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. The changes were announced over the weekend. I made the decision based on advice from the Advisory Committee on the Safety of Blood, Tissues and Organs (SaBTO) following its consideration of a report by the For the Assessment of Individualised Risk (FAIR) steering group. The recommendation was to implement the introduction of an individual behaviour-based risk assessment that will allow some men who have sex with men (MSM) to donate blood if they have one sexual partner who has been their partner for more than three months. I am pleased to be able to introduce that change to the donor deferral policy in Northern Ireland, which means that MSM in longer-term partnerships will no longer be automatically deferred from donating blood provided they have been with the same partner for the previous three months.”
“Legislation will be required to give effect to these proposals and, following the consultation period, it is my intention to bring a draft Bill to the Assembly at the earliest opportunity, subject to the advice of the Office of the Legislative Counsel and the agreement of the Executive, within the current mandate, if feasible. <BR /> <BR />I encourage everyone to read about the consultation and to submit a response on the Department's website. In the meantime, I urge everyone to discuss their wishes for organ donation with their family and friends. I look forward to the support of the Health Committee in bringing forward the legislation as expediently and quickly as possible.”
“The Member will be fully aware of the work that was originally commenced on this issue by our party colleague Jo-Anne Dobson. It is something that we, as a party, have committed to in the past. That is why I was pleased to launch the public consultation on the introduction of a statutory soft opt-out system earlier this week. That consultation runs until 19 February. At that point, my Department will publish details of public engagement events that will take place in the new year to ensure that all stakeholders have an opportunity to hear about the proposals and submit responses.”
“I thank the Member. I try to smile occasionally, but it is not easy, being an Ulster Unionist.”
“Our visiting policies are kept under constant review, especially with regard to where we see the coronavirus spread across the community. Where we see increased community spread, we have to add additional restrictions on visiting capacity. Until we get into a place where we see a continued reduction in the number of COVID cases that are active in our community, it is highly unlikely that we will see a massive change in any visiting policy for hospitals. We must remember, even coming up to Christmas, that the virus does not recognise the time of the year, the calendar or social events. We always have to take the same due care and caution, no matter what the time of year. That is what the Member's original question was about.”
“What may be a supportive and welcome three-hour respite over the Christmas period back in the family home has to be balanced with the challenges to that individual of the period of self-isolation that they will have to take part in when they return to the care home. That is why I said in an earlier answer that that should be carefully considered by residents, families, friends and care home staff. The more residents who leave a care home and return, the more pressure will be put on some of the care home facilities with regard to being able to provide that supportive self-isolation.”
“I thank the Member. That is part of the guidance that we have given for care home visiting over Christmas. It is important for those individuals and families who are able to take someone out of a care home for a family visit during this special time of year that we take the same precautions when that individual returns to the care home, so there are additional pressures. That is what I said with regard to someone coming back into a care home as well. On returning to the care home, the resident will have to self-isolate. The impact of that period of isolation on the resident has to be taken into consideration.”
“Specific guidance will be provided, I am sure, by the Education Authority to schools. However, I will ask and ensure that the PHA carries forward that communication, so that a clear line of sight and guidance is there and accessible. Any child who presents with symptoms of COVID-19 goes through the same process as an adult when it comes to identifying or accessing testing after that point, if they are not in school.”
“The PHA's contact tracing team; the greater team will take over what has been the work of a very specialised cell to support principals and staff.”
“We have been working closely with, and taking guidance from, MHRA and the Joint Committee on Vaccination and Immunisation with regard to what vaccines are suitable for certain cohorts. It is a welcome step that the Pfizer vaccine is suitable and can be used for care home residents and staff, because we can get it. That vaccination programme has been started. As I said, just over 4,000 people have been vaccinated since we received that accreditation. As each vaccine is accredited by MHRA, we look at the green book guidance to see what clinical groups it is suitable for and to ensure that we know what clinical groups it is not suitable for. That is the guidance and training that is given to all our vaccinators before they go out to deliver a vaccine.”
“<BR /> <BR />My expert advisory group on testing is keeping an eye on the mass testing programme that we have seen being piloted in parts of south-east England to make sure that we can use that testing to maximum efficiency and efficacy not only to facilitate support for the care home residents and staff but to allow safer visiting.”
