care Board with the LCGs, the LCGs were critical for going back to the grassroots. They are not just looking at how acute care is delivered by health and social care, as primary and secondary care and the community and voluntary sector are really critical. <BR /> <BR />The amendments lend themselves to the aspirations that were laid out by all political parties in the run-up to New Decade, New Approach.”
“A lot of work by health and social care professionals continued, but people need to understand that we could not have a situation in which men who wanted to give blood were prevented from doing so by the party opposite because they were gay. We could not have the situation with organ donation, where people were speaking out of two sides of their mouths, and that was the case with vaccination, sexual health and awareness, mental health and the rest. A lot of platitudes were offered, but we needed to ensure that equality was delivered. <BR /> <BR />I am content that the Bill and the amendments address a lot of those concerns. I do not recall hearing previously many of the concerns that Paula has raised here today, although she raised some.”
“<BR /> <BR />We did not advocate these amendments in order to be mischievous but because we, and those who responded to the Bill, felt that there was something slightly lacking. Many people had concerns. Everybody agreed that there was a need for reform. All the parties supported the transformation of healthcare, going right back and focusing on the Bengoa report. We focused on "systems, not structures". Anybody who watched the state of health and social care at that time appreciated that that was an opportunity for us all to try to get it right. <BR /> <BR />There was a suspension of the institutions for three years.”
“I support the Bill and the amendments. Before I begin my substantial remarks, I thank the Committee staff and, in particular, Aoibheann and Claire from the Bill Office. Without their help, our scrutiny would have been much more difficult. <BR /> <BR />Our party was the first to raise concerns about the Health and Social Care Bill. We scrutinised it thoroughly and, for some people who attended the Committee, ad nauseam. I see that the Minister is trying to hide his joy at that remark, but that is our job. The Health Committee is flat to the mat. Everybody who attends it does so diligently — well, most of us who stay for most of the meetings do. When hard subjects come up, some people duck out or let on that they cannot lend their services, but that is another day's crack.”
“that he has been causing, but he also needs to look at the crisis in care. People have remained in accident and emergency because they cannot get out and they cannot get a bed. Those who get a bed cannot get home because of the lack of care packages. This is a crisis point. The Minister needs to bring his plans for addressing that to the House as a matter of urgency.”
“The Executive cannot also deliver health and social care for the Minister; it is his problem. It is our problem, but he needs to fix it. One of the ways he needs to do that is by looking at the”
“On Thursday, we received a briefing from officials who tried to assure us that that payment would be made before Christmas. I am not confident about that. <BR /> <BR />I want to see people who work in social care being paid a living wage. I want to see clearer career paths and a better, joined-up approach. The Minister said that he will bring forward his proposals to reform social care, and I urge him to do so. Lack of workforce planning is at the heart of every problem in health, and, as we can see today, that is most evident in social care. I heard speculation in the media this morning that this is a problem not just for the Minister but for the entire Executive. I respectfully disagree with that. The Executive have agreed to support Health with additional funds.”
“Even throughout the pandemic, many people have lost access not only to day care but to respite places. That puts additional burdens not only on unpaid carers but on the whole social care system. <BR /> <BR />The domiciliary care workers who deliver those packages, particularly those who live and work in rural communities, face additional hardship. Social care is community care. It is care at home. It is personal and it is vital. I have never seen the system under pressure such as it is under today. The Department must undertake and publish a report into the true cost of social care. The workforce, particularly in social care, has continued to be an afterthought. For an example of that, we only need to look at the COVID recognition payment of £500. Eight months after that was announced, we are still asking where it is.”
“I would like to make a statement on the crisis in our health and social care system, primarily focusing on social care. Our social care system is well and truly broken, and it is estimated that over 1,600 people are waiting for a package of care after being assessed as needing it in order to help them to recover from illness and live safely in their homes. <BR /> <BR />What are care packages? They are packages of care that involve carers preparing meals, giving medication and helping with intimate personal care.”
“That recommendation will obviously inform our approach to that work.”
