Michelle O'Neill
Mid Ulster · Sinn Féin · Northern Ireland
“We are shocked and deeply saddened for both the victim of the horrific incident in north Belfast and the people who have been impacted on by the disorder that we have witnessed since. There is absolutely no justification for racism, violence or intimidation.”
“It is the latest chapter in a political psychodrama. It has been playing out in Westminster for forever and a day but particularly over the past 10 years. Tomorrow is the 10th anniversary of Brexit, which inflicted so much damage to the wider economy. We are now on the verge of having a seventh British Prime Minister in 10 years.”
“We cannot look at things in isolation. Whether it is the refugee integration strategy, the framework or the legislation, all those things need to move together and at pace.”
“I agree with the Member about the ugly language that was used to describe some people in our community. Like the Member, I have met many people from the black and ethnic minority community in recent times. I do that on an ongoing basis, but I did so recently given what happened over the last number of weeks.”
“There is not just one answer to it, as the Member knows. We need to come at it from every angle. That could be a policing response initially, for which additional funding was secured. I agree that this is the third year in a row in which we have had that type of racist behaviour on our streets. Likewise, I would describe it as a pogrom.”
“Building on that progress, the Executive Office is contributing £3·3 million towards the Derry on the North Atlantic Museum, which is due to open in 2027 and will further enhance Ebrington’s role as a heritage and tourism destination. <BR /> <BR />Ebrington is also continuing to develop as a vibrant events space.”
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“That is absolutely in line with my vision for health and social care. That is what we need to move towards. <BR /> <BR />It is a combination of factors. In the immediate term, we just need to keep working. The board and the trusts need to keep working with GPs to make sure that, for any areas that are identified as being under pressure — there are a number of them — we are forward planning, realising what is coming down the line, particularly in relation to retirements, and making sure that we have succession planning in place and plans to make sure that they can pick up the slack where other GPs perhaps retire, for example.”
“Those are all things that will help to take the pressure off GPs in the immediate term. <BR /> <BR />The longer-term solution is looking at training more GPs, and I have already announced that I will do it. There is an absolute shortage, and the point that I made earlier is a really key one: traditionally, in the past, the GP workforce would have been male and of an older generation. There is an ageing population there. Now, a lot more females are employed. There are actually more females than males employed as GPs. They do not all — not just the females, even the males — want to be independent contractors. Let us look at more flexible ways of allowing GPs to work. For example, can trusts be involved in contracting GPs to work for them and provide services for their communities?”
“You are right: on 23 December, I announced that I would take forward the recommendations of the GP-led working group, which charted out key issues that needed to be dealt with in the short, medium and longer term. I have said that I am wedded to making sure that we take those things forward. There is a range of issues. Without listing them all, it is about looking at multidisciplinary teams: who else can we put in to support the GP? As I said and recognise, GPs are under tremendous pressure, so we have to make sure that we do everything we can to support them. The best way that we can do that is to further enhance things like, for example, askmyGP. In the short term, we have committed to askmyGP being rolled out to an additional 30 surgeries. We have increased the number of pharmacists placed within GP services.”
“I have offered up how I believe we can do that. We are engaged with the Southern Trust around its potential involvement. That is looking towards salaried GPs. This practice had four GPs — two main contractors and two salaried GPs. One contractor left, and the other felt under pressure when the two salaried GPs went off on maternity leave. They did not receive the proper locum cover; they could not attract it. A combination of factors led us to this. We need to make sure that the public are assured that they have first-class GP services, and the board is making sure that that is in place. They will continue to monitor it, but we need a longer-term solution here and we are actively working to find that.”
“Let us be very clear again that patients will continue to receive very safe clinical care. Medical staff, nursing staff and prescribers are in place. They are all involved in making sure that patients receive first-class care. That is the guarantee that the board has given, and the board will continue to monitor that situation. Let us be very clear on the message that we are sending to the public. I am involved in responsible politicking, I assure you, and I would not make an announcement in relation to securing a contract if I did not believe that that was the case. When the board confirmed with me, the contractor had confirmed that he was willing to take up the position. <BR /> <BR />We find ourselves in a difficult situation, but we have to chart our way through it. The best way to do that is to find a permanent solution.”
“That is a wider issue in relation to the recruitment of GPs. We have to look at other ways of having GPs in place. Looking towards salaried GPs is one option that we need to explore an awful lot more.”
