Robin Swann
North Antrim · Ulster Unionist Party · Northern Ireland
“I thank the Minister for his detailed statement. I know how passionate he is about the subject and how many times he has brought it to the Executive.”
“It has been reported that today will potentially be the warmest day of the year. As we move into the summer and our summer holidays, I want to raise public awareness of wildfires across Northern Ireland, which have been detrimental to farmland and our environment over the past number of years.”
“Wildfires are still having a detrimental impact on our environment and, occasionally, on livestock, but that reduction shows the impact of the Northern Ireland Fire and Rescue Service's proactive approach to educating the general public and engaging with rural communities and schools on its fire safety message, which is to stay alert, not…”
“There has been a lot of talk of sport in this place over the past few days, with everybody concentrating on UEFA. One sport that is going on across Northern Ireland at the minute is cross-community and goes across all age groups without fear, favour or distinction: pigeon racing.”
“I want to put on record that, since this place passed the amendment that recognised pigeon racing as a sport under the 2016 Act, over the past five years, pigeon racing clubs across Northern Ireland have been able to obtain £113,000 of rates rebates through the sports and recreation rate relief, allowing many of those clubs to continue ra…”
“There was much coverage on social media over the weekend of an incident in Staines in England, in which a police car rammed a young calf to bring it under control. It has restarted the conversation about animal cruelty. <BR /> <BR />I am dealing with a specific case in my constituency.”
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“As the Member has the update about the tendering process, I am sure that she will be aware that the decision to pause it was taken before my time. There has been ongoing engagement with Nexus on current provision. I look forward to working in partnership with Nexus in the next year to make sure that service delivery not only meets the needs of the women who present to the service in the future but allows my Department and the SPPG to do that further piece of scoping work on what is actually required for mapping out future sustainable arrangements.”
“The Member makes a valid point. Again, having discussed the situation with officials this morning, it is clear to me that further work is required on mapping out future sustainable arrangements so that we can make sure that that support and guidance are there on what is needed. That one-year extension will allow proper consideration of and a decision on the implementation of the best way forward for counselling services of that nature.”
“The waiting list for the Nexus provision has been discussed extensively between departmental officials and Nexus to make sure that everyone who is on that list receives the due and timely support as provided for in the contract. That is what we want to do, working in partnership with Nexus, during the extension of the next 12 months, while a further scoping piece of work takes place to see what the service looks like at the end of that time and at who provides it.”
“This specific contract to provide that support is held with SPPG and my Department, and that is why I felt that it was within my gift to extend it for a year. That is the direction and the advice that I have been given by my officials. If the Member knows different, I will follow up with her later.”
“I thank the Member for that point, because that is crucial in regard to my announcement about extending the contract for a year. I want to see improved services and delivery, and my officials have been engaging with Nexus over the past few months to make sure that we close the gap between what we expect — what we are paying for — and what is being delivered. I have asked my officials to engage with Nexus to make sure that there is a regular monitoring update on how that new contract is being taken forward. Unfortunately, this may be the first time that Nexus has been made aware of this, because I wanted to give the House the opportunity to hear that through my answer to the question for urgent oral answer.”
“My officials have been engaging extensively with Nexus in the past few months, as we approached the end of the contract, to ensure that those who had already engaged with the service received the support that they need. The challenge was identifying who would take over and provide that support, because, as I said, this was not about funding; it was about ensuring that we had the appropriate support and mechanisms in place. The conversations between my Department, the strategic planning and performance group (SPPG) and Nexus have been looking towards how, in the last two years, we have addressed the underperformance that I spoke about in my initial answer.”
“That is the question that I have asked departmental officials. I asked how this was being managed in identifying alternative pathways to ensure that, come 1 April, no woman was left without a port of call and without that support mechanism. That is why I have taken the decision and directed that the contract be extended for one year, with the caveats that I outlined in my initial answer.”
“That was intended to ensure that anyone currently in receipt of counselling, or who has had an initial assessment, will receive an appropriate service from Nexus. However, that still left a potential gap in provision for new people coming forward for counselling, and I believe that the one-year extension that I have announced today addresses that concern.”
“<BR /> <BR />This one-year extension will allow proper consideration and a decision on and implementation of the best way forward for counselling services of this nature. I should also advise Members that the planned ending of this contract was not a cost-saving measure. The intention has always been to use the available funding to continue to support people who are victims and survivors of sexual abuse, in line with the draft domestic and sexual abuse strategy 2023-2030. <BR /> <BR />A priority had been to ensure that clients currently in receipt of counselling services would continue to receive them after April 2024, and my Department has been involved in detailed discussions with Nexus to make the necessary arrangements.”
