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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“Therefore, the reports in the media today that Northern Ireland is almost 200,000 doses short of the flu vaccine for the over-65 age cohort, or that we are unable to complete the vaccination programme, are simply not true. I want to reassure everyone listening that there is no shortage. Further plans are now in place to procure even further quantities of vaccine at a later date, if necessary. <BR /> <BR />Finally, I would like to thank all of our GPs, practice nurses and Community Pharmacy for their expertise and persistence over recent weeks. This is an incredibly busy and pressurised time for them all, and yet, without them, our flu vaccination programme would simply not succeed.”
“<BR /> <BR />As was outlined by the Public Health Agency last month, uptake has been exceptional with higher numbers of people getting the vaccine than ever before. A temporary pause was placed on some aspects of the seasonal flu vaccination programme but those additional vaccines are now available. <BR /> <BR />Let me assure Members that there significant quantities of the vaccine available for those over 65. There are approximately 323,000 people over the age of 65 in Northern Ireland. Initially, we aimed for a target uptake of 85%, which equates to 275,000 vaccines. Therefore, we purchased 286,000 vaccines. Last month, I approved the purchase of a further 10,000 vaccines bringing that total to 296,000. The additional 10,000 vaccines arrived in Northern Ireland on Thursday 5 November.”
“I am glad to have this opportunity to come to the House today to clarify some of the issues regarding this year's flu vaccination programme. <BR /> <BR />First, let me assure Members and, more importantly, those listening at home, that there is no shortage of ordered vaccines. This year in total, 1,050,300 doses have been procured for the flu vaccination programme. As of last Friday morning, 826,890 doses have been delivered to Northern Ireland. A total of 601,243 doses have been delivered to GPs and trusts. I can confirm that, as of this morning following two further deliveries totalling 192,700 doses, the total vaccines delivered now stands at 1,019,590 doses. Around 30,000 doses of the childhood vaccine are still to be delivered and that is the only order that remains outstanding.”
“<BR /> <BR />The step that the Minister of Education took to support the expansion of free school meals in school holidays was welcome, but it was an embarrassment that we had to do that and that we do not have support mechanisms across our society that prevent people being driven into those situations. There is a partial responsibility among us all in the Executive and the House to make sure that children do not have to hide toast in their nappies because they do not know when they will get their next meal.”
“The story that the Member raised broke many a heart and brought a tear to many an eye when people realised that that was happening in our community and sector. <BR /> <BR />The work that is being done by social services in identifying and supporting those families that need that help is crucial. There is also an onus on us, as elected politicians, to make sure that those individuals know what help is available and how to access it. We should also make it as easy as possible to access for the people who need it. It is heartbreaking to think of the reliance on food banks that we now have in Northern Irish society.”
“That was one of the pieces of advice and guidance that were sent out. Shielding letters were often based on those who were eligible for a flu vaccine, so the counter works. One of the things that we did was to expand it so that anyone who was a carer of someone in receipt of a flu vaccine was also eligible. That is why we saw that massive uptake at the start. <BR /> <BR />I know that many saw it as a criticism, but it delivered far in excess of our expectations, and I must congratulate our GPs, community pharmacists and all the peer vaccinators across our health and social care system. They went out of their way to deliver what is usually a three-month programme in 26 days.”
“By way of an update to the Member, one GP sent out flu vaccination letters to 500 patients and 499 turned up. That is unheard of anywhere else. They were able to trace the one remaining person and realised that he or she did not receive the letter. The initial uptake far outstretched any of our expectations of a vaccine programme. It was also beneficial that we took the time in the summer to order additional vaccines, because they will supplement the cohort that was missed during the first phase.”
“The majority of that was administered within 26 days, and the highly proficient system that we put in place outstripped our supplies of flu vaccine. The other batch is due in the next couple of weeks, so that should allow us to pick up on those who missed out — they did not miss out, but they thought that they were going to be vaccinated at an earlier stage. Arrangements for the schoolchildren's vaccine were in place and remain so, but we very much got ahead of ourselves with those in the adult ranges. One of the things that it has proved to us is that, when a COVID vaccine becomes available, we know that the systems will work very efficiently.”
