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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“In the context of a very disappointing Budget settlement for my Department, I believe that that ring-fenced allocation will make an important contribution towards supporting GPs with their clinical negligence indemnity costs. <BR /> <BR />It is important to be aware that the issues impacting on the sustainability of general practice are much broader than simply indemnity provision. We need to acknowledge that general practice faces a range of issues that are complex and will require a sustained long-term response. The provision of support for indemnity costs as part of the 2024-25 general medical services contract is just one of a range of measures that are being implemented to secure the ongoing sustainability of general practice locally.”
“As I said earlier, I was pleased to recently give my approval to the 2024-25 general medical services contract, because I believe that the contract is an important step towards achieving greater stability across general practice. It makes significant progress, including the provision of dedicated funding for indemnity costs. <BR /> <BR />A key aim of the new contract arrangements is to provide GPs with greater certainty about their income throughout the year. The specific provision of £5 million of funding towards indemnity costs is part of the overall basket of measures designed to support the ongoing sustainability of primary care.”
“I am not sure that in all cases those additional payments are considered as a poor alternative. Some families value those payments and make full use of them. If the Member has specific concerns about anyone who is receiving those direct payments, I am happy to engage further with her in that area. As I said in previous answers, we are seeing a mismatch in demand as well as the increasing complexity of cases. Prior to the Member making it, I have not heard a call, nor have I been asked, to initiate an independent review of those payment processes, but I will take that under consideration.”
“Rather than the establishment of a larger regional facility to look after the more complex cases, I would prefer to have more localised facilities, so that families can remain closely in contact with those who are seeking respite and not have to travel further distances. I would rather that we were able to invest in, repurpose and upgrade some of the facilities that we currently have and to add capacity to them, instead of bearing the additional cost of rebuilding a regional facility. <BR /> <BR />I take the Member's word in relation to the facility that he mentioned at the start of his question.”
“I thank the Member. I do not know directly the facilities that he speaks of, but I can be assured that, if the Member is praising them, they and the service that they provide are worthy of praise.”
“The children with disabilities framework is also being finalised by my Department in response to the increasing challenges that are faced by families of children with disabilities and the corresponding difficulties experienced by trusts in meeting the rising demand and the increased complexity of need.”
“As I said, we are seeing pressures in respite provision because we have a reduced number of facilities and staff and a higher level of acuity and more intense cases. I have not seen the message from the individual to whom the Member refers, but we recognise that there is more to be done. I am challenging our trusts on the provision across all areas so that we can improve not just long-term respite facilities but short-break provision. <BR /> <BR />To gain a better understanding of that provision across the region, as I said, my Department has developed a monitoring framework to capture monthly data.”
“Further to that, the Department has established a children's services reform process to reform our children's services while we look at where additional facilities and provision can be made. As I said in my initial answer, we are seeing increased demand and pressure in that area and increased acuity among the young people whom we support. We are trying to fit the facilities that we have, supported by the staff that we have at this time, to the young people affected to meet their higher needs. It is unfortunate that other parents and families are losing out on respite services, and I do not want to see that continuing.”
“The Member raises a point about the repurposing of a number of our facilities to look after young people who need more-intense, long-term care. I recognise that having a reduced number of facilities and a reduced workforce has meant that our ability to provide placements for those young people was actually an ask for political representatives from the area. There has been that displacement, unfortunately, while we build up our capacity elsewhere. <BR /> <BR />With regard to planning for the future, I initiated a task and finish group, which has been established by my Department, to finalise the adult learning disability services model and the children with disabilities framework.”
“My departmental officials continue to work with the Northern Ireland Children's Hospice to plan for a more sustainable future, because it is acknowledged that regional availability of respite for young people with a disability is a pressure across our trusts. There has been a reported increase in the number of children and young people with a disability and an increase in the demand for access to short breaks and respite services. My Department continues to work with each of the trusts to closely monitor regional service provision for young people and adults.”
