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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“<BR /> <BR />The identification of the South African variant does not mean that it will become prevalent, let alone dominant, in Northern Ireland. The Department and PHA officials continue to monitor the situation extremely closely and will take all necessary actions to assist in investigating and managing the situation. I re-emphasise that all variants of the virus spread in the same way and that we can all help to stop them spreading by following the tried-and-tested public health advice. <BR /> <BR />I wanted to take the opportunity to update the House rather than Members hearing it elsewhere or through the press.”
“With your indulgence, Mr Deputy Speaker, before I go into my closing remarks, I want to make an announcement to the House with regard to COVID. Three confirmed cases of the South African variant of COVID-19 have been detected in Northern Ireland. Our overall assessment of the wider risk to the public remains low at this time. The PHA has set up an incident-management team and instigated a range of swift public health interventions, including intensive enhanced case finding and enhanced monitoring and surveillance. Our Public Health Agency has also provided support and advice to the individuals who have tested positive and will work directly with them to reinforce all necessary public health advice, including the requirement for the individuals and their contacts to self-isolate.”
“The Member makes the point, and I know that it is of personal interest to him. It was highlighted in the debate earlier when reference was made to the additional number of children that we have seen being taken into care in the past year. As the corporate parent of those children, it is of concern to me that we make sure that the supports are available and that there is a way of identifying the children who most need that additional support. I want to make sure that mechanisms exist through my Department, supported by the Department of Education, and that there is a collaborative approach to supporting our young people.”
“<BR /> <BR />In the earlier debate, the Member referred to my Department coming together with the Department of Education and the Department for Communities to look at a holistic support mechanism for children going into schools in the summer holidays, or even over the Easter break. If possible, that is something that I would be keen to progress, and it is something that our mental health champion has also brought to the fore, through a greater piece of work around additional support being available for the children who need it once the school terms end.”
“I thank the Member. He highlights one of the areas that has often been underfunded in our service — the support of the mental health of our young people through the child and adolescent mental health services (CAMHS). I know that the lack of provision and the need for more support is something that the Member has championed, worked for and dedicated himself to within his constituency. The support that we have for our pupils and staff is provided in conjunction with the Department of Education, and the Education Minister has a co-funded project coming forward for that specific task so that we can tackle it.”
“That is a piece of work on which we have engaged with the Government of the Irish Republic so that we come forward on it, not at the same time, but as closely as possible, because there is a thought process that if there is a minimum price per unit of alcohol in the Republic of Ireland, and we are not doing something similar in Northern Ireland, it will encourage cross-border trade. It is my intention that we go out for consultation at the end of this mandate. I will be clear to the Member: I do not think that we have the scope in this mandate, by way of capacity in my Department or the time that is necessary, to bring it forward in a meaningful way, but I intend to put it to consultation so that the preparatory work is done for whomever comes into this role in the next mandate.”
“It is all part of the mental health strategy and the consultation that is out at the moment, so I encourage the Member, and any organisation that she may be aware of, to get involved with that so that we can highlight the need for increased mental health services in Northern Ireland.”
“I thank the Member for her question. The provision of mental health supports for those with a dual diagnosis has been a significant challenge for the Department over a number of years, because, often, people with a dual diagnosis will have been seen by one speciality or the other, but never holistically. Rather than producing a dual diagnosis-specific cohort of workforce, there is, as part of the mental health strategy, work ongoing on how we can make sure that any mental health provision is person-centric, so that, regardless of what they are presenting with or their diagnosis, they get the support that they need when they need it, where they need it, which is more important than creating another service.”
“I thank the Member. He moves from teachers to those in the agri-food sector. That demonstrates the difficulty: once you start to identify the importance of one section of the workforce, it expands easily. That is why we concentrate on the JCVI guidance and vaccinate people in order of priority of risk so that we save lives and prevent serious illness. The Member may or may not be aware of it, but we have put in supported testing facilities in some of our agri-food factories across Northern Ireland. That was supported by the Department of Health and Social Care (DHSC) in England. As opposed to simply vaccinating sectors, we can support by increased testing in certain sectors.”
