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.”
The complete record
Every one of 5,640 lines we hold for Robin Swann, in date order, each linked to its source. Free to read, in full, without an account. Page 78 of 113.
“A point that the Member has made various times is that we do not wait for the outcomes of the SAI. Learning from what happened in the Southern Trust is live and ongoing. I welcome the input, advice and guidance from Public Health England (PHE) as well. Rather than just the Southern Trust learning from PHE's experience of outbreaks across hospitals in England and Wales, that learning could be shared across all our trusts here in Northern Ireland so that we do not witness the terrible loss of life that we have seen in Craigavon Area Hospital and Daisy Hill.”
“I do not have the specific update to hand but I will get back to the Member. I know that the panel has been appointed for the SAI that is ongoing at level 3. I have given assurances to the investigating team and reassurances to the families — I have met one of the families — that the panel will have the ability to set up its own terms of reference, with input from the families, and there will be no restriction of access to information or whatever the panel needs once it has been commissioned and is up and running.”
“<BR /> <BR />If there have been breaches of the rules and regulations, I encourage the PSNI to investigate all available media, including social media, no matter the situation or scenario. It may take enforcement to get the message through to that small minority of people who think that they are either above these regulations or immune to COVID-19. Unfortunately, we are at that point, and that is why I welcome the establishment of the compliance and enforcement group within the Executive and support the work that it is doing.”
“When we put regulations and guidance in place, they are there for a reason: to prevent the unnecessary spread of COVID-19. When I see the examples that were shared widely on social media over the weekend and what has happened in other situations, it concerns me. The Member is right: more often than not, someone from such crowds ends up in a hospital setting, which puts pressure on our hospital services, our nurses and our doctors. There has to be some recognition that our regulations and guidance are put in place to prevent hospitalisations, to prevent people entering ICUs and to prevent deaths. It is a clear message that comes from the Executive collectively: our guidance is there for a reason.”
“It claims that those are beyond its control, but I would have liked to see a more stringent application of the guidance that was already in place.”
“The Member raises concerns that have been widely publicised. The images were brought to my attention over the weekend, and I was disappointed and angry to see them. If one person in that group or community has COVID-19, there is every chance that it has now spread among the group. However, that is not restricted to the group that we saw at the GAA match; it is the same for any group that we see being portrayed on social media, whether in a bar setting or a university hostel, where social distancing is not being observed. I was disappointed and angry at what we witnessed and what the Member refers to. I note, however, that the GAA has suspended all games and expressed disappointment at what it classifies as after-game actions.”
“The Member is being deliberately obtuse in her supplementary question. The 2020 abortion regulations came into force on 31 March. They set out the circumstances in which an abortion may take place and establish the requirement for terminations to be certified by a registered medical professional and notified to the Chief Medical Officer. As terminations are carried out outside any normal commissioning arrangements, there is currently no agreed protocol for processing notifications of termination. They contain sensitive personal information. To date, they have been counted, but, otherwise, unprocessed. The Member is aware of that and the services that are provided across a number of other trusts in Northern Ireland.”
“My Department has not given instructions to the Health and Social Care Board to commission abortion services. However, abortion is now legal and can be carried out by registered medical professionals. I will not comment on the locations in trusts where abortions have been carried out. The Member will be aware that I have sought Executive agreement on the establishment of an emergency early medical abortion service to ensure that women's health needs are addressed during this pandemic.”
“I do not recognise what the Member says about the memorandum of understanding not being operable. I think that it works. We have challenges, which we are addressing on either side of the border. They are not political or personal; they are operational with regard to legislation and the sharing of personal data. That is coming from the respective AGs, and it is being worked on at the moment. Primary legislation would need to be conjunctive and coherent on both sides of the border at the same time. We are not there yet, and we do not need it; there are good working relationships between me and the Health Minister in the Republic of Ireland, our CMOs and our public health agencies, which we can build on and improve. Legislation is not the answer.”
