Pam Lewis
South Antrim · Democratic Unionist Party · Northern Ireland
“I thank the Minister for her answer. Indeed, I thank her for the assistance that she, as Minister of Justice, gave my constituents Kathryn and Aaron McCollum following the tragic death of their much-loved husband and father. Her assistance was deeply appreciated.”
“I thank the Minister for her answer. I very much welcome the amendment to the Justice Bill on this subject, and I thank my colleagues across the Chamber for the good work that they have done on it. What cost is the PSNI carrying for the seizure, storage and disposal of those vehicles? Is that cost creating a barrier to enforcement?”
“It progresses 18 recommendations from the independent review of charity regulation, with a focus on a more risk-based approach that promotes trust and accountability without placing undue burdens on charities.”
“I welcome the opportunity to speak as a member of the Communities Committee at Second Stage of the Charities (Amendment) Bill. I thank the Minister and the Chair of the Committee for outlining the details of the Bill.”
“The public must have confidence that charitable funds are being used properly, that trustees understand their responsibilities and that there is effective oversight when misconduct or mismanagement occurs.”
“<BR /> <BR />I welcome the streamlining of accounting and reporting requirements. For small charities, administration can be a real challenge and burden.”
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“Thank you, Mr Deputy Speaker, and I thank the Member for his intervention. I am sure that we will hear more about those savings plans as the debate continues. <BR /> <BR />The number of people waiting longer than 12 hours in accident and emergency units has fallen by 50%, and the number of qualified nurses and midwives has increased by 800. <BR /> <BR />The health budget is often described as a bottomless pit, with no amount ever being enough to address all the issues in the service. At the end of the financial year 2013-14, rather than returning a collective underspend of £43 million to the Department of Finance for reallocation, other Departments chose to report an underspend in order to protect their future budgets.”
“<BR /> <BR />I am aware that the Members opposite are not keen to focus on the good news stories in the health service, but I am happy to point out the previous Health Minister's successes in, for example, the context of Transforming Your Care. Since former Minister Poots took over the health portfolio in 2011, there has been an enormous 22·8% reduction in the number of people waiting for 13 weeks or more for inpatient appointments.”
“As a member of the Committee for Health, Social Services and Public Safety, I refute the allegations and insinuations made in the motion. I am not in the habit of pointing fingers or apportioning blame, and I feel that the motion is simply an attempt to distract from the real successes and the reasons for the pressures in the health service. <BR /> <BR />Since 2011, the Department of Health, Social Services and Public Safety has delivered £490 million of budgetary savings, with a further £170 million planned for 2014-15. That has been delivered despite the increased costs in relation to the allocated funding and the rising demand for services. It is abundantly clear that the previous Minister was dedicated to making savings where possible and delivered substantial reductions in spending.”
“I thank the Minister for his statement. Continuing the theme of waste and waste reduction; given the success of the carrier bag levy and the support that the public have given that environmentally friendly scheme, how much work is being done with retailers and other stakeholders, whom I assume include manufacturers, to encourage a major cut in the production of waste before the retailer stage?”
“Following on from the suspiciously long debate on the issue last week, could the Minister outline what action the Department for Transport at Westminster would have taken if the Assembly had not approved the regulations to enforce the road user levy?”
“I hope that this point is considered and that a mechanism for online business is put in place as the Bill progresses so that customers can instantly see food hygiene ratings displayed on the website or app as prominently as if they were visiting the establishment in the flesh and observing the rating in the window or on the door. <BR /> <BR />In closing, the Food Hygiene Rating Bill will provide consumers with a clear and user-friendly way to identify the hygiene standards of any food outlet and enable them to make informed choices. It will undoubtedly increase standards across the hospitality industry and ultimately, most importantly, reduce the incidence of food-borne illnesses. I support the Bill.”
