Gary Middleton
Foyle · Democratic Unionist Party · Northern Ireland
“I thank the Minister for his statement. As other Members have stated, the First Minister spoke publicly about the £150 million secured for pay awards, including £37 million for teachers.”
“I thank the Minister for her response. Although the FE sector is facing a difficult budgetary landscape, NWRC has been able to punch above its weight.”
“<BR /> <BR />Of course, we recognise that there is more to do, but we then come to the central issue: funding. The Education Authority faces an overcommitment of some £280 million. The Department is chronically underfunded. The independent report entitled 'Investing in a Better Future' made that clear.”
“I welcome the opportunity to speak on the motion. I do not think that there is a single Member who does not want to see our children healthy, well fed and ready to learn. We all recognise the statistics before us: 13% of children live in food-insecure households. We understand that nutritious food is the fuel for educational attainment.”
“That targeted, sustainable intervention is designed to support what many describe as the working poor; families who work hard but struggle to make ends meet. <BR /> <BR />The Opposition's motion mentions comparisons with other jurisdictions, nothing that they are expanding universal provision. However, they are being selective.”
“We hear calls from the Benches opposite for subsidies and expansions, but we rarely hear where the money should come from. If we are to find the extra £202 million for this specific policy, which Department does the Opposition suggest that we take it from?”
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“As Mr McGuigan touched on, we know this is something that goes across all Departments. I appreciate that the Infrastructure Minister is here as well. All our Departments have a role to play, and we very much need a coordinated approach to tackling climate change. <BR /> <BR />It is recognised that there will need to be actions and interventions across a wide range of areas to address the immediate and longer-term effects of climate change in a fair and just way. We will need all the Departments to work collaboratively and to lead by example in their relevant areas of responsibility. It is also noted, of course, that the Executive should bring forward a climate change Act.”
“I support, obviously, amendment No 2, which is tabled in the name of me and my party colleague William Irwin. I think it is fair to say, from all the contributions today, that people are concerned about climate change. Some of us are more energised than others, but I think people are genuinely concerned and know that action needs to be taken. The Executive and Assembly must use an evidence-based approach to ensure that there are measures and targets in the Programme for Government to tackle the climate crisis. In the 'New Decade, New Approach' document, there are a number of potential measures that would go some way to ensuring that there is a coordinated and strategic approach to the challenge of climate change. I must say at the outset that I welcome that the Minister is here.”
“I thank all the Members who contributed, and I congratulate the new Members on their maiden speeches. I am glad my maiden speech was made long before the suggested tradition of wearing a bow tie for it.”
“I thank the Minister for her positive response. It leads by good example. Will the Minister ensure that the entire Executive and all Departments are kept on board in any discussions as the Bill progresses to ensure that everybody across the board is bought into it?”
“I thank the First Minister and deputy First Minister for their commitment in this area. Will the First Minister give a commitment that the views of our many mental health experts in Northern Ireland will be taken into account in the progress of the working group?”
“We need to ensure that we can encourage people with autism to get into workplaces and ensure that people are mindful and understanding of their requirements and needs. In closing, I urge Members to get behind the motion and, indeed, the amendments, whichever way they fall.”
“Given those figures, it is vital that the teaching force in Northern Ireland receive current, relevant and up-to-date training to assist them in delivering a curriculum that allows every child to reach their full potential. It is vital that no child is left behind. Only 16% of autistic adults are in full-time employment in the UK, even though 78% do not have a learning disability. Many of those say that that is an adverse effect of a lack of support during the school years and of not receiving a full education, with mental health deteriorating as a result. That gap needs to be filled. Over the past couple of years, I have met individuals with autism who now work in the public sector, some in very exciting roles.”
“<BR /> <BR />Many of us in the Chamber, including me, have family members with autism. We know about not only the challenges but the opportunities that that brings, whether that be at the initial assessment stage, through education or as they move into the workplace. As my colleagues said, we know of the delays around assessment, but, when that assessment comes, it is vital that the services follow, right through education and into the workplace. <BR /> <BR />According to recent Department of Health figures, one in 30 school-age children has autism in Northern Ireland. Of those, 78% are in mainstream schools, not special schools.”
