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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“<BR /> <BR />I have consistently said that the transformation of the health and social care system will require significant funding, but it is important that, first, we build capacity in primary care by developing multidisciplinary teams, increase surgeries that do not require overnight stays and move towards elective care centres to focus on waiting lists, among many other things.”
“Those pressures are being managed proactively, and will continue to be, in order to live within our resources, but let us be clear: public finances will continue to flow in the absence of a January monitoring round. We are all aware that Health is facing significant and increasing challenges, and, in endeavouring to meet the ever-increasing demand from within constrained financial resources, there are a significant number of front-line-service pressures right across the sector. As I said, those pressures are being proactively managed in order to live within resources. We will continue to engage with the Department of Finance to address the additional investment necessary to support the delivery of services.”
“As the Finance Minister said in the previous Question Time, as there is no Executive, due to the DUP's mishandling of the renewable heat incentive (RHI) scandal, there will be no January monitoring. We refused to tolerate the DUP's arrogance and the contempt that it continued to show towards power sharing and the principle of equality. That is regrettable, given that we are all aware that Health is facing significant and increasing challenges in endeavouring to meet the ever-increasing demand from within constrained financial resources. There are a significant number of front-line service pressures right across health and social care, from the hospital sector through to community services and social care.”
“I am as committed today to the transformation and the work that needs to happen on it as I was when I announced it in the Chamber a number of months ago. We have to deliver transformation; otherwise the health service will continue to be in crisis and waiting lists will continue to grow. Transformation is the long-term answer. If we invest, I believe, wisely in primary care and in bringing care into the community — that includes domiciliary care workers and everyone who works at the coal face and supports individuals — we will arrest the picture, and we will be able to change things. However, in the absence of transformation, we cannot keep doing things the way we are and expect people to have different outcomes.”
“I think that I have clearly set out what needs to happen. I set out the transformation vision, Delivering Together, which is the road map; that is what we have to do to transform the picture. There is no doubt that our GPs are under significant pressure. We all recognise that; we all see it every day, and we all engage with people who are trying to get an appointment but cannot. GPs need our support, and that is what I said I wanted to do. It is about building a multidisciplinary approach and about making sure that when you go to your GP, you can, perhaps, be seen by an occupational therapist or physiotherapist or anyone you might need in a multidisciplinary team. <BR /> <BR />If we do not get to that place, our hospitals will be continually under significant pressure and our waiting lists will continue to grow.”
“I also intend to invest in technology to help to transform how general practice works and improve services to patients. To that end, I have confirmed the further roll-out of the askmyGP system. I have also said that I will bring forward a public consultation on the role of GP federations. Further detail on our approach to building multidisciplinary teams will follow over the next short period. <BR /> <BR />Given my focus on support and investment for primary care, I have also increased to 111 the number of GP training places over the next two years. This year, 2016-17, also saw investment of up to £7 million in GP services following contract negotiations, building on investment of up to £5 million made last year.”
“Investment in primary care is critical. The vision for transforming health and social care, 'Health and Wellbeing 2026: Delivering Together', set out clearly the importance of primary care. As part of that vision and direction of travel, I confirmed my intention to invest significantly in primary care. We have to change the future model of delivery. The future model of primary care must be focused on keeping people well and healthy; it must be based on multidisciplinary teams embedded in GP practices. <BR /> <BR />I have already announced plans to have named district nurses, health visitors and social workers for every GP practice; to support the development of new roles such as physician associates and advanced nurse practitioners; and to continue to invest in practice-based pharmacists.”
“That is in relation to performance, but the issues faced by the Southern Trust in relation to out-of-hours services are pretty typical of issues with out-of-hours services across the piece. This points to the need to train more GPs, and I have already set out what I am going to do. It points to the need to look at other services that can be provided in the community and how else we can provide additional nurses. I have said that we need to enhance the role of advanced nurse practitioners, and we need to look at placing pharmacy at the centre of GP services. I have set out the direction that we need to take to fix a poor picture in relation to the stress and pressure that I have no doubt GPs are under. The situation in the Southern Trust is symptomatic of the wider issues and the need to transform health and social care.”
“From 20 December to 2 January, the Armagh base was open 18 out of 28 times, which is 64%. Although the Armagh base may be closed, the GP out of hours is a trust service, and patients in Armagh will be provided with a service. When it is closed, it affects only appointments, and patients will be offered an appointment in one of the other bases. Normally, the Armagh base has one GP; however, on six of the occasions that the Armagh base was open, it was staffed by two GPs, and on one occasion it was staffed by three GPs. The GP out of hours service is provided to all the Southern Health and Social Care Trust population and is delivered by GPs, triage nurses, nurse practitioners and pharmacists from bases throughout the trust.”
