Paula Bradley
North Belfast · Democratic Unionist Party · Northern Ireland
“I am especially grateful to all the women who, especially in my first mandate here, were a constant support and encouragement to me as a new MLA. Nothing ever prepares you for this role, but many inside and outside this Building are the glue that holds it all together.”
“I thank them for their support, especially over the last week, with the phone calls, emails, cards and flowers, but, most of all, for allowing me to be part of their lives, sometimes at the most difficult times. Secondly, I want to thank my party, of which I have been a member for 20 years.”
“Thank you, Mr Speaker. I will try my very best to get through these three minutes without tears in my eyes, though I doubt that that is going to happen. <BR /> <BR />I will begin by thanking you, Mr Speaker.”
“After much discussion with officials concerning the objectives of the Bill, the detail of an SMI loan, the process of registering and removing the statutory charge and how and when an SMI loan is repaid, the Committee was content with the Bill as drafted. <BR /> <BR />I welcome the Final Stage of the Bill.”
“I welcome the Final Stage of the Bill. It is probably the shortest Bill that the Committee considered, but it is no less important, as it aims to protect owner-occupiers in receipt of an income-related benefit from the threat of repossession.”
“I know that I have caused a few headaches over the past two years, but you have always delivered week in, week out and put the needs of the Committee first and foremost. You have made my role as Committee Chair so much easier. For all that you have done, I am truly thankful.”
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“He also said that it would require investment, and that is not just financially, but through other doors, including clinicians, who would have to invest in it as well. We look forward to seeing what he can do and how it will be taken forward. <BR /> <BR />We all know that we face great financial pressures, and that is something else that the Minister has to face. However, we also have to face them, as elected representatives and members of the Health Committee. There are challenging times ahead, but I believe that the recommendations set down by the Health Committee are valued and would go more than some way towards alleviating the pressures of elective care.”
“Again, we forget sometimes when we look at all the facts, figures and statistics that patient need is the most important thing. Sometimes, we need to be brought back to that to remember that that is important. The Member also mentioned the Belfast Trust, which is my trust. It was one of the worst offenders, although that is for many reasons. It is the largest trust and has the highest demand. It would be nice to see that changing in some way, but I know that it has a difficult task ahead of it. <BR /> <BR />The Minister highlighted the number of constituents he has. He is very much aware of all the complaints that we keep hammering on his door about. He welcomed the Committee's recommendations on referral-to-treatment targets, and he agreed that it would be more transparent for the patient.”
“Recently, I have been looking at the women in politics issue. To try to make it more desirable for political parties, we should maybe look at incentives. It is probably something similar: in order for trusts to perform, and to perform to meet the demand, incentives are maybe a way forward. <BR /> <BR />Mr McGimpsey brought us back to what we should be remembering: we should be delivering the best care we can and the best outcomes for our patients. He used the words that I used many times in social services, "patient need".”
“He also spoke of the need for enforcement and said that changes would not happen if there was no enforcement. That reminded me of being a mother. If you do not follow through with what you say you will do when you are trying to get a child to do something, changes will not happen. So, it is exactly the same across the board in any walk of life, regardless of what we are dealing with. <BR /> <BR />Mr Brady also talked about Portugal, its benchmarks, and what seemed to be like league tables showing who was performing and who was not. It would not be a bad idea to have that. When I sat on the Health Committee previously, we got various tables relating to elective and other types of surgery. They told us which hospitals and trusts were performing and which were not. He also spoke about incentives. That is another good idea.”
“I think that all of us agree that those waiting times need to be reduced, regardless of whether we believe in the use of private healthcare or the use of the NHS. <BR /> <BR />I spoke earlier about what Mr McCarthy said. He talked about constituents, and he said that we need to cut the length of time that our constituents have to wait, because they are suffering and are in pain. You are absolutely right. <BR /> <BR />Mr Brady talked about "target and terror" in England: I think that that was the term he used. I found that quite interesting; I wonder how it would work. Yes, it might well work. In that approach, management was held to account. That is exactly who needs to be held to account because they should be managing their service more effectively.”
