Maeve McLaughlin
Foyle · Sinn Féin · Northern Ireland
“However, as the Minister outlined, the Bill widened somewhat as a result of its passage through the Assembly, with the inclusion of the provision on smoking in cars carrying minors, the promotion and reporting of organ transplantation and organ donation, and the study by the Department on a levy on sugar-sweetened drinks.”
“Our amendment, which has been further amended by the Minister, provides an evidence base of the impact and details how a levy on sugar sweetened drinks would be administered, and I welcome the fact that it has progressed to Final Stage.”
“Go raibh maith agat, a LeasCheann Comhairle. On behalf of the Committee, I welcome the Final Stage of the Bill. <BR /> <BR />The objective of the Bill, as the Minister outlined, is to modernise the model of the code of conduct used by the Social Care Council to bring it into line with other health and social care regulators.”
“<BR /> <BR />The Committee considered the provisions on transplantation and organ donation as part of its scrutiny of the Human Transplantation Bill. The majority of the Committee supported the duty to promote and report on transplantation and organ donation.”
“This is simply to protect children from the effects of second-hand smoke or from even taking up smoking. The stark fact remains that 2,300 people die every year in the North from tobacco-related illnesses.”
“However, stakeholders were content with the provisions as made. <BR /> <BR />There was significant comment on what was not included in the Bill: the banning of smoking in cars carrying minors.”
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“I thank the Member for his kind comments. Most certainly, Kieran, that is what you will be remembered for. I am not sure that I would go as far as to say that it was only things that had just occurred to you in the course of the meeting, but well played, nonetheless. You did your best with it, and, again, I wish you and your extended family every success for the future. <BR /> <BR />I thank Committee members for their cooperation on the legislation and, indeed, on the heavy legislative lift that the Committee has had in the last number of weeks and months. I will leave it at that. I welcome the fact that we have taken this to the Final Stage.”
“I also want to join in the love-in that has broken out in the Chamber today and thank the other Committee members. I pay tribute to the current Health Minister for his cooperation on a number of key issues, and, in particular, I pay tribute to Kieran McCarthy. During my baptism of fire in this brief in the last number of years, I thank him for his input and his valuable role. Suffice it to say, Kieran, that "Any other business" will never be the same again without you.”
“That should not be the end of the road for transplantation or organ donation, but, as we stand here today, it is the appropriate legislation. <BR /> <BR />Finally, as these are my last comments as Chair of the Health Committee, I want to pay particular tribute to the staff and Clerk of the Committee. All in the House will acknowledge that the portfolio is a wide and varied one, and I pay particular tribute to the staff who have done that work very diligently. I also pay tribute to the departmental officials who often had to bear my wrath and that of the Committee and did so in a very professional manner.”
“Our amendment, which has been further amended by the Minister, provides an evidence base of the impact and details how a levy on sugar sweetened drinks would be administered, and I welcome the fact that it has progressed to Final Stage. <BR /> <BR />I welcome the amendment on organ donation and human transplantation, and I acknowledge the work that Jo-Anne Dobson did to take her Bill to a certain point in the legislative process. I do not think that I need to rehearse the very stringent and robust evidence that we heard or the learning that we all underwent from her Bill. However, we have something going forward in law that is what the clinicians and charities asked us to do. It does what it says on the tin. We now have a responsibility to the Department of Health to promote and report on organ donation.”
“This is simply to protect children from the effects of second-hand smoke or from even taking up smoking. The stark fact remains that 2,300 people die every year in the North from tobacco-related illnesses. I welcome support for that amendment and hope that it goes some way to playing its part in the delivery of a robust tobacco strategy across the North and across the island. <BR /> <BR />Moving to the amendment on the sugar tax levy, I thank Members for their support. It needs to be stressed that this is not a panacea for all our ills, but it is, in our view, the right public health approach. There is a direct link between sugar consumption and ill health, whether that be diabetes, obesity, dental decay or, in many cases, cardiovascular disease.”
