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.”
The complete record
Every one of 5,636 lines we hold for Michelle O'Neill, in date order, each linked to its source. Free to read, in full, without an account. Page 67 of 113.
“They recently got back to me, and I am considering their comments and plan to respond to them shortly. The key message that I took from the meetings with both groups is that they want to get on with making sure that they have the best possible services available to their families and be part of the process of designing services. For us to be able to do that confidently, we need to build up that trust again. I believe that the independent facilitator is the mechanism that will allow us to build those relations again to give those people confidence that the trust is putting their needs first and foremost. The whole process of co-production is exactly how we need to develop services in the future. Those involved have an opportunity to lead the way in producing and designing the services together.”
“I met members of the Western Learning Disability Action Group and the Southwest Carers Forum on 11 October to hear directly their concerns following what we all know now to be a breakdown in the relationship between them and the trust. At that meeting, I agreed a number of actions, including that I will consider appointing an independent person to support a process of co-production between the trust and local families and carers to develop a plan for how the planned £5 million investment will be spent. That is a practical example of partnership and the co-design approach that I am very keen to promote. <BR /> <BR />I recently wrote to the groups representing the families for their comments on the draft terms of reference for the independent facilitation.”
“That will be important to ensure that everyone understands what is a complex subject, and they were grateful for that. I have asked officials to arrange a meeting between the group and the Health and Social Care Board, which is carrying out a review of the learning disability capitation model.”
“The Member will be aware that we have. Based on the financial data that has been provided by the Health and Social Care Board, the average capitation variance relating to the funding of adult and community learning and disability services in the Western Trust area has been quantified at around £7 million per annum. To be clear, a capitation variance of that type does not necessarily mean that there has been an underspend, but, given that it is a complicated calculation and that capitation is complicated, when I met members of the group recently, one thing that I promised them was that they would be given a meeting with the board so that they could go through all the calculations and understand for themselves exactly how they are worked out. They are glad to take up that opportunity.”
“<BR /> <BR />Those actions mark my commitment to finding a co-designed resolution to the issue and to working with the families and the trusts so that the focus can return to the delivery of much-needed front-line services on the ground for people with a learning disability and their family. I believe that we all share that focus, and I am determined to do all that I can to ensure that it is realised.”
“I have also met representatives of local families and carers and subsequently spoken with the chief executive of the trust to relay the concerns of families and carers and to make clear my expectation that progress be now made on the development of a new investment plan that has the backing of the families. To support that, I proposed at a meeting that I had with the families in October that an independent facilitator should be appointed to work with the trust and the families to restore trust and confidence following the recent breakdown in relationships. That work will be taken forward in the context of the wider communication and engagement plan, and I have asked the trust to develop that. Furthermore, I have appointed a senior official from my Department to oversee progress and act as a point of contact for the families.”
“As is clear from my many public statements, robust action continues to be taken on the issue. To begin with, I have confirmed that increased investment of £3 million in adult community learning disability services is now in place, and a further £5 million is planned by the Western Trust.”
“We have to do everything that we can; that is my focus. It is absolutely about bringing down the waiting lists as quickly as we can and transforming health and social care. I am not aware of any particular initiatives on emotional support or well-being, but, again, anybody who is concerned about that should go back and speak to their GP.”
“I encourage anybody who is sitting on a waiting list and has been waiting for a very long time to contact their GP again if their condition is worsening. It is then up to the GP to refer them to the hospital services, to prioritise that patient and ensure that the consultant whom they are waiting to see knows that their needs have changed. That process is ongoing, and we are asking GPs to continually do that. Anybody who has been sitting on a list for a long time whose condition has worsened should go and see their GP. <BR /> <BR />I absolutely understand how frustrating it is if you have been waiting for a long time, be it for yourself, your children, your parents or anyone else in your family. It is annoying because you are worried about your health and what it means for you in the future.”
“Key areas of innovation that we are considering for the plan, subject, obviously, to securing the required investment, include the further development of ambulatory assessment and treatment centres that will allow patients to be assessed and diagnosed and, if required, to receive a treatment or procedure all in one day. I recently visited similar facilities in the Royal Victoria and the Mater. I was impressed to see the positive impact that they have on the experience for patients and staff. Elective care centres will also be established for less complex, planned treatment. The centres will be a resource for the region, and the way in which they operate will be designed around patients. Put simply, they will allow clinicians to see and treat more patients.”
