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 stand by my view that the commissioning of abortion services could be considered as significant or controversial and outside the scope of the Programme for Government. The commissioning of that service also seems to cut across the human rights responsibilities of the First Minister and the deputy First Minister. In view of that, I am obliged, under the ministerial code, to bring the matter to the Executive to discuss and agree before it can proceed.”
“To get to the position in which my Department could issue a commissioning direction, as the Member is aware, and in furtherance of legal advice, I brought a paper to the Executive on 3 April 2020 that provided options for the establishment of an early medical abortion service in Northern Ireland. My Department resubmitted that proposal to the Executive in May, and I wrote to the Executive in November. As yet, no decision has been taken by the Executive, so there is no commissioned service for abortion in Northern Ireland. I am satisfied that I have executed my duty as Health Minister by bringing the matter, under the terms of the ministerial code, to the Executive to discuss and agree.”
“I thank the Member. Those accusations are unfounded. It is not just the general public who are making those accusations. At times, the Member is trying to make the issue very personal and about how I view it. <BR /> <BR />My Department does not dispute that women in Northern Ireland are legally entitled to abortion services. The legal advice that was received by my Department states that the Abortion (Northern Ireland) Regulations 2020 do not require my Department to commission the relevant services. Registered medical professionals can now terminate pregnancies lawfully. Such terminations, subject to the regulations, are to be carried out on Health and Social Care premises.”
“In April 2020, my Department invited the Executive to give their agreement to exploring options to see whether it was possible to put in place some limited measure to access a commissioned early medical abortion service in Northern Ireland during the COVID-19 emergency. This proposal aimed to mitigate the travel restrictions preventing women from Northern Ireland accessing the abortion service that is available in England. The Executive did not agree to my Department's proposal. My Department resubmitted this proposal to the Executive in May 2020, and I wrote to the Executive Office on 26 November 2020 to request an update. As the Executive have not agreed to this proposal, no further work has been taken forward by my Department.”
“My departmental officials are in regular contact with their counterparts in the Republic of Ireland, and I know that the issue has been talked about.”
“I thank the Member for pointing that out and making the correction. As I said in response to the question that Mr Sheehan asked, we want to push as many people as possible to get dual registration so that opportunities are not missed. We do not want to see people on the other side of the border, where their certification and registration do not cover them from a liability point of view.”
“As I said, that support mechanism has been provided to the Northern Trust, and I am sure that it is engaged in making sure that as many care packages as possible are fulfilled financially and that the personnel are in place to fulfil them. If I recall correctly, the Northern Trust has recently advertised to recruit domiciliary care workers in the area. I can follow up on that with the Member.”
“It is about meeting the demand for the care packages that are there. As a constituency representative, the Member knows as well as I do that it is OK to fund care packages but that it is a different matter when it comes to getting people to deliver them. It is not solely now a challenge for rural constituencies. One thing that I have been very clear about during the pandemic is the valuable service that our domiciliary care workers provide. I have referred to them as the Cinderella service. Until we saw the real value that they bring, domiciliary care workers were often forgotten about and never mentioned.”
“I thank the Member for his question. I know that it is something that he is very passionate about, because he has raised the issue with me, specifically as it concerns Mid Ulster. The Northern Trust has received additional moneys to encourage and support the provision of additional domiciliary care workers for the area. I do not have a recent update on the level of success that the trust has had, but those additional supports have been referred to the trust and talked about.”
“I had a conversation with the Secretary of State about that and also raised the matter with the Prime Minister when he was here last Friday. We are concerned about the different rates of vaccination in the two jurisdictions. We would like the whole island to be at the same level, but I will not slow down the vaccination process and procedure in Northern Ireland. It would have been unfortunate that, had we shared the Oxford-AstraZeneca vaccine with the Republic of Ireland prior to its announcement on Sunday, those doses may have sat unused. Although I am open to the sharing of vaccines to ensure that we get the entirety of this island to a level of vaccination, my focus, as Health Minister of Northern Ireland, is on the people of Northern Ireland in the first instance.”
