Robin Swann
North Antrim · Ulster Unionist Party · Northern Ireland
“I thank the Minister for his detailed statement. I know how passionate he is about the subject and how many times he has brought it to the Executive.”
“It has been reported that today will potentially be the warmest day of the year. As we move into the summer and our summer holidays, I want to raise public awareness of wildfires across Northern Ireland, which have been detrimental to farmland and our environment over the past number of years.”
“Wildfires are still having a detrimental impact on our environment and, occasionally, on livestock, but that reduction shows the impact of the Northern Ireland Fire and Rescue Service's proactive approach to educating the general public and engaging with rural communities and schools on its fire safety message, which is to stay alert, not…”
“There has been a lot of talk of sport in this place over the past few days, with everybody concentrating on UEFA. One sport that is going on across Northern Ireland at the minute is cross-community and goes across all age groups without fear, favour or distinction: pigeon racing.”
“I want to put on record that, since this place passed the amendment that recognised pigeon racing as a sport under the 2016 Act, over the past five years, pigeon racing clubs across Northern Ireland have been able to obtain £113,000 of rates rebates through the sports and recreation rate relief, allowing many of those clubs to continue ra…”
“There was much coverage on social media over the weekend of an incident in Staines in England, in which a police car rammed a young calf to bring it under control. It has restarted the conversation about animal cruelty. <BR /> <BR />I am dealing with a specific case in my constituency.”
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“<BR /> <BR />It is not that there are no moneys there: I have already made those commitments to CPNI, and we continue to engage as to how we can progress and support it.”
“I will say to the Member that currently, as he knows, I have no budget available. For 2024-25, however, I have approved the front-loading of the Doctors' and Dentists' Remuneration Body (DDRB) uplifts in recognition of the national minimum wage uplifts in April 2024. That will be paid forward by £1 million a quarter, to be reviewed in-year, in light of budgeting for the DDRB. I have also approved non-recurrent funding of £4 million associated with medicines and hearing services pressures and an increase of the retained margin from £26·5 million to £31·5 million on condition that CPNI agrees a concurrent margin survey methodology and that that becomes a target rather than the minimum threshold.”
“The Department is working on that, and we are facing significant financial difficulties, but I want to work as closely as possible in partnership with community pharmacies.”
“<BR /> <BR />My Department recognises the fundamental role that community pharmacies have been carrying out and has repeatedly acknowledged the concerns that have been raised by Community Pharmacy NI (CPNI), which is the representative body for community pharmacy, and by individual contractors in relation to drug pricing increases and the differences due to inflationary and cost-of-living increases generally. My Department remains committed to working with CPNI on commissioning arrangements in the existing ministerial mandate and financial envelope. <BR /> <BR />It is important, however, to emphasise that there is no provision for additional funding for the community pharmacy sector in the current assessed budget available to Health. That is disappointing in the context of our overall package.”
“I thank the Member for his point. As he knows, community pharmacies continue to play a pivotal role in delivering health services to communities in Northern Ireland. They have been, and continue to be, some of our most accessible healthcare professionals, and they were on the front line of community health during the COVID response. There is a very high level of public confidence in the professionalism and dedication that has been shown by community pharmacies throughout what have been extremely challenging years.”
“One of the trust facilitators who presented at the event made it clear that, initially, they were sceptical about the benefits of MDTs: now, however, they have come to rely on MDTs as a key part of the health service. Not only are MDTs crucial going forward, so is the review of the GP general medical services contract. The Member will know that we are working to finalise that shortly.”
“I have not put in a specific bid for MDTs at this point. I have made a wider bid for the health service within the Department of Health budget. The Member is right to identify MDTs in relation to receiving special funding. He will be aware that under New Decade, New Approach, MDTs were funded under transformation. The teams that are established are now considered a core service, so they are no longer under that funding stream. Any further investment in MDTs will be from transformation moneys that we will look for. <BR /> <BR />It is also, however, about how we expand that. I attended a conference last week about how the South Eastern Health and Social Care Trust is working with primary care to promote and enhance MDTs across the Province.”