“<BR /> <BR />The Committee considered the provisions on transplantation and organ donation as part of its scrutiny of the Human Transplantation Bill. The majority of the Committee supported the duty to promote and report on transplantation and organ donation. I am pleased that the Bill has reached Final Stage today and look forward to its implementation. <BR /> <BR />I will make a number of comments now as an individual MLA. I welcome the inclusion of my party's three amendments, albeit that, to some extent, they amended themselves, particularly the ban on smoking in cars carrying under-18s. That, quite simply, is the right thing to do. The right approach to public health involves the early intervention and prevention that we hear and speak so much about.”
“However, stakeholders were content with the provisions as made. <BR /> <BR />There was significant comment on what was not included in the Bill: the banning of smoking in cars carrying minors. During Committee Stage, the Department provided the text of an amendment that would give it regulation-making powers to allow for the creation of offences for smoking in a smoke-free private vehicle and failing to prevent smoking in a smoke-free private vehicle where under-18s were present and also for fixed penalty notices to be applied to that offence. The Committee welcomed the new policy and agreed to support the amendment, which was subsequently tabled by the Minister at Further Consideration Stage and supported by the House.”
“However, as the Minister outlined, the Bill widened somewhat as a result of its passage through the Assembly, with the inclusion of the provision on smoking in cars carrying minors, the promotion and reporting of organ transplantation and organ donation, and the study by the Department on a levy on sugar-sweetened drinks. <BR /> <BR />The evidence received by the Committee on the Bill as introduced was positive. There was firm support for banning the sale of nicotine-containing products to persons under 18 years of age. That support was carried through to the creation of an offence for proxy purchasing for nicotine-containing products. Very little comment was made on the clauses that amend provisions in areas such as dental and pharmaceutical services and charges for services provided to persons not ordinarily resident.”
“Go raibh maith agat, a LeasCheann Comhairle. On behalf of the Committee for Health, Social Services and Public Safety, I welcome the Final Stage of the Bill. As the Minister outlined, the Bill has been significantly altered, and I believe that it has been altered for the better with regard to its nature and operation. <BR /> <BR />The Bill started off with two main purposes: first, to allow the Department to make regulations on banning the sale of nicotine-containing products to minors; and, secondly, to amend existing provisions in areas such as dental services, pharmaceutical services and charges for services provided to persons not ordinarily resident.”
“The Committee sought a written ministerial assurance that those powers are in line with a person’s data protection rights under other pieces of legislation, and the Minister subsequently provided this written assurance. No amendments were proposed to any of the clauses, either by the Committee or by the Department. I am pleased to see the Bill reaching its Final Stage today and look forward to seeing its implementation in the future.”
“Go raibh maith agat, a LeasCheann Comhairle. On behalf of the Committee, I welcome the Final Stage of the Bill. <BR /> <BR />The objective of the Bill, as the Minister outlined, is to modernise the model of the code of conduct used by the Social Care Council to bring it into line with other health and social care regulators. A further feature of the Bill will be extending opportunities for the recognition of the continuous professional development activity of social workers post registration. <BR /> <BR />The evidence received on the Bill at Committee Stage was straightforward and very supportive of the clauses. The only issue that the Committee pursued related to clause 2, which provides powers to disclose information about a person's fitness to practise.”
“Go raibh maith agat, a LeasCheann Comhairle. On behalf of the Committee for Health, Social Services and Public Safety, I support the motion. As the Minister outlined, the statutory rule seeks to make consequential amendments to the primary legislation, resulting from the abolition of contracting-out from 6 April 2016. The proposed amendments are minor and technical in nature. The Committee considered the proposal for the statutory rule on 27 January 2016 and approved the subsequent rule on 10 February. There were no issues raised by the Committee.”
“Go raibh maith agat, a LeasCheann Comhairle. On behalf of the Committee for Health, Social Services and Public Safety, I support the motion. <BR /> <BR />As outlined, the primary objective of the Tobacco Retailers Act is to prevent young people from taking up smoking by making it more difficult for those under the age of 18 to access tobacco products. The Act is intended to assist authorised officers of councils in carrying out their duties on tobacco control by providing them with a complete register of tobacco retailers. The statutory rule prescribes the amount of fixed penalties for certain tobacco-related offences under the Act. The Committee considered the proposal for this statutory rule on 27 January 2016, and we approved the subsequent rule on 2 March 2016. Again, no issues were raised by the Committee.”
