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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“I thank the Member for his question. I am conscious not to mix what has been announced in England on what they are doing on social care and the funding of that, but there is a Barnett consequential from that announcement. I have asked around the Executive table for that consequential to be ring-fenced for health spend in Northern Ireland, because, in Northern Ireland, our social care service is part of our healthcare service. In England, social care services are looked after by councils and districts, whereas here in Northern Ireland it is all done by us.”
“I thank the Member for her question. As I said in my initial response, we need not to conflate continuing healthcare with the greater reform of social care, because they are two very separate issues. The continuing healthcare scheme, which was initially discussed and is the subject of the question for urgent oral answer, has only been utilised by one trust in Northern Ireland. The Member is referring to the greater reform of adult social care in Northern Ireland, which, as I have said, will be the subject of a public consultation. I look forward to the House addressing such issues in the forthcoming public consultation, and I note that the Member's party was one of the parties that made a submission to the public consultation on continuing healthcare.”
“I thank the Member for the question. The working group has met. It is due to meet again in another couple of weeks. At that stage, we had hoped to have the publication of the guidance. It does not look like it will be able to finalise that at the second meeting. Hopefully, it will do so at the third meeting. We asked Age NI to sit on that group, because, as the Member will be aware, it represents a large cohort of the service users and potential applicants to the scheme. It was very critical of the Department's response, so we brought it in as a critical voice when preparing the guidance on the future of continuing healthcare before it became part of the wider review of adult social care in Northern Ireland.”
“I look forward to the House addressing such issues and the input of parties, individuals and organisations such as Marie Curie into the forthcoming public consultation on the reform of adult social care. It is worth noting those individuals and other political parties who took the time to respond to the public consultation on the reform of continuing healthcare when it was launched in 2017.”
“I thank the Member for her point. As I said in an earlier answer, the review was carried out following a report by Age NI. This policy was brought to light, and the need for the publication of the guidance raised, by the Office of the Northern Ireland Public Services Ombudsman (NIPSO) when it consulted, in 2017, on the variance across trusts. That is why we see only one of the five trusts actually utilising the current continuing healthcare policy. <BR /> <BR />As I said in my initial response, it is vital that we separate continuing healthcare from the review of social care and the reform of adult social care. As I think the Member indicated, that query was raised by her party colleague Arlene Foster.”
“An argument could, perhaps, be made that the state should provide free or subsidised social care in such circumstances, just as it provides free healthcare at the point of need. It is also the case that the financial cost of such provision would be significant, with major implications for other areas of public spending. I look forward to the House addressing such issues in the forthcoming public consultation on the reform of adult social care.”
“I can very much appreciate the concerns raised by service users and advocates. It is only right that, when issues are raised, they are addressed by those in government responsible for decision-making. <BR /> <BR />The matter of continuing healthcare is only one small part of the health and social care system, but it very much relates to the wider issues relating to social care, how it is provided and how it is funded. I am, therefore, very keen to look at this matter in the round, in the wider context of how we deliver health and social care in Northern Ireland. <BR /> <BR />The reality is that many people, particularly older people, need to move into care homes because of the impact of medical conditions on their ability to look after themselves.”
“The Department undertook a consultation, launched in 2017, that was designed to establish a clear position on the matter. I inherited the scheme and the public consultation on its future. I wanted to provide more clarity, at least in the short term, pending wider consideration of how social care should be funded in the future. In taking up my role, it was clear that the previous inequality, confusion and variance across the region needed to be addressed. In February 2021, I gave approval on the way forward, with the aim of creating a fairer system. A stakeholder working group has been established, with the aim of producing guidance to underpin the new position. The aim has always been to publish the guidance over the coming weeks, once the working group was able to come to an agreement.”
“I welcome the opportunity to clarify the situation with continuing healthcare. I appreciate that social care is an extensive and complex area. However, I urge Members and those listening not to conflate the issue with the policy decision that was announced in another part of the United Kingdom last week. <BR /> <BR />The fact is that continuing healthcare has become an outdated and much criticised scheme, principally serving to offer only confusion and false hope to individuals and families. A review carried out by my Department, following an Age NI report in 2014, found a risk of variance in the application of departmental guidance and in continuing healthcare practice across the trusts. That led to regional inconsistency and a potential postcode lottery for individuals.”