“<BR /> <BR />Short-break provision in Northern Ireland for young people with complex needs and severe learning difficulties who are being cared for at home may comprise overnight periods of care in a short-break residential unit; day or overnight periods of care with an approved carer; support or care services provided to the young person in their home that enables the family to do other tasks; befriending services; community activities; and day trips. <BR /> <BR />Short breaks and respite services are also provided across the five trusts by the Northern Ireland Children's Hospice for all children with a life-limiting condition.”
“I thank the Member for his question. Short-break, or respite, care provides valuable opportunities for children and young people with complex needs to spend time away from their parents and primary carers, while also allowing parents and primary carers to have a break from their caring responsibilities. <BR /> <BR />Across Northern Ireland, respite care for young people with complex needs and severe learning difficulties is delivered by the five health and social care trusts in partnership with the community and voluntary sector (CVS). Access to, and the frequency of, short breaks is dependent on individually assessed need.”
“That would be for the trust to answer. If the Member wants to write to me about a specific case, I will follow up on it. Waiting list initiatives are using private resource to support the core health and social care services that we deliver. The Member asked about the number of hernia operations performed in the Northern Trust. We used waiting list initiative money to engage with the private care sector to provide that specific support and do that work. The Member may wish to contact me about a specific case.”
“In my previous request for funding in the recent Budget exercise to deliver additional waiting list initiatives, it had been my Department's intention to target £4 million this year at supporting approximately 800 hernia patients who have been waiting for the longest period. Unfortunately, the Budget allocation provided no targeted resource.”
“I thank the Member for his question. The various waiting times for hernia repair operations depend on several factors. Those include the type of hernia that patients may have and the severity of their condition, as well as their personal circumstances. <BR /> <BR />My officials have been advised that 576 hernia repair operations were carried out in the Northern Health and Social Care Trust in the past 12 months. Given the reduced waiting list initiative funding that has been allocated in quarter 1, trusts have had to prioritise that funding for red-flag and absolute-time-critical patients.”
“I am sure that the Member will appreciate that, for such a specific question, I do not have that level of detail in front of me, but I will get it to her in writing.”
“I thank the Member for his question. I cannot speak on behalf of other Ministers and parties, but I can assure him that my party and I are absolutely prioritising health, as he would expect. <BR /> <BR />On investment in MDTs in the further roll-out, he will not be aware, but I will inform the House, that I have put in a bid for money from the transformation pot so that we can recruit further health and social care staff, because, as we heard in the debate in the House last week, MDTs were originally included in the transformation funding. Unfortunately, owing to re-profiling, it now forms part of my Department's baseline figure. There is a commitment that we maintain the MDT model and also that we invest not only in staff but in finance to ensure that we can roll it out across Northern Ireland.”
“<BR /> <BR />While recognising demand for an increase in the level of funding allocated to general practice and social care, my Department also recognises the necessity of viewing the health and social care system as a whole. Any decision to redirect money from one part of the system to another part results in those pressures. I assure Members that my Department recognises the pivotal role that general practice plays in our health and social care system and continuity in the provision of healthcare that they provide as that first point of contact.”
“We fully recognise that the majority of those initial assessments are done at primary care level. The 5·4% represents a figure of £375 million which was quoted in the report for investment in primary care. It is not fully comprehensive, as it focuses on the elements of funding that are allocated directly to GP practices and federations. It does not include elements of spend that are allocated to other health and social care bodies. That includes trusts that are invested in primary care and a significant proportion of spend in our primary care MDT model, as well as investment in the primary care elective programme and work on No More Silos. Investment in the general practice pharmacy scheme is also captured in that money.”
“The Member makes a vital point with regard to how I would like to increase those multidisciplinary team (MDT) programmes. Over the past number of years, my Department has made significant additional investment to build capacity in primary care through initiatives such as the primary care MDT model and our general practice pharmacist programme. Those programmes represent recurrent additional investment. We also previously made available significant funding to enable GPs to improve their telephone systems and accessibility. Work is ongoing with regard to how we support the wider multidisciplinary teams but also invest in general practice.”