“As the Minister pointed out, the Committee considered the proposal for the statutory rule on 3 February 2016, and we approved the subsequent rule on 10 February 2016. No issues were raised by the Committee.”
“Go raibh maith agat, a LeasCheann Comhairle. On behalf of the Committee for Health, Social Services and Public Safety, I support the motion. <BR /> <BR />The statutory rule, as was outlined, seeks to make consequential modifications to primary legislation to comply with the Treasury's requirement for the Department to introduce a further consequential modification to the Pension Schemes Act 1993 to ensure that the new 2015 Health and Social Care pension scheme operates as intended in terms of its interaction with the wider framework of pensions and tax legislation.”
“<BR /> <BR />Amendment Nos 11, 12, 13 and 14, as has been said, are also technical; they remove the term "activities" and insert "transplantations". They cause us no issues, and we are happy to support them. <BR /> <BR />In conclusion, we are happy to support all the amendments in group 3. It is important that, as we move through Further Consideration Stage and, hopefully, to Final Stage, the Assembly has done the right thing in ensuring that the promotion, and the duty to promote, organ donation is legislated for.”
“The language used has been the subject of conversation and dialogue, and it is appropriate that we get the language right in this regard. We have no issue with amendment No 8. <BR /> <BR />We can support amendment No 9. I suggest that we are not about condoning any negation of the Department's duty to promote transplantation, and we have been very interested to hear what the Minister has to say and what assurances have been given. The duty will be on the Minister to promote it at least once a year. The Minister is actually, in our view, adding more to it and making it broader. We have no issue with amendment No 9. <BR /> <BR />Amendment No 10 is technical; it inserts "respect of" and causes us no issues at all.”
“There is overwhelming support for such a duty by way, for example, of a public awareness campaign. There is a general view that increased promotion will result in the outcomes required for an increase in donation rates. <BR /> <BR />I turn to the amendments tabled by the Minister. Amendment No 8 reads:”
“There has been much debate, as the Minister outlined, on the need to have a duty placed on the Department to promote transplantation. It is worth reflecting on evidence such as that from the Heart Foundation, which highlighted that the current system is ultimately failing to meet the demand, for example, for donor hearts and that eight people are waiting on life-saving hearts. <BR /> <BR />So there has been much debate and expectation around the need to tackle the issue of human transplantation and organ donation. It has been apparent, however, that there is unity on the need to promote organ donation, and the Sinn Féin amendment that was brought here a few weeks ago does that. It simply places a responsibility on the Department of Health to promote and raise public awareness of organ donation.”
“Go raibh maith agat, a Phríomh-LeasCheann Comhairle. I rise to speak on group 3 as tabled for Further Consideration Stage, namely amendment Nos 8, 9, 10, 11, 12, 13 and 14. As with other groups tabled today, it is important that we remind ourselves of the context.”
“I think that it is reasonable for us as a society to expect that, once the Act comes into a place, a study can be conducted within a year. As the Minister said, amendment No 7 removes subsections (3) and (4). That, effectively, tidies up the whole issue of consultation versus study, which I have dealt with. Amendment No 16 amends the long title to make provision in relation to sugar-sweetened drinks. <BR /> <BR />In conclusion, we have issues around amendment No 5 and are happy to support the other amendments that are in front of us today. Again, as in the previous group, this is a key public health initiative and is quite simply the right thing for the Assembly to do.”
“It stands to reason, from the evidence, that the highest consumption of sugary drinks, for want of another description, is among children and young people. There is a higher percentage in areas of high social need, so it stands to reason that an initiative that would go some way to preventing that access would have a positive health outcome. In our view, therefore, we cannot stand over the sense that it would be regressive. <BR /> <BR />I have not heard anything to say why we would need to extend the consultation time to two years.”