“I beg to introduce the Organ and Tissue Donation (Deemed Consent) Bill [NIA30/17-22], which is a bill to amend the Human Tissue Act 2004 concerning consent to activities done for the purpose of transplantation and make consequential amendments about the provision of information about such consent.”
“We are assessing them in the order of the closest date of travel. Those applications are being prioritised.”
“I thank the Member for her question. If she wants, she can check Hansard. It was the first question asked of me, although her specific issue was not covered. The interim service that we provide via a paper-based system through the Health and Social Care Board will be effective up until 20 July. It is our hope and intention that, with everything going well, as it currently is, the UK-wide certification programme will be up and running by 20 July, and it will take into consideration the worst-case scenario, which is that it will take 10 days for a certificate to be delivered. We are standing down our internal, Northern Ireland-specific process because the UK process is to be up and running by that date. We will keep that under constant review, however. We had received 4,500 applications for our internal service up until 1.00 pm today.”
“The Member raises the issue of a very special cohort of carers who often go unrecognised and unacknowledged, especially those who balance a caring responsibility, whether it is for a parent or sibling, while undertaking their own educational challenges. She will be aware of the £4 million investment that we made in carers' organisations so that they could submit bids and proposals for how they would support specific groups of carers. The early indication is that there are a number of bids and applications from organisations that will look specifically at supporting young carers. Until those applications have been accepted and assessed and the nominations have been announced, I am not in a position to provide any further update, but I will keep the Member up to date.”
“I thank the Member for her question and would have been surprised had she not raised the issue. I committed to asking the Public Health Agency to assess where those centres are with social distancing and face coverings and whether testing can make a difference to how many people we can have in each centre. That assessment has not yet been completed. As soon as it is sent to the Health and Social Care Board or my Department, I will take action on its recommendations. As the Member highlighted, as we have debated here and as we all recognise, the additional service that respite centres provide, even if it is day care, is priceless to carers.”
“That concept was used not only by Nye Bevan in creating the National Health Service but by my party colleague and former Health Minister, William Grant, the MP for Duncairn in Belfast, when he brought forward the Health Services Bill in this place on 10 July 1947.”
“I thank the Member for her supplementary. I assure her that I receive many such contacts daily from constituents, as do my Department and other elected representatives in the House. We published the elective care framework because people are waiting for such extended periods. <BR /> <BR />Today, we celebrate not just the birthday of the National Health Service but the recognition of Her Majesty The Queen in awarding the George Cross to our health and social care system. In Northern Ireland, we have acknowledged the length of our waiting lists and how underfunding over the past 10 years has challenged the key precept of the National Health Service, which is that it is free at the point of delivery, free at the point of use and free at the point of need.”
“As the Member is aware, I have asked the Executive for £707·5 million of additional investment to be made available over a five-year period in order to implement the framework, and that will reduce the backlog of patients and build HSC capacity to meet annual demand for services. Subject to that funding commitment, the Department made it clear that, by March 2026, no one should wait more than 52 weeks for a first outpatient appointment or inpatient day-case treatment or 26 weeks for a diagnostic appointment and that, by March 2026, we will have eradicated the gap between demand and capacity for elective care.”
“I thank the Member for her question. I do not have current figures for gall bladder surgery waiting times in front of me. I am sure that the Member will understand that, but she will be aware that, when we published the elective care framework, it set out a five-year plan with firm, time-bound proposals for systematically tackling the backlog of patients who are waiting longer than the ministerial standard and how we invest in and transform services in order to allow us to meet population demand in future. <BR /> <BR />Our current system of one-year Budget cycles contributes to the inefficiency in the system, as it does not allow us to plan services properly. The framework takes a multi-year funding approach to tackling the backlog of patients who are waiting longer than the ministerial standard.”
“At the moment, we are also considering an option, as yet unconfirmed, to run COVID boosters in conjunction with the flu jab because of the large crossover in the cohort of people who are eligible for a flu jab and have been recommended to take a COVID booster.”