“As a result of those actions, a total of £38·9 million will be made available for repurposing. Of that, £5 million will be dedicated to GP indemnity as an interim measure, pending identification of the long-term model for future provision.”
“I have already indicated that, as Minister, one of my immediate priority areas, subject to available resources, is enhancing primary care. I was pleased to announce recently that the 2024-25 general medical services (GMS) contract has been agreed. A key aim of the new contract is to provide GPs with greater certainty over their income throughout the year, as well as reducing the administrative burdens and associated costs to practices. To support that, the 2024-25 contract brings the quality and outcomes framework (QOF) and specified enhanced services into the core contract and under the clinical care domain of a new contract assurance framework. The associated funding is incorporated into the core contract. In addition, funding that is provided for clinical waste will also be repurposed into core GMS funding.”
“<BR /> <BR />In 2006, we introduced legislation banning smoking in indoor public places and workplaces. At the time, such legislation was not without its challenges, but it is now heralded as being one of the most important pieces of public health legislation of our time. The Bill offers us a similar opportunity to take bold action to protect our children and grandchildren from the misery that tobacco use brings and to protect them from new forms of nicotine addiction. <BR /> <BR />I thank my officials for their work on the LCM and also for their engagement during the lack of a functioning Assembly. I thank Members for their acknowledgement of that work. I commend the motion to the House.”
“Council enforcement officers are represented on the tobacco strategy steering group, and we are aware of their support for the measures. Detailed discussions on enforcement will be arranged with them in the coming weeks. We are confident, however, that we can work together to ensure effective and efficient enforcement. <BR /> <BR />I have covered most of the specific concerns that Members raised. We know that countries around the world are considering ways in which to address further the harms of tobacco use and the growing use of vapes among young people. It is critical that Northern Ireland not be left behind on such significant public health initiatives. As Members will be aware, a key element of the reform of our health service is enabling people to stay well for longer. The Bill offers a huge opportunity to do just that.”
“I sincerely hope, for the sake of public health but also because of the Member's concerns, that it does not become an issue as a result of the Windsor framework and the protocol. <BR /> <BR />I will move on to the issue that Nuala McAllister raised about enforcement. As we know, age-of-sale restrictions already exist in Northern Ireland, and enforcement of them falls to our councils. The Department actively engages via the PHA and funds tobacco control officers to carry out test purchasing activity and to engage with retailers to support compliance with tobacco legislation. We envisage those arrangements continuing. We will engage again with councils in the coming weeks to seek their views on any additional operational challenges from the new regime.”
“It does concern me, as the Member knows, and that is why I raised that specific issue when I met Minister Leadsom yesterday. Our understanding, however, is that it is for the UK Government to ensure that Northern Ireland complies with the Windsor framework. Since this is a UK Government Bill, it will ultimately be for the UK Government to determine whether there are any barriers to our inclusion and to deal with any challenges in relation to that. I emphasise that we have been assured by the UK Government that no such barriers exist, but I recognise the Member's concerns and the position that he holds. I thank him for his support for the intent and the content of the LCM.”
“I specifically raised that with Minister Leadsom yesterday, and she provided me with the reassurance that the work of her and my departmental officials and the legal advice that she has received indicates that that will not be an impediment.”
“but the tobacco products directive is concerned with the manufacture, presentation and sale of tobacco and nicotine-containing products. It includes restrictions such as limitations on the nicotine content of e-cigarettes, requirements for the manufacturers to report on ingredients in tobacco products and e-cigarettes, and a requirement for the provision of information to customers, including health warnings on packaging. Potential EU barriers were considered, in conjunction with the UK Government, during the development of the Tobacco and Vapes Bill. We remain unaware of any barriers presented by the Windsor framework to the measures set out in the Bill being applied in Northern Ireland.”
