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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“Wales has not yet matched the 2023-24 recommendations of the DDRB, the national review pay body for doctors in Northern Ireland. While that situation may yet be updated, that is the current factual position. I am sure that Members will want to correct the record in that regard, because I know that a number of them mentioned Wales. <BR /> <BR />Let me assure the Assembly that, as far as I and my Department are concerned, my Department's negotiations with the BMA junior doctors committee have not closed down. The talks have not collapsed. Indeed, there are important issues of real substance to be progressed. Our doors remain open. I had a very open and amicable engagement with members of the junior doctors committee earlier today, and I reiterated that point to them. On taking up office, I met the BMA central committee on the matter.”
“However, I deeply regret the decision to strike again, because it will cause serious disruption to patient care at a time of already significant and prolonged stresses on the service. Therefore, I again question what the industrial action can hope to achieve in a Northern Ireland context. This is a national dispute that will only be resolved at a national level. For reasons that I will set out, it is beyond the Executive's remit and the resources that have been provided to us to provide a unilateral solution. <BR /> <BR />I begin by correcting a factual inaccuracy in today's motion, because, as things stand, no agreement has been reached in Wales on junior doctors' pay. Indeed, the 5% pay increase for 2023-24 that has been implemented in Wales was lower than the corresponding uplift in Northern Ireland.”
“Thank you very much, Madam Principal Deputy Speaker. I am grateful to the Alliance Party for bringing this issue to the Floor of the Assembly today, because I want to acknowledge the vital contribution of our junior doctors to the health service, their commitment and expertise and the long hours that their jobs have long involved. It has always been a tough and demanding job, and the current extreme pressures on our hospitals have, undoubtedly, significantly exacerbated that. <BR /> <BR />I fully understand the frustration behind the latest phase of industrial action, and I respect the mandate that the BMA junior doctors committee has received from its members.”
“Again, I thank the Member. As I said, we had no notification that the statement was being made; rightly, the Minister wanted the families to be the first to hear it. I understand that there is an early action for an interim payment of £210,000 to those who were infected with HIV and/or hepatitis C and are currently registered with the financial support schemes. The new compensation scheme that was recommended by Sir Brian in his second report will award compensation across five heads of loss: an injury impact award; a social impact award; an autonomy award; a care award; and a financial loss award. I am not aware of the exact details of delivery or whether there will be a right of appeal, but, as soon as I am, I will make sure that details are circulated to all Members.”
“Anyone who listened to Sir Brian's comments yesterday about where the failings were will know that the British Government did not act quickly enough on the heat treatment of blood products and did not pool plasma donations, rather than having a wider complement. I took from his report yesterday that there is a belief now that the supply of blood for our Blood Transfusion Service here in Northern Ireland is safe, particularly given the investment that we have made in it. I hope that no one takes it away from this that, in receiving a blood transfusion in Northern Ireland or having an operation, those risks remain. We have put quality standards in place for the treatment of blood that is donated prior to it being given in donations or transfusions to those who need it.”
“I do not say this lightly: we must make sure that we can provide reassurance to anyone who looks to the Government or the health service in Northern Ireland. Those people should be able to trust and believe in the advice, guidance and support that they are given.”
“I thank the Member for her point. Looking at a number of the inquiries that we have had, I think that that culture needs to be challenged. I refer to Sir Brian's comments yesterday. It was a very powerful experience to hear him go through his rationale and reasons and, especially, to hear him identify the people who have been failed by the system. He also said what Governments need to do, not just the Westminster Government but our Government in Northern Ireland. He talked about a duty of candour and how Governments should take on that duty of candour in how they address their culture. All the devolved Administrations and Westminster should look at that as we work our way through these recommendations.”
“As part of the support that has been provided by the Belfast Trust, through the specific contaminated blood unit, that has been asked about and explored. If there is a further need, I am open to it. I understand that that support is available currently. Given his comments, I will follow up with the Member on whether it needs to be expanded or looked at again.”
“The Member makes a valid point. I wish to use this question for urgent oral answer to urge people who think that they have been infected or affected to come forward to their GP or look for the additional support that is out there. The payments will be made to those who are already on our schemes. It is important that those who feel that they have been infected or affected also take the step of making themselves known to their GPs and coming forward through the health service.”