“Yes, these things do happen, but, again, there are other people out there who, for ethical reasons, are absolutely against using a system in which they would cancel NHS treatments in order to provide private treatments. Mr McKinney also said that we need to better match supply with demand. That is absolutely right. He also called for greater transparency when we look at the private sector. I think that better transparency would alleviate some of our concerns. <BR /> <BR />Mrs Dobson brought up the human cost, as I said earlier. That is an excellent point. When we look at how this affects the patient, we see how difficult life becomes. She also spoke about the waiting times and the need for them to be set to ensure that patients do not have to wait for extended periods, as we are seeing at present.”
“He talked about other countries where private healthcare is used and told of how the demand in Northern Ireland has increased in the past years. That demand has, of course, exceeded our supply. That needs to be addressed as well. He questioned whether we were getting value for money from the private sector. We all know what the public opinion of private healthcare is, and the Minister has talked about it. We know the public's opinion on consultants who, maybe, are moving or manoeuvring lists, or whatever that might be. From what I saw in the facility that I visited, that certainly did not appear to be case. Many consultants there were purely private consultants. <BR /> <BR />So, I think we need to look at it on balance.”
“I also was on that visit, and I saw a very efficient healthcare facility that appeared to be doing things in a much better way than our own health service. So, maybe there are lessons to be learned. Rather than us saying that we need to stop doing something, or that we need to do x, y or z, maybe our National Health Service needs to learn a few lessons about how to run its service more effectively. Mrs Cameron also talked about the ambiguity in our system and how we measure waiting times. <BR /> <BR />Mr McKinney spoke about recommendation 4, which relates to the use of the private sector for elective care. He said that, in 2009, £55 million to £65 million — 5% of the total spend on elective care — went to the private sector.”
“I thank Mr McCarthy for his remarks. He is absolutely right. We all know what it is like to be pain, and we know how much that can bring us down and how that makes us feel. We also know that there is a heightened risk and a great risk of suicide among our elderly population as well. A lot of people waiting for care are older people. There is also the knock-on effect of having to have someone come in and look after you and your loss of dignity. There are so many different things to do with elective waiting times that need to be addressed very soon. <BR /> <BR />Mrs Cameron also brought up a recent visit to a private healthcare facility. The Minister also brought that up, as did other Members.”
“I thank the Minister for that, and I will be speaking to him within the next day or two. This only happened last week for the second time.”
“We have 79-year-old men brought into hospital, and that is the case. It does not always happen the day before or the week before. It is happening to our constituents and our own family members, people who we know and love, daily.”
“He is also aware of the amount of letters that we, as MLAs, send through to his office, asking that waiting times be looked at. A number of Members brought that up, and I do not see that changing any time soon. In fact, a lot of Members said it, and they are absolutely right. I see that increasing as the months and years go on, and that really is a very sad state of affairs. <BR /> <BR />Mr McCarthy, in an intervention to Mr McGimpsey, mentioned the fact that we have constituents who have been given times and dates for surgery, only to receive notification that it has been cancelled. On a personal level, I have a 79-year-old father who has appeared for surgery twice. He has actually been to the hospital twice at 7.00 am, only to be told at 5.00 pm, "We are not doing your surgery today". That is the state of play that we are in.”
“The Chair also acknowledged that this was a complex task, and the Department said that it would take time and money to implement. The Committee believed that this would lead to cost savings in the long term, and I absolutely agree with that. The Committee also recommended that this should be introduced as soon as possible in our health service here in Northern Ireland. <BR /> <BR />Mrs Cameron brought up the issue that I and many Members did about our constituency offices. Regularly, we have people calling in because they are suffering and are in pain and have come to the end of the road and do not know where else to turn. Quite often, they end up at our offices wanting our help. The Minister mentioned that he also is aware of that because he is also a constituency MLA.”
