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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“<BR /> <BR />Medical staff have played an important part in Mark's life and my family's life, and they play an equally important role in the lives of countless families touched by organ donation across Northern Ireland. It is for that very personal reason that I took the decision to bring forward the private Member's Bill. I want more parents to be able to see their son or daughter transformed back to having a fit and healthy life before their eyes, just as we saw with Mark, to move back from being a mere shadow of themselves, which they become following organ failure, and to see more people being released from a life sentence of dialysis and returning to as normal a life as possible.”
“Three years after his transplant, when he became 18, Mark moved from the care of the children's hospital to the wonderful care of Dr Aisling Courtney, the clinical lead for transplantation in Belfast City Hospital, and, more recently, to Dr Neil Morgan, consultant nephrologist at Daisy Hill Hospital, Newry. <BR /> <BR />In our home, we know what it is like to have someone save the life of our son because of a kidney donated by someone who died in England on 4 February 2009. We think of that person and their family every single day, but we will never know who they are. Like many families, we have sent a letter, and we hope that they have received comfort in knowing how we appreciate, from the bottom of our hearts, the gift of new life that Mark has received.”
“In all life's experiences — birth, marriage and, ultimately and unfortunately, death — nothing can, could or should ever prepare a young mother, as I was, to look at the very real prospect of losing her son or daughter. I faced that prospect, and I firmly believe that it shapes you as a person for the rest of your life. It gives a real sense of priority and focus, and, in our case, it strengthened an already strong faith at that time and has done so ever since. <BR />Now that Mark is through his transplant and has returned to his fit and generally healthy self, he knows too well the responsibility that comes with looking after the precious gift that saved his life. I know countless transplant patients who, in their daily lives, seek to honour that gift and honour the donor in all that they do.”
“We never knew when that would happen but, at the age of 13, his kidneys began to slowly shut down. The wonderful staff at Craigavon Area Hospital and then the Royal Belfast Hospital for Sick Children, including the amazing Professor Maurice Savage, Dr Mary O'Connor, renal nurse Hazel Gibson and her team, became our second family. They loved and cared for Mark as if he was their own. I will never ever be able to repay those 15 years of care that we received during the seemingly endless journeys to and from, initially, Craigavon, and then the children's hospital, before his transplant. <BR /> <BR />Like every transplant patient, Mark celebrates two birthdays each year: his real birthday on 20 March, and the birthday of his new life on 5 February.”
“I welcome the opportunity to move the Bill. I rise to speak, first, as a mother of a transplant recipient and as an unashamed lifelong supporter of the life-saving and life-giving power of organ transplantation. I feel that it is only right that, in the Chamber, we reflect our life's experiences in what we do and seek to achieve as elected Members, in the interests of all our constituents. <BR /> <BR />If Members will allow me to be personal for a moment, long before I entered politics, our life as a family was turned upside down with the birth of our second son, Mark. We knew when he was five weeks old and diagnosed with severe reflux of the kidneys that he would be very ill throughout his young life and would eventually need a kidney transplant.”
“Does the Minister agree that the figures clearly show that the board lost the run of itself in terms of administrative staffing, with a 40% increase in three years? Why was it allowed to become a bloated board? Will the Minister accept that he and his predecessors have responsibility for pumping it up to 600 staff?”
“What assurances can the Minister give that the reduction in college places will not adversely affect young people with special educational needs entering further education and those already progressing in community and off-campus provision? Minister, you are aware of the particular concerns in my constituency of Upper Bann.”
“I thank the deputy First Minister for his answer. Does he share my concern and perception that sharp practices in business dealings here risk damaging the worldwide reputation of Northern Ireland as a place in which to invest and do business?”
“Does the deputy First Minister accept that the redevelopment and regeneration of the Maze site should not be dependent on the location of a conflict transformation centre there? Will he prioritise the redevelopment of the Maze and the jobs it will bring?”
“What assessment has been made of the worth of the signature projects with regard to literacy and numeracy? How can the Minister address underachievement when the first thing to be cut is that programme?”
“It is about time that the Executive and the Department step up to the mark and start giving our local mental health provision the support that it deserves.”
“The facts speak for themselves on that important and life-saving issue. <BR /> <BR />The Appleby report found that Northern Ireland required almost 44% higher per capita funding than England, yet actual spending at the time was between 10% and 30% lower than per capita spending on mental health in England. Michael McGimpsey identified mental health as an area that required additional funding and used the remainder of his time in office to begin delivering just that. <BR /> <BR />Later, the Bamford review clearly identified the need for improved access to services and for a more coordinated framework for provision to be developed. Frustratingly, however, few of the recommendations have been followed through to completion.”