“The Member makes a valid point about those other inquiries and their recommendations. As I said in my answer to Mrs Dodds, there is a need for an overarching quality framework. I think that the Committee has scheduled — or it may have already received — a presentation on what that looks like. The Member will get the opportunity then to have a look at how we will bring all the recommendations together, rather than looking at individual recommendations from individual inquiries. Unfortunately, there is a commonality across many of the recommendations, so it makes sense that we bring those forward in a single set of actions.”
“When we met Minister Glen, at the start of this month, one of the commitments made was that there would be no postcode differential in how those who had been infected and affected would be treated or supported through the compensation package, because we believe — I believe — that they have already been failed by the state. To delay that because of where someone lives would be a further failure.”
“He did not give us any detail at that stage, so we were listening to the statement as he made it today. I hope that I will have received it in writing by the time I return from responding to this question for urgent oral answer. <BR /> <BR />I can reassure the Chair that we were able to process the previous payment of £100,000 through the Business Services Organisation (BSO), because there is a payment process there. I have already explored the situation. Once I have received that money from Westminster, we can, by direction, transfer it to BSO. We will make those payments in the same time frame as the rest of the UK.”
“I thank the Chair for her comments. I spoke with Nigel yesterday regarding the event. Simon's voice was used in some of the video evidence that was given to the inquiry and, yesterday, when the findings of the report were being presented. Northern Ireland has a number of advocates and champions for that group, but those two brothers have borne a heavy workload, along with many others, such as Conan McIlwrath and Paul from Londonderry, who have undertaken work on behalf of the group. Many, many others were involved, but I do not want to leave anyone out, so I will not name anyone else. <BR /> <BR />We were not given sight of the announcement on payments that was made today in Westminster. The representatives and I met Minister Glen, on 3 May this year, regarding what the compensation package might look like.”
“<BR /> <BR />It is also important to say that, before I left office when I was previously Health Minister, I had written to my counterparts in England, Scotland and Wales about bringing forward a duty of candour on a UK-wide basis to make sure that we were working to the same level and standards across all four health services. Sir Brian's recommendation, from yesterday, goes a step further regarding that duty of candour, because it includes government. The failings, especially around the infected blood, were shown to be from not just the health service but across government. Those wider failings were acknowledged yesterday in what was a very moving outworking, when Sir Brian presented his report, in Central Hall, to many, including people who had been infected, people who had been affected and people who had lost loved ones.”
“I thank the Member for that point. In the report that was published yesterday, Sir Brian included a wide-ranging recommendation that a statutory duty of candour be placed on government and Executives. There are other recommendations regarding the duty of candour, and, as the Member said, it has been referred to in other inquiry reports. The Member will be aware that we are looking at an overarching outcomes quality framework and how to bring together all the outstanding recommendations from all the inquiries — I think that I mentioned that when I was in front of the Committee. The recommendations from Sir Brian, yesterday, strengthen that position on where we want to go, as a Department, on making sure that we get this right.”
“I am, however, committed to working with my ministerial colleagues, on a four-nations basis as well as across the Northern Ireland Executive, to respond, because I do not doubt that the work of the inquiry and its recommendations will help to inform and shape the delivery of healthcare in Northern Ireland in the future.”
“The detailed recommendations of the final report are wide-ranging, cutting across a range of areas in my Department, including quality, safety, improvement and workforce policy, as well as the culture and working practices of the wider Executive, Civil Service and the health and social care system. Addressing the recommendations will require a collective effort and coordination of communications in collaboration with the infected and affected community. <BR /> <BR />I want to carefully consider the details in the report and its recommendations published yesterday. Therefore, I am not yet in a position to respond in detail.”
“Those victims are to be applauded for their courage and dignity in coming forward to tell their stories. It is with deep regret that we cannot undo the actions of the past. However, it is incumbent on those of us in government and in the health service to ensure that it never happens again. <BR /> <BR />I am grateful to Sir Brian Langstaff and his team for their thorough work to produce a comprehensive report, which was published in seven volumes that were released yesterday, comprising 2,500 pages and 12 recommendations, including 50 individual recommendations.”