“I accept absolutely that people are worried about the future of their GP practice. That is understandable. I also accept that the surrounding GPs, who are under tremendous pressure, as we already know, are feeling the impact of it all. What we need here is a permanent solution, and I assure all the patients that this is what we are working towards. What we have in place now is a temporary solution, but I assure you, following a meeting that I had with the board earlier today, that there is GP cover, medical cover and nursing cover in place for the next six weeks. They will continue to make sure that we have rotas filled and cover that until we have a permanent solution. <BR /> <BR />There are a number of options for a permanent solution. The fact is that only one GP expressed an interest in the advertisement to come forward.”
“It is a temporary arrangement. We are working towards making sure that we have a permanent solution. We have to be creative about how we do that. Long gone are the days when the only solution to GP services was when GPs became independent contractors — individual businesspeople in their own right. The make-up of the GP workforce is now more female, and more people want a bit more flexibility. Not every GP wants to be a contractor; some want to be salaried, so we need to move towards that. We are engaged with the Southern Trust on how it can get involved and play its role. I believe that what we have in place now is making sure that we provide safe patient services.”
“This is, obviously, a temporary arrangement to make sure that we support the patients on the ground.”
“<BR /> <BR />I assure you that I do not make public announcements on the back of a potential public rally or anything like it; I made the announcement about the Bannview practice because a contractor had, in fact, confirmed that he was going to take on the practice. Since then, he has realised that he is not able to fulfil the obligations of the contract. That is why we have found ourselves in this situation. As of lunchtime yesterday, the contractor has officially confirmed to the board that he is no longer able to enter into the contract with the Department. <BR /> <BR />What is most important is that patients continue to receive safe clinical services, and the board, as I said, will monitor that. Ultimately, we need a permanent solution.”
“I say to all patients that they will continue to receive safe clinical services and that the board will monitor that. We have medical and nursing cover in place. We have arrangements with the Dalriada practice for out of hours and independent prescribers, all working collectively as part of a team to make sure that patients have access to first-class GP services, which they are rightly entitled to. It is important that we do not scaremonger but are responsible about this. I will ensure that the board, as I have asked it to do, writes to every member of the surgery to make sure that they are fully abreast of the situation.”
“I have accepted all of that group’s recommendations as signalling the direction of travel needed to ensure that everyone here continues to have access to high-quality, sustainable GP-led services.”
“To that end, I have confirmed the further roll-out of the askmyGP system. Given my focus on supporting and investing in primary care, I have also announced an increase to 111 GP training places over the next two years. <BR /> <BR />There has been significant investment in GP-led services over recent years. This year, 2016-17, saw the investment of up to £7 million in GP services following contract negotiations, building on an investment of up to £5 million made last year. Those commitments, which will help to ease the workload of GP pressures and attract more doctors into general practice, will build on the already significant investment in general practice over recent years and reflect some of the recommendations of the GP-led working group.”
“In 'Health and Wellbeing 2026', I set out the importance of primary care, and I have confirmed my intention to invest significantly in it. The future model of primary care must be focused on keeping people healthy and well, and it must be based on multidisciplinary teams embedded around general practice. I have already announced plans to have named district nurses, health visitors and social workers for every GP practice as well as plans to support the development of new roles such as physician associates and advanced nurse practitioners. Our continued investment in practice-based pharmacists will see over 100 in place in the near future. I also intend to invest in technology to help to transform the way in which general practice works and to improve services to patients.”
“I fully appreciate that patients are concerned about the current situation, but I reassure them that every effort is being made to secure a permanent solution for the practice and that the board will write to all patients to advise them of the current arrangements.”
“Yesterday, unfortunately, that contractor officially withdrew their intention to take on the practice. This is an extremely disappointing development, and I met the HSCB today to ensure that patients will continue to receive safe and high-quality healthcare and that all possible options for a permanent solution are being considered. <BR /> <BR />The HSCB has confirmed to me that it is actively seeking to secure a permanent GP contractor to take over the Bannview practice. It is also exploring other options, including the Southern Trust taking on the contract for Bannview. The board will continue to manage the practice and ensure that GP services are provided to patients whilst it works to secure a new contractor to take over the practice. No decision has been made to close the practice.”
“The Health and Social Care Board (HSCB) widely advertised the GP contract for Bannview practice, met a number of practices and held an information evening with practices in the surrounding areas. It also provided information and support that would be available to a new contractor taking on the Bannview practice. Despite all of its efforts, no applications were received by the closing date of 2 December 2016. The HSCB continued its efforts to secure a contractor for the Bannview practice, and, having identified an interested GP, it held a number of very positive meetings with the prospective contractor. Consequently, on 5 January 2017, a new GP contractor confirmed to the Health and Social Care Board that they would take on the Bannview Medical Practice from early March 2017.”