“We can support that, but we stress that the study will need active participation from the various sectors and wider society. That should, if conducted properly and accurately, provide us with the evidence that we need in moving forward. <BR /> <BR />We take issue with amendment No 5, as we are of the view that the work can be conducted within a year of commencement of the Act. I listened carefully to the Minister. He referred to a lack of consensus on moving on and the lack of an evidence base on health outcomes, and he questioned the competency to legislate. However, the plastic bag levy was legislated for through this very House. <BR /> <BR />There are concerns that the tax may be regressive.”
“Some of the research that we looked at, particularly that carried out by Safefood in 2012, estimated that the direct health costs such as GP, inpatient and outpatient costs and prescriptions to deal with obesity in the North was £92 million per year. So, there is a clear concern about strain on the service, and it is important to reflect the fact that sugary soft drinks are a particular concern in that regard. <BR /> <BR />The tax needs to be part of a broader strategy; the Sinn Féin amendment was a recognition of that. It is not a panacea for our issues, but it is certainly a positive public health initiative that can and should be legislated on. <BR /> <BR />Amendment No 4 leaves out "consult" and inserts "carry out a study", and amendment No 6 removes "consultation" and inserts "study".”
“Go raibh maith agat, a Phríomh-LeasCheann Comhairle. I rise to address the second group of amendments, particularly amendment Nos 4, 5, 6, 7 and 16. <BR /> <BR />It is important at this juncture that we reflect on a number of factors in relation to a sugar tax levy. The Sinn Féin amendment at Consideration Stage was based on key principles. First, as the Minister said, as a society we consume too much sugar. There is a strong correlation between sugar consumption and health problems, dental decay and obesity. The Minister mentioned the number of people who are overweight or obese. It is also a strain on the health service.”
“This is a major public health initiative that is being taken by the Assembly. It is quite simply the right thing to do. We support amendment Nos 1, 2, 3 and 15.”
“It is apparent that, in some regards, enforcement requires a dual process by local authorities and the PSNI. We have witnessed high compliance with other smoke-free legislation, and its success will be greatly assisted by a public awareness campaign. I appreciate the Minister's commentary on full consultation on the regulations. <BR /> <BR />We need a long-term, sustained, comprehensive tobacco control strategy that looks at all the influences, curtails the tobacco industry, helps people to stop smoking and ultimately protects children and others from second-hand smoke. Amendment No 1, in our view, amends the Smoking Order 2006 in accordance with subsections (2) to (7). It amends article 6 to ensure that regulations provide for a private vehicle to be smoke-free when a person under 18 is present.”
“Whilst we can reflect on the fact that smoking rates have reduced, it remains the case that they are the biggest cause of preventable death. Tobacco kills half of its long-term users: between six and seven people every day here, and 2,300 people a year. Quite simply, the prohibition of smoking in cars carrying under-18s is the right thing to do. It is important to point out that children are particularly vulnerable in how they develop physically and to all that second-hand smoke entails. Our aim is not only to advance the legislation and amendments but to move towards a tobacco-free society by 2035, which is an aspiration of all the cancer charities in their daily endeavours. <BR /> <BR />The Minister referred to enforcement in relation to the amendments, and that issue has to be tackled.”
“From our perspective, "smoking" means all nicotine products, and that is reflected in the legislation. It means all enclosed vehicles whether they are moving or parked. The amendment applies to those who are in a car and not just passengers.”
“Go raibh maith agat, a Cheann Comhairle. I support the amendments in group 1, including the new clause and amendment Nos 2, 3 and 15. As the Minister stated, those amendments received support from the Committee. They are required to tidy up this legislation and the existing Smoking Order 2006, and, importantly, to deal with the enforcement of a ban on smoking in cars or vehicles carrying under-18s. The main purpose of the Sinn Féin amendment at Consideration Stage was simply in the interests of children's health by way of prohibiting smoking in vehicles where under-18 children are present.”
“Go raibh maith agat, a Cheann Comhairle. I thank the Minister for her answer and, indeed, for the focus she has had on Derry and the north-west for quite a number of years. Will she confirm how much DCAL has invested in the north-west since the City of Culture ended in 2014?”
