Fearghal McKinney
South Belfast · Social Democratic and Labour Party · Northern Ireland
“We need to do everything we can to bring investment and job opportunities. A prosperity strategy should also include a massive programme of workforce training and skills enhancement.”
“In particular, we want the Programme for Government to adopt a much more joined-up style of government that delivers much greater accountability and transparency and will itself say that it wants Northern Ireland to work.”
“<BR /> <BR />We can point to collective achievements — local government reform among them — but just months ago the echoes of our past threatened our political future, reinforcing the challenges to our delicate political system that the Good Friday Agreement could never have foreseen.”
“Creating much better social cohesion and integration must be another Programme for Government requirement. <BR /> <BR />Health reform, job creation, better infrastructure, creating world-class education and tackling social deprivation are issues on which the SDLP is not prepared to compromise.”
“There are many big challenges facing Northern Ireland, perhaps the biggest of which is to get people into work. It is our job to create the infrastructural and educational opportunities and to maximise those opportunities.”
“It is our job to ensure that our people can and should dare to dream that life can be better; that our children will not be forced to leave these shores for the promise of work in Australia or America because of a failing economy — I referenced the Joseph Rowntree Foundation's latest research; that our health service provides a service th…”
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“I will, Mr Principal Deputy Speaker. I will just reinforce the point that the Minister needs to be in his seat. Cancer patients and other patients are suffering, and the public is calling for action.”
“These are drugs that, under normal circumstances, would be routinely available here. What this decision does not address is the great inequality forced on cancer patients who are denied 40 life-extending cancer drugs. This is a huge gaping hole in the provision of cancer services here. There are also severe economic repercussions as a result. As the former Minister continues to stall the issue, Scotland, in comparison, has taken great strides in opening up access to cancer drugs through trialing and, in doing so, has bolstered its economy through incentivising its life science sector. It is now well on its way to doubling the value of the industry to £6·2 billion by 2020. In this context, a cancer centre of excellence would have a hugely positive economic impact here while, at the same time, developing cancer treatments.”
“<BR /> <BR />Last week, we saw the Public Health Agency launch a campaign aimed at raising awareness of the signs and symptoms of breast cancer. This is a welcome move, but what action is being taken to increase capacity to facilitate an anticipated extra demand for services? It is against this backdrop that the Minister's absenteeism continues to be an issue of regional concern. His bleating in today's 'Belfast Telegraph' rings hollow given the extent to which this Chamber and the wider region is hearing concern among patients and the public over health service delivery. <BR /> <BR />Patients, the public and representative bodies, such as the Royal College of Nursing, all recognise the damage that this is causing. The Minister's only response has been to release £1·5 million of funding, dubbed by the media for NICE-approved cancer drugs.”
“Thank you, Mr Principal Deputy Speaker. Subsequent to that, we have had three Ministers, and not only the previous three Health Ministers but the Finance ministry have been with the DUP. So, it is not as if they have to argue with a party opposite or with someone they may have different views with. They only need to sit down with each other and attempt to deliver on some of this. I thank the Member for her intervention. <BR /> <BR />The reality of the situation that is facing these breast cancer patients is that, after urgent GP referral, women who warrant urgent diagnostic testing, such as a mammogram or needle biopsy, face delays in seeing a consultant, which could impact on survival rates. Where is the Minister on that issue?”
“<BR /> <BR />On top of this, breast cancer treatment targets are falling by the wayside. The percentage of women seen within the 14-day target after urgent referral has, worryingly, dropped from 94% to 81% in June this year alone.”
“His comments are a stark reminder of the current service that we find in health here. For me, the failure to meet cancer treatment targets is yet another layer of the same problem, and that is unacceptable. It is another damning indictment of the empty Benches opposite, and of the empty ministerial chair opposite. <BR /> <BR />Cancer patients' lives are being put at risk, with hospitals continually breaching targets that were put in place to ensure speedier diagnosis and treatment in order to maximise patients' chances of survival. From April to June this year, only slightly less than 70% of patients with an urgent referral for suspected cancer began treatment within 62 days. That is against an official ministerial target of 95%, but, of course, the Minister is not at his desk to focus on that statistic and the human stories behind it.”