“Do not use your electioneering on me today, let me tell you. I am interested in delivering for the public. I am interested in doing absolutely everything I can. I will continue to do that until the day I cease to hold office.”
“Do I apologise for prioritising mental health? No, I do not. Do I apologise for setting out a vision for transforming health and social care and delivering better health outcomes? No, I do not. Do I apologise for putting a focus on tackling health inequalities? No, I do not. Do I apologise for all the things that I have done in relation to engaging with staff and making sure that their voice is heard? No, I do not. The issue of waiting lists has been unacceptable to me since the day and hour I took up office, and I have been working every day to deal with those issues.”
“I am in office until the eve of the election, whenever it might be called, and I will continue, at my desk, doing my work every day. That includes taking decisions relating to the future of the air ambulance and how it will be staffed. I have always said that I will be guided by the Chief Medical Officer and his recommendation, and that continues to be the case.”
“We have made it very clear. let the public decide; let the people decide. We have had DUP arrogance, failure to recognise the public mood, failure to listen to concerns and failure to do the right thing. The public will now have an opportunity to have their say, and I look forward to engaging on the doorsteps with everybody who wants to talk about it, but I am making it very clear: we will only come back and be part of an institution and Executive that have equality embedded at their core.”
“We will, however, only ever come back to these institutions and be in the Executive if equality is embedded at their core.”
“Again, we are back to the same point. The reason why we are in this situation is the DUP, its arrogance, its lack of integrity, the RHI scandal and everything else that went before it. The DUP should have listened to the calls for Arlene Foster to stand aside, allowing a full investigation to disclose all of the information and have it in the public discourse. There is a crisis of confidence in the institutions — an absolute crisis of confidence. People do not trust the DUP, so I absolutely think that Martin McGuinness took the right decision. We know that he took the right decision. It is now over to the public to have their say. Our track record on delivery and on putting equality at the core of the Departments for which Sinn Féin has held the ministerial portfolio speaks for itself, and we will never be distracted from that.”
“I want to make sure that I drive forward the transformation piece, but I tell you this: I will not be part of a government in which the DUP is not interested in equality. We cannot be partners in government with people who care about certain sections of society only. It is not good enough.”
“The Finance Minister, Máirtín Ó Muilleoir, answered you earlier in relation to section 59. This is another example of the DUP trying to scaremonger and get cover. The reason we are in this situation is absolutely of the DUP's making; it is nobody else's. Had the DUP listened to the public outcry and been really serious about having integrity in government, it would have stood aside. We are in this position because of the actions of the DUP, not those of Martin McGuinness. Martin McGuinness did the right thing; he tendered his resignation because he was no longer prepared to lead his party in government with people who are not interested in equality or mutual respect. Our position is very, very clear. I want to be at my desk delivering for health and social care.”
“Do not talk your nonsense with me. Do not try to muddy the waters. I am absolutely committed to making sure that I deliver every support to those people with a disability or a learning disability. I am absolutely committed to making sure that we get to the bottom of the issue in the Western Trust and that those families can get on with caring for their loved ones. I do not think that you should use the issue to try to score petty political points. I am not interested.”
“I have done absolutely everything I can. You are right: I am leaving office. Do you know why? Because I will not tolerate the arrogance of the DUP. That is exactly why I am leaving office. You can sit on the sidelines, but you are absolutely irrelevant. Let me tell you why: you could have brought all the motions you wanted to the House, but the only person who could hold Arlene Foster and the DUP to account was Sinn Féin and Martin McGuinness when he placed his resignation before the House. So do not talk —”
“It is more important to make sure that they start to build a relationship with the trust again and that the independent facilitator accommodates that to allow them to feel confident that their loved ones are being looked after and for trust to be built up again between the individuals and the trust. For me, making sure that that work is done is far more important than trying to make a headline for yourself in next week's local paper. <BR /> <BR />I want to be a Minister. I have shown my track record and what I could do when I came into office. Every decision that I took was based on equality and mutual respect, and my track record in transforming health and social care, listening to staff and patients, listening to —”
“You should not shout over me. <BR /> <BR />I have done everything that I can to work with the families. I agreed a number of actions with them. I told them exactly what I was going to do. I told them that I would appoint an independent facilitator and that it was time that we started to try to build a relationship. I thought that we could do that through the appointment of an independent facilitator. That is exactly what I have done. It is important that we support those families and that they feel that they are being listened to. I said that we would get to the bottom of the issue and get clarity on the £8 million that we talked about.”