“I thank the Member for those very pertinent questions about boosters and where they will be delivered. At the moment, the Joint Committee on Vaccination and Immunisation (JCVI) has made an initial determination that boosters will be necessary for those who are clinically extremely vulnerable and in the older age groups. The JCVI is still assessing the need for that, but we are preparing for it, should it be necessary, if it decides that that is the best way to go. As the Member will be aware, we always follow JCVI advice and guidance. We have assessed the situation here, and we believe that GP services will be the best place to deliver the booster programme.”
“The GP determines the most appropriate approach to addressing a patient's needs safely, using their clinical expertise, and decides whether a patient can be managed over the telephone, should be signposted or directed to other appropriate services or if, based on the GP's assessment, a face-to-face appointment is appropriate. <BR /> <BR />It is important to be clear about the extent to which primary care was already facing considerable pressures, even before having to cope with the continuing pandemic situation. That is why we are investing in technology to support GP practices and in initiatives such as the multidisciplinary team programme and the introduction of advanced nurse practitioners and additional general practice nurses, which have already made a difference to the way in which primary care services are being delivered.”
“I thank the Member for his question, and I welcome him to the House, while acknowledging the unfortunate circumstances that have led him here. <BR /> <BR />GP services are working to make the best use of available resources for everyone who seeks to access the care that they need. GP practices are open and are providing face-to-face appointments and alternative consultation options for patients as appropriate. The general practice telephone-first consultation process allows patients to seek timely medical advice from their GP for routine and urgent problems.”
“I thank the Member. She will be aware of the extent of the Cumberlege report. My officials continue to work to develop our response and are working with colleagues across the United Kingdom in that regard. The work of the group that I set up to consider the report and engage with UK colleagues has been progressing on a number of recommendations. As the Member said, I hope to be able to provide fuller detail shortly on the work of the group. Not all the recommendations are within my power, as Minister of Health, to take forward, as some reside with the Department of Health and Social Care in London, but we continue to engage with it in a Northern Ireland context.”
“I thank the Member. I am aware of the admirable efforts of Mesh Ireland to help mesh-injured women. In correspondence with that group, I addressed its comments and indicated that the issues that it raised reinforced similar issues that had been raised by representatives of another group that I had recently met. A further meeting on the issue was, therefore, not necessary. The focus should be on the rebuilding of health services. The Belfast Health and Social Care Trust mesh centre collaborated with the specialist centre in Bristol. The service resumed work on 17 June, with one clinic per week. That, unfortunately, is a reduced capacity due to COVID risk assessments and having to reduce footfall in Belfast City Hospital.”
“I refer the Member back to the point that my Department has resumed planning work to deliver a service-commissioning specification. That work will consider setting in place the most appropriate access arrangements for women seeking abortion. However, as I have stated previously, under the ministerial code, I am required to bring any matter that is significant or controversial, and is clearly outside the scope of the Programme for Government, to the Executive for consideration and agreement. It is not possible at present to provide a precise timescale for the introduction of a fully commissioned abortion service. However, it is estimated that the work will take approximately nine to 12 months to complete.”
“At this point, it is not known how long services will be paused in the Western Trust. It is my understanding that efforts are ongoing to put additional staff in place as soon as possible to resume the provision of an EMA service with minimum disruption. My Department continues to monitor that situation. In the meantime, and in the event of a prolonged pause, it is likely that women residing in the Western Trust area will be referred to the central contact point, which remains available to women from Northern Ireland and is managed by the British Pregnancy Advisory Service.”
“I thank the Member for her question. She has raised this issue numerous times. I will refer her to the position that has been confirmed: this issue is cross-cutting and controversial and is not a decision for me and my Department to take but is actually one for the Executive to take.”
“<BR /> <BR />In light of the extreme funding pressures facing my Department at present, I have written to the Northern Ireland Office Minister of State, Robin Walker, to request additional funding to support those services because, as yet, the Westminster Government have not provided any additional funding to my Department since introducing the abortion regulations in March 2020. Last week, Minister Walker again confirmed that the funding support that I have requested will not be forthcoming.”