“As I said, waiting times are a product of increased pressure on the health service. Demand will continue to grow year on year because we have an ageing population, the emergence of new technologies and changes in practice in healthcare. Those factors will not go away, and we need to consider how we will deal with them in a way that delivers the best outcome for patients and is sustainable in the long term. <BR /> <BR />The long-term solution is the transformation that I have set out in 'Delivering Together'. We need to move to a population health model and create a more sustainable service, one that makes the best use of the resources that we have to deliver the best possible services to patients.”
“I want to bring waiting lists down, because they are totally unacceptable to me. I am happy to be questioned day and daily about what I am doing. I will bring forward a plan in January that will clearly set out how we will do that. We have to transform and bring in ambulatory clinics and assessment centres. We have to do so much more and do it at speed.”
“I am not sure that I understand the question, but, on the figures that you refer to, it is important to note that, when we had that recent debate, Members were just adding up x, y and z. Yet when we publish the stats, we are told, "Do not do that. Don't take that approach because it is not an appropriate figure". <BR /> <BR />The figures that I highlighted in the answer to Mr Aiken are very clear, but they are for the Northern Trust only. It is important that the public understand and have confidence in the fact that we are doing everything that we can. We have to transform health and social care. That is the reality, and it is the longer-term plan. In the meantime, people cannot wait until we get to the point where our health service is transformed, so I have set out all the things that I am doing.”
“You can laugh all you want, but your friends the Tories cut the Executive's block grant year-on-year and made it really difficult, and we are in the position we are in because of that. <BR /> <BR />I will not be found wanting in my approach to dealing with waiting lists. I will do absolutely everything that I can. I continually come to the House to say everything that I am doing. I will continue to do that because I want the public to get the message loud and clear: I am doing absolutely everything that I can to bring the waiting lists down. The public will thank us for that, and that is what they should judge us on.”
“That shows the Executive's commitment to dealing with waiting lists. <BR /> <BR />I said that I would publish my plan in January in relation to elective care and set out targets for dealing with waiting lists. Let us be very clear: I did not inherit this problem, and it did not happen overnight. It has been the result of year-on-year cuts to the block grant by the Tory Government. It has been about their austerity policies.”
“I want to work with all the parties in the House to deliver that, because, if we do not do that, we will be having this conversation for many, many years to come. In the short term, I am about making sure that my Department does absolutely everything it can. It is about maximising the delivery of the commissioned volumes that our trusts are commissioned to deliver. It is about continuing to prioritise patients by clinical urgency. It is about the chronological management of non-urgent patients. It is about using the dedicated schedule and staff to manage the patient pathways. It is about overtime clinics. It is about a range of issues. I have identified £4 million to invest in elective care over the next number of months to allow us to do more and reach an additional 10,000 people.”
“I am not interested in massaging anything; I am interested in making sure that people get seen in the most timely manner and get the health and social care that they deserve when they need it. That is my priority as Health Minister. <BR /> <BR />I have said clearly that we need to transform health and social care. We are trying to deliver 21st-century health and social care with a 20th-century system that is out of date and cannot keep up with the rising demand. We have more people being seen, but, obviously, people are living longer and have more complex conditions, which makes it all very difficult. <BR /> <BR />We have short-term initiatives, and we have longer-term initiatives. In the longer term, let us transform health and social care.”
“In the first half of this year alone, there have been over 240,000 consultant-led outpatient appointments and nearly 89,000 admissions for inpatient day-case treatment. Notwithstanding the structural issues, they continue to work incredibly hard to deliver the best possible service to patients.”
“However, unless we tackle the root causes, that will remain the case, as we have a 20th-century model delivering services for a 21st-century population. This is having an increasingly negative impact on the quality and experience of care. The long-term solution is the transformation of our health and social care system as outlined in 'Delivering Together'. It is only by transforming the health and social care system and implementing new models of care that we will be able to alleviate the pressures on our health and social care services, sustain improvements in waiting times and deliver better outcomes for patients. <BR /> <BR />That said, I pay tribute to staff right across HSC.”
“The latest provisional information indicates that, at 31 October 2016, the number of people waiting longer than 18 weeks for a consultant-led outpatient appointment at Antrim Area Hospital had increased by 1,382 compared with the same period last year. Currently, 777 people are waiting more than 52 weeks. <BR /> <BR />In order to minimise the impact on patients, the Health and Social Care Board continues to work with the trusts to maximise the delivery of funded capacity and ensure the application of good waiting list management practice, including assessing and treating urgent cases first and, thereafter, seeing and treating patients in chronological order. <BR /> <BR />I am firmly of the view that the current waiting lists are unacceptably long.”
