Jo-Anne Dobson
Upper Bann · Ulster Unionist Party · Northern Ireland
“I thank Nichola Mallon for tabling this important question today. I understand that, through correspondence with my colleague Andy Allen, and he articulated this earlier, limited resources and challenges are being cited as the reason. Those are not acceptable reasons for young children to be denied access to a drugs trial.”
“I take no pleasure in speaking on the motion today, but I do so as the Ulster Unionist Party health spokesperson. I wish to focus my comments on, as the motion says, the "grave consequences" for the health of our people of Northern Ireland.”
“The GP crisis, as we know, threatens cover across Northern Ireland. That became abundantly clear given the number of Members who wanted to take part this afternoon. With hundreds of GPs considering resigning, that rescue package can no longer become a reality.”
“<BR /> <BR />I want to turn my comments to the present GP crisis and pay tribute to the work of GP representatives. A rescue plan is needed, but, sadly, one is unlikely to come forward any time soon. Shameful.”
“Minister, this is a desperate situation that has caused real anger in Portadown and has the potential to impact on the health of all patients of the health centre, creating a domino effect across practices. Portadown must be prevented from becoming Humpty Dumpty. What is your response to the anger of the patients in Portadown?”
“Minister, I, like Mr Anderson, have met many of these homeowners, farmers and businesses in upper Bann that have been affected, and livelihoods have been put at risk. Many farmers have been there for generations, and they do fear that it is Groundhog Day.”
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“I have run out of time, but there is so much more that I could say on the issue.”
“The Department is absolutely correct to focus on high-quality front-line care, but it is unacceptable that, even now, after the production of the spending plan, the Department still has no definition of "front-line services". I urge the Department and the Health and Social Care Board to get that sorted out. <BR /> <BR />I could go on, Mr Deputy Speaker —”
“<BR /> <BR />In its spending and saving plans for next year, the Department believes that it has identified further savings of £164 million. Of that, the vast majority — £113 million — will come in the form of cash-releasing efficiencies and productivity gains in trusts. Quite simply, I do not believe that those £113 million savings will be achieved. This year should prove that. Although I welcome the additional allocation to health, in reality, it is offset by the £220 million of pressures being carried forward from this year. <BR /> <BR />Looking ahead to next year and following another back-room Budget, I welcome the fact that the Department has at least identified the provision of high-quality front-line care and the implementation of Transforming Your Care as its top two strategic priorities.”
“Yes, the Health Department was protected in the reductions in 2014-15, but, in reality, that did not filter down to local services. You have only to look at what is happening in each of the trusts. Recent attempts to generate savings, such as reducing beds and closing units, have been so entirely piecemeal that the decisions to cut key services in order to provide short-term savings will inevitably carry through with devastating consequences for next year. The fact that a number of trusts' key decisions have been overturned or abandoned, such as closing the minor injuries unit in Bangor, the admittance of patients to Dalriada and the reduction of the domiciliary service in Belfast, demonstrates that even the trusts have had little or no confidence in their own decisions.”
“That takes us to where we are today, with a health service that is buckling under immense and growing pressure, crippled by the legacy of a flawed and destabilising four-year budget; staff stretched to and beyond the limit; and patients left waiting longer, suffering physical pain and continued agony as a result — the human costs of when budgets fail. Yet, unfortunately, we continue to be led by parties whose economics are based on a Wonga loan rather than on doing what is right for Northern Ireland. <BR /> <BR />While some may still have believed that the numbers were balanced for this year, in reality, it was achieved only after one serious pummelling of public services and by stretching healthcare staff beyond what should be reasonably expected of them.”
“Is it any wonder that a world mental health survey covering 30 countries, including Israel and Lebanon, concluded that Northern Ireland has the world's highest 12-month and lifetime post-traumatic stress disorder levels? <BR /> <BR />Alongside the real hurt and pain comes the financial cost, with the total cost of mental illness in Northern Ireland estimated to be in the region of £3 billion annually. Beneficial though the Barnett formula is for Northern Ireland, unfortunately, it still has its drawbacks. By not recognising individual need, it means that we have to spread what we have further than at first appears.”
