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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“Members will be aware that my son Mark is only one of those people. <BR /> <BR />The fundamental point is that increasing the rate of organ donation will allow us to save more lives, especially given the ageing population, when need will only increase in five, 10 or 15 years' time. As long as Northern Ireland continues to look on from the sidelines, especially as other regions of the UK introduce or consider the introduction of their own soft opt-out systems, lives will continue to be needlessly lost. It is a tragedy that, last year alone, 17 people passed away while waiting on an organ. In addition, many other people on the transplant list, such as those who require a kidney transplant, are being confined to a lifetime on dialysis, and they and their families are suffering as a result.”
“<BR /> <BR />I also noted the concern that was expressed during the Second Stage debate on the Human Transplantation Bill about the cost of my proposal for a public awareness scheme. I wonder whether those same Members hold those concerns tonight. <BR /> <BR />I strongly support all measures that will increase the number of organ donations. There are few more selfless acts a person can do than to sign up to become a donor. We must remember that many transplantations take place after the loss of a loved one, yet, for the recipient, that organ represents the chance of a new life. It is a second chance to live a long and healthy life, which is why the issue should be treated with sensitivity. There are countless examples of people who were desperately ill and are now living perfectly healthy lives.”
“<BR /> <BR />Whilst I support the amendments in the Bill, public awareness is just one part of the soft opt-out system and will not allow us to avail ourselves of the changes brought into being to the organ donor register last July, namely the ability for those who have an issue with donation to opt out. I do not, however, wish the Health Department to kick the can down the road by stating that, if these amendments are passed today, we must wait for the legislative changes to kick in before we can ever look at adopting a soft opt-out system in the future. Given the public will for change, I challenge the Health Minister to ensure that organ donation is given prominent billing in the ongoing discussions regarding the next Programme for Government.”
“I welcome the opportunity to speak on the third group of amendments. It will come as little surprise to Members that I am prepared to accept my own wording in relation to organ donation, as contained in amendment Nos 6 and 7, which are a direct lift from my private Member's Bill, the Human Transplantation Bill. However, for the record, Members will be aware that, having been presented with the opportunity through a private Member's Bill to change the law to a soft opt-out system, parties and Committee joined together to oppose the system that they had both previously supported.”
“I thank the Member for giving way. I thought that it would be useful, in the context of the debate tonight, to quote from the Opt for Life proposed legislative change in Northern Ireland. The proposal clearly sets out a three-pronged strategy for organ donation: putting in place new legislation, putting the required infrastructure in place and creating good public awareness during and after the proposed legislation.”
“<BR /> <BR />I support the amendment; it is only right that we have a consultation and start to open up a public conversation on the issue, but, in reality, I suspect that we are still some time away from being able to make an informed decision as to whether or not to introduce such a scheme.”
“Whilst we support the amendment, we would have much preferred to see it being brought forward as part of a wider UK package. It would, however, be right to have concerns about the capacity of a relatively small country like ours to adopt such a scheme on our own. How, for example, would it be administered without placing a major bureaucratic burden on whatever Department would ultimately be responsible? Also, major care would need to be taken to assess properly the differing impacts on families from different socio-economic backgrounds. Whilst I want average consumption reduced, I do not want the occasional can of Coke to be priced out of reach of young people or their families.”
“However, like the banning of smoking in cars in which there are children, sometimes, if there is clear and solid evidence and a foundation for doing so, difficult options need to be explored. This is why I believe that, if a levy were to be introduced in Northern Ireland, its primary motivation should be to influence consumption levels rather than simply to raise revenue. I expect that any money raised would be invested directly in public health campaigns. It has been estimated that a 20% duty on SSBs would reduce the number of obese adults in the UK by 180,000 or 1·3% of all obese adults and would raise around £1 billion in taxation revenue.”
“However, I believe that, in the last number of years, the tide has started to turn, with many parents actively trying not to put such items in lunch boxes or in kitchen cupboards. Nevertheless, through the sheer variety of items on display and the effectiveness of advertising, too much sugar is being consumed. It is time that we started looking at other measures to reduce the sugar intake of children, not only in Northern Ireland but across the British Isles. I am aware that a number of countries, including many states in the US, have introduced taxes, mainly on sugar-sweetened drinks. <BR /> <BR />I am very conscious of the fact that government should not usually interfere or introduce additional charges on something that many people consider to be entirely a matter of choice.”