“<BR /> <BR />I set out a vision for transforming health and social care that very clearly put it at its core that we need to invest heavily in primary care and bring care closer to people's homes. That is absolutely the vision I am wedded to and will continue to be wedded to until I leave office. I would much prefer to be driving forward with that transformation agenda, but there is a crisis of confidence in these institutions because of the actions of the DUP. As a result of the actions of the DUP and because of its continued arrogance and disrespect towards the public, I believe that the public are rightly entitled to have their say on the future, and that will include GPs.”
“I think my track record speaks for itself in what I have done, in the early days in office, on investing in primary care to make sure that we support our GPs. I have taken on board the whole review and the recommendations that were put forward under the GP-led review. I am as committed today as I was when I announced I would take on board all those suggestions and make sure that we implemented them. <BR /> <BR />The situation we are in today is not of my making. It is absolutely down to the arrogance of the DUP. It is down to the RHI scandal. Let us be very clear about where we are in relation to the current situation and why we are in the scenario that we are in.”
“<BR /> <BR />I have also said I will bring forward a public consultation on the role of GP federations. Further detail on our approach to building multidisciplinary teams will follow over the next number of months on how we are going to do that and how we are going to secure what I have set out in 'Delivering Together'. 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. This year, 2016-17, saw the investment of up to £7 million in GP services following contract negotiations, building on investment of up to £5 million made last year.”
“I set out in 'Health and Wellbeing 2026' the importance of primary care, and I have confirmed my intention to invest significantly in primary care. The future model of primary care must be focused on keeping people healthy and well and must be based on multidisciplinary teams embedded in general practice. I have already announced plans to have named district nurses, health visitors and social workers for every GP practice to support the development of new roles such as physician associates and advanced nurse practitioners and to continue to invest in practice-based pharmacists. I also intend to invest in technology to help transform the way general practice works and informs the services to patients. To that end, I have confirmed the further roll-out of the askmyGP system.”
“<BR /> <BR />The Southern Trust has taken a number of actions to support the out of hours service, including the introduction of nurse practitioners and clinical pharmacists to support GPs in managing the service. Patient and staff safety is of the highest priority, and, in the event that there are insufficient clinical staff to cover all out of hours bases across the trust area, resources may be consolidated in fewer bases. Where this is the case, all patients calling out of hours services continue to receive telephone advice and are offered an appointment at an alternative base or a home visit, as deemed clinically appropriate, following the initial telephone triage. <BR /> <BR />There has been significant investment in GP-led services over recent years.”
“The out of hours base in Armagh city is open each weeknight and for three slots on both Saturday and Sunday. The Southern Health and Social Care Trust seeks to ensure that a safe and sustainable GP out of hours service is available across all five bases in the trust area, including Armagh. In 2015-16, the Southern Trust out of hours service received nearly 94,000 initial patient telephone calls. The service provided over 5,000 home visits and 52,000 GP, nurse or pharmacist telephone assessments, and 36,000 patients had appointments in the Southern Trust out of hours centres. Despite the increasing pressure facing the service, more than 85% of people contacting the trust's GPs out of hours were triaged within 20 minutes.”
“It very much points to the need to look towards more care in the community, making sure that we provide support close to people and, in an ideal situation, in their home, if that is possible. Short breaks or residential care, as you call it, are a crucial component of the continuum of comprehensive support services, but we need to make sure that we provide every possible opportunity for people to receive care in the manner in which they need it. I believe that, like everything else right across health and social care, it is about bringing care closer to people and closer to their home.”
“I do not have the breakdown for east Belfast, so I cannot give you information on that, but I am happy to provide it for you in writing. As I said previously, we need to recognise that it is not just about the residential facility; we need to have in place a combination of measures and appropriate supports because everybody has different needs and requirements. We have more adults with a learning disability and more families under an awful lot of pressure as the people providing the care get older. Respite care, which is now more commonly known as "short breaks", is something that we need to continually keep under review. One of the things in the review of learning disability services in the Bamford evaluation is looking at where we should target supports.”
“I have also appointed a senior official from my Department to oversee progress and act as the point of contact for the families. Arrangements are being made to facilitate a meeting between the Health and Social Care Board and the families to discuss the capitation formula, because this is a complex subject, and I know that the families are keen to understand and know more about it. I am happy to facilitate that.”