“No. I am thankful for the cross-party support that I received in the House yesterday for the stance that we have taken. That stance is science-led, and it has been led by the updated guidance that the Department received from the MHRA on Sunday. The MHRA provided the additional information and assurance that we sought after the Irish Republic made its decision on Sunday morning.”
“The urgency is to make sure that we have all bases covered so that there is no opportunity for someone to miss the registration process that allows them to deliver their professional skills and support on either side of the border, should that be affected. We encourage all staff members who have to register in either jurisdiction to do it as quickly as possible to make sure that they are not personally or professionally caught out.”
“I thank the Member for that question. I do not envisage it having a big or particularly negative impact. Only a small number of health staff will have to register on the other side of the border. Unfortunately, it is an outworking of part of the protocol. We are supporting the officials and employees who have to register. That concern was raised by the Northern Ireland central alert system (NICAS) in particular, the team that transfers critical patients between Northern Ireland and the Republic of Ireland. It has a particular concern about the accreditation and certification required to do that.”
“That being the case, that information is already available on my departmental website, the COVID-19 dashboard and the Public Health Agency's dashboard, and that is where we can see the trajectory of the virus and where it is taking us. Also, the R paper that we produce supplies more than just the R number that we use to inform the Executive's discussions, and it is published weekly on my Department's website. I have heard many calls to make data available. The data is there for those who wish to see it.”
“No, I do not, and I was thankful that the 'News Letter' printed an apology in which it said that its headline, which included quotation marks, was not a direct reflection of anything that I had said.”
“That is something that we have thankfully not seen in Northern Ireland; in fact, in the answer that I gave yesterday, I stated that, when we opened up our vaccine portal to over-50s, within three hours, 30,000 people were willing to come forward for the vaccine. I know that the Member was one of those who got a booking, and I thank her for her support and endorsement not just of the vaccine but of those involved in the vaccination process. It is an amazing achievement for our National Health Service — those who work in it and the volunteers who are supporting them — to see it in full operation.”
“The question for urgent oral answer that was asked yesterday allowed us to give an update. We take our guidance from the Medicines and Healthcare products Regulatory Agency (MHRA). That guidance regarding the safety and efficacy of the Oxford-AstraZeneca vaccine has been repeated by the World Health Organization (WHO) and the European Medicines Agency (EMA), so I struggle to see why the authorities in the Republic took the decision that they did. It is their right to do that, but I am concerned that it has an overall impact on their vaccination process and discourages people in the Republic of Ireland with regard to the efficacy of the Oxford-AstraZeneca vaccine.”
“I thank the Member. Our current memorandum of understanding with the Republic of Ireland is about sharing information and data quickly and efficiently so that each jurisdiction knows what is happening and what decisions the other will take. I was disappointed, therefore, to receive the notification and find out through the media about the decision that the Irish Republic was taking with regards to AstraZeneca. I have asked the Chief Medical Officer (CMO) to engage with his counterpart, who is the co-signatory, to make sure that we realise the full operational value of that memorandum of understanding to prevent reoccurrences of that. It does not help either of us when we are blindsided by a decision that is taken in either jurisdiction.”
“<BR /> <BR />We continue with that ongoing rebuilding framework, and, as I said, we will publish the next three-month rebuilding schedule for April to June towards the end of this month. We have made it clear that we will take it in three-month blocks so that we can escalate proportionately and with as much speed and dedication as we can. <BR /> <BR />As I said in an earlier response, we have to look at a regional approach so that patients are willing to travel outside their trusts and the areas where they would usually have been seen. We now see that our health professionals, such as surgeons, are willing to travel from Belfast to utilise operating theatres in the South West Acute Hospital (SWAH) and other areas so that we can get full capacity from our health footprint and get as many patients as possible seen as quickly as possible.”
“The Member is well placed in the position that he has taken. That was and still is one of the biggest challenges that face my health service and all those who work in it. It is a health service that, for the past 10 years, has been underfunded, under-resourced and undervalued. Unfortunately, when we saw the complete escalation of pressure that the global pandemic had placed on our health service, drastic decisions had to be taken. Those decisions about what services had to be scaled back so that we could support patients coming forward with COVID-19 were not taken lightly by my Department, trusts or clinicians. I am reassured when I see the rebuilding plans and engage with the trade unions and the royal colleges about their desire to get back up and running as fully and as quickly as they can, as safely as they can.”