“I thank the Member for her question regarding the support that we have given to care homes. We are managing 87 care homes that have had outbreaks. It is a challenging time for those homes and the residents in them, but I welcome today's indicator that we are beginning to see that number decrease. That has been brought about by the testing regime, in which we test weekly, that we have in place. Due to the weekly programme, we have seen a greater ability to identify asymptomatic residents and staff. Only 40 of the 87 confirmed homes are currently showing symptomatic residents. Our weekly testing programme has picked those up.”
“<BR /> <BR />I recognise the need for families to come together at Christmas, but it is critical that we keep doing everything that we can to stop the virus spreading as we begin the process of vaccinating those who are considered to be most at risk from coronavirus.”
“Members of that bubble should strictly limit their contact with others in the two weeks before a visit from the care home resident. Other precautions, such as good personal hygiene and regular handwashing by everyone, should be maintained. On returning to the home, even if visiting away for only a few hours, the resident will have to self-isolate. The impact of that period of isolation on the resident, as well as on the care home's ability to accommodate such periods of self-isolation, should be carefully considered by the resident, family, friends and care home staff in any discussions.”
“Care homes are asked to make particular efforts at this time to facilitate visiting, in line with the regional visiting guidance, by offering a range of options for visiting. They include indoor visiting rooms or areas, visiting pods, outdoor visiting and virtual visits that can take place in line with the care home's visiting policy. Visits into care homes are preferable to those out of care homes by the residents. Longer visits away from the home carry greater risk. Shorter visits, ideally, for a few hours, are, therefore, preferable if a visit away from the care home is to take place. <BR /> <BR />If a visit out of the care home is agreed, a number of measures to mitigate the risk of bringing infection back into the care home are identified. When away from the care home, the resident should be in contact with only one household bubble.”
“I thank the Member for her question. On 10 December, my Department issued additional guidance on Christmas visiting arrangements in care home settings, and that is available on the nidirect and Department of Health websites. That additional guidance emphasises that care homes should recognise the right to a family life for those in their care. In particular, it acknowledges the importance that many people attach to seeing family and friends over the Christmas period.”
“That work is ongoing, and a number of avenues are being looked at — whether we follow the Scottish or the Welsh model, whether it requires legislation or a framework model, and what can be done in the time that we have left in the rest of the mandate to bring forward that legislation — to make sure that safe staffing and the rest of the framework commitments that the Executive signed up to are delivered.”
“I do not see any opportunity that would move nurses to take strike action, because I do not recognise the statement that there has been no movement to date on safe staffing. There have been conversations about the terms of reference, and there has been engagement on workforce planning between my Department and the unions that are involved. <BR /> <BR />The Member will be fully aware that I and the Executive gave a commitment when we were able to bring our nurses and other healthcare workers off the picket line earlier this year that not only pay parity but safe staffing would be a priority for me, my Department and the Executive.”
“As Members will be aware, that decision was taken by the Nursing and Midwifery Council in order to meet its requirements for students to be able to complete the 2,300 clinical placement hours. It is not that we do not value greatly the work that they do and the commitment that they give to those roles, even in a training capacity, because we do. The statement was made by the Nursing and Midwifery Council regarding the supernumerary status of nursing students.”
“Thank you for your direction, Mr Deputy Speaker, but I often answer many such questions in here. <BR /> <BR />The Member said that a decision was made not to pay student nurses, but it is a regulatory requirement that nursing and midwifery students must complete 2,300 clinical placement hours in order to be able to join the NMC register. The emergency standards ended on 30 September, and students returned to supernumerary status. There are no plans at present to reinstate those arrangements. That is a UK-wide position. The Nursing and Midwifery Council has issued a joint statement, which was signed by the four UK Chief Nursing Officers, confirming the present position on keeping programmes on track and safeguarding supernumerary status.”
“The Member will not be the only one to take credit for my announcements. Like anything else, success and delivery have many fathers. <BR /> <BR />It is hoped that the payments will be made by the Business Services Organisation in time for the December payroll. BSO has done a tremendous amount of work since I gave it the direction to try to get that money in place. I can guarantee that, if it is not in the December payroll, the money will definitely be paid in January. Our intention is to get it out to as many as possible before Christmas. I thank and congratulate the Business Services Organisation for moving so swiftly to deliver it.”