“Like my colleague, I recognise the Circle of Support organisation in my constituency and the many parent-led organisations that do fantastic voluntary work. The support that they provide is very important. <BR /> <BR />There is no doubt that there is widespread support for the motion. We know that, just last September, a rally was held here at Stormont. We know that there was an online petition with over 10,000 signatories. It is a hugely emotive issue. We, as elected Members, and the Minister need to ensure that it is delivered on, and I hope that that will happen over the next number of weeks and months. As colleagues mentioned, teachers and classroom assistants have indicated their support for the motion. All the teachers' unions in Northern Ireland support the introduction of mandatory autism training.”
“I thank my colleagues for tabling this important motion. The fact that it has been tabled at such an early opportunity sends a signal as to how important the issue is not only to us but to wider society. I thank the Minister for being in the Chamber today. We hope that he will take on board the valid points that have been made by all contributors so far. I also pay tribute to Autism NI, the National Autistic Society and all the fantastic organisations that, over the past number of years, particularly the past three years, have kept their shoulders to the wheel. The fact that the all-party group on autism has continued to meet has been mentioned. That is valuable and important work, and, hopefully, that will pay dividends in what we will see over the coming weeks.”
“<BR /> <BR />Finally, as at every stage of the process, the Democratic Unionist Party will judge each situation on what is best for Northern Ireland economically and constitutionally within the Union.”
“Despite the fact that Northern Ireland trades more significantly with GB than it does with the Republic of Ireland, the EU and the rest of the world combined, the current proposals would see our east-west trade being subject to the rules of the EU customs union, notwithstanding the fact that Northern Ireland would remain part of the UK customs territory. <BR /> <BR />The Prime Minister has described his withdrawal agreement as being "oven-ready", but it is very clear from the Chamber and from business and stakeholders that there is no appetite for the current withdrawal agreement. For our part, the Democratic Unionist Party will continue to work to shape a solution in Northern Ireland's interests. It is important that the new Northern Ireland Executive are represented on the UK delegations to the EU.”
“<BR /> <BR />All of that is very much welcome, but it is disappointing that, when MPs from this place joined together just days ago in the House of Commons and put forward amendments that would have ensured that access was truly unfettered on the movement of goods on both an east-west and west-east basis, those were opposed and not allowed to progress by the Government. <BR /> <BR />The checks as proposed would lead to greater burdens for trade between GB and Northern Ireland, and, consequentially, they would have a negative impact for consumers.”
“In that agreement, the UK Government made a number of commitments, which can be summarised in four broad points. The UK Government have already committed to ensuring that there is a new deal for Northern Ireland as we leave the EU, maximising trade opportunities and investment. There is a commitment that Northern Ireland will remain an integral part of the UK internal market and that it will remain in the UK customs territory. There is a further commitment to legislate to guarantee unfettered access for Northern Ireland businesses to the whole of the UK internal market, with legislation in force for 1 January 2021. Finally, there is an aim to maximise the free flow of trade and a commitment to ensure that Northern Ireland businesses benefit from the UK's new free trade agreements signed with other countries.”
“I join colleagues in supporting the motion tabled by the Executive Office. We are now three years on from the referendum having taken place and since the people of the United Kingdom voted to leave the European Union. Of course, as democrats, we strongly believe that the result of the referendum should be delivered and that the voice of the electorate should be respected. Today is very much a welcome opportunity for all of us here in the Chamber to give our views and perspective, particularly on giving consent to the UK Government. <BR /> <BR />My party has long held, and continues to hold, the view that Northern Ireland and the entire UK will have a bright future outside the European Union. It was the New Decade, New Approach agreement that brought the House back.”
“I congratulate the Minister on his appointment and, indeed, the Committee Chair on his appointment. I look forward to working with you both in the time ahead. I welcome the Minister's statement, and I join him in paying tribute to the many workers in our health and social care system for all the work they do, given the challenging times that they have had to face over the past three years in particular. <BR /> <BR />The Minister's statement mentioned that pay parity on its own will not address recruitment and retention. To that end, will he work with his Executive colleagues to ensure that the graduate entry medical school in Londonderry is delivered and that we work to ensure that we address some of the unique challenges that are faced in our trusts?”
“The Minister has emphasised on a number of occasions the importance of the business case for the regulations. Can he indicate whether a business case has been completed to ensure the right approach and, if not, when it will be in place?”
“I thank the Minister for his answer. Will he outline whether the current political situation will have much of an impact on this proposal that he wants to carry out? Will he give some indication of a time frame for when such a consultation can be completed?”