“A number of options have been identified, including the provision of support from the community and voluntary sector, our health and social care trusts or primary care. However, having discussed the situation with officials, it is clear to me that further work is required on mapping out future sustainable arrangements. In that case, I have therefore instructed that the Nexus contract be extended for a further 12 months, with close monitoring of performance throughout that period. Whilst there may be some deep concerns about the broader delivery of the contract, equally, I am not prepared to tolerate a position in which, come April, new victims and survivors have no service at all.”
“I should clarify that those issues relate largely to efficiency and lower than expected numbers of sessions, rather than the quality of the counselling that is being provided. The areas of underperformance that were identified include the number of counselling services provided, with a projected 24% gap this year between the contracted sessions and the total delivered. To put that in perspective, on the current trajectory, that is over 4,000 fewer sessions being delivered than expected. Considering the need and demand for such services, that causes concern. <BR /> <BR />My Department has been examining potential alternative arrangements, following the conclusion of the Nexus contract.”
“I want to reassure Members of my recognition of the absolute importance of sufficient specialist counselling for victims of sexual abuse. I can advise the Assembly that Nexus was awarded a three-year contract in April 2019 to provide a specialist counselling service for victims of sexual abuse, with an option for two one-year extensions. The second of those extensions ceases on 31 March 2024. <BR /> <BR />My Department has been in communication with Nexus over many months in connection with the contract and has worked extensively with the organisation to improve waiting list times and the standard of service that is being delivered. Unfortunately, significant performance and operational issues have been identified in the delivery of that contract.”
“The Member will know that we have a highly dedicated and highly professional cohort of people working across health and social care, not just in our system but across GP surgeries, Community Pharmacy and domiciliary care. No matter where they are found, we should applaud and thank them for the work that they do, rather than coming to this place or to the media to deride some of the work that they do.”
“Since my return to office, I have engaged extensively with healthcare professionals across the system. One of the things that is giving healthcare staff a sense of improved morale — I will not say that it is high morale — is the fact that we are back in this place. That is because our health service staff value and recognise what this place can bring to them and their working conditions. That has been demonstrated by the fact that, once again, I was able to bring forward an offer for a pay resolution for Agenda for Change staff, which this place was unable to do. <BR /> <BR />Staff morale is not based solely on money, however; it is about the reward for the work that they do.”
“I thank the Member for his point about the validation of statistics in Northern Ireland. We take that very seriously in the Department. The Northern Ireland Statistics and Research Agency (NISRA) and the information and analysis directorate (IAD) advise on what we publish. The South Eastern Trust figures are delayed until we get them completely validated in what is a new system. I hope that Encompass produces a more streamlined, safer healthcare records system, because it is being brought forward at a significant cost to the Department of Health and Northern Ireland. I look forward to the information that is held on those computer systems leading to a more effective, safer healthcare system in Northern Ireland.”
“I certainly will. I think that I sent out a request this morning to meet the Member's party colleague about that, and I am sure that one of us will update him at the appropriate point.”
“I thank the Member for his question. I will take a point of clarity at any point, but I think that banning the sale of disposable vapes falls within the responsibility of his party colleague the Minister of Agriculture, Environment and Rural Affairs. I am working on legislation with my UK colleagues, however, and, this morning, I met the Secretary of State for Health, Victoria Atkins, to discuss Northern Ireland's place in the tobacco and vapes bill that will shortly go through Westminster in regard to how we look at the sale of tobacco products and the wider piece about vapes.”
“That was done under the auspices of the child protection senior officials group, which is a cross-departmental strategic forum that provides direction on existing or emerging child protection issues. My Department chairs that group. The wider point is about how we make sure that the information about direct routes of referral and support is communicated across the entirety of our service.”
“The Member raises something that has been in the media recently. To the Member and the House, I say this: any form of child abuse, including exploitation, is totally unacceptable and must be appropriately addressed. All children and young people in Northern Ireland are entitled to live in safety, to achieve their full potential and to have their rights respected. Prevention of and protection from abuse, including exploitation, is a complex matter, with many risk factors that require input from a range of statutory and non-statutory partners. I think that the Member's point is about making sure that everybody is aware. <BR /> <BR />In 2023, my Department, working jointly with the Department of Justice, led a two-year action plan to address child criminal exploitation in Northern Ireland.”