“I have not had an assessment in writing, but I am aware of the current pressures that GPs and primary care are currently under. That is why we are working through that review of the GP contract and what we need to go forward. <BR /> <BR />We have a good working relationship with Dr Stout and his colleagues to make sure that we work in partnership to provide a future for GP services.”
“I thank the Member for her question. Given where we currently are at with that, I hope to do it within the next couple of weeks.”
“I thank the Member for his question. He will be aware that I visited Downe Hospital a while ago, when I was last in office. I agree that it is a fantastic facility. As I have made clear in the Chamber many times, I need to utilise every square foot of all hospital facilities. I hope that, when I later publish the regional blueprint for the acute hospital sector, it receives good support and endorsement from all parties.”
“I will certainly accept the Member's invitation if he puts it to me in writing.”
“In addition, the day-procedure centre at Lagan Valley Hospital delivers endoscopy sessions for the region. As of 17 March this year, the day-procedure centre had delivered 4,465 scopes. The centre forms part of a wider network of elective care centres that aim to enhance the efficiency and quality of care for patients and to help drive down our lengthy waiting lists. Plans for the further expansion of elective care centres will be subject to having sustainable funding and the workforce that is required to build further capacity.”
“I thank the Member for his question. Lagan Valley Hospital is our flagship regional day-procedure centre. Opened in October 2020, in the midst of the pandemic, the day-procedure centre at Lagan Valley Hospital has provided much-needed regional support for urgent and red-flag day procedures in response to the downturn in elective activity in other hospitals. Since opening, the day-procedure centre has treated over 13,500 regional patients across a number of elective specialities, including plastic surgery; ear, nose and throat; general surgery; breast surgery; urology; ophthalmology; gynaecology, and varicose vein surgery. That work includes a mixture of general anaesthetic procedures, local anaesthetic procedures and diagnostic procedures, utilising the theatres there and procedure rooms.”
“There are discussions at the North/South strategic group about the development of priorities for joint research projects and clinical trials, which will be supported by funding from the Health Research Board in the Republic of Ireland. Cross-border work is therefore ongoing. I wish that I had the funding available to implement fully the cancer strategy that I launched when I was last in office.”
“The Member will be aware that I launched the Northern Ireland cancer strategy and made clear that it would be delivered to its fullest only when it was fully supported financially and that that would require parties' commitment to the service. Neither my Department nor I wants to scrimp on the strategy or not see it delivered fully. Unfortunately, we find ourselves in the position that the strategy has not been able to be progressed, as I said in an earlier answer, at the pace that I would like to have seen. That has been as a result of the lack of a recurrent budget and of having a Minister in position to drive it. There is not just ongoing work in the north-west, to which the Member referred. The All-Island Cancer Consortium is involved in cross-border work as well.”
“Again, I thank the Member for the point. I am aware that it is part of a debate later on. We have been having conversations across both Departments on how we might make best use of facilities in Northern Ireland and Southern Ireland, because we both face the same challenges. Paediatric pathologists are a very small workforce and work pool, and, no matter how many recruitment processes we have put out over the past number of years, we have been unable to recruit anybody. We are therefore looking at all alternatives regarding an all-island approach, but still maintaining the relationship with colleagues in the United Kingdom. While we try to get provision here, we are utilising facilities in Alder Hey that look after the support that is needed for parents and families who find themselves in that challenging situation.”
“Again, the Member raises a specific issue. On the wider engagement piece regarding cancer specifically, the Member will be aware of the setting up of the All-Island Cancer Consortium, which was an outworking of the Belfast Agreement in 1998; it still does good work. I signed a renewed memorandum of understanding back in 2020. Minister Donnelly and I have spoken about it. We engaged at the North/South Ministerial Council, but we also spoke prior to that, shortly before my returning to office.”
“I will continue to engage with Minister Donnelly on areas for further partnership working, primarily through the North/South Ministerial Council.”