“My contribution will focus on the health service and the pressures that it faces. <BR /> <BR />There can be no doubt that, as the motion states, Northern Ireland faces challenges, many of which are unique to our shores. Mental health, for instance, remains a major issue and one that can be linked to our past experiences, an issue that we on these Benches have repeatedly raised. It is a sad fact that Northern Ireland is in the top quarter of the global league table for suicide rates. In Banbridge, as in many other areas in mine and other constituencies, high suicide rates have torn families apart and left behind a long legacy of hurt and pain. According to a report prepared by the Commission for Victims and Survivors, 40% of adults have had one or more traumatic experiences linked to the Troubles.”
“I also thank the Minister for his answers so far. Regarding the news on the new campuses, will the Minister assure us that the impact of the recent cuts to his Department's budget will in no way affect the ability of the colleges to staff the new builds once opened and that everything will proceed as planned and staffing levels will be as required?”
“I thank the First Minister for his response. Given their joint public support for a soft opt-out system, which he has outlined again today, and the earlier Budget announcement on health, have the First Minister and the deputy First Minister pressed for any additional resources to enable the Health Minister to introduce the new system?”
“I also note the Minister's optimism as regards the allocation for health. Let us face reality: the health trusts have been ordered to make an additional £130 million cash-releasing efficiencies and productivity gains next year. Can the Minister give a commitment that the scenes of earlier this year, when each of our trusts had to make stringent in-year cuts to make emergency funding available, will not be repeated next year?”
“I also thank the Minister for her statement. Will she detail how the recommended 2015 budget grant provision of under £4 million compares with previous years? Is she absolutely confident that, as the crisis in public spending in key services such as health and education looks set to continue, no further savings can be made from the Loughs Agency?”
“I thank the Minister for his statement. It is proposed that the Food Standards Agency will have its budget reduced from £8·5 million to £7·4 million. Given that food hygiene official controls constitute over 60% of the entire FSA budget, how is the Minister sure that such a reduction will not impact on food safety standards, especially with regard to clamping down on the blight of cross-border smuggling and illegal slaughtering?”
“Will the Minister clarify how many farms that received less favoured area support in 2014-15 will no longer be eligible to receive such support? Will she provide an update on the estimated value of the one-year transitional payment?”
“On a point of order, Mr Principal Deputy Speaker. Is it in order for the Chair of the Regional Development Committee to heckle me and make derogatory personal comments when I am asking my question to the Minister? I know that that is the cut and thrust and tumble of the Chamber, but I feel that personal comments are a step too far. I ask that the Hansard report be reviewed.”
“I thank the Minister for his answer. I am sure that many, including my constituents, know that the Minister is committed to provision of those winter services. Does he agree with me that Simon Hamilton should know better than to seek to apply pressure to the budget over the port's reserves for what appear to many to be party political reasons?”
“Does the Minister agree that cuts to the Fire Service would have a more momentous impact than cuts to most other public services, especially on farms and in rural areas, where we have seen far too many farm deaths in recent years? What further scope for efficiency does he believe exists in the Fire Service without touching those vital life-saving front-line services?”
“— in tourism across Northern Ireland? Sorry, Mr Principal Deputy Speaker, but, with the hecklers to my left, it is very hard to ask a question.”
“Specifically for Upper Bann, does the Minister agree that the short answer is "precious little"? You will be aware that each year in Scarva we have the second largest tourism event in Northern Ireland and massive tourist potential, yet, in Upper Bann in the past three years, the only tourism development scheme that received funding was, ironically, the relocation of the tourist information centre in Banbridge. Why have you chosen to centralise funding and not strategically target investment —”
“I thank the Minister for her answer. She will be aware that I have written to her on behalf of a company in my constituency that has concerns about the displacement of jobs and investment, following Invest NI's support to the industry. Is it her view that displacement has occurred? Will she agree to meet, alongside me, representatives of the company to discuss its concerns?”
