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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“He spoke of a £140 million deficit and went on to say, as it got to the last £40 million, £60 million and £80 million, that the impacts would be felt very harshly. These were comments that were made despite additional finance from monitoring rounds; that were made from a better financial position than set out in the original Budget, and that would no doubt be branded as obscene by the First Minister if they had been made by any other political party. Nevertheless, as noble as the previous Minister's Damascus road conversion was, the simple reality was that he left it too late. He took up office in March 2011, but it took him three years before speaking out. Are we to believe that he did not look at his budget more than a month in advance? Of course not. He knew what was coming, yet he chose to do nothing about it.”
“We said that the budget for this year could have just about worked on £4·8 billion, yet we were told that there was no money left and that the cupboard was bare, even though OFMDFM had found enough money for pet projects such as the social investment fund, and we all know how that worked out. <BR /> <BR />The then Finance Minister, Mr Wilson, went to great lengths to assure us that health had got a good deal. He told the previous Assembly that it had got a settlement worth being "proud of". In fact, his leader even went on to bemoan those who were not cheering about the settlement and labelled them "obscene". <BR /> <BR />Members, we all remember the words of the Minister's predecessor only weeks before he was sacked. Flanked by senior officials, he said that the budget for this year did not add up.”
“Thank you, Mr Deputy Speaker. I thank the ex-Minister for that lengthy speech, for the phone going off and for reminding us about that issue. If he waits his time, I will come to it in due course. <BR /> <BR />As I said, the fourth year — this year — would be difficult for health, and we are seeing the end product: operations postponed, temporary closures and lives and livelihoods disrupted. We warned that, by allocating £4·659 billion, the budget would compromise public safety. Even though we were supported by senior officials, including the Chief Medical Officer, we were accused of scaremongering and exaggerating, but not now.”
“I welcome the opportunity to speak on the motion. The Minister and his party may refute the allegations of maladministration of the budget, and, to be fair, I do not think that the management of it was entirely to blame, and it is, rather, a combination of factors. Maladministration played its part, as did the hopeless allocations made in the first place. In 2011, we warned that the budget did not add up and that this year — the fourth year — would be very difficult for health. We are now seeing the end product: operations postponed, temporary closures and lives and livelihoods disrupted.”
“It is proposed that, next year, the FSA's budget will be cut from £8·5 million to £7·4 million. That is a cut of 12·8%, which is the largest of any Department or body in the draft Budget. As we have heard today already, food safety and food hygiene are hugely important, and so I am concerned that the body tasked with protecting the public is having such a large cut to its budget. What impact does the Minister think the budget reduction will have on the FSA's ability to deliver its body of work and introduce new policies such as the one that we are discussing today?”
“Councils will also invest significant staff resources in properly applying the current system, and that will only increase with the passage of the Bill. At a time of fundamental reform of our local government, I believe that it is a rather apt opportunity to bring in these responsibilities. I ask the Minister, however, looking at the commencement clause with the Bill, when approximately he envisages his Department making the order to bring in the bulk of the Bill? Will he be linking it, for instance, to the establishment of the new 11 councils in April? <BR /> <BR />One last issue that I would like to raise with the Minister is the future budget for the Food Standards Agency. It is directly related to the Bill and many other areas of work relevant to the Department of Health.”
“For instance, I especially welcome the decision to increase the time for a food business to appeal a rating from 14 days to 21 days, and I note the call from the Federation of Small Businesses for clarity on what types of establishment may be exempted from the scheme. That is an important point and one that I urge the Minister and his officials to think carefully about. I trust that if they do decide to make such a regulation under clause 1, they will only do so in consultation with councils and bodies such as the FSB. I would appreciate it if the Minister could make such a commitment in his remarks later. <BR /> <BR />Whilst the Bill may have the greatest impact on businesses, I appreciate that the scheme will not enforce itself.”
“That may be bad news for the 83% of businesses with a mark of 0, 1 or 2 that currently do not take part in the voluntary scheme, but it is great news for consumers. I am conscious, however, that the scheme will have a regulatory impact on businesses, especially those not already complying with the voluntary scheme. It makes no distinction between large and small and so some will inevitably be better prepared to deal with it than others. <BR /> <BR />I am aware that the Department has made some changes following responses received during the consultation exercise and I commend it for that.”
