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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“That also responds to what the Member asked. The more of our health professionals that we can keep concentrating on their specialties without needing to divert them to COVID services, the better that it will be for the people of Northern Ireland. As the royal colleges asked for in their press release, it is vital that the people of Northern Ireland respond and react to the asks in the government guidance so that we can drive down the spread of COVID-19.”
“I am sure that the Member is aware that a number of medical royal colleges issued a joint press statement this morning. I and officials from the Department have met representatives of the colleges and discussed with them how we can re-engage and make sure that some of the services that we put in place in our surge plans can continue. Those include pain and neurology clinics, as well as urgent flags for cancer. Services will be dependent on the availability of staff and premises, however. <BR /> <BR />In their press release this morning, the royal colleges summed it up better than any of us can when they stated:”
“We have seen some of those things introduced in Daisy Hill Hospital as its emergency care provision has reopened. <BR /> <BR />It is about how we utilise a very limited number of staff on a smaller footprint because of social distancing. It is also about making sure that we can get patients seen by the right person at the right time in the right place.”
“The pressures on our emergency departments are historical. A piece of work was done to review emergency departments, and I announced on Friday that that is now available on the Department's website. It is about how we look at the reformation of our emergency care services. Doing that will be a challenge, especially at this time. Something that we are doing through our COVID-19 urgent emergency care action plan, 'No More Silos', is looking at how we can work across all our services. We have seen over the past six months how primary and secondary care have really come together to work collaboratively. That was demonstrated in our COVID centres, and it is vital that that continue in this next phase. <BR /> <BR />Ten key actions are set out in 'No More Silos', including:”
“Out of a meeting with the Royal College of Surgeons and other health professionals last week, there was an indication that they are prepared to do that in order to get to grips with our waiting times.”
“So, it is about filling the gap in the staffing vacancies but also embedding the creative and innovative solutions that we have seen, such as the establishment of the elective care centre in Lagan Valley, the orthopaedics network and the cancer reset cell. <BR /> <BR />It is about looking outside of what has been the norm in our health service. It is about breaking down the silos that were not intentionally but artificially created in the system, when we did not look across all our trusts and services to see how we could react collectively to challenge waiting lists. It is also about challenging surgeons, doctors and other health professionals to travel to other sites.”
“I thank the Member for his supplementary. Mr Speaker, before I move on to answering it, may I thank Mr Easton for his service on the Health Committee? I am led to believe that he will be moving to another, more important Committee some time in the next weeks. He has served on the Committee since 2007, and I thank him for his service, dedication and detailed knowledge, which we heard in the question that he just asked. <BR /> <BR />He is right. The lack of nurses and doctors in our current system is a subject that he has often raised. When this place came back on 11 January, one of our big achievements was to put in place 300 nursing training places every year for the next three years. The Member has highlighted many times that that would not even fill our current gap.”
“That may continue in the short to medium term. It will inevitably have an adverse impact on outpatient waiting times for some time to come.”
“In addition, a growing number of specialties are adopting virtual clinics using videoconferencing. Embedding those recent innovations will be essential to maximising outpatient activity during a second wave of the pandemic. <BR /> <BR />It is important to emphasise that the impact of COVID-19 on elective care services will be profound and long-lasting. It has been acknowledged that services will not be able to resume as normal for some time due to the constraints imposed by COVID-19, including social distancing and the use of PPE. The increasing prevalence of COVID-19-positive cases in the community and our hospitals in recent weeks is impacting on the rebuilding of elective services. Staff are being redirected to respond to those pressures or are required to self-isolate, and, as a consequence, some cancellations have been required.”
“<BR /> <BR />As part of the process to rebuild health and social care (HSC) services in the wake of the first wave of COVID-19, I published the 'Rebuilding Health and Social Care Services Strategic Framework' in June. The framework outlines HSC's plans to rebuild services and sets out the approach of resetting elective activity in an environment that is safe for staff and patients, while planning for a second wave of COVID-19. <BR /> <BR />In developing those plans, trusts have taken account of the new innovative practices that were introduced during the first wave of the pandemic. For example, trusts have adopted the use of technology such as telephone and virtual clinics to a much greater extent. Outpatient appointments have, where possible and where appropriate, moved to telephone appointments.”