“You have a neck on you to tell anybody to take anything seriously. I have taken up this issue. From the very first day that I came into office, the issue was brought to my attention. I have done absolutely everything I can to work with the families.”
“These require me to approve the appointment of a facilitator, which I will do following further engagement with representatives of the families in the area. I have also appointed a senior official from the Department to oversee progress and to act as a point of contact for the families. Arrangements are also being made to facilitate a meeting between the Health and Social Care Board and families to discuss the capitation formula. Obviously, it is a complex subject, and the families are very keen to know more and to understand it.”
“Maybe the Member was not in earlier; I did answer this question, but I am happy to do so again. I have repeatedly made clear my commitment to making sure that the issue is resolved. I have met the families and agreed a number of actions with them that we are going to take forward to facilitate their being able to achieve the information they asked for. I have made arrangements for the appointment of an independent facilitator to work with the trusts and the families to restore relationships, so that a plan for further investment in adult community learning disability services can be developed in the area as a matter of priority. <BR /> <BR />The terms of reference for this work have been finalised and were issued to the chief executive of the Western Trust in December.”
“There is a European-wide issue, perhaps even a global issue, about a shortage of people to work in these fields, and that is where the workforce strategy comes in. <BR /> <BR />Nobody should have to wait in corridors or side rooms, and our staff are doing everything that they possibly can. This year, we were in a better state of readiness in our preparations for winter than we ever have been. I made sure that I brought everybody in — all the heads of the trusts, the board and the Ambulance Service — to be assured that everything that could have been done in advance was being done. We did have particular, challenging issues this year, not least being the fact that more people attended our emergency departments, but also because we had outbreaks of viruses such as the norovirus, which obviously put additional pressure on hospitals.”
“Obviously, the priority has to be about making sure people are seen as quickly as possible. It is regrettable to say that some people have had to wait the extreme length of time that they have had to do. I have outlined the challenges that our emergency departments face, but we are not alone in that. The same challenges are right across this island; they are in England, Scotland and Wales. Actually, they are as far as Europe where there is an issue about recruiting consultants. It is an issue that needs to be factored into the future workforce planning, because one of the things that I always said when I took up post was that I was really surprised that there was not an overarching workforce plan.”
“I concur. The staff in the emergency departments have been under immense pressure. They have all come in when they are supposed to be off. They are coming in, covering shifts and doing absolutely everything. I absolutely put on record how fantastic they have been, and they continue to work really hard as we get through the winter period. <BR /> <BR />I can confirm it for you in writing, but I believe that we have been successful in the recruitment of at least one emergency consultant at Daisy Hill. We had advertised for two posts. I will confirm it in writing when contracts have been signed, but I believe that we were successful in attracting someone to the post.”
“I want to pay tribute to all the health and social care staff; in particular, those staff who have had to face increased demand in emergency departments in all our hospitals over the last number of weeks and who continue to do their very best in extremely difficult circumstances.”
“A workforce planning review of emergency medicine has been carried out, covering the period from 2014 to 2022. A number of recommendations have been made, which are being considered by the Department.”
“The plans for each area include a comprehensive range of additional or enhanced measures to manage expected winter demand, as far as possible avoiding the need for patients to go to hospital or, where this is necessary, avoiding the need for admission through the usage of ambulatory pathways. Where patients do require hospital admission, the plans propose a range of additional enhanced measures to optimise patient flow on a seven-day basis, including timely discharge. However, the rise in demand was right at the upper end of the forecast, and this has been reflected in the impact on emergency departments. <BR /> <BR />HSC trusts are also continuing to work to recruit emergency medical doctors, but there is a recognised shortage of those staff. The Department is continuing to address the issue of medical workforce planning.”
“The latest provisional information that has been provided by the Health and Social Care Board (HSCB) for the nine larger acute hospital type one emergency departments indicates that, from Saturday 24 December to Wednesday 4 January, there was an increase of 8% in the number of people who attended emergency departments compared with last year. In some hospitals, this figure was as high as 14%. There was an increase of 5% on the same period last year in the number of patients who were transported by ambulance to emergency departments. <BR /> <BR />As I have said, the trusts and the HSCB put detailed plans in place for this winter.”
“With your permission, a LeasCheann Comhairle, I will answer questions 4 and 12 together as they both relate to the pressures that are being faced by emergency departments and the action that is being taken to address them. <BR /> <BR />The period following Christmas and new year is always one of increased pressure for health services right across Europe. I wish to assure you that we plan for this on an annual basis. However, it is true that this year has been an exceptionally challenging period for trusts and the Ambulance Service across the region due to winter illnesses, including norovirus.”