“The health service's use of contaminated blood in the 1970s and 1980s resulted in untold suffering and loss, and I reiterate my Department's apology and my apology to all those in the infected and/or affected community in Northern Ireland. They were failed by the system that should have been there to help them. For that, I am deeply sorry. <BR /> <BR />While I welcome the publication of the final report from the infected blood inquiry, I also recognise that it is a poignant time for so many. The publication of the final report will be a watershed for victims, many of whom have given evidence to the inquiry. It will, no doubt, have been a traumatic experience, opening up old wounds and bringing back painful memories that they would prefer to forget.”
“Principal Deputy Speaker, with your indulgence, I have a substantial answer to the Member's question because I had hoped to bring a fuller statement to the Assembly to follow up on the announcement on compensation, which was made just a few hours ago. <BR /> <BR />Supporting victims of contaminated blood has always been one of my top priorities since first becoming Health Minister in 2020. I have met, on many occasions, those from that community, and I am aware of the life-changing impacts and financial hardship that people have endured as a result of receiving a devastating diagnosis following treatment with contaminated blood used by the NHS. The anguish and trauma that they have endured over many decades is inconceivable.”
“He can be assured that I continue to raise my concerns with Executive colleagues about what I see as a financial shortfall in the allocation provided to the Department of Health as we go into the Budget process next week.”
“I thank the Member for his question. He may be aware that, when I was in Westminster yesterday, I engaged, as I have said on a number of occasions, with Ministers from the Department of Health and Social Care and with the shadow Secretary of State for Health and Social Care, Wes Streeting. I highlighted the concerns and pressures that we face in the Department of Health in Northern Ireland, especially with the budgetary process.”
“I will follow up on the Member's question for priority written answer, because I am sure that it has been asked not for any headline-grabbing opportunity but owing to a real concern that has been raised with him. I assure the House and the Member that I will follow up on that.”
“I thank the Member for his detailed question about risdiplam. I will need to get back to him in writing about that, because I do not have information in front of me about that specific medication. I hope that the Member accepts that. I will revert to him in writing. Does he have a supplementary question in which he wants to expand on his initial question?”
“One such workshop is planned for this year. I hope, however, that the Member has raised those concerns directly with the practices rather than coming here to air them initially.”
“I say to the Member that, if she has a direct complaint to make against Priory and Springhill surgeries, I will provide her with details of where she can make a complaint. She will be aware that the contract held by those practices is the initial route of access. <BR /> <BR />My Department has established a GP access working group to explore issues relating to access to services and to oversee work to improve patients' experience. The group's membership includes representatives from general practice and service users. Work is ongoing to develop guidance for practices on managing patient demand and optimising workflow to maximise efficiency. The group is also considering how technology can be and is being utilised to help develop improvements to the process of accessing services for patients and practices alike.”
“I thank the Member for her question. I will cover more than just North Down, if I may. At the start of questions for oral answer, I provided answers that were about the work that we have done on the GMS contract and being able to repurpose £5 million of that for the indemnity that GPs have accessed; for the move away from the QOF to the quality assurance and improvement framework (QAIF), which should free up more time; and for the further investment that I and, I think, all of us want in our multidisciplinary teams, which should see access to primary care move more quickly. It is about long-term investment, however, rather than a quick fix.”
“The national patient safety alert was issued by the Department and was reflective of messaging that was agreed across the United Kingdom. Supply disruptions were initially expected to be resolved at various stages last year, but there have been ongoing challenges with certain prescriptions and medications. We are hopeful that those disruptions will work their way through the system between May and September. Unfortunately, there are challenges with supply chains not just in Northern Ireland but across the United Kingdom and globally.”
“I thank the Member. This issue was raised in the media last week, and it received some coverage at that point. The direct communication comes from the medical professional who has prescribed the medication, rather than my Department. We do not hold that level of detail on who the patients are.”
“During the period of supply disruption of medicines and treatments, communications were issued to healthcare professionals across Health and Social Care settings that provided advice on the appropriate actions to take to manage patients affected by the disruption. It is anticipated that issues currently affecting ADHD treatment will be resolved at various dates between this month and September.”
