Robin Swann
North Antrim · Ulster Unionist Party · Northern Ireland
“I thank the Minister for his detailed statement. I know how passionate he is about the subject and how many times he has brought it to the Executive.”
“It has been reported that today will potentially be the warmest day of the year. As we move into the summer and our summer holidays, I want to raise public awareness of wildfires across Northern Ireland, which have been detrimental to farmland and our environment over the past number of years.”
“Wildfires are still having a detrimental impact on our environment and, occasionally, on livestock, but that reduction shows the impact of the Northern Ireland Fire and Rescue Service's proactive approach to educating the general public and engaging with rural communities and schools on its fire safety message, which is to stay alert, not…”
“There has been a lot of talk of sport in this place over the past few days, with everybody concentrating on UEFA. One sport that is going on across Northern Ireland at the minute is cross-community and goes across all age groups without fear, favour or distinction: pigeon racing.”
“I want to put on record that, since this place passed the amendment that recognised pigeon racing as a sport under the 2016 Act, over the past five years, pigeon racing clubs across Northern Ireland have been able to obtain £113,000 of rates rebates through the sports and recreation rate relief, allowing many of those clubs to continue ra…”
“There was much coverage on social media over the weekend of an incident in Staines in England, in which a police car rammed a young calf to bring it under control. It has restarted the conversation about animal cruelty. <BR /> <BR />I am dealing with a specific case in my constituency.”
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“I thank the Member for her question. The role of our carers has been highlighted many times in the House, not least by Ms Armstrong, who has been an advocate for carers, as have many other Members. <BR /> <BR />The advice document that was specifically developed for carers and young carers was first published on 10 April. Additional funding of £500,000 was provided to trusts via the Health and Social Care Board (HSCB) to allow for direct payment flexibility to be introduced, and that option is still there.”
“<BR /> <BR />I have had the conversation with the Chief Medical Officer and the Chief Scientific Adviser, and I am still supportive of reopening places of worship for acts of private worship, provided that social distancing and hard surface hygiene guidance is followed and face coverings are used. It is important at this time that people be given the opportunity to pray in private if that is their wish. The power of prayer is that it does not matter where it is done; it is the act itself and the belief in doing it that matter.”
“As the Member will be fully aware, there are decisions that I do not take easily or lightly as Minister. In response to his specific question, we saw, through contact tracing, outbreaks and incidents that related specifically to churches. What was very clear in what our Chief Scientific Adviser and the Chief Medical Officer put forward was the data provided to our test, trace and protect system by those who had contracted COVID on where they had been. Those who attend church were more open and up front about where they had been. It was pointed out that there were a number of incidents involving churches.”
“Under the three main headings of new outpatient activity, review outpatient activity and inpatient procedures and day-care activity, we conducted in the region of 57,000 procedures in April 2020. In October 2020, when we still had an increased number of COVID patients and increased support for them, the figure had gone up to 98,500. That is nearly 40% higher in those areas of expertise, while we were still looking after a high number of COVID patients, because of the work that was put in place by the Department, by the trusts and by individual care pathways to support their own patients while dealing with an increase in COVID patients.”
“I thank the Member. There was a question for urgent oral answer specifically on surge planning last week, when I addressed some of the misconceptions about the detail of work that has already been done by not just my Department but all six of our trusts, including our Ambulance Service. The point that the Member makes is the main one: while our hospital and care system is supporting COVID patients, those are beds, support mechanisms, specialists, specialities and skill sets that are being taken from elsewhere. To give the Member an indication of where we are with the work that our surge plans have done, I will compare where we were in October, as the last verified numbers, to where we were in April.”
“The difficult messages are the ones that we have repeated consistently about how we combat this virus: good social distancing, good hand hygiene, good respiratory hygiene, wearing face coverings and reducing the number of contacts that you have in a day and in a week. With regard to the financial support mechanisms for not just businesses but individuals, as the Speaker indicated, the Finance Minister will be making another statement to the House, and I will support him in that.”