“I thank the Minister for her answer. She will be aware that, last month, I, alongside Sport NI and DCAL officials, met Lurgan Ladies' hockey club and Killicomaine Junior High School. We are delighted that Killicomaine Junior High School has since had its new pitch confirmed by the board. What more can the Minister do to ensure more effective partnership working that will deliver further good-news stories for clubs and players in Portadown and Lurgan?”
“I support the motion and thank Members for their contributions.”
“He also said that if the hospital was to disappear it would hurt for a generation. I hope his Minister, who has ultimate responsibility for the trust he lambasted here today, will listen to us and to Mr Frew. <BR /> <BR />Maeve McLaughlin referred to the closure as being short-sighted and spoke of Transforming Your Care. <BR /> <BR />In conclusion, we need to hear from the Minister what the plans are for future respite services for all 4,200 MS sufferers and their families across Northern Ireland. That is something on which I am looking for answers from the trust, the board and the Minister directly. Minister, you can make the intervention. You have the ability, you have the authority and you know in your heart that this is the right thing to do for MS sufferers in Northern Ireland.”
“Yes, working with the trust's spokesman. I thank the Member for his intervention. <BR /> <BR />Fearghal McKinney praised the campaigners who were at Stormont last week, where he joined his colleagues from north Antrim. He said the real concern was over how the cuts are being administered. He also said that the decision to close the hospital is contrary to TYC, which I totally agree with. <BR /> <BR />Kieran McCarthy said that it was right to speak up loud and clear on this issue. He cited the Budget as the underlying cause of the decision and raised concern for the future. He also referred to TYC. <BR /> <BR />Paul Frew supported the motion and the campaign, which he described as being managed by the people. We have joined those people and given them a voice today.”
“I thank the Member for the intervention. The point was very, very well made, and I totally agree with him.”
“The fact is that the trust sought for some time to strangle the existence out of the centre. <BR /> <BR />I will turn to comments made by Members. Mervyn Storey reminded us that Terence O'Neill opened the hospital in 1963. He praised those defending the hospital as a credit to their community, and I totally agree with him. He spoke about the long-term failure to address the medical needs of the community of north Antrim. <BR /> <BR />Daithí McKay supported the motion, saying that this was decision day for the Minister. He also praised the campaign of the Save the Dal group.”
“I thank the Chair of the Health Committee for her intervention. I totally agree. Yes, it is, in effect, closure. <BR /> <BR />What guarantees will be available in years to come, Minister? None. There is no long-term strategy for people living and struggling daily with a long-term debilitating condition. The reason, I suspect, it is being re-provided to the private sector is not to save money but to make sure that the service is easier to adjust and tinker with in the years to come. <BR /> <BR />Whilst Dalriada is located in the Northern Trust, it was, in theory, to be used by all. In theory. Of course, 30% bed occupancy is not good enough, but if patients were not being allowed to enter the centre in the first place or not even being told about it, it is little wonder that so few were receiving care.”
“I am not alone in the Chamber in representing constituents who are denied this service. Their passion is to raise public awareness of MS, to fundraise and to support fellow sufferers. They view this so-called temporary closure as a bitter blow to every MS sufferer in Northern Ireland — that is 4,200 sufferers and their families. <BR /> <BR />Yet we are being asked to believe that the service at Dalriada is no longer required and can be met through private providers who, as we stand here today, have not signed a contract. Even if a commitment is signed today, this week or next week, what guarantees are there that this respite service —”
“<BR /> <BR />Speaking to people with MS, and their carers, I am in no doubt of the importance of effective respite. It gives family members the opportunity to travel in the knowledge that their loved ones are safe and secure. The debilitating fact about MS is that symptoms come and go, robbing people of their independence to do even the most basic tasks, and leaving them to suffer the most spine-chilling level of pain. <BR /> <BR />Having a centre with the staff and skills required is a huge benefit and grants carers the precious period of respite that they so richly deserve. I know so many people coping with this condition, whom I have supported. I would be here all day if I listed their names, people who have touched my life. They would dearly love to receive respite in my constituency, but it is not available to them.”