“I can assure the Member that I am actively looking at that area and issue and how best we can use the funding. I am glad that she welcomes the new scheme. It has certainly received positive feedback from the community and voluntary sector. Given how we have now aligned the new scheme, we need to look at that additional funding. I am committed to doing that. I am looking at potential ways in which we can support the community and voluntary sector, and I particularly want to look towards mental health. I think that there could be an opportunity for us to do something in relation to that. I will keep the Member informed as to how we will roll it out, but I am looking at the 25% and how best we can make sure that it does enter the community and voluntary sector arena and how best it can then be spent.”
“I have always said that the future of delivery may look different, but there is no doubt about it: hospitals like the Downe Hospital should look at this as a real opportunity to be part of the new vision for health and social care.”
“Obviously, there was a change in the approach to monitoring rounds. We were doing things differently. It is now a process of ongoing conversation with the Finance Minister, and I can assure you that I regularly knock on his door. I had an opportunity to go down and meet some of the staff of the Downe Hospital. I very much welcomed that opportunity. They are absolutely passionate about what they can do. They also see very clearly their role in how health and social care will look in the future. The Downe Hospital absolutely has a key role to play. I am looking forward to working with the staff to ensure that we develop that and that the Downe Hospital plays a significant role in the future delivery of health and social care.”
“Whilst, as I have said, I was supportive of the innovative aims of the proposed innovation scheme, I was concerned that closure of the core grant scheme would leave a significant gap in relation to the strong advocacy role that is performed by the voluntary and community sector. Work on the design of the scheme has started, and I have asked officials to engage the sector in the design process. Organisations that are currently in receipt of core grant funding will continue to receive grants at current levels until the new core grant scheme is up and running and accepting applications. To be very clear: there will be no reduction in grants in 2017-18 as previously planned. All 65 voluntary and community organisations that are currently in receipt of core grant funding were informed of my decision by letter on 5 January.”
“The more that I have considered that over recent months and the more that I have engaged with the community and voluntary sector, in place of the innovation scheme, the more that has led me to intend to establish a new core grant scheme that will be linked to the vision for health and social care and transformation. It will support the core functions of voluntary and community sector organisations and will be open to applications from any voluntary and community sector organisation that demonstrates that it meets the aims of the requirements of the new scheme”
“It is really important that I listen to the views of the groups out there on core grant funding, and I did so over the past number of months. One of the issues that they consistently raised with me is their belief that the loss of core grant funding will be detrimental and take away from their ability to provide advocacy services. Therefore, I would give some consideration to what was originally tabled for the way forward, where there would have been a reducing percentage of core grant funding going out and an innovation scheme coming into place.”
“This situation absolutely falls at the feet of the DUP and its arrogance.”
“The public need to be very sure that, when I or any other Minister who is part of an Executive takes a decision, it is done on the basis of the public interest and on the basis of equality, parity of esteem and mutual respect. <BR /> <BR />I do not think that the public will thank us or anybody else for being part of institutions that do not have equality at their core. It is now over to the public to have their say. I will send this message to the public: I believe that I have set out a vision for health and social care. I wanted to be at my desk continuing to deliver the transformation. I will stay at my desk until the eve of the election, when that ceases to be the case. I am as determined today to deliver on the principles of the health service as I was when I took up office and set out the transformation journey.”
“I have said it previously and will say it again: let us be very clear that the reason why we are in this scenario is because of the DUP. We are in this scenario because of the DUP's arrogance and the fact that it continues to ignore the public concern over the RHI scandal. Until seven months into this mandate, it failed to publish a plan for how it is going to stop the flow of money. Despite all the pleas and calls for the First Minister to stand aside, she ignored the public, and we now find ourselves in a scenario in which we have no option. Martin McGuinness took a very considered decision to place his resignation before the Assembly. It was absolutely the right thing to do. I only want to govern and be part of institutions that have equality at their core. Without that, there is no public confidence in them.”
“What do I say to the people on waiting lists? I say that it is not good enough, and I continue to say that. It is absolutely not good enough. I set out how we needed to transform health and social care in the short, medium and longer term. I set out a number of key actions that we need to deliver from the Bengoa report and the direction of travel for doing that. There are 18 points. We have actioned quite a number of those, and we are on target to deliver on the others. There was some confusion last week. I will publish an elective care plan. I will publish exactly what I intended to do with waiting lists, because that is important for trying to build public confidence. <BR /> <BR />We cannot let the waiting lists issue overshadow the real, meaningful transformation that we need to achieve.”