“I thank the Member for his statement. Look, unity, and unity of message, is important. We are united in having one enemy, and that is COVID-19. I have been consistent in my messaging and my position since I took up the role of Health Minister in this pandemic. Have there been opportunities where I could have scored political points? There have been many. Have I taken them? No, because I do not believe that that is how I, in this position, am best served in supporting the people of Northern Ireland who need healthcare, and in supporting our healthcare workers as well. I will say to the Member to be careful that he does not get drawn into the trap of others and criticise their political messaging and sniping by sending political messages and engaging in political sniping. It is too easy; it is far too easy.”
“Work will be ongoing with the sector to ensure that there is clear guidance on what can be claimed and a streamlined and efficient process for administering the applications. It is about those care homes making claims to the trusts for expenditure that they have incurred, rather than an upfront payment.”
“I was hopeful that the new funding package would facilitate those visits, to the immense benefit of residents and their families. <BR /> <BR />The way that the funding package works is that expenditure can be claimed back by homes on a number of grounds, which include support for additional staffing because, for instance, there were more acutely unwell residents or there was a need to support individuals who were self-isolating, and also for block-booking of agency staff and continued enhanced cleaning support for changes to the physical environment, and that was to include the support for safe visiting. Trusts were provided with funds to administer applications to this fund in a regionally coordinated and consistent way.”
“I thank the Member for his question. I announced a new £27 million funding package for the care home sector. The funding was also to support care homes to continue paying staff at 80% of their salary when on sick leave for COVID-19-related reasons. That measure was first announced in June and then extended to the end of the 2021 financial year. The £27 million funding package is in addition to previously announced support packages, and it includes financial support for testing and visiting, to recognise some of the additional management time that is needed to respond to COVID-19. It is widely accepted that a fine balance had to be achieved on care home visiting. I am conscious of the extreme pressures on homes, but I do not want to see their doors totally closed to visits.”
“I thank my Executive colleagues for supporting the asks that were made, because they are dramatic and will have an effect on the public of Northern Ireland and our businesses. <BR /> <BR />Mr Speaker, you referred to an Executive announcement on support packages that will follow this statement. I look forward to that. I left the Executive meeting to come here. I hope that the support packages are as beneficial to the people and businesses of Northern Ireland as the BBC seems already to know they are.”
“The severity and depth of the two-week intervention that we are bringing in on 27 November, which will take us through to December, should get us to a point at which the rates of transmission are being driven down and allowing our hospitals breathing space to enable them to discharge a number of the COVID patients who are already there. <BR /> <BR />As my statement referred to, the next steps are the forthcoming initiatives. The initiatives relating to mass testing are at an advanced stage. This morning, there was an announcement of another vaccine. That will be three vaccines approaching a level of effectiveness of between 70% and 90%. It is about such stages as those and asking the public to re-engage with us when these restrictions end on 11 December. They are time-limited to that date because of their severity.”
“The Member makes the point about our four-week intervention not having completely the desired effect that we thought it would have. We saw a decrease in the first two or two and a half weeks, when schools were closed, but, unfortunately, when schools reopened, we saw that rate start to go back up. The Executive policy, as stated in a meeting in May, was to keep the R rate at or below 1, which means a continual decrease in the number of positive cases in Northern Ireland. The deciding factor for the Executive on Thursday was the number of hospital admissions.”
“<BR /> <BR />What I saw in Queen's this morning on that collaborative piece on mass testing was impressive in how it interacted with our test, trace and protect system so that a test positive case there, which can come forward in a matter of hours, was already being contacted by the test, trace and protect system to make sure that it is fully locked in to the entirety of our support programme.”
“<BR /> <BR />In regard to the Member's question of whether we will be or are looking at more targeted interventions in mass testing, I will say that we are trying that initiative in one of our trusts and in care homes. We are putting those testing devices, while they are still limited in number and still new, to the best use and best purpose in order to identify those who are asymptomatic and those who are testing for COVID so that we can get the best support in place.”
