Mark Durkan
Foyle · Social Democratic and Labour Party · Northern Ireland
“That review involved an extensive engagement exercise with charities, regulators and funders, aimed at creating a more modern and proportionate regulatory system.”
“When the review was commenced in 2021, many organisations were still in the midst of responding to the pandemic. Since then, they have faced a succession of new and evolving challenges. The ending of European funding programmes, on which so many in our communities relied for decades, has left a significant gap.”
“<BR /> <BR />The broad principles behind the Bill are sensible. The changes will modernise charity regulation, strengthen the Charity Commission's ability to intervene where misconduct or mismanagement occurs, improve information sharing and, importantly, reduce unnecessary red tape, particularly for smaller charities with limited adminis…”
“I welcome the opportunity to speak today. Before turning to the detail of the legislation — there will not even be that much detail in the debate today at Second Stage — I pay tribute to our charity sector. Across every constituency, charities provide support that changes and saves lives every single day.”
“<BR /> <BR />Whilst the SDLP supports legislation that removes unnecessary bureaucracy, we should not kid ourselves that administrative reform alone will secure the future of charities and organisations in the voluntary and community sector.”
“I thank the Minister for giving way. Like other Members, I welcome the fact that we have reached this point. There seems to be consensus among Committee members and, I am sure, all Members that the introduction of these measures will save lives, which begs the question of whether the 10-year delay in introducing the measures had an opposi…”
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“The core purposes of nurture education are to provide a flexible and preventative resource that is responsive to the particular needs of the children attending that nurture unit; to provide ongoing assessment and support for early years children showing signs of emotional stress and behavioural difficulties, with the aim of enabling the child to access the curriculum and return to full-time participation in their mainstream class; to help the children to learn to behave appropriately, which is something that some Members in here might be able to benefit from; to improve children's self-esteem and develop their confidence through forming close and trusting relationships with adults; and to work in partnership with teachers, parents, schools, staff and outside agencies to enable consistency of approach both at home and at school.”
“I am happy to contribute to this important debate on an important issue. It is good to hear the support around the Chamber for nurture education. It is hard to imagine that anyone, anywhere would have any problems with it. <BR /> <BR />Nurture education developed in London in the late 1960s and early 1970s as a response to identified need. The provision offers a short-term focused intervention strategy that addresses barriers to learning arising from social, emotional or behavioural difficulties in an inclusive and supportive manner. As an early intervention strategy, the core focus group for nurture provision is pupils in the early stages of primary education, from primary 1 to primary 3.”
“We will not be supporting the motion, but we do support those people working in the centre and elsewhere to meet the needs of people and their families who are living with autism. We need to work for them and with them to ensure more funding and better services for autism. While we will be voting with the Minister on this occasion, he cannot ignore that much of what his Department does in relation to autism is not up to scratch.”
“Nowhere is this collaboration more essential than in the area of health, where enhanced relationships between jurisdictions on this island will not just save a lot of money but will save a lot of lives. I would be a bit more concerned about his remarks if they were not at odds with the actions of some of his party colleagues when they were Health Ministers in the not-too-distant past.”
“<BR /> <BR />It is clear from reading the information pack that what the centre does, it does very well, outstandingly well, in fact, according to an inspection this year. Transdisciplinary support has expanded due to additional staffing, and staff working with pupils, schools and parents have developed their extensive and holistic special skills and are highly valued. That leads to improved outcomes for the pupils at home and at school. Facilities have improved, and investment has been made to upgrade the ICT infrastructure. <BR /> <BR />With regard to today's debate, though, I am slightly concerned at the tone used by Lord Morrow in relation to North/South cross-border projects. We need to see more North/South collaboration across a wide range of issues.”
“<BR /> <BR />It seems to me that the Middletown motion just about typifies service delivery, or lack of it, for people with autism. We have a great vision and the promise of better things to come. I think of the Autism Act, but, ultimately, it does not materialise. Reading into it more and listening to today's debate, it is hard to understand the wisdom or rationale of the motion, given that it seems to fly in the face of what the experts tell us about residential provision. If anything, rather than assist people with autism, the motion almost misleads and manipulates them. I echo Mr Lunn's sentiments that we want to see the centre, and, indeed, all autism services, fully and adequately funded.”