“I thank the Member for her question. There are no barriers that spring to mind apart from, at times, the challenges of communication. That has come about because of political decision-making on either side of the border. We have had challenges around the transfer of information on travel locator forms, on which we are currently receiving legal advice. The Member's junior Minister, Declan Kearney, and I attended the North/South Ministerial Council meeting in health format on Friday at which a number of those issues were addressed. I can assure the Member that there is no deliberate barrier to sharing information or to how we respond to COVID-19. There are technical and legal difficulties that we are working, on both sides of the border, to address as soon as we possibly and practically can.”
“That gives us an opportunity to build on our mental health response to the pandemic and build that into a 10-year strategic plan with a substantial evidence base. We can reinvigorate and reorganise services to better reflect the new and emerging profile of need, and we can build on innovative solutions that have come to the fore during this period.”
“It included the development of an online app library to support self-help, the roll-out of psychological first aid training to staff and volunteers on the front line and the provision of free online stress control classes, which have been available since May and will continue to be available until the end of the year. It also included bereavement guidance and a workforce well-being framework and dedicated psychological helplines for front-line staff. <BR /> <BR />That support remains in place as we continue to battle COVID-19 and the impact of the pandemic on our community's mental health. A key element of responding to the emerging mental health need is the implementation of the mental health action plan, which includes the development of a new mental health strategy.”
“I thank the Member for his question. It is accepted that the COVID-19 pandemic, in particular, lockdown and other restrictions, will have a negative impact on our population's mental well-being. At the start of the pandemic, I put arrangements in place to mitigate and address that impact. When I published the mental health action plan on 19 May, I included a dedicated COVID-19 mental health response plan. That plan set out the mental health response to the pandemic and outlined specific actions, including public health messaging to support people to look after their mental well-being while staying at home and the provision of updated mental health support and advice on the mindingyourhead.info website.”
“Three stroke units in Northern Ireland achieved an A grade and four units received a B grade, which is a significant improvement on six months ago when only two stroke units achieved an A grade and two units achieved a B grade. The delivery of care is currently at a very high standard and that has been assessed and accredited by the SSNAP audit. Our current provision is fit for purpose and supports our patients. As I said, the review will be done in the time that it takes for me to come to the right decision that ensures the future-proofing of stroke services in Northern Ireland.”
“Again, as I have said, no decision has been made on the location where our stroke services will be reconfigured, should they need to be reconfigured. The Sentinel Stroke National Audit Programme (SSNAP), which assesses the delivery of stroke services, happened between January and March of this year.”
“As I said in my recent answer, this is a once-in-a-generation chance to improve stroke services and deliver improved outcomes. For that reason, I am not prepared to rush into a decision without access to all the information. That information is needed to make the right decision. I make no apology for seeking further analysis of the options outlined as to where and at what level stoke services will be delivered in Northern Ireland, and it will have an impact on staff. If we make any changes to what that future stroke service may look like, I need to make sure that we have the staff to deliver it. There is no point in coming out with recommendations if we do not have the ability to deliver the work we need it to do on the ground.”
“I assure the Member that it will not be set aside, but I also assure him that it will not be rushed as this is a once-in-a-generation decision to change how we support those who have had a stroke and those who need aftercare following a stroke. I will decide in due time with due process, and I will make sure that I consider the additional information I have sought from my Department and the responses from the consultation.”
“I intend to consider that analysis alongside the consultation analysis and the evidence base for reform in reaching my decision, and I will update the House accordingly.”
“As a consequence of the need to prioritise the response to the coronavirus pandemic over the past few months, work on a range of projects, including Reshaping Stroke Care, has been paused. While I believe that that was the right thing to do, I appreciate the wider impact that it will have had on stroke patients across Northern Ireland. I can assure you that Reshaping Stroke Care remains a key priority, and I recognise the urgent need for the reform of stroke services in Northern Ireland. Over 19,000 people responded to the consultation on Reshaping Stroke Care, and my officials have completed an analysis of responses. I have asked for some further analysis to be undertaken regarding the staffing requirements for the hyper-acute stroke network proposed in the consultation, and that work is currently under way.”