“I thank the Minister for her detailed response. The Minister mentioned the special court sittings. Can the Minister give her assessment of how successful she feels that scheme is and whether she plans to extend it across the Province?”
“<BR /> <BR />It is also fair that we recognise the work of the Public Health Agency (PHA) and the information that it provides on sexual health issues, including HIV, and the work and awareness training that it carries out throughout our trusts. <BR /> <BR />We need all the many health and social care organisations and volunteer sector organisations to continue the great work that they do. However, we need to work more closely together, encouraging greater collaboration and ensuring that the Department gives a clear strategic direction in this important area. I commend the motion to the House.”
“As a member of the all-party group on sexual health, I have seen at first hand how Positive Life interacts and engages with a wide range of stakeholders to ensure that their issues are heard and how it works collectively with those in the sexual health field. We must do all that we can to support it in its work to promote awareness and prevention. There is a clear need for a new campaign to promote such awareness through outreach, counselling, harm reduction and education. We need to challenge the old perception and the old stigmas and ensure that people living in Northern Ireland understand what it means to live with HIV here. We encourage the Minister to support Positive Life and the work that it does and to assist it in the development of a centre of excellence at its new headquarters.”
“It is essential that those on the front line — our GPs and nurses — be given the necessary support and advice not only to deal with those who have been diagnosed with HIV but to prevent HIV. The fact that, as I mentioned, hundreds of others who have HIV are unaware that they have the virus is deeply worrying. More information on prevention, early diagnosis and treatment would help alleviate the fear, destigmatise the testing and, I hope, promote a more confident approach to those who present for testing. <BR /> <BR />Through the motion, we commend the work of Positive Life and the role that it plays in supporting those with HIV, advocating on their behalf, working to destigmatise HIV and ensuring that those affected are treated with respect and dignity and live a healthy life.”
“To challenge some of the stigma, it is important that we recognise that, of the people currently living with HIV, just over 40% of those cases involved heterosexual contact. <BR /> <BR />Stigma increases the likelihood of late diagnosis. Late diagnosis can have serious implications and can result in increased risk of other conditions, such as tuberculosis, pneumonia and some cancers. It also limits treatment options and affects the overall prognosis. Given that treatments can now mean that a person who is diagnosed early with HIV can reasonably expect to live a long and healthy life, it is hugely important that people who may be at risk test early. Crucial to that is the need for people who work in our health service to be able to recognise the risk factors and symptoms of early HIV infection.”
“It is estimated that there are hundreds of others who do not know that they have HIV. <BR /> <BR />Sadly, there is still a stigma attached to HIV that affects the people living with it. A recent survey indicated that, of those living with HIV in Northern Ireland, 61% felt ashamed of their diagnosis, compared with 49% elsewhere in the UK. That same survey revealed that 68% of people in Northern Ireland diagnosed with HIV had a negative self-image, compared with 56% elsewhere in the UK. It is difficult enough for those suffering with the condition to seek diagnosis and treatment, and it is unacceptable that that is made even more difficult by a lack of understanding around the condition and its effects.”
“However, it is also an appropriate time to recognise the progress that has been made and, more importantly, focus on the work that is still to be done in preventing the spread of the virus, improving the treatment and health of people infected by it and eradicating the stigma and prejudice that are still too often associated with HIV. <BR /> <BR />In October of this year, research revealed that there were now over 900 people living with HIV in Northern Ireland. That is an increase of 15% on the 2015 figure. The 103 cases of HIV diagnosed last year is the highest number to be recorded in a single year. Not only is that a worrying trend, it highlights the need for more to be done to address the condition and ensure that there is early diagnosis and treatment of those affected.”
“I propose the motion, which stands also in the names of Paula Bradley and Trevor Clarke, on behalf of the DUP. We believe that it is an important and timely motion that will go some way, I hope, to raise further awareness, reduce the stigma and recognise the very positive work that is ongoing in the area of HIV. It is also fitting that we do so today, which is World AIDS Day 2016, and that we wear the red ribbon which, in itself, is a powerful symbol to challenge the stigma around AIDS and HIV. <BR /> <BR />World AIDS Day can be a difficult and emotional time, when people reflect on the damage that the virus has caused and the lives that have been lost as a result.”