“As we heard from Members, there have been long-standing concerns about Dalriada's future. The people for whom it provides respite and intermediate care, as well as its loyal team of staff, will have seen its value in the eyes of the trust diminish. Even its physical appearance has gone downhill. <BR /> <BR />While it is easy to comment on bricks and mortar, the real cost of the closure will be the human impact on the people who use the service, not only the 69 with MS indicated by the Minister but many hundreds more family members and carers who benefit from the relief that Dalriada provides. The many benefits of respite care, be they medical, financial or otherwise, ripple outwards from the patients to their family circle and friends. Minister, that must never be forgotten or underestimated.”
“Some in the Chamber may find that hard to accept, but I ask them to speak to the Minister directly or to the trust privately. It saddens me to say that I suspect that not all the reductions that we have been told about are just as new or as recent as we are led to believe.”
“Frustratingly, however, whilst the funding crisis in our health service may not have been unexpected, as my colleague Mr McGimpsey said, it was avoidable. I will reiterate a point that I have been making over the last number of weeks and months. The funding void will have been known about long before it struck. It could have been avoided, but it was not, and trusts have now been forced to slash services. Members, this is where we are today. <BR /> <BR />While suggestions for cuts may indeed come from the trusts, be in no doubt that the Minister is required to give his personal approval of them. There is no question that the Minister was asked for his opinion on the Dalriada, and there is no question that he approved the closure of the respite centre.”
“I welcome the opportunity to make a winding-up speech on such an important debate. I was delighted to hear all the support from fellow MLAs. Minister, our motion calls for you to reinstate the service at the Dalriada immediately. I will start with a plea: do it, Minister, and do it now. This is an issue that, as we know, has caused so much public anger, emotion, concern and protest. Much of that has been reflected in an emotionally charged debate in the Chamber today. As John Dallat put it, this has the ability to unite us across the Floor. <BR /> <BR />I will refer to Members' comments, but, first, I will make a few comments of my own. Minister, I appreciate that difficult decisions need to be made.”
“Unfortunately, the Republic has been allowed to get ahead in building routes into the Chinese market. As Agriculture Minister in this Executive, can she give a commitment that, for the Chinese market, she sees the Republic of Ireland as nothing other than a major competitor? Ideology must not get in the way of standing up for our farmers and agriculture sector.”
“In addition, it is hard to get an absolute definitive value of the contribution made through care, as it is typical of Northern Ireland people to be modest when asked how many hours they spend helping their neighbours and friends. <BR /> <BR />We need to remember that growing numbers of older people are exploring new opportunities as they reach pension age. Those in the current generation of pensioners — the baby boomer generation — are the best educated that Northern Ireland and the UK have ever seen. People in the current generation, with their relatively good health, ideas and energy, will no doubt make an even greater contribution than their predecessors. <BR /> <BR />In conclusion, I hope that tonight's debate will have a positive impact on the wider public debate about the future of our ageing population.”
“From supporting local events to sitting on committees and relaying their knowledge and experience, older people are often the backbone of many local charities and institutions, using their expertise to help others and bring forward leaders and champions for the future. <BR /> <BR />Whilst the Assembly talks about preparing to care for an ageing population, we must remember that older people themselves are often the ones providing the care. At a time when our Health Department and the trusts appear so committed to reducing key services, huge numbers of older people living here say that they regularly help out their elderly neighbours. If services like domiciliary care are to be reduced, reliance on that generosity is only likely to grow.”
“In some of those cases, without that arrangement, the cost of childcare would be too prohibitive to allow the parent to work at all. <BR /> <BR />The childcare role is especially relevant in Northern Ireland, where, despite the many promises and strategies, our local childcare system is still largely ineffective. In addition, without the dedication and commitment of older people, many of our best-known charities would not be nearly as successful. As I know too well from my association with the many local organ donation charities, volunteers, many of them over 50, make a fantastic contribution every day. The value of volunteering, whether through charities or, indeed, our church organisations, is enormous each year and could never be accurately costed.”