“As I said in my opening comments, I believe that there is a practical benefit to retaining as much consistency as possible in product rules, as a single regulation regime across the UK helps to ensure a coherent and operable enforcement regime in relation to those products. <BR /> <BR />Something was raised by Mrs Dodds, Mr Chambers and Mr Allister, whom I thank for his support and for rightly using his political mandate to raise his concerns in relation to the outworkings of the Bill. He referred to the EU tobacco products directive, which is listed under annex 2 of the Northern Ireland protocol. Article 5(4) of the protocol states:”
“<BR /> <BR />Our CMO has been clear that e-cigarettes should only ever be used as a short-term measure, and only to assist smokers who choose to use them in their efforts to quit, recognising that other licensed and effective quality-controlled nicotine replacement products are available, free of charge, through the Northern Ireland smoking cessation services, so it is not always necessary to resort to vapes for that purpose. <BR /> <BR />Mrs Dodds spoke about the powers of the Secretary of State. There are provisions relating to vape and nicotine product standards that mirror the existing provisions in relation to tobacco that are set out in the Westminster Children and Families Act 2014. Those provisions allow for UK-wide regulations, with the consent, again, of devolved Administrations.”
“The Member raised that in her contribution. I will come to that. <BR /> <BR />Working through the debate, I think that Mr McGrath mentioned cessation services. The tobacco strategy that has been talked about — the Committee Chair talked about it — is supported by the comprehensive action plan, which includes educational initiatives in schools. There is also, however, a stop smoking and vaping pilot service in schools in the south eastern area. The PHA is exploring models for supporting smoking cessation in disadvantaged communities, and there is continued investment in smoking cessation services. There is also an intention to further develop hospital inpatient smoking cessation support services.”
“While retailers may need to ID the cohort of smokers that are close to the legal-age boundary, it is expected that the number of smokers below the legal age of sale will continue to decline as a result of the legislation.”
“She may not be aware of this, but, yesterday, I met Minister Andrea Leadsom, the sponsoring Minister for the Bill. She indicated that she will meet the DUP Westminster team later today to work through some of the issues that the Member raised. I look forward to the positive outworkings of that. <BR /> <BR />Mrs Dodds, along with other Members, raised the suggestion that retailers will be burdened with having to regularly distinguish between 39- and 40-year-olds when dealing with identification. That point does not take account of the already declining smoking rates among young people, which we hope, when combined with the Bill's measures, will result in a further decline in smoking prevalence among young people.”
“Part 5 of the Bill provides the Secretary of State with UK-wide regulation-making powers on the potential extension of e-cigarette notifications, which would also have to be brought before the Assembly. <BR /> <BR />Mrs Dodds also mentioned the visit of Cathy Brokenshire, which was timely. Many in the House had great respect for James Brokenshire when he was Secretary of State for Northern Ireland. I thank Dame Arlene Foster for setting up the visit. Not only did Arlene and Cathy engage with party representatives but they met my Chief Medical Officer and deputy Chief Medical Officer on this issue. I look forward to further publicity and awareness events later in the year. I thank the Member for raising that. <BR /> <BR />She also mentioned that the legislation will move through the House of Commons and the House of Lords.”
“Therefore, additional work is being done in that area. <BR /> <BR />Mrs Dodds raised an issue about ensuring that the legislation was fair, deliverable and workable in bringing forward the regulations. I can confirm the powers that the Bill will introduce. It will provide powers to introduce a ban on the free distribution of nicotine products. Those powers will sit with my Department but will be subject to the draft affirmative procedure. The powers to regulate retail displays of nicotine products and non-nicotine vapes will also sit with my Department and will be subject to the draft affirmative procedure. When it comes to product standards and issues relating to e-cigarettes and nicotine products, the Secretary of State will bring forward UK-wide regulations, but that will be done with the consent of devolved Governments.”
“When the smoking age was increased from 16 to 18, the number of illicit cigarettes consumed fell by 25% and the smoking rates among 16- and 17-year-olds dropped by almost a third. <BR /> <BR />Mr McGrath and Mr Durkan raised the issue of how shopkeepers and retailers will have to deal with the outworkings of the Bill. Members will be aware that assaulting a shopworker will be made a separate offence in England and Wales as part of a Government response to a wave of retail crime. Our Justice Minister has indicated that assaulting a retail worker can already be prosecuted under existing laws here that are designed to protect any member of the public from harm. She indicated, however, that she will give further consideration to including protections for those workers in the proposed sentencing Bill.”