“For instance, the young people who experienced the worst of the violence in the 1970s are the cohort with the highest and most rapidly increasing suicide rates in the decade after 1998. <BR /> <BR />The Ulster Unionist Party has serious concerns about the Public Health Agency consultation on the future of the Lifeline crisis intervention service. The most well-known feature is, of course, the crisis response helpline, and I am in no doubt whatsoever that it has been a salvation for people experiencing great distress or despair. I ask the Minister directly today to throw that service an urgent lifeline. As the figures for service users prove, it is simply not true to say that the current service is Belfastcentric. In fact, from April 2012 until September this year, there were 1,184 referrals in my constituency of Upper Bann alone.”
“Quite simply, far too many people are being lost to suicide, particularly young people in relatively confined geographic areas. <BR /> <BR />I pay tribute to the local charities, including MindWise, that do fantastic work, often with very limited resources, with the most vulnerable in our society. Given that suicide remains one of the largest killers in Northern Ireland after cancer and heart disease, it is clear that there is so much more that we need to do. Northern Ireland's suicide rate has almost doubled since 1998, putting us in the top quarter of the global league table of suicide rates. Worryingly, there is a growing body of evidence that suggests that the trend is associated with the Troubles.”
“The total financial cost of mental illness in Northern Ireland is estimated to be in the region of £3 billion annually, with the majority of costs not healthcare-related. Instead, the costs are to reduced economic output, owing to factors such as sickness absence and non-employment. Human costs, however, entail by far the biggest financial loss, in the form of premature death and institutional problems. <BR /> <BR />Anyone, no matter what age, gender, socio-economic status, life experience or profession can develop mental health problems, and it is often an invisible condition. As constituency MLAs, I am sure that we all know of people who are facing serious mental health issues but who mask their condition, often bottling it up until it becomes just too much to handle.”
“Thank you, Mr Deputy Speaker. You are forgiven. <BR /> <BR />I welcome the opportunity to speak to the motion. In recent weeks, the Assembly has debated major issues such as patient waiting times, autism and delays in key cancer services. Another issue, however, arguably just as pressing, is our endemic rates of poor mental health and how we, as an Assembly and a society, respond to that. <BR /> <BR />One in four people in Northern Ireland will experience a form of mental ill health in their life. Let us think about that for a moment: if we think of our family and our friends, one in four is a perturbing figure. Although the issue affects all regions and communities across the UK, we know that there is a 25% higher incidence of mental health problems in Northern Ireland compared with England and Scotland.”
“Given the interest from farmers, I was concerned about the lack of detail forthcoming from officials who presented to the Agriculture Committee recently. There can be little doubt that the capital grants scheme will be of most interest to the sector. Can the Minister detail some specific points identified in this year's whole farm needs assessment?”
“I thank the Minister for his answer. I would like to record my dismay at the Minister failing to respond to the Adjournment debate on the topic that I tabled back in March about how the new structures would affect my constituents. Does the Minister not share the concerns of my constituents and of businesses about a town the size of Banbridge that is left without any response units?”
“Shame on them, and, when, ultimately, they take up their ministerial posts again — using the report on paramilitaries as a fig leaf — they should not think that all will be forgiven. People will long remember the actions of the DUP over the last few weeks: undemocratic, unBritish and unworthy of office.”
“I thank the Member. I do not agree with him. My party has never shied away from taking difficult decisions and never will. <BR /> <BR />The fact that one in five of the population — 373,000 people — is waiting for treatment, a hospital appointment, or a diagnostic test, was not weighing on his conscience. <BR /> <BR />The disgraceful way that the DUP has acted over recent weeks was clearly illustrated last week. Whilst the DUP and its Ministers had repeatedly failed to take part in major debates, including on Bills, they all rushed in to vote down the reduction of SpAds' salaries. Talk about putting party interests ahead of matters of real public importance. I can think of no clearer image of the DUP acting in a selfish, arrogant or contemptuous manner.”