“I thank the Member for his question. I fully appreciate that every patient should be able to avail themselves of the best treatment that the health service can provide, and in a timely manner. It is regrettable that any patient has to wait longer than is clinically appropriate for outpatient assessment. I fully understand the distress and anxiety that long waiting times cause, particularly when patients are suffering pain and discomfort. <BR /> <BR />I assure you that waiting times for elective care remain a key priority for the health service in Northern Ireland. Unfortunately, elective care activity had to be reduced during the first wave of the pandemic as medical staff were redeployed to treat COVID-19 patients. That inevitably had an adverse impact on outpatient waiting times, which were already unacceptable prior to the pandemic.”
“As I have said many times, mental health is one of my priorities. I am honoured to be in a position where I can drive strategic change and improve mental health services. It is hugely important that we strive to reduce stigma associated with mental ill health, continue to push for parity of esteem with physical health, and provide adequate resource to ensure that we have a system that adequately cares for our community. <BR /> <BR />Mr Principal Deputy Speaker, I thank you for allowing this Adjournment debate. I thank the Member who brought it and the Members who spoke in it.”
“My officials are already working closely with our partners in the voluntary and community sector and with the mental health champion to ensure that people with lived experience can meaningfully contribute to that work.”
“The first cluster of actions in the action plan, therefore, revolve around a new 10-year mental health strategy, and I intend to publish a consultation draft of the strategy by the end of the year and a final strategy and 10-year funding plan by July of next year. <BR /> <BR />The new strategy will be person-centred, taking a whole-life approach, with a whole-system focus, and the aim is to ensure long-term improved outcomes for people's mental health. To support my Department in that work, I recently established a strategic advisory panel to provide co-produced policy advice and support. That panel has wide membership, including voluntary and community-sector representatives, individuals with lived experience, health and social care professionals, professional bodies and the mental health champion.”
“<BR /> <BR />We must ensure that our mental health system of the future can meet and adapt to the new challenges that have been brought about by COVID and can address those historical issues to ensure that all who need mental health care and treatment will receive it. Since taking up my post as Minister of Health, I have made it very clear that mental health is one of my key priorities. On 19 May, I published the mental health action plan and the COVID response plan, with 38 actions to kick-start the reform of mental health services, and work to implement the action plan is progressing. However, there is also a need to ensure that mental health services are developed strategically and are evidence-based.”
“<BR /> <BR />Mental health services in Northern Ireland have historically been underfunded, and parity of esteem is an aspiration that we have yet to achieve, but we are working towards it. The pressures that have been caused by the pandemic are significant. There is much to suggest that we are at the start of a surge in mental health needs. Early international evidence indicates an increase in need, especially for treatment of low-level depression and anxiety and among those with existing severe mental illness. Our trusts are reporting increasing referrals and heightened acuity of patients, and the general trend is towards new and increased pressures across the secondary-care mental health services.”
“To date, the Western Trust has received a total of £1·2 million to carry out interim remedial work to improve safety, user experience and therapeutic benefit. <BR /> <BR />As we look to the future, particularly given the impact that the COVID-19 pandemic is having on our communities, it will be important to ensure that mental health is adequately resourced to address capital demands and to ensure that adequate treatment and support services are available for those who need them. As Members will be aware, mental health services are already facing unprecedented pressures. Inpatient services are under extreme pressure, with workforce issues compounding an already difficult position. Our mental health staff are dedicated, caring, highly skilled and committed, but they are doing a very difficult job in increasingly difficult circumstances.”
“<BR /> <BR />It is, of course, disappointing that we cannot progress that capital project, which would greatly improve the therapeutic experiences of those who need inpatient treatment in the Omagh area. However, that does not mean that my Department does not take seriously the need for improved inpatient units across the country or the need to ensure high-quality care for patients. Indeed, in recognition that the existing older mental health inpatient units provide a very unhelpful environment for therapy for patients who are facing the challenges of mental illness, my Department has prioritised funding over the last two years to carry out essential upgrades to the existing facilities.”
