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.”
The complete record
Every one of 711 lines we hold for Jo-Anne Dobson, in date order, each linked to its source. Free to read, in full, without an account. Page 3 of 15.
“I agree with the motion in endorsing the important work of the all-party group on epilepsy and the expert support of Epilepsy Action NI. Its report, produced in autumn 2014, into epilepsy service provision across the five local trusts brings out a number of interesting findings. However, the most noticeable issue is that information on epilepsy varies from trust to trust, especially regarding the frequency of epilepsy and neurology clinics. <BR /> <BR />The report also argued for the need to expand the use of, and investment in, specialist nurses. This could alleviate some of the pressures experienced by consultant neurologists. However, the conclusion, which focuses on the modernisation of neurology, is the most helpful.”
“It is also concerning that, historically, the Department does not collect data for expenditure on epilepsy services as that cannot be broken down within neurology. Add the fact that the Department could not provide information on the number of patients who have presented at emergency care departments, and that makes a firm case for change. <BR /> <BR />We cannot hope to manage what is not being effectively measured. That is why it is important, as the motion suggests, to bring forward a database that will enable service provision to be measured, and, therefore, targeted.”
“This often involves family members, friends and work colleagues who know the condition, the triggers and how best to look after their loved one during an epileptic episode. This can lead to constant worry and concern, and really makes the need for increased research and family support for people once diagnosed. <BR /> <BR />The effect of epilepsy on self-esteem, especially for young children, must never be overlooked. We know that epileptic episodes can often be triggered by work, especially long hours, or when people are under stress. However, that is for those who are able to continue their career. <BR /> <BR />Looking into the issue ahead of this debate, I was disappointed to learn that, despite the question being asked in the House, there are no plans to develop a database for epilepsy patients.”
“I welcome the opportunity to contribute to the debate as a member of the Health Committee and the all-party group on epilepsy. <BR /> <BR />As has been highlighted, epilepsy affects an estimated 20,000 people in Northern Ireland. In my family, my nephew Matthew lives with it every day. A smaller number of those people receive monthly treatment. However, services continue to struggle to cope with current numbers, so it is clear that there needs to be improvement. As was articulated by Members during the previous debate on epilepsy, in May 2013, there are shortages in the number of medical staff needed to deal with this specialty. <BR /> <BR />For so many affected by epilepsy, self-care is an integral part of daily life.”
“Following yesterday's announcement by the Prime Minister that we now have a time frame for triggering article 50, will the Minister update us on a proposed time frame for negotiations on key agri-food support, such as a new basic payment scheme and rural development programme?”
“I thank the Minister for her answer. She confirmed, in reply to an earlier question, that she will work with the Health Minister on the issue of prisoners. Has she worked with the Health Minister on the issue of prison officers? What practical steps are in the pipeline to help prison officers?”
“There is certainly a lesson on how to spin a spin doctor. However, as we know, the role was created using the royal prerogative. Will you, as a proud republican, confirm how you feel about exercising the powers of a monarch?”
“I am thinking particularly of the Banbridge plans when I say that I encourage the Minister to ensure that the local business community and residents have the full opportunity to have their say and their views listened to and taken on board. <BR /> <BR />If investment is to be successful, businesses and residents must feel ownership of change. I urge the Minister, when plans are being progressed by his Department, to ensure that everyone has an equal opportunity to benefit when it comes to initiatives like shopfront schemes, town centre Wi-Fi or public realm works. Positive changes that may have been a very long time coming should be allowed to have the maximum impact. <BR /> <BR />Again, I thank the Member for securing the debate, and I very much look forward to hearing what the Minister has to say.”
“Public realm works encourage businesses to invest, and the Executive must foster that investment and business growth to its full potential. <BR /> <BR />The fact that aspects of government policy impact on local families, whether they are business owners or employees, must never be forgotten. I very much welcome the action that has been taken to progress town centre public realm works, including — I am sure that the Minister will refer to it later — the Banbridge master plan. I commend the Chamber of Commerce and especially Banbridge Regeneration Committee for their ongoing work and commitment to their communities.”
“Last year saw investment in town centre public realm works on the one hand, whilst, on the other hand, small businesses suffered from a rerating exercise, which was nothing short of a shambles. Thousands of small businesses, many of them family-owned for generations, rightly appealed, with many of those appeals eventually being upheld. For many of the dozens of small businesses for which I made representations to DFP last year, this often meant cancelling plans to expand their business or not taking on a new member of staff. Government must not give on the one hand and take away on the other. Investment in town centre infrastructure must, therefore, go hand in hand with packages of support that help small businesses to grow.”