“<BR /> <BR />The last procedural recommendation in the report is recommendation 11 on political and technical groups. The Committee agreed that there are no procedural obstacles to making provision for political or technical groups via changes to Standing Orders. However, the Committee also reflected that further detailed information and research would be required in order to inform the development of any future procedures. <BR /> <BR />Finally, should the Assembly accept the recommendations contained in the AERC report, the Committee on Procedures will seek to take forward those recommendations that relate to its role as a matter of priority. Although the Committee is currently very busy, we appreciate that the report says:”
“Those issues are: the formation of the Opposition, including qualification; the timing of the formation of the Opposition; the dissolution of the Opposition; the leadership of the Opposition; topical questions from the leadership of the Opposition; speaking rights in the Assembly; enhanced speaking rights for the Opposition; and the Opposition's right to chair the Public Accounts Committee. <BR /> <BR />I move to the Committee's consideration of recommendation 10. The Committee agreed that, as a proportional representation formula is applied to the allocation of seats on Statutory Committees, it is likely that any official Opposition will already have the opportunity to be represented on all Statutory Committees. The Committee agreed that it could seek to bring forward an amendment to Standing Orders in respect of the balance of parties.”
“<BR /> <BR />The Committee made the most comment in its response to recommendation 8, which highlighted that, during a previous Committee on Procedures' review of provisions for Standing Orders, as set out in the Assembly and Executive Reform (Assembly Opposition) Act (Northern Ireland) 2016, the Committee had not been able to establish that there would be cross-party support to introduce some of the Standing Orders necessary to give that recommendation effect. If recommendation 8 is agreed by the Assembly today, the Committee on Procedures will need to further consider a range of issues with the intent of bringing forward new draft Standing Orders to be agreed by the Assembly with cross-community support.”
“The Committee suggested that AERC liaise with the Assembly Commission on whether an amendment to Standing Orders would be required or whether it could be accommodated as an element of the review of the FAPP scheme. <BR /> <BR />Recommendation 6 recommends the continuation of the current arrangements for enhanced speaking rights. The Committee thought it would, again, be possible that existing arrangements could be continued without a change to Standing Orders. On the other hand, the Committee agreed that, if recommendation 7 of the report were accepted by the Assembly, an amendment to Standing Order 20(7) could be accommodated to allow the first question for oral answer to Ministers to come from the official Opposition.”
“Before I begin my comments, I wish Peter well and a speedy recovery, and I put on record my condolences on the sad loss of his mother. <BR /> <BR />Following a briefing from Trevor Reaney, whom I, on behalf of the Committee, thank for the report, the Committee was pleased to review and respond to the draft recommendations. The Committee's response to AERC focused on those recommendations that are likely to require procedural changes, namely recommendations 4, 6, 7, 8, 10 and 11. I will try to briefly reflect the Committee's view on each of the procedural recommendations in turn. <BR /> <BR />The Committee's view was that recommendation 4 may not, in fact, require a change to Standing Orders.”
“That seems fairly piecemeal, to be honest. I know that you said that it is significant, given that the work looks at removing nine types of single-use plastic. Given that the directive has to be honoured by January 2022, will the Minister commit to trying to give further detail on his answer? I appreciate that it is a topical question and that he may not have all the details, but I know that others would appreciate a bit more detail on what he is doing in his Department on behalf of the Executive.”
“Is it for nurses? Is it for doctors? Is it for beds?”
“If they are getting additional support through that £21·2 million —”
“I thank the Minister for coming to the House. With respect, I do not think that anybody who has been waiting on a hospital trolley for 30 hours is going to understand what No More Silos means. I think that we all accept that, and I am not being pernickety but, if the £21·2 million is for emergency care, say so, because families are sitting in cars outside hospitals in which their elderly parents are waiting on a trolley for 30 hours to get a bed. We need to be clear. <BR /> <BR />I ask the Minister to be mindful of another thing. At the weekend, I spoke to a nurse at the children's hospital in the Royal who had worked in Africa. She said to me that both the emergency department and the children's hospital in the Royal were akin to the scenes that she saw in Zambia. Our health and social care staff are under massive pressure.”