“I thank the Member. The one before was easier to answer. The flu vaccination programme is proceeding at pace. One of the things that we have done is to increase the order of flu vaccinations. We did that in the summer. The initial batch that arrived was in the region of 665,000. Our vaccination programme usually runs from 1 October into December, and then the second batch arrives for times of need. This time, we increased the number of people who will get the flu vaccine, and we increased its promotion. That initial batch of 665,000 was distributed.”
“As I said in response to the initial topical question from the Committee Chair, prioritisation of who receives that vaccine is managed by the Joint Committee on Vaccination and Immunisation so that there is equity and equality across the United Kingdom and we do not get drawn into a political sphere where politicians get to decide who gets access to a vaccine and who does not. It is left in the hands of medical professionals who can best decide, when the vaccine becomes available, what groups need to have it and in what order.”
“If there are any further easements, I cannot give a guarantee.”
“The CMO issued updated guidance about two and a half weeks ago, although it was done online and through social media and we did not post it out to everyone. The Member underestimates it. By the time that we finished issuing shielding letters, there were 208,000. The number of people who finished up in that shielding group far outweighed our initial expectations. That updated guidance is online. I will send it to the Member so that he can forward it to his constituents. It is an area of concern for many. When that group meets tomorrow and the additional advice comes out, I will make sure that it is shared with all MLAs and across all Health and Social Care sectors. We can then inform each of our constituents who have those concerns, should they fall under renewed advice or into renewed categories that we are concerned about.”
“I thank the Member for his update. I know that he was not in for the initial part of Question Time due to the COVID-19 seating arrangements in the House, but I informed Ms Bradshaw that the CMO is meeting the shielding advisory group tomorrow to review where we are. One of our concerns is that we have seen an increase in the number of over-60s who are testing positive. The test rate that we have shows that roughly 23% of tests are for someone in that over-60 age group. We all know that they are the most vulnerable section of our community should they contract COVID, because there is a high incidence of it ending in hospitalisation. It is a piece of work that the CMO is looking at. He is meeting the shielding advisory group tomorrow to update recommendations to me and the Executive.”
“It is a holistic approach that we are taking forward to make sure that the support is there.”
“It is a conversation that is ongoing between my Department and the Department for Communities, which is held by the Member's colleague Minister Carál Ní Chuilín, about how we can provide additional supports. There is a non-refundable payment loan that can be drawn down. The conversation that has been raised is that our system is means-tested so that anyone who earns over £21,000 per annum is not eligible for it because it is being handled through the Department for Communities and social services. It is something that the Minister for Communities and I are looking at to ensure that anyone who does test positive, or becomes a contact to someone who is positive, is supported and encouraged to self-isolate and to remain at home so that they are not put under a financial burden to get back to work or out into the community.”
“As I said in response to another question, even the best system in the world, when we get those large numbers, does not simply rely on a test, trace and protect system to bring it under control. COVID-19 takes a multitude of tools to bring it under control. In Germany, whose test, trace and protect system has often been lauded as the most efficient, they are saying that, once you get over 50 cases per 100,000, no test, trace and protect system can effectively manage that. We are sitting at 200 per 100,000, so we have a long way to go. I would rather see us dropping the incidence of COVID-19 and then rely on test, trace and protect, isolation and support to provide the enhanced service that manages and keeps COVID-19 under control.”
“I thank the Member for her question. Earlier, I gave a few statistics for our current test, trace and protect system. At times, it does come under criticism because of what happens in other places. At the Committee a couple of weeks ago, some of the management team came under unfair criticism and personal attack, which was unfortunate. In that dedicated team there are now 220 tracers working under three different employment contracts — full-time, part-time or on-call bank — so that they can flex up. <BR /> <BR />We made advances over the summer in being able to contact people by text message and online. The digital ability to test, trace and protect is being enhanced continually.”
“It decides what flu vaccines we should prepare and buy in advance, the groups that they should be allocated to, and in what order. It has already done an initial trawl as to where it sees the priority for a COVID-19 vaccine. One of its main thrusts is by age and by working sector. The first sector that it is looking at is those in care homes and the care home working sector. The next sector will be for those over 85. It will then move down into those working in the health and social care systems and will then be ratified by age group. <BR /> <BR />The JCVI is undergoing the stratification of who will be accessible. I will write to the Member with that because it is accessible. I will also inform the Committee and update the House, should that be useful.”