“Added to those important developments is the fact that our dedicated staff, including consultants and specialist nurses, consistently provide a service that is second to none. They must be recognised and commended in the Chamber for their tireless efforts under intolerable pressures. <BR /> <BR />Northern Ireland has had a proud history in providing world-class cancer treatment and research, but the reputation is in jeopardy due to emerging holes in cancer provision. Only two weeks ago, I addressed that issue to raise concerns over elective care waiting lists, an issue that has now made global headlines. My views were reinforced, last week, by testimony from Nigel Edwards from the Nuffield Trust, who said that excessive waiting times may cost patients' lives.”
“I welcome the opportunity to participate in today's debate. I rise as SDLP health spokesperson in support of today's motion. Northern Ireland has long held a record of having some of the most advanced cancer treatment and research in the world. Throughout the last 10 to 15 years, the calibre and range of treatment has constantly been expanding, from the vision of the Campbell report in 1996 to the establishment of the cancer network in 2004 and the cancer centre in 2006. I am looking forward to the opening of the new radiography unit in Altnagelvin, which demonstrates a proactive approach to cross-border cancer care. <BR /> <BR />At the weekend, I was delighted to get a presentation about some of the aspects of cancer care in Derry.”
“The Member has used the image of the hokey-cokey over and over again: is he telling the House now that the UUP did the "hokey" bit to give the DUP the right to do the "cokey"?”
“Will the Member accept that the Chamber probably would probably interpret your remarks somewhat differently if your Minister had not actually resigned his seat and did the hokey, as opposed to the hokey-cokey, and abdicated complete responsibility for roads and important infrastructure?”
“Tell the truth and stop giving others excuses. Tell the truth about Robert McCartney. Tell the truth about the Northern Bank. Tell the truth about Joe Rafferty. Tell the truth about Paul Quinn and others. Do not tell us to go to the police as some kind of cover: just tell the truth. You have an electoral mandate that entitles you to places in Government. You do not have to keep lying. Tell the truth and set yourselves free —”
“At least, the grand old Duke of York actually marched his men up the hill. The DUP might pretend differently, but it does not even know whether it is halfway up or halfway down, for Mr Hamilton was back at his seat, pretending to be resigned and pretending not to be, all within the same half hour. It is appalling. If what is described in the health service was not happening, it might even be funny, but it certainly is not funny because it is happening in the health service. <BR /> <BR />The motion comes from Sinn Féin, but it, too, has questions to answer. Just as the DUP needs to stop acting like rogue Ministers and honour their commitment to power-sharing and delivering for all the people of Northern Ireland, so, too, does Sinn Féin need to face up to some stark realities, which actually involve something very simple: telling the truth.”
“<BR /> <BR />All that public concern has not diminished over the last number of years. In fact, it has grown with DUP stewardship of the health service. These are genuine concerns that are compounded by the fact that A&E four- and 12-hour targets are continually breached as a matter of routine while, at the same time, the domiciliary care sector, which is meant to be picking up the slack in the community, particularly for older people, is buckling at the knees. That is unsustainable. These concerns have been rehearsed over and over in the public domain. We believe that it is completely unacceptable that, due to internal unionist wrangling, the Health Minister is not in his post as he continues to be embroiled in party politicking. The DUP calls this escalation over wider political concerns.”
“He went to the press to release welcome but limited funding for some newly approved cancer drugs. Remember that his announcement was all about NICE-approved drugs and treatments, which should be routinely available for patients here. These are drugs that have been deemed clinically effective and cost-effective and are readily available in other parts of the UK. I agree that it is a welcome announcement, but does it address the fact that over 40 cancer drugs that are available in England and the rest of the UK are not available here? No, it does not. Does it address the list of issues that I have just articulated? No, it does not. Does it address that widespread concern? It certainly does not. If anything, it exacerbates it. The Minister is not in his seat again today.”