“Last year, I awarded a further £15,000 grant to Informing Choices as part of an uplift to all core-funded bodies in recognition of the financial challenges faced by the voluntary and community sector during the COVID-19 pandemic. <BR /> <BR />I can confirm that my Department is considering a request for further funding from Informing Choices to support its decision to provide a central access point into the early medical abortion (EMA) services that trusts began to provide from April 2020 in line with their statutory responsibilities under law. That remains under consideration, and I have not received final advice on that yet. My officials are engaging with Informing Choices and carrying out the usual due diligence checks in relation to that request, as you would expect.”
“I thank the Member for her question. First, it is important to state that Informing Choices Northern Ireland, formerly the Family Planning Association of Northern Ireland, receives substantial public funding from my Department and the Public Health Agency of approximately £137,000 each year to support the provision of free sexual health advice and counselling. That service includes phone- and web-based non-directive advice, counselling and literature on a range of issues for people who are often young, vulnerable or in crisis. That includes contraception, STIs and pregnancy choices, as well as sexual health and relationship education for people with learning disabilities.”
“Applications for large projects are being accepted immediately, and those for smaller projects will be accepted in September 2021. The fund is being managed by the Community Foundation for Northern Ireland, and is now accessible via the Community Foundation's website.”
“I thank the Member for his question. I was pleased to announce and launch this morning the £10 million mental health support fund. There were nearly 200 representatives of voluntary and community groups there. The fund is open to all charitable organisations that offer support services to people with mental ill health throughout Northern Ireland. <BR /> <BR />Groups are invited to submit proposals on key themes, all of which are linked to improving the mental health and emotional well-being of the population. The fund will equip and enable those charitable organisations to provide a wide range of support services for people with mental ill health and help to ensure that those who need to can continue to access mental health support services in the community. <BR /> <BR />To manage demand, applications will be staggered.”
“I thank the Member for that point. As she will be aware, not only did we produce the mental health strategy but I produced a costed funding plan alongside it, because it is important to indicate to the House and to Executive colleagues that there is a commitment in my Department to driving forward the changes that we need to see made in the area of mental health. <BR /> <BR />The costings were done at quite a granular level in my Department to ensure that we were being realistic about any financial ask that we were going to have to make to prove the case not just to the Minister of Finance and his Department but to the Executive. That is why that work was undertaken and why both documents were produced at the same time.”
“My officials are considering the future of crisis services, and the crisis cafe in Newry is one of the positive examples of new initiatives that will inform the way forward in that important area.”
“The Newry-based WELL-Bean cafe, which is run by PIPS Hope and Support in partnership with the Southern Trust, is a good example of that. To reduce mental and emotional distress, the cafe provides a clinical alternative to emergency departments . The pop-up-style cafe is based on a Leeds model and has been co-produced by those with lived experience and those working in the area of mental health promotion and suicide prevention in community, voluntary and statutory services. <BR /> <BR />The crisis cafes are not a replacement for existing services but a complement to them. By providing quick and easy access to early intervention and prevention, we can improve the outcomes for our population.”
“I thank the Member for attending this morning's launch of the £10 million mental health fund. It was good to see him there to acknowledge the importance of the fund.”
“<BR /> <BR />My Department and the Health and Social Care Board are working together on the development of a regional mental health surge and rebuild plan, which will outline the proposed approach to medium-term and longer-term planning for managing the surge and rebuild. That will work across the stepped care framework in line with the 10-year strategy, together with the key actions required over the next six to 12 months to manage increasing referral rates and to prepare for longer-term rebuild, reform and redesign. The work will be overseen by a mental health pandemic response group, which will be chaired by the Department and will comprise colleagues from the Health and Social Care Board, the Public Health Agency (PHA) and health and social care trusts.”
“I thank the Member for his question. It is accepted that the COVID-19 pandemic, lockdown and other restrictions have all had a negative impact on our population's mental well-being. The Health and Social Care Board has explored the evidence for the rising demand in mental health care and treatment and made a series of initial projections of how that would translate into the Northern Ireland context. It estimates that there will be up to 32% more new referrals to mental health services over the next three years. A key element of responding to that emerging mental health need has been the development of a new mental health strategy for 2021-2031, which I published on 29 June. It sets the future strategic direction for mental health in Northern Ireland for the next decade and takes full cognisance of the impact of the pandemic.”
“I am pleased that every party, not just in the Executive but across the House, has stressed the importance of vaccination and indicated that people should get not just their first dose but their second dose.”