“Some businesses will rightly consider the current scheme a benefit, especially if it is a chance to advertise their impeccable hygiene standards, but many others with lower ratings may avoid the scheme for fear of deflecting possible business. I believe that it is even more important that consumers are informed about establishments with lower ratings. It is all about giving consumers enough information to make those informed decisions. As has been said, if people knew about the poor hygiene standards of some establishments or if a mandatory scheme were in place, I have no doubt that it would help reduce incidences of food-borne illnesses in Northern Ireland. The Bill will remove the luxury of opting out of the scheme.”
“I believe that it is even more important that consumers be informed about establishments with lower ratings. It is all about giving consumers enough information —”
“I also welcome the opportunity to speak on the Second Stage of what I expect to be an uncontroversial piece of legislation. The overall aim of the Bill, which is to make the display of stickers mandatory, makes sense. I suspect that many members of the public will be surprised to learn that it was not already compulsory. The current voluntary scheme has, to its credit, worked quite well. The biggest disappointment, however, was the fact that those businesses with a lower rating were — not at all surprisingly — the least keen to publicise it. Some business will rightly consider the current scheme a benefit, especially if it is a chance to advertise their impeccable hygiene standards, but many others with lower ratings may avoid the scheme for fear of deflecting possible business.”
“Can he detail approximately how much a scare costs, what training is provided to staff and how costs will be met to protect patients and staff?”
“The Minister will know about the very real worry and concern amongst the public. People will be waiting to hear the results and hoping that the Ebola virus has not reached our shores. At this time, we are all holding our breath for the patient and their family, and we are thinking of the staff at the Royal. <BR /> <BR />Minister, we need to be aware that this may be only the first of many scares. Perhaps the Minister can outline for us how those will impact on front-line services at our regional hospitals. Can he also give a commitment that, at a time when our trusts are under such immense pressure, these pressures will not be a barrier to our health service adequately responding to future Ebola scares?”
“I thank the Minister for her answer. She outlined the considerable financial commitment that her Department has made to support Invest NI job creation announcements and she will be pleased, no doubt, with the proposed budgetary uplift that her Department will be receiving next year. However, does she share my concerns that a lot of the recent Invest NI announcements have come from promises of R&D support from the Department for Employment and Learning, which is seeing its budget face a major cut?”
“For the sake of pancreatic cancer sufferers and their families, now and in the future, I truly hope that the Minister will act.”
“<BR /> <BR />The purpose of this motion is rightly to raise the profile of pancreatic cancer. However, I would make it clear that getting this motion in the Order Paper and debated in the Chamber will do nothing unless it is followed up by tangible action. The measure of the Minister will be the action that he takes after this debate is over.”
“Research into innovative pancreatic cancer screening tests should be considered an absolute necessity, especially because of its difficulty to diagnose. The lack of awareness of the cancer is also putting a massive strain on the health service. Many people, as we know, learn that they have the disease only after being admitted as an emergency to their local hospital. As the Minister no doubt will be well aware, often the costs associated with these are huge. By improving awareness among both the public and medical staff, people could be diagnosed earlier and start receiving vital treatment quicker. Conversations need to be held with general practices about additional training that could be beneficial. We need to create a new screening practice. None of this should be impossible to achieve.”
“<BR /> <BR />Just because it might not be financially attractive to the drugs companies should not have to mean that research is neglected. For instance, Queen's University is becoming an increasingly significant global leader in tackling cancers. I would like to pay tribute to the vital work that is done there. I ask the Minister today whether, through the support his Department offers to bodies, including the National Cancer Research Institute, pancreatic and other neglected cancers could be prioritised more. One per cent of funding simply is not enough.”
“Early detection is key, but unfortunately its symptoms mirror those of a number of much less critical illnesses. That is why tragically so many people are misdiagnosed and miss out on help when they first go and seek it. This also contributes to its frighteningly short survival period of just two to six months from diagnosis. With a one-in-90 chance of getting the cancer and a 95% chance of dying once diagnosed, you can see why it does not attract the same commercial funding for research as the more treatable forms of cancer. This is proven by the fact that pancreatic cancer is responsible for 5·2% of UK cancer deaths but gets only 1% of the National Cancer Research Institute's partners' research spend.”