“I thank the Member for clarifying that. I am very aware of that. <BR /> <BR />A fairly recent study found that 24% of children living in Northern Ireland were obese, and our obesity figures for children aged 11 years were higher than England, Scotland or Wales. It is in that young age group that the consumption of excessive SSBs can have the biggest impact. The average child obtains one tenth of their daily calorie intake from SSBs. Of course, that is only the average child: some will not consume them at all, and, at the other end of the scale, there will be children consuming wildly excessive amounts. <BR /> <BR />Soft drinks and other sweetened goods more generally are far more prominent now than they were 50 or 60 years ago.”
“I support the amendment. We should first be clear about what the amendment means or, rather, what it does not mean. It does not mean that a sugar tax will be inevitable, and it does not mean that every item of confectionery will suddenly cost more. I am glad that those who tabled the amendment have decided to restrict it for the time being to sugar-sweetened beverages or SSBs. There is no doubt, however, that the regular or excessive consumption of sweetened soft drinks is directly linked to weight gain and obesity and a raft of other health conditions, such as diabetes and heart disease. A fairly recent study found that —”
“I appreciate that some people will be concerned when they hear about the Assembly taking decisions such as this, but, before people jump to a conclusion, I urge them to consider the issue and to accept that, when actions are harming the lives of children, the Assembly should have a duty to intervene and introduce safeguards that limit such actions and harm. Whilst I do not expect the PSNI to carry out roadblocks as a result of this legislation, it is my hope that criminalising smoking in cars with children will prevent people from doing it in the first place.”
“Most drivers already take an active decision not to smoke in cars if children are travelling with them, but one of the leading local charities believes that as many as 13,000 children may still be exposed to second-hand smoke in cars across Northern Ireland. Some parents smoke in cars under the assumption that winding down the car window will let the smoke out, but, as we have heard, in reality, that only pushes it back into the car. In such a confined space, smoke can reach up to 10 times the recognised unhealthy level, and it often lingers for hours. <BR /> <BR />People should, absolutely, be free to do what they wish, within the law, in their homes and cars.”
“Exposure to second-hand smoke is known to cause asthma, bronchitis, pneumonia, sudden infant death syndrome, middle ear infection and a raft of other health problems. In addition, children who are exposed to smoke from an early age are statistically much more likely to smoke later in life.”
“People have been protected in public areas and in their workplaces since 2007. <BR /> <BR />On that issue, we also have the smoking ban in psychiatric hospitals, which is due to come into effect next month. That will, in itself, raise a number of questions over how it can be effectively managed by staff. However, there is very little legislation in place to protect children and young people from the effects of smoking. <BR /> <BR />Young people are particularly vulnerable to exposure to second-hand smoke, much more so than adults, which is why the amendments are so important. Medical practitioners will tell you that children's bodies are still developing and that exposure to harmful substances puts them at risk of severe respiratory diseases.”
“I therefore fully support any efforts taken to assist people to give up the habit and to stop others from taking it up in the first place. <BR /> <BR />Smoking causes harm, not only for the individual but for those around them. When people decide to smoke, they take a conscious decision to do so. However, when people have to breathe in other people's smoke, they have little choice in the matter. Second-hand smoke is a toxic by-product that is medically proven to affect anyone who is exposed to it. <BR /> <BR />The ban on smoking indoors in public places split public opinion when it was first proposed. However, even the most ardent smoker would not think about lighting a cigarette in a restaurant or pub now. Who could possibly disagree that the ban has not only helped the health of our workers but also greatly improved those environments?”
“Whilst many people realise that the habit is damaging and generally bad for your health, I am sure that most would be shocked to realise the true impact of it on the local population. The habit kills well over 2,000 people here every year. That is more than the number of deaths from obesity, alcohol, illegal drugs and road accidents put together. It is our leading cause of preventable death, and it is putting a huge amount of pressure on our health service. <BR /> <BR />It is interesting to note that funding from the Department, through the Public Health Agency, towards TV advertising was £206,000 in 2011-12, whereas, in 2015-16, it is £58,000. In addition, smoking is the largest cause of inequalities in death rates between the richest and poorest in our communities.”