“Wikipedia can barely keep up. All this nonsense has been done in the interests of the DUP, not of Northern Ireland. <BR /> <BR />For the past month, the focus has been on the nonsense of the in-out, hokey-cokey, yo-yo Ministers. Instead of a Health Minister who is at his desk, tackling the growing crisis in our hospitals or coming to this Chamber and responding to Ulster Unionist motions on waiting times and the delays in cancer services or the SDLP motion on autism, what we have seen is that he is often seen wandering calmly through the corridors upstairs. The fact that one in five of the population, or 373,000 people to be specific —”
“They took their historic position of blaming the Ulster Unionist Party. What was said in their early statements about an exclusion motion against Sinn Féin was nonsense, and unworkable under their St Andrews Agreement. It is ironic that yet another aspect of that agreement has come back to bite that party the hardest. <BR /> <BR />Their other fudge was to seek an adjournment of the Assembly. When that failed, the DUP acted in the most ham-fisted and stupid way possible. The First Minister did not resign; he merely stepped aside. The Finance Minister stayed in post to keep an eye on so-called rogue or renegade behaviour in the Executive, and took on the First Minister's position, though not when it comes to signing documents, apparently. Then the other DUP Ministers resigned and were reappointed, as the motion says, "more than 20 times".”
“The blanket denial from Sinn Féin about all of this meant that we had to act, and we acted decisively. <BR /> <BR />The Ulster Unionist Party is not in denial about the existence of any paramilitary organisation. When we withdrew from the Northern Ireland Executive, we explicitly called on the UDA, UVF and the rest to go away, taking their paramilitary flags and markings with them. However, they are not in the Executive of Northern Ireland; Sinn Féin is. If this institution is to retain any credibility and if we accept the word of the Chief Constable, who implicated still-active members of the Provisional IRA, which is still inextricably linked to Sinn Féin, in the murder of a man on the streets of Belfast, then true democrats cannot and should not tolerate that. <BR /> <BR />The DUP's immediate response was predictable.”
“The events of recent weeks, when DUP MLAs became momentary Ministers, have only further lowered the public reputation of this Assembly and the institutions. No one could be oblivious to the fact that these last few weeks have caused real and lasting harm. <BR /> <BR />On Wednesday 26 August, the Ulster Unionist Party announced our decision to withdraw from the Northern Ireland Executive to form an opposition and offer people an alternative, as is the case in any normal democracy. We all know that the background to this was a statement from the PSNI Chief Constable, who stated that members of the Provisional IRA were involved in the murder of a man in east Belfast and that an infrastructure still exists at a senior level of the Provisional IRA.”
“Is the Minister satisfied that the fund will achieve what it was intended to do during the current financial year?”
“The Minister will be aware of the concerns, as highlighted by his colleague there, across rural communities about the continued rollback of services, including GP surgeries and post offices. Indeed, schools in my constituency have certainly not been immune to it. Can the Minister give the House a commitment that the new strategic planning policy statement will lead to vibrant rural communities in the future and not continued rollbacks?”
“I beg to introduce the Human Transplantation Bill [NIA 64/11-16], which is a Bill to make provision concerning the consent required for the removal, storage and use of human organs and tissue for the purpose of transplantation; and for connected purposes.”
“So TYC was broadly heading in the right direction, albeit with those few issues that my party would like changed, but it was never given the attention that it deserves. The last number of Ministers have referred to it in high-level terms only, as if it was a convenient strategy to use as a fig leaf when they were challenged on what they were doing in regard to the growing problems across our health service. I hope that the Department will read the Committee's report, but if it is not followed up with action then, ultimately, it has been a waste of our time, a waste of their time and a waste of time for the staff and organisations that contributed so openly to it.”
“Whilst that is very welcome, it ultimately has an impact on the health service as it adapts to supporting more people with chronic conditions for longer. <BR /> <BR />However, the Department is failing even to plan for the present, let alone the future. There are serious staff shortages across our GP service, with many over 55 set to retire next year in radiology and emergency medicine, to name just a few. If people cannot see their GP on time, many of them will be forced to attend A&E, which, in turn, will cause further delays there. That led to our recommendation for the Department to prioritise the recruitment of an additional 50 GP training places.”
“<BR /> <BR />Of course, aside from that, the implementation of TYC has been completely bungled. As was highlighted in the Committee, the Department could not even give a proper answer on how the £25 million, so far, had been spent. My party has always warned that seeking to move in excess of £80 million from secondary to primary care, at a time of growing pressures, was always unlikely. The Department effectively left the future of TYC at the mercy of monitoring rounds. <BR /> <BR />Members, demand is changing. As recently revealed by the Northern Ireland Statistics and Research Agency (NISRA), the number of people aged 85 and over has grown by over 1,000 each year in the last decade. During that time, the population aged 85 and over increased by 41% — six times faster than the population aged under 85.”