“That is not just for the patient but for the patient's family, the patient's employer and their work colleagues. It has a knock-on effect across the board. <BR /> <BR />The Chair is absolutely right that it is timely that this review is being carried out. The Committee looked at how other countries and regions handled their elective care, and it came up with five recommendations. The first recommendation that the Chair talked about was that to reduce the referral-to-treatment time targets. As I said earlier, our service measures it all in separate parts of the patient's journey, and, of course, that is no way to measure their journey. Their journey should be measured from beginning to end to give the patient a clear sense of how long they will have to wait for treatment.”
“<BR /> <BR />At this stage, I will turn to what other Members had to say. The Chair, in moving the motion, said that the issue had been a concern for more than a decade. As someone who worked in the health service for many years, I fully understand that, as I understand the pressures that the health service is under. The Chair also said that waiting times are a serious issue and those for elective care are an extremely serious issue. She is absolutely right because there are people in severe pain, and the knock-on effect of that is poor mental health. There are other knock-on effects, too, and Mr McCarthy and Mrs Dobson spoke about the human cost. They said that, sometimes, we are very good at looking at percentages, facts, figures, finances and so on, but we need to come back, at every stage, to the human cost.”
“It is right that we explore ways in which waiting lists can be reduced so that appropriate treatment can commence. <BR /> <BR />In September 2000, an additional £5 million was made available to reduce waiting lists under four key areas: clinical initiatives, management actions, service planning and efficiency measures. Prior to 2002, cuts in services due to financial reasons had led to an increase in waiting times in three major areas. First, from 1996, there was a 30% reduction in elective procedures. Then, from 2002, there was a decrease of 18% in bed capacity, while an increase of 10% in inpatient surgery and delayed discharges impacted on a bottlenecked system. In 2009, I am happy to report that the PAC commended DHSSPS on the dramatic drop in outpatient waiting times, yet, in 2014, we have bed pressures and extended waiting times.”
“I thank all the members of the Committee. I was not on the Committee when it was looking at this issue, although I certainly wish that I had been. I also thank all Members. It certainly has been a very interesting debate. <BR /> <BR />The National Health Service has, since its inception, always had to manage its resources. From talking to constituents, I know that waiting times for appointments and treatments are one of the biggest issues for service users. For patients, there are four distinct waiting times: to see their GP; between seeing their GP and receiving appropriate tests; for referrals to specialists; and from seeing specialists to receiving treatment. For some conditions, those waiting times can have a negative impact on long-term health outcomes.”
“I thank the Minister for her reply. I congratulate the members of the Northern Ireland team; I know that some of them are from my home borough of Newtownabbey. The Minister is also aware that fly fishing is truly an inclusive sport, no matter what age you are, what culture you come from or whether you are an urban or a city dweller. Will the Minister look at how funding is allocated for that type of sport? As I said, it is very inclusive. There are no barriers when it comes to fly fishing; it is there for everybody.”
“I also thank the Minister for his very comprehensive statement. Like the Minister and, I imagine, most Health Committee members, I have met the parents and parent representative groups concerned with paediatric congenital heart services. The statement refers to the family advisory group and the inclusion of parents and parent representatives in decision-making. What specifically does the Minister see as the role of the parents and parent representative groups in the implementation of the new model?”
“When he was elevated to the lofty heights of Minister, I was elevated to his position as vice Chair of the Committee, so I do not know whether to congratulate him. He spoke about Barn Halt Cottages. My colleague Pam Cameron and I visited there last year and saw a very successful and worthwhile supported living project that promoted independence in our older population. We have many places out there that are good models of support. We just need to work on that, and we definitely require much more.”
“Mr Robinson spoke about services' need to maximise the number of people able to live in their own communities, and he outlined the benefits of that, particularly for those with mental health issues. We know that, within our ageing population, we also have a higher level of people with mental health issues. <BR /> <BR />I am going to run out of time very shortly, so I will maybe skip on. I will cover Ms McCorley's comments first. She spoke about a need for further understanding. She also spoke about data gathering in the trusts, which linked to what the Chair of the Committee said at the beginning. <BR /> <BR />In closing, before I get told off as well, I want to congratulate the Minister.”
