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 />There are areas of concern relating to elective and emergency activity; radiology, pathology and cytology results; patients whose cases were considered in multidisciplinary team meetings; oncology; and the safe prescribing of an anti-androgen drug outside established NICE guidance in the management of prostate cancer. Across those areas, to date, 1,159 patients' records have been reviewed, and 271 patients or families have been contacted by the trust. The group's work continues across those areas of concern. Further details of the various review strands are appended to the statement.”
“<BR /> <BR />The trust also established a review group to assess the further findings of the initial look-back exercise and to explore the potential need for a further look-back exercise in the context of the emerging concerns. That group has been working diligently since August, and I am now in a position to inform the Assembly of its most recent findings. Whilst Mr O'Brien has worked in the Southern Trust for 28 years, in consultation with the Royal College of Surgeons, the review group has looked at the time frame from 1 January 2019 until 30 June 2020. During that time, 2,327 patients were under his care. The review group identified the most vulnerable group of urology patients in that cohort and concentrated on those patients initially.”
“<BR /> <BR />When my Department was contacted on 31 July, the trust confirmed that the following actions had already been taken: discussions with the GMC's employer liaison service had been conducted; the case had been discussed with NHS Resolution, which recommended restrictions of clinical practice; restrictions were put in place by the trust preventing the consultant from undertaking clinical work in the trust and denying him the access or ability to process patient information; the trust requested that the consultant voluntarily undertake to refrain from seeing any private patients at their home or any other setting and that he confirm the same in writing; and a preliminary discussion was undertaken with the Royal College of Surgeons' invited review service regarding the consultant's practice and the potential scope and scale of any further look-back exercise that may be required.”
“The initial look back identified concerns with 46 cases out of a total of 147 patients who had the procedure and were listed as being under the care of the consultant during the period addressed by the initial look-back exercise.”
“The trust became aware that two out of 10 patients listed for surgery under the care of the consultant were not on the hospital’s patient administration system at that time. As a result of those potential patient safety concerns, an initial look-back exercise in relation to the consultant’s work was conducted to ascertain whether there were other areas of potential concern. <BR /> <BR />The initial look back, which considered cases over an 18-month period of the consultant's work in the Southern Trust from 1 January 2019 to 30 June 2020, concentrated on whether patients had had a stent inserted during a particular procedure and if the stent had been removed within the clinically recommended time frame.”
“Mr Speaker, it is with deep regret that I inform the House of a further occurrence of serious concerns about the clinical practice of a hospital consultant notified to my Department by one of our health and social care trusts. The incident concerns the clinical practice of a urology consultant, Mr Aidan O’Brien, who retired from the Southern Trust earlier this year. <BR /> <BR />On 31 July 2020, the Southern Trust contacted my Department to report an early alert concerning the clinical practice of the consultant. The trust informed my Department that, on 7 June, it became aware of potential concerns regarding delays in the treatment of surgery patients who were under the care of the consultant urologist employed by the trust.”
“In my comments this morning, I appealed for that united approach once again. So I say to the Member, to every Member and to anybody who is listening to this: let us put those differences, those political challenges and those political point-scoring opportunities behind us for the next number of days, weeks and months until we get this virus under control. <BR /> <BR />I support the motion. In concluding, I again remind all present, and those listening to this debate, about the important responsibility that we all have to ensure that we follow the public health advice to drive down infections. I appeal to everyone: reduce your contacts, keep your distance, wash your hands, wear a face covering and download the StopCOVID NI app. Mr Principal Deputy Speaker, thank you for your indulgence.”
“I know the point that the Member is making, and I respect the point that the Member is making. However, the common message coming out of this place must be one of encouragement to the people of Northern Ireland that there is hope, if we challenge COVID-19 as a collective. If it is done politically, that saddens and challenges me as the Minister of Health. What I do not want is some of the political commentary that has developed over the past number of weeks and months. <BR /> <BR />We were able to get Northern Ireland into a very good place during the first wave of COVID-19. We did that because we stood side by side. We did that because we stood shoulder to shoulder with our healthcare professionals, with those who had tested positive for COVID-19 and with those who needed support.”
