Colm Gildernew
Fermanagh and South Tyrone · Sinn Féin · Northern Ireland
“I thank the Minister for his statement. I have been working with Dungannon Chamber of Commerce and Industry. It will welcome this work, particularly in light of its concerns about vacancy and protecting the retail heart of towns such as Dungannon.”
“I thank the Minister for his answer. Minister, you said that there has been an improvement. However, recently, there were reports of over 1,400 patients waiting more than 28 days. How will you ensure that trusts consistently meet the targets for suspected cancer appointments in particular?”
“However, the Committee will want to examine carefully how any new or amended powers would operate in practice. Powers relating to information sharing, official warnings, directions, removal from office and disqualification can have significant, long-standing consequences for charities, trustees, staff, volunteers and, indeed, public confi…”
“<BR /> <BR />The regulations are consequential to the uprating order and provide the supporting technical changes needed to ensure that the revised benefit rates operate correctly. The regulations increase the earning limit for carer's allowance from £196 a week to £204 a week.”
“In response to those findings, Minister Hargey introduced the Charities Bill, which was enacted in 2022. The legislation put in place many of the review's priority recommendations in the limited time remaining in that mandate. The Charities (Amendment) Bill represents the next stage of that reform programme.”
“The Committee will wish to explore the implications of those changes, including for organisations operating across jurisdictions or delivering charitable activity in or from the North. Our charity sector includes a diverse range of bodies.”
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“The Belfast Trust advised the Committee that protests cause considerable distress and anxiety to patients and staff. The Northern Trust advised that it had to move the location of its clinic on two occasions, as there were concerns about the ongoing impact of personal and abusive protests on service users and for patient and staff confidentiality. The PSNI advised in correspondence that, in the 12-month period from January 2021 to January 2022, police were requested to attend 55 incidents related to the issue. <BR /> <BR />Many of the organisations described the detrimental impact of the actions and behaviour of protesters on those accessing services, and they highlighted the impact on particularly vulnerable groups, such as minors and those attending services as a result of sexual assault.”
“It is a good example of a Department working with the sponsor of a private Member's Bill in order to ensure that the Bill is as robust as it can be. The Committee's clause-by-clause consideration of the Bill was based on previously tabled amendments by the Bill sponsor and, therefore, does not take into account some of the amendments that we have before us today. The Deputy Chair, Pam Cameron, and Deborah Erskine did not take part in the formal clause-by-clause consideration. <BR /> <BR />The Committee heard evidence about why safe access zones are required. The Belfast Trust advised that, since the beginning of 2021, despite lockdown and COVID-19 restrictions, there have been weekly protests from various anti-abortion groups outside its clinics, including its College Street premises.”
“The Committee discussed that, and we agreed our approach. Those discussions are in the Hansard reports, which are available. I advise any of you who wish to revisit that issue to look at those reports. I will move on. <BR /> <BR />I thank all the individuals and organisations who took the time to submit written evidence, and I thank all those who attended Committee meetings and gave oral evidence. The Committee was briefed by the Bill sponsor again yesterday on the amendments that she has tabled. Clare outlined that she worked with the Office of the Legislative Counsel and the Department of Health to draft those amendments. While acknowledging that they were brought late, the Committee welcomes that joined-up approach and cooperative working by the sponsor and the Department.”
“That happened as a result of a request from the sponsor of that Bill to facilitate a particular individual who has taken a court case. We felt that that was the appropriate and compassionate thing to do. It does not mean that you can then create the precedent that you will hear from 6,000 individuals whose evidence made very clear what their view is. You are still left with how you would fairly address the individual responses of 6,000 people.”
“I will outline in my remarks whom we heard from. <BR /> <BR />I thank all those individuals and organisations for taking the time to submit written evidence and all those who attended Committee meetings and gave oral evidence.”
“Of the responses from organisations, approximately 27 outlined their general support for the Bill, and 18 outlined their opposition. I thank all those individuals and organisations —”
“Their views were clear and were presented to us. I am certain that you are not suggesting that we should have heard from them all. Therefore, how would we pick?”