“Whilst there have been some improvements in recent years, on the whole, the overall survival rate has barely budged over the past few decades when compared with those of other cancers. This is further compounded when you consider that, overall, people are now living nearly six times longer after cancer diagnoses than was the case 40 years ago, as Mr McKinney mentioned. While mortality for most common cancers is declining, as has been pointed out this evening, pancreatic cancer is set to become the fourth biggest cancer killer by 2030. I think that we need to ask why. With advances in medical research and medication, this should not be the case. <BR /> <BR />There is no doubt that one issue is public awareness and, in the case of pancreatic cancer, the lack of it.”
“I also welcome the opportunity to speak on this motion this evening. It is a sad fact that pancreatic cancer unfortunately does not have the same profile as many other cancers. There is a general unfamiliarity with the disease. Unfortunately, this runs from patients right up to the medical services. Sadly, as the motion says, too often, people are not diagnosed until it is too late. As has already been said, pancreatic cancer is one of the leading causes of death by cancer in Northern Ireland. In fact, according to Pancreatic Cancer UK, it is the fifth biggest cancer killer. <BR /> <BR />Unfortunately, as we know, the UK's survival rates are some of the worst in Europe.”
“I ask the Minister to tell us how many people have found themselves in that situation. Of course, once again, it was through no fault of their own. Despite the constantly moving environment, the Committee's report is timely. Introducing a system of recording referral-to-treatment times, for instance, would at least allow us to make a more informed assessment of what is really going on across our hospitals. <BR /> <BR />I welcome the publication of the Committee's report, and I look forward to the Department implementing its recommendations without further delay.”
“Indeed, the language that the chief executive of the Health and Social Care Board used last week was that they will "go through the roof." <BR /> <BR />Of course, another important decision taken — maybe too late for this Committee report to consider — was the suspension of using private clinics. Whilst I believe that the costs were becoming too great and trusts were becoming far too dependent on their services, this has unfortunately resulted in patients who had initial appointments finding themselves back to square one, including some who had already undergone pre-ops. I am sure that I am not alone in the Chamber in helping constituents who have been placed in that position.”
“There can be very little doubt that his predecessor, by leaving it well into the last year of a four-year Budget before speaking out on the financial situation facing Northern Ireland's health service, compromised wide-ranging patient services. I am not sure whether he or his party were to blame for that delay. Either way, Northern Ireland's finances are in an appalling situation, and there is no doubt that patients' safety has been compromised. <BR /> <BR />Unfortunately, we witnessed the beginning of the impact last week. As we know, elective care is one of the areas singled out for savings. Waiting times here will inevitably rocket.”
“Of course, it is easy for often unnamed officials to point to the numbers, look at the balance sheets and emphasise how much could be saved, but, away from the computer screens and balance sheets, in patients' homes, the reality is much more brutal. It means that people wait longer at home for treatment for painful and debilitating conditions. People, young and old alike, and their families wait anxiously for the post every day and have to put up with that pain. No matter how many painkillers they take, nothing seems to dull it completely. That is the true cost of a failing budget. <BR /> <BR />I hope that the current Minister will be more gracious than his predecessor and accept culpability for the current situation.”
“<BR /> <BR />Patients who wait on a list for what can seem an excruciating period for non-emergency surgery will often end up costing the taxpayer far more through increased GP consultations and prescriptions, but we must never forget the human cost — the worry, pain and concern of family members. This should be to the fore of any discussions on waiting times. <BR /> <BR />I know that the Minister's priority will be life-saving operations. However, I have to say that I found it frustrating when, only a few weeks ago, he said:”
“I welcome the opportunity to speak on the Committee report. Before I begin, I would like to pay tribute to my colleagues Roy Beggs and Sam Gardiner, who were members of the Committee throughout the many sessions. <BR /> <BR />Many officials in the Health Department, the Health and Social Care Board and, not least, the trusts may resent the fact that waiting times need to be set and should, in theory, be worked towards. However, in reality, we should consider them as quite an effective barometer of the real state of play in our health service. Of course, targets are not set just to ensure that Health Ministers live up to their responsibilities; they are set because there are sound reasons to ensure that people do not wait for excessive periods.”