“It remains essential that we address the impact of the virus on the population of Northern Ireland and that we protect our healthcare system, the people who work in it and, importantly, the people whom we serve who require care and treatment within it. It is clear from what I outlined here today that much progress has been made to date as we collectively find, test, trace, isolate and support those throughout society who have been impacted on by COVID-19. <BR /> <BR />Earlier, I said that COVID-19 was our common enemy. I firmly believe that it is our common enemy. It is not just the health service's common enemy, it is the common enemy of our economy and of our education service because, day and daily, we must tackle it not only at an institutional level, an Executive level and an Assembly level but at a personal level.”
“I am sure that a presentation can be provided for members of the Committee, who have been supportive of the work that we have been doing at a departmental level and of me as Minister. I am appreciative of the multiple engagements that I have had with the Health Committee and the proactive stance that it takes. However, I encourage Mr Sheehan to be challenging but not to get personal when dealing with the departmental professionals who come to present to the Committee. As I said, the vaccination programme will begin as soon as possible after it is made available to us in Northern Ireland. <BR /> <BR />In supporting the motion, I thank all Members who made contributions.”
“They are not yet approved for use in the United Kingdom. However, there is now a very real prospect that we will be in a different place next spring and summer as we deliver our vaccination programme. I acknowledge the enormous work currently in progress to ensure that we are ready to commence our programme as soon as the vaccine is made available to us in Northern Ireland. I hope that that will allay some of Mr Sheehan's concerns about the ongoing work.”
“It is important to highlight that the approach to contact tracing in the future will be based on that hybrid model of service provision. That model will focus on innovative digital solutions to reach and deliver early messages to cases and their close contacts while enabling targeted input from expert, professional healthcare staff who will risk-assess and deal with the more complex cases, clusters and outbreaks. Work to develop and refine this hybrid service model is being taken forward, at pace, through the Public Health Agency, and it is being overseen by my Department. <BR /> <BR />There is no doubt that more hard work and difficult times lie ahead, but it is important to know that there is hope. You will know that, although still early days, exciting progress is being made on COVID-19 vaccines.”
“Using that enhanced tracing approach, PHA's contact tracers are working with indexed cases to capture information for seven days prior to the date of their symptom onset or the date of testing if the case has no symptoms.”
“In association with conventional contact tracing, which aims to identify a case's close contacts and then reach them to advise them of the actions that they must take, enhanced contact tracing ensures that there is a strong focus on identifying the likely source of a case's infection and the potential common exposures that can lead to clusters and outbreaks. That was the issue that Ms Bradshaw specifically raised. <BR /> <BR />That combination of conventional and enhanced contact tracing will increase the contribution of the contact-tracing service to the control of community transmissions across Northern Ireland and to detecting the source of clusters in community settings.”
“The PHA is progressing significant work through social media and other media channels in order to encourage our public to stay vigilant in the fight against coronavirus and to ensure that everyone who has symptoms comes forward for a test. It explains the vital role of the contact-tracing system, how it operates in practice and its crucial role in preventing the daily spread of the virus. <BR /> <BR />In parallel with those developments, the agency has also commenced enhanced tracing for all new cases notified to the contact-tracing service from 16 to November.”
“However, we continue to use any benefit that the current period of restrictions affords us in order to strengthen the contact-tracing service. <BR /> <BR />The service continues to look for ways to improve and find new solutions to assist in the delivery of its functions. Increased understanding of the service and further developing the public's trust in the service model will continue to be essential to its success over the coming months. Our Public Health Agency is driving forward a mass media campaign to optimise the public's awareness and understanding of the components of the contact-tracing system and, in particular, to increase the public's awareness of the benefits of using the digital self-trace platform that is offered by the service.”