“I think that it is important to remind the House of just exactly the scale of work for which the Minister has abdicated responsibility: wastage, which is running into tens of millions of pounds; 360,000 cancelled appointments every year; the elective-care crisis; the A&E crisis; waiting lists at doctors' surgeries; the shortage of doctors; pay increases for nurses and health staff; cancer drugs; and domiciliary care. All of them need strategic answers whether the DUP gets the answers that it claims it wants from others. <BR /> <BR />Last week, the DUP opted not to be here and not to address the widespread concern of the public and health professionals. Instead, the former Health Minister sought to spin his way out of the problem. Did he come to the House to explain? No, he did not. Did he issue a statement? No.”
“I welcome the opportunity to participate in the debate. I do so as health spokesperson for the SDLP. I do so more in sorrow than in anger, though with a healthy dose of both. <BR /> <BR />The debate is a very important one. It reflects last week's debate on the motion on waiting times for elective care, which the SDLP successfully amended to call for greater leadership, funding and strategic focus in the health Ministry. Last week, I reflected the genuine concerns of the SDLP, this Chamber and the public at large that, as we continue to witness the biggest crisis that the health service has ever faced, we have no Health Minister to respond.”
“I thank the Member for giving way. I apologise that I was not in for the earlier contributions to the debate. Does the Member accept that Ireland, North and South, knows intimately the pain of emigration? At its height, Ireland's population was close to 9 million. We have significantly less than that now, so we have space.”
“Our amendment is consistent with what you are saying. It calls for immediate action to alleviate current pressures. That should be the voice of the Assembly. The important point is that, when the Minister and the Department worked with the trusts on these issues over Christmas last year, it led to cuts. The contingency plans led to cuts like those to the Dalriada Hospital, the Armagh minor injuries unit and Bangor Community Hospital, although the DUP was able to argue narrowly on that point in that constituency. Your proposal could lead to a cuts charter.”
“Will the Member accept that, while welfare reform issues have dominated, all the issues relate back to budgetary allocation and that, in fact, health service spend was ring-fenced, outside of the welfare issue?”
“By that, we mean that the money must be found now to treat the patients now and action must be married to a further strategic TYC plan. I urge its support for our amendment in that context. <BR /> <BR />The picture is very clear: it is one of failure and one of no response. The public is rightly disappointed. I urge the House to support the amendment.”
“I thank the Member for his helpful intervention: I could not agree more. <BR /> <BR />It is not only that the DUP has no answers; the reality is that it is to blame. It has had its chance; it has failed and failed miserably. There is still a chance; it lies in the concepts and strategic thoughts around TYC, which, at its core, saw the strain on the health service, as I have reflected. All of this stands in stark contrast to how TYC systems were introduced, for example, in Australia, and where the transformational change in Canterbury, for example, reduced strain on the expensive end of the hospital. That worked very well. <BR /> <BR />To the Ulster Unionists, who may be thinking of not supporting the amendment, we say quite clearly that we need to take immediate action to alleviate current pressures.”
“No, I cannot give way any further. <BR /> <BR />He would sooner resign his Ministry than confront the issues that affect so many people here. <BR /> <BR />There — right there — is his empty seat. That is his response.”
“Here we have the man with a disappearing plan —”
“All the time queues were growing as the public were ill-served. Maybe we will have the absentee Minister in for an hour or so at some stage next week, until he resigns again.”
“By any measure, the population here has been failed. Here we are in September 2015 with no Health Minister to address an issue that is impacting on one in five people here. The public are rightly angered. <BR /> <BR />I said at the outset that I would address one of the core issues at the heart of the problem. It is leadership at the highest level. The House and the public are right to ask why a queue of DUP Ministers has failed them so badly in health. First Edwin Poots, who attracted more publicity over conscience issues than health, failed to implement the plan and failed to secure sufficient budgets to run the system. His exit bought the DUP more time to attempt to explain away their failure with a new Minister, Jim Wells, who used up that vital time dithering and focusing on conscience issues.”