“First, I offer apologies from Colin McGrath, our education spokesperson, as he cannot be here for today's debate, and double apologies from him that I have to speak instead of him. While not overly familiar with the situation or, indeed, the history of Middletown — I would like to learn more and would like to see what is happening there — I am all too familiar, as, I am sure, are most of us in the Chamber, with the many challenges facing those with autism and their families every day. <BR /> <BR />Mrs Overend elaborated most on those challenges and the huge frustrations and difficulties that they cause. Children have to wait a completely unacceptable time for diagnosis, and, sadly, that seems to set the trend for what they can expect from services and statutory service providers for the rest of their lives — not a lot.”
“I thank the Member for giving way. Will he say whether all those successes have taken place in the past five months?”
“I thank the Member for giving way. I am sure that the Member would recognise the right — indeed, the duty — of any of us as MLAs to make representation on behalf of constituents with concerns.”
“Is it applicable to nursing homes and residential homes, where statutory provision is extremely poor and is currently being closed by stealth?”
“We spoke about the reconfiguration of services. There is a need for improved care in the community, improved primary care, an enhanced role for GPs and an enhanced role for community pharmacy and allied health professionals. Those enhanced roles have to be matched by enhanced resources. <BR /> <BR />I am conscious that I have not that long left, so I will touch on one more thing. On the morning of the Minister's statement, she said, in response to a question asked by Mr Carroll, that she was working towards a position where we did not need to use the independent sector. Is that applicable across the board? I think that she answered that on dealing with elective surgery and waiting lists, but is it applicable in social care too?”
“We have certainly expressed a bit of concern about the lack of specifics in the report. The amendment calls for more meat on the bones, as I did on the morning of the report's publication. It is important that we see that soon and give certainty to people and to places that might have concerns about the future of facilities in their area. I think that that is inevitable, given the reconfiguration of services that is necessary and will, ultimately, whatever way it is dressed up, lead to the closure and withdrawal of services from areas. While Bengoa will form the foundation of the Minister's vision or the Minister's policy, we will not allow Bengoa to be a fig leaf for every difficult or unpopular decision that has to be taken by the Minister or any health trust, wherever it may be. <BR /> <BR />There is a need for so much.”
“I thank the Member for his intervention. I assure him that it will be different this time, now that we have done away with those pesky parties.”
“Mr Farry made an interjection highlighting the fact that we have been told a lot that it is different this time because this is a report that the Executive fully endorse. I do not recall the Executive not endorsing Transforming Your Care, for example. Let us make sure that it is more than the Executive endorsing this plan.”
“I have to say in response to Mr Middleton's remarks that they did not really get much negativity from me nor, I believe, from my Opposition colleague, as he described Mrs Dobson. We asked questions around the lack of detail in the report, and it would be a dereliction of duty not just of us as Opposition MLAs but of any of us here, as MLAs and public representatives, not to ask questions about how the plan will be implemented and delivered and how it will improve healthcare for those out there who need it and those of us in here who, undoubtedly, will need it some day. <BR /> <BR />The problem with the past reports to which this is so similar has been the failure to implement them.”
“I thank the Member for the intervention; I am not sure that I thank him for the extra minute that he has got me, right enough. I concur with his view that there is more to this than more money. It is about how we do things differently, not how we spend more money on doing the same old things. <BR /> <BR />A lot of expectation, anticipation and suspense was allowed to build up around Bengoa and then, when it was published, the fact that it was so similar in many respects to reports that we had received, read and seen before meant that there was almost a bit of an anticlimax. I found that to be the case very much among the media, in that they were almost searching for negativity in reaction or response to the report.”
“It is fair to say that, since May, any criticism or question that has been levelled at the Department of Health or, indeed, the Minister — I do not think that there has been much in the way of criticism of the Minister — has been responded to with almost a stock answer that the Bengoa report will sort that out.”
“I rise in support of the motion and the amendment. Mr Sheehan said that he did not detect any opposition to the need for radical transformation: that is fair enough, and it is because there is none. I do not think that anyone in here or anyone anywhere could oppose the notion that our healthcare system needs to be reformed. We see that every day, we hear that every day in our constituency offices, we might hear it around our kitchen tables and we hear it over the air waves. <BR /> <BR />Many people have to live with the fact that the healthcare system that we have allowed to evolve is far from perfect and is not fit for purpose, but, for some time, we have been promised a magic bullet that will cure all the ills in our health service.”