“I am certain that Mr Allister will understand that Committees generally do not take evidence from individuals. Maybe Mr Allister could advise us whether he suggests that we should have taken evidence from all 6,000 respondents or just from those respondents whose views he supports.”
“<BR />On 19 January, the Committee received correspondence from Abolish Abortion asking that the Committee reopen its evidence gathering to allow ministers and pastors to give evidence. The Committee considered that request and said that there had been a significant response from organisations, including statutory bodies, staff representative bodies, professional bodies and pro-life and pro-choice organisations. The Committee felt that the views of organisations and individuals were clear from their written submissions and that members had used those written submissions to inform their views on the Bill. Therefore, the Committee did not reopen oral evidence sessions. <BR /> <BR />The Committee received a wide range of views, with the vast majority of individual responses being not in favour of the Bill.”
“On 12 October, the Bill passed Second Stage and was referred to the Committee for Health for scrutiny at Committee Stage. The Committee issued a call for evidence, and there was a substantial response to that call, with the Committee receiving a total of 6,459 written submissions. A total of 47 written submissions were received from organisations, with the rest coming from individuals. <BR />At the Committee meeting on 2 December 2021, members agreed to take oral evidence from a number of statutory organisations. Evidence sessions were held with the Department of Health, all five health and social care trusts, the PSNI and the Human Rights Commission. The Committee also took evidence from the Bill sponsor on three occasions.”
“In contributing to the debate on the amendments, I will give a brief overview of the Committee's scrutiny of the Bill and make some further comments on the Committee's view on the Bill sponsor's proposed amendments. The Committee has not considered the amendments in the name of Mr Allister and Ms Bradshaw. Therefore, there is no Committee view on those amendments. <BR /> <BR />The Bill seeks to allow for the establishment of safe access zones outside premises that provide lawful abortions or related information, advice or counselling. The Bill also creates offences that apply to safe access zones and allows the police to enforce those offences. <BR /> <BR />On 7 October 2021, the Bill sponsor, Ms Bailey, briefed the Committee on the principles of the Bill.”
“Those views were taken into account as part of the written submissions.”
“Minister, can you give a commitment that, within the rebuild plans, those staff will be prioritised to return in a coordinated way? Will you also give a commitment to ensure that the trusts publish those plans as quickly as possible?”
“Minister, the three-year Budget prioritised health and, as you stated, set aside funding for the elective care plan. Now that the DUP has walked away from its responsibility, what impact will that have on waiting lists?”
“Will the 16 new DVA examiners be allocated in a fair way?”
“There is also huge frustration at the current long waits for driving tests. While I understand that the DVA plans to hire 16 additional driving examiners, will the Minister provide assurances that some of those examiners will make their way to Fermanagh and other centres so that the backlog is tackled equally across the North?”
“I thank the Minister for her answer. The Minister will know that Fermanagh is the only county in the North that does not have a theory test centre. I would like to see the Department moving towards righting that wrong.”
“I will not make extensive remarks either. I am sure that an extra envelope will be going out my way. <BR /> <BR />I remain deeply impressed by the commitment and the work that have gone into the Bill in the Assembly across parties and Members and with the sector and those who are most impacted. It is a fantastic example of how the Assembly can make a real difference to people's lives. It is what people like and want to see the Assembly doing. I commend everyone's work, including Justin's decision not to move his amendments. That is also an important contribution, and it shows his commitment to working with others on the issues that he is concerned about.”
“<BR /> <BR />The definitions in that Act outline that "Department" means the Department of Health and that references to NI "departments" means all other Departments, not including the Department of Health. Therefore, the Bill, as drafted, states that the autism reviewer must not be employed by, or subject to, the direction or control of the NI Departments. Due to the definition in the 2011 Act, that would not include the Department of Health. Therefore, the purpose of amendment Nos 2 and 3 is to insert reference to the "Department" in two places in the clause to provide that the autism reviewer cannot be employed by any NI Department or be subject to the direction or control of any NI Department. <BR /> <BR />I thank the Bill Clerk for identifying the issue and commend the Committee's tabled amendments to the Bill.”