“<BR /> <BR />However, I feel that a loophole exists around the displaying of hygiene ratings for businesses that operate online. In a world of ever-increasing reliance on technology, many of us order food through websites or apps and pay and arrange delivery without ever visiting the premises. Whilst it is proposed that should a member of the public wish to, they can check the hygiene regulations through the Food Standards Agency website, I feel that that defeats the point of having a system that should be instantly recognisable and identifiable.”
“A mandatory scheme will provide a consistent approach to food-hygiene rating; will undoubtedly increase customer confidence; and ensure that best practice is carried out across the industry. <BR /> <BR />As I mentioned, the voluntary scheme is managed by local district councils and, as such, it is anticipated that there will be no additional cost to councils in moving from a voluntary to a mandatory scheme. It is anticipated that any additional cost for rerating a business at its request will be met by the individual business. It is proposed that failure to display a rating or to display an incorrect rating will result in a fixed penalty notice. That will allow for offences to be dealt with quickly and means that only the most severe breaches of food hygiene standards will be dealt with through the courts.”
“Therein is the crux of the problem with the voluntary scheme. Fifty-six per cent of businesses display their rating; however, that falls to only 13% of business ratings between 0 and 2. It is therefore safe to assume that people could, unwittingly, be eating in an establishment that has a far from perfect standard of food hygiene. <BR /> <BR />Whilst there has been some opposition from the food industry, it has been, unsurprisingly, from those at the lower end of the rating scheme. The aim of the Bill is not to increase administration or workload for businesses but to provide consumers with knowledge of how their selected food outlet performs with regard to hygiene.”
“I recently experienced an example of this. After a conversation with a friend who worked in a restaurant that I ate in regularly, I learned that the establishment had a 2 rating and was, therefore, not displaying the sign. Needless to say, I have chosen not to eat there since.”
“It has been administered through our local councils by environmental health teams through routine inspections, with the rating provided as a sticker that can be displayed within the food outlet. <BR /> <BR />I think there is a common misconception amongst the public that it is compulsory for food outlets to display their ratings. I have often noticed when a food hygiene score of an establishment is displayed but have not always noticed when the score is absent.”
“What is perhaps even more troubling is the vast number of illnesses that go unreported, are simply written off as an upset stomach and are treated at home without even being reported to a doctor, therefore not making it into the statistics. I am sure you will agree that the potential figure for those who actually suffer from food-borne illnesses could be astronomical. With that in mind, the reduction of food-borne illnesses is paramount. <BR /> <BR />A mandatory rating scheme will not only provide consumers with the tools to make an informed choice but will serve to increase food hygiene standards across the industry. The current scheme in its voluntary form has been extremely well received by the general public.”
“As a member of the Committee for Health, Social Services and Public Safety, I support the Second Stage of the Food Hygiene Rating Bill. The Bill has relevance to everyone who eats food from outside of their own home from the various establishments, as my colleague Paula Bradley outlined at length. It is a matter of huge public significance but, until now, it has gone largely unnoticed, due, in part, to the fact that the current scheme is operated on a voluntary basis. <BR /> <BR />We heard that we have in the region of 48,500 food-borne illnesses each year in Northern Ireland, accounting for some 450 hospitalisations and 20 deaths.”
“I thank the Member for giving way. Does the Member realise that the £1,000 is a maximum charge and that it can be paid daily, weekly, monthly or annually? Road usage and vehicle weight affect the payment. The maximum is £1,000 a year.”
“I thank the Member for giving way. Can I just ask the Member to clarify that what he and his party actually want us to do is to continue as we are without the enforcement of this tax, which is not of our making but has come from the Department for Transport at Westminster, which, if it is not brought in by Northern Ireland, will come and enforce it itself? Can the Member just clarify that that is the position?”
“Given that this will level the playing field for a substantial number of businesses that will be assured that overseas companies are no longer being given a free run on Northern Ireland's roads, it strikes me as somewhat unbalanced that, on the one hand, Sinn Féin is prepared to accept bail-outs and parliamentary expenses from Westminster, yet dogmatically rejects all other aspects of parliamentary business even when, just like this piece of legislation or the welfare reform package or the work of the National Crime Agency, they are necessary measures and should be implemented without further delay.”