“The Member is aware — I have said it on a number of occasions — that we follow the Joint Committee on Vaccination and Immunisation (JCVI) guidance, which assesses by risk with regard to mortality and the implication that it would have should the individual in that cohort contract COVID-19. I will stick by the JCVI recommendation, which is by age and clinical profile. <BR /> <BR />I am aware that work is going on in JCVI to look at specific occupational cohorts that may be at more risk, but, as yet, we have received no update. Until I receive further guidance from JCVI, I will stick to the guidance that we have, as it has worked for us so far. We see a decrease in the number of infections in care homes and in society and a decrease in the number of hospitalisations.”
“People need the help and guidance in the document.”
“Certainly. I think of the engagement that we have had through the mental health, well-being, resilience and suicide prevention subcommittee of the Executive. On the back of Mr Lyttle's recommendation, we engaged with the group Elephant in the Room. That meeting was very productive and led to subsequent meetings with other Ministers. We will share that document throughout the Executive and ask our Education Minister to share it with all schools. We will also share it with the Minister for the Economy so that she can share it with universities and further education colleges. We should make sure that we share this excellent co-produced document as widely as possible, as it would benefit not just us in the Department and the young people who engaged in the production of it but those who receive it.”
“<BR /> <BR />The creation of a new mental health strategy that puts the needs of the individual in the centre, respects diversity and equality and supports emotional well-being and positive mental health is of paramount importance to our communities. To date, we have held three large virtual events, with over 90 participants attending each, and, over the coming weeks, the Department is holding small, themed consultation meetings to provide an opportunity for individuals to meet virtually with my officials to discuss specific aspects of the draft strategy in more detail. <BR /> <BR />The consultation, as the Member knows, is due to close on 26 March. I encourage anyone with an interest in mental health to engage and share their views.”
“I thank the Member for his question. I know that this is close to his heart. From my recollection, mental health was never talked about in the House until he raised it and made it a topic of conversation not just here but in elected bodies and among elected representatives across these islands. <BR /> <BR />On 21 December 2020, I published the draft mental health strategy for public consultation. That was a hugely important step forward, as it will set the strategic direction for mental health in Northern Ireland for the next decade and beyond. The draft strategy was produced thanks to a coordinated effort from many people with lived experience and from across different organisations and sectors.”
“Our community pharmacy partners are part of the future-proofing of vaccinations when we get to the wider population. They are currently completing flu vaccinations for the younger cohorts that we had not done previously, and we appreciate their support in doing that. Community pharmacies have been able to concentrate on the delivery of the flu vaccine, and that has allowed us to develop our regional centres for COVID vaccines and allowed our GPs to easily identify people who need the COVID vaccine and concentrate on them. It is about working in partnership. The Department now has a strong working relationship with Community Pharmacy that it maybe did not have in the past.”
“<BR /> <BR />I made it clear to the House earlier that the draft Budget is currently out to public consultation. There have been bids for many things, and I recognise the work that Community Pharmacy has done and continues to do. It is part of our funding process. I am sure that the Member has been lobbied by members of Community Pharmacy to raise the subject, but I encourage him and them to feed into the public consultation process so that it is not just my voice asking for money and support. The Minister of Finance also needs to hear about the support that my Department needs for community pharmacies.”
“I thank the Member for acknowledging the work of community pharmacies. Led by my Chief Pharmaceutical Officer, the Department has had engagement with Community Pharmacy and developed a working relationship with that representative body to develop a commissioning plan for services up until March 2021. The plan focuses on the provision of services to the public during the coronavirus pandemic to ensure access to medicines at this time, including the funding and commissioning of the prescription delivery service for certain patients. It is my Department's intention to continue that work with Community Pharmacy Northern Ireland to negotiate a new commissioning document and road map for the delivery of services during 2021-22 and beyond. That will be developed further in due course, once we are over the current pandemic.”
“I might have touched on the last piece, Mr Robinson. We are seeing the early shoots of the benefits that the vaccine programme will bring. We have often talked about it being the light during the dark days of the pandemic. While we are seeing good numbers and good uptake and people are about to start receiving their second dose of a vaccine, I caution that we should not take those rays of hope and extinguish them too quickly by rushing out of the current restrictions and regulations. We need to balance the benefits that vaccination brings against managing regulations and restrictions until we see greater vaccination of the entirety of the population of Northern Ireland.”
“— and the residents and staff vaccinated with the first dose, while 99% of homes have received their second visit for the delivery of second doses. <BR /> <BR />I think that I have proved that I get no favour in the House.”