“I welcome the opportunity to speak at the Further Consideration Stage of the Bill. The Committee has not had an opportunity to consider Mr McNulty's amendments, so there is no Committee position on amendment Nos 1 and 4. <BR /> <BR />I will outline the reasons for amendment Nos 2 and 3 in the Committee's name. At the Bill's Consideration Stage last week, the Committee proposed an amendment to ensure the independence of the autism reviewer. Following further consideration of the amendment by the Bill Clerk, a potential issue was identified with its drafting. It was advised that two further amendments would be required to tidy up the clause and ensure that it has the intention that the Committee and the Assembly wishes it to. The issue comes down to section 4 of the Autism Act 2011 and the definitions that it contains.”
“Those are, however, not comprehensive, and they do not cover all types of transfers of value. As the Minister has outlined, they are voluntary and rely on consent for persons' names to be disclosed. The Department said that it agrees with DHSC that the strengthening of requirements in statute will help to resolve those problems. Members raised no issues in relation to this LCM and it was noted by the Committee. <BR /> <BR />I will make a very brief comment as Sinn Féin's health spokesperson. The Health and Care Bill is a Westminster Bill to reform the NHS in England and Wales. However, even with health and social care being devolved, there are areas of overlap in the use of arm's-length bodies. On behalf of Sinn Féin, I would say that transparency in payments is a crucial issue, and we would welcome the banning of abusive practices.”
“The Committee was briefed by a departmental official on this final LCM on today's clár, on the mandatory reporting of healthcare payment data, on 10 February. This provision arises from recommendation 8 of the Cumberlege report and seeks to address the perceived and real conflicts of interest in the provision of healthcare and treatment where healthcare professionals and others have financial links with pharmaceutical and medical device companies. <BR /> <BR />The other intention is that responsibility for transparency should lie not only with the medical profession but with the pharmaceutical and medical devices industries themselves. The Committee was advised that a number of voluntary reporting schemes are operated by trade bodies for pharmaceutical companies and medical device manufacturers.”
“It is important, as the Minister mentioned, that there is full consultation here. It is important that we see subsequent and more intensive consultation to pick up on local issues.”
“<BR /> <BR />The Committee took the decision that, while it was not required to report on the LCMs, it would publish all relevant information on the Committee's web page. I ask that, moving forward, the Department makes clear whether or not an LCM is a subsequent LCM when it is laid in the Business Office, and notifies the Committee of that at the earliest possible stage. The Committee agreed to note the LCM. <BR /> <BR />I will make some brief remarks as Sinn Féin spokesperson. I welcome the additional element of approval for the Assembly. I would welcome hearing from the Minister how that will be actioned and processed. On a general point about all the LCMs, at times there are concerns that full consultation is not done here. Some of the particular and unique complications that we have here are sometimes not fully considered.”
“The current process outlines that, once an LCM is laid, a Committee has 15 working days to report on the LCM and the motion should then not normally be moved until at least five working days after the Committee report is published. However, there is provision for what is called "a subsequent LCM" to be moved, if appropriate. That removes both the requirement for the Committee to report and the time frames. For all three of the LCMs that are before us today, the Committee was not advised by the Department that they were subsequent LCMs until almost two weeks after they had been laid. That created some confusion about the role of the Committee and its ability to report on the LCMs. I acknowledge the Minister's comments on that.”
“That introduces a stipulation that the consent of each devolved Administration must be gained for any change that impacts their area of competency. The Committee welcomes that safeguard. <BR /> <BR />The Committee requested further information on how consent is expressed and processed. Officials advised that a memorandum of understanding was being drawn up to outline the process. The Committee has requested sight of that when it is drafted, and, indeed, it would welcome any further information on that from the Minister. <BR /> <BR />I will flag up an issue on the process for laying LCMs and Committee consideration of LCMs.”