“I also thank the Member for securing the debate. At the outset, I will say that I will be the only Ulster Unionist contributing. My colleague Doug Beattie MC has asked me to give his apologies. <BR /> <BR />Investing in town centres is a crucial issue for economic stability and jobs right across Upper Bann, not only for Portadown, Lurgan and Banbridge but for the smaller villages from Gilford to Loughbrickland and from Waringstown to Donaghcloney. The bottom line is that, whilst it is important to continue to invest, improve and innovate our town centres, it is equally important that the Executive fully support the small businesses that trade there. That requires a sea change in the silo mentality often adopted by Departments. <BR /> <BR />I will give one example.”
“Will the Minister undertake to review new build projects, especially for schools in the Dickson plan area?”
“I thank the Member for giving way and note her very personal comments on her constituent. We all have constituents who have been victims of online stalking, whether stand-alone or coupled with physical stalking. I note that the motion described stalking as a hidden crime, but cyberstalking can be even more veiled. Does the Member agree that keyboard warriors who prey on the innocent and vulnerable should equally be subject to the full rigours of the law and included in any future legislation?”
“I thank the Minister for his answer. Does the Minister appreciate that there is frustration amongst councillors because they have not been given the powers that the public thought they would get when they were elected two years ago? What is the timetable for devolving regeneration powers to the 11 councils?”
“I also thank the Minister for her answer. She will be aware that farmers who were subject to remote sensing in previous years suffered delays in their payments. That certainly came in for much criticism. How will the Minister ensure that those whose farms are included in the future are fully informed and that delays are avoided? Does she plan to review the targets?”
“I am asking for a personal commitment from the Minister today that we adhere to this time frame because, in the meantime, too many people are dying, so it is important that it is time-bound. <BR /> <BR />In conclusion, I thank all those who contributed to the debate, including my party leader, who has made mental health and well-being a priority issue for those of us on these Benches, and I commend our mental health spokesperson Robbie's continued work on this important issue. I also commend the Assembly's research service on the comprehensive information pack provided to us all ahead of the motion. In closing, I will quote from our mental health policy document, which we released in March this year:”
“Michelle Gildernew spoke passionately about being a sufferer herself and about the loneliness and isolation. She referred to mental health during pregnancy. <BR /> <BR />In relation to the amendment, I feel that there is a difference between calling on the Minister to appoint, as our motion does, and exploring the role and the remit, as the amendment states. The Minister said that she is a mental health champion at the Executive, and it is good to know that she is already fighting that cause. That is important if we are going to explore this, and I am pleased that we are all in agreement. I think that six months is a reasonable time. We cannot miss the opportunity and let it run indefinitely.”
“She supports the motion and the amendment, but stressed that we need to get it right and that this should be a priority for the Health Committee. Indeed, it is important that it is. <BR /> <BR />Mark Durkan spoke of a difficult, complex and innovative issue. He spoke of independence and autonomy in mental health, and, again, I cannot agree more with his comments. He spoke of the importance of a mental health champion. <BR /> <BR />Paula Bradshaw said that, for many, dealing with the past is about dealing with it now, in the present. She said that issues need to be tackled at source and that a champion should interconnect between services. She referred to a working group being set up on this issue. <BR /> <BR />Others made very emotional contributions.”
“She said that the amendment would strengthen the motion. Perhaps she would consider it better that this be impartial and independent from government funding. She went on to refer to statistics and children's mental health services, where children are being treated in adult wards. <BR /> <BR />Paula Bradley, the Chair of the Health Committee, spoke of growing up during the Troubles, and we established that she is older than Robbie Butler. She went on to talk about severe PTSD and mental health issues that she has witnessed at first hand. She said that we need to get help for the young men and women coming back from war and agreed with the intervention by my colleague Doug Beattie that we need to get real support for those with PTSD. I cannot agree more with that.”
“I will now make some brief comments regarding the contributions during the debate. My colleague Robbie Butler, in moving the motion, referred to those alarming rates of poor mental health, as did other Members. He pointed out that, in this Chamber, the cold hand of poor mental health would affect around 30 of us. That is a frightening statistic. Robbie went on to point out that now is the time to enforce this. It is time for action. He said that this is a scourge and that families are left to pick up the pieces. He paid tribute to all who provide high-quality roles in the system, but said that the system is at breaking point. <BR /> <BR />Catherine Seeley spoke on the amendment. She started by saying that it is important to encourage young people to speak out on mental health issues.”