“I thank the Member for her question. The four million testing devices would allow us to do the entirety of the population. That would be a massive logistical challenge. This morning, I attended Queens University Belfast, which is running one of our first mass-testing initiatives. It has already been set up in the Whitla Hall. Its intention is to be able to do 6,000 tests per day by the end of the week, which is highly ambitious. That will allow us to work out what that will actually look like and how mass testing will deliver what we want it to. We have been involved at a departmental level in what has been happening in Liverpool and in the outworkings of that, where the wider mass testing of the population maybe is not just bringing forward the results that many would hope for.”
“That is why I welcomed, when we came back in January, the Executive's commitment that our health service would be a priority, as would not only the people who need it but the people who work in it.”
“We can do that by ensuring that the staff do not have to look after more COVID patients and by following and abiding by the regulations that are coming forward from this Friday so that we can break those rates of transmission and many of our healthcare professionals can get back to work on their specialities and the areas of expertise that they trained for and we can provide the best healthcare system that we can. <BR /> <BR />The Member referred to the email that he received that talked about a crippled service. I do not disagree with it. Our health service has been under stress and strain for many years, but we have a number of things in place that will see it rebuild and rebuild better and not go back to the way it was. It would be a detriment if we allowed our health service simply to go back to where it was.”
“I will certainly be able to provide, which I look forward to, an update on the specifics of the outworkings of that cancer reset cell once I receive them. I do not have them with me today, but I will get them for the Member and will update the rest of the House on how that work is progressing. <BR /> <BR />It is crucial that we allow our healthcare staff to look after the patients of Northern Ireland and provide the care that they need.”
“While we are expanding and expending our health service resource on combating COVID, the challenges come in meeting the needs of non-COVID patients. That is why we published our surge plans and rebuilding plans and why we announced the cancer reset cell, which the Member rightly referred to, and discussed how that could approach how we deliver cancer services on a regional rather than simply a by-trust basis. <BR /> <BR />The work of that cell is ongoing on how we can bring together the operations, diagnostics and care pathways that were operating across trusts almost as silos. Although that is not the correct term, they were operating on a trust basis rather than across the whole of Northern Ireland.”
“I thank the Member for his question, and I know that it is in no way political. I received the same email. I am sure that the Member is well aware that I receive many emails from our healthcare professionals, from families and from individuals who find themselves in exactly the same situation.”
“As capacity increases with the mass-testing programme, we are considering that.”
“The message that that healthcare worker put out may have come from America, but I am sure that it will be echoed and replicated by any healthcare worker in any facility that is combating COVID-19.”
“I thank the Member for his comment. I do not spend much time on social media at present, but that is an accurate message. We fight the virus now in our streets, in our shops and in our homes, where transmissions have taken place. As Health Minister, the ask that I make on behalf of our health service is the same as the ask that that doctor makes. If we encourage the people of Northern Ireland to come together and work together to break the chains of infection by following the messages that we have consistently put out of social distancing, good hand hygiene, good respiratory hygiene, wearing a face covering and reducing the number of contacts as much as possible, we can break the chains of infection that lead to hospital and ICU admissions.”
“Although times are tough and will be tough over the next couple of weeks, with everything that is coming, a new dawn is coming, and it will come sooner if we can all work together.”
“I was involved in a meeting on Saturday with the Chancellor of the Duchy of Lancaster, our First Minister and deputy First Minister, the First Minister of Scotland, the First Minister of Wales and a number of Chief Medical Officers on how we get what we do at Christmas the same across these islands. I am glad that there has been an ongoing conversation between Her Majesty's Government in London and the Irish Government to make sure that we come to a collective message across these islands to ensure that families get as much continuity of messaging as possible, especially at that time. For Christmas, we should take not only a message of hope and encouragement but a message of faith and trust. We need to instil that message, and our Executive and our Assembly need to put that message out with a unified voice for our people.”
“I thank the Member. One of the messages comes from Christmas, and it is not simply about family gatherings; it is about hope, faith and belief. That is the message that we need to portray for this Christmas. How do we do that collectively?”