“That is one of those decisions that is taken out of my hands. One of the things that the Department of Health does, and this is the case across all four nations, is to ensure continuity of supply. The decision on any vaccination programme is handed over to the Joint Committee on Vaccination and Immunisation (JCVI).”
“That would leave us with 575,000 doses, which would be the equivalent of initially vaccinating 255,000 people. I stress to the Member that it is one out of six potential vaccine candidates. It is the first to be brought forward.”
“I thank the Member for his question, which is very topical. The UK Government, acting on behalf of the whole of the UK, have access to six potential COVID-19 vaccine candidates. That reflects a national strategy to ensure that we have a supply of vaccines, should any of them prove to be safe and effective. <BR /> <BR />The vaccines are at various stages. There was an announcement about one yesterday. It still has to undergo rigorous testing and complete the development process that vaccines must complete before they can be considered for use in a vaccination programme. <BR /> <BR />The United Kingdom would be eligible for the one announced yesterday and has pre-bought over 20 million vaccination doses, which will be distributed across the devolved Administrations using the Barnett formula.”
“I thank the Member for his question. Contrary to media reports suggesting an increase, suicide rates in Northern Ireland have remained relatively stable over the past decade. That mental health funding is in place. As I detailed earlier, it is approximately £300 million a year, which is only 5% to 6% of total HSC funding. It is accepted that that is significantly lower than funding in other places, and that is why I continue to put in bids and to increase the finance to make sure that we get a support package, and not just one that provides finance but one that provides personnel to support those who need it.”
“The increase in the level of dual diagnoses has been brought to the fore, especially during lockdown. The Assembly all-party group on dual diagnosis and addiction has raised the issue, and it is something that my Department is working on. <BR /> <BR />Initially, the issue was brought to the House and debated. What often was happening was that the dual diagnosis fell as two diagnoses rather than be brought together in one place. The challenge that my Department and the trusts face in their work is for people to receive the appropriate support, guidance and help that they need.”
“In the June monitoring round, I approved funding for 2020-21 for perinatal mental health as part of the mental health action plan. That action requires recurrent funding and so creates an inescapable pressure of £4·7 million recurrently. The business case proposes a phased implementation, with the first phase requiring £3·4 million and the second phase an additional £1·3 million. A submission seeking approval of the business case and the recurrent finding will be sent to me on receipt of the finalised business case from the PHA. <BR /> <BR />I had that answer prepared. I knew that it was something that the Member would raise, because it is an issue that she has championed in her time in the House.”
“Recurrent costs associated with the business case are significant, with high costs apportioned to the extensive multidisciplinary team complement proposed for each trust.”
“The business case for specialist community perinatal mental health services was received by the PHA. Officials in the mental health and capacity unit reviewed the document and consulted professional colleagues before requesting further evidence from the PHA to support the proposals. Following a further review of the amended business case, there remained several minor discrepancies, and the PHA has agreed to complete those amendments as soon as possible. The PHA has noted that its response to the current COVID pandemic has added substantial pressures to this workload.”
“It needed additional support pre COVID, and I am pleased that, due to the support that we have across the Executive and even in the New Decade, New Approach commitments, that support is now coming forward and that work is being championed by our interim mental health champion, Professor Siobhán O'Neill.”
“The Member raises the point of the additional mental health strains that COVID has put on the population of Northern Ireland and on our health professionals because of the stresses and strains that they cope with. That is why, when we produced the mental health action plan, we included a specific section on COVID-19 to pick up on the specific additional points that are being brought to bear because of additional pressures, be they from self-isolation or the loss of a loved one due to COVID, which is affecting many people across Northern Ireland. <BR /> <BR />The additional pressures on our mental health service are being compounded by COVID. It is also a part of our health and social care system that needed additional funding.”
“The new mental health strategy will, going forward, provide the strategic direction for mental health services when the full strategy is published in July 2021. I intend to also publish a 10-year funding plan, and that will provide a comprehensive outline of the funding required for future mental health services.”