“That equipment can also be used for the enforcement of other road-traffic offences. <BR /> <BR />On the day of the Committee meeting in September we were told that, of the five SL1s presented, one creates the offence on the Northern Ireland statute book of not paying the levy, two add that to the list of fixed-penalty notice offences and set the amount for non-payment, and the other two set it on the list of financial penalty deposit offences and set the amount. By law, the levy has been payable by all HGVs using UK roads since 1 April 2014. <BR /> <BR />The Committee proceeded to a vote on the rules and voted in favour of them by eight to three, with all Sinn Féin members voting against. <BR /> <BR />I am at a loss as to why Sinn Féin opposes this change.”
“The benefits of the Department of the Environment enforcing the levy include having a coordinated approach to hauliers by having one enforcement body looking after all HGV matters, including weight, drivers' hours and roadworthiness, as well as the levy. As has been alluded to, the Department for Transport is quite happy to come to Northern Ireland to enforce the levy if need be. So, the choice that we have today is not luxurious. <BR /> <BR />The Department for Transport is making funding available for additional enforcement officers for this work, which will slightly mitigate the loss of staff caused by the centralisation of vehicle licensing in Swansea. The DfT is also providing funding for cameras and other equipment to allow for enforcement of the levy.”
“The maximum charge for the largest vehicles is £10·00 a day; for smaller vehicles of up to 25 tons, it is £1·70 per day. The largest annual charge is £1,000 a year for five-axle vehicles or £640 for six-axle vehicles. Those charges are set to reflect the road wear created by the number of axles, weight and so on. <BR /> <BR />As already mentioned, the levy is a tax, so it is an excepted matter under the Northern Ireland Act 1998. Ministers past and present, supported by their Irish counterparts, have made representations to the Department for Transport focusing on exemptions for particular routes, for example the A5. As the Chair of the Committee mentioned, those representations were not successful. The proposer from the party opposite said that some exemptions would not be acceptable. They want every road to be exempted.”
“This is to the benefit of the enforcement authorities and hauliers, and it ensures that Northern Ireland hauliers are not financially disadvantaged compared with British hauliers through adjustments to vehicle weight bands. <BR /> <BR />It must also be worth noting that the levy is paid by many in Northern Ireland already. The motions today ask us not to enforce it. They ask us to let others pay the levy and adhere to the law that already stands in Northern Ireland but not to enforce it on those who do not pay. <BR /> <BR />By way of background, on 11 September, departmental officials briefed the Environment Committee, and I will quickly run through some of the information that was given. The levy can be paid daily, weekly, monthly or annually. The fees depend on the time covered and the weight of the vehicle.”
“<BR /> <BR />The levy is an excepted matter under the provisions of the Northern Ireland Act 1998, and the responsibility for its implementation rests with the Department for Transport. However, the Department of the Environment is required to introduce some limited new secondary legislation relating to the HGV Road User Levy Act 2013 on to the Northern Ireland statute book. As part of that process, the Department of the Environment consulted on those requirements. <BR /> <BR />It is worth noting that the levy received support from the Freight Transport Association and the Road Haulage Association, which represent the majority of road freight operators in Northern Ireland. Their support extends to the proposals for the secondary legislation that is needed to allow the effective operation of the levy in Northern Ireland.”
“As Deputy Chair of the Environment Committee and a DUP member of the Committee, I oppose all five motions tabled by the party opposite to annul the regulations. <BR /> <BR />All these statutory rules are to enable the enforcement of the HGV Road User Levy Act 2013. The UK Parliament passed the Act on 28 February 2013, providing legislation that introduces a specific time-based charge for the use of the UK road network by heavy goods vehicles weighing 12 tons and over. The key objective of the new law is to ensure a fairer arrangement for UK hauliers. Currently, foreign-registered HGVs do not pay to use the road network in the UK, whereas UK-registered HGVs pay charges or tolls in most other European countries.”