“The hospital is also the base for many of the community care services and specialist teams that help people to be cared for in their home and in the community as far as possible, including the community stroke team, community diabetes team, acute care at home team, community palliative care team, adult mental health teams and the area's health visitor and social work teams. <BR /> <BR />It is a very busy hospital, and, as I said, the potential exists for South Tyrone Hospital to do more. I am currently undertaking a process of engagement with stakeholders across health and social care to build a collective view about how our health and social care services should be configured in the future.”
“In addition to the 45-bed inpatient rehabilitation unit at Loane House, South Tyrone Hospital has a 15-place day hospital for elderly patients. It has a rapid access clinic that provides care for older people referred by their GP who need to be seen within 24 to 72 hours but are not acutely ill and do not need to be admitted to hospital. South Tyrone Hospital has the largest minor injuries unit, which sees more than 26,000 patients a year, giving it a vital role in providing care locally and reducing some of the pressure on the larger emergency departments. The hospital provides day surgery and diagnostics, including CT scanning, and a range of outpatient clinics and allied health professional services.”
“As I said, it is too early to say what services will be provided in any individual hospital. However, I expect that the potential of the South Tyrone Hospital will be fully explored as the transformation process goes forward. Again, there are opportunities. You are absolutely right: South Tyrone Hospital provides a range of services to the local population and is an excellent example of a flexible and resilient local hospital.”
“I have said that I will listen to staff and patients, and I will design services with those people so there will be no surprises. All the decisions that will be taken about where we deliver services in future will be taken with full public consultation. Those decisions will be taken on board from the outset, not just as a tick-box exercise or as a consultation mechanism further down the line. From the outset, I will involve all those people in how we reconfigure services. The key goal and prize for me is better health and social care for everybody.”
“I thank the Member for her question. She will know that I am also a rural MLA and am very conscious of the needs of rural people. I want to make sure that people have full access to services on an equal basis. Bengoa and Delivering Together are not about withdrawing services. They are about reforming our health and social care system and delivering better health outcomes for individuals. There is a lot of potential there for services to be delivered at some Western Trust sites and, indeed, at many other sites. <BR /> <BR />When we look to the future, we should be looking towards opportunities. I am certainly looking towards that, because we all need to have a conversation about how we deliver better health and social care for all our population. That is what I am wedded to, but nobody should scaremonger or run ahead of themselves.”
“However, given the level of commitments that we have in 2017-18 and 2018-19, this cannot be funded without substantial additional capital resource. Obviously, I am involved in the Budget 2017 process, which is expected to conclude by the end of this year. While the redevelopment of the Craigavon Area Hospital site is a priority project, it is important that we continue to look at everything now in the context of Delivering Together and how we are going to transform health and social care. That will be part of my key considerations for future services, whether in the Southern Trust area or any trust area.”
“The Southern Trust has identified the redevelopment of the Craigavon Area Hospital site as one of its key capital projects, and the Department recognises that it is a priority project. However, there are a number of similar large-scale priority projects across the HSC that will also require significant levels of funding. Plans for a new build are with the Department for consideration, and we are actively looking at them. <BR /> <BR />The key drivers for the project are the condition of the existing estate and the growing population and associated hospital activity. The capital costs for phase 1 of the new build are over £450 million, so a decision on the progression of the project will be considered alongside other capital investment priorities and will be further dependent on budgetary availability, value for money and affordability.”
“<BR /> <BR />As set out in 'Health and Wellbeing 2026: Delivering Together', my Department and I will work with the wider health and social care system to design new partnership approaches to the planning and management of health and social care services. I want the new model of person-centred care to be designed in collaboration with people and communities and to be focused on what services people need and on how they can be provided most effectively, rather than on the buildings in which they are provided. The way we design and deliver services will be focused on providing continuity of care in an organised way and will increasingly involve working across traditional organisational boundaries.”
“Following a full public consultation in 2014 about the future provision of hospital services for older people, the Southern Health and Social Care Trust's long-term plan is that all inpatient care will be delivered at Craigavon Area Hospital and Daisy Hill Hospital. However, it was acknowledged that the transfer of inpatient services from Loane House on the South Tyrone Hospital site would be dependent on the trust securing the necessary capital investment for the construction of a new unit on the Craigavon Area Hospital site. Therefore, there are no immediate plans for the closure of Loane House.”