“I welcome the opportunity to speak on this group of amendments. No one who has been watching the Bill's progress will have been surprised to see amendments of this nature coming forward. However, I reiterate the point I made at Second Stage: the Department should have brought this issue forward. That would have allowed for a greater degree of consultation as well as an opportunity for key stakeholders, such as the PSNI, to fully engage in the process. Indeed, I find the Department's appeal for a Back-Bench MLA to take forward a ban on its behalf, through amendments, to be quite bizarre. <BR /> <BR />The facts are clear. In Northern Ireland, approximately one in four people smoke, and one in two smokers will ultimately die early because of it.”
“I thank the Minister for his answer. I am aware of increases in criminal activity, particularly in Louth and Dundalk, which is leading to a bleed across the border, with the A1 dual carriageway and housing estates, including those in Banbridge, becoming particularly vulnerable. What reassurances can the Minister give that the PSNI, particularly in Banbridge, has the adequate resources to effectively address that issue and bring those responsible to justice?”
“Given the sensitivity of the issue, my party would rather wait until that review is complete. We will therefore be opposing amendment No 116.”
“I welcome the opportunity to comment on the third group of amendments. I start by expressing my disappointment that, for the second day running, a petition of concern that could not have any detrimental impact on one community or the other has been tabled to important Executive legislation. It would have been much better for the House to consider amendment No 116 in a genuine manner rather than it effectively being vetoed by a single party. Nevertheless, I and my party also oppose the amendment. Committee members received some stakeholder evidence on the issue, and, although I am sympathetic to the principle of giving 16- and 17-year-olds the power to make a lasting power of attorney, I am aware that the Department of Finance and Personnel is currently reviewing that.”
“Today, we are passing the next stage of this legislation, and it appears that the Department is no more equipped than it was when this was first proposed by Bamford. I feel it is very important for us to pass legislation in this Building that makes a real change to the lives of our constituents. However, it is equally important that the Government are ready and prepared to act once the ink is dry.”
“Given the considerable efforts and, indeed, hope of those who presented evidence to the Committee, is the Minister able, at Consideration Stage, to provide us with an update on the implementation arrangements and on when those who will fall under this important legislation will begin to see a positive change in their daily lives as a result? <BR /> <BR />Finally, I do not think that we would be able to have this debate without mentioning the costs. This is an issue on which the Committee regularly sought information, not least because the costs provided by the Department were pretty vague. Even as we stand here today, the Department is unable to say how much this Bill will cost and how it is going to pay for it. The Minister said earlier that it would not be proper to put money against a Bill that had not been passed into law.”
“We are content to support the amendments in group 2. Again, these reflect many of the issues that came up during the Committee deliberations. Several of the amendments in this group, such as amendment Nos 403, 404 and 405, relate to commencement. I am aware that the Minister has indicated in response to a written question that the Bill's timetable still allows for Royal Assent by the end of the current mandate and has further indicated that the commencement date is to be confirmed subject to progress on implementation arrangements.”
“I also support the amendments that have been tabled by Sinn Féin. Those that would insert the term "approved practitioners" into the Bill should hopefully ensure that it will remain flexible to changes in service provision in years to come. <BR /> <BR />The only other comment that I have at this stage is that, while I note that the Sinn Féin amendments would tighten the language in some areas of the Bill, such as clause 14, it was disappointing that they did not show the same consistency with my amendments yesterday.”
“It was important, however, that the bodies that will, ultimately, implement the Bill had sufficient opportunity to feed into it. <BR /> <BR />I support the first group of amendments. The Minister has reflected many of the issues that we heard in Committee.”
“I also welcome the opportunity to speak on the first group of amendments. I am glad that the Bill has reached this stage, as, for a time, there was concern about whether it would get caught up in the dissolution of the Assembly. I, again, express my disappointment at how long it took for the Bill to come to the Floor, especially considering that it and the wider single legislative framework were first proposed as far back as 2009 following the Bamford review. Nevertheless, as the Chair of the Ad Hoc Committee explained, it is a very important Bill, and I believe that all members of the Committee showed a willingness to see it reach this stage. There was, understandably, significant stakeholder interest in the Bill, and I was impressed by the quality of the evidence that we heard.”
“I thank the junior Minister for the answer and update. I note that the southern steering group last met on Tuesday 1 December. Will the junior Minister explain, given the long delays with the fund and the impending end of the Assembly mandate, whether the groups will meet more frequently to move processes along?”