“I completely agree with the Member. We have not said that we proposed the idea. The idea came from the Ulster University. For you to suggest that it was the SDLP that proposed it is deeply unfair and quite sad in reality. <BR /> <BR />We will support the motion. We strongly believe in a graduate-entry medical school. I look forward to hearing from other Members, but the commitment that the Executive no doubt will give is that they are focused on delivery rather than on cheap political point-scoring and cheap headlines.”
“The Economy Minister and the Health Minister have already outlined their support for the proposal and its benefits. We have heard from the SDLP and will no doubt hear the Ulster Unionists' view on the medical school. However, I was — no surprise — slightly disappointed this morning that the tone for the debate was set out in the media. The SDLP press office was extremely busy this morning in saying that it is proposing a new medical school for Magee university. It even created a new hashtag, #ConstructiveOpposition. I am sorry, but this is a case of johnny-come-lately rather than constructive opposition.”
“The General Medical Council (GMC), the BMA and the Royal College of General Practitioners have all voiced their support, and there is no doubt that this proposal will help to address the challenges arising from the shortfall in the number of GPs and other issues that face primary care.”
“That is what we want to try to help address the issues in the west. When medical staff and doctors are trained, we want them to stay, because that will help address the shortages. <BR /> <BR />Whilst the medical school will service a much wider area than my constituency, Londonderry is suitably placed, with the newly opened radiotherapy centre, the innovation work that is ongoing with C-TRIC and the outstanding medical courses that already exist in Ulster University at Magee. There are also very strong partnerships with Altnagelvin Area Hospital, and they bode well for any future medical school. <BR /> <BR />Through our work on the Health Committee, we have heard from various organisations that fully support the proposal.”
“At that time, the Minister said that medical locum costs in the Western Trust had trebled in the past three financial years and were projected to be £12·5 million for 2015-16. As the previous contributor said, the medical locum costs for the incoming year are expected to reach £16 million, which is unsustainable. Those significant locum costs are a direct result of being unable to recruit staff and secure them in the trust. That is having a wider impact on the Western Trust through the deficit that is incurred. Of course, the trust is unable to spend the money that is being spent on locums in other priority areas. <BR /> <BR />A graduate entry medical school in the north-west would go some way to addressing those challenges. Research shows that the majority of people stay to train and work in the place where they study at university.”
“I welcome the opportunity to speak on the motion. As a Member for Foyle and a constituent who lives in the Western Trust area, I am all too aware of the specific challenges that face our area, not only from a health perspective but from other perspectives as well. <BR /> <BR />Specifically on the health challenges, we know from our regular briefings with the Western Trust that there are significant budget challenges and difficulties in recruiting and retaining staff in the area. In March, my colleague, the then Health Minister, Simon Hamilton, had an initial meeting with Professor Patrick Nixon from Ulster University, to discuss the proposal to establish a graduate entry medical school in the north-west.”
“Thank you, and I thank the Minister for his response. Will he give a commitment that whatever finance has been allocated to the A6 will be secure and will not be spent elsewhere, as other Members suggested?”
“I thank the Minister for her answers so far. She will be aware that there has been an increase in the number of children and young people presenting with mental health issues; it is as many as one in nine. Will she look at what specialist services — she touched on eating disorders and addressing that issue — are being provided to help to address that worrying trend?”
“The Minister outlined a review into marching bands' funding. Will the Minister consider, as part of that review, the need for bands to have resource as well as capital funding made available?”
“Can the Minister outline his approach to dealing with the needs of people right across the section 75 groups?”
“It is no longer acceptable that, if you live in a certain community, your access to services is going to be different or you are going to be disadvantaged. We know that, in some communities, you are twice as likely to die from smoking or you are three times as likely to die from suicide. These health inequalities are no longer acceptable. <BR /> <BR />These reforms will see that our communities get the health service that they deserve. We have to recognise that finance alone will not solve this. We need to fully implement what the report says, and we look forward to working with the Minister to ensure that it happens.”
“The Executive have given a clear commitment to showing that leadership, and we also need to see that from others outside of the Executive. <BR /> <BR />To keep staff on board, it is vital that the Minister keeps ensuring there are conversations happening with the staff and that they feel valued and are kept up to speed with the changes that are required. With all of the recommendations in the report, the clear outcome is that there is a willingness among the staff to make the change that is required. The Health and Wellbeing 2026 vision outlines the pathway and how we are going to make these changes. <BR /> <BR />We must recognise the challenges of population change and the health inequalities which exist within our communities.”