“<BR /> <BR />As I said earlier — I have said it many times — when this place came back on 11 January, one of the collective achievements was the agreement to invest in our health workforce. The Executive put in an additional 300 nursing training places per year, over the next three years. However, it takes a number of years for them to come through that basic training, never mind getting the enhanced skill set that is needed to operate in our ICUs, with anaesthetists and the additional workforce there. Our workforce really is stepping up at this time, and it is incumbent on us to give it as much support as we possibly can.”
“The appeal has been a more targeted approach to the skill sets that we need. As of last week, we had received 3,157 applications, and 516 of those are tentative job-ready offered or actually appointed. Over 600 applications have been rejected as they do not meet the skill set or are not applicable for the position. There is a balance in the workforce appeal working. It is not possible to get an increase in the highly professional skills that we need — that is the ICU nurse, the anaesthetist and the respiratory ward professionals — in that time. We see that across all jurisdictions. In parts of England and Wales, the Nightingale facilities cannot be opened because they do not have the skilled workforce. They have the premises, but they do not have the staff.”
“I thank the Member for her point. When we talk about the wave, the timeline often gets confused. It is nine months since the first. The first case of COVID in Northern Ireland was in February, so it is nine months since that case. We have been through a wave; we have been through the first pandemic, which lasted for months. We saw a return to a glimmer of normality only in July or August, when our staff were already overwhelmed, over-exhausted and at a point where they needed a break. To train an ICU nurse, an anaesthetist, a doctor or anyone in the short space of a few months is not practical or possible. I am sure that many of the colleges that register professionals will make that same point. <BR /> <BR />The workforce appeal was launched again in the approach to the second phase of the pandemic.”
“Whoever it is and whatever avenue is providing that information out of the Executive, it is not helping the cause that we are trying to achieve in coming to a united purpose.”
“A paper was presented to the Executive for the meeting on Thursday. It was circulated two days or a day before, as is normal practice —. Sorry; I apologise to the Chair. It was circulated to members of the Executive the night before, when the paper was finalised. The Executive met the following morning. <BR /> <BR />I am led to believe that the BBC had the paper before the Executive had the opportunity to discuss it. I want to make this point. One of the challenges to decision-making in the five-party Executive is enhanced and amplified by the running commentary that comes from the Executive to multiple strains of the media. We should be making those challenging, difficult decisions within a space closed for discussion. However, papers are transcribed and transmitted, often through social media, before our conversation has finished.”
“Governments around the world are grappling with the same awful dilemmas, but we need a collective spirit and a unified purpose, not just in the Chamber but across society. <BR /> <BR />Everyone across Northern Ireland must do their bit. We can help change the course of this pandemic. We can help save lives. Hope is on the horizon, and a happier new year stands before us. Let us do all we can to make sure that as many of us as possible get to enjoy much better times in 2021.”
“There are real grounds for optimism, given the progress on vaccines, the development of rapid mass testing and improvements in treatments. <BR /> <BR />I need to be candid with the public. I will not offer false hope or pretend that there are shortcuts available to get us through these next few months. We all have to hunker down and play our part in abiding by restrictions, staying at home, working at home when possible, cutting our contacts, keeping our distance, wearing a face covering and washing our hands. We can do that. We must do that. <BR /> <BR />The restrictions that start on Friday will make a difference. We all have to play our part in making them work, by our words and deeds, and that includes everyone in the Chamber. The Executive must now put the last few weeks behind them. These are extremely difficult decisions.”
“For practical purposes, it is simply not possible to increase hospital capacity in the short to medium term. The key factor here is the supply of staff and, given the specialist skill set required, there is a long lead-in time for this. While some marginal gains in capacity can be made in specific areas such as ICU, they come at the cost of reduced capacity elsewhere in the system and involve the redeployment of existing staff. In addition, when doubling times of cases are in the region of seven to 10 days, even a doubling of hospital capacity, were it achievable, would buy only a limited period of relief before intervention was required. <BR /> <BR />It is, of course, important to give people hope as we face into this most difficult of winters.”