“Nevertheless, I am assured that every attempt is made to protect the most urgent appointments where achievable and that postponed tests, procedures and operations are all rescheduled as quickly as possible. To that end, my Department has commissioned trust rebuilding plans for the three-month period from April to June, and I will publish detailed activity projections alongside those. <BR /> <BR />While the number of COVID patients in hospital and in ICU has reduced in recent weeks, the emergence from the latest wave is slow and the situation remains extremely challenging. Trusts are keeping the position under daily review so that they can reinstate and resume surgery fully as soon as capacity is safely available.”
“I thank the Member. He will be aware that I deeply regret that anyone has had their surgery or medical procedure postponed or delayed. Those critical decisions are very distressing, and they are never taken lightly. The downturn in elective care has been a consequence of the unprecedented pressures that the COVID-19 pandemic has placed on our hospitals over the past year. <BR /> <BR />From 17 March 2020 to 5 March 2021, a total of 16,938 procedures, operations and diagnostic tests were postponed. However, it is important to note that that includes cancellations for all reasons, not just those that are COVID-related. Procedures are often cancelled for myriad other reasons, such as clinical circumstances, patient cancellations and staff pressures.”
“I thank the Member for his question. I had an initial discussion with my counterpart in the Republic of Ireland, the Minister for Children — I cannot remember his name; apologies — a number of months ago. The investigation is being taken forward as an interdepartmental piece of work, so the First Minister and deputy First Minister had meetings with him, along with Judith Gillespie, who has been in regular contact as well, about the direction that the independent inquiry will take and the need for both jurisdictions to share information because of the nature of what will be necessary as we get to the bottom of that piece of work.”
“The Executive have been very clear about that in how we take forward that independent investigation.”
“I thank the Member for acknowledging the large number of correspondence cases and Assembly questions that we are dealing with. The remit of the independent investigation into mother-and-baby institutions and Magdalene laundries will be shaped by victims and survivors, as she referred to, with the support of the truth recovery design panel, which, as I am sure that the Member is aware, has been appointed. I am confident that the issues in the access to and the protection of records relating to mother-and-baby homes and Magdalene laundries will be fully considered by the co-design process and the independent investigation into those institutions so that the individuals whom she directly referred to — I have been in touch with her — have input and can feed into that process. It is about co-production and co-design.”
“My correspondence also made it clear that all staff and former staff, where appropriate, should be notified of the ongoing need to preserve the records and that reasonable steps should be taken to ensure that any agents or third parties do not delete or destroy potentially relevant records.”
“I thank the Member for bringing this topic to the Floor of the House. On the matter of records held by mother-and-baby homes and Magdalene laundries or by other organisations on their behalf, in December 2020, I wrote to the holders of those records and to the Health and Social Care Board requesting that they ensure that all reasonable steps are taken to preserve the records in their possession and that they are maintained in keeping with best archival practice. <BR /> <BR />I also requested that they immediately suspend any routine procedure for deleting or destroying any such records and ensure that the suspension remains in place for the duration of any further investigation.”
“<BR /> <BR />Hospices in Northern Ireland have received additional funding from my Department and also directly from the Department of Finance during the pandemic because we have acknowledged that, particularly with regard to the services that they supply, they do rely on a considerable amount of voluntary contributions and people supporting them in that way. So, it was right that the Executive centrally supplied that additional funding during this time.”
“I thank the Member. I acknowledge the work that our hospices have done, not just over the past 12 months but over the past number of years. Their funding is also mentioned in New Decade, New Approach. There has been an ongoing issue with regard to how they are funded centrally and what funding they receive from central resource. That conversation will continue with the Health and Social Care Board and with representatives of my Department until we get to a satisfactory resolution from both sides.”
“I was disappointed that my position was misrepresented in the House yesterday by a number of Members who were in full knowledge that this matter is cross-cutting, controversial and one that must be decided by the full Executive. It is not for me alone to move.”
