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 70 of 113.
“My Department set the following targets, which set out reasonable timescales for the discharge of patients from hospital. They are that 90% of complex discharges from an acute hospital take place within 48 hours; no complex discharge should take more than seven days; and all non-complex discharges from an acute hospital should take place within six hours. There were a total of 32,288 discharges from the Ulster Hospital in the 12 months from 1 August 2015 to 31 July 2016. Of those, 4,443 did not meet the targets.”
“It will allow us to give confidence to patients that there is regional oversight and one medical lead and that that will filter right across, no matter where you live in the North.”
“As a member of the Health Committee, the Member will be very aware that there are recruitment difficulties right across the piece. It is very difficult to recruit into posts, but we have to keep trying. We cannot just say we have not been successful one time and then give up. We will have to headhunt people where necessary. We have to do absolutely everything we can to attract the right clinicians to support the population here. I am assured that the board, in conjunction with the trust, is doing absolutely everything it can to make sure we recruit someone into that post. I am very happy to update the House on progress on that in the future. I think it is important that we establish that regional medical lead.”
“As I said in the previous answer, the Department for Communities obviously funds those whole areas of work that I set out. That is really important. Going forward with a new-style Programme for Government that is very much outcomes-focused will allow us to work collectively a lot more. I think we will see in the Programme for Government how Departments need to interact. We do not have the luxury of working in silos. We have to work together. For me, the need to coordinate, collaborate and ensure that we design services and support people is key, whether that be within the health sector or working in conjunction with the community and voluntary sector. I think the Department for Communities and I will have a lot of overlap in how we can support people better. I am looking forward to that.”
“The programmes also receive funding from the Department for Communities and are targeted to persons with a variety of long-term health problems and primarily to those in receipt of health-related benefits.”
“Examples of condition management programme sessions include problem management; assertiveness; building confidence and self-esteem; healthy lifestyle; getting a good night's sleep; stress management; managing low mood and depression; fatigue management; anxiety management; pain management; back care; and what is next after the condition management programme (CMP).”
“All health and social care trusts offer condition management programmes to help participants with a range of health problems to better understand and manage their conditions. Only the Belfast Trust and the Northern Trust offer specialist programmes for ME patients. Those are 12-week, voluntary, work-focused programmes to help participants with a range of health problems to understand and manage their condition, become engaged in more meaningful activity and return to work or training, either now or in the future.”
“I am not sure what the Member means when she says that the "ice is ... beginning to thaw", but involving patients, carers, families and service deliverers in the design of services is at the core of the new way forward. The strategic direction, which I have set out, very clearly puts the needs of the patient at the centre of decision-making. It is really important that people feel ownership, understand why things are done in a certain way and are part of designing the care pathway that they will need to use. As we go forward, the service is very much patient-centred, but, in order for us to be successful in delivering better outcomes, we need to listen to everybody's voice.”
“When taking decisions on the way forward, it is important that we evaluate what has been done. The pilot will feed into the evaluation and allow us to assess what is required. Suffice to say, the board is working to recruit a regional medical lead. I think that that answers your question. <BR /> <BR />It is important that we continue to support those with ME. There has been investment over the past number of years, and it is important that we continue to build on that good work, in the spirit of Delivering Together — our new way of working — and design services that are fit for purpose and meet the needs of those who suffer from ME. When designing those services, we need to listen to patients, carers, families and staff who provide services on the front line.”
“The Health and Social Care Board is working at present to recruit a regional medical lead for ME, and, when successful, it will consider how best to deliver the specialist ME knowledge and expertise across all remaining health and social care trusts.”
“Since 2013-14, the Health and Social Care Board (HSCB) has provided funding to the Northern Health and Social Care Trust for a pilot condition management programme with specialist knowledge and expertise in helping people diagnosed with ME. ME patients, as recommended by the National Institute for Health and Care Excellence (NICE), were placed on supported self-management programmes specifically adapted to take into account their unique needs and offering lifestyle advice and coping techniques in 12 sessions. The pilot was successful and is now funded recurrently. A similar model is in place in the Belfast Trust.”