“It is clear that contact-tracing services in many other countries have experienced similar strains in recent months. Large numbers of positive cases have been notified for tracing as a consequence of increased transmission and disease activity. A number of digitally enhanced solutions have been introduced to our contact-tracing service, including a new digital self-trace platform. <BR /> <BR />The positive impact of those developments can be seen in the performance of our current service. For example, in the six-day period up to 16 November, 90% of indexed cases were contacted within 24 hours of notification to the service, while in the three days from 13 to 15 November, 92% of those contacts were successfully reached within 48 hours.”
“<BR /> <BR />Aligned to our testing programme, I am determined that our contact-tracing system will continue to offer us the best opportunity to identify cases and their close contacts as swiftly as possible and to disrupt chains of transmission between cases and their contacts. It is important to acknowledge the work of our Public Health Agency in establishing the service, which is the first of its kind to be established in the United Kingdom. <BR /> <BR />There is no doubt that our contact-tracing service has faced many challenges, not least the threefold increase in the numbers of positive cases that were notified to the service over a short period in October. That rapid increase in cases undoubtedly strained our contact-tracing system.”
“However, it is important that I highlight that those new testing interventions, which involve new approaches to testing and the deployment of new technologies, are additional to the COVID-19 testing programme that we have established and operate across Northern Ireland. It is also important to highlight that our current testing programme continues. That uses laboratory-based PCR testing and has to date focused mainly on the testing of symptomatic people. It will continue, and my Department will continue to work to further expand both pillars of that programme in the coming weeks and months.”
“Such a programme to test larger populations in Northern Ireland — for example, testing in a local government area — would, no doubt, pose many logistical and implementation challenges. Its success would rely heavily on cross-departmental and multi-agency joint working. However, I believe that it would assist us in further reducing infection and, by extension, protecting our health service and saving lives.”
“That will require swift and agile planning and roll-out over the coming weeks, working closely across a number of Departments and other delivery partners. <BR /> <BR />The testing technologies in those NTIs are based on saliva testing and swabs tested outside of laboratory settings. They use our lateral flow devices, which can produce results for the person tested within 60 to 90 minutes. As I mentioned, those new interventions test asymptomatic individuals — people with no symptoms — with the aim of improving our ability to detect the virus, find positive cases earlier and reduce the risk of onward transmission of infection. I am keen to offer new testing interventions at a larger population level in Northern Ireland as soon as is possible and practicable.”
“<BR /> <BR />The testing of asymptomatic students started today at Queen's University using our lateral flow devices. The learning arising from that NTI will be important to help us to better understand how asymptomatic testing can be implemented and extended more widely in the future to other parts of Northern Ireland. It is through undertaking those NTIs that we can develop fully informed plans for the future to everyone's benefit. Plans are progressing to offer testing to the wider population of students who attend Queen's University Belfast, Ulster University and a number of other colleges. In that context, asymptomatic testing will form part of a wider strategy to support and enable students to travel home for Christmas.”
“As we progress to implement those, we will evaluate the new technologies that are used for testing and realise their benefits for our citizens, services and wider economy. The testing of asymptomatic healthcare workers is due to begin this week. That NTI will enable the early identification of the SARS-CoV-2 virus in healthcare staff who do not have symptoms. That will ensure that those front-line staff self-isolate early, which will reduce the risk of onward transmission of infection. That testing will take place, in the first instance, with staff working in the Belfast Health and Social Care Trust in acute services such as oncology, haematology and nephrology. As I said, testing will commence this week, and roll-out to other trusts will follow in a planned manner.”
“I totally agree that robust systems for testing and contact tracing are critical if we are to try to limit the impact of COVID-19 on our lives, our livelihoods and, importantly, our health and care services. However, I urge caution: neither testing nor contact tracing alone can ever be expected to provide the full answer. They are an essential part of the equation, but no more so than the need for all the people of Northern Ireland to continue to follow the public health advice, which is vital. <BR /> <BR />I am pleased to advise Members that we are now commencing the implementation of a number of new testing interventions (NTIs). In Northern Ireland, those NTIs are part of the UK-wide population testing programme.”