“<BR /> <BR />The outcome of that exercise was that, on the basis of clinical risk and limitations of therapeutic benefit, the Northern and South Eastern Trust projects were deemed, at that point, to be of a higher priority and were, therefore, given approval to proceed to stage-1 design in December 2018. At that time, the Western Trust was advised that it would be given permission to proceed to stage-1 design in the 2021-22 financial year, subject to business-case approval and the commissioner's support being in place. <BR /> <BR />I inform Members that a bid for the funding to commence the new Western Trust unit in 2022-23 has been included in my Department's response to the recent four-year Budget exercise, the outcome of which is due towards the end of this year.”
“Given the difficult budget constraints that the health service has continued to operate under for a number of years, it was not possible to progress those projects simultaneously. <BR /> <BR />In 2018, therefore, my Department carried out a prioritisation exercise to determine the order in which the remaining three units would be built. A task and finish group was established to carry out that exercise, and the group visited all old, acute mental health inpatient sites across the three trusts to establish a prioritisation list for the new builds.”
“I think that Mrs Barton referenced that in her contribution. Since then, new builds have been completed in Belfast, the Southern Trust and the northern part of the Western Trust. The new builds are state-of-the-art inpatient facilities that provide high-quality care to those suffering from mental ill health. I thank Members for recognising today that, despite the need for financial investment in the structures in which that healthcare is provided, the staff are providing high-quality care for those who need it most. <BR /> <BR />Building in the remaining three areas — the Northern Trust, South Eastern Trust and the southern part of the Western Trust — has, as Members rightly indicated, not yet commenced, and that is why we are here today.”
“The Executive have been able to build on that since their formation in January. We have an Executive subcommittee that looks at mental health, well-being, resilience and suicide prevention, so we have cross-party support at an Executive level for the real need to develop and enhance mental health support, provision and facilities. <BR /> <BR />As Members may know — some Members referred to this — for the last decade, work has been ongoing to improve mental health inpatient facilities across Northern Ireland through capital build projects. In 2010 — I think that this was referred to — it was determined that there should be six mental health acute inpatient units across Northern Ireland. There was to be one in each of the five HSC trusts, apart from the Western Trust where, due to geographical challenges, two units were to be built.”
“I thank the Member for bringing this debate to the House, because it provides us with the opportunity to discuss the acute mental health facility at Omagh Hospital and Primary Care Complex, and mental health in general. I commend Mr Buchanan, who showed such passion and such sympathy for the needs of the rural population when it comes to accessing mental health services and the necessary support. For a long number of years, I sat on the then Agriculture and Rural Development Committee with the Member and Mr McAleer. It was an issue that was often raised, whether through Rural Support, young farmers or the tackling rural poverty and social isolation funding, which was well championed by the Committee. I always liked to see that joined-up working across Departments when it came to tackling the issue of mental health.”
“By following that advice as we go about our daily life, we can protect ourselves and others from serious illness, protect our health service, our economy and our education service and help to avoid further prolonged and more stringent restrictions.”
“That is the interpretation of many of what herd immunity means. It is not what Sweden practised, even though many claim that it is. <BR /> <BR />We all have a responsibility to help to curb the spread of the virus. We do that by maintaining social distancing; by maintaining good hand hygiene and respiratory hygiene; by wearing face coverings; and by self-isolating immediately if we experience any symptoms, including a new, persistent cough, a fever or a loss of or change in smell or taste. We do that by seeking a test if we experience any of those symptoms, by downloading the StopCOVID NI app and by complying with the restrictions and regulations that are in place.”
“It would be different if this were simply about positive cases that were stand-alone and did not lead to an increase in hospital admissions. We have seen admissions increase over the past seven days, and we will see them increase further over the next seven days. Those hospitalisations lead to further ICU admissions and further deaths. Positive cases translate to hospitalisations, ICU admissions and potential deaths. We have to learn to live with the virus, and we do that by bringing in the regulations and restrictions that we have brought in to date. There is only one set of steps that we know to work, and that is the set that we used at the beginning of this year, but we have to make sure that the steps are proportionate and balanced.”
“The Member's point is that there is some level of immunity, which we do not know yet. This is still a new virus. Northern Ireland had its first case in February. Members keep talking about what we knew eight months ago. Eight months ago, this scared — I will not use the language that is in the back of my head, but I know how I felt as Health Minister at that point. <BR /> <BR />The point that I made earlier and that the Member has made is that the issue is how we live with the virus. We will live with the virus using various shades of — I will not use the word "lockdown" — implementation of regulation and restriction. That should be proportionate to the increase in cases, hospitalisations and ICU admissions.”