“<BR /> <BR />Recently, and you are aware of and attended it, the Future Search event in Belfast looked at bringing together all the partners across the community, voluntary and statutory sectors and looked at how, collaboratively, we can do more to deal with suicide in our society. I am very much committed to that collaboration, that partnership working, and I am very much somebody who wants to listen to those who are engaging with people with mental ill health, day and daily, in their communities at 12.00 midnight. I know the commitment of some of the community and voluntary sector individuals, and I really want to work with them in the time ahead.”
“I thank the Member for her question, and I can absolutely give that assurance. The community and voluntary sector does amazing work and is very engaged in all our communities. It is absolutely part of the picture in supporting all those people who find themselves with mental ill health. Going forward, obviously, I am consulting on the Protect Life 2 strategy, the suicide prevention strategy, and I intend to engage personally on that issue as I believe we can continue to improve what is good out there and learn lessons where we need to do so. I want to work with the community and voluntary sector.”
“I am committed to tackling mental health issues, and I am very committed to making sure that we support our young who find themselves in such a vulnerable situation and making sure that the health service responds to their needs.”
“I am committed to developing services with the Minister in the South. We have embarked on identifying areas where we can collaborate, but the issues of perinatal mental health and dual diagnosis stand out as areas where we can do something, because we do not have a service on this island. We are actively looking at what is available in the Twenty-six Counties, and we will then develop the conversation further. <BR /> <BR />We need to do more to support those young people, and there is a lot of debate about what that might look like. We need to have that conversation. I have met with you and Carál Ní Chuilín and Gerry Kelly about how we can do more, particularly given the challenges and recent deaths in North Belfast.”
“I have already answered that in relation to the number of places that we have announced for GPs, nurses, named social workers, health visitors and district nurses and the roll-out of askmyGP to 30 more practices. All those things come with a cost, but I have decided that I can do them within the budget I have set out and that I am planning with the Executive. This is about real, meaningful change; it is about investment in the front line; it is about investment in primary care. For us to be successful in this transformation programme, we have to do that.”
“I cannot say that enough: we do not have a choice. We have to transform Health and Social Care, otherwise the system will break at some stage in the future. In recognition of that, the Executive are fully behind the strategy and the two-mandate plan. We have never had a two-mandate plan before, so that is really significant in itself. It sends out a very strong political leadership message that the Executive are committed to delivering this transformation programme alongside tackling all of the immediate issues that we have.”
“The Executive have recognised that we will need a period of double running, but they also appreciate that it will not be forever; it will be until we transform the system and put Health on a sustainable footing. We do not have a choice, because if we do not do it, the system will be in crisis and the entire block grant could be sucked up by Health. What would we do then for every other service and Department — for Education and roads and everything else that is important to people's lives? <BR /> <BR />We do not have a choice. The Executive have clearly committed to the plan and, in doing so, have clearly also committed to the transformation fund. We will see the allocation of funding as part of the Budget process in the next few weeks and months, and I am sure that we will discuss it in the Chamber. We do not have a choice.”
“Furthermore, we have a real opportunity to make sure that primary care is embedded, multidisciplinary and action-based. This is really going to change the picture. <BR /> <BR />On rural services, I absolutely agree with the point about designing services. Although people are always happy to travel if they are getting a better outcome, we do not want to starve them. It does not mean that everything has to be centralised in Belfast, for example. It can be the case that services are spread across the North. I am not going to give examples, because people will seize on them, but there are really good, innovative things being done in each trust. Each trust has a crucial role to play in determining where we develop services and where they are safe, because at the core of all of this has to be patient quality and patient safety.”
“Absolutely. This is about trying to address the challenges for GP services, but it is very much about, as I said, building up that team. The multidisciplinary approach is going to make a real difference, I believe. The fact that GPs have a team around them that can interact and that can rely on one another will make a significant difference to primary care. Staff are working even harder and are under a lot of pressure, so we have to get this right. We have to do it. Social workers are telling me about the pressures that they are under. I constantly hear about social workers going home and having to sit up until 2.00 am writing up reports. That is not sustainable for anybody's working pattern. I want to do more to work with all those teams to make sure that they support one another.”