“I thank the Member for her point. Whilst supply disruptions of some ADHD treatments have now been resolved, my Department is, like her, aware of ongoing supply disruptions that involve various strengths and preparations of other ADHD treatments across the UK, caused by a combination of manufacturing issues and the increase in global demand for such products. As the Department of Health and Social Care (DHSC) leads on the maintenance of medicine supply chains to the UK, my Department has been working closely with it, other devolved Governments and the MHRA to ensure that the impacts of the shortages are mitigated and that patients continue to get the medical supplies that they need. Nationally and locally tried-and-tested mitigations are in place to deal with medicine shortages.”
“I have engaged with the Education Minister about that final point. It is about how we make sure that those allied health professionals, who have the best skills, are there to support our young people as they go through education. I do not think that I am breaking confidentiality by saying that, through the transformation funding available from the Executive and the financial package, there is a joint ask from my Department, Education and Justice to allow us to increase the number of training places for speech and language therapists. We realise that there is a deficit in that support across education and early years provision. We need to support that as well. There is cross-working and cross-determination to make sure that we meet the needs of our young people by supporting the allied health professionals to whom they need access.”
“We have had engagement and joint working across the Department of Health and the Department of Education on how to support children and to make sure that the child is at the centre of that support. I would be keen for the Member to raise any specifics about a case or example. I would be happy to engage with the Member about that or to follow up a supplementary question.”
“I am keen to explore it, but I am far more open to increasing our social work training places here at home rather than having the unfortunate situation where people have to study social work across the water with the potential for coming back here.”
“The Member identifies and is fully cognisant of the pressures on our social care workforce. I have a bid going into the transformation programme that sits with the Executive with regard to additional places for MDTs. That is for another 40 social work training places in Northern Ireland. I would like to make sure that we get that support from the Executive but also that we have the financial package to support the students during their studies. <BR />My concern — I think that the Member will realise that it is a genuine concern — would be that, if we extended that provision to social work students, there could then be a duty to extend financial support to any student who went to study across the water. I will not rule it out.”
“It has been looked at. The issue of the bursaries and supports that we provide for students who study in Northern Ireland has been raised before. Unfortunately and not just because of financial restraints, any Northern Ireland student who decides to study outside Northern Ireland is not able to access those. That is something that I would like to be able look at, but, again, it is about investing in the workforce and students who are here under our current remits.”
“Absolutely. I had a good conversation with our junior doctor committee this morning. It was about recognition: I recognise the strains and stresses that they are under and the remit that they have to seek further pay settlements with regard to industrial action. However, they acknowledged the challenging position that I am in with the budget allocation that I have. While we continue to talk and negotiate, we continue to engage at all levels. The issue is the subject of a debate that will take place later this afternoon.”
“I am concerned about how I will be able to honour further pay recommendations that may be made this year by the Review Body on Doctors' and Dentists' Remuneration (DDRB) but also Agenda for Change.”
“I thank the Member for his point. I believe that my Department has done everything that it can within the limits that we are under. I met junior doctors this morning and made it clear, with regard to the challenge of them coming forward with additional pay asks, that I do not have the financial capability to meet them. The Member should look at the concerns that the Fiscal Council raised in its recent report about the potential for further industrial action because most of the additional moneys that were provided to the Executive in February for restoration went towards pay commitments that had been made for 2023-24. I was straight with the junior doctors this morning, as I am with the House, in saying that I do not have the financial capability or flexibility to provide additional moneys.”
“<BR /> <BR />On the financial outlook, I have engaged a Getting It Right First Time (GIRFT) report and brought in professionals from England to look at our back office and management spending across trusts. They are in place. Our trusts have been asked to look at the impact that their budget allocation will have — which procedures will they have to cease? — and to come forward with that information by the end of this month.”
“I can absolutely assure the Member that I have done so. As I said in an earlier answer to Mrs Dodds, I have an updated assessment of where we are on the elective care framework. I first published that framework in June 2021, and, with an ambitious investment of £570 million, it would have tackled waiting lists over a five-year period. Unfortunately, that finance was not there in the two years that the Assembly did not sit, and, at this minute in time, no additional moneys are earmarked for that in this financial year. We have continued to work on where we are with the elective care framework, looking at our day-case procedure units, our overnight elective care centres, our rapid diagnostic centres and our post-anaesthetic care unit beds to determine how we utilise the resource that we have in making further use of that estate.”