“Innovation was touched on by my colleague, the Chair of the Health Committee, and I think that it is no longer acceptable that we keep doing things as they were, just for the sake of it or for the fact that we have been doing it for 20 years. We need to look at innovative ways of doing things and we know there is much innovation within our health service at this minute in time. <BR /> <BR />We need to address elective care performance, and we know that a strategy is going to be released in January on how we address that. Of course, the difficulty will be trying to address the waiting times and ensuring that we push forward with the transformation. That is where we need clear leadership, not only professional or clinical but political leadership.”
“No, I am going to try to make some progress. The expert panel's report makes the challenges very clear, and it also makes it clear that we need to draw on the experience of those who already deliver care and take on their expertise to build on the existing foundations. We have to remember that much positive work is already happening in the health service, and we should not be running it down. We are here to make sure that the work continues while also reforming it and making it better. We need to communicate the plans, of course, and the Minister has done that so far by outlining the 12-month vision and the need for additional transitional funding. The transformation board will see all this through.”
“Thank you, Mr Speaker. That is not the point that I was making; I was referring to the negative tone. It is unfortunate that there has been a knee-jerk reaction to the publications; we have seen it in the media. Unfortunately for some Members, they should reflect on the position of the media, get real with the facts and wait for a response from the Minister.”
“The Chair touched on the fact that, as members of the Health Committee, we meet with various groups weekly. Last week, we had a stakeholder event with a wide representation of groups. They made it very clear to us that they recognise the change that has to happen. It is very disappointing that, so far, the tone from the Opposition parties — I do not include the Alliance Party in this — has been very negative. The report has been out only for a matter of days, and they have not given it a chance. When you reflect on that and get behind the public and professional opinion —”
“I welcome the opportunity to speak today. I also welcome the publication of the reports from the expert panel and from the Minister. I thank the expert panel for the work that it carried out, and I also thank the Department for setting out a pathway for implementing this change. <BR /> <BR />The expert panel's report has a clear statement:”
“I thank the Minister for her answers so far. Can the Minister outline whether she plans to follow through on the previous Minister's plans for the Health and Social Care Board?”
“I thank the Minister for his answers so far. He outlined the fact that we have a long-standing relationship with Fujitsu. Will he assure the House that, or give any information on whether, this will stand us in good stead as the company goes through the evaluation process?”
“I thank the Minister for outlining the report. The expert panel report states that action must be taken to address elective care waiting times. The Minister stated that she intends to bring forward a strategy to try to address and reduce waiting times. Can the Minister outline what content she foresees being in the strategy?”
“There is an increase in demand combined with the return to nursing practice programme. These are two examples of where the universities and the Department can work together. <BR /> <BR />The need to train and retain more nurses has been mentioned. That obviously has to continue, but we also want to see the continued professional development of the nurses we already have. Finally, it is important that we refer to workforce planning, because the change in the demographics of the country continues. That is something that we have to bear in mind and work on proactively over the next number of years.”
“We also need to work proactively with our colleges and universities to promote nursing as a career choice. Mr Durkan referred to the fact that it is not just a career choice: people go into it to genuinely make a real difference and provide a first-class service. I do not have to go any further than my constituency to see the work that our colleges and universities do in nursing. The nurse training provided at the Magee campus is first-class. It is in the top 10 in the United Kingdom. The partnership working between the Department of Health and the universities and colleges should continue. I urge the Minister to ensure that that is promoted and that nursing is promoted as a real career choice that can make a difference in our community. There were over 2,200 applications to Ulster University this year for only 264 undergraduate places.”
“<BR /> <BR />That takes me on to the next point of the motion, which asks that the Health Minister build on that work. I have no doubt that she will strive to do so, and I appreciate that the Bengoa report comes out tomorrow, with the Minister's vision coming alongside that. Not to pre-empt what is to come, but I expect that nursing and the increase in nursing numbers will be a major part of that solution.”
“I do not particularly disagree with anything that the Member has said, and I think that the issue of language has also been touched on. It is important that we ensure that those who come here are able to undertake the language as fast as possible and fit into our service. Ultimately, we have to pay tribute to those who are already here and doing a fantastic job in our health service. <BR /> <BR />The second point in the motion recognises the work carried out by previous Ministers. We touched on the fact that 100 additional nurse training places were made available earlier this year. That marks an 15% increase in the annual number of preregistration nurse training places, taking the number of places over the 700 mark for the first time since 2009.”