“I thank the Member for his question. The Executive have discussed this matter many times and sought numerous pieces of legal advice. I am pleased to report that the Executive agreed to my latest proposals at our meeting last Tuesday. The regional Business Services Organisation (BSO) has been instructed to make the necessary arrangements for the reimbursement of any deductions previously made to pay.”
“It is also important that patients can move from west to east because, as I am fully aware, when we need to send patients, including vulnerable children, for specialist surgery, it is important that we have access to skilled professionals in Birmingham hospital and Evelina hospital. Those working relationships are in place. <BR /> <BR />If the Member provides me with details, I will follow up on the specific issue that she raised about no neonatal cots being available on the island.”
“I thank the Member for her question. I am unsure of what exactly she means by "neonatal cots" or the point of time at which none was available. The departmental website details the number of available ICU paediatric beds, and I do not think that it has shown that they were completely full at any time. I am happy to take up that specific matter with the Member after Question Time. <BR /> <BR />We are able to transfer patients, especially paediatric patients, to the Republic of Ireland. We have built up a relationship, especially in critical care, so that, if need be, patients can move from North to South or from South to North.”
“Patients and health professionals are willing to travel, so the Assembly's support for the work that our health service is willing to do to tackle our waiting lists and support patients would be well placed.”
“I thank the Member for her question. I do not have those statistics to hand today but I can certainly provide her with an update. We are looking at a more regionalised approach to waiting lists across a number of disciplines. I would like to see the same level of access to a procedure no matter where somebody lives in Northern Ireland. It should not depend solely on the capacity in one trust. As I said earlier, one of the things to emerge from COVID is greater collaboration. Surgeons and patients are more willing to travel, and we are able to deliver services to people when they need it, but it will not always be on their doorstep. As politicians, we often face that challenge in our health service, and campaigns are run by people trying to retain everything on their doorstep.”
“Those will work regardless of Brexit. They are negotiated relationships with the Irish Government, and they will continue. We will continue to build on them by looking, for example, at how we can provide some kidney transplant and other organ transplant services for patients from the Irish Republic.”
“That conversation is ongoing, not just between the Irish Government and us but, because some parts of this are devolved and some are centralised, between the Irish Government and Westminster. A three-way conversation with officials is ongoing. We will raise the subject again at the meeting of the North/South Ministerial Council that is due to take place in a few days' time. We are fully aware of not only patients from Northern Ireland traveling to the Republic of Ireland but large numbers of patients from the Republic of Ireland coming to Northern Ireland for cataract operations and suchlike. We already have, as we touched on yesterday, a number of cross-border working relationships: children's cardiac surgery is being performed in Dublin; and Altnagelvin provides support for cancer services and palliative care.”
“Additional funding will be necessary to do that, because with that we can support more staff to deliver the services that we need.”
“One of the things that has come out of COVID has been a breaking down of silos that were not created intentionally or systemically but that grew over time. We have seen surgeons from Belfast being willing to travel to the South West Acute Hospital (SWAH) and take lists and patients with them to make use of our facilities that are in another part of Northern Ireland. We are no longer looking at simply working in trusts or trying to centralise services; we are looking at a regional approach. I am hopeful that, once we get through this pandemic, which I firmly believe that we will, the new working procedures and collaborations that we have seen across a number of specialities in a number of disciplines will make a serious dent in our waiting lists.”
“I thank the Member for his pertinent question. With regard to bidding, I will be chancing my arm for as much as I possibly can get to tackle waiting lists. As I said, when I took up this post back in January, waiting lists were an Executive priority and there were additional moneys in New Decade, New Approach assigned to address them because, as an Executive, an Assembly and a society, we realised that they were too long. <BR /> <BR />Waiting lists have got longer, and we are looking at how we can reconfigure some of our services from day elective units in Lagan Valley, which I visited last week. The surgeons, the nurses and the rest of the staff there have exciting plans on how they can reconfigure the way in which we deliver services across Northern Ireland.”