“I ask again how we can expect our community and our ageing population to have the knowledge of what supported living is when many others in Departments, trusts and the health professions do not know. He went on to mention the Belfast Trust and said that its supported living scheme was not open to everyone but only to those with specific needs. Again, I think that we need to look at what people want and are asking for. <BR /> <BR />Mr Brady spoke of the long-term policy and the shift in the number of those wishing to remain in their own homes. He also spoke about the need for carers to be supported, about Transforming Your Care and about the lack of clarification.”
“We cannot begin to expect our community to understand what supported living is if health professionals, Departments, trusts and Members are not fully aware. <BR /> <BR />Mr McCarthy declared an interest in the subject, although I cannot think why. He, too, said that evidence received had shown that there was no clear definition. He also said that we need to ensure that provision is there and that people had the right to live in their own homes in their own communities and to make the decisions that affect them, because it is their decision to make. <BR /> <BR />My colleague Mr Dunne said that there was a clear issue in the provision of suitable alternative housing and around the lack of knowledge among those who may require it.”
“He said that he understood the need for supported living and the lack of options available to meet individual needs. Again, he brought up the issue of the definition of supported living. That vein ran through the contributions of almost everyone who spoke this afternoon. From my social work background, my definition of supported living would have been extremely different from that of other health professionals, so if there is a difference there, is it any wonder that there is a difference between what Departments, trusts and Members believe it to be? There needs to be a clear definition. I think that that would go some way to facilitating the decisions that health professionals have to make.”
“I come from a social work background, and that was definitely an ethos that we promoted: all people have the right to live where they want to and be in the communities that they want to live in. He also spoke of the significant voids in the Northern Ireland Federation of Housing Associations' facilities and how housing associations were facing financial losses. He also said that we need to look at risk sharing between trusts and housing associations. Another two words that he used that jumped out at me were "communication" and "transparency", because there does not seem to have been too much of either over supported living. He also pointed out the lack of strategic thinking. <BR /> <BR />Mr Beggs spoke on a personal level and as a constituency representative.”
“My colleague Mrs Cameron indicated that Northern Ireland has one of the fastest growing populations in the United Kingdom and that, therefore, we need to look at our strategic planning in the years ahead. She also said that we should not continue with our "firefighting approach" and that a planned approach was required. She also highlighted the fact that there is a lack of awareness amongst the general public about the types of supported living available as well as other means that will ensure that people can remain in their homes for longer. She also said that it is vital that all five trusts set out an action plan, which should be clear and concise, about supported living. <BR /> <BR />Mr McKinney made the excellent point that people should be able to retain relationships and everyday life and be able to be part of their communities.”
“I note also that she stated that the Committee recommended that the Department should begin forecasting the need for supported living places over a 10-year period and that these indicative forecasts should be kept under review and reassessed when decisions are being taken, especially when building new facilities.”
“She highlighted the long-term projections and the fact that officials did not recognise a need for long-term projections, even though they recognised that we have an ageing population and that that is only ever likely to increase.”
“<BR /> <BR />Recommendation 11 looks closely at the terms of developing housing options for older people. As has been said, we have an ageing population, and that is truly a given fact. Thankfully, we now have people living longer. Most of us in the Chamber today can anticipate living well past the threescore years and 10 that we would have expected several decades ago. To ensure that we can build on that, the Committee believes that coordinated thinking by a number of Departments is required. <BR /> <BR />I now turn to what my fellow members of the Committee had to say. I thank the Chair for her opening remarks and for setting out the Committee's scrutiny for community-based options for older people.”
“<BR /> <BR />In her evidence, the Commissioner for Older People suggested that there was no correlating relationship between increasing the role of supported housing and the declining need for residential places. That was also supported by the Health and Social Care Board, which stated that, although it had evidence of a 5% decrease in the demand for residential places, that was not just because of the supported living element but because the provision of care in people's own homes had had an impact. Therefore, I believe that the Department of Health needs to do further work to provide a stronger strategic guideline, building on that contained in TYC, on the relationship between supported living provision and the provision of residential care.”