“Perhaps I would have bought that point had the Regional Development Minister not resigned. Is it entirely appropriate that he reflects that when he does not care about our roads system? Anyway, it is unsustainable. <BR /> <BR />The situation was foreseen. Over four years ago, authors of the TYC plan considered future demand and present stresses. They consulted, and I will tell you what they said in 2011. I will read it to you. They stated that demand would rise by 4%, that that would lead to an increase of 50,000 outpatient appointments in 2015, and that a failure to act:”
“Absolutely, and what would you have welcomed today? A Health Minister, or even some Health Committee members from the Benches opposite, to potentially explain your point. The process has been a sticking-plaster approach. Short-termism. Historically, the Department of Health relied on the private sector to effectively pick up the slack in addressing the elective care backlog, but, again, due to financial and strategic mismanagement, that funding is no longer available. The Department has consistently bid for that extra funding in monitoring round, as my colleague helpfully mentioned. When the money ran out and the focus was on the other big crisis, the route to the next crisis was fixed.”
“The reason for that was that they needed resources to plough into the system to prevent the accident and emergency crisis that dominated the headlines for two years. The reason for that was that the health service was not properly budgeted for and a plan that they came up with was not implemented. Moving money and staff did prevent the A&E crisis, but the elective care waiting list just grew and grew.”
“First, there was reassurance that it was all being implemented and that there were targets in the Transforming Your Care (TYC) plan. Then, as the questions piled up, the evidence began to disappear, and, in the end, we had another review, which basically called it as it was: failure of leadership; failure in commissioning; failure to deliver. Of course, there were bits of movement here and there, but you tell the public, who watch in disbelief as the crisis piles up, that that is improvement and they have real cause not to believe you. <BR /> <BR />The present crisis in elective care was always going to happen. The reason is that the health service cut the budget on elective care surgery.”
“Many of those suffering are in agony, with no end in sight as to when they will receive treatment. In the twenty-first century, that is simply unforgivable. This morning, we will hear more stories similar to those. <BR /> <BR />These are important contributions, but, ultimately, their resolution — and future resolutions — will not be mitigated until there is a proper strategic focus at the heart of our health service, followed by implementation. Strangely enough, there is one. It is just that it has not been implemented. I should know, because I have spent the last two years constantly asking questions about its implementation, only to be fobbed off with obfuscation.”
“The pressures on our elective care waiting lists are as much a strain on them as on the public and those in need. The figures have been rehearsed over and over in the public domain among health professionals and also in the Assembly Chamber. They are disgraceful, and action is called for, not retreat. Waiting lists are the worst that they have been in 15 years. We have seen outpatient waiting lists swelling by 46% in the past year alone. That is creating great difficulty for many patients at the worst end, even contributing to deaths caused by system stress or the frail and the elderly being humiliated and neglected. I know this first-hand. My constituency office, like those of other Members, has been inundated over the last years. I have heard harrowing stories.”
“I will touch further on its impotence over health service change later in my contribution. <BR /> <BR />The DUP has put huge public concern over this issue second to its own narrow political interests, which are in favour of a spat between it and the Ulster Unionists. Good luck to them. I hope that the public responds in kind and that that public remembers that, in their hour of need, the Health Minister ran away. <BR /> <BR />At the outset, I want to acknowledge that today's debate is a very important one. In every debate that I have participated in, I have acknowledged the dedicated professional approach of the nearly 55,000 staff employed by the health service here. I have applauded their commitment, their energy and compassion, and I do so again today.”
“As SDLP health spokesperson, I welcome the opportunity to bring the amendment to the House. I just wish that my gratefulness to the House to debate this important issue was matched by a DUP Health Minister who would have welcomed the opportunity to respond to reflect to the Assembly, and to the wider public, that he has a plan to deal with the waiting list crisis that is perhaps the worst in health service history here for many years. But, no; the Minister has chosen not to be here. I urge all of you in the Chamber, in the Gallery, and even those outside the Chamber, to focus during this debate on that empty chair and, indeed, empty chairs right across the Benches opposite. That is the answer that the DUP has given to the debate on this unprecedented waiting list crisis. Absolutely nothing.”