“It is also the case that the associated levels of community transmission would inevitably result in a further significant increase in outbreaks in care homes, among extremely vulnerable older people, as was experienced in the first wave, which would result in excess deaths in that population.”
“Mass testing is an exciting development, and, together with a vaccine, it offers great hope for a way out of our nightmare. However, it is not a panacea; certainly not at this time, and certainly not without restrictions in place before Christmas. <BR /> <BR />Enhancing hospital capacity is also cited in some quarters as the answer. In theory, measures to increase hospital capacity would allow an increased epidemic level to be managed without a further lockdown. However, that would inevitably be associated with increased deaths and might be limited by the need of staff to self-isolate, as a consequence of healthcare-related outbreaks in hospitals, or clusters and outbreaks in the community.”
“However, I have written and spoken to the Secretary of State for Health, Matt Hancock, to request four million rapid lateral flow device tests for Northern Ireland. <BR /> <BR />I want to see us playing a pivotal role in the UK pilot on mass testing. My ambition is evident. At the same time, it needs to be remembered that we are still at the stage of pilot programmes. They will help us to assess the effectiveness and accuracy of rapid testing technologies. Reliance on mass testing alone would represent a high-risk approach in the run-up to Christmas. It may not be viable for logistical or test-supply reasons. However, there may be scope to target more limited mass testing to high-risk areas. That would be of help, but, again, it would not avoid the need for Northern Ireland-wide restrictions at this time.”
“However, it is important to recognise that that is largely based on theoretical considerations and that there has been, as yet, no clear demonstration anywhere in the world that mass testing can significantly reduce transmission in a short period against the background of a high level of community transmission. Modelling suggests that repeated mass testing of most of the population would be required to maintain control of transmission by that means. That would mean a very high degree of population buy-in and would present huge logistical challenges. Slovakia and Liverpool required military logistical support to deliver their programmes and at least a two-week run-in period before the testing was implemented. It remains unclear whether the required number of tests would be available to us in Northern Ireland.”
“That is the bleak picture that the Executive were faced with last week, and that is the context for the lengthy and difficult discussions that we had. <BR /> <BR />I know that Members will ask whether other measures could have been deployed. The reality is that, given our current position and the rates of transmission, there are no feasible alternatives. As I have stated, other countries with different health services from ours have arrived at the same conclusion during the second surge in Europe. There has been considerable interest in the potential of rapid mass testing to reduce the transmission of the virus.”
“That increase in transmission would have occurred from a relatively high baseline, meaning that an already serious situation would have rapidly become much worse. Without decisive intervention, the hospital system would have been at risk of being overwhelmed in mid- to late December. To care for the increasing number of critically ill COVID-19 patients, we would have been forced to halt some, or even all, planned activity for other conditions, some of which are urgent in nature. We would be facing the prospect of a significant increase in both COVID-19 and non-COVID-19 deaths. In such circumstances, it is also likely that even a full lockdown, beginning around 14 December, would have been insufficient to prevent the current levels of hospital pressure being significantly exceeded.”
“There has been a sustained reduction in the number of cases per day since the onset of restrictions, but numbers of cases, admissions, hospital inpatients, ICU occupancy and deaths remain at a relatively high level. In particular, hospital inpatients are at a higher level than was reached in wave 1 and have been declining only very slowly. As a consequence, the hospital system and staff remain under serious pressure. <BR /> <BR />By last week, we were on the verge of permitting a significant relaxation of COVID-19 restrictions. It was highly likely that that would have resulted in the R rate rising significantly above 1, with a subsequent increase in cases, admissions, inpatients and ICU occupancy in December.”
“Please choose your words carefully, both inside and outside the House, today and in the coming days and weeks. <BR /> <BR />Let us remember that many countries, including near neighbours and, indeed, large swathes of Europe, are currently in lockdown. Those include countries with health services different from ours. We should not kid ourselves that we are so special or so unique that we can avoid taking similarly tough decisions. We cannot simply wish this virus away. <BR /> <BR />The paper that I presented to the Executive last week made the case for strengthening restrictions in light of the path that the pandemic is taking. With schools open and existing restrictions in place, the R rate had settled at around 1 by last week. That meant that we had reached approximate equilibrium with regard to community transmission of the virus.”