“In preparing for the debate, I was surprised to find that the trusts could not provide the Committee with a figure for how many people they expected to be placed in supported living facilities over the coming three years who would previously have been placed in residential homes. <BR /> <BR />The lack of strategic direction regarding the role of supported living in replacing residential placements is concerning, bearing in mind that the policy direction is laid out in 'Transforming Your Care'. I do not accept that the newness of this type of care is a reason for the lack of strategic planning, which is vital to ensure that people and their families have access to appropriate care at the appropriate time.”
“In my research for the recommendation, I was absolutely astounded to discover that there is no clear-cut definition of what constitutes supported living, and there appears to be some confusion among the relevant stakeholders about what is meant by the term. Not only is there confusion over what is meant by it but there appears to be a level of confusion among housing associations, the board, the Department and the trusts on the types of people suitable for supported living accommodation. <BR /> <BR />According to the TYC document, the increase in community-based options such as supported living would see a correlating decline in the demand for the provision of statutory residential homes.”
“It gives me pleasure to wind on the debate. Although I have been on the Health Committee for just under three weeks, I sat on it previously. I believe that I have an understanding of the issue, not only through my membership of the Committee for Social Development but through my former career in hospital social work, where I worked predominantly in elder care and looked at the specific needs to promote independence and empowerment among our older population. <BR /> <BR />Before I start, I draw Members' attention to recommendations 10 and 11 of the Committee report. In recommendation 10, the Committee recommends that the Department clarify its strategic position on the links between the availability of supported living places for older people and the availability of places within statutory residential homes.”
“I also thank the Minister for his statement, and I especially welcome the £60 million for health. The Minister touched on this in an earlier answer to Mrs Dobson, but will he comment on the extent to which the £60 million allocation, along with the £20 million from the June monitoring round, will deal with the immense pressures faced by the Health Department?”
“I thank the Minister for her answer. The Minister mentioned Bombardier. We know that Bombardier announced significant job losses in September. Many of those workers are my neighbours in my community in Newtownabbey. Can the Minister comment on Bombardier and its importance in Northern Ireland?”
“No, I will not; I do not have time. <BR /> <BR />I have been a member of the Social Development Committee since the inception of the Bill. When it was introduced to us, all members from all parties raised many concerns but never once did I hear anybody say, "Let's scrap this. Let's start our own Bill". We wanted to change it, and I believe that what we have from the Minister brings forward the changes that we wanted. <BR /> <BR />In conclusion, we have looked at the experiences on the mainland and learnt from their mistakes. We are in the best place now to implement this package, which will clearly bring us into line with the rest of the UK while also acknowledging the uniqueness of Northern Ireland's position. I oppose the motion and call on those who really want to protect the vulnerable to support the amendment.”
“Instead, I believe that we should work to help that 30%, discover why they are worse off and move to a position where that will not be the case.”
“Rather than defending the poor and vulnerable, all that we are doing by delaying this, and not having a proper debate and facing the reality, is inevitably making things worse for those we want to protect. <BR /> <BR />I believe that it is time we stopped hiding and looked at the facts about welfare reform. In an article by the Joseph Rowntree Foundation, it studied the figures and came to the conclusion that, when dealing with child and working-age poverty, universal credit could have a positive effect. It is anticipated that 35·5% of households will be better off, 34·5% will see no change and 30% will be worse off in some way. If we accept the motion and do not accept welfare reform, we will be sacrificing 70% to protect 30%.”
“Thank you for that, Mr Principal Deputy Speaker, because it is rather difficult. During the entire debate, I have shown Members in the Chamber respect by not having conversations. I would like that same respect in return. <BR /> <BR />In his written statement to the Assembly, the Finance Minister, Simon Hamilton, made the impact of delaying welfare abundantly clear to everyone. The increasing financial penalties imposed from Westminster for us not implementing welfare reform will have far-reaching effects and, as we know, have already started impeding the delivery of public services. By not implementing welfare reform, we will affect everyone right across our society.”