“In addition to existing areas of cross-border cooperation, my officials are engaging with and considering proposals from Minister Donnelly's office for further collaboration across several priority areas, including enhanced cancer service provision; alcohol, drugs and substance use; and children's services. Cross-border cooperation in healthcare will also be facilitated through the PEACE PLUS programme, which provides funding and significant opportunities for tackling shared challenges in health and social care across both jurisdictions through partnership working. I am always willing to explore cross-border collaboration where there is a clear population health need and a sustainable long-term solution.”
“I am not aware of the specific case that the Member has raised. If there are ongoing SAIs in relation to a specific case, such as the individual that the Member mentioned, I do not have the detail here. I will go back and ask officials in the Belfast Trust to investigate. I am sure that the Member would expect nothing less.”
“Whilst I cannot discuss individual cases, there may be serious adverse incidents (SIAs) related to dental care being raised currently through the Belfast Trust's established processes, and, in line with established serious adverse incident processes, the trust will ensure the appropriate level of engagement with patients and their families throughout any investigation.”
“<BR /> <BR />The strategic planning and performance group (SPPG) sought clarification from the SPPG-PHA (Public Health Agency) governance team and from the Belfast Trust, and neither is aware of any reported severe adverse reactions relating to dental procedures in children at the children's hospital or young persons at the school of dentistry or within the wider Belfast Health and Social Care Trust services, including the community dental service general anaesthetic lists from 2020 to the present day.”
“I thank the Member. Children and young people with disabilities receive dental care across a range of settings in Northern Ireland: general dental services, community dental services and hospital dental services. Those with the most complex needs are treated in the Belfast Health and Social Care Trust Royal Victoria Hospital under the care of paediatric and special care dental consultants. The children's hospital on the Royal hospital site provides care for children up to 13 years and young people from 13 to 18 years are cared for at the school of dentistry.”
“I will still push for funding for my Department, for the health service and for waiting list initiatives.”
“I thank the Member. I push all the time that health should be central to everything that we do, not just in a Programme for Government but in a Budget. That was the commitment that was made in the House when this Executive were established. I want to hold my Executive colleagues to that commitment and that promise, not just to me as Health Minister or my Department but to the people of Northern Ireland. The Member is right: it is the most crucial topic that we talk about, and it is affecting every household across Northern Ireland. <BR /> <BR />A Programme for Government will be beneficial, but it has to be funded and costed, and I am sure that we do not disagree on that. However, we are still working with a single-year Budget that does not allow the large-scale transformation pieces.”
“The Member makes a valid point that has been reiterated across the House many times, not just by me but by Executive colleagues. When we talk about waiting lists, the challenge is having a non-recurrent Budget that does not allow us to make the strategic changes that we want to make across health, which needs that long-term, recurrent investment. Look at the waiting list initiatives: the funding that my Department has been given over the past number of years from a single-year Budget makes those larger pieces of transformation that we want to do all the more challenging, but we still push on in looking at how we can develop overnight care, day case procedure units and rapid diagnostic centres while we can do that within the remit of the budget and workforce that I have available.”
“When we look at the approach that is being proposed in the programme, where it looks at a child-centred, whole-child approach, it has to be a whole-Executive approach.”
“I was able to talk with representatives of the Royal College of Paediatrics on, I think, 4 April and update them on where the child health partnership and the project board are and how we look at bringing children's services in the Department on to an even keel and tackle some of the horrendous waiting lists that have been described. As regards the other recommendations, the royal college is fair in regard to how we tackle health inequalities, especially among our young people, but that is not solely a challenge to my Department, the Department of Health. There is a challenge to every Department and our Executive as a whole: how we improve access to education, those early years structures and supports, access to special educational needs, housing and welfare and all the rest of it.”
“It provides information on travelling to appointments, the hospital travel costs scheme and the patient transport service, and it provides advice if treatment is no longer required or if a patient cannot attend their first appointment.”