“That is why it behoves us to move towards treating mental health on a par with physical health. Indeed, the establishment of cross-governmental mental health champions in each community was recommendation 12 of the independent Mental Health Taskforce to the NHS in England's report published earlier this year. <BR /> <BR />Increasingly, we also hear how fewer initiatives should come from Departments and how more should come directly from medical professionals. I understand that this is a key priority for Professor Bengoa in his current process of making recommendations. That being the case, the Department of Health and its officials should have nothing to fear and everything to gain from the benefits of a mental health champion.”
“The list is not exhaustive, but, most of all, a mental health champion would be for those who suffer a daily battle not with a physical illness but with an illness inside their head and a seemingly endless battle within themselves, which, sadly, for too many, leads to greater harm, both physical and mental. It is a relentless spiral of depression that affects not only individuals but their friends, family and wider community. <BR /> <BR />The stigma that so many people have spoken about during their contributions today is also a major challenge, which, although being tackled, still remains in our communities. We can clearly link the long shadow cast by Northern Ireland's conflict and the fact that we have one of the worst records of poor mental health and well-being in the world.”
“I commend all those whose tireless work has saved many lives since, including charities, which are making a real difference on the ground. They include MindWise, Yellow Ribbon, Praxis and Action Mental Health, but so many others also do a magnificent job. <BR /> <BR />To those who have a real passion and commitment to fight poor mental health, a mental health champion would make the most difference. Those who, every day, help people, young and old alike, throughout our communities with the treatment and therapy to recover and manage their illness. Those who treat the side effects on other areas of life, including on their family and friends. Those who deal with the financial implications of poor mental health, and those who help people to know how to cope in a crisis.”
“As my colleague Robbie Butler said at the outset, that should be a level at which a champion can become the voice of mental health services in Northern Ireland. <BR /> <BR />I want to acknowledge briefly all those who spoke during the debate. We heard many emotional stories. All of them tug at our heartstrings, and all of them, in different ways, prove why we need a new approach to dealing with poor mental health in Northern Ireland. <BR /> <BR />At a constituency level, I know the link that poor mental health has to suicide levels. Back in 2009, my home town of Banbridge was labelled the suicide hotspot, and I know how the town has tried to come to terms with the tragic waste of young lives in the years since.”
“I am pleased to make the winding-up speech on the motion and pleased that it has been such a constructive debate on an issue that affects far too many of our constituents. Indeed, as was referred to earlier, the Office for National Statistics estimates, as is stated in the wording of our motion, that one in four adults experiences at least one diagnosable mental health problem in any one year. Alongside our health service, so many charities and voluntary organisations battle multiple challenges every single day, and Members referred to that earlier. They do life-saving and life-changing work. The intention of the motion is to bind the services provided in Northern Ireland and move them to the next level.”
“I thank the Minister for his answer. He will be aware that the issue has been raising, if he excuses the pun, growing concerns from motorists every year. Does he agree with me that a closer working relationship between Transport NI and councils could lead to a better response to grass cutting next year? Will he instigate that new working relationship?”
“Will the Minister outline what consideration is being given to providing patients, personally and publicly, with details of the time that they are expected to wait for an appointment following an initial referral from their GP? Does she agree with me that more accurate information should reduce the number of missed appointments?”
“— and £5 million capital will be used for. Can the Minister break it down for us?”
“I, also, thank the Minister for his statement and, like others, welcome the additional £72 million being allocated to the Department of Health. Equally, I welcome the realisation from the Minister that this does not address the underlying issues. He will remember that I touched on this yesterday. What guarantees can the Minister give that our health service has the capacity to use these additional multi-million pound allocations? Also, the statement lacks clarity on what the £67 million resource —”
“<BR /> <BR />Without a sure and stable financial footing, our health service will continue to lurch from crisis to crisis. Its staff continue to work in unprecedented conditions, and, as patients, our constituents are left to wait, worry and risk coming to even greater harm. If the Executive are serious about tackling the number one priority that they face — the deepest crisis since devolution was restored — I implore the Finance Minister to seek to set a sure footing for the finances of our health service for the long term.”