“It is important that, when we ask someone to shield again, they have support mechanisms such as a voice at the end of the phone or on the other side of the door, and they have someone to support them.”
“In the rural communities, the work of Rural Support and the Good Morning telephone lines, such as Good Morning Ballymena and Good Morning Ballycastle, that operate across Northern Ireland is important. As I said when answering the previous Member, community organisations such as Orange lodges and the GAA provide community cohesion and additional support. They really stepped up with additional support and engaged to make sure that no one was left all alone. Making sure that no one feels abandoned is one of the largest challenges. That was something that came out of the Patient and Client Council research with the initial shielding group. The research said that it was vital for a person who was shielding to have someone to talk to.”
“I know that the Member has raised before the issue of the mental health challenges for people who have been asked to shield. Again, through my engagement with Community Pharmacy when they looked at working with delivering prescriptions, I know that one of the things that its volunteers said was that it was not the time to deliver the prescription that was the most vital; it was the engagement at the door, where they actually had face-to-face interaction. That is one of the challenges. Just to correct the Member, there is no one shielding at the minute. We have not advised anybody to do that. However, it is about making sure that there is community support and engagement with people.”
“As I say, that is why I have been engaging with the Department for Communities and the Department of Finance to make sure that there is a holistic package. Community Pharmacy did vital work during the first period of shielding by setting up a delivery mechanism for those who needed prescriptions. A lot of community volunteers were used to deliver that. It is about making sure that all the support mechanisms are in place before we take the second step.”
“Following on from the answer that I have already given, the four CMOs are looking at a risk matrix that will assess what we have learned from the first cohort, specifically in regard to what medical conditions and underlying medical conditions are more vulnerable to the worst effects of COVID-19. What we have seen, coming into this period and from the learnings from the first part, is that a number of the groups with medical conditions who were asked to shield were not adversely affected by COVID. It is about keeping as many people not shielded as is physically possible. <BR /> <BR />With regard to support mechanisms, the Member is correct: if we as a Government and as an Executive ask someone to shield, we have to make sure that the support mechanisms are there.”
“<BR /> <BR />With regard to support mechanisms, when we ask someone to shield, it is important that we have the support, not just from the community, which has been invaluable in the first cohort of shielding, be it local community groups, the GAA or Orange lodges. That first cohort who shielded were well looked after by their community. We need to ensure that those groups have the ability to do that again. I have been in contact with the Member's colleague the Minister for Communities to ensure that that support is financially and physically supported as well. It is crucial that we provide an infrastructure to support people if we ask them to shield for a second time.”
“Again, the Member makes a valid point. Work was commissioned and carried out by the Patient and Client Council (PCC) on the experiences of the first cohort that had to shield. That is where that part of my answer comes from. There are those in that cohort who do not want to shield again, and there are those who do. That is why, at this point, we are looking at a further risk matrix, should we have to provide a second piece of guidance about who should shield. It will be a much smaller cohort who have to shield for very specific medical reasons, and that will be supported by guidance from the Chief Medical Officers (CMOs) from across the four nations.”
“There is always a degree of risk in contact with the outside world, but remaining indoors indefinitely is also detrimental to physical and mental health. I therefore encourage clinically vulnerable people and older people to be particularly careful in following the advice on limiting household contacts, social distancing, handwashing and wearing a face covering. However, I also ask everyone in our community to play their part in keeping each other safe. At this difficult time, it remains more important than ever that we stick together, stringently follow the public health advice and adhere to the new regulations.”
“I know that some of those who were previously shielding are relieved that there has not been a return to the advice to stay at home at all times. I recognise that, for others, the pause in shielding has been difficult to navigate and has brought with it new uncertainties, which, when combined with the rising numbers of COVID-19 cases in the community, has led to a sense of increased anxiety. There is no easy route through the current difficulties that we all face, but it is important that we continue to seek to achieve as balanced an approach as possible.”