“The Chair also mentioned that the tobacco industry has lobbied intensively against a number of progressive tobacco-control measures by raising fears of the black market and criminal activity, to which the Institute of Public Health referred in its recent report for the Health Committee. Evaluations of the impact of those measures, however, repeatedly conclude that they do not contribute to increased rates of out-of-country purchases of illicit tobacco or cross-border purchases of tobacco and tobacco products. <BR /> <BR />We are aware of the continued threat of illicit tobacco and the potential for it to dilute the effectiveness of legislative measures, but it is addiction to nicotine that drives the demand for illicit tobacco and vapes. With reduced addiction, we expect reduced demand.”
“Beyond the age of 21, therefore, the chances of becoming a regular smoker are significantly reduced, but a smoke-free generation approach is expected to continue to provide beneficial reductions in smoking initiation.”
“Further engagement involved policy colleagues from England, Scotland, Wales and Northern Ireland. <BR /> <BR />Stephen Donnelly, the Minister for Health, and Colm Burke, Minister of State with responsibility for Public Health, Wellbeing and the National Drugs Strategy, announced on 14 May that the Irish Cabinet had approved a proposal for legislation that would increase the age of sale of tobacco to 21. We are aware that the adoption of Tobacco 21 in the Republic of Ireland will create cross-border divergence. In time, however, it will still mean that no one on the island under the age of 21 will be able legally to buy cigarettes. Tobacco 21 and the smoke-free generation measures aim to achieve the same end, acting on the same population group over the same period.”
“As I said in my opening comments — this was reinforced by the Chair of the Committee — we will engage further with the Youth Assembly on these issues as our regulations are developed. <BR /> <BR />I turn now to the specific issues raised. The Chair of the Committee raised the issue of engagement with the Republic of Ireland. I think that Mr Allister touched on that as well. There are regular informal meetings between tobacco control officials in my Department and their equivalents in the Irish Republic. There have been regular updates on those developments, including on consultations in the United Kingdom and the Republic of Ireland on smoking and vaping. There have been discussions with the Chief Medical Officer in the Republic of Ireland and direct engagements with the policy team there.”
“I thank all Members who contributed to the debate. I thank those who said that they will support the LCM. I am not sure of Mr Carroll's position. He raised questions, but I do not think that he indicated whether he supports the LCM. <BR /> <BR />I thank the Committee for its timely engagement on the LCM with officials and the Youth Assembly. That has proven to be helpful. Like others, I extend my thanks to the Youth Assembly for its extremely helpful contribution to this discussion. It is clear from that engagement that vaping is a key concern for young people. I am pleased that most Youth Assembly members were supportive of the Bill's proposals in that regard.”
“<BR /> <BR />I have received correspondence from Members, councillors and parents seeking additional measures to set smoke-free targets and to allow us to tackle the problems of youth vaping. While we have made good progress in reducing youth smoking rates in Northern Ireland, there is no room for complacency. Every year, approximately 127,000 new smokers are recruited across the United Kingdom. The UK Government Bill offers us a key opportunity to address the issues and to address them quickly. I ask Members to support the motion.”
“We will, of course, engage with enforcement authorities and the Public Health Agency (PHA) on those matters. <BR /> <BR />Regarding human rights and an equality impact assessment (EQIA), the Department of Health and Social Care in England has confirmed that the Bill is compatible with the convention of rights. The UK screening exercise concluded that there is no evidence to suggest that a smoke-free generation policy will have a significant negative impact on people who live in rural areas or those with protected characteristics. In recognition of our local equality obligations, my Department has also completed screening exercises that will be published shortly and which have reached the same conclusions.”