“Bodies such as the Education Authority and the Health and Social Care Board provide absolutely key public services. Whilst they may operate outside the Department, I believe that it is important that they are named in the Bill. <BR /> <BR />In closing, I want to say that I am disappointed that the Minister's party cannot support our amendments, given the fact that Oliver McMullan recognised that they were designed to strengthen the Bill. Finally, in trying to strengthen the Rural Needs Bill for our rural communities, you just cannot win with the DUP: 'A Fresh Start', but the same old "say no" DUP.”
“Amendment No 1, for instance, will place a higher threshold on statutory duty, and despite the Department's protestations, I hope that it will appreciate why a general duty to consider was not sufficient in this case. <BR /> <BR />I am disappointed that the DUP decided that it was necessary to table a petition of concern against amendment No 5. I am still waiting to hear a credible reason for that. The purpose of the amendment was to tighten some of the language and indeed, when the Minister herself advised the Committee that she would support it, she acknowledged that it further strengthened the Bill. <BR /> <BR />The only other amendment that I want to comment on is amendment No 13, which lists the public authorities. It is an important one.”
“The Council for Catholic Maintained Schools (CCMS) continues to operate within its individual area of interest, showing no regard whatsoever for anything that the Education Authority or the previous boards were doing. My amendment will place a responsibility on DARD to try to coordinate and handle the sharing of information. <BR /> <BR />Our last amendment, amendment No 12, simply puts in the Bill a date, 1 June 2017, by which these new responsibilities will commence. I fully trust that the Bill will come into operation well in advance of that date, but the amendment will act as a safeguard, just in case. <BR /> <BR />In addition to our amendments, I, unlike other Members, support those that have been tabled by the Chair of the Committee and the Minister.”
“In addition, I hope that it will be a clear desire of the House to ensure that when a public authority falls below expected standards, DARD will not be found wanting in its criticism of it. <BR /> <BR />Amendment No 11 is fairly minor but important. It proposes a change of emphasis from hoping to secure cooperation between public authorities to placing a duty on the Department to secure it. There have been too many instances over recent years of Departments and arm's-length bodies working in isolation from each other. A typical example was the widely discredited area planning and viability audit processes in our school sector.”
“<BR /> <BR />Amendment No 7 places a duty on public authorities to include in their annual reports information on how they have complied with the legislation. It will not be good enough to say simply that they have considered the needs of our rural population; they will need to detail how. <BR /> <BR />Amendment No 9 places a duty on the Department of Agriculture to give its assessment on how each public authority has met its obligations under the legislation. As the sponsor of the Bill, and the Department with lead responsibility for implementing it, DARD must surely be prepared to take some responsibility for enforcing it. The first step of that must be to keep an overview on how public authorities are responding to it in practice.”
“<BR /> <BR />Amendment No 6 is probably one of the most important amendments. Therefore, I was somewhat bemused by Mr Irwin's comments that it was, he felt, expensive and not necessary. In my opinion, if staff are going to have a role in identifying and meeting rural needs, it is essential that they have the capacity and the awareness to allow them to generally understand the challenges that our rural communities experience. The training does not necessarily need to be that onerous or burdensome — or expensive, Mr Irwin — but it does need to be wide enough to ensure that staff in positions of importance are properly informed on the issues relating to the impact on rural areas of Northern Ireland that they will be addressing.”
“Whilst our amendment to the Bill on a presumption against rural school closures was not accepted, it is my hope that it will be, in some other legislation. <BR /> <BR />I am glad, however, that the Minister has taken the Bill forward. Whilst it is difficult to see anything in the Bill that anyone would disagree with — I may refer to that in closing — I felt that parts of it could have been improved and strengthened. As a result, Robin Swann and I tabled a number of amendments, several of which, I was glad to see, appear in the Marshalled List. Those amendments, as we know, are amendment Nos 6, 7, 9, 11 and 12. I will take each of them in order. However, given that none of them is particularly technical, I hope that they will be fairly self-explanatory to Members.”
“I, like many Members, know at first hand that living in the countryside has many wonderful benefits, not least the tranquility, but it has, undoubtedly, its challenges. Public transport and access to essential public services are very often much reduced, compared with that available to our urban-dwelling neighbours. People in the countryside do not expect to have a GP clinic in every small village, but, when changes are being made to existing provisions, they should expect that their additional challenges are at least considered. On a side note, that certainly did not happen in my home village of Waringstown, where the branch surgery was, first, temporarily and then permanently closed without any notice to patients. The same goes for schools.”