“Again, it will prevent hospital admissions, which is what we should all be working towards. People to not want to be in hospital. I look forward to the development of these ambulatory centres. I think that they will make a real, positive difference to bed blockages and waiting lists.”
“No, ambulatory care centres are a different set-up altogether. They allow people whom a GP thinks need to be seen by a consultant to go into a centre. For example, I visited one centre last week in the Royal, and there is also one in the Mater. One of the things that they do is, if you are referred to one, you can have your blood tests and X-rays, see the consultant and be assessed and watched throughout the course of a day. The stats show that quite often, as I said, you can then be sent home and do not have to be admitted to hospital. That is the ideal, for nobody wants to be in hospital unless it is absolutely necessary. If we can scale up the number of those ambulatory centres — the form that they take may be different, depending on where they are placed — that will make a real, meaningful difference to individuals.”
“The trusts are up for that, and the Department is up for that. Together we can, as I say, deliver first-class health and social care outcomes for all the population. That should be the only aspiration that we all work to for the health service.”
“On the Western Trust issue, I have met the families and the carers, and I continue to do so. I have given them all reassurances that we will get to the bottom of it. What we seriously need to be about — this is the core tenet of what I am talking about — is co-production and co-delivery meaning that. It means proper collaboration. It means people understanding that, if you make service changes, patients need to understand why you are doing so. They need to know that it is about trying to provide a better service for them. They need to understand that and be given every piece of information. I am committed to that. In building capacity in communities, co-production, co-delivery and co-design are going to be instrumental in helping us deliver a first-class health and social care system. Openness, honesty and transparency are key.”
“I have costed everything that I am talking about. With the Minister of Finance and my Executive colleagues, I am working through the due process of the Budget decisions. That will all become very clear to you, so do not be too worried. You will see it all in due course.”
“I have clearly said that I have set out a direction of travel. I have also said that the Executive have endorsed that direction of travel, in the recognition that we need additional funding. We are about to go through the Budget process, and I would like to see, at the other side of that Budget process, that we will also have a funding allocation that allows us to transform the system. It is very clear that what we have here is a real road map for change and transformation; one that will deliver incremental change, year-on-year, that will see staff and patients supported and that will lead to an open and honest conversation about where we are going.”
“It must be exhausting being so negative all of the time.”
“We should not have to rely on provision outside of the health service to deliver all those services that are much-needed.”
“Obviously, I am working towards a position where we do not need to use the independent sector. In the meantime — it will take a number of years to get to that point — there are people on waiting lists and we cannot just leave them there. We are going to have to do a combination of things in the short term. We are going to have to make sure that we are at full capacity within the health service, but also, in the short term, we are going to have to use the independent sector. I cannot let patients suffer whilst we get to a transformed health and social care system. I believe that, in the short term, we are going to need the independent sector. Certainly, for me, the longer-term goal is universal healthcare, free at the point of delivery for all people who need health and social care services.”
“I am absolutely committed to moving to outcomes-based analysis; that is where we need to be. We will not do that overnight, but it is certainly what we are working towards. I will update the House every six months on the plan because that shows that we are serious about transformation and driving it forward. It is also about saying to Members that I want to work with them and deliver better health outcomes for all of the population. There is no danger of this falling down if there is genuine effort to implement it. I will not be found wanting in my political leadership. Also, the oversight structure that we have put in place, which is clinician-led, will make a real, meaningful difference and is something that has not happened before.”
“Yes. The Executive have endorsed the direction of travel and have endorsed the plan. In endorsing it, they have also recognised that transition is going to take additional funding. They also endorsed the fact that, in order to bring down waiting lists, it will need additional funding in the short term. So, for a time, we are going to have dual running. We have to keep the health service delivering every day alongside the transformation piece, but we cannot be distracted from transformation because, if we do not do it, the system will be in crisis in years to come.”