“The Member follows on from a debate that was had in this place yesterday, and I will be clear to the Member. I have said from the beginning that the establishment of a commissioned abortion service in Northern Ireland is cross-cutting and controversial. That is the legal advice that I have received and the legal advice that I will follow, and the Member knows that, having received it, I would be in breach of my ministerial duty if I did not bring it to the Executive. Should I not do that and should I even want to take that as a direction under my ministerial role, it would be called in and challenged. I think that the Member knows that well.”
“So, when the Northern Trust puts forward those business cases and business proposals, we will consider them within the round of the funding that we have available.”
“<BR /> <BR />It will take time for us to come back down from that provision, but it is also that important time when we look to the revenue budget that I have for updating what is a relatively new hospital. If we had been looking at the continuing funding and support of the Northern Trust on a regional and revenue basis along the entire pathway over the past 10 years, we would not have been in the situation that we are in now, whereas we know that we have already looked at the Northern Trust and at the Antrim Area Hospital specifically with regard to how it was able to reshape and re-image its emergency department. Even with a relatively new hospital and a new design, that was necessary in the past number of years.”
“I thank the Member. It is an issue that he has raised in relation to a patient or constituent who had approached him, and who, because of our regional approach, was able to get an operation elsewhere, but not in Antrim. A surgeon who is based in Antrim raised concerns with the Member. He is right: long-term underfunding of that hospital did not allow it to be in the shape that it needed to be in. We saw that in the Northern Trust region, particularly when a large number of COVID patients came forward and we had to move our intensive care ward out on to one of the main wards so that we could support the high number of COVID patients who required ICU support.”
“The Member will be aware of the approach that I have taken recently with regard to looking at our service as a regionalised, rather than a centralised, process so that we can best utilise the facilities that we have around Northern Ireland and ensure that we can get best use of our staff, our operating theatres and our footprint. It is about looking at where we can establish green pathways for care in the locations where we are seeing a small number of COVID patients being supported so that we can critically upscale the rest of those service provisions. The Member will be aware of the elective care unit that we have established in Lagan Valley Hospital and the sites across Northern Ireland that we are trying to utilise on a regional basis rather than within the trust setting.”
“That Bill will facilitate the closure of the Health and Social Care Board and transfer responsibility for strategic decision-making back to my Department. It will streamline our structures, reduce bureaucracy and enable our resources to be better coordinated. As ever, our ability to rebuild will be heavily predicated on the resources being available to do all that we need to do. A multi-year Budget is critical to the planning to achieve sustainable, long-term change within our health service.”
“That will be informed by the work that we have progressed to date and the learning that we have gained as a result of the pandemic. <BR /> <BR />A key priority for rebuild is the need to return critical care to its usual position to facilitate an increase in elective care. I have agreed that the de-escalation of the ICU and the rebuild of elective care will follow a number of key principles. They will underpin the trust's rebuild pans for April to June 2021. The principles include the de-escalation of the Nightingale facility at Belfast City Hospital. <BR /> <BR />Another critical step in rebuilding the system is the introduction of the Health and Social Care Bill, which passed its Second Stage this morning.”
“I thank the Member. As he knows, COVID-19 has reinforced the need to rebuild our health and social care system in new and better ways. Firm foundations for change have already been laid, with such key initiatives as multidisciplinary teams in primary care and new day-case elective care centres put in place; the roll out of upskilling of the social care workforce; the putting in place of a new rapid response mental health hospital liaison service; and a commitment to put in place 900 additional nursing and midwifery training places by 2022. As we emerge from the latest COVID-19 surge, I am determined to rebuild as quickly as possible. That will include the stepping up of elective care services and the reshaping of existing services.”
“I thank the Member for his question. I am glad that he acknowledges the autism strategy that we launched just last week. It is important that that be fed into as much as possible. On the delivery of future services, it is important that the Western Trust engage in order to scope out demand for any additional facilities that it needs in its locality, be they day care or day opportunity facilities. I know that that work has started and is supported. It was commenced through personal and public involvement (PPI) events that were held in Strabane. Service user engagement and informal care engagement events on how we take forward the strategy will commence soon.”