“I am committed to reforming the services that we provide so that we can truly have a health service that delivers for all the people whom it serves. We have made real progress on a number of fronts. Members will be fully aware of the detail, including creating Northern Ireland's first regional day procedure centre at Lagan Valley Hospital, which provides a regional resource for less complex planned day surgeries and procedures. <BR /> <BR />The health service has rapidly introduced new ways of working, including the regular use of technologies such as virtual clinics, telephone appointments and videoconferencing to deliver services in new and innovative ways. In terms of the tools that we have at our disposal to address the challenges of COVID-19, our testing programme and contact-tracing systems are key.”
“<BR /> <BR />There is no doubt that the pandemic is having a devastating impact on our hospital services, particularly in elective care and increasing difficulties in our emergency departments. I take exception when people accuse me or my health service of turning into a COVID-19 service. The assessment and medical support that are given to patients, as they present, are assessed and delivered by clinical need, by extremely experienced and professional health service professionals who have been doing this day and daily.”
“Specifically, Mr Mike Nesbitt talked about mental health awareness in this place before it was seen to be the right thing to do in many other places. Mr Nesbitt has been championing mental health since long before many took up that cause. Thankfully, it is now firmly on the agenda not just of this place but of political discussions across these islands. Since taking up post as Minister of Health, I have been very clear that mental health is a priority for me. To underline that commitment, I appointed Professor Siobhan O'Neill as the interim mental health champion in Northern Ireland. I fully recognise the additional challenges that COVID-19 has presented for mental health, not least for our young people. I will ensure that this area remains front and centre in our response to the pandemic.”
“That is why the additional measures, which were agreed by the Executive last Thursday, are needed and were covered in my statement to the Assembly this morning. I am hopeful that we will come out the other end of this period in a better place and, in particular, that we will be able to reflect more positively on the R number at the end of the two weeks, in order that we can all enjoy some sort of normality, over a short period during Christmas. <BR /> <BR />I will turn to some specific issues highlighted in the motion. You will recall that our Chief Medical Officer recently spoke about the impact that the current situation is having on mental health right across society. That was raised by a number of Members today.”
“All that work, including the continuing efforts of many to maintain services where and when possible while tackling the largest pandemic of the modern world, is testament to the dedication and expertise of our staff across the system. <BR /> <BR />Following the decision by the Executive last week, we now face a challenging, but totally necessary, period of extended restrictions. I fully appreciate the huge impact that those restrictions will have across so many sectors in Northern Ireland and the many sacrifices that people are making, but it is my job to protect our health service and to save lives. I will not and have not shied away from that. Without this circuit breaker, we would, most certainly, continue on an upward trajectory that would cripple our health service.”
“No pressure. Thank you, Mr Speaker. First, I thank the members of the Health Committee for proposing the motion. It provides us with the valuable opportunity to consider the impact of the COVID-19 pandemic on our health care system, the staff who work across that system, and the patients and public whom we serve as we continue to manage and mitigate the impacts of the current pandemic. I have listened very closely to those Members who have spoken in support of this issue today, and I can confirm that I am happy to support the motion. I thank the Chair for the tone and tenure of his opening comments on how he wished the debate to proceed. <BR /> <BR />In what are, clearly, unprecedented circumstances, our fantastic health and social care service has remained steadfast in its dedication to patients and those in need of care and treatment.”
“My answer to the Member's main question is no, because we made advances in our testing capability and in the ability of test, trace and protect. As for lessons learned, we have instigated a backward tracing programme in which our test, trace and protect individuals are now asked where they have been for the past seven days. That is an enhancement. We have also made technological advances with test, trace and protect so that those who test positive can interact by a text message or online and additional advice can be provided. Steps were taken during July and August to make sure that those systems were more robust. <BR /> <BR />With regard to the testing regime, by using pillar 1, pillar 2 and now mass testing through the lateral flow, we have an increased capacity that is meeting our current need.”