“I thank the Minister for her response. She outlined some of the physical and, indeed, psychological impacts that drink spiking can have. Again, it is carried out with the overwhelming intention in mind of sexual assault or rape, the majority of which offences are committed against women and girls. <BR /> <BR />Will the Minister agree that the issue could be examined as part of the strategy to prevent violence against women and girls? I am sure that she will also agree that it is terrible that, in the 21st century, we are having to educate, overwhelmingly, women and girls on how to protect themselves. The penalties for those offences should be the deterrent rather than the focus being on trying to teach women and girls how to be safe when they go out for a drink, a walk or something else. It is ridiculous.”
“If 24 red-flag children who either have cancer or are suspected to have cancer are waiting a year, what does that tell you about the rest of Health and Social Care? <BR /> <BR />Again, I thank Colin, and I thank the commissioner for bringing forward the report, but there is a challenge for us all, because, when it comes to equality in health at the point of need, we are failing children and young people.”
“However, with the length of time that children and young people are waiting for their first or second appointments or for diagnoses, the list is getting worse. It was like that before COVID. Let us be honest about that. COVID has compounded it, but it has got progressively worse. There are no signs that it will be fixed soon. <BR /> <BR />At the heart of it is the fact that it is not just about money; it is about workforce planning. No safe staff legislation has been brought forward. The approach to workforce planning is to bring more agency staff in, and that is completely unacceptable. We have heard practitioner after practitioner talk about how the system is bursting at the seams.”
“I thank Colin McGrath for bringing this Matter of the Day. As Colin said, 17,000 children and young people under 18 years of age are waiting for equality. I also commend the Children's Commissioner for bringing the report forward. However, I have serious concerns, as will most Members. There are 24 children who have been waiting for a year and are considered to be red-flag cases. That is horrendous. It is horrendous for them, their clinicians and their medical teams but more so their families. We know them. They are people like us, and it is awful. <BR /> <BR />The system is broken. The system needs to be fixed. We have all said that we need to take politics out of health. We all agree on that.”
“I also put on record my gratitude to Voice of Young People in Care (VOYPIC) and other organisations concerned with the rights of children who are looked after. They have been waiting for legislation such as this for years. Many of them have been the voice of the voiceless. I know that they will be delighted that the age will be extended to 25 as a result of the Bill; indeed, there are clauses that talk about adult children who have been through the system. That will be well recognised. <BR /> <BR />I thank the Minister for bringing the Bill to Second Stage.”
“If someone with the best will in the world and the greatest compassion wants to do their job but is not able to execute their duties, they are, although it is not their fault, in breach of their statutory and corporate responsibilities. No one — none of us here and no one in Health and Social Care — wants to be in that position. <BR /> <BR />I referred to the fact that the guidance needs to be very clear. I have worked with social workers over many years. They know who they are, and I know that they are listening. I put on record my thanks and gratitude to them. They have done what they were asked to do and then some and in very difficult circumstances. They have put themselves at risk on many occasions, particularly when children have kicked out at them and been violent.”
“I ask the Minister to look at contact arrangements and contact centres. They need to be age-appropriate. I know many in social services who try their best, but arrangements sometimes do not suit estranged parents or other siblings, particularly when they are trying to get everybody together and there are gaps in age. I ask for greater flexibility. The fact is that there are massive pressures on social services now as there were well before COVID. When we look at workforce planning and at the roles and the guidance that will be needed for the legislation to be understood, we definitely need to look at the resources that are to be attached.”
“We all know that children who grow up and are reared through a corporate system by corporate parents are really disadvantaged. Personally, I am delighted to see the age of 25 recognised, as it is in Europe. It is great that it has happened, because it will mean an awful lot to those young people. It is really important that, when we look at the legislation, we check it against the UN Convention on the Rights of the Child. I have no doubt that that will happen.”