“The review work happens across the PHA, and I am quite sure that it will be very happy to meet with the women who have been impacted and who actually know how it is to go through an ovarian cancer diagnosis. I am very happy to engage with individuals and my door is open. It is important that, if we are going to have awareness campaigns, we target them where we can make the best effect. So whether that be a stand alone campaign or as part of Be Cancer Aware, I am open for that conversation.”
“For the record, I will make sure that we thoroughly review the impact of the campaigns that we have had to date and make sure that, when it comes to future campaigns, we target those areas where we absolutely can make a massive difference.”
“In comparison rates with, for example, England, we do not perform as well. I am not sure about the South. I am happy to provide that detail to the Member. Suffice to say that, whenever it comes to awareness, we have to do everything that we possibly can on awareness campaigns. Whether that is for ovarian cancer, lung cancer, breast cancer or any of the other cancers, it is important that we reach as many people as possible and that we drive home that early intervention and early detection message. We all know that, if cancer is discovered earlier, the chances of survival and getting support are obviously a lot higher. <BR /> <BR />I am happy to write to the Member with the specific statistics.”
“The indicators used in the Be Cancer Aware evaluation are, for example, how the campaign reached individuals, public awareness of the signs and symptoms of cancer, the number of people being referred urgently for suspected cancer by GPs and the proportion of urgent referrals that result in a cancer diagnosis. Evaluations have shown that each campaign phase has had a good campaign reach through the population. Other important measures of campaign outcomes include the stage of the disease, the diagnosis and survival rates. Data for these indicators take much longer to come through and are not yet available.”
“A range of topics are covered in the campaign evaluation, including awareness of cancer advertising and symptoms and knowledge and recognition of the relevant campaign material. The aim is to look at changes in recognition and knowledge between pre- and post-campaign interviews. For each Be Cancer Aware campaign and targeted cancer site — for example, lung, bowel and breast — there is a comprehensive evaluation process that covers a number of different indicators. Together, that gives us a detailed picture of the potential campaign effects.”
“It is only for those that have not been recommended by NICE that patients are asked to use the individual funding request process. <BR /> <BR />My predecessor established the clinically led task and finish group to reform the process and went out to consultation. I aim to introduce the new arrangements during 2016-17 on a phased basis. Over the next number of months, we will have the new process rolled out. For me, it has to be transparent and people need to know how to access the help that they need.”
“Officials are working with the clinicians, who obviously have the expertise, to develop a new individual funding request process. That new process will ensure that any individual funding requests are clinically assessed and scrutinised by a regional committee to give assurances that clinical judgement and patient care are at the heart of the process. It will also improve access to these drugs, provided that there is a compelling clinical case. <BR /> <BR />We always have to be aware that reforming the individual funding request process and increasing access to drugs not fully endorsed by NICE will carry a significant cost at a time when the health and social care budget is facing real pressures. Let me be very clear, all cancer drugs that have been recommended by NICE for routine use in the health service are available in the North.”
“I think the Member is referring to the cancer drugs fund that exists in England. Obviously, we have our own processes here in the North through the individual funding request (IFR) process that exists to enable access to specialist drugs whose clinical and cost-effectiveness has not been fully established. I think we all realise that the current process has flaws. It should be less cumbersome and a bit more transparent, I think, in allowing access.”
“When it comes to reviewing how effective those campaigns are, I am very happy to look at where we can have the greatest impact through patient numbers, as I said, and on tackling cancer in areas of deprivation, where survival has historically been poorest. It is not ruled out. I am happy to correspond with the Member as we develop the next stage of the awareness campaign.”
“I will obviously put on record that Una Crudden was an amazing woman. She used her own difficult circumstances to highlight ovarian cancer for other women. I commend her for that. I had the pleasure of meeting her; she was an absolutely lovely lady. Quite often, the public tend to listen more when they hear a real human story about someone's cancer journey and how they dealt with their illness. <BR /> <BR />I do not have a closed mind to the idea of an ovarian cancer-specific campaign, but it is important that we analyse how effective the previous work done on awareness has been and we target our resources to make sure we reach the largest number of people possible. I really believe in early intervention and prevention. We need to do more in the public health agenda.”
“Prevention and early intervention are very much in keeping with my vision of Delivering Together. We need to support people to keep well in the first place and, when they need care and support, services should be safe and of the highest quality. The Public Health Agency is reviewing available evidence from other cancer-awareness campaigns to help inform the next phase of the Be Cancer Aware programme. However, specific cancer sites are yet to be decided for the next phase of the programme.”