“The Minister touched on my question at the end of her answer. What ongoing engagement has she had with the Minister for Communities regarding improving the condition management programme?”
“Go raibh maith agat, a Phríomh-LeasCheann Comhairle agus gabhaim buíochas leis an Aire as a freagraí go dtí seo. Can the Minister inform the House whether he is considering any further exemptions on rating? I am thinking, for example, along the lines of credit unions.”
“Can the Minister tell the House how much funding has been received for our airports over the years from those faceless bureaucrats in Europe, through various structural and transportation funding programmes?”
“I thank the Minister for his answer. He will be aware that we are the only region on these islands that does not have its own specific climate change legislation. Our reliance on the agri-food industry, for example, is very similar to that of the Irish Republic. Does he accept at all that Northern Ireland-specific climate change legislation and Northern Ireland-specific targets for the reduction of emissions could and should be beneficial to our economy as well as to our environment?”
“It is fair to say that, today, the Minister has demonstrated that he is capable of answering questions on anything apart, maybe, from how he voted on Brexit.”
“The Minister talks about flexibilities in the system. We are aware of the reduced penalty available to people who pay within 14 days. Will the Minister consider introducing new flexibility and giving people a bigger window when they can avail of the reduced fee, maybe 28 days, so that people who are paid monthly or those on low incomes can avail of that reduction?”
“I thank the Minister for his answer and for his action thus far on the job threats at Fujitsu. He outlined to us the conversation that he had with a senior representative from Fujitsu. During that conversation, did he seek from that member of staff any comment about the quality and dedication of the Fujitsu workforce here?”
“I thank the Minister for that very comprehensive answer. Will she expand on that by telling us what her Department is doing to protect not only our red squirrels but other species at risk here?”
“I very much thank the Minister for her statement and welcome the publication of this report, which contains some extremely sensible and necessary proposals. However, the lack of specifics in the report and in the statement on the transformation or rationalisation of our hospital estate means that a spectre of doubt will loom over services in several areas. When will she be in a position to put more meat on the bones of this statement and let us know what this means for where?”
“By an extension of that logic, given that the proposer of the amendment mentioned workforce planning in his remarks, could the Member not see fit to support the amendment?”
“We welcome the Minister's announcement last week on the 1% pay increase but cannot ignore the disparity that still exists between here and other regions. The motion and the amendment describe nursing as a career choice, but, for so many, it is much more than that. It is a true vocation. People do it because they care. They devote and dedicate their lives to helping others but feel that this good nature is taken advantage of and taken for granted. They often have to work several unpaid hours every week. <BR /> <BR />I urge the Assembly to support the amendment. It is time for us to care for our nurses and deliver for our midwives.”
“A survey of midwives who have left or who plan to leave found that over half were unhappy with staffing levels. Around half are not satisfied with the quality of care that they are able to give. Most worryingly of all, only 9% of midwives who had left or were about to leave said that they felt that midwifery is valued by the Government. That is something that we really need to address, and we can start that today by supporting the amendment. <BR /> <BR />We need midwives to know that we value them, not only for bringing our babies into the world but for their vital role in maternal mental health care. We need to see the full implementation of the Northern Ireland maternity strategy. The most obvious way to make our nurses and midwives feel valued is through fairly rewarding their invaluable work.”
“<BR /> <BR />With severely limited job prospects on completion of training, many midwives are forced to leave here to seek job opportunities elsewhere, where they are able to obtain permanent employment and progress in their career. Elsewhere, they can earn the experience they require and will also be paid substantially better than those employed here. We need to get new midwives in now so that they can benefit from the experience of that older cohort who are due to leave. <BR /> <BR />Maternity services here are performing extremely well given the circumstances in which they are operating, but that is due largely to the selfless dedication of midwives and other maternity staff. However, those who have the capacity to go the extra mile for mothers and babies day after day are feeling undervalued and overworked.”
“<BR /> <BR />An ageing workforce, as referred to by the motion's proposer, is a major worry. There is a big group in the over-50 age range that is due to retire in the very foreseeable future. Nowhere is that more pronounced — this brings me to the amendment — than in the area of midwifery. According to the royal college, Northern Ireland faces a shortage of 100 midwives by 2017. That is next year. Forty-one per cent of midwives are aged between 50 and 60. There is growing concern in the trusts that, inevitably, there will be an insufficient number of midwives to staff our already bursting maternity units due to an inadequate number of midwives being trained to replace those who are about to retire. We really are heading towards a midwife crisis.”