“Elective care centres are within the HSC estate, so they will be developed in line with need. As I said in my statement, we do not yet know the number or where they will be placed, but the service reviews will allow us to do that. Elective care centres will really help us to deal with waiting lists by allowing people who have been scheduled for minor surgery to be seen without interruption to the service. That, in itself, will bring down waiting lists in the longer term. We will consult on the criteria, and, next year, we will move towards deciding where the elective care centres should go, and I think that they will make a real, meaningful difference to patient outcomes.”
“It blights all our communities, and people who find that they are vulnerable because of mental health issues need to be supported.”
“The Royal College of Psychiatrists clearly said that in its report when asking for parity of esteem to be established. When I talk about parity of esteem, I am talking about moving towards true recognition, attention of resource and the Department's attention to the mental health issue. When we focus more on recovery and promoting good, positive mental health messages; when we invest in service developments; when we do more for perinatal health; and when we review the Bamford action plan — I have set out a plan for the next five years — you will be able to see how we will deliver parity of esteem. I am very committed to doing that, and I think that all Members share that aspiration. For far too long, mental health has not had the attention that it deserves.”
“Maybe the Member misunderstands what parity of esteem is. It does not mean giving the same resource to physical health and mental health —”
“<BR /> <BR />The criteria for service reviews will go out to consultation over the next number of weeks, and I look forward to receiving Members' views. When the criteria are agreed, let us get on with the service reviews and making sure that we design a first-class health and social care system.”
“If, for example, after a stroke, people have to travel 20 minutes extra, but their outcomes are better — they will live longer, their mobility will not be as reduced and their speech will be better — I think that they will be prepared to do that. This morning, I listened to Janice Smyth from the Royal College of Nursing clearly say that people will travel if they get a first-class service. People need to understand why you make changes, so I want to communicate with staff, patients, carers and families to make sure that we are all part of designing the services and that people understand the care pathways and why they have to travel to services. Let us not focus today on closures; let us focus on building a first-class health and social care system.”
“You cannot help being parochial. The expert panel has set out the criteria that it believes should be considered when it comes to service reviews. It also set it out very clearly that we cannot keep delivering every service in every hospital, so we need to specialise. That is good not only for patients and patient outcomes but for the staff who get to build their skills and knowledge. When it comes to the direction of travel, today is not about closures or hospitals; it is about changing the picture and about better health outcomes. What does that mean? Does it mean that you travel a little further to get a first-class service?”
“That is the message that I will leave as your answer: it is about how I can help the health service to do more and support it to deliver the first-class service that it is committed to delivering. I think that the direction of travel that we have set out here is the correct one. Hopefully, it will command universal acceptance. We need to recognise that, for the first time ever, the Executive have endorsed a plan, and they are committed to tackling waiting lists and delivering better outcomes for the population. To me, that is how we should be measured because, in government, you take tough decisions and deliver better outcomes for the whole population.”
“It is clear that we have to drive change. I will provide the political leadership for change, but we need clinician-led oversight of service reconfiguration. November is next week. Over the next couple of weeks, I intend to set out what that panel will look like. Suffice it to say that it needs to be clinician-led. It also needs to include people from inside and outside the health and social care system. I am working up the detail of that and will make an announcement in the coming weeks. We can have a lovely direction of travel, but it is important to drive the implementation. I will drive it politically, but I am asking for clinicians. <BR /> <BR />I remember that, when I first came into office and was speaking at an event somewhere, my message to the health service was this: help me to help you.”
“I assure the Member that I do; I believe that I said that at the outset. I said that I endorsed the recommendations that the expert panel had put forward. I said that very clearly in, I think, the opening paragraph. Let me say it again in case you missed it: I endorse the expert panel's report, and I have set out my plan of action on how I will take those things forward.”
“There is no service on this island to support women with mental illness in pregnancy. I would certainly be very proud if we were able to deliver such a service, and I think that we could do it collaboratively across the island. That would allow us to develop it a lot more quickly than perhaps we could do individually. Recently, I have had conversations on dual diagnosis and young people and adolescents with mental health and addiction problems, and I think that, again, we do not have any service right across the island. If we include transplantation, those are just three areas where there is scope. A scoping study is ongoing, which I look forward to receiving. I want to take forward measures that allow us to develop a first-class service for the population.”