“Whilst the report is to be warmly welcomed, I note that pension costs have not been included. In basic financial terms, we cannot ignore that fact of life. Until we look properly at pension costs, how can we plan for the pressures of our ageing population? <BR /> <BR />It is to be celebrated that people are living longer and are able to continue to make a greater contribution to our society than was possible in the past. That is why it is important that older people have the opportunity to continue working, if they choose to do so. We all know many examples of older people who are doing brilliant work and providing key services. Take, for instance, grandparents providing childcare for their children's children.”
“As has been said too often when we are discussing a growing and ageing population, too much of the focus is on the cost of support and not on what our older people give back to society in return. There is no doubt that an increasing elderly population will put greater pressure on some of our care services, but we must never forget that those additional costs are offset by the massive contribution that our elderly people make in their later years. They are not only an economic asset worth heralding through directly supporting our local economy but our elderly generation make a major societal impact on their communities. <BR /> <BR />On a day when the Assembly considered yet further fundamental reform to our pension system, it is imperative that we look at the massive and positive contribution of our elderly population.”
“True, but not to those observing. I will give him style tips at some point.”
“I welcome the opportunity to make a contribution to tonight's debate. I did smile, however, during Mr Weir's contribution, when he pointed out that I would reach pensionable age before him — a fact that I know people watching the debate will find incredible.”
“I also thank the Member for her answer. I am aware that the Commission previously engaged in a business efficiency programme that looked at each area across the secretariat and identified a series of measures to help to meet budgetary obligations. Will she outline in more detail the measures adopted?”
“Nevertheless, can this Minister tell us what legal advice his Department and the former Minister got previously, where it came from and whether he will be able to let the Assembly see it?”
“I was going to thank the Minister for his answer, but it was really a non-answer. Perhaps we can explore it a bit more deeply. Despite a direct request from the head of the Civil Service and the report being conducted by DFP, that Minister is still feebly trying to claim that the issue had nothing to do with him. He is either avoiding his duties or is wrongly trying to protect a party colleague. <BR /> <BR />Nevertheless —”
“I very much welcome that commitment. <BR /> <BR />The Minister's statement refers to the pubs and clubs culture and, very frighteningly, the tap on the shoulder received by some young girls and, indeed, boys. Can he assure the House that, if, during the inquiry, any specific case or evidence was uncovered, full information was provided to the PSNI and appropriate authorities to enable an investigation?”
“I thank the Minister for his statement. I note poignantly one of the last paragraphs. He said:”
“— will simply see more people seek residential care?”
“Will the Minister accept that decisions coming out of the trusts to significantly scale back domiciliary care packages, including reducing the number of visits, fly in the face of a supposed policy of giving older people more choice and more control over their care, as well as enabling as many as possible to remain in their homes? Does he accept that the current proposals —”
“— not based on which services can be reduced but on those which will save the most money.”
“If you remember, Michael McGimpsey had to deal with a £700 million reduction in his spending during the 2008-2011 comprehensive spending review period. Nevertheless, despite what the DUP may have thought when drafting the Budget, they could not cut their way out of the problem with the 2011-15 Budget. As a result, we are where are we are today, which is a reluctant realisation that poor decisions were made. <BR /> <BR />Trusts are now left panicking to make cuts —”
“<BR /> <BR />As I said earlier, the public are now suffering the human cost of when budgets fail. The Minister's predecessor will have known that, even in ordinary circumstances, asking for a one-off £160 million bailout would have been undeliverable. It may have been a slightly different story if the Executive had at least known that it was coming. He may not be entirely responsible for the current crisis, but he certainly did not do anything to prevent it. In fact, he precipitated it. <BR /> <BR />Of course, the previous Minister and his colleagues go to great lengths to stress the savings that have been achieved before this year. Indeed, it may surprise them that I congratulate them for that, but let us not assume that these were the first cuts that were ever implemented by the Department.”