“Much of the debate has been constructive, although some of the rest has been less so. Few people will object to the overall objective of the plan, not least in ensuring that Northern Ireland's health and social care system meets patients' needs well into the future. Unfortunately, however, the initial report also made a number of errors. Its comments regarding 50% of statutory care homes were unnecessary and utterly took away from the value of it. Of course, the decision by some of the health trusts to equate the phrase, "at least 50%", to effectively mean 100% was totally disingenuous and caused very real hurt. I well remember meeting scared and frightened care home residents in my constituency, so I think that policymakers need to be much more sensitive when formulating their words.”
“I also welcome the opportunity to speak on this issue. Unfortunately, however, as my colleague Michael McGimpsey said, it appears that Mr Hamilton once again has decided that he has better things to do than to be held to account by the Health Committee. Of course, this is the same Mr Hamilton who thought it appropriate four weeks ago to neglect the plight of the 373,000 people waiting for a first outpatient appointment, a diagnostic test or an inpatient treatment at hospital. Then, last week, he failed again to respond to the Ulster Unionist debate on cancer and the SDLP motion on autism. So, today, it has come as no surprise that he thinks it is acceptable to avoid some of the most pressing issues facing his staff across the health service. <BR /> <BR />The Assembly has spent considerable hours discussing Transforming Your Care.”
“I thank the Minister for her answer. I am just sorry that Gregory Campbell is not in the Chamber to hear the answer, but anyway. The costs for the project have been spiralling, not least since the Minister's hopes to save £26 million by using the existing buildings on the site were later dismissed. Can she give a commitment that, in light of the ongoing absence of a business plan, as well as a possible alternative of utilising the empty Driver and Vehicle Agency (DVA) buildings in Coleraine, the project represents the best value for public money?”
“I am glad that the Minister is aware of the Chancellor's announcement at Westminster. Notwithstanding the need to recognise the primary childcare responsibilities of both fathers and mothers, will the Minister ensure that Northern Ireland keeps pace with the rest of the UK on this policy area?”
“The Minister will be aware that the funding gap between universities in Northern Ireland and universities in Great Britain is growing. Will he assure the House that the Big Conversation about higher education is not a device to put off making a decision while the funding gap continues to grow?”
“It is not the fantastic teaching staff or carers; it is the processes and procedures that they are forced to operate by. Those have led directly to a considerable backlog and are failing and letting down a generation of vulnerable children both now and in their later life. <BR /> <BR />I support the motion's reference, therefore, to the increasing number of children diagnosed with autism and the difficulties that they experience in receiving the vital extra support that they so urgently need. That is exactly the experience that many of our constituents are dealing with every single day. I therefore support the motion.”
“The processes take far too long, leaving behind uncertainty, which, in itself, can have, and has had, a profound effect on children who cannot cope easily with change or who require additional dedicated support that simply is not being put in place. <BR /> <BR />The Education Minister will also be aware of the provision that has been fought hard for at St Mary's Primary School in Banbridge. The sad fact of that case was that by the time the support and care was discussed, agreed and eventually begun to be put in place, it was too late for the child for whom the original request was raised. That is totally unacceptable. That is the nub of the problem with autism provision for our children. The procedural wheels grind far too slowly, and parents and their children are frustrated at every turn.”
“Very often, when they finally get through the process, it is too late as their children have advanced. Many vulnerable children have advanced despite the system rather than as a result of it. <BR /> <BR />Parents feel trapped into paying for extra support privately and are left wondering how their child's development could have been much better if they had just received the right support in the first place. They are parents who only want the best care at school for the children whom they love and care for at home. They are shouldering a burden that should be helped and not hindered by the responsible Departments and their policies. <BR /> <BR />Both Ministers will be aware that, at a constituency level, I have been involved in helping local parents who feel totally let down.”
“I welcome the opportunity to speak on the motion as a member of the Health Committee, my party's health spokesperson and a former member of the Education Committee. From looking at the systems in place for our most vulnerable children, it is crystal clear that, year on year, there is a total lack of a joined-up approach to providing appropriate care to children with autism, especially Asperger's. The Health Department and the Education Department, along with the Education Authority and the health trusts, need to start working together. As we know, that simply is not happening, and our young people are being let down as a result. It is a total disgrace that so many parents are forced to fight so hard for school-based care for their children.”
“Does the deputy First Minister agree with me that this entire saga has damaged public confidence in some politicians and business figures locally?”
“It is crystal clear that we need to help those people to get diagnosed right now. I will end with this question: is there anyone more vulnerable than the cancer patient who is spending weeks worrying while not receiving the treatment that their life so depends on?”