“<BR /> <BR />With the focus firmly on protecting those most at risk from the virus, the programme has expanded to cover everyone aged 65 and over, those who are clinically extremely vulnerable to COVID-19, carers and the clinically vulnerable. That is priority groups 1 to 6. The trusts' mobile and roving teams will focus on groups for whom travel to a vaccination centre would be challenging, such as elderly residents in care homes or supported living centres where the clinical risk is considered to be similar to that in a care home. Again, the programme is entirely dependent on the supply of vaccine, but rapid progress has been made. The vaccine has been offered to those in priority groups 1 to 5 and is now being extended to those in priority group 6. That should be completed in March. All care homes have been visited once —”
“<BR /> <BR />The long-term success of the programme depends on achieving high uptake rates in all sections of the adult community, and every effort will be made to ensure that the programme continues to be rolled out rapidly. The main variable impacting on the vaccination of the population is the availability of vaccine. It is hoped that vaccine supply will increase. That, combined with a strong uptake of the offer of vaccination among the population, should help the rate of vaccinations to rise. The rate of increase should also be assisted by the opening of an additional mass vaccination centre at the SSE Arena that, we hope, will become operational in April.”
“I thank the Member for his question. As of close of play yesterday, 499,206 vaccines had been delivered in Northern Ireland; that is just shy of half a million. Some 468,000 people have received their first vaccine, which is 95% of the over-80s, 90% of the over-75s, 84% of the over-70s and 69% of the over-65s. As the Member may be aware, we have now moved to the groups of people who are clinically extremely vulnerable or carers. Those figures are a testament to the effective work of GPs and trusts in deploying the vaccine as rapidly as possible. It is hoped that, in line with the commitment in other parts of the UK, the vaccination programme will be open to all adults over 50 by 15 April and all of the population by the end of July.”
“In order to get to a position where my Department could issue a commissioning direction, as the deputy First Minister is aware, and in furtherance of legal advice, I brought a paper for discussion to the Executive on 3 April 2020 that provided options for the establishment of an early medical abortion service in Northern Ireland during the COVID-19 pandemic. As yet, no decision has been taken by the Executive, and therefore there is no commissioned service for abortion in Northern Ireland.”
“Yesterday, the deputy First Minister stated that, in her opinion, it is my legal responsibility as Health Minister to make available the services to which women have a legal right. 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 for discussion and agreement. I stand by my view that the commissioning of abortion services could be considered to be significant or controversial and outside the scope of the Programme for Government. <BR /> <BR />The commissioning of the service also seems to cut across the human rights responsibilities of the First Minister and deputy First Minister. In view of that, I am obliged, under the ministerial code, to bring the matter to the Executive to be discussed and agreed, before it can proceed.”
“I have never ducked a question here before, Mr Deputy Speaker, and I am not going to start now. My Department does not dispute that women in Northern Ireland are legally entitled to abortion services. The legal advice that my Department received stated that, while 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.”
“Once we get through the work that Whiteabbey is doing to support COVID patients through their rehabilitation, using nurse-led allied health professionals, it will be about how we take that facility to the next step, should it be for orthopaedic provision or for the rehabilitation of stroke patients. <BR /> <BR />People are welcome to look at the bids that we have for the use of that facility so that they can see how our health service is looking to the future and how we can use the developments and the progress that we have had to make in the past 12 months to create a better health service. We do not simply want to return to what we had this time last year.”
“I thank the Member. We have been careful to ensure that any large-scale investments that we have made, such as that at the Whiteabbey Hospital facility, are future-proofed. He will be well aware that all the reforms and reviews of the health service that have taken place over the years have been about restructuring services, rather than closing buildings and hospitals. That is not what I am about. <BR /> <BR />During the pandemic, we have seen that our current footprint is under too much pressure. The service has been underutilised and underfinanced for the past 10 years. When we have the opportunity to rebuild and rejuvenate sites such as that at Whiteabbey, it is about looking at how we take them forward.”
“However, we also have to be cognisant that, through the first wave of the pandemic, our workforce stayed on their feet because of adrenalin. They stay on their feet now because of their dedication to their patients and their colleagues. We must always factor in the well-being of our staff as we look to rebuild as quickly as possible but also support staff who have been at the sharp end of the pandemic since it began this time last year.”