“That allows patients to check average waiting times for first outpatient hospital appointments across different clinical specialties in each health and social care trust area. The new My Waiting Times Northern Ireland website provides detailed information on average assessment and waiting times by specialty and trust. In addition, the website provides links to support for patients' health and well-being while they wait for treatment.”
“I thank the Member. Although I was not able to attend the launch of the report today, I met people from the Royal College of Paediatrics and Child Health a fortnight ago and talked through some of the recommendations in the report. I had good engagement with them at that event. A wide range of online well-being support is available to people who are on waiting lists. That exists across primary care, where the multidisciplinary team programme is improving access to early supports and proactively supporting good physical and mental health and social well-being. A new online tracking system that the Member may be aware of, My Waiting Times, was launched on 25 May last year.”
“Nevertheless, some good progress has been made across several areas. The Member is aware that I attended the meeting, which his party colleague sponsored, at which the potential benefits of the Welsh initiative for patients on waiting lists were presented. Following that presentation, I asked my officials for an assessment of the implications, including the potential costs, of adopting a similar process here. I will consider that in the context of advice from officials.”
“The reduction of waiting lists is a key priority for me and has been indicated as a key priority for the Executive. My officials are taking forward a range of measures to address it. However, as the Member is aware, it is a complex matter that will take time, effort and, importantly, adequate and recurrent investment. I fully acknowledge the need to have in place measures to help those who are on waiting lists. The elective care framework that I published in 2021 proposed a £700 million investment over five years. Whilst it set out firm and time-bound proposals, unfortunately, as Members know, the subsequent absence of agreed Executive Budgets combined with the political disruption for much of the period since has meant that the implementation of the framework is not what it should be.”
“I thank the Member. I refer him to the answer that I gave to the substantive question, which was that puberty blockers are available on NHS prescription only for under-18s who were accepted for and remain in the Belfast Health and Social Care Trust Knowing Our Identity service endocrine pathway prior to March 2020. I have been advised that that is the current stance on that piece of work, which was done following consultation with the clinical ethics committee and the Belfast Health and Social Care Trust, in liaison with the then Health and Social Care Board.”
“I thank the Member for his point. As I said in my answer, my officials have been working with the gender identity service pathway review group and the gender identity services liaison panel, which includes clinical, managerial and service user representation, to develop the gender identity service. The liaison panel is due to meet in June, when that subject will be discussed.”
“When it comes to that issue and the Cass review, our principal focus has to be on providing the best healthcare and support for our young people. I echo the comments by Dr Hilary Cass about the toxic and polarised nature of much of the debate on this subject. That is particularly the case, as the Member will know, on social media. That toxicity is not in the best interests of our young people, nor does it help us find the right way forward in healthcare and support. On her specific question, I do not have the numbers with me, but I will write to the Member with an answer and share it with the Assembly.”
“I thank the Member for the clarity. As I said in answer to the substantive question, puberty blockers are only available on NHS prescription for those under-18s who were accepted prior to March 2020 onto the Belfast Health and Social Care Trust's Knowing our Identity service and remain on it. That decision was made following consultation with the clinical ethics committee and the Belfast Health and Social Care Trust, in liaison with the then Health and Social Care Board.”
“<BR /> <BR />My officials have been working with the gender identity service pathway review group and the gender identity service liaison panel, which includes clinical, managerial and service user representation, to develop the gender identity service. At the liaison panel's next quarterly meeting, which is due to be held in June 2024, its members will have the opportunity to discuss in detail the ban on puberty blockers by NHS England.”
“Puberty blockers are only available on NHS prescription for those under-18s who were accepted onto the Belfast Health and Social Care Trust's Knowing our Identity endocrine pathway prior to March 2020 and remain on it. In March 2020, following consultation with the clinical ethics committee, the Belfast Health and Social Care Trust, in liaison with the then Health and Social Care Board, amended the service specification, which meant that new referrals after that date would no longer have access to the endocrine pathway. That was due to challenges in the adult gender identity service, given that there was no readily available appropriate transition pathway for young people at age 18 to allow for the safe continuation of endocrine treatment.”