“I welcome the opportunity to outline the Committee's consideration of the LCM. The Committee was first briefed on the LCM in October 2021, and it raised some issues about its purpose and about when the Secretary of State would use the powers that are in the amendment. Those powers would allow the Secretary of State to transfer the functions of five relevant bodies that provide functions directly to or are relevant to the North. Those include bodies such as the Human Tissue Authority and the Health Research Authority. In October, the Committee was advised that the Executive had the same concerns and, therefore, there was no approval to lay the LCM. In January, the Committee was advised that agreement had now been reached to lay the LCM following the introduction of a devolved Administrations clause into the amendment.”
“I welcome the GMC's support for efforts to ban the practices. Sinn Féin will certainly support the LCM.”
“<BR /> <BR />I will make some brief remarks as Sinn Féin's health spokesperson. There are no medical reasons that can be thought of for either of those abhorrent practices. I very much welcome the efforts to close down any potential of them happening. Both practices are harmful and deeply intrusive and, clearly, can be seen only as a form of abuse. Virginity testing is not currently offered or performed in any healthcare practice in the North that is regulated by the RQIA. However, it is important that we extend the ban and criminalise that. Just as female genital mutilation was made illegal, that will make it an offence to carry out the procedure, with or without consent, and also, importantly, to aid and abet in the offence. Hospitals and healthcare facilities must be safe spaces for everyone.”
“The Department advised that, at a meeting of the National Women and Infants Health Programme, it was stated that they were not aware of hymenoplasty being offered or requested in the public care system, and it was not an area of concern that had been brought to their attention. <BR /> <BR />The Committee received correspondence from the General Medical Council (GMC) to advise that it supports the efforts to end virginity testing, hymenoplasty and associated abuses. It further advised that, if the law changes, it will amend its guidance on cosmetic surgery to include hymenoplasty as a banned procedure. That is very much to be welcomed. <BR /> <BR />I conclude my remarks as Chair by saying that the Committee welcomes the amendment to ban virginity testing and hymenoplasty and noted the LCM.”
“The LCM will ban the practice and process of virginity testing and hymenoplasty procedures, as the Minister has outlined. <BR /> <BR />The Committee was briefed by officials at its meeting on 27 January. We asked a number of questions, and departmental officials provided some clarity that the procedures were not happening in any facilities that are managed by trusts or regulated by the RQIA. They also outlined that the World Health Organization had identified the North as one of the places where virginity testing had taken place, and that it could be happening privately. The Committee agrees that it is important to criminalise those procedures and welcomes the amendments to the Health and Care Bill. <BR /> <BR />The Committee sought further information on the present situation in the Twenty-six Counties.”
“It is good to see the Minister looking well in the circumstances and, hopefully, well on the way to recovery. We look forward to welcoming him back to his place here. I am sure that you look forward to that, too, Minister, given the technological difficulties that we all face. <BR /> <BR />I welcome the opportunity to make some remarks as Chair of the Health Committee and then some brief comments as my party's health spokesperson. The first legislative consent motion that is before us today relates to virginity testing and hymenoplasty. The Minister wrote to the Committee just before Christmas to advise that the LCM on virginity testing and hymenoplasty was progressing, following an amendment to the British Government's Health and Care Bill.”
“Minister, thank you for that answer. I am aware from letters sent by my children's school that schools have had a very rocky few months. I am also aware — I declare an interest in this — that there are significant issues with school trips as well, because of omicron. Minister, will you assure us that you will continue to engage with front-line staff and their unions in the time ahead?”
“We also need it to deal with the 358,000 people who are waiting to see a consultant for the first time, the 116,000 people who are waiting for their first hospital or surgery appointment and the 147,000 people who are waiting for a diagnostic test. Those needs cannot be cast aside by one party that is continuing to deal with political difficulties of its own making.”