“I thank the Minister for his very full answer. Does he believe that enough is being done to promote on-the-job training for young people exiting the formal education system?”
“I urge all our GPs to give serious consideration to using the tool in their practice to provide an effective and proven backup to their own clinical experience.”
“<BR /> <BR />Although the tool does not replace the interaction that a GP will have with his or her patient, it can only serve to enhance the community feel of the GP's surgery, which has to be recommended under Transforming Your Care. It could also lead to earlier diagnosis of difficult-to-identify cancers such as pancreatic cancer, thereby leading to possible surgical intervention and increased survival rates.”
“<BR /> <BR />It is imperative that our GPs and health professionals receive thorough training and support to identify possible pancreatic cancer. In 2013, Macmillan Cancer Support launched an electronic cancer decision support tool pilot scheme that served to assist in the clinical judgement of patients. The tool works through the existing IT system by identifying patients' symptoms and the demography over the past 12 months. It calculates risk and highlights whether further investigation is warranted. That tool would be particularly useful in the diagnosis of pancreatic cancer, as the likelihood is not always immediately apparent and the symptoms can be non-specific. Further to the success of the nine-month pilot, the scheme was rolled out free of charge to all GPs across the UK.”
“We must also take responsibility for improving our diet and general way of life. That said, there is growing evidence to suggest that a genetic link to predisposition to pancreatic cancer may be identifiable, in the same way as the identification of the BRCA2 gene has been instrumental in improving early diagnosis and survival rates for breast, ovarian and prostate cancer in people with a family history. We must invest resources in further research into the p16 gene, which has been identified as a possible faulty gene linked to pancreatic cancer. In 2013, only 1% of the National Cancer Research Institute budget was invested in pancreatic cancer research. Pancreatic cancer research clearly remains neglected, and more must be done to identify those at risk and to diagnose early to improve outcomes.”
“I apologise for using a great number of statistics, but the disparity between the early diagnosis of pancreatic cancer and other forms of cancer is astounding and can be properly conveyed only in that manner. The one-year survival rate for patients diagnosed during emergency hospital admission currently stands at 9%. For patients diagnosed following GP referral, it is 26%. That statistic alone speaks loud and clear on the need to provide adequate training and support for health professionals in order to improve patient outcomes and, ultimately, survival rates. <BR /> <BR />As with most cancers, there is a link to our lifestyle choices that cannot be underestimated, with smoking, obesity and diabetes all being identified as contributory factors in the occurrence of pancreatic cancer.”
“It is an unfortunate reality that 48% of diagnoses come following emergency admissions to hospital — twice the total of other forms of cancer.”
“<BR /> <BR />The lack of awareness and the difficulty in diagnosis has no doubt contributed to the poor survival rates, with only 10% of new patients being suitable for curative surgery due to late diagnosis. It is often the case that the patient has had a period of unexpected weight loss and jaundice prior to diagnosis. Unfortunately, by the time those symptoms appear, the tumour has become too advanced to treat surgically. As a result of the early stages of pancreatic cancer being largely asymptomatic, with the initial symptoms often being mistaken for other illnesses, around 40% of patients will visit their GP three or more times before they are referred to a specialist, with a staggering 16% visiting seven times prior to diagnosis.”
“I support today's motion on pancreatic cancer. On many occasions, I have spoken in the Chamber about the need for public awareness, support for our clinicians and an improvement in patient outcomes in the fight against cancer. I thank in particular my colleagues Tom Buchanan and Paula Bradley for bringing the motion before the Assembly this evening. <BR /> <BR />Pancreatic cancer is equally devastating for sufferers and their families. However, unlike cancers such as bowel, breast and prostate, the five-year survival rates have remained unchanged, as we have heard, for the last 40 years. Contributing to 6% of cancer deaths, pancreatic cancer is the fifth biggest cancer killer in the UK, and it is expected to become the fourth biggest killer by 2030, overtaking breast cancer.”