“That, along with the failure of the Department to brief the Committee, makes genuine scrutiny almost impossible, and that is something that, I hope, the Finance Minister will consider. Nevertheless, with the new Health Minister in place, an opportunity exists to address some of the long-standing concerns over the management of her Department's finances, not least the levels being spent on administration — something that, I see in today's Estimates, is set to increase yet again — but also other more practical steps, such as, once and for all, giving the Fire and Rescue Service the front-line status that it deserves. Those are not challenges that can be forgotten about; they must be addressed head-on. To do so, they must form part of the planning for the future system of healthcare in Northern Ireland.”
“<BR /> <BR />Looking at the document before us, I find that the figures in it are effectively impenetrable, given the extremely limited information accompanying the spending lines.”
“There are undoubtedly many challenges that our health service faces: an ageing population; the increase in the incidence of diabetes; the delivery of autism services; the promotion of public health and healthy eating; and, from my perspective, the continued promotion of the life-saving power of organ donation. <BR /> <BR />Last year, as a result of the chaos in our health spending over recent times, the Minister of Finance and the Executive were given unprecedented controls over the Department of Health's expenditure. I ask the Minister for an update on those powers, and whether he is confident that the contents of the Estimates before us mean that this summer will not see a repeat of the bizarre scenes from two years ago, when our then Health Minister went on the airwaves in some sort of internal party pincer movement.”
“Failure to do so could result in yet further headline-grabbing, multi-million-pound figures that, whilst giving short-term confidence to patients, do little to fix the problems experienced by one in five of our population and by the very dedicated healthcare professionals at all levels who seek to care for those of us who are ill. <BR /> <BR />Health is arguably the most important Department in the Executive, though, apparently not when it comes to choosing it during a d'Hondt process. It consumes half the Executive's Budget, which should be reason enough to ensure that its future is planned and is, therefore, stable, rather than being held together and managed for the short term.”
“On the one hand, we have the promise of stable finances and sustainable services that can only come with reform; on the other, the wheels of government grind slowly. <BR /> <BR />It looks as though our health service vision is already being set for just the next three to four years, before we even see the findings of Professor Bengoa. We should be looking seriously at proper, costed, future planning to achieve the best healthcare system for all our people. I know that the Finance Minister has a business background, so he will know the importance of future planning. I encourage him, in speaking to his Executive colleagues, especially to his colleague the Minister of Health, to seek to forward plan, not to budget for the short term but seriously plan for the long term.”
“while continuing to seek short-term funding from the Executive. However, it now appears that "stable finances" are to receive only lip service. Officials told me on Thursday that they are working on just a three-year budget for capital and four years for resource. That does not show the forward planning that is needed in our health service, and, indeed, surely when we receive the findings of Professor Bengoa and the subsequent response from the Executive, the long-term budget will become clear. Would it not be more sensible for that budget to look to the future, across the next 10 years or so, as is happening in other regions of the United Kingdom and in the Republic of Ireland?”
“<BR />While other Committees have had Ministers and permanent secretaries before them, the Health Committee has had departmental officials who were unable to take questions from us on the very reason why they attended. At a time when the crisis within all levels of the health service is felt dearly by staff and patients alike, this does not bode well for the future; neither does the apparent lack of commitment from the new Minister and her Department to see an end to short-term funding of the health service. That is an aim that the Executive should work towards. When you speak to the trusts, GPs and health managers at all levels, you find that the one thing that they crave, but do not have, is stable finances. I was initially heartened that the Minister included that very phrase in her address to the House last Monday.”
“I welcome the opportunity to speak today from a health perspective. First, however, I register my bitter disappointment at the information — or, rather, the total lack of information — that we received from Health officials at last Thursday's Health Committee. Presenting before us for the first time in the new mandate, officials were scheduled to brief us on the June monitoring round. However, despite the Minister referencing this bid in her statement to the House last Monday, they told us that they were unable to discuss or answer any questions on the June monitoring round, which was the very reason why they were attending the Committee in the first place.”
“John O'Dowd said that on 21 November 2011.”
“Before the new Minister rushes to congratulate or give credit to the former Minister for improvements in GCSE results among Northern Ireland students, will he reflect on the former Minister's comments from when he was in post? He said that Northern Ireland does not have a world-class education system and:”
“I thank the deputy First Minister for his answer. Perhaps, in future, it would be better to make such announcements, if they should definitely be made, in the House. However, we are where we are with this one. Can he provide the House with an update on the action plan following this report and when it is likely to be completed?”