“There are definitely areas where we can build on that. Some of the collaboration that already exists, particularly in children's cardiac services and radiotherapy for cancer patients, shows that we have been able to develop really innovative services for the population on the island. That benefits not only patients but staff because they are allowed to specialise in the areas that they wish. There are so many more opportunities — for example, transplantation of organs and rare diseases. We have also developed a programme of work with the Department of Health in the South to identify other areas of mutual benefit. I set out in a statement areas where I think that we could collaborate more — for example, mental health and perinatal mental health in particular.”
“Only those who are acutely ill or are in for emergency reasons should be in hospital. If we can work towards that, people can see a real difference to the support that we provide in communities. Acute care at home is a really fine example of how that works. All the staff and clinicians go into people's homes and support them to stay in their own bed at night. That can make a big difference to someone who is not well. For me, it is about doing more of that. Structures will change in time. Let us invest in primary care. That is certainly my vision for what I want to do.”
“<BR /> <BR />You talked about closures. We need to frame the conversation on the best outcome for individuals and on what delivers the best possible health outcome for individuals. The report that Professor Bengoa and the expert panel took forward very rightly focused on delivering better systems, not structures. I could have spent the next five years focusing on structures, but the outcomes would not have changed. If we get the system right, the structures will change in time. If we invest in primary care, we can make a real difference to what people get in their community. Let us remember that the traditional model of going to hospital is not a 21st century one; there is a recognition out there that we need to do things differently. People want to stay at home, and we should support them there as long as possible.”
“The Ambulance Service plays a key role in health and social care and has been very progressive in the new initiatives that it has brought forward to ensure, in particular, that an ambulance crew does not sit for a long time at a hospital waiting to drop a patient off into the care of a clinician. We need to do more of that. <BR /> <BR />Some of the challenges we have in the Ambulance Service are in relation to the workforce. We will look at every element of the health and social care system, including ambulance staff, to make sure that we have proper workforce planning and meet the needs of the service. I am committed to working with the Ambulance Service. The report does not talk about the Ambulance Service, but it is an integral part of the HSC system and we need to work with all elements of the system.”
“I am committed to supporting these people and helping them with their professional development. I look forward to the report, but I am passionate about making sure we do more to support domiciliary care workers, because support the system. They keep people at home longer and patients can be discharged from hospital more quickly. <BR /> <BR />Alongside this, in March, we will consult on the review of adult social care. That will also allow us to improve on how we deliver services and will make sure that we have settings to care for people that are appropriate and adaptable, because not everybody fits into the one approach. That is the conversation we will have about this matter.”
“Some innovative practices have improved patient flow. Our emergency departments are full, particularly in winter, and patient flow is very difficult. Often, older people cannot be discharged from hospital because there is no domiciliary care package in place, and there are particular challenges in relation to the workforce there. <BR /> <BR />In December, I will receive the report on the review of domiciliary care. I passionately believe in domiciliary care. These people, mostly women, are the lowest paid in our health service. Quite often, the trusts contract the work out to independent providers. Care workers do not get any mileage allowance and, if they work in a rural area, there could be 20 miles between one person's house and another's. That takes what are already low wages down even further.”
“We have to tackle the root causes of health inequalities head on. We can no longer tolerate the correlation between deprivation and health outcomes. We can truly judge our system when we have improved that picture. I think that the direction of travel that we are going to take will lead to that improvement.”
“The vision that I have set out in Delivering Together is focused on keeping people well in the first place and on providing the education, information and support that they need to make informed choices, regardless of where they live. By building capacity in our multidisciplinary teams in primary care and ensuring that there is a named health visitor, district nurse and social worker for every GP practice, they will be better equipped to respond earlier and work with people to address the lifestyle choices that impact on their health and well-being. <BR /> <BR />What I have outlined is investment in, and development of, community resources. We will work with our partners and all the community to develop the strengths and assets to tackle the determinants of health and well-being.”