“The First Minister and deputy First Minister headed up those bulletins, so the substantive response to that question should come from the Executive Office. My Department, through the Chief Medical Officer (CMO) and the Chief Scientific Adviser (CSA), still provides regular media briefings. Those are no longer in the format of podium briefings but in a fortnightly media-specific briefing at which the CMO and the CSA make themselves accessible to all media outlets on a range of subjects and questions. The Member is correct that joined-up messaging, especially coming into this crucial period as we fight the pandemic, is important. I have said from this place in the past that our all giving the same message is helpful, especially on vaccines.”
“I encourage the Member to speak to her constituents to make sure that they avail themselves of all the opportunities to get the vaccine.”
“First, I welcome the Member to her place, and I look forward to working with her over the remaining months of this mandate. <BR /> <BR />The Member asked what additional walk-in clinics will be available, specifically in the Western Trust area. Further mobile and pop-up clinics are planned in July, and walk-in first doses are available in Omagh from today and in the Foyle Arena from tomorrow. I encourage all those who are eligible and are not yet vaccinated to make use of those clinics to protect themselves. Every vaccination counts as we face a potential spike in infections, and, throughout the vaccination programme, the Western Trust has operated vaccination centres at three locations across the Western Trust — Londonderry, Omagh and Enniskillen — to ensure that that access covers all.”
“I thank the Member for his question. Our vaccine dashboard shows the geographical position across Northern Ireland, so you can see where there are concerns about low uptake. The Member will see that that is where we are concentrating some of our mobile testing facilities: Belfast city centre, Castlewellan and The Quays in Newry. In all areas where we have seen low uptake, we are doing that outreach programme. We have also expanded into various workplaces, including those of fishermen in Kilkeel and food-processing factories. In that way, we encourage anyone who is eligible, especially those at higher risk, to come forward and get the vaccine. We are trying to make that as easy as possible, and that is the idea of these walk-in clinics.”
“I thank the Member for encouraging people, especially those in younger age groups, to come forward and get the vaccine while it is available.”
“I thank the Member for highlighting, as was referenced, the different avenues that we are taking and promoting to reach young people and to get the messaging right. It is about getting the vaccine, not just to protect yourself but to protect others. One of our concerns, especially with young people contracting COVID, is not the immediate effect but what is now established as long COVID. There is always the chance that anyone who contracts COVID may not end up in hospital or ICU now, and they may not transmit it immediately to a loved one, a work colleague or a family member, but they may not have planned for or considered the long-term effects. It is easier for people to come forward and take up the vaccines when they are available, and there is large-scale availability now from multiple sources across Northern Ireland.”
“While terminology and language are always important in the House, I particularly want to clarify that point. <BR /> <BR />I thank the Member for highlighting the fact that we are seeing different approaches across trusts to encouraging people to come forward. The on-street and walk-in vaccine pop-up clinics that we saw over the weekend are targeting those people who have not availed themselves of the vaccination programme in more formal settings. I again acknowledge all those who have come forward, and I encourage those who have not had their vaccine or, in the South Eastern Trust, their ice cream to come forward.”
“While it translates well in some areas of this country, I am glad that the Member clarified that it was ice cream. I assure him and anyone who is going that that is all that is involved and that that is all that they will get with their vaccine.”
“I thank the Member for that, but I have to raise a slight concern about his last comment. Where I come from, "Grabbing a poke" actually has a quite different meaning.”
“The vaccination programme has been designed to be agile and pragmatic in order to make it as easy as possible for people to be vaccinated. While the figures mentioned are impressive, we will strive to drive the uptake rates for first and second doses even higher.”
“I thank the Member for his question. The vaccination programme continues at pace. I can confirm that uptake has been very strong across Lagan Valley. Information on the vaccine uptake and total doses by postcode is available on my Department's vaccination dashboard, which shows that in the nine postcodes in the Lagan Valley Assembly area, there were 142,755 first doses and 105,955 second doses. I am sure that the Member will join me in commending all those in the area who have already come forward and played their part in helping to protect themselves and those around them. <BR /> <BR />Aside from thanking all those involved in the vaccination programme for their dedication and ongoing commitment, our best way out of the pandemic is through vaccination.”