“However, on a whole-economy basis, those are outweighed by the social benefits. The UK Government have published a UK-wide impact assessment, and the net present value for the Bill is estimated at £18·6 billion over 30 years. In other words, there will be a net benefit of £18·6 billion over the next 30 years to the UK economy, and that takes account of the healthcare and societal costs associated with smoking tobacco. Secondary legislation relating to vapes would be subject to further detailed impact assessments. <BR /> <BR />Members may want to note that further restrictions on tobacco and e-cigarettes may come with some additional enforcement and communication costs. However, several of the measures are not new. For example, enforcement measures are already in place on the age of sale for tobacco and nicotine vapes.”
“The UK Government Command Paper relating to these proposals also includes the fact that there are high health risks associated with the other ingredients in vapes. The long-term health harms of inhaling colours and flavours are yet unknown, but they are certainly unlikely to be beneficial. <BR /> <BR />In addition, there are growing concerns about the social and educational harms of vaping, with increasing numbers of post-primary schoolchildren at risk of disciplinary action, including suspensions, as schools attempt to deal with the number of children vaping on school premises. <BR /> <BR />I turn now to the regulatory impact assessments that have been carried out. The smoke-free generation measures will result in some cost to retailers in lost profits, training costs and additionality.”
“The Institute of Public Health in Ireland took forward a rapid review of evidence on behalf of its Department and found strong, high-quality evidence of an association between e-cigarette use and subsequent tobacco cigarette use based on longitudinal data. The reviews included found that those who had used e-cigarettes in their lifetime had over three times the risk of tobacco cigarette use at follow-up. Those results support a conclusion that there is a gateway effect of those products. That substantiates my view and that of our Chief Medical Officer (CMO) that robust measures to address the appeal of those products to children are justified. <BR /> <BR />The World Health Organization points to nicotine's deleterious impact on brain development, potentially leading to learning and anxiety disorders.”
“<BR /> <BR />I want to say a few words regarding our growing concern about the detrimental impact of vaping, particularly on young people. Vaping rates among young people here continue to rise, and recent Young Persons' Behaviour and Attitudes Survey data shows that current e-cigarette use rose from 5·7% in 2019 to 9·2% in 2020. However, among year 12 pupils, the growth in current use has been particularly concerning, with reported current use rising from 11·7% in 2019 to 23·6% in 2022. <BR /> <BR />While-cigarettes may have a role to play in helping some people to stop smoking, the long-term harms of continued use are still unknown.”
“Members are all too aware of the financial pressures that our health service faces. In 2019-2020, Northern Ireland hospitals spent £218 million treating smoke-attributable conditions. The same year, there were 38,617 smoking-attributable hospital admissions. Every penny spent on treating tobacco-related illness is avoidable. The harsh reality is that that is money that our hospitals could use to address other pressures. <BR /> <BR />Once the Bill passes into law, the age-of-sale changes will not be commenced until January 2027. If the Assembly agrees to Northern Ireland's inclusion in the Bill, we will use that lead time to engage with councils on enforcement functions and will continue to work closely with the UK Government on the development of guidance for retailers.”
“Smoking kills up to two thirds of smokers and, as I outlined, increases the risk of multiple serious health conditions. Three quarters of smokers say that they would never start if they had the choice again. I heard the Chief Medical Officer in England recount his observations of a smoker who had undergone limb amputations as a result of smoking and was crying as they lit yet another cigarette. That is how addictive smoking is. I can think of no better law than one that would prevent that misery for our future generations. <BR /> <BR />Smoking does not just impact on smokers; it impacts on non-smokers exposed to second-hand smoke and on families dealing with the illness and death of loved ones. Unfortunately, it also has implications for us all as taxpayers and users of health services.”
“<BR /> <BR />I have listened to some argue that this is nanny statism, suggesting that the smoke-free generation proposals will deprive people of freedom of choice and that the decision to smoke or not smoke should be a personal choice. Sadly, smoking has little to do with personal choice. It results from an addiction to nicotine that usually starts at a young age. It is an addiction that is notoriously hard to overcome, and it has deadly consequences.”