“I have repeatedly made clear my commitment to ensuring that the issue is resolved. Actions are being taken forward to facilitate that, and I have met the families involved. I have made arrangements for the appointment of an independent facilitator to work with the trust and the families to restore relationships so that a plan for further investment in adult community learning disability services in the area can be developed as a matter of priority. The terms of reference for that work have been finalised, going initially to the chief executive of the Western Trust in December. They require me to approve the appointment of a facilitator, which I will do following further engagement with representatives of the families in the area.”
“It is also really important that we continue to support our carers, because they are absolutely stretched to the limit. They do such fantastic work to support family members or the friends whom they might care for. We need to continually drive home the message that carers are also entitled to be cared for. They need to have their carer's assessment, and we need to be able to meet the needs identified as a result of that. I absolutely believe that carers provide invaluable work that the health service could not provide, and we need to recognise that. I believe that I have done so through meeting carer representative groups and engaging with carers over the last seven months.”
“It is important that we continue to provide services in conjunction with those people who use them.”
“I absolutely understand the heartache, and I have met many families and carers who have lived experience of supporting their loved ones and friends. As I said in a previous answer, it is so important that we listen to the views of those people and design services that meet their needs. Whilst providing residential care is one element of the type of support that you can provide to people, there are other ways in which you can support people. It is important that we tailor support to the needs of the individual as opposed to trying to impose a blanket approach. That is very much what we need to do. We need to invest more to make sure that support is in the communities and help people in their homes without them having to move if that is what their families want.”
“<BR /> <BR />I will respond to the Member in writing on any potential issues with Hollybank, but, needless to say, it is important that we plan those services in conjunction with families and carers because they know their needs and what they need from Health and Social Care. If there are any particular issues with Hollybank, I am happy to write to the Member, but, as I said, it is key that we listen to the views of families and carers and make sure that we design appropriate services. That is certainly how I conduct my business as Health Minister.”
“Obviously, the Northern Trust provides a variety of short breaks to over 500 adults with a learning disability, some of whom may have complex health needs or challenging behaviour. Those are provided at Ellis Court, which is a six-bedded residential unit in Carrickfergus, and Hollybank, which, as you said, is a five-bedded residential unit in Magherafelt. Those services are pre-booked so that families can have a planned break from caring. The trust also has contracted bed-based services from the independent sector — namely, two beds in a residential setting in Coleraine, which specialises in the management of service users with highly challenging behaviours. Those services are also pre-booked.”
“That applies as much to services for people with a learning disability as it does to other parts of the health and social care system.”
“I am committed to working with everyone in the HSC and with the people who use these services to ensure that, where necessary, we make changes to how we do things so that resources are targeted where they are most needed. Clearly, while we have made progress on developing supports for carers and people with a learning disability — for example, through short breaks — there is still much to do. For my part, I am committed to doing all that I can to ensure that the services that we provide are effective in securing the best outcomes for people with learning disabilities. <BR /> <BR />As I have said before, where that requires us to change how we do things, we have to be prepared to do that if we are to move beyond short-term responses and crisis management.”
“<BR /> <BR />Funding for short breaks and respite provision is not separately identified in trusts' financial returns. However, the demand for short breaks is increasing, due in part to the continuing rise in the number of adults with a learning disability, especially older adults whose parents face increasing challenges in coping as they enter their later years, and the increase in the number of people with complex needs coming through from children's services. <BR /> <BR />In light of that and given the challenging times we find ourselves in financially, we need to make sure that we are getting the best value for the money we already spend.”
“Respite care, now known as "short breaks", is a vital form of support, particularly for those in our society who play an invaluable role in caring for people with a learning disability. Short breaks are available on a planned basis in all health and social care (HSC) trust areas as well as in emergency situations, and they are provided in a variety of forms, depending on the needs of those accessing them, which are often complex and varied. <BR /> <BR />With the introduction of other forms of support, however, such as crisis response teams, the demand for emergency respite is expected to reduce. Other sources of vital support for those caring for someone with a learning disability and challenging behaviour include community-based behavioural support services, which have been established in all five trust areas.”