“The Minister has touched on my question. Can she detail the extent of partnership funding required for the project?”
“I thank the Minister for her answers thus far. While we welcome the July sign-off, will the Minister reflect on the speed with which other Departments are moving in the direction of rural proofing, particularly the Department of Health?”
“Of course, Mr Deputy Speaker. I am struck by the figures. There could be savings in this. I have more to say, but time has beaten me. I support the motion.”
“It is supposed to be a mixed market, if you like, in that sense, and, if anything represented that, it would be a centre of excellence for MS, as Mr Allister has talked about, a step-down facility in the local community, married to further and better services being delivered out into the community, which prevents people having to come up to the very expensive side of health, be it in Causeway, Antrim or, indeed, Belfast. We have not got that, and I will make a plea once again for us to return to the principles of that and let us start jointly finding some mechanism to achieve that. <BR /> <BR />I refer to the report as well. It makes some clear recommendations on how Dalriada Hospital could be retained and reconfigured, and I am struck by the figures.”
“It is important to state to the House that the Dalriada closure was not a strategic cut; it was a short-term cut. The previous Health Minister had to admit that in this very Chamber, and I welcome the fact that the courts took the right decision on it. <BR /> <BR />Mr Frew wants a holistic approach. I want a holistic approach, and I think that the Chamber, as reflected here today, wants a holistic approach. That is what TYC was supposed to be about. It was supposed to identify the elements in a community that could be dealt with to keep people away from the expensive side of the health service.”
“<BR /> <BR />For me, to get down to the nuts and bolts of it, the decision lays bare the lack of strategic direction, with the Department looking for cuts and then foisting cuts on trusts that make them without a strategic context. In fact, the excuse comes back from the trusts that it is counter-strategic. We all know that the health service is under severe financial pressure, and, as Mr Frew said, we have to be mature about that, but it is how cuts are administered that is important. The House will be aware — I have reminded it many times, as the Minister will be aware — of the importance of TYC at the heart of the health service and how that plan has not been funded properly. Therefore, major cuts have emerged as a result and those impositions of contingency plans are counter-strategic.”
“Other trusts need to avail themselves of that service to make it, too, as viable as possible. <BR /> <BR />If we look back over the decisions and events of the last months, we can see how important local hospitals are to communities and the strength of a community coming together in force. I was delighted, as others have clearly reflected here today, to see the strength of that support and the fact that it resulted in 20,000 signatures being brought here to Stormont, as well as numerous debates and rallies, and I welcomed the opportunity of being invited to Bushmills. It became clear very quickly just how prized and valued the Dalriada facility was in the local community and, importantly, that it had local cross-party political backing.”
“I too welcome the opportunity to take part in today's Adjournment debate. I do so because, as SDLP health spokesperson, I recognise the important role that Dalriada plays in the local community. I commend Mr McKay for bringing the debate to the Chamber. I also commend all those who have been involved in the Save the Dal campaign. At the start, they adopted an emotional approach to it, but, very quickly, as has been reflected in the debate today, they moved on to the strategic approach, which, I think, has been very welcome. <BR /> <BR />Mr Allister referred to the MS unit. It is important to recognise the extent to which that illness puts severe pressure and demands on individuals and families, and respite provision is all the more important, as is — I think that this is what you were reflecting — the need for a centre of excellence.”
“It says that we do not have an economic vision or strategy and, worse, that we do not recognise that the problem exists. It does exist, and it needs a resolution. The price that we are paying for doing nothing is already too high.”