“I thank the Member. I am sure that no bias was intended. Rather than being in my favour, it is usually the other way round with the Deputy Speaker. <BR /> <BR />The Member makes a very important point about getting our health service back to delivering the services that many of our healthcare professionals want to provide. The professional services that they provide are what they have trained for, and they want to see patients back in waiting rooms, in theatres and on operating tables. We are preparing another set of three-monthly rebuilding plans, which I hope to publish in the very near future. We will do that once we see a continuing trajectory of a decrease in the number of inpatients in our hospital system.”
“As the Member will be aware, in New Decade, New Approach, the reduction of waiting lists was a priority for the entire Executive. The current Budget is out for consultation, and we will seek support in order to provide additional staff and capacity and to be able to use the independent sector. Anybody who wants to respond to the ongoing public consultation is welcome to do so to ensure that the voice of Northern Ireland society is heard on how it wants to address unacceptably long waiting times. That was the case before COVID-19, and it definitely will be after it.”
“Our HSC trusts are working with clinicians and the Health and Social Care Board to prioritise the care needs of patients who have been referred to the HSC system and to ensure that all available capacity, including that in the independent sector, is utilised as effectively and equitably as possible across the entire region. <BR /> <BR />Reducing elective care waiting lists to an acceptable level will require significant and sustained investment and additional staffing. I have made it clear that hospital waiting lists must be a major Executive priority in 2021 and beyond.”
“<BR /> <BR />Even during a rising number of cases at the end of last year, those rebuilding efforts continued, and, thanks to the huge efforts of staff during phase 3, which was October to December last year, our health service exceeded the projected activity for the number of outpatient appointments delivered at a regional level by 16%. As we emerge from the latest wave of the pandemic, the focus of the health service will continue to be on resettling all elective services, including outpatients, in an environment that is safe for staff and patients. <BR /> <BR />The situation is extremely challenging.”
“I thank the Member for his question. I fully appreciate that all patients should be able to avail themselves of the best treatment that the health service can provide in a timely manner. Waiting times were wholly unacceptable before COVID-19 and, regrettably, they will be even worse after it. <BR /> <BR />After the first wave of the pandemic, I was clear that rebuilding services across all programmes of care, including outpatient services, needed to be a key priority of the health and social care system. To that end, trusts were required to publish rebuilding plans on a three-month rolling basis, which set out plans to increase HSC activity incrementally.”
“Care homes are being actively encouraged to adhere to all aspects of the revised visiting guidance, including the introduction of care partners. Care partner contact can continue, provided visits are aligned with infection prevention and control measures. In addition to that, my Department is undertaking work to facilitate the testing of care partners as part of the care home staff testing programme. Trusts will continue to engage with care homes to reinforce the care partner message. Key workers are also ensuring through family communications that families are aware of that role and are offering support to them to help them to set up the role when that need is identified.”
“The Member raises the impact of restrictions on visiting and contact with families. That has been recognised, and the trusts are working in partnership with families and care homes to ensure that contact is maintained between residents and relatives in line with regional visiting guidance. <BR /> <BR />It remains my position that care home visiting and the subsequent implementation of the care partner role is critical to the health and well-being of care home residents, particularly those with dementia. The care partner contact is in addition to visits to a resident, and that is organised according to the care home's visiting policy and the Department of Health's COVID-19 regional principles for visiting. However, the level 5 visiting restrictions should not prevent care partners from being permitted access to care homes.”
“My Chief Social Work Officer is leading on that work so that we can progress it and make sure that it not only encapsulates what has happened in the pandemic but encapsulates the longer-term benefits for our health and social care services.”
“The Member is well aware of my desire to make that change in our adult social care and our social care service across Northern Ireland. I am on record saying at the Health Committee that it is the Cinderella service of our health service. One of the outworkings of the pandemic has been to bring that workforce, and the dedication in the work that it provides, into the limelight. It is my challenge, as Minister, to make sure that those people continue to receive recognition and acknowledgement, not only for their work but for their commitment to the people whom they look after. As I said in answer to Mr McGlone, this is ongoing work, but we want to get it right.”
“The Member partially answered his question. There is ongoing reform of that service. The specific support that is being given to those with dementia who are living in care homes and who have borne the brunt, as the Member rightly indicates, of the pandemic is about the additional supports and measures that we put in place now, rather than our waiting specifically on that piece of work being completed with regard to strategies and implementation. We made sure that those people were part of that vaccination group because of the exact specifics, as the Member realises, that made them more vulnerable from the first wave and that we saw and acknowledged.”