“I thank the Member for his question. I recognise that this is a difficult and worrying time, particularly for those who may have an underlying condition that means that they are more clinically vulnerable to the impact of COVID-19. Members will be aware that new restrictions came into force across Northern Ireland from 22 September. Those new regulations do not constitute a lockdown, but their overriding goal is to keep household-to-household contact as low as possible in order to help reduce the spread of COVID-19. <BR /> <BR />The need for further specific advice for those who were previously shielding is being kept under continuous review. At this time, however, there has been no change to the decision to pause shielding, which came into effect from 1 August.”
“That is an approach that was advanced in Germany at the very beginning of the pandemic, where 10 people were tested and put into the one sample. If the sample tested positive, the 10 were tested again. There were queries over the efficiency of that process, because the 10 people had to wait on the first result before being called for the second test to be done, and they then had to wait for that result. It therefore delayed one of the 10 people in that pool being identified as being positive. It is not something that we did in the first pandemic, and it is not something that we are considering doing this time either.”
“I am not sure what you mean. Did you say "pooling" or "pulling"?”
“The regular testing programme makes a positive contribution to the entire healthcare service and to how we fight the pandemic. It is kept under regular review by that group.”
“A large piece of work has been done on who is eligible and on when we should be doing a regular testing programme. The Member knows full well that one of the first cohorts for which regular repeat testing has been put in place is our care home staff and residents. We have seen, through expert advice and guidance and scientific advice and guidance, that that is the cohort that needs regular testing so that we can protect residents of care homes. When we look at where we are with the number of care homes showing positive cases, we see that that approach has been effective in ensuring that we are keeping care home infections as low as possible. The expert advisory group regularly looks at who should be tested and at when they should be tested.”
“I am concerned to hear about the specific case that the Member raises. It is not something that I recognise or that I want my testing system or the test, trace and protect system to do. Again, not wanting to comment on an individual case, if the Member wants to provide me with the name and address of her constituent and the care company, I will make sure that this is followed up on and that the Public Health Agency gets in contact with the company, because there is a duty of care that the care company should act on.”
“<BR /> <BR />The priority groups eligible for testing are kept under constant review by my Department's expert advisory group for testing and are updated regularly in line with the emerging scientific and medical evidence as the pandemic continues to evolve. The position with regard to the appropriate frequency of testing of domiciliary care workers is kept under active review by that expert group.”
“I thank the Member for her question. The current general policy is that all staff who are symptomatic or who are isolating as a symptomatic household member are eligible for testing in Northern Ireland. That includes community-based domiciliary care providers who, as essential healthcare workers, can access testing, either through the HSC laboratories or via the national testing programme. Should there be an indication of more than one symptomatic individual among a group of care workers, an appropriate risk assessment will be undertaken by the Public Health Agency, with testing of all individuals undertaken as deemed appropriate by that risk assessment.”
“Our community pharmacy partners in the health service do deliver the flu vaccine for those who want to come forward and pay for it. They can provide it, as can our GP services. It is about getting as many eligible people not just to receive it but also to give it. There is a large piece of work going on across the health and social care system on peer vaccinators so that we can increase the pool of people who can give the vaccine, and our community pharmacy partners are part of that pool.”
“We have purchased extra doses of the flu vaccine. As we expand, each category is only expanded to match the availability of the doses that we have. If we have extra capacity, we will be expanding the eligibility of those groups that can get it. I am assured by my health professionals that there is enough flu vaccine this year to meet the demands of those who we are asking to come forward. However, should we get additional supplies, we will be increasing availability to those who are due to access, or who can access, the flu vaccine.”
“One of the most important things that we are doing is asking anyone who is eligible for the flu vaccine to come forward and get it because it protects them and it helps us to fight COVID-19 at the same time.”
“The Member makes a valid point, and I thank him for reiterating it. We have been clear that having the flu and COVID-19 at the same time increases the extreme risk to the patient. The groups that are entitled to the flu vaccine will be contacted by their health professionals. In keeping with the advice, the eligible population groups for flu vaccination in Northern Ireland are as follows: primary school children; anyone who is at increased risk of serious illness from flu due to an underlying medical condition; pregnant women; residents of residential or nursing homes; main carers for an elderly or disabled person; front-line health and social care workers, including those working in care homes; and those aged 65 and over. The amount of vaccine that we acquired has been increased on the normal standardisation for the year.”