“I appreciate that, LeasCheann Comhairle. You are right. I am doing this to give people advance notice; in the absence of clarity, I will repeat it at Committee Stage. I hope that the officials who are listening will have that information when they come to the Committee. <BR /> <BR />In relation to care plans, I was delighted to hear the Minister say that the Bill takes into consideration young people between the ages of 21 and 25. I considered bringing forward a private Member's Bill on this issue because, having worked with the Children's Law Centre and, indeed, with children who came through fostering and with looked-after children in the system, when it comes to statutory responsibilities, the fact that the age of 25 was not recognised, particularly when children were trying to access housing, made it very difficult.”
“I appreciate that this is new and that it will be improved, but I looked for references to welfare checklists in article 3 of the Children Order, and they are not there. I assume that that is with the statutory authorities, but, when you scrutinise legislation, you should not assume anything; you get it clarified.”
“As a woman who is just over — well, a good bit over — 55, I wonder what that means. Does it relate to the life expectancy of an adoptive parent? What is that? Our life expectancy is, thankfully, slightly longer now. Given that there is a shortage of people who can foster and adopt, it is important for that to be clarified. <BR /> <BR />Will the Minister provide further detail on clause 76 on the adopted children register, specifically in the context of clauses 12, 60 and 105 in relation to privacy and disclosure? They are all connected and related to each other. <BR /> <BR />Colm mentioned clause 88 in the context of inter-country and all-island adoption as I have done. <BR /> <BR />I mentioned the welfare checklist that is specified in clause 119 on special guardianship.”
“In the past, some of the religious institutions were adoption agencies, and those parishes were referred to on birth certificates as well as some of the paperwork that people were subsequently able to retrieve. It is important that that is reflected. <BR /> <BR />I will raise an issue on clause 68. The legislative position has been that:”
“I want to see the guidance and criteria for that. I understand that people are coming at this from a good place, but, in the past, particularly in the Magdalene laundries and mother-and-baby homes, information was power. That power was used to control people and prevent their access to information. An awful lot of power was in the hands of one or two people. It is hard to legislate for that, but we have an opportunity to ensure that that is not repeated. <BR /> <BR />Clause 65 concerns the meaning of adoption. It is laid out in chapter 4, and Colm touched upon it. When you look at areas around the border — Fermanagh, Cavan, Monaghan, Derry, Donegal — you see that some parishes there are all-island. That includes not only Catholic but Church of Ireland parishes. I am not sure about others; pardon my ignorance.”
“They want to find things out. That facility is crucial, notwithstanding the implications of the Data Protection Act 2018 and the Public Records Act 1923, for people researching history, particularly that before partition. We need to look at that. While we need to protect people's rights, people need to be able to access information. That is vital. <BR /> <BR />I ask for additional information about clause 61, which concerns disclosing protected information about children. Subsection (2) says:”
“Perhaps social services, the police or others have such a checklist, but we will need to see it when we scrutinise the Bill. It is important that the concept of consent be included in the checklist. It is mentioned in clause 1(4) and is relevant throughout the Bill, particularly in clause 52, which concerns the modification of the Children Order in relation to adoption. The welfare checklist is important in every clause, but certainly in relation to kinship, which has been missed in that clause and should be included. <BR /> <BR />Clauses 60 concerns disclosing protected information about adults. Jim Allister raised a point about that at the start of the debate. Often, as I know from some of my constituents who found out that one of their grandparents had been adopted as a child, people want to know about their family history.”
“and clause 33 difficult to read. We are talking about human beings here, but it reads as though we are talking about returning items. I know that that is not where the Minister or officials are coming from. Legislation is dry and devoid of emotion at times, but, to be honest, I found that wording a bit inappropriate. That is not what any of us want to see. <BR /> <BR />Clause 38 concerns recovery orders. The reasons for those have been listed in the context of breaches that are outlined in clauses 15 to 37. Again, we need to look at the definition of harm in clause 133, and at the introduction of subsequent legislation. <BR /> <BR />We need to consider a welfare checklist. I looked for such a checklist in the Children Order and in the Bill, but I could not find it, even though children's welfare is mentioned throughout the Bill.”