“These areas tend to be among the most disadvantaged in our society. <BR /> <BR />By not implementing welfare reform, we are not protecting vulnerable people. In fact, what the House is doing by dragging its heels on the issue is financially impacting on everyone in our society. In his written statement to the Assembly, the Finance Minister —”
“No, I will not. <BR /> <BR />Rather than having this "block everything" reaction, we have not only a financial responsibility but, more importantly, a social responsibility to look at what the facts are and implement a welfare reform system that, as the Minister said, has been tailored specifically to the people of Northern Ireland. <BR /> <BR />Welfare was designed initially to help the most vulnerable and poor within our society. We know that it was envisaged as being a hand up rather than a handout. Sadly, as time has evolved, we now see families in a second or third generation of non-working. None of us can deny that the circle of poverty is thriving in areas of Northern Ireland where more people are more dependent on welfare than on work and among those who are in work but find themselves part of the working poor culture.”
“I also welcome the opportunity to speak on the motion and to make the winding-up speech on the amendment in the names of me and my party colleagues. I am sure that I am not the only one in the Chamber who recognises just a hint of hypocrisy in the motion's deep concern for the poor, vulnerable British people. That has certainly not been the case over the past years, but the shift is very welcome today. <BR /> <BR />As we are all aware, welfare reform is a highly emotive issue that has received a lot of media coverage. As a result of the coverage and peddling by individuals and certain parties, a lot of misunderstanding and scaremongering is being fed to the general public, which has heightened fears, especially among those who we have a duty of care to protect.”
“I thank the Minister for his answer. A lot of us are interested in this because a lot of us had a local council background before we became MLAs. I have been speaking to councillors in my area who have been doing their training and have found it extremely worthwhile. Does the Minister agree that there needs to be a certain level of uniformity across all councils in order to avoid any inconsistencies or opportunities for individuals or developers to take advantage in some council areas?”
“I am sorry, Minister, that my question is in the same vein as most of today's Question Time, which is to do with the transfer of planning powers to local councils.”
“I thank the junior Minister for his responses. Will he inform the House whether the consultation responses contained any reference to current legislative protections for the LGB community?”
“I thank the Minister for his answers. Minister, when we talk about some of the most vulnerable, we often think about those in receipt of disability benefits. How will the new personal independence payments (PIPs) affect children and older people?”
“We all make mistakes, and the Minister has shown us real leadership by admitting when he was mistaken.”
“It was also attended by members of the Northern Ireland Housing Executive, including the head of procurement. I believe that the issue is not, as other Members have stated, about the integrity of the Minister but rather is a cheap political game by other parties that, for reasons best known to themselves, want to see a political hunt occur. I do not agree that any impropriety occurred, nor was there a deliberate attempt to mislead the Committee. The Minister told the facts as he understood them at the time and, when he realised his mistake, he sought to rectify it as soon as possible. <BR /> <BR />As I previously stated, I do not agree with the report that claims that the Minister deliberately misled the Committee. No man or woman is infallible.”
“It is clear that the review of the scheme was needed, as significant savings occurred as a result of the review. That can only benefit people in social housing within our communities, as the savings can be used elsewhere. The Minister also had no role in the review, nor did the Department reap any monetary benefit from the review. Furthermore, Turkington's did not financially benefit from its attendance at the meeting. It appears, therefore, that the only people to benefit from the findings of the meeting were the Housing Executive tenants, who we represent in order to get better value and less disruption. <BR /> <BR />I also note that the Minister sought to correct the Committee as soon as he was aware that the mistake had been made in the attendees of the meeting. It was certainly not a back-door meeting.”
“In examination of the evidence, I can see no benefit that the Minister would gain, either politically or materially, by not fully disclosing the facts. It is clear that the Minister believed that he was meeting representatives from Turkington's in their capacity as representatives of the Glass and Glazing Federation. Members of federations often wear numerous hats. They have the hat in which they represent their own company and the hat in which they represent the industry. It is clear from the evidence that that was indeed an easy mistake to have made. <BR /> <BR />So, who did benefit from that misunderstanding? It is clear that the Minister was at all times driven by desire to save the public purse money. In these times of economic challenges, I believe that that action shows appropriate leadership.”