“It is not about getting out there and seeing how we survive. We do not do that with the flu, polio or other medical challenges that modern society has faced and combated through vaccination. Simply letting the virus rip and seeing where it ends up, which is what many interpret herd immunity to be, although Mr Allister moved away from that phrase, is not something that I will support as Health Minister, and I do not think that it is what the Member means.”
“The Member is right, and this is something that I have always said: the impact of what we do must be balanced by the Executive as a whole. That is about me putting forward my case as Health Minister to ensure that our health service is not overwhelmed and does not run into the same challenges as it did in the first wave. Today, we have 22 people in ICUs and 140 in inpatient beds. Those 140 people need to be nursed, supported by auxiliary workers and domestic staff, fed and looked after. They need to be in those beds while they combat COVID, but those are 140 beds that our health service cannot use for other patients. <BR /> <BR />Mr Allister raised the issue of community immunity. That will come about through the implementation of vaccination and the uptake of the vaccine. We still do not know how long a vaccine will be potent for.”
“He is right that the detail of the law, as drafted, gives me phenomenal power, but he knows me well enough to know that I take the use of that power very seriously and would not use it without guidance from and consultation with the CMO, the CSA and my Executive colleagues. <BR /> <BR />Mr Allister referred to anonymous sources in the media. I say to him — he is a long-standing Member of the House and of the legal profession — would he base a legal argument on anonymous sources whom he heard quoted on Radio Ulster? I do not think that he would, as a professional or a politician, so I will not engage in that debate. It was designed solely to set a direction of conversation before that conversation had, in fact, happened.”
“The Member's final comment was that more may need to be done. We are in this together. That is the message from society and Northern Ireland as a whole. <BR /> <BR />Mr Allister talked about the detail of the regulations, as I expected him to. The paragraph to which he referred states that, after consulting the CMO and the CSA, I can make a direction. If the Member thinks that my Executive colleagues are so timid and so afraid of me that they simply go with what I say without challenge or contest or without putting forward a different option, I wish that his impression was right, because it would make this work an awful lot easier.”
“It is about making the best decisions with what we have to prevent the collapse of our health service and prevent more people getting COVID and to ensure that our education and our economy can go ahead. The Member was right to say that there is no absolute. So many people expect, want or ask for an absolute. They call on the Executive to produce that absolute, but there is none. Things are done from personal perspectives, understanding and approaches, which we as an Executive, as an Assembly and as a society have to take on. One of the most important words that the Member used was "empower". It is about the actions of individuals and communities to support those who need help, whether as a result of COVID, self-isolation or mental health challenges, and that is the challenge that we also have to address.”
“That is why I asked for a group to be set up within the Executive to work across Departments and with outside agencies to increase the emphasis on enforcement and compliance so that we can give a clear signal to those who abide by the guidance and the regulations that anybody who thinks that they are above it and bigger than it will be held to account. I welcome that. <BR /> <BR />Sinéad Bradley was called to speak without knowing that she was going to be. I thank her for her comments. She had a heartfelt approach to the message that needs to come from this place: this is about what we can do for others. It is a balancing act; there is no win-win.”
“The Member also raised another challenge that is often repeated: people saying that this is a lesser strain. No, it is not. There is nothing to prove that it is a lesser strain. It goes back to the earlier point: we now have better ways to treat the virus. In most cases, we know how to treat it. We now have medications that we did not have at the start of the pandemic, and we know which ones work. The dangerous narrative that people do not have to worry about this and that it is no worse than a minor flu falls. <BR /> <BR />The Member raised the issues of enforcement and compliance, which have been raised across the piece.”
“The Member talked about the information that is available. Much more information than people realise is available on our dashboard about the number of hospitalisations and the number of people who have been discharged. The information is broken down in great detail and gives the number of hospital admissions, the numbers in ICU and a breakdown of positive cases by age group and council area. There is a lot of information there.”