“We cannot continue on a path of letting the past govern our future or even become our future again. We must recognise that all this is now our responsibility. By virtue of our mandate, it is our responsibility to keep the political system together, to keep our institutions intact and to best deliver for our people. <BR /> <BR />I said a few moments ago that we should have delivered a better future, even for those with a past. The only way that we can fill the vacuum is with a renewed focus on our economic future. We had a debate earlier that focused on that — jobs with a focus on tackling, once and for all, the deprivation and long-term unemployment that holds so many communities back and allows malevolent forces to prevail. The debate that we concluded earlier underscores that.”
“That would be OK had the IRA been shut down, but we know that that is not the case. Mr Speaker, people here are not stupid. They know that someone in Sinn Féin knows who is responsible, and those responsible must be brought to justice and a clear message put forward that such acts have no place in our society. There is a shadow, and it darkens the sky. If you stand back far enough, you can see the shadow, literally, of a gunman, and it hangs round the neck of the talks. Mr Kelly referred to NAMA; can I refer to assets? <BR /> <BR />In stark contrast to the underplayed reaction of Sinn Féin, we have the UUP on the opposite Benches moving prematurely in a blatant electioneering attempt, removing its Minister from office and threatening the very existence of the institutions. That only plays into the hands of those who thrive in a vacuum.”
“We are all very aware that, by denying knowledge, Sinn Féin raises questions about itself and its commitment to pursue justice. Deniability is the order of the day, and we have heard it repeated here: deniability around Paul Quinn; denial around the murder of Robert McCartney; and denial in the case of Mairia Cahill and many others. There is denial while, in the background, the name of anyone who may cause embarrassment or has been a victim in those circumstances is blackened. <BR /> <BR />There are now calls for the re-establishment of the Independent Monitoring Commission. I think that it is important that we look back at some of its words from 2008. It said:”
“We need certainty, not ambiguity, and that is the responsibility of us all. <BR /> <BR />We believe that the PSNI must be allowed to follow all evidential leads in the McGuigan murder and that Sinn Féin should be forthright and frank about all the details that its members may know in relation to both murders. We also believe that an Garda Síochána, along with the PSNI, should be allowed to carry out a full assessment of the operations and capacity of the Provisional IRA and that the NCA should similarly be allowed to look at not just its activities but its assets. <BR /> <BR />The extreme response of some and the deniability of others have made a difficult situation worse. That is why we call today on Sinn Féin to divulge whatever information it may have on those recent killings.”
“In many ways, the political developments and fallout may have lost sight of that point. Regardless of those men's past, their cold-blooded murder was absolutely barbaric, and the perpetrators of such must be brought to justice. <BR /> <BR />The SDLP remains committed to peace and is unequivocally opposed to all forms of violence. Among other things, the Good Friday Agreement did two things. It rejected our violent past and envisaged a better future for us all — Jock Davison and Kevin McGuigan included. That paramilitary groups, loyalist and republican, have been allowed to operate and threaten our peace and stability is because we have not pursued the agreement's ambition sufficiently to starve them of oxygen and control. If there ever was any currency in creative ambiguity, there is none now.”
“It is highly regrettable that we find ourselves here to debate an issue that has caused an immense deal of suffering and that, as a consequence, has injected further political instability. <BR /> <BR />From the outset, I express my sympathy and that of the SDLP to the families and friends of Kevin McGuigan and Gerard Davison.”
“It highlights the need for more robust and accurate economic data; encourages better cross-border cooperation; calls for a more detailed analysis of the impact of a potential EU exit; and calls for the establishment of economic zones to target regional imbalance. <BR /> <BR />I am conscious that time has beaten me, but I recommend the report to the Assembly.”
“We are cutting higher education while other parts of the UK and the Republic are investing more in it. Here is the irony: we want corporation tax to attract companies to bring in students and graduates, and, in the meantime, we are cutting the training for those very graduates. <BR /> <BR />We need to make a very clear point. We do not need to restructure the institutions of the Assembly to get joined-up government. Ministers must realise, first and foremost, that their brief entails a major economic component and that working in silos must no longer be an option. <BR /> <BR />Today's report also makes recommendations for key economic interventions across government, business and the community.”