“If the Member is suggesting that the DUP is adopting some kind of a copycat strategy, that is ill-considered. We are dealing with a public health pandemic. We are not dealing with a situation in which the Assembly was presiding over a scheme that had the potential to bleed millions of pounds over years. He is comparing apples with pears, frankly, and I do not think that it adds to the debate. <BR /> <BR />We need the increased Health budget, proposed by Conor Murphy, to address the needs of the patients in our community who are waiting anxiously for cancer treatment, cardiac care, orthopaedic procedures and the other procedures that are so badly needed.”
“We need the recurrent funding that Conor Murphy proposed so that we can begin to tackle those waiting lists, rebuild a health and social care workforce that is well paid and well respected, and transform health and social care so that it better meets the needs of our constituents.”
“The Health Minister has already set out a number of strategies for improving health outcomes, and it is proposed that his bids for the elective care, cancer and mental health rebuild strategies are met in full, providing £120·9 million, £182·4 million and £255·3 million over the Budget period. That is a total Budget allocation of £1·9 billion. That is recurrent funding over three years and would allow planning on workforce rebuild, cancer services and other services. <BR /> <BR />However, all of that has been put at risk by the resignation of the First Minister. The health and well-being of our constituents and communities cannot be held hostage to the political difficulties that one party has created for itself.”
“<BR /> <BR />We believe that the Department needs to undertake further work and to make progress on transparency and accessibility in our budgetary processes. Throughout the past two years, we have been advised by the Department that a multi-year Budget is required to provide some surety and allow planning so that we can tackle some of the key issues that are inherent in our health and social care system. <BR /> <BR />While the mandate is coming to an end, I am sure that any incoming Committee will look closely at the Department's budgetary planning in order to make sure that the Department delivers the transformation that is needed to ensure better health outcomes for everyone in our community. <BR /> <BR />I will now say a few words as a Sinn Féin MLA.”
“<BR /> <BR />Throughout the past two years, I have taken the opportunity in Budget debates to outline the difficulties that the Committee continues to experience in identifying spend across various streams. We cannot look at the papers that are supplied and identify, for example, how much it is proposed that we spend on mental health, on cancer or on the split between primary and acute care, and we cannot track the investment outcomes that are involved in addressing the continuing health inequalities that we see across our population. We have struggled to get clarity on total spend, and, following Budget briefings, we have written to the Department in order to ask for further detail.”
“<BR /> <BR />The Committee was briefed on transformation just last week, and we see the transformation agenda as key to addressing waiting lists and providing the best levels of care across the North. The Department needs to place transformation at the core of all budget and Department needs in order to consider how funding can be directed and allocated into transforming our health service. An example is seen in the continued and, indeed, growing reliance on locum and agency staff. The latest indications are that the total cost of locum and agency spend is close to £300 million this year. That cost has increased fourfold since 2014-15, and it could clearly go some way towards achieving transformation if workforce planning, recruitment and retention issues were addressed.”
“As a Committee, we have heard of the great work of the multidisciplinary teams (MDTs) in GP surgeries and the real benefits that they bring to patients and communities. However, this year, we saw no increase in the roll-out of MDTs, with funding being allocated on a standstill basis only. We know that it can be done, and we know how it can be done. Indeed, we have cross-party agreement on the road map, including the roll-out of multidisciplinary teams, with investment in primary and community care as advised by countless reports over the years. Moreover, we know that investment will be repaid with early intervention, health promotion and prevention, easing pressure on acute care over the longer term. However, we need to acknowledge the risk that, without sufficient funding, transformation becomes much more difficult.”
“Those allocations have been welcome and much-needed, and they have helped the Department and the Executive to provide a map out of the pandemic and to get closer to a return to normality. However, as we all know, we cannot accept a return to normality for the health service because normality has become increasing waiting lists, overcrowded emergency rooms and people having to wait longer to get the diagnosis and treatment that they so badly require. <BR /> <BR />The previous Committee heard evidence in 2016 that, without adequate investment in transformation, hospital waiting lists would rise and GP practices would close. Members will all know that that is happening as we speak.”
“I welcome the opportunity to participate in today's debate as Chair of the Health Committee. I will