“We could also spend hours pointing fingers about years of underfunding of Health and Social Care (HSC) and years of underinvesting in staff, but, again, what would that achieve today? <BR /> <BR />I trust that everyone in the House is united in wanting the new restrictions to work. We have to give our hospitals and our heroic staff some vital breathing space. If we successfully drive down infection rates, we have the opportunity of having a better Christmas. It will not be a normal festive season by any means, but we all have the power to help change the atmosphere. We can do that by abiding by the new restrictions and strictly following public health advice. I urge all Members to promote public health messaging at every opportunity. Please do not undermine it.”
“That is the Assembly’s job. There are strong and legitimate opinions, and feelings have run high. That does not mean, however, that we have to descend into party political point-scoring. This is far too important an issue for that. To say that the past few weeks have not seen devolution at its best is something of an understatement. Frustration and anger are widespread. We could spend hours in the Chamber raking over the ashes of the decisions that were made and not made. I have made my views known both inside and outside the Executive. Nevertheless, I fail to see where another bout of division and recrimination would get us now. What good would it do? Whose cause would it serve?”
“We can each play a part in saving lives and preventing avoidable deaths. That is how serious this is and how high the stakes are. <BR /> <BR />As a society, we can now look forward to 2021 with some optimism, given the progress made towards mass vaccination. I do not want to have to look a grieving relative in the eye next year and say, "Yes, we could've taken action before Christmas and that would have saved your loved one’s life". I do not want to have to say, "I am sorry that we did not intervene. I am sorry that they are not here with us to enjoy these better days". <BR /> <BR />Today, I make a heartfelt plea for unity around the Chamber. The public are watching and looking to us for united leadership. It is, of course, the duty of the Chamber to hold the Executive to account and to scrutinise policy decisions without fear or favour.”
“As the House is aware, the Northern Ireland Executive have decided to introduce tighter restrictions to break the chains of infection of COVID-19. The measures were detailed in a written statement to Members that I issued following last Thursday’s Executive meeting. They take effect from first thing this Friday morning for two weeks. <BR /> <BR />In summary, we will in large part revert to the lockdown situation that applied earlier this year during the first surge of the pandemic. The major difference is that schools will remain open. I will set out the rationale for the new restrictions. In summary, they are essential to preventing a further spike in infections overwhelming our hospitals. The onus is now on all of us to follow strictly the public health advice and to comply with the letter and the spirit of the tightened restrictions.”
“We are seeing the percentage occupancy of beds because, unlike the first wave when we downturned the majority of our procedures, this time our health service is trying to keep as many procedures and services going. They are really pushing the limits so that we can deliver to the people of Northern Ireland the healthcare that they want and deserve. That is why the House should be indebted to the entirety of our healthcare family across Northern Ireland.”
“What the Member highlights is the desire of everybody working across the health and social care system — our nurses, our doctors, our porters, our administrative teams, community pharmacies, GPs, and people in the Department — to make sure that we have a service that can deliver for everyone when they need it and where they need it. <BR /> <BR />This is a strenuous time across the entirety of our service. Many proposed reviews, from Bengoa to Compton, have been put in place. The transformation process has started and continues in and across our health and social care system, although not at the pace that we need it to go. As I have said before, we are trying to run three health services: our current health service, a transformational health service, and a COVID health service.”
“They are a group of ICU nurses, anaesthetists, theatre nurses out of that original 1,600 that we are short of. They are a group that were specifically targeted and that we asked for in our workforce appeal. They came back and helped us out. <BR /> <BR />That is where we are seeing and experiencing the majority of the strain. That is why, during the first wave, we made sure that we had psychological and mental health support for our healthcare workers. We know not only in society is that going to be a need, but that it is a need in our current workforce. We want to make sure that they are being provided with all the support they need.”