“With the increased emphasis on community nursing, we have the bizarre anomaly in the Western Trust where a dedicated, skilled and experienced community nurse has to go back to working in a hospital for two years before, or if, they are to progress from being a grade 5 to a grade 6. <BR /> <BR />The Chief Nursing Officer has told us that nurses are suffering because of inconsistent decision-making by the trusts and the board. They are worried that they are being ignored. There are also genuine concerns that the bank system is being used as a mainstream recruiting mechanism rather than the flexibility tool that it was originally designed to be. More permanent nurses will, obviously, reduce the spend on agency workers and assist long-term workforce planning. Nurses are also being called in to do extra administrative duties.”
“<BR /> <BR />Despite significant investment in the health services, there is an acknowledgement that current structures are not fit for purpose. In Northern Ireland, standards of care have been called into question due to the weak infrastructure underpinning the current provision of care. I know that the Minister will address that tomorrow with the long-awaited publication of Bengoa. It is hugely important that we enhance the quality of education and training for healthcare assistants and increase progression routes into nursing. We also have to look at progression routes in nursing.”
“The PCC is the patients' voice. It would certainly concur with the view expressed in the amendment that existing shortages have affected patient outcomes. <BR /> <BR />While we applaud and support past and current initiatives to increase the nursing workforce, such as the overseas nurses recruitment drive, we have to question the potential impact of Brexit on nursing levels. Prior to the referendum, concerns about this were voiced by Jeremy Hunt. There may be damage caused by losing some EU workers who work in Health and Social Care. Uncertainties around visas and residency permits could cause some to return home and some not to come here in the first place, with an unpredictable impact on hard-pressed front-line services.”
“<BR /> <BR />Today, I, along with many other MLAs, dropped into an event upstairs hosted by the Patient and Client Council (PCC).”
“When I looked at the information pack ahead of the debate, it was clear to me that the sentiments that nurses express to me reflect a wider picture. While some statistics in the pack actually showed an increase in the number of whole-time equivalents, they certainly do not tell the story of nurses' increased workloads. Those increases in workload, unfilled vacancies and recruitment freezes in the workplace all contribute to additional stresses on workers already operating in an extremely stressful environment. It is so bad that, according to the Royal College of Nursing, almost one fifth of newly qualified nurses will probably look for another job elsewhere in the next 12 months. Imagine if that were to happen: the impact of that on patient care in Northern Ireland would be devastating.”
“<BR /> <BR />What we want to do is attract and retain more nurses and midwives to the profession to help to shoulder the massive workload and responsibility of those already doing the job. The motion highlights the ongoing problem of the nursing shortage here. This is not a situation that has developed overnight, and, yes, efforts have been made over a number of years by trusts and previous Ministers to address it. Indeed, such efforts are still ongoing, but the fact is that it has not been fixed yet. It needs to be fixed and fixed now. <BR /> <BR />I speak to nurses regularly — nurses who work in hospitals, in care homes or in the community — and the common theme that emerges is that nurses and other healthcare workers feel overworked and undervalued.”
“I very much welcome the opportunity to speak on this important issue, and I am pleased to propose the amendment. It incorporates midwives into the original motion, which focused solely on nurses. <BR /> <BR />First, I want to put in place my party's gratitude and respect for our hard-working nurses and midwives. Nurses are the backbone of the health service, a health service that is under severe strain. We all know that, when we are under severe strain, it is the backbone that feels it first and feels it worst. Let me be clear — I hope that everyone is clear — that supporting the motion and amendment is in no way a criticism of the heroic, often thankless, work that nurses do. Last week, a call for the Minister's intervention to improve services was twisted by some here and portrayed as an attack on those who deliver that service.”
“Yes, it is a crisis and, yes, it is unprecedented. Has there been a time before when there have been 400,000 people on waiting lists, regardless, Minister, of how that is computed? The Minister said that the problems facing cancer services, increased demand and workforce planning, are reflective of pressures right across the health and social care system. We ask the Minister to intervene. Will she not? Why are parties voting against the motion today? Now, that really is opposition for opposition's sake.”