“Sinn Féin will only be part of institutions that work and deliver for all in our community. There can be no return to the status quo. If something is broken, you stop and fix it. That is the Sinn Féin approach. <BR /> <BR />Today, Sinn Féin will not renominate for the position of deputy First Minister. Sinn Féin has honoured all agreements. We have striven to make these institutions work. Martin McGuinness has acted at all times with integrity, with dignity and with respect. He has taken personal and political risks to build a process of reconciliation. If we are to return to this Chamber, there must be real, meaningful change. There must be respect and equality for all sections of our society. The institutions must operate to the highest standard, with no place for arrogance or malpractice. It is now over to the people to have their say.”
“It has displayed disrespect towards women, the LGBT community, ethnic minorities, the Irish language and Irish identity. That has diminished the credibility of these institutions. <BR /> <BR />The renewable heat incentive (RHI) scandal was created by the former First Minister when she was in the Economy Department. Her refusal to step aside shows a total disregard for the concerns and outrage of the public. Martin McGuinness resigned as deputy First Minister because that was the right thing to do. We will not tolerate the arrogance of and disrespect from the DUP. Sinn Féin and the public will not tolerate financial scandal, incompetence or waste of public money. The institutions can function only with the support of the people and can operate only on the basis of equality and respect.”
“I start by paying tribute to my friend Martin McGuinness. For over 10 years as deputy First Minister, Martin McGuinness has worked tirelessly to make these institutions work and to make sure that they deliver for all our people: unionist, nationalist and everyone else in our society. He took a leadership role to promote equality, respect and reconciliation. His record, his commitment and the limitless energy that he brought to this process is beyond question. During that time, he has faced threats, a lack of respect and a failure by the DUP to reciprocate his Trojan efforts. He persevered because it was the right thing to do. The DUP has again treated these institutions and sections of the community with contempt and with arrogance.”
“These are the only two points that I want to make: there should be integrity and credibility, and people should stop playing games and give the public answers. The First Minister needs to stand aside.”
“Those are what I am most interested in in how we take things forward. <BR /> <BR />In the future —”
“You will have your opportunity to speak. <BR /> <BR />This is about antics and stunts, so let us get back to the crux of the issue: credibility and integrity. Each and every one of us needs to have those. Arlene Foster needs to step aside. We have made that very clear. Let us use the next number of weeks to reflect so that, when we come back to our motion, which we have now tabled for debate early in the new year, I will look forward to all those who tabled the motion today supporting that motion. That is the key to delivering what the public are asking for. The public mood shows that people are angry. People want and deserve answers, and we will deliver those. I will not be distracted by party politics. This is not an orange and green issue, and it is not an issue between parties: it is about public confidence and integrity.”
“I am absolutely wedded to delivering front-line public services for individuals. I am a Health Minister with massive challenges in budgetary issues and in trying to do all the things we need to do to increase our investment in primary care. Those are the things that the public want to hear us talk about, not this stuff. So for me today, this is about antics, this is about stunts, this is about —”
“Let me make this point. <BR /> <BR />Those who tabled the motion focus on one issue: Arlene Foster standing down. I have said that I agree with that, but your motion does not go far enough. Your motion does not look at the whole gamut or at the need for the investigation. Your motion does not look at every other issue that needs to be out there in public. That is why we tabled an amendment that, given all the antics that went on this morning, the Speaker, for his own reasons, decided not to accept. We will bring that amendment back as a motion. I welcome the fact that Naomi Long said that the Alliance Party will be able to or could support that when we come back to it early in the new year. <BR /> <BR />People should stop getting on with all the nonsense. The institutions have taken an absolute kicking here.”
“Let me say that, when I listen to those who tabled the motion, in some senses, I doubt your motivation. I listened to your antics and your contributions today. The public are not interested in playing games; the public are interested in answers. The best way to have those is to have this full investigation.”
“Let me finish this point. <BR /> <BR />All that information needs to be in the public domain. <BR /> <BR />Secondly, the public need to know that action is being taken to stop the flow of money from the public purse. That is key in all this. The public need to know and to have faith that, when a problem was identified and a scandal uncovered, it was stopped. We need to do that. Thirdly, all this has to be in the public domain. Everybody needs to know exactly who benefited from the scheme and when they are going to benefit. All that information needs to be out there, and, for me, those three things are key. <BR /> <BR />Our position is very clear, and we have made it absolutely crystal clear. The First Minister, Arlene Foster, needs to step aside while this investigation happens.”