“I thank the Minister for giving way. I want to raise a point I raised yesterday, again in my speech and now for a third time. Minister, this is specifically about the status of the £30 million announced by Simon Hamilton on 6 March. Whilst the Executive previously agreed to allocate £40 million, virtually no record exists of the subsequent allocation. Can the Minister confirm that that money was received and is in the process of being spent?”
“I look forward to working proactively with the new Minister.”
“However, I and my party are firm in our belief that decisions about the future of our health service must be made on the grounds of what is best for patient outcomes and well-being rather than focusing inflexibly on buildings and organisation charts. Too much time has been given to the flawed assumption that, if hospital sites close, it would free up endless resources elsewhere. It will not; the savings would be negligible given that the single biggest cost is medical staff salaries and that the consensus is that we need more staff, not fewer. It is the same for the abolition of the Health and Social Care Board: whilst, on paper, it looks like streamlining, moving staff from one administrative body to another will ultimately do little to improve patient outcomes. We need genuine reforms, not ploys.”
“This is a major challenge for the new Minister, and one on which, if it has not done so already, the Royal College of General Practitioners will want to have its say. I know that it has an important message to deliver: addressing the major challenges facing the entire primary care system will benefit the entire health service. <BR /> <BR />I know from speaking to GPs that they face the daily challenges of repeat prescriptions, increased complexities of patient conditions and the effect of the deep-seated worry that comes with an ill patient being left waiting. We desperately need to move to a sustainable model to allow our health service to plan for the future. My party awaits the findings and recommendations of Professor Bengoa and his team.”
“<BR /> <BR />It can often be forgotten that the issue of waiting times running into month after month is not just an issue that affects our hospitals — far from it. Little in the health service can happen in isolation without impacting on another service. As well as heaping worry onto families, increasing waiting times have been increasing pressures on our GP surgeries. Primary care is a gateway to our health service. However, the continued management of pain and symptoms for those who have been left waiting for a long time for an appointment is heaping further pressure onto an already over-pressurised primary care system. If the patients are feeling the pressure of being left in an endless queue, so, too, are our health professionals at all levels. That has been very much in the media today.”
“In the year when our waiting lists really got out of control, the fine for failing to implement welfare reform was £87 million. The overall black hole in the Executive's finances was £212 million in that same year. The penalties certainly did not help the waiting times, but they did not cause them either. Short-term funding announcements simply do not work; they especially do not work when trying to run a health service from year to year. Emergency monitoring round allocations worked for only so long before even they proved to be inadequate. All the time, genuine measures such as shifting more care into the community and advancing the broad agenda of TYC appear to have fallen by the wayside.”
“<BR /> <BR />Of course, it is not just cancer patients that avoidable delays are especially detrimental to. The waiting times for cardiology and orthopaedics mean that there are patients finding themselves in increasingly perilous situations whilst all the time having to endure the unimaginable pain and distress of waiting. I do not intend to go over how we found ourselves in the situation where our hospitals are clearly teetering above collapse, as the staff working in them regularly tell me, although I will make one comment: the previous Health Minister and those around him tried to build the narrative that the problems in our hospitals were a direct result of the previous debacle on welfare reform. Let me be clear, especially for the benefit of new Members: they were not.”
“<BR /> <BR />In addition, yesterday's comments go against what the experts are saying and what the Minister's own board said last year. Let me quote directly from the 2015-16 draft commissioning plan. It said that spiralling waiting times could lead to severely delayed diagnoses of life-threatening illnesses, with suspected bowel cancer patients particularly at risk. It stated that such delays for assessment and treatment were very significant and that it was possible that, in some cases, increased waiting times for assessment may result in a delayed diagnosis of a serious or life-threatening condition, with a reduced likelihood of a successful outcome. Perhaps, the Minister should reflect in future before making such conclusive statements.”
“In my opinion, it did not generally recognise the severity of the problem. When she was asked by my colleague Robbie Butler whether she accepted that delays meant that patients were coming to harm, I was surprised to hear the Minister assert so definitively that they are not; that they are all under the protection of their GP. Well, if a GP suspects cancer and refers the patient for an urgent scan but that scan is badly delayed, does the Minister still think that the patient is being protected from coming to harm? Of course not. That is a simple example, but it is one that is heartbreakingly too common at present. I am sure that I am not alone in the Chamber in having a considerable number of such cases passing through my constituency office.”