“The lack of targets and measurable outcomes meant that it always had the potential to become just another dormant Executive strategy.”
“I welcome the opportunity to speak in this stage of the Rural Needs Bill. As I said in the Second Stage debate, it is essential that the Bill carry weight and be much more than a mere box-ticking exercise. Although the previous rural White Paper action plan included a lot of positive sentiments, unfortunately, I, like many, felt that it focused more on show than on substance.”
“I also thank the Minister for his statement. Given the North/South Ministerial Council's arrangements for surgical treatment of children with congenital heart conditions, will he update the House on when Our Lady's Children's Hospital in Crumlin will have the capacity to treat our children from Northern Ireland?”
“I thank the Minister for her statement. I note the presentation from the Deputy Chief Veterinary Officer. Given the cooperation between Departments on preventing the spread of swine flu, was that issue part of the discussion? Was she aware that about 150 cases have been reported in Northern Ireland in the last four weeks?”
“When we talk about patient safety, it is important to remember the service that responds to critical incidents across Northern Ireland every day. They prevent injury and save lives, and without that financial support that critical service is placed at risk and even greater pressure is placed on our health service, not to mention the increased risk of loss of life. <BR /> <BR />I appreciate that we can often focus on the numbers on the spreadsheet and the statistics on a sheet of paper, but the central argument I make to the Minister, in all sincerity, is this: behind the numbers lie our constituents. They feel and bear the ultimate outworkings of budgets — the successes and the failures — and I ask the Minister, as I know he appreciates the point, to take that on board.”
“<BR /> <BR />Before I draw my remarks to a conclusion, I ask the Finance Minister to take on board the will of the House. Just last month, we debated changes to the Fire and Rescue Service. Following that debate, the Assembly resolved that the Health Minister should”
“With an annual budget of almost £4·9 billion, it is simply unacceptable that the Assembly is being asked to approve this without any meaningful detail whatever. It is my fear that, given the obvious failure to address the crisis across our hospitals, we will be standing here this time next year making the same points and expressing the same bitter disappointment on behalf of the constituents who have elected us to serve in their best interests. Before the Minister talks about the additional allocation for next year, which I of course welcome, I ask him not to, because he and I both know that it does not come anywhere close to addressing the increase in demand and other inflation-related increases. So far, from what little we have been able to gather, the Budget does nothing to address what is undoubtedly this Executive's biggest failure.”
“Thank you, Mr Principal Deputy Speaker. <BR /> <BR />It is my sincere hope that the Department and trusts will be able to work together to deliver the savings in a way that does not compromise the safety of our patients. Of course, as well as approving changes to allocations in this financial year, the Assembly is being asked this week to effectively sign off on a significant proportion of next year's allocation. I understand that essential services need to continue and wages need to be paid, but the fact that, as we stand here today, we know little of the detail is indicative of a Health Department and Minister who believe that they are above scrutiny and accountability.”
“Excuse me. I just hear noises from my left.”
“I thank the Member for the intervention and for giving an unelected Member a lesson on the OFMDFM SIF, which I continually raise —”
“I thank the Member for his intervention. You have had three Health Ministers: if they had manned up, constituents of yours and mine would not be waiting in pain.”
“Yes. It is as expected. I was waiting for you.”
“The plain truth is that £40 million will barely make a dent in our current unprecedented waits. However, I hope that it is followed in the next year, hopefully under a new Minister, with a recognition of what needs to be done. I have major concerns in the short term that the savings that the Department is demanding of trusts are putting an already stressed health service under even greater pressure. Those savings put pressure on services, including domiciliary care, that can and will lead to long-term pain and greater long-term financial costs for patient care for our most vulnerable. It is my —”
“I have said in the House before that statistics often mask the pain, fear, hurt and worry that our constituents feel. They have elected us to serve their best interests. <BR /> <BR />I am sure that none of us needs to be reminded that the longer a patient is forced to wait for a diagnosis or treatment, the more harm they are likely to come to. There is no greater issue facing the Executive or the Assembly right now than the horrendous situation of our hospitals and the inexcusable stress that that puts on patients. That is not even to mention the excellent staff, who are operating in extremely strained circumstances. It is regrettable that it took so long and so many patients to wait in pain for successive Health Ministers to realise that there was a problem and the extent of it.”