“I would not say that they are fully supportive of the decision taken and the challenges that that brings, but they recognise that it was done in order to break the chains of infection.”
“While that may sound like simply a number, to put it into perspective, I ask the Member to picture in the back of his mind an eight-bed ward, which, I am sure, he will be familiar with from visiting many friends and family in hospital, and then picture 50 such wards solely supporting COVID inpatients. That demonstrates the challenges that our health service faces in supporting not just COVID patients but all other patients. <BR /> <BR />With regard to the decision on churches, as the Member rightly indicated, it is not one that I recommended or brought forward easily. The Executive, the junior Ministers, the Chief Medical Officer and the Chief Scientific Adviser engaged with Church leaders after the decision was made about what is necessary and why it is necessary. As I indicated, the Church leaders have made statements.”
“I thank the Member for his three questions. In regard to the First Minister and deputy First Minister not wanting to be here in case they were tagged with an unpopular decision, one of the things that have become clear since I took up post is that it is not about trying to be popular; it is about trying to do what, I believe, is right not just for the people of Northern Ireland but for our healthcare workers. <BR /> <BR />The Member rightly indicates the fall in the number of positive cases. However, I encourage him to look on through the dashboard to the number of COVID-19 inpatients who are in our hospitals, and he will see that, since 9 November, that number has not fallen below 400.”
“I know that many individuals are stepping forward to volunteer for that. However, I have always found that, when it comes to such positions, those who volunteer may not be the best people for the job, because they come with preconceived ideas that may not be of benefit. When such people were brought into either the health service, the Health and Social Care Board or the trusts, some of their ideas were not practicable or workable.”
“I thank the Member for her two questions. The messaging on Christmas is being discussed with the Chancellor of the Duchy of Lancaster, the First Minister and deputy First Minister, the First Minister of Scotland and the First Minister of Wales to ensure that there is a consistent approach. That conversation also involves the Chief Medical Officers to make sure that there is not a higher price to pay for what we do at Christmas. I look forward to that work concluding and a joint message coming forward. The Government of the Republic of Ireland are also included in that to ensure that there is consistency across these islands for all families. <BR /> <BR />The Member asked about bringing forward an independent task force to take over in order to take the politics out of decision-making.”
“The steps that had been taken are commendable and had broken many a chain of infection, but we were still seeing a number of cases coming through.”
“Again, I acknowledge the benefits that gyms provide. However — this is similar to a previous answer — through the test, trace and protect system, we saw outbreaks that were associated with gyms. That is why we took that decision and made the recommendation that gyms, too, close for the two-week period. I must stress to Members that it is for a two-week period while we reinforce that key, simple message to stay at home. That is the rationale that was taken. There is little point in a gym being open if the key message is to stay at home. There is still the availability of outdoor exercise that any individual can participate in. When it comes to what we could see through the test, trace and protect system, gyms were indicated as a source of infection.”
“The message that I give is one of apology to that individual and many others across the community who cannot engage with the services that they need because we are supporting patients who are coming forward with COVID and need to be hospitalised due to clinical decisions and interventions. The challenge — it is not one of a message of hope, because that message would bring little comfort — to us all is to drive down the rate of infection and to break the chains of transmission, so that we can successfully reduce the number of COVID inpatients in the hospital system and people like the person whom the Member mentioned can be brought forward to see the specialists they need to see as quickly as possible.”
“I thank the Member. I touched on the issue earlier. I attended what is the first initiative in Northern Ireland, which is being rolled out by Queen's University. It will see its students and staff tested using the new devices. That is part of the programme of travel corridors that will allow students to return home for Christmas. While mass testing may be part of a solution, it is not the solution, nor should it be seen to be. A lot of work is ongoing. We have considered mass testing of the population, but we have to make sure that it is an appropriate use of those lateral flow devices when we receive them and with regard to the number that we receive. However, it is part of the armoury that we are now building up that will make 2021 a safer place.”