“The Public Health Agency also worked with the late Una Crudden to produce a video calling on women to read the leaflets and make themselves aware of the symptoms of ovarian cancer. The agency has also developed a Be Cancer Aware website that provides information about the signs and symptoms of a range of cancers, including ovarian cancer, and explains what people can do if they are concerned. It also includes signposts to recommended sources of support. <BR /> <BR />Public awareness of the signs and symptoms of cancer is a key factor in detecting cancers early and increasing the chances of successful treatment and survival. Raising awareness, therefore, could have the greatest impact on patient numbers and tackling cancer in areas of deprivation, where survival has historically been poorest.”
“The Public Health Agency (PHA) is delivering a Be Cancer Aware campaign to improve the public's awareness of signs and symptoms of cancer. As part of the campaign, the Public Health Agency undertook a specific ovarian cancer-awareness programme in September 2014 in partnership with Target Ovarian Cancer and Angels of Hope, which is a local charity. That entailed the widespread distribution of leaflets and posters to highlight the signs and symptoms of the illness. The leaflets and posters were distributed to hairdressing salons, bingo halls, pharmacies and GP practices. They helped to raise awareness of the signs and symptoms, in particular among women over the age of 50, and encouraged women to speak to their GP if they experienced any of those symptoms.”
“<BR /> <BR />The Member will be very aware that the Act is a very complex piece of legislation. We are working our way through all the issues as we speak. Officials in my Department and in DOJ are working through all the initiatives, because, when we commence the Act, we need to make sure we can deliver on it. From his previous role as a Minister, the Member will be very aware of the challenges we have with the Mental Capacity Act. It was significant legislation, so it is important that we have everything lined up and can deliver everything when we commence the legislation.”
“Surely the Member is not blaming Bairbre de Brún for all the issues we have in mental health in our society. We are a society coming out of conflict, which is an issue in itself, but we obviously have a prevalence issue that continues to rise with young people and mental health issues and more people being referred to the service. We have a societal problem. I do not think we can pinpoint it on one area; we have a societal problem that we need to address. We need to address it across every Department, council or community and voluntary sector organisation that wants to get involved. Do people have access to a job? Do they have a home? All those things contribute to people's mental well-being. We have a collective responsibility as an Executive and a society to help people who find themselves with mental health issues.”
“The consultation has closed; however, I have said that I want to go out and engage personally. I have met a number of organisations and individuals about the strategy. I intend to go out next week, and I am doing consultation events in Belfast and the Dungannon area. It is important that I listen to the people who have been bereaved by suicide and make sure that I develop a strategy that very much has their views, ideas and initiatives embedded when going forward. We will work on that over the next number of months and collate the responses we have received. As I said, it is really important that we listen to those with lived experience.”
“<BR /> <BR />It is an area we have to do an awful lot more in, but the Bamford evaluation points to those issues, the service gaps we have and where we need to do a lot more. This is certainly one of those key areas.”
“The regional acute inpatient services at Beechcroft are frequently under pressure, and I think Members are aware of that. An independent review in 2014 concluded that the current 33-bed model was appropriate but that, crucially, it was dependent on the further strengthening of the crisis resolution and home treatment services. What else can we put into the community that stops people having to go into acute inpatient settings? That is an area we need to focus on. <BR /> <BR />I should also say that a managed care network for acute child and adolescent mental health services is being established as we speak. That will bring acute services into one managed system and, again, will ensure greater consistency across the region and streamline access to Beechcroft.”
“We do not have a service to support those families, and perhaps we need to look at that. If we cannot do it here, let us look at it on an all-island basis. Is it something we can provide on the island? It is so important that young people know there are services to support them so that they do not feel they have nowhere to go. I am keen to make sure we do that.”
“Child and adolescent mental health services (CAMHS) are delivered under a stepped care model. The board leads on a reform process under the auspices of the stepped care model implementation review. A lot of progress has been made, but you are right: more young people have been referred to our services. We always have to adapt to the needs of society. If more younger people are coming in, we need more emphasis on CAMHS. I am committed to making sure that we do that. We invest over £20 million annually in CAMHS. That shows that there is a recognition that we need to put the funding there to support those young people. I am also considering reforming investment options across a range of other services, including CAMHS. As I said, it is important that we look at children and young people with a dual diagnosis, for example.”
“I will work with Executive colleagues throughout the Budget process and will not be found wanting when it comes to shouting and fighting hard to make sure that we have an adequate budget for health and social care in general and, in particular, as in this case today, to address the issues that we have with psychological therapy itself.”