“The only way that we will restore that public confidence is if the investigation is totally independent, in that not one of us can touch it. I think that it has to be an independent investigation. For me, the message that needs to go out to the public today is genuine. We have to get to the bottom of this RHI scandal. We need to know the ins and outs, and we need to know the design of the scheme and who did what, when they did it, how they did it and with whose influence they did it. We need all those —”
“I am not interested in the internal wrangling of the DUP. Get on with it; fight among yourselves. I am interested in this: public confidence in politics. I am interested in making sure that people have faith that, when they go out on election day, they can return us to come up here to do business, deliver for public services, stand up against Tory austerity and deliver front-line services. That is what I am interested in. <BR /> <BR />There is a massive job of work to be done here on public confidence. We in Sinn Féin feel that the best way to do that is to make sure that the First Minister stands aside because she has a conflict of interest. There cannot be a full investigation that the First Minister in any way has her hands in through how it is played out.”
“Every action and delivery that has happened to date has been overshadowed by the fact that the DUP cannot accept that its leader needs to stand aside to make sure that there is a full investigation of the issues that have been played out and drip-fed into the ether for the past number of weeks.”
“I think that the Benches opposite are absolutely misreading the public perception. We have spent a good part of the past number of hours since today's business in the Chamber started on antics, shambolic actions and statements being made without the authority of the entire Executive Office. I do not think that that is good enough. I am embarrassed as I stand here listening to the debate that has taken place so far. You are losing the run of yourselves. This issue is about public confidence. <BR /> <BR />The Member who spoke previously talked about how the Executive had delivered in the past number of months since they came into play after the election. They have delivered on many fronts.”
“I thank the Members for their comments on the Act. It will lead to benefits for the public and for consumers. As we enter the festive period, it is estimated that 4·3 million meals will be eaten out. I encourage the public to make the most of the new transparency measures.”
“Furthermore, at its meeting on 27 October 2016, the Health Committee agreed that it was content for my Department to make the proposed order, and it is with its support, Madam Principal Deputy Speaker, that I bring this draft order before you today. Subject to affirmative resolution, the order will become effective forthwith. I commend the draft order to the House.”
“<BR /> <BR />Where enforcement officers feel that a stronger penalty is more suitable, they retain the option of prosecuting the offender, who would then be liable to a fine of up to £1,000. A consultation on the draft order was carried out between March and June 2016, and the majority of respondents agreed with the amounts proposed.”
“<BR /> <BR />The order for which I seek Members' endorsement specifies the amount of the fixed penalty and the fee in relation to conducting a requested rerating visit. The advantages of introducing fixed penalty notices are twofold. In the first instance, they provide authorised officers with an additional enforcement tool. Secondly, they reduce the burden on the North of Ireland Courts Service by reducing the number of prosecutions taken. It therefore follows that the amount of fixed penalty notices applied must be at a sufficient level to deter people from committing the offence, but not so high that they would encourage offenders to aim for a more favourable outcome from a court hearing.”
“<BR /> <BR />In summary, the key provisions of the Act are that it requires all food businesses within scope to display a valid food hygiene rating sticker; requires relevant employees within a food business, on request, to orally inform the person making the request of the establishment's food hygiene rating; requires all food businesses with an online food ordering facility to display a valid rating on said platform; introduces offences in relation to the non-display of a valid rating and provision of information about the rating; allows for fixed penalty notices to be applied for the non-display of valid rating offences; allows for the charging of a fee in relation to conducting a requested rerating visit; and specifies timescales within which requirements under the Act must be completed.”
“Subject to the Assembly’s approval, the order will outline the amount of fixed penalty to be applied for relevant non-display offences as set out in section 10 of the Food Hygiene Rating Act 2016. The order will also specify the fee associated with the request for rerating inspections as set out in section 4 of the Food Hygiene Rating Act 2016. <BR /> <BR />The aim of the Act is to enable consumers to make an informed choice when deciding where to purchase and, therefore, ultimately to improve hygiene standards. The Act had a positive response and received Royal Assent on 29 January 2016.”
“I look forward to working with Positive Life, organisations such as the Rainbow Project and many others that provide excellent services on how we shape our HSC response to supporting individuals who need our support. <BR /> <BR />I commend the motion. I am delighted to have the opportunity to speak to it and look forward to working with Members as we design services to make sure that we deliver better health outcomes. That is what it is all about.”
“We will come back to the sexual health strategy, based on the work that has been done and on the recommendations that come forward, but I am certainly open to looking at that. In deciding the direction of travel that we will take in Health and Social Care, and given what I said about how we will deliver, design and produce services together, we absolutely have to listen to the experiences of families and of those living with HIV. We have to listen to service users, families and staff on the ground, and, if we do that and let it shape our sexual health services in the future, we can deliver first-class services, improve what is there now and do more.”