“Again, as was the case in the recent Ulster Unionist Party debate that focused on outpatient waiting times, the purpose of this motion is not to apportion blame or to make political points. Instead, it is about focusing the minds and dealing with the problem at hand. I have spoken about the absolute necessity for adequate numbers of specialist cancer nurses, for instance, but that is still not happening. Another key aspect is workforce training for GPs. Indeed, we had a call last week from Pancreatic Cancer UK, Action Cancer and Cancer Focus —”
“The fact that one in five of those urgent cases is not being seen in time is disgraceful, especially when breast cancer has one of the better outlooks if it is caught in time. Of those seen in June and who had to wait for more than 31 days, 13 had urological cancer. Let us remember that behind every admittance number or percentage is an individual patient with family and friends who is going through what may be the most difficult time of their life.”
“Given that Belfast is home to some of the best breast cancer facilities and personnel in Northern Ireland, I find it inexplicable that such a large-scale failure is happening. Lest people assume that it is a case of Belfast not being able to cope with its larger number of patients, in June the Northern Trust encountered the same number of patients and yet was able to meet the target in full. Is it a case that the crisis in other cancer types is leading to a bottleneck of cancer treatments in the Belfast area? <BR /> <BR />As was highlighted only last week by Dr Miriam McCarthy, a consultant with the Public Health Agency (PHA), we have a 14-day target for red-flag referrals for cancer.”
“That is not to mention the increase in stress, anxiety and worry across families, especially among elderly relatives when younger family members are waiting. Of itself, 62 days — two months — is a long time to wait not knowing and worrying and breeding other health concerns, which puts further pressure on an already pressurised health service. Fear of the unknown is often the worst fear of all. <BR /> <BR />One of the key benchmark targets is that all urgent breast cancer referrals should be seen within 14 days. In June, 1,336 patients were seen by a breast cancer specialist for a first assessment following an urgent referral. However, only 81% were seen within 14 days, a significant fall from 94% in January. While some other trusts are meeting their targets in full, in Belfast only 27% of breast cancer sufferers were seen within 14 days.”
“My heart goes out to every one of those people and their families. As we stand here today, we should take a moment to think about them, the treatments that they are undergoing and the suffering that each, in their own way, will be going through. <BR /> <BR />Our cancer wards can be the scenes of some miraculous recoveries, but they can also be places of profound physical and emotional suffering. Simon Hamilton, the Health and Social Care Board and each of the health and social care trusts must not for one moment forget how each of those 106 people has been failed. While an apology is the very least that they deserve, unfortunately for some, as a result of these delays, they will already have come to harm.”
“At the other end of the scale, the Western Trust managed to treat 88% within 62 days, yet that was still well behind the target. <BR /> <BR />There is a variance also in speed of treatment for individual types of cancer. Although I am glad that the target was met in April 2015 for patients diagnosed with breast cancer, fewer than 65% of patients diagnosed with lower gastrointestinal (GI) cancer commenced treatment within 62 days during April to June 2015. Most horrifying, however, is the fact that, of the overall 106 patients in June 2015 who had waited longer than 62 days for treatment, 31 were later diagnosed with urological cancer; 18 with lower GI cancer; 13 with head and neck cancer; 11 with skin cancer; 11 with lung cancer; eight with upper GI cancer; six with gynae cancer; and five with breast cancer.”
“There, in black and white, we have the health service, civil servants and an on-off Minister who should be in charge of it effectively admitting that people will lose their lives as a result of the current crisis. <BR /> <BR />The publication of the 'Northern Ireland Cancer Waiting Times' on 24 September further confirmed the scale of the problem. Target after target is being widely missed. For instance, in the most recent month for which figures are available — June 2015 — 347 patients commenced treatment following an urgent referral for suspected cancer. Of those, 241, or 69%, commenced their first treatment within 62 days. The target is 95%. Every one of the five health and social care trusts failed to meet the target in each of the last three months. Belfast achieved only 57% and the South Eastern Trust 61%.”
“That is in addition to the higher-level warning that 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.”
“The future looked positive, with advances in cancer treatment seemingly guaranteed and a service that was world leading, once you got through the door. I know that those experts are still in place and still trailblazing with their discoveries and work, but the outlook for people diagnosed with cancer now could be worse than it was only a couple of years ago. Saying that in 2015 is, I feel, absolutely shocking. <BR /> <BR />There is no starker signal of this than what is contained in the Department's 2015-16 commissioning plan, which is still in draft form for a year that we are well over halfway through. It contains a multitude of warnings. However, the one that strikes me most is that spiralling waiting times could lead to severely delayed diagnoses of life-threatening illnesses, with suspected bowel cancer patients particularly at risk.”