“They are clear and concise, and they provide us with a clear statutory framework to address the very core issues that have been raised with us by stakeholders from clinicians to charities in evidence and in the wider public debate. I urge the House to support the amendments.”
“A number of organisations referred to the reporting requirements and suggested that any report should highlight successes and challenges. They said that, if there was a change in the number of organs donated, steps should be taken rapidly to understand the root cause. Again, those are all important pointers for us as we move forward. <BR /> <BR />I also suggest that the amendments provide us with an opportunity to develop an all-Ireland network for the sharing of learning that happens in Dublin and Belfast. I know that, recently, the Minister alluded to exploring something on a Belfast-Dublin corridor for that issue. <BR /> <BR />I am pleased to be able to take forward the amendments.”
“That is an important point as well, because we have heard much about the legislation that has been implemented in Wales. This provides us with a space to find the learning, positive and negative, that comes from that process.”
“We have heard much about the work that the Public Health Agency and other sectors have done. Each family needs to start to discuss organ donation and understand what their responsibilities would be, should a member of the family be in the position to save a life. <BR /> <BR />Amendment No 6 is clear and concise. It places a statutory duty on the Department to promote transplantation. Amendment No 7 sets up a mechanism that requires annual reporting by the Department on transplantation activities. That, again, has been an important feature throughout the debate. It would include the number and nature of such activities. It would require the Department, once every five years, to indicate how effective it has been in promoting transplantation activities and any potential ways in which the law could be amended to increase transplantation.”
“I thank the Member for his intervention. That is certainly one of the virtues of the democratic process and the role of the House in scrutiny. I think that all of us went on a journey in relation to the issue, and I do not expect that we are out the other side of it yet. I take the Member's point about language. It is certainly something that the clinicians have raised. Part of what we propose today is the inclusion of both organ donation and transplantation. I am happy to look at how we can strengthen that or even provide clarity. We will be guided by the Minister and the Department's sense on that as well. <BR /> <BR />There is overwhelming support for the duty. It was highlighted by many in their evidence that the public awareness campaign will need to motivate every family.”
“The only time that the situation in Spain changed was when the infrastructure was addressed, in terms of issues like specialist nurses. However, there was — I am coming to the point of the amendments — unity on promoting organ donation. Amendment No 6 before us tonight, which was consulted on in the private Member's Bill, does exactly what it says on the tin: it places a duty on the Department of Health, Social Services and Public Safety to promote and raise public awareness of organ donation. There was overwhelming support for that duty on the Department to promote organ donation by way of a public awareness campaign.”
“I thank the Member for her intervention. There was absolute unity across all the sectors on public awareness and education. However, it is a matter of formal record that, when Opt for Life and many others came before the Committee, they stated clearly that what we were ending up with was not the journey that they had set out on. We need to be mindful of that. <BR /> <BR />It is important to point out that there was absolutely no evidence to suggest that the notion of opting out impacts either positively or negatively on organ donation rates. There was simply no evidence that the Committee could find. Often, Spain is heralded as the success, but evidence has shown us that the rates stayed exactly the same for 10 years.”
“The Bill was flawed, in our view. The majority of evidence heavily criticised it on the issue of deemed consent. That was a consistent approach from clinicians to charities, including Opt for Life, which stated, "deemed consent under no circumstances". I say that because it is important to lay out the context. There was simply no evidence anywhere in the consultation —”
“<BR /> <BR />It is good that the public conversation has developed and become very vocal. However, it has to be said that the private Member's Bill that came before us in recent times was complex and confusing. Expert evidence, medical and otherwise, highlighted that huge sections of the Bill were inadequate. Experts, from clinicians to charities, all heavily criticised the Bill. It needs to be said that, in the context of these amendments, they were particularly critical of the then clause 4 on the deemed-consent issue. Indeed, Joe Brolly, in his own formidable style, stated that the Bill was "gobbledygook".”