“<BR /> <BR />Daniel McCrossan spoke about his personal experience, and I think that Mr Allister picked up on that. That is so valuable. A number of Ministers are now self-isolating because they have been in contact with somebody who has tested positive. That goes to show that this virus excuses nobody and misses nobody and that nobody is above it or immune from it.”
“I do not think that we can simply legislate or fine our way out of this. If I did, I think that we would see a lot more draconian measures. There is a role for enforcement and encouragement, but there is an onus and emphasis on personal responsibility. I think that the majority of people in Northern Ireland are taking that upon themselves, but a small minority is doing damage. I echo his comments about the role of local councils. Derry City and Strabane District Council in the past few weeks has been an example to other councils. The messaging and coordination and having voices at a local level have got people engaged. We have not seen the outworkings of that through a decrease in numbers up there yet, but the message is now there. That was replicated across other council areas as they saw the incidence in their areas start to increase.”
“That is not how I work, that is not how our health service works, and I sincerely hope that nobody in this House thinks that we should measure our reaction in that way with the severity and the proportionality of the regulations that we bring in. <BR /> <BR />We have had conversations round the Executive table about some of the other points that Mr Sheehan raised. There is the challenge of encouraging people who are contacted through our test-and-trace procedure to self-isolate. I know that a conversation is going on between the Department for Communities and the Department of Finance to make sure that we get the support payment measures that are available in England. <BR /> <BR />The Member for Foyle Gary Middleton said that everyone has a role to play and that we must all take personal responsibility.”
“Not as many people are dying at this time, but we have always seen a lag from infection to hospitalisation to ICU to deaths, and that is why we are taking steps now to reduce the number of deaths. There are improvements in treatment and in knowledge, but the best thing that we can do is stop people getting the virus. Pat rightly challenges that narrative. Not as many people are dying now, but I ask people who put forward that narrative: what is your trigger point? How many people dying a day from COVID-19 is the point at which you want us to take action? Should we sit back until you say that a certain number of people have died so I, as Health Minister, have to do something?”
“<BR /> <BR />The Member is right about the statutory challenge role of the Committee and of the House. I have raised that point before in the Committee and in the House, and it was addressed when the junior Ministers came from the Executive Office to address some of the regulations. Many of the regulations are cross-sectional, they cross all Departments, and they have implications across other bodies apart from mine. As these are health regulations, I am here to table them, but they are brought by and for the Executive. The point that the Member made is valid because there is a dangerous narrative that more people are getting the virus but not as many people are dying.”
“<BR /> <BR />It goes back to the points made by Mrs Cameron and Mr Sheehan about the changes that we have made regarding orthopaedics moving to a regional service, the elective surgeries at Lagan Valley and our cancer reset services. All those steps are critical in ensuring that we can maintain a service. It is not the service that I would like or want, but it is so that we can maintain a service while we have to support and help all those coming forward with COVID-19. There is no point in our health service where we can ask somebody to make a judgement and say to someone who is walking up to the door of a hospital, "You have COVID-19. I don't have a bed for you today". I do not expect our health service to do that, so the additional pressures come at that point of challenge.”
“That is information that needs to be clarified. <BR /> <BR />Mr Easton has continually raised one of the most salient questions since I came into post and this place was reestablished: do we have enough nurses, whether through recruitment of international nurses or local recruitment processes? The answer is no. We did not have enough nurses in March, we did not have enough in January and we do not have enough now. The more the virus spreads in the community, the more that our health staff, including nurses, are at risk of contracting it, no matter what precautions are taken. That is the challenge that we face when we look to support the patients with COVID while trying to maintain the service that needs to be provided. Those are some of the challenges and changes.”
“I agree, but I will not get involved because we still have work to do to try to get out a united message from our Executive and the House about what needs to be done. <BR /> <BR />Mr Easton also indicated concerns about testing. We have continued to access pillar 2 testing and have enhanced our testing in pillar 1; in the past couple of days, we have hit more than 10,000 tests per day. We need to ensure that our public dashboard shows the number of tests per day, the number of people tested and the number of positive tests. There is a specific indicator for the number of people who have been tested for the first time. There is further information on the dashboard that shows everybody who has had repeated tests and how the positivity rate ties in to the percentage of positive tests and the number of successfully completed tests.”