“For example, there has been a much greater use of technologies, such as telephone and virtual clinics. Outpatient appointments have, where possible and appropriate, moved to telephone appointments. In addition, a growing number of specialities are adopting virtual clinics, using videoconferencing. Embedding those recent innovations will be essential to maximising elective activity during the pandemic and in the future. <BR /> <BR />Waiting lists were a clear priority in New Decade, New Approach. However, those plans have been delayed by the pandemic, and I am conscious that public spending is likely to be very constrained next year and that all Departments will be facing serious funding pressures. Tackling waiting lists will not be possible without sustained and substantial investment and additional staffing.”
“Each trust surpassed its target for the period of July to September, but the pandemic has undoubtedly exacerbated what was already a crisis with waiting times. Given the reduction in the level of elective activity that can be delivered by trusts as they focus their efforts on responding to the pandemic, they have been utilising the local independent sector's capacity to support the delivery of core health service activities and the rebuilding of our services. During the period from 1 April to 15 November, approximately 3,500 patients had their procedures carried out in the independent sector, which was paid for by the health service. <BR /> <BR />In rebuilding services, trusts have taken into account new and innovative practices that were introduced during the first wave of the pandemic.”
“Similarly, there were 39,907 outpatient reviews in April compared with 56,071 in October. Overall, there was over 73% more activity in October than there was in April. Our surge and rebuild plans were effective in keeping services going.”
“<BR /> <BR />In the wake of the first wave of the pandemic, I was clear that rebuilding services across all programmes of care, including elective care, while protecting staff and the public from COVID-19 was a key priority for the health service. Thanks to the huge efforts of our health service staff, much progress was made to restart elective care services. <BR /> <BR />During the first wave, our health and social care system delivered 12,150 new outpatient consultations in April, and there were 29,163 in October. Some 4,859 inpatient or day-case procedures were delivered in April compared with 13,301 in October.”
“Mr Deputy Speaker, with your indulgence, I ask for extra time to address this question as it is an important subject. <BR /> <BR />Elective care waiting times were unacceptable before COVID-19, and, unfortunately, they will be even worse after COVID-19, because the need to redirect HSC resources to respond to the pandemic has had an inevitable and serious impact on waiting lists. The spread of coronavirus is continuing to cause serious disruption to our health and social care system, and it was unavoidable that elective care activity would reduce due to the need to redeploy staff to COVID-related activity.”
“I thank the Member for her question. As I said in answer to the original question, 870 people have come forward to be part of the vaccination programme. They are part of the initial wave of those who will receive the vaccine. Those 870 individuals have submitted application forms to help out as vaccinators during the programme. They will be supported by administrative workers, delivery workers, pharmacists and everybody else who is playing a vital role in making sure that we get the vaccine delivered in compliance with the strict delivery processes and management protocols.”
“<BR /> <BR />The First Minister and deputy First Minister and I visited our test, trace and protect system in the PHA building in County Hall, Ballymena, on Friday, and, as far as I am aware from their press statements and public statements, they were impressed with what they saw and the service being delivered.”
“I thank the Member for his question, although I am unsure how it links in with the substantive question from the Member for Strangford. However, I can answer that. There has been expansive investment in the PHA, not only in finance but in people, to ensure that it could complete all its duties over the period of the pandemic, including an impressive increase in the test, trace and protect system. It is now contacting well over 90% of individuals within a 24-hour period, and, to a lesser extent, within a 48-hour period, at a more effective level than other devolved Administrations. The strength of the Public Health Agency has been added to and improved and will continue to be invested in.”
“The Member makes a valid point about the cut-off date for accreditation. If she knows of anyone, I will gladly take their contact details. I have been contacted by a number of GPs who find themselves in exactly the same position with the timeline. However, they can engage, and, after an hour or an hour and a half of online training, they can be part of the vaccination programme. If the Member knows of individuals, I am happy to take their details. We are encouraged by the high numbers of people who have come forward to be part of this important programme. To date, 870 people have come forward to go through a process to assist in what will, hopefully, be mass vaccination programmes across the entirety of Northern Ireland, including North Down.”
“I thank the Member for her question. Training for those who administer the COVID-19 vaccine is mostly completed online. The HSC Clinical Education Centre has provided some one-to-one training under the service level agreement. To date, there have been no additional costs.”