“The Minister will be aware that we discussed this vital issue at our meeting first thing this morning. I am aware from my constituents of the increase in MS sufferers and their absolute anger at this decision. Minister, what impact will the additional budget oversight by the head of the Civil Service have on your Department? Was this particular move subject to additional oversight or accountability?”
“Is the Minister satisfied that this budget will be spent during the year? What are her plans for 2015-16 for the legacy?”
“In the light of today's draft Budget announcement and the further tightening of public spending, will the Minister now be upfront about the budget for a key rural development programme proposal: the farm business improvement scheme? You mentioned it, Minister, in answering the previous question. Will you guarantee that the Executive, when requested by the strategy board, will be able to provide the £250 million?”
“I thank the Minister for giving way. Is the Minister saying that, if more children in Northern Ireland had heart problems, he would be forced to deliver the surgery?”
“I thank the Member for giving way. Does he agree with me that very little clarity has been given to parents over the past three years and that there has been only false hope?”
“I thank the Member for giving way. I am loathe to say that it was a coincidence; I think that I will table more Adjournment debates if that is the impact they have, but anyway. Does the Member share my hope that, with the change in Minister, good news will finally be delivered to the families you spoke of? We both know them and hold them very close to our hearts. Hopefully, the Minister will be able to deliver good news to the children and their families.”
“Minister, will you now please bring forward that test? As we know, the earlier that something is detected, often, the easier it is to address. Children's cardiac services is one of the most challenging issues facing the Minister. He needs to take cognisance of the medical advice being offered to him and find a way of balancing that with the wishes of the clear majority of the people of Northern Ireland. <BR /> <BR />The Minister will soon be making a very difficult decision. He knows my views and those of my party. I know that, after his meeting yesterday and today's debate, he will at least know the views of the parents of Upper Bann.”
“In March, the Assembly debated the issue of pulse oximetry screening for newborns. In fact, the Minister participated in the debate. He said:”
“<BR /> <BR />Another issue that parents are concerned about locally is whether Northern Ireland's cardiology skills and the associated services will be maintained and developed. The prospect of losing children's heart surgery could have a very detrimental impact on the remaining service. Specifically, Minister, when will the £1 million promised by John Compton last year for paediatric cardiology services be delivered? Northern Ireland is at the forefront in many areas of paediatric cardiology, such as telemedicine, research and training. I know that you will share my belief that it is critical that those are further developed. <BR /> <BR />As I draw my remarks to a conclusion, I will raise with the Minister one more issue that would be of direct benefit to parents in Upper Bann.”
“The number of children affected may be relatively small, but, in my opinion, that is something to be pleased about rather than used to cast doubt. Parents in Upper Bann hold many of the same concerns. If the findings that Edwin Poots previously revealed are acted on, what provision, for instance, will be put in place to ensure that all patients, including those needing urgent emergency treatment, will receive care in a safe and time-critical fashion? Although Upper Bann is closer to Dublin than some parts of Northern Ireland are, it is most likely that, in an emergency, families will still have to travel first to Belfast to get the diagnosis before travelling onwards if surgery or emergency interventions are no longer available there.”
“<BR /> <BR />The manner in which that information was revealed — through a clearly planted question on the day that the previous Minister knew that he was being sacked — showed little regard for the concerns of the families or the seriousness of the issue. In addition, the Minister would have known that, by making the announcement in the manner in which he did, it would have only been prolonging the agony for those families. He would have known that it would be weeks before the report would be published in full. <BR /> <BR />My party still wants to see services retained in Belfast. We believe that, with the right level of dedication, the Minister and his Department would be able to hold on to the required expertise.”