“All those additional ancillary costs and challenges have to be funded as well. I am always looking to improve on the support that we provide to those who need it most.”
“I thank the Member for her question. She indicates the pressures that we are under. We get many requests to increase facilities or provision of support to individuals, but that is dependent on the financial support that I get from the Finance Minister. As to what we can and should do, as we are well aware, there has been under-provision over the past number of years, especially of mental health services. It is something that we want to do. As the Member will be aware, the primary challenge for provision of day care or day opportunities in the Western Trust area is often transport, especially in rural areas. Furthermore, the Western Trust has a number of individual service users who have complex needs and thus require skilled staff to accompany them in order to meet their nursing needs and administer medication.”
“If the Member wants to engage with the Western Trust, we will follow up on that.”
“I thank the Member for his question. If I recall correctly, he has written to me about autism provision and services. I know that he has raised the issue before. As he acknowledged, I said in my initial answer that we have received no requests either at the Department of Health or through the Western Trust. If the Member wants to make direct contact with the Western Trust and raise his issues, I am sure that the trust will look into them. We can then progress them, should there be a need to facilitate access to those services. As I said earlier, I encourage the Member to direct those young people to where I mentioned earlier. If necessary, we can provide additional information on how they can look for day opportunities through self-directed support so that they can find a more tailored, personal approach to the support that they need.”
“That is based on assessed need and means that individuals can make use of a direct payment in lieu of traditional day care. That model of care allows for bespoke arrangements to be put in place to meet individual needs and enables people to avail themselves of the activities at weekends and in the evenings.”
“There are two day centres for adults with a physical or sensory disability in the Western Health and Social Care Trust area: Glen Oaks in Londonderry and Drumcoo in Enniskillen. In addition, service users can avail themselves of the day care provided by the independent sector across the region. <BR /> <BR />The trust’s adult physical disability service has contracts with a number of independent sector providers in West Tyrone, including Strabane and District Caring Services, Leonard Cheshire and the Cedar Foundation. Although those services are working at capacity, there is no existing waiting list in West Tyrone for access to the day centres. Across the sector, we are increasingly seeing that the demand from younger people with disabilities is for day opportunities through self-directed support.”
“I thank the Member for his question. As Minister of Health, I understand fully the importance of day centres in the provision of services to meet the wide and varied needs of people with a physical or sensory disability. The strategic location of day centres for adults with physical or sensory disabilities across Northern Ireland is a matter for the health and social care trusts to determine in partnership with the Health and Social Care Board as the commissioner of the services. <BR /> <BR />There are no plans to augment the existing service provision with an additional centre located in the West Tyrone area, and neither my officials nor their Western Trust colleagues are aware of any specific demand from the local community or individuals for such an additional facility to be provided.”
“Care partners are still a vital tool in facilitating visiting. However, family members need to be supported so that they understand that there are additional supports for them, as I have said, such as early access to the vaccine and regular testing. That will give assurance not just to the family members but to the care homes and to the loved ones whom they visit.”
“I thank the Member for her questions. On her point about additional insurance costs, my Department has made additional funding available to care homes so that they can pick up other costs associated with COVID while we still provide, if necessary, a free supply of PPE. Where there are challenges, we have also provided trust staff to support homes. <BR /> <BR />When we first identified and utilised the care partnership process, it was taken up by other jurisdictions as a way of opening up care homes so that loved ones could visit. It is still a vital tool while we, as a region, remain at level 4. On 1 March, we moved from level 5 to level 4. That is the scale that we, and all other jurisdictions, use to indicate the visiting that we can facilitate in care homes and hospitals. We follow those set criteria.”
“There is an ongoing challenge with some care homes getting the necessary support. Some do not fully understand their responsibility to ensure that there is safe and effective visiting, which is possible now that we are under the surge level 4 conditions. We fully intend to support those care home providers but also, where needs be, to give them that bit of extra encouragement, shall we say, should they fail to do that. We value and recognise the importance of a visit from a loved one to a resident of a care home and the benefit that it brings.”
“For those who enter into the formal care partnership arrangement, we have early availability of vaccines through the carer section and access to testing.”