“I thank the Member for his request for a press release. I can give him the update that there will be no geographically specific priorities for an area. Those will stick strictly to the JCVI's accreditation and deliberations on who needs the vaccine most. As I said earlier, the venue that will be used in the Southern Trust area is the South Lake Leisure Centre in Craigavon. In the South Eastern Trust area, it will be the Ulster Hospital at Dundonald. That is where initial programmes will start. Care homes in the Member's constituency will also receive the vaccine for their residents and staff.”
“<BR /> <BR />While the vaccine provides a crucial tool to allow visiting to take place, we must ensure that not only do we get the first vaccination in place but we get the second one in place and encourage as many residents and staff to take up the offer of a free vaccine, which is delivered by the NHS and supported and paid for by the British Government.”
“I thank the Member for that point. As we have made clear in the past, it is not the initial vaccination that is most important but the second one and giving it time for the efficacy to kick in. I can update the Member that, as of today, we have had vaccination teams across all five trusts and have vaccinated in up to 54 care homes. We have started with those that have the largest number of residents. That is just shy of 4,000 individuals, including care home residents and workers and the vaccination teams themselves.”
“As I have said, the JCVI has set clear prioritisation for those who receive the vaccine, and at certain levels. Therefore, as regards whether I can guarantee access to the vaccine, yes, I can, because we are part of that UK pre-buying, which will see a massive number of vaccines being made available to us. Additional vaccines, once they have received MHRA accreditation and approval, will also be part of the additional programme.”
“I thank the Member for her comments. However, as I am sure that she is aware, I do not agree with them with regard to the vaccine. If we had been left to procure the vaccine on our own, we would have neither the buying power nor the financial capability to pre-buy seven different vaccines to the extent that we have, or been able to provide the accreditation or certification that the MHRA has provided to allow us to be part of the first delivery of vaccines across the world. We are now delivering them into care homes and vaccinating their staff and residents. <BR /> <BR />With regard to the delivery of vaccines, we have already received upwards of 50,000 of the Pfizer vaccine, which allows us to vaccinate just over 20,000 individuals.”
“We are entering an extremely challenging winter for the NHS in Northern Ireland. I cannot stress enough the importance of the population following the public health advice in order to drive down infections.”
“Due to the logistics of the strict handling conditions attached to the use of the Pfizer vaccine, it is very difficult to deploy the vaccine in a GP setting. However, every effort is being made to try to arrange either a trust-based or GP-based programme for the over-80s. From early January 2021, subject to the availability of a suitable vaccine, it is intended to roll out the programme through primary care-led vaccination clinics that will be responsible for the vast majority of eligible individuals of 50 years and over. GPs will work their way down through the eligible cohorts, starting with the oldest. <BR /> <BR />While the start of the vaccination programme is a highly positive development, I stress that it will be months before the vaccination programme is complete.”
“<BR /> <BR />My officials have worked closely with the Medicines and Healthcare products Regulatory Agency (MHRA) to develop a deployment model that will enable deployment in care homes and that takes into account the unique characteristics of the vaccine, including transport requirements. Teams from health trusts will vaccinate care home residents, working closely with local GPs under comprehensive health trust governance arrangements that are designed to ensure that the integrity and efficacy of the vaccine is maintained throughout. Trust mobile vaccination teams intend to visit all the homes over the next few weeks subject to dealing with any that have a current COVID-19 outbreak. <BR /> <BR />We are considering how the arrangements might be extended to include the over-80s living in the community.”
“However, in light of the planned delivery schedules of the vaccine in December and January, the staff programme will now have to be phased, starting with those who are at greatest risk or those who work directly with patients at the greatest risk. Ultimately, all health and social care workers will have the opportunity to be vaccinated, and that is expected to be within the first quarter of 2021. There will be seven trust vaccination sites operating in Northern Ireland. Those will be located at the Royal Victoria Hospital; the Ulster Hospital in Dundonald; South Lake Leisure Centre in Craigavon; Seven Towers Leisure Centre in Ballymena; Foyle Arena in Londonderry/Derry; Omagh Leisure Complex; and Lakeland Forum in Enniskillen.”