“I thank the Member for her question. I am due to meet Ray Jones next week to discuss his recommendations. If the Member has made herself aware of the review, she will realise that it is a detailed, in-depth piece of work. It was co-produced very astutely, with Mr Jones at the head. I was pleased to be asked to speak when the review was launched recently in the Stormont Hotel. I am due to meet Ray in the next week or so about the steps that we will take and in order to identify the more challenging pieces of work that have already been taken forward that sit within his recommendations that will require not only the support of the House but significant change in the Executive in regard to how we look at the wider children's social care piece.”
“Unfortunately, yes. A number of GP practices are in a similar position. As I said, my Department is working with our colleagues in GPNI and the British Medical Association committee on what can be done to stabilise those positions and look to the future of the GP contract. I want to ensure that our general medical services (GMS) contract is fit for future purpose and can better meet the changing environment and context of primary care. Discussions with the Northern Ireland general practitioners committee on the 2024-25 GMS contract and beyond are ongoing. My aim is that the negotiations promote stability in our general medical services.”
“I thank the Member for raising the issue of GP contracts. He will be aware that, unfortunately, the two practices that he mentioned are not isolated occurrences. I can say that, for all the contracts that have been handed back, we have not seen a practice having to close at any stage, because other options have been brought forward: other trusts' GPs have come forward to take on those contracts, trusts have taken them over or local GP federations have stepped in. There are a number of months to go on that position, and I ask the Member to reassure his constituents, as I do, and to work with my Department and the GP federations to identify and support any future provision and to give reassurance and stabilisation not just to the patients but to the people who work in those practices.”
“Of course. As the Member is supportive of me in this role with regard to what we can do, I am keen to meet him to discuss the issues he has raised.”
“I thank the Member for his question. He has raised the point with me, and I know that he has a strong interest in it. He rightly points out that the responsibility for implementing the Armed Forces Act 2021 and taking forward the New Decade, New Approach commitment to further legislation to incorporate the armed forces covenant lies with the First Minister and deputy First Minister. I would sincerely like to see progress in that regard, but I am unaware of the most recent instructions. After this session, I will ask my officials to engage with their counterparts in TEO to ascertain whether or when further direction or clarity will be forthcoming to my Department.”
“I thank the Member for her point. She has moved slightly away from medication into services. She will be aware that there is disparity among our trusts with regard to ADHD supports. That is especially the case now, as we are seeing increased presentation of adult ADHD. There is no commissioned service for that at this time, but my departmental officials are looking at that, at how we establish that pathway, having identified it, and at how we use the supports that we currently have for those who are presenting with ADHD.”
“The Member will be aware that supply disruptions of some attention deficit hyperactivity disorder treatments have been resolved, but my Department is aware of ongoing supply disruptions involving various strengths and preparations of other ADHD treatments across the UK. Those disruptions have been caused by a combination of manufacturing issues and increased global demand for those products. As the Department of Health and Social Care leads on the maintenance of medicine supply chains to the UK, my Department has been working closely with them, as well as with the other devolved Governments and the Medicines and Healthcare products Regulatory Agency (MHRA), to ensure that the impact of these shortages is mitigated and that patients continue to get the medical supplies that they need.”
“The Finance Minister has already indicated her direction of travel for the preparation of a Budget for next year. That will be done through one-to-one engagements with each Department's Minister about their core needs, not just for funding for the likes of our voluntary and community sector but about how we fund what we in Health want to do across the entirety of that sector. I will have those engagements and discussions with the Finance Minister about what our overall financial package looks like.”
“I do not think that it was fair that the Department of Health had its funding slashed so dramatically and that it may be under similar conditions in the forthcoming financial year. The measures that had to be taken in the absence of an Executive, a Minister and a recurrent Budget were drastic, and I hope that next year's Budget puts us in a better position.”
“The Member's question raises a very important point about where we move with the development of our women's health action plan as we take it to the next step of developing a strategy from the action plan. We announced the introduction of primary human papillomavirus (HPV) testing. When that is introduced, my hope is that, not only will it remove a significant part of the current backlog, it will speed up the ability to report on those slides and tests. Those steps are being taken to address the issue.”
“My Department continues to work closely with the Public Health Agency and the Southern Health and Social Care Trust to ensure that the review is progressed in a safe and timely manner. It is a complex review. Plans to increase the number of slides to be reviewed weekly are now well advanced, with the intention that the full review will be completed by early summer.”