“<BR /> <BR />I particularly support the Committee's recommendation to develop policies that proactively mitigate potential conflicts of interest for doctors who carry out private work as well as working in the health service. In order to understand those potential conflicts of interest more fully, the Department should ask the Patient and Client Council to carry out research to examine the extent to which health service patients are advised about the option of paying for treatment in the private sector.”
“<BR /> <BR />I appreciate that there is a need for the private sector to support the health service and was extremely impressed during a recent visit to a private health care facility. I am concerned that our health service has the ability to perform in exactly the same manner but often underachieves owing to management issues. I suggest that a more businesslike approach should be adopted throughout the health service to maximise its potential and minimise waste. That said, I feel that the private sector should be used only at the very margins of need and not as a way to manipulate waiting list figures. The money saved could be ploughed into long-term planning to fill consultant posts, particularly in areas of recurring need such as joint replacement, ophthalmology and gastrointestinal services.”
“Patient treatment needs to be based on clinical need and not simply be an exercise in box ticking to manipulate figures. We must work urgently to reduce the £72 million spent on private sector treatment in 2013-14 and redirect the spending to address baseline capacity and match supply with demand. <BR /> <BR />There is a groundswell of public opinion that the use of private sector providers, some of which employ doctors who also work in the public sector, is a method of privatisation of the NHS by the back door. I understand that point of view, as the current position is simply one of moving patients around the system among the same groups of clinicians. The NHS is an excellent and equitable system, and it seems unfair for it to become a two-tier system that allows those who can afford it to be treated sooner.”
“It seems that Northern Ireland has a growing over-reliance on the private sector to treat those who have spent extended periods on a waiting list for NHS treatment. With a relatively small pool of specialists, it is evident that there are potential conflicts of interest, with doctors treating patients in both a public and private capacity. Although the need to meet patient waiting time targets is of huge importance, it is vital that maintaining long waiting lists is not incentivised, making patients feel that they have no option other than to be treated privately. <BR /> <BR />The use of the private sector is often seen as a way in which to meet targets and save money. However, it has been shown that that approach does not work in the long term and is usually more expensive than doing additional work in the public sector.”
“<BR /> <BR />There appears to be some ambiguity around where the responsibility lies in managing and reducing waiting times in Northern Ireland. In England and Scotland, dedicated teams and departments are tasked with monitoring and managing waiting times. Without similar measures being in place in Northern Ireland, there seems to be an element of passing the buck between the Department, the board and the trusts as to who is ultimately accountable for ensuring that patients do not wait excessive periods for referral. Although it may not be feasible for an entirely new team to manage waiting lists, it is clear that a more joined-up approach between all bodies is required to reduce waiting times. <BR /> <BR />The Committee has been particularly concerned with the health service trend of using the private sector to manage waiting times.”
“The situation is far from ideal and can have wider implications for their long-term physical and mental well-being. <BR /> <BR />We in the UK are blessed with an excellent health service that is free to users at the point of delivery, but the reputation of the NHS is often tarnished by the image conveyed by poor patient experience. With no linked-up method of measuring the patient's journey from GP referral until the start of treatment, it is impossible to provide targets or, indeed, to give patients a clear indication of how long they are likely to wait until their life-improving treatment at specialist level commences. That adds further distress for a patient during what can already be a worrying time.”
“As a member of the Health, Social Services and Public Safety Committee, I support the motion on the review of waiting times for elective care. <BR /> <BR />I am sure that I would not be the only one in the Chamber to say that my constituency office regularly deals with members of the public who contact me to request assistance as they have been on a waiting list for elective care for a considerable time after being referred by their GP. In many cases, people have been left in considerable pain and are often left dealing with the distress and anxiety caused by the extended waiting time. In addition, a great number of people that I have spoken to have had to take periods off work as they are unable to work owing to their condition.”