“The reason was that they were in a very different place back on 21 September; they had among the lowest infection rates in Northern Ireland. What we did at that time was proportionate to where we were; we then moved to increase the regulations from ones that covered postcodes to ones that covered the entirety of Northern Ireland. <BR /> <BR />I share Mr Easton's concerns about everything that he raised, from the pace of change and what we have seen in the past seven and 14 days, to the trajectory that we are on. That is why we are saying that we need to make the interventions. He expressed his annoyance at the message that was put out this morning because it undermines the general health message.”
“When someone receives a positive result, they will receive a text message and a link to a specific website, where people can enter their details and contacts. That is to try to enhance and speed up the transfer of information. It is about utilising modern technology in the work that we want to do. One of the things that makes our contact-tracing service unique in comparison with some of the others is that we still hold it in-house. It is not operated by a private or for-profit organisation; it is run within the confines of the Public Health Agency. <BR /> <BR />Ms Bradshaw also asked why we did not include the Derry City and Strabane or Newry and Mourne council areas when we brought in the regulations on 21 September.”
“Every day counts when it comes to bringing in additional steps. <BR /> <BR />Ms Bradshaw mentioned Executive messaging about these regulations back in September. I do not have a detailed account of what the First Minister and deputy First Minister said in the press conference that day, but I will refer her comments to the Executive Office and the Executive information service to see where they fall. <BR /> <BR />One of the most critical points in our contact-tracing system is the information that the individuals whom it contacts give to it. The more information that our contact tracers get from people who have tested positive, the more that it helps us to shape the data that we have and the understanding of where we see the virus going. On Friday, the contact-tracing service moved to an online offering as well.”
“<BR /> <BR />One of the challenges that we have when we talk about our council areas and then try to compare them with council areas in the Republic of Ireland and England is that we are talking about a population of 1·8 million or 1·9 million, which is smaller than Manchester. When we hear of restrictions being brought in in Manchester, we try to compare that with what is being done in Derry City and Strabane, when the scale, complexity and number of people involved are not a direct comparison. It is about how we get our messaging right to reflect that as well. <BR /> <BR />Mr Chambers also asked about time. Time is critical. Every day counts. As I said in my opening remarks, we are looking at a seven-day doubling of cases and hospitalisations. We also see other indicators, such as increasing positive cases among our over-60s.”
“<BR /> <BR />People try to say that their area is not as bad as Derry City and Strabane, but being the best of a bad lot is not a good place to be. In fact, the Mid and East Antrim council area, which is partly in my constituency and partly in Mr Allister's, is now the lowest. We look at that and hold it up and go, "Mid and East Antrim is now low". It is at 83·7, according to yesterday's figures. That was when we brought in the initial measures in the Ballymena BT43 and Belfast areas. When the regulations that we are debating today were actually brought in, Mid and East Antrim was lower than it is today. It is in a good place, because it is the lowest of our council areas, but that does not mean that it is doing the best that it can, because we have so much to do across the entirety.”
“<BR /> <BR />Mr Chambers spoke about how we compared, or could compare, areas across Northern Ireland. I have heard that on the media this morning. What I will say to the Member is to compare where we were on 27 September to the present day — roughly 14 days. In the Antrim and Newtownabbey council area, positive cases have increased fivefold. In Ards and North Down, they have increased fourfold. In the Armagh City, Banbridge and Craigavon council area, they have increased threefold. In Belfast, they are up fourfold. In Causeway Coast and Glens, they are up sixfold. In Derry and Strabane, they are up fivefold. In Fermanagh and Omagh, they are up fourfold. In Lisburn and Castlereagh, they are up fourfold. In Mid Ulster, they are up fourfold, and in Newry, Mourne and Down, they are up fourfold.”
“<BR /> <BR />One of the issues that she raised — again, it is a concern of mine — was the anti-mask rally that was held in the Guildhall, where that group spoke against masks, vaccines and regulations. There is one thing that I think everyone who attended that rally has in common with all of us: they expect the health service to be there for them. While they rail against it, while they attack the regulations, while they attack the guidance that is coming out from our scientific advisers and the heartfelt pleas from our nurses, our doctors and anybody in the health service who is asking people to follow the regulations, they still expect those people, at the end of the day, to be there to make them better, should they contract COVID or anything else.”