“An additional 2,255 women with the overall review cohort have already attended for their next routine cervical smear test, which will remove the need for them to have their older slides reviewed, as their latest test will provide the most up-to-date and accurate assessment.”
“I thank the Member for his question. The ongoing cervical cytology review in the Southern Health and Social Care Trust involves up to 17,500 women. It contains two elements: a review of the cervical screening slides held by the trust for women who have had a smear test; and a call forward inviting women to have a new cervical smear test where a previous slide is no longer held or is no longer suitable for review. <BR /> <BR />As of 28 February, 2,564 slide reviews had been completed, and the trust has called forward 1,960 women to attend for a cervical smear test, of which 621 have attended to date.”
“Once we get over Wednesday, I hope to be able to engage further with the BMA's junior doctors committee, and I am always open to having that engagement.”
“I thank the Member for her question on safe staffing. It is legislation that I want to introduce. It is in my legislative programme for the coming year, if the Executive support it. I am committed to introducing such a Bill in this mandate, and work continues in partnership with key stakeholders to ensure that a consultation document to inform the development of safer and effective staffing legislation is ready for publication later this year. <BR /> <BR />I have said to the BMA and to junior doctors specifically that they can have the conversation with me about the additional things: their working conditions and how they are being treated and managed in their trusts. I am open to having those conversations.”
“I thank the Member for that. As I said, we have published updates, and I am committed to working with stakeholders from across the system on the strategy's continued implementation. I again caution, however, that my Department will require significant funding in order to do that. <BR /> <BR />It is encouraging to note that that strategic approach to workforce development has supported an additional 8,911 people — a 15·7% increase — in the whole-time equivalent staff employed directly by the health and social care sector in Northern Ireland between March 2018 and December 2023. That workforce strategy has therefore seen nearly 9,000 additional whole-time equivalent staff employed in our health and social care system.”
“I thank the Member for her comments, specifically on the workforce plan and the workforce strategy. She will be aware that my Department's ambition for developing our workforce is outlined in 'Health and Social Care Workforce Strategy 2026 — Delivering for our People'. <BR /> <BR />I was pleased that the strategy's second action plan, for the period 2022-23 to 2024-25 was published in June. It was developed following widespread engagement with stakeholders from across Health and Social Care. The implementation of that ambitious programme of work is ongoing and includes initiatives to enhance our attraction and retention of staff while removing barriers to recruitment. It also reduces agency spend and supports employers in the provision of staff health and well-being services.”
“I thank the Member. Following on from the discussion that we had when he raised the question for urgent oral answer, the 30% to 35% divergence is from where they would have been in 2008 had inflationary pay increases been enabled year-on-year. The Member will be aware that that was a national decision based on national funding. It should not be left solely to the Department of Health to sort out an issue that resulted from decisions on financing taken nationally at that time.”
“Despite that offer, junior doctors have indicated their intention to take strike action for 24 hours over 6 and 7 March. <BR /> <BR />My Department remains willing to engage with the BMA to discuss the way forward on outstanding issues. That includes a commitment to further engagement on pay, contract reform and non-pay issues relating to working conditions. Any pay discussions will, of course, be better informed when there is greater clarity with respect to the outcome of the current industrial action being taken by doctors in England.”
“<BR /> <BR />As for other medical professionals' pay, I have asked officials to move to immediately implement the Review Body on Doctors' and Dentists' Remuneration (DDRB) recommendations for 2023-24 pay for all doctors and dentists employed in health and social care. That represents a pay uplift of 6% for 2023-24 for all doctors, plus an additional £1,250 for doctors and dentists in training, known as junior doctors, and an additional 3% for new contract specialty and specialist (SAS) doctors. <BR /> <BR />For junior doctors, the DDRB recommends an average pay increase of 9·1% in 2023-24 and that those in their first year receive a 10·7% uplift. That offer should be viewed in the context of pay settlements across the wider Northern Ireland public sector.”
“I thank the Member for his question, which follows on from his question for urgent oral answer a couple of weeks ago. Pay negotiations with Agenda for Change trade unions completed on 22 February, and I wish to commend the constructive approach of trade union colleagues to negotiations. Under the proposed settlement, our health and social care Agenda for Change staff will receive a consolidated pay uplift of 5% and a non-consolidated pro rata payment of £1,505. <BR /> <BR />In addition, any remaining staff in band 1 and staff on the lower point of band 2 will have their pay increased to match the higher pay point of band 2. Those awards will be backdated to April 2023. Unions are now consulting their members, and I want to give them time and space for that to happen.”