“I apologise if my question is similar to Mr Lunn's. I did not quite pick up what he said about the fish kill in the Sixmilewater.”
“Does the Minister have any plans to reduce or remove anything from the rate scheme for next year?”
“I apologise for not being in the Chamber at the beginning of the Minister's statement. I welcome the Minister to his new and challenging role, and I congratulate Edwin Poots on the excellent job that he has done in recent years. What public health initiatives will be able to be taken forward in light of the statement?”
“I trust that the Health and Social Care Board will accept the Committee's recommendation to ensure that each HSC trust develops and promotes both the concept of supported living and the facilities in its area.”
“It is, therefore, incumbent on each of the trusts to engage with all sections of the community, such as housing associations, GPs and community groups, to ensure that the information is received by the appropriate persons. It is also vital that the information that is placed on the trusts' websites provides clear and concise material on the concept of supported living and how it differs from residential care. <BR /> <BR />The concept of supported living is key to the success of Transforming Your Care. However, the key to the success of supported living is in ensuring that the information is received and understood by its potential service users before their need arises.”
“So that the information reaches all potential service users, it is vital that the five trusts formulate an action plan setting out their proposals for raising awareness of the concept of supported living for older people as a model of care, as well as proposals for better promoting the facilities in each area. It is evident that some of the trusts have made inroads into promoting the concept while others have been found lacking. I appreciate that, in these days of technological advances, many of us receive our information through social media or websites. However, the target audience of the information cannot be forgotten. Whilst many of the potential service users are familiar with those methods of communication, many more would prefer to receive information and knowledge through more traditional means.”
“Some of the confusion in the definition of supported living has, no doubt, led to a lack of public awareness of the services available. It is clear that, when people are in full receipt of the information and advice on the services accessible to them, they are in a position to make an informed decision on what is most suitable for them. The awareness of supported living will therefore make them more likely to choose the concept, should their health begin to deteriorate. <BR /> <BR />Responsibility for disseminating the information falls to the five health and social care trusts, and it is that task that, the Committee feels, is not being carried out as effectively as it should be.”
“That said, the confusion that exists around the definition of supported living has created a degree of ambiguity that must be overcome by the Department in order for the proposals to progress. For the purposes of the motion, I refer to the Department's latest definition of supported living:”
“<BR /> <BR />One of the core principles of Transforming Your Care centres on home being the hub of care for older people. However, we still have an over-reliance on acute and unplanned services to respond to crises. Rather than that firefighting approach, we must move towards a proactive, preventative and holistic service to maintain the health and well-being of older people, rather than the current dependence on institutional and hospital care. Research suggests that that preventative approach can deliver better outcomes for older people, with fewer hospital admissions and shorter lengths of stay. Indeed, the appetite for remaining in their own communities is evident amongst the vast majority of older people whom I have spoken to in my constituency of South Antrim.”
“As a member of the Committee for Health, Social Services and Public Safety, I support the motion. I welcome the review of supported living for older people in the context of Transforming Your Care. <BR /> <BR />The population of Northern Ireland is growing at the fastest rate in the UK. In relation to today's motion, it is worth noting that, by 2020, the number of people over 75 years old is expected to increase by 40% from that in 2009. The number of people aged over 85 is expected to increase by 58%. Whilst longer life expectancy and good health are things to be celebrated, it is clear that a strategic plan for helping our older generation to live as independently as possible for as long as possible is a matter of great urgency.”
“I thank the Minister for his answers thus far. In light of the very many fatalities, especially this year, how effective does he deem the very graphic and expensive television adverts, which are part of campaigns to cut road deaths, to be? It is to be seen how effective they are. Does he appreciate that those campaigns can cause families of victims great distress?”
“I thank the Minister for her answer. Something was published on that in the local press recently. Maybe, when the Minister has been briefed on it, she will see that there has been a drop in numbers. If so, what might National Museums Northern Ireland do to reverse the trend of reduced visitor numbers to what is a very important part of our cultural wealth in Northern Ireland?”