“There is an ongoing conversation. One of the decisions that the Executive have made is to prioritise young people's education. More non-pharmaceutical interventions have been suggested as means to allow education to continue in a safe and practical manner. My Department engages regularly with the Department of Education to bring forward and discuss those suggestions.”
“It was not just about the activities in the classroom or in the school building; it was about what happened at the school gate, what happened when transporting pupils to schools and what parents were doing when their children were in school.”
“One of the conversations has been around early intervention and bringing forward the school holidays by a week. One of the points that have been made and been listened to is that, when schools are closed, if there is no adequate provision for young people to interact, they could end up being in a worse situation when it comes to the spread of COVID than they would be in their places of education. <BR /> <BR />During the four weeks that we had, the only difference that we saw between the first two weeks and the second two weeks was the opening of schools, and I think that the Chief Scientific Adviser indicated that, where we saw the R rate increase, it was not solely attributable to what happened in classrooms but was associated with schools. That was part of our messaging.”
“We have all heard some of the heartbreaking stories about those who have lost their life due to COVID, and there are many other stories that we have not heard or seen that are equally tragic and hurtful to many a family who will have an empty chair or chairs around the table this Christmas. I pass on my condolences to all families who have lost loved ones. I have said before that the hardest reports that I have read and continue to read are the daily reports that give us the number of positive cases and deaths. Behind each of those numbers is an individual with a family. <BR /> <BR />An assessment has been made and a conversation has been had in the Executive on the importance of education and continuing our young people's education as much as it is practicable and safe to do so.”
“<BR /> <BR />With regard to the analysis of behaviours, one thing that is increasingly challenging for my Department and the Executive is that there are those who seem intent on undermining our health message by their words or actions. Once you see that happening, it makes it harder for any individual to follow that advice and guidance in good faith. However, I welcome the statements from our Churches and religious leaders on the difficult decisions that have been made by the Executive as we once again try to bring the spread of COVID-19 under control.”
“On the Member's last point and given the Executive's interaction, through the junior Ministers, with the leaders of the Churches, I think that they all recognise the responsibility that they have and the challenges that they have in following the advice and guidance on how we manage COVID. As the Member will know, they are not easy decisions for me or for the Member's colleagues in the Executive, where the conversations were had. It is not about restricting anyone's freedom to worship or pray, and I am disappointed that the Member would even try to put that allegation to me because it is not in keeping with me.”
“However, as I am sure the Member will appreciate, we can progress to full service in day centres only when it is safe to do so.”
“<BR /> <BR />I appreciate the frustration felt in the House, by service users, by parents and by carers that day-centre provision is not yet available at the level at which it was accessible pre COVID to bring about that respite. My officials are working closely with the Health and Social Care Board and the trusts to identify ways to increase day-centre provision. In the interim, however, services are continually monitored and assessed so that service uptake is checked and the unfilled spaces are reallocated, where possible, as quickly as possible. Aligned to that process, trusts have been working with families and community colleagues to scope out additional and alternative supports, should that be from direct payments and domiciliary and the respite options.”
“I thank the Member. I know the passion and personal experience that she brings to this. I am fully aware of the challenges that our service users, carers and families face throughout the pandemic, and the Member has raised with me specifically the impact of the closure of day centres. She talks about equality across the region. Day-care centres provide valuable opportunities for people to reach their full potential, but they also provide respite for those with caring responsibilities. In July, the trusts restarted that day-care centre provision in line with the public health guidelines. However, the Member will be aware that there are significant barriers to restoring full-time provision because ensuring the safety of service users, families and carers is also paramount.”
“We have not yet put in a bid for additional payments for carers or the support networks that have been asked for, but I am aware that the Minister for Communities has made specific bids for funding with regard to what the Minister of Finance may announce after this statement — I do not want to pre-empt anything — that would provide additional financial support for those in receipt of some benefits.”