“People living with dementia who are in receipt of residential and nursing home care were amongst the top priority groups for the first round of vaccinations.”
“That protection includes the application of infection prevention and control measures, such as the use of appropriate PPE by care staff, the introduction of social distancing where possible and the suspension of most visits to care homes where there has been a COVID-19 outbreak. <BR /> <BR />A number of regional supports have been made available to care homes with dementia units, including staffing and financial support on a regional and trust basis, and the provision of extra training and education sessions related to supporting dementia residents and care staff. The aim of that is to understand and respond to changes in behaviour in people with dementia during the COVID-19 pandemic.”
“I recognise that, for many people living with dementia and their families, the past 12 months have been extremely challenging. Many people who live with dementia will have other significant health vulnerabilities and needs that place them at particular risk from the COVID-19 virus. Monitoring is particularly important for individuals with dementia who may be less able to report symptoms because of communication difficulties. Measures have been put in place to provide protection against the virus for people living with dementia either in their own home or in a care home setting.”
“I am on record talking about the value that I place on the skill, dedication and hard work of the health and social care staff. I have seen first-hand the magnificent job that all health and social care workers perform, the risks that they take and the sacrifices that they make. That has never been more evident than it is now in how they are dealing with COVID-19. My officials are finalising the details of the special recognition payment, and answers to frequently asked questions are available on my Department's website. <BR /> <BR />It is highly unlikely that that payment will be made in this financial year, but we will process it as quickly as possible. It covers a large section of not just our own workforce but additional workforces, which we have acknowledged will receive part of, or subsequently, all of the payment.”
“Support for additional costs above normal childcare costs will be reimbursed by the trust and through working with us, the HSC trusts, HR, Finance and finance colleagues in the Department. Any funding for additional childcare in these circumstances will be covered, but people should also be aware of the resulting tax implications, as HMRC will see it as a taxable benefit.”
“I thank the Member. As she said, childcare availability in the pandemic was one of the key actions, and it has continued to function in Northern Ireland since the start of the pandemic, although in a limited way. Initial access was restricted to vulnerable children and, as the Member said, the children of key workers.”
“I thank the Member. If he is willing to share that information through my private office, I will follow up on it. He referred to 18 June. The additional support is in place for this wave of the pandemic and for the extra work and the extra pressures that it is putting on our health and social care staff. <BR /> <BR />If the Member could forward that detail to me. I will make sure that all the trusts are aware of the answer that I have given to the Member as well.”
“We hope to resolve those issues as quickly as possible.”
“<BR /> <BR />Following the recent surge in COVID-19 cases and the need for a further lockdown and school closures since the start of January 2021, there have been a small number of cases in which the childminders of HSC staff have ceased operating and/or their working hours have changed, after-school clubs have closed or they can no longer access informal childcare arrangements. In those instances, any additional costs — I stress additional costs — for childcare that have been legitimately incurred by health and social care workers as a result of the pandemic will be reimbursed. My officials, along with trusts' HR and finance colleagues have been exploring a range of options for funding additional childcare costs in those circumstances and the resultant tax implications, given that that is seen by HMRC as a taxable benefit.”
“I thank the Member for his support. We all owe our health and social care (HSC) workers a great deal for their exceptional efforts. They have gone over and beyond what one could normally expect to see. <BR /> <BR />During the initial period of the pandemic, some health and social care trusts provided childcare free of charge to key workers on an interim basis. That is to be commended. Those trusts continue to support staff with their childcare needs and have actively encouraged staff to use the different flexible working options that are available to them, including utilising their local schools, which provide care during the day for the children of key workers.”
“I think that the Member is referring to the regulations and the change of regulations that are being brought forward. Given the pace at which they move and the way that the changes are made, it is not possible to carry out full equality impact assessments on the change of regulations. I know that he raised the question —.”
“One of the things that came forward, especially from the ethnic groups, was not to, I suppose, contain them within the same information that is coming out of GB about access to services, information and the vaccine. They wanted to be very clear that there seemed to be two different narratives and that the support for and uptake of the vaccine in Northern Ireland was greater than among their counterparts across the water and, shall we say, at the same level as the Caucasian population of Northern Ireland. That is because of the work that they have done, supported by the Public Health Agency and a number of other agencies that have engaged with the key stakeholders through the Regional Traveller Health and Social Wellbeing Forum and the Migrant and Minority Ethnic Council. That information has been disseminated throughout the pandemic.”