“I have not heard anything today to suggest that the Assembly does not accept that fact. The motion says that this is:”
“Members raised and, yes, the Minister addressed the Southern Trust figures, and she described them as unacceptable. The motion notes those "with anger"; maybe it should have been more in sorrow than in anger. We have said not that cancer services are deteriorating but that the crisis affecting them is. Is it not? Have we not to respond to that crisis? <BR /> <BR />We ask that the Assembly:”
“We regret, however, that the public have not had time to read the Bengoa report in advance of her vision being made public. She outlined some of the undisputed good work being done in tackling cancer here. That is great, and we all want to see more of it. The Minister's attack on the motion, its proposer and its supporters was, in my opinion, ill judged. I am not going to get dragged into a slanging match with her. We will work with her and with others in transforming the health service, if she will let us, because, every day, we see and hear more compelling evidence that it needs to be transformed. <BR /> <BR />In conclusion, I would just like to ask this: which part of the motion are Members opposed to and voting against today?”
“Carla Lockhart said that the motion was too specific to one form of cancer. I have never heard any motion opposed in here on the grounds of being too specific. Other parts of her contribution were excellent, and I concur entirely, particularly on the cancer strategy. <BR /> <BR />I will move on a wee bit. Many Members made many valid points; unfortunately, I do not have time to cover them all. The Minister said she was grateful for the opportunity to set the record straight. She is proud of those working in healthcare: I think what we have established today is that we all are. She said that the Opposition ducked responsibility by not taking the Ministry. Again, I will ask this: did her party duck responsibility in the South? She has promised to set out her vision for health and social care next week, and we look forward to that.”
“I did not hear anybody saying that heads should roll. When it comes to having it both ways, perhaps the Member should cast his mind back to when a Minister from his party was trying to close care homes, and they were protesting outside them.”
“He then proceeded to a critique of the motion in language that was a wee bit less than judicious and certainly not short on political point-scoring. I sympathise, albeit belatedly, with Pat on the loss of his wife. I am sure that that is something that hurts greatly and always will. <BR /> <BR />The best way to improve the system is to work together, and that is precisely why the motion should be supported by everyone here. <BR /> <BR />Gary Middleton said that the Opposition cannot have it both ways: we cannot praise workers and criticise services.”
“I thank the Member for that intervention. It is clear that, in some cases, even attack has been seen as the best form of defence, because of the number of attacks that were launched, not just on the content of the motion but on the spirit in which it was brought. Any study of today's debate in Hansard will clearly show that it was the tone and content from the Government Benches that was less than conciliatory. <BR /> <BR />Kellie Armstrong spoke of the human impact from first-hand experience. I welcome her contribution and commend her courage. <BR /> <BR />Pat Sheehan said that every debate should be balanced and fair. We should be "judicious in our language" and refrain from trying to score political points.”
“My party colleague Sinead Bradley made a very emotive contribution. She is conscious of people waiting on lists, and the stories behind those lists, where people are living in a vacuum, awaiting a diagnosis, and then there is the tendency to cyber-self-diagnosis. She reiterated the fact that we are not, in any way, attempting to fault or slight workers. She urged the Minister, and her Government colleagues, not to go into defensive mode; but that plea has obviously fallen on deaf ears. I really cannot understand this circling of the wagons that has taken place.”
“They, and many other groups like them, do invaluable work; it is often unheralded and I take this opportunity to pay tribute to them too. He outlined the rationale behind his approval of the centre and said that it was not just for the people of the north-west; it was part of an overall strategy to ensure easier access to cancer services for people across the North. He spoke of the good performance here on breast cancer and the need to constantly strive to improve — that is what we are doing.”
“That is completely off the mark and, in my opinion, out of order. Nobody says more about the problems in our healthcare system than our hard-working healthcare staff, and nobody wants to see them fixed more than they do. I do not know if the Member has seen any of the comments of her party colleagues in the South on waiting lists there. Are they attacking workers in hospitals and doctors in the South? <BR /> <BR />We had a very positive contribution, I thought, from Edwin Poots, a former Health Minister, who wished the current Minister well, as do I. He spoke of his role in giving the go-ahead for the radiotherapy unit in the north-west. I again thank him for that. He spoke of the work of the Pink Ladies Cancer Support Group in my constituency.”