“Go raibh maith agat, a Cheann Comhairle. I will speak in support of amendment Nos 6, 7 and 8. There has been much public debate about the need to promote organ donation and transplantation over the last number of years and in recent times, centring around the former private Member's Bill. There has been much debate about the need to place a duty on the Department to promote organ donation and transplantation. We need to reflect on the facts and look at the information. For example, the British Heart Foundation highlights, very starkly, that the current system is failing to meet the demand for donor hearts and points to the fact that there are currently eight people in the North waiting on a life-saving heart. There is much expectation and indeed a very human cost to this particular debate.”
“I thank the Minister for giving way. Does the Minister agree that the amendment tabled today does exactly what it says on the tin? He mentioned some of the issues to do with consultation and the definition of sugary, sweetened drinks. What sugary, sweetened drinks should we subject to a levy? What factors need to be considered? What rate should a financial levy be set at? What are the anticipated health and economic impacts? Does the Minister not agree that consultation is exactly what we are calling for?”
“I thank the Member for giving way. On a similar track, the BMA gave evidence to the Health Committee and referred to a recent study that said that the concentration of toxins in a smoke-filled vehicle — in essence, a car — could be up to eleven times greater than in even a smoky bar. There was clearly an identified urgent need in relation to that statistic that was given to the Committee.”
“We need to look at all the influences, at what curtails the tobacco industry, at what helps people to stop smoking and at what protects children and others from second-hand smoke. I urge the House to support amendment No 1 in our names in group 1. Thank you very much.”
“It is apparent from the work of Cancer Focus, in particular, and the other cancer charities when they worked with organisations in England in 2012 and found that 80% of people wanted a ban on smoking in cars carrying children. There is a view in charities that, with such a high level of support, legislation could be self-enforcing. That is why we have issues with Mr McKinney's amendment. Enforcement needs to encompass that dual process, and I encourage the Health Minister to outline how that could be taken forward at Further Consideration Stage or, indeed, through regulations. <BR /> <BR />In conclusion, I believe that we need a long-term, sustained, comprehensive tobacco control strategy.”
“I thank the Member for his intervention. He is right in a sense. There is no robust evidence or any real indicators that e-cigarettes impact negatively or positively. The jury is still out on that. However, there is a wealth of evidence on the impact that second-hand — indeed, what is now being called third-hand — smoking has, particularly on children and young people. Again, I point out that the terminology on the use of nicotine products or tobacco is something that was done in full communication and conjunction with the Committee and the Bill Office, so I think that this is a step in that direction. <BR /> <BR />I want to reference enforcement because there has been some discussion about it.”
“Indeed, that was why we offered our support to the extension of the Tobacco Retailers Act to include e-cigarettes and why we advocate that that is a genuine enhancement to the legislation. <BR /> <BR />My colleague outlined the impact —”
“Turning to the amendments before us, the Committee did not form a view on any of them during Committee Stage, so there is no formal Committee position on them. Therefore, that concludes my comments as Committee Chair. <BR /> <BR />I would, however, like to make a few comments as a Sinn Féin MLA on the proposed amendments in group 1 in the name of Rosaleen McCorley, Daithí McKay and myself. Rosaleen articulated the position on amendment No 1 and our position on the rest of the amendments. In reply to some of the commentary earlier, particularly from Mr Ross, I should say that amendment No 1 prohibits the use of nicotine products or tobacco in enclosed vehicles, and it is our intention that the debate be as wide as possible.”
“<BR /> <BR />The Committee was aware that Executive approval was required for the departmental amendments, as they represented a change in policy, but, on Monday 15 February, the Minister wrote to the Committee to advise that Executive agreement had not yet been received for the amendments and that he was seeking agreement through the urgent procedure to allow him to meet the deadline for tabling amendments to the Bill. However, as we stand today, the amendments were not tabled.”
“<BR /> <BR />During the Second Stage debate, the Minister indicated that he intended to table an amendment to ban smoking in cars carrying minors. During the Committee Stage, the Department proposed such an amendment for consideration by the Committee. Such an amendment would provide the Department with regulation-making powers to allow for the creation of offences on smoking in a smoke-free private vehicle, for failing to prevent smoking in a smoke-free private vehicle where under-18s are present and for fixed penalty notices to be applied to the offences. The Committee welcomed the new policy and, therefore, agreed to support the amendment at Consideration Stage.”