“They are working their way across my desk. The Member will be aware that I have not accepted the Budget allocation that I was given because, although it is over 50%, it is a decrease of 2·3% on what we finished last year at when it is compared with where we were financially, including the allocation for pay increases and pressures. That work is being done. It has needed a recalibration, given what we as a Department were expecting in financial support against what we have received.”
“I thank the Member for that point. My officials recently advised the Health Committee that these are the figures from the work on the original bid that we made. That bid included funding for 6,000 patients waiting over four years for a dermatology outpatient assessment; 4,400 patients waiting for knee and hip replacements and other orthopaedic procedures; 4,200 patients waiting over three years for gynaecology outpatient assessments; 1,100 patients, many of whom are children, waiting over four years for tonsillectomies; 2,800 patients waiting for cataract procedures; and 2,100 patients waiting over three years for a rheumatology outpatient assessment. Twenty thousand patients could have been seen at mega clinics across a number of specialities. That is a snapshot, and many more patients could have been seen for other procedures.”
“<BR /> <BR />This is a missed opportunity to improve waiting lists, where significant progress could have been made. No additional funding for tackling our waiting lists has been provided by the Executive. Had I been allocated the funding that I bid for, there would have been an initial focus on the people waiting for more than three years. Over 28,000 patients waiting more than three years for treatment would have been treated, and over 57,000 patients waiting for more than three years for a first outpatient appointment would have had an appointment. Instead, unfortunately, our waiting lists will continue to grow, which stands in stark contrast to other supposed commitments that tacking them would be a priority.”
“Madam Principal Deputy Speaker, with your permission, I will take questions 6 and 13 together. <BR /> <BR />The £34 million that has been earmarked for waiting lists, which comes directly from the UK Government and has been long announced, does not cover even half of what is required to maintain the number of red-flag cancer patients and time-critical patients. My officials are working with trusts to examine whether it is possible to displace other hospital services to fund the remaining investment needed. That in itself will cause significant damage and disruption to our services. If we are unable to do so fully, that will lead to longer waiting times and reduce the care available to red-flag and time-critical patients, which would be deplorable.”
“It is an example of the commitment that I and my Department have to general practice.”
“I think that the Member is referring to the state-backed indemnity scheme that was initiated in GB. We were not able to replicate that directly in Northern Ireland, but, if we want to move to the enhanced package, which could be an indemnity scheme, I believe that our GPs can join that state-backed scheme. It supports GPs across England and Wales. As I said in a previous debate, I met Andrea Leadsom, the Minister responsible for primary care, yesterday, and I raised with her my belief that Northern Ireland GPs should be able to access the state-backed indemnity scheme. We will see how that moves forward and what the next steps will be. The £5 million that we have put into indemnity payments for GPs represents the first time that that has been done in Northern Ireland on that scale.”
“The Member makes a valid point that is often raised here, which is that no part of our health and social care service works in isolation. It is about how all the parts come together to work. I recently announced an overarching framework, agreed between Community Pharmacy Northern Ireland and my Department, for how we can look to expand the services that can be provided in community pharmacy. There is a financial ask along with that that I am unable to meet at this minute in time, but I have always recognised how, even in some of the most challenging times during the pandemic, we were able to utilise and leverage the skill set and professionalism in community pharmacy to support primary care. We should not see primary care as being just GPs but take a more holistic approach across Northern Ireland.”
“The Member's question was about indemnity costs for GP services. As I said in my answer to question 1 on the revision of the GMS contract, as a result of those actions, an additional £38·9 million will be made available for repurposing, £5 million of which went to indemnity. The remaining £33·9 million has been added to core global sum payments made to practices. Funding will go towards investing in multidisciplinary teams and the ask from GPs about supporting indemnity. There is also the matter of replacing QOF in the contract assurance framework. That will now remove a lot of the administrative burden that GPs raised concerns about. We can move that forward so that they can progress. They were raising concerns that they were spending more time on administration, and this will enable them to have more time to see patients.”
“I believe that, as an Assembly, we need to work together to ensure that we get the funding that we need for Health and Social Care so that we can ensure the long-term sustainability of provision for those whom we serve.”