“<BR /> <BR />The business of government grinds slowly — far too slowly — when it comes to protecting the needs of some of the most vulnerable children in our society and addressing the very real fears of their families. I do not blame the current Minister for the actions of his predecessor, and I welcome his assurance to my colleague Robin Swann this morning that he will take a deep personal interest in the issue. Nevertheless, I reiterate my disappointment and that of my party colleagues, as well as that of many other people, at the manner in which it was revealed that the international review group has found that retaining children's surgical cardiac services in Belfast is unsustainable.”
“However, the issue of children's cardiac services is especially emotive, given the age of many of the young people involved and the sheer challenges that they are expected to overcome, often in the first few weeks of their life, and, for too many young children, in the weeks, months and years that lie ahead. There are parents across Upper Bann — I know that the Minister has already met several of them because he mentioned it in the House this morning — for whom the issue is so very dear. It is for those parents and their children that I have secured this Adjournment debate. They and other parents have made lengthy trips to this Building over the past three years, to be met with little more than hollow promises, followed by reports, reviews and consultations.”
“Taking a long, cold look at things seems to be something that Stormont is all too familiar with. Parents and their children looking in from the outside can be forgiven for wondering when the long, cold looks will end and the action start. Those are the same parents whom the Minister spoke about earlier, saying that it is a bitter pill for them to swallow — bitter indeed. Meanwhile, those same parents have the worry — the very real, sickening worry — for their children's health and life. <BR /> <BR />As I and everyone else know only too well, health is an issue that leaves no home untouched.”
“The reason why this is such an important debate is that it is the first time that the current Minister will speak on this issue in the Chamber. <BR /> <BR />Hold on, Mr Deputy Speaker. That was from the speech that I had planned to give, until this morning's impromptu statement from the Minister. Nevertheless, I would have thought that the previous Minister could have shown respect to the House and to the many families who are worried sick about the issue by at least making a formal statement on it. Alas, it was not to be.”
“You mentioned the parents, who we all work very closely with. How do you plan to address their very real fears and the concerns of the local families who you have met? Words and promises simply are not enough.”
“I thank the Minister for his statement and congratulate him on his elevation to Minister. I look forward to working with him. I also look forward, Minister, to hearing more from you at this evening's Adjournment debate. Given the timing of the statement, I should, perhaps, be trying to secure more Adjournment debates. <BR /> <BR />You mentioned the north-west, which is the furthest away, and we need to ensure the early diagnosis of those vulnerable children. Will you outline what infrastructure will be put in place?”
“I also thank the Minister for his statement. I welcome the additional allocation of £60 million to health. Thinking ahead, however, not least with the trusts projecting a £130 million deficit for this year and the Health Department forecasting its pressures increasing to £317 million next year, what realistic chance — Ian McCrea touched on this in the previous question — is there of agreeing the required level of funds for 2015-16 in the next three weeks to meet George Osborne's time frame?”
“I thank the Minister for her reply. I am sure she will agree that the key to attracting more visitors from England, or anywhere else, is to promote a positive image of Northern Ireland. In the light of disappointing visitor numbers, does she agree that we need to review the current arrangements, where Tourism Ireland does not treat us as a distinct tourist destination to be marketed in Great Britain?”
“I thank the Minister for his answer and welcome the action that he is taking to progress the project. It is the first time that the people of Banbridge will have a bus station, a facility that has been lacking in the town for far too long. Does the Minister agree that this is an example of the Ulster Unionist Party listening to the real priorities of people in Banbridge and, through this and other projects, holding good to its promise to deliver?”
“What plans does the Minister have to help our newly trained teachers who are still unemployed to find employment, irrespective of their gender?”
“Does the Minister agree with me that multiple benefits accrue from involvement in sports, not least promoting physical and mental well-being and social inclusion, which all support the health service by reducing demand on cardiovascular, diabetes and obesity services, to name only three?”
“<BR /> <BR />George was a loyal Ulster Unionist, a member of the loyal orders, a former soldier of the Ulster Defence Regiment and a people's politician, here and on Craigavon Borough Council, and George was so much more than that. He was a loving husband, father and grandfather. He was a quiet man of integrity and honour. On visiting the family's home, I was told by George's son Kyle how much the hundreds of sympathy cards and tributes on social media meant to the family. I know that the tributes this afternoon will add to that. He will be sorely missed by all our numbers.”