“The flu vaccine is the best protection against flu for our population.”
“Each of the seasonal influenza vaccines used in Northern Ireland provides protection against the three or four influenza viruses that have been identified by the World Health Organization as the viruses most likely to cause significant disease that year. The vaccine will provide protection only against those viruses. Factors such as a person's age and health will affect their response to the vaccine given and therefore influence the vaccine's effectiveness in preventing flu. Vaccine effectiveness is reported across the UK and included in each annual national flu report, which can be found online. Vaccine effectiveness can vary between population groups and according to the strain of virus covered by that vaccine as well as the closeness of the match between the vaccine and the strain of flu.”
“The day-to-day decision to permit visitors to a facility will still lie with the nurses in charge. It will be based on a risk assessment and will rely on the ability to ensure social distancing and the safety of patients and visitors. <BR /> <BR />This is not the experience that I want for expectant mothers, and I recognise that it is a very anxious time for all families. Many difficult requests have been made, and will continue to be made, of the public in all aspects of health service provision in order to reduce the spread of infection and to protect expectant mothers, their families and the staff who provide that care.”
“Again, that is not an easy one, and the Member will know that. The guidance is based on the best scientific advice available at any given stage. Northern Ireland is currently at surge level 4 when it comes to our visiting regulations, and those state that, in maternity settings:”
“I can give the Member that reassurance, as I did to the Health Committee. They contribute to this decision-making process not only through their professional nature but through their human input and their caring side. As I have said, this decision is not an easy one, but it is one that is there to ensure the safety of those visiting and of those who have to facilitate their visiting.”
“We must ensure that nobody dies alone, and, through the dedication of our healthcare system and the professionals in it, we will ensure that that does not happen.”
“I thank the Member. Her point is very valid, and members from the trade union side have raised with me how staff are being portrayed as callous in this situation, even though the guidance was developed by health professionals and is recognised across a number of jurisdictions. It is being done to ensure that visitors, carers and hospital staff are kept as safe as possible in very trying times. We do not want to do this. My Chief Nursing Officer and her advisory team do not want to do it, and the staff in those settings certainly do not want to do it, because it places an increased burden on them as well. I have heard many testimonies, as, I am sure, the Member has, about the end-of-life care that the staff across all health settings have given.”
“I accept the Member's point, which is why we issued the regional guidance. I do not recognise the situation in which no one is allowed to be with a dying family member. If that is happening, I hope that the Member will give me the details, because I do not recognise such a situation. The guidance states that one family member is allowed to be present, and it is up to the ward manager, the nurse in charge or the manager of the care home to make sure that that happens safely. I will look into the specific case that the Member mentions.”
“<BR /> <BR />In all circumstances, the intention is that each individual should receive personalised and compassionate care, including the appropriate palliative treatment. The pandemic situation exacerbates difficulties in palliative care situations due to the physical distancing regulations that prevent or limit family visiting. However, all efforts should be made to allow at least one family member to be present with their dying relative in all care settings where possible. I recognise that the application of those measures does not allow the level of visiting, contact or support that we would like to facilitate, but my main priority continues to be the reduction of the risk of COVID-19 transmission across all healthcare settings and prevent further outbreaks as far as possible.”
“On 23 September, my Department updated the visiting guidance following a review of the regional alert level. The new guidance revises the principles for visiting, which apply across all healthcare settings during the COVID-19 pandemic and will be reviewed, based on evolving evidence. The visiting guidance has been informed by the Department of Health's COVID-19 guidance on the ethical advice and support framework, which recognises that some patients will be cared for in contexts where recovery is not expected, including in hospitals. The decisions to permit visitors into facilities on a day-to-day basis will lie with the person in charge. That will be based on a risk assessment and rely on the ability to ensure social distancing and the safety of patient or resident and the visitor.”