“I thank the Member for the question. His party leader, the Justice Minister, and I have promoted the increased use of naloxone by not just my blue-light services — the Ambulance Service and the Fire and Rescue Service — but the PSNI and other community settings that have the appropriate support. <BR /> <BR />As regards an overdose prevention centre, the Member will be aware that drug consumption rooms or safe injecting facilities are not permitted under the UK-wide Misuse of Drugs Act 1971. The issue of criminal sanctions for those found in possession of drugs is governed by the Misuse of Drugs Act and remains a reserved matter. Pilots for overdose prevention facilities are being progressed in Glasgow and Dublin. I will give due consideration to the new interventions, as appropriate, within a wider legislative framework.”
“<BR /> <BR />There is a big piece of work to do on what both strategies not only intend but want to produce. They are both needed and will be supported by the funding allocation.”
“I know the Member well enough to accept what she says. I know about her engagement on the issue and her passion for and commitment to it. She knows me well enough as well to know what will happen when the money and funding come forward. Co-occurring mental health and addiction problems and dual-diagnosis problems were of such importance to me that they are both in the substance use strategy and the mental health strategy. They do not fit neatly in to either of those categories. There was always a concern that those people would get lost and fall between both strategies. To address the problem, it is about how we work not just in health but with our PSNI colleagues and the voluntary and community sector, which plays such a crucial role in supporting those people who present to EDs and helping them address the challenges that they face.”
“Therefore, it is critical that we reinforce linkages with the mental health strategy's early intervention and action plan, the development of that regional mental health crisis service and the development of the regional mental health service in order to devise better pathways and models for those who are in mental health crisis and who have co-occurring addiction problems.”
“The strategic planning and performance group and our Public Health Agency (PHA) are working in partnership to develop a regional mental health crisis service for Northern Ireland. <BR /> <BR />Dual-diagnosis services vary in how and where they are offered in trusts, with treatment and support being located in addiction services, early intervention support services or acute mental health services. Dual diagnosis or co-occurring mental health and addiction problems are a key priority in the substance use strategy and the mental health strategy.”
“I thank the Member for her question. Addressing the harm that is related to alcohol and other drugs is a key priority for my Department, which leads on the Northern Ireland Executive's 10-year substance use strategy entitled 'Preventing Harm, Empowering Recovery'. The strategy aims to directly prevent and reduce the harm that is related to substance use through a range of cross-departmental actions and support. We are seeing an increase in the complexity of cases that are in mental health and substance use services as well as in those that present to emergency departments. It is vital that there is no wrong door and that people get the right treatment at the right time, particularly when presenting in crisis. Implementing the new regional crisis service is a commitment in the mental health strategy 2021-2031.”
“<BR /> <BR />Specifically in regards to Ovarian Cancer Awareness Month, my Department will be supportive of any request that we receive to highlight what steps are being taken, how we make sure that people are aware of their symptoms and the potential identifiers, and the services and support that are available.”
“I thank the Member. The original question from Mrs Dodds referred to the cancer strategy. One of the strategy's first aims and enablers was about raising cancer awareness across all the different cancer sectors and subspecialties in order to make sure that people are aware of not just symptoms but treatment pathways. It is also about having that wider conversation about cancer across society, including among families, so that if people have troubling, niggling symptoms that they do not feel they should go to a doctor with, their family will encourage them to do that. That was the key enabler of the cancer strategy. As I said to the Member who asked the previous question, those rapid diagnosis centres are about how we could move that forward.”
“I thank the Member for an important question on how to take what we are doing now and future-proof and develop it. Those rapid diagnostic centres were established in four of the five trust areas so that a vague symptom pathway was available for patients with non-specific but worrying symptoms that may indicate cancer. There are now plans to make that service available across the entire region by the summer. Additionally, a project group has been established to consider new cancer pathways where the rapid diagnosis centre model could improve outcomes for patients.”
“I thank the Member for his supplementary question. One of his party colleagues has raised that directly with me. There has been a piece of work on the identification of pathways. That was to make sure that clear pathways were established in our system for everybody who received further notice about treatments and red flags, for example. The learning from the implementation and roll-out in the South Eastern Trust will be embedded as we go forward and, hopefully, see Encompass starting to be rolled out across the Belfast Trust in the summer.”