“We do. That is something that I have asked departmental officials to look at, and they have been looking at it. A team in the Department has been established within the strategic planning and performance group, which looks at, manages and engages with trusts on delayed hospital discharges through a range of regionally agreed measures. However, I need to be realistic: stabilising and enhancing social care represents part of the answer to delayed discharges but requires sustained and significant additional funding. So, it is not just the wait for social care packages that is resulting in delayed discharges: there are other constraining factors at work. There is ongoing work in my Department to look at those and challenge trusts on whether they could be doing better.”
“I hope that the measures that I have referenced will grow the workforce and drive down some of the unmet need that we have across the Province.”
“I thank the Member for that point. As well as the additional £70 million that I announced, there have been two uplifts to the independent sector home care rate in the past few years. That has been done to recognise the complex work that that valuable workforce does and to entice more staff into the field. My officials have established the social care collaborative forum as an outcome of the review of adult social care. That forum is looking at many issues around home care, including maximising capacity and the home care workforce. It is working with the Northern Ireland Social Care Council on developing standardised enhanced training, recognised qualifications and promotional options for home care staff.”
“The Member raised the specific facility of Rainbow Lodge in the Northern Trust at the Health Committee. I have looked at the additional respite capacity in that facility but also across Northern Ireland, because the issue does not just affect the Northern Trust. Our supply of respite is constrained by the pressures that we see in cases, such as the one indicated by the Member who spoke previously, where complex additional needs consume quite a lot of our respite care.”
“I thank the Member for her point. If she writes to me about that specific case, I will get back to her and engage with the Northern Trust on it. She highlights the issue of additional complex needs. We made provision whereby people who have waited a long time, especially for a care package, can go into domiciliary care. Sometimes that meets a need; sometimes it does not. However, the Member can write to me about the individual case that she mentioned.”
“I intend that the £70 million will be rolled out as quickly as possible. I made the announcement in advance of a Budget being agreed because we have a high level of unmet need, especially across the Northern Trust because of not just the size but the rurality of the area that that trust covers. I hope that the additional money will help. The trust is reviewing how it commissions domiciliary care services to ensure a value-for-money approach and to proactively drive efficiencies to optimise its current capacity.”
“I recently announced a £70 million support package for social care providers and hospices. I hope that that funding will help the independent sector organisations to deal with rising costs.”
“I thank the Member for his question. Four new providers have contracted with the Northern Health and Social Care Trust in the past while. Collectively, they have taken on 766 packages of care, totalling 6,659 hours. The Northern Trust continues to target the recruitment of home care staff across the trust's geographical area, with an additional focus on areas where a larger unmet domiciliary care need remains. <BR /> <BR />Demand for domiciliary care packages continues to outweigh the sector's capacity to take on the work. I recognise the important role of our independent sector home care providers and have approved funding, in advance of the 2024-25 Budget being confirmed, to address the employer's requirements in relation to the national living wage increase.”
“I beg to introduce the Hospital Parking Charges Bill [NIA 02/22-27], which is a Bill to modify the operation of the Hospital Parking Charges Act (Northern Ireland) 2022 so as to postpone the ban on charging money for parking vehicles in hospital car parks.”
“I therefore commend the motion on the regulations to the Assembly.”
“The general public continue to make up their own minds regarding the vaccines that they receive, and hundreds of thousands continue to take up the offer of vaccination when they are invited to do so. <BR /> <BR />Mr Frew will know that the vaccine damage payment is a UK-wide system that is set at the Westminster level. To date, my Department has not reviewed stepping outside what is a UK-wide system, given that COVID-19 vaccinations are administered through that system and the purchase that is supplied and regulated is done on a UK-wide basis. <BR /> <BR />I firmly believe that the provisions are vital and should be extended as proposed, that the COVID-19 and influenza vaccination programmes in Northern Ireland have made extensive use of those flexibilities and that their cessation would cause significant disruption to our programmes.”