“However, the 1995 Children Order will probably need to be amended, if not fresh legislation brought forward, because it needs to take into consideration and include reference to the Domestic Abuse and Family Civil Proceedings Act 2021. I will make reference to that when I reach clause 133. <BR /> <BR />I found clause 32:”
“I am not being pedantic or nitpicky, but when talking about clause 17, the explanatory and financial memorandum (EFM) uses language that we need to look at as it talks of a parent's consent to "his child" being adopted. As recently as yesterday, we mentioned that a woman has choices, and one of those choices is the adoption of her child. That needs to be reflected in the Bill. The terminology might be something archaic in the law that has been transported, but I do not think it is right. <BR /> <BR />Clause 18 relates to placement orders, and, again, it references the Children Order. The alignment of adoption law with the Children Order 1995 is very welcome.”
“I think that is a mistake, because data protection has, as the term suggests, legal protections that are very clearly laid out. If they are not clearly laid out, there are implications for the Bill under articles 8 and 13 of the European Convention on Human Rights (ECHR). <BR /> <BR />Clause 17 is headed "Advance consent to adoption". It cross-references with clause 51, which covers provisions that allow a parent to relinquish their child for adoption if they wish. In order to do so, they must have no further involvement with their child. Clause 51 should have a bit more of a focus on consent. I know there are additional and separate categories of consent. As with any massive Bill, you go back and forward. I am not complaining about that; that is what we are here for.”
“Again, while the clauses are almost deliberately going into each other because of their connection, I believe we need greater definition, because it is not there. For me, clause 12 also presented some concerns about, arguably, clause 60 and 61, which are on disclosure. I will touch on that again. I ask for additional information on that because I want to know what the rights of adopted children are, and the Bill is not very specific on them. Colm made the point about how the Adoption and Children Bill should be called the Adoption of Children Bill, because it is a bit misleading. I accept that that is not deliberate; it is probably the nuance of language. <BR /> <BR />The Minister mentioned data protection, and I welcome that, but I have looked across each chapter and clause, and data protection is not mentioned once.”
“Further on, the Bill talks about RQIA's role, but I want to know what the differences are. The Minister and Members across the House will fully appreciate that I want to see additional clarity on those differences when it comes to private fostering and adoption arrangements. <BR /> <BR />I referred to the role of RQIA and the management of adoption agencies in clause 9, but I will turn now to the management of agencies in clause 10. What role, if any, will the statutory advocate have? Again, I welcome that advocate having statutory power and vires, but the role is not clear to me, even though I read clause 10 quite a few times. <BR /> <BR />Clause 12 is headed:”
“Colm and other Members mentioned kinship. If kinship is special guardianship, the Bill needs to say so. I know it is not the intention of the Minister and his officials, but the lack of mention of kinship undermines the work involved in and the value of kinship. I know that is not intentional, but, when we are correcting previous legislation and guidance through the Bill, we need to reflect that. If kinship is not special guardianship, fair enough, but I want to know exactly what it is. <BR /> <BR />Clause 9 covers the general power to regulate adoption agencies. Again, I want to know the differences between those adoption agencies that are under the guardianship, care or the scrutiny of the regional health and social care boards and those agencies that are not. What regulates them?”
“My understanding is that the adoption authorities are the five health and social care trusts. The regional board and its relationship to each of those trusts needs further definition. As has been raised, and I will touch on this again later, there needs to be a seamless link between each adoption authority and their procedures. The guidance on that needs to be clearer and seamless as well.”
“That is not to say that it will be as it was in the case of mother-and-baby homes and Magdalene laundries, but we need to have quite a lot of detail. <BR /> <BR />Clause 3 refers to the regional adoption board.”
“Like many others, I am used to reading legislation, and I will certainly scrutinise the Bill in the Health Committee, but there is a lot to be said for plain English. The less ambiguity around legislation, the better, because we need to ensure that people have a clear understanding. <BR /> <BR />Minister, I commend you for bringing the Bill to Second Stage. As the Chair, Colm, outlined, the Committee had discussions with and presentations from officials. I want to come back to those at a later stage. <BR /> <BR />I would appreciate "private fostering" and, indeed, "private adoption" being outlined in clause 1. I would like there to be further explanation of what those private arrangements may entail, because that is really important.”