“The Executive have also jointly agreed to fund the mental health champion with £500,000 per year. Furthermore, over the last couple years, a programme of capital investment to provide immediate improvements to the old mental health facilities has seen around £3·5 million in funding, which will directly benefit mental health patients. <BR /> <BR />I welcome the additional COVID funding made available for the Department of Health through the HSC during this particularly challenging time, including funding to support mental health services. From that funding, I am seeking to make available up to £2·6 million to ensure capacity across mental health services, including support for the adult acute mental health bed management network, the provision of additional nurses and funding for psychology therapies and waiting lists.”
“That includes £1·5 million for the implementation of the mental health action plan secured through June monitoring; an additional £300,000 approximately, also secured through June monitoring, for mental health co-production work; and an additional £180,000 secured through June monitoring for suicide prevention. There is £1·5 million for my Department to support the Department of Education in its work on mental health in schools. To assist suicide prevention in 2020-21, £649,000 has been allocated to zero-suicide initiatives in HSC trusts. An additional £190,000 has been allocated to enable the continued delivery of the multi-agency triage team project, and a further £60,000 has been allocated to the Derry crisis intervention service to allow its continuation to the end of the year.”
“With the Principal Deputy Speaker's indulgence, I may take more than two minutes for the answer, because of the nature of the issue. <BR /> <BR />Since taking up my post as Minister of Health, I have been very clear that mental health is one of my key priorities. I have created a mental health champion, and I have published the mental health action plan, which includes a dedicated COVID-19 mental health response plan. My officials are also working on developing a new 10-year mental health strategy that I intend to publish for consultation by the end of the year. Also, since taking up the post of Minister, I have provided additional funding for mental health.”
“The Chief Medical Officer is meeting his shielding advisory group tomorrow to see what steps we need to take and whether those should replicate what England is doing. That guidance and updated advice will be considered in the context of where we are in Northern Ireland with the spread of COVID-19, R and the direct affect that they would have on that specific group of individuals in Northern Ireland.”
“Whether we do that by a sectoral rather than a geographical basis is still something that my expert advisory group on testing is exploring.”
“We are observing in Liverpool a pilot of mass testing, and I think that it will be useful. However, in being part of the observation group that is overseeing what happens and learning the lessons from it, we want to make sure that that sort of mass testing can be utilised to its best and most effective use and that any individual who tests positive receives the correct support and advice. It is easy, when we look at Liverpool, to put it in the context of being a large city, but when you put it in another context, you see that Liverpool has a population that is actually larger than Northern Ireland's. It is about using mass testing most effectively for the region. We will look at a number of pilots once the testing system, should it be lateral flow, proves efficient.”
“One of the difficulties that PHA and DHSC had was that, although the Member said that the she was aware of three such individuals, no one was prepared to give their contact details, name, address or identification so that it could be followed through the system to see whether it was happening. However, it is something that the DHSC and the PHA are aware of.”
“I thank the Member. It is something that her party leader, the First Minister, raised with me earlier in the week. We contacted DHSC to see whether that is a possibility. It is looking into its systems to make sure that it does not and cannot happen. It would be unthinkable for somebody to fake a positive COVID test for the sake of a payment, because that puts pressure not only on other individuals and their family members but on our health service by making it look as though we have a higher incidence than we actually do. <BR /> <BR />Fortunately, when we see the number of positive cases compared with the number of hospitalisations and people who are in an intensive care unit (ICU), it does not seem to be a widespread practice.”
“I thank the Member for her question. Testing through the national testing programme is managed by the Department of Health and Social Care (DHSC) in London. I am advised that a few such incidents have been reported through the Public Health Agency (PHA), and my officials have been made aware of that. Upon investigation by the Public Health Agency and the DHSC, they have advised that no specific details have been received to enable the issue to be investigated further. My officials will continue to liaise with DHSC on the matter as required, and DHSC has advised that individuals who have been impacted by such an incident should contact the 119 helpline to provide their specific details for further investigation.”
“Since the outbreak and the first wave, every politician has had to be careful of the challenge around the phraseology and language used, because of the impression that can be given. I have been clear that the phrase "living with COVID" may be useful at the point at which we have a vaccine and the virus is under control. At this minute in time, because of the increased rate in Northern Ireland, we are not at that point. As for the phrase "living with COVID", one thing that I do not want to see is more people dying from COVID.”
“The current regulations 9 and 10 fall at midnight on Thursday, so it would take the support of the Executive to bring forward further recommendations. If they fall at that point, I think, we will move back to the bare basics in regulation 2, which still stands and is current.”
“We took a strategic approach. A fortnight before we announced that we were increasing the testing frequency, we put additional funding into the care home sector so that money could be drawn down and used to supply the administrative support that those homes need. It could also provide additional staff, if needs be, to come in and do those tests, which can take up to 10 or 15 minutes to perform, of residents or staff. My Department has already put in place additional financial supports for the care home sector.”
“It is vital that we bring down the case rate so that the real benefits of test, trace, protect and isolate can come to the fore. It is all part of the overall package. The fewer cases there are, the more impact and effect test, trace and protect has.”
“The improvements that we made over the summer were brought forward when we saw the dramatic increase in positive cases. We went to a text alert service for some people who had tested positive. We also introduced a "digital first" system whereby people could go online and identify their contacts. That made it easier for someone who tested positive to interact, whether they wanted to talk to someone on the phone, do it online or respond by text message. That is what we have done in the past number of weeks. <BR /> <BR />Often, we look to Germany for best practice. One thing that should be noted is that Germany has said that, when you get a case rate of over 50 cases per 100,000 of the population, there is no way that any test, trace and protect system can keep on top of that.”
“That is a success rate of over 90%. By any international standard, 80% is what should be reached. From the 4,023 cases that were identified and contacted a further 9,267 contacts were identified, and 9,173 of those were eventually contacted. That is a success rate of 99%. When it comes to the failings that have been pointed out about the test, trace and protect system, often, people look at the criticism of the Westminster system and then apply those aspersions to our system.”
“One thing that often happens with our test, trace and protect system is that the failings of other systems are pointed towards our system. <BR /> <BR />In our current system, in the past week, we have transferred 4,450 cases to test, trace and protect. Of the cases transferred, 4,023 were successfully detected.”
“About 46% of those homes are confirmed as being positive because of staff, not residents, testing positive The increased testing programme has proved beneficial in indicating and identifying staff who may be asymptomatic so that they do not take the virus into care homes, where residents are more vulnerable to the virus.”
“We have increased testing. The recommendation was that we tested staff every fortnight and tested residents once a month, unless the home tested positive or showed a confirmed case, in which case we increased the testing capacity. <BR /> <BR />When a home does not have an identified case, we use pillar 2. Once a home has an identified case, either a resident or a member of staff, it moves to pillar 1, which is the Northern Ireland-based testing programme, so that we can get a response to those test results more quickly. Testing has been increased to once every two weeks in order to upscale the frequency. <BR /> <BR />The Member referred to the number of care homes that are rated as having confirmed cases.”
“The memorandum of understanding is working well, although there are areas where it needs enhancement. One challenge that was evident over the weekend was the reaction to travel restrictions from Denmark. It took engagement from us with the Health Minister and engagement from the Westminster Transport Minister with the Transport Minister in the Republic of Ireland to make sure that information was shared on anyone who had been in or travelled through Denmark and who then entered the Irish Republic through Dublin Airport while we put in those restrictions. That engagement is ongoing. The Chief Medical Officer and senior colleagues meet their counterparts in the Republic of Ireland weekly to discuss their approach to COVID-19 and their experience of responding to the pandemic.”
“<BR /> <BR />The need to consider the best evidence and practice applies not only to the strategic public health response but to all parts of the health and social care sector in responding to COVID-19. That can be seen in the reduction in mortality rates for those diagnosed with COVID-19, as experience has provided enhanced insight into the best form of treatment. However, as a novel virus, it is important to recognise that the evidence on COVID-19 is changing over time, and there is often no consensus on the most appropriate response.”
“Throughout the pandemic to date, the Northern Ireland Executive have received expert advice and recommendations from the Chief Medical Officer and the Chief Scientific Adviser in respect of the most appropriate public health response. That advice has been based on the emerging evidence from the rest of the UK and from the rest of the world. For example, the Chief Scientific Adviser attends the Scientific Advisory Group for Emergencies (SAGE) and reviews evidence from the Scientific Pandemic Influenza Group on Modelling (SPI-M), which examines the data on the trajectory of the virus, nationally and internationally. In addition to that, evidence from UK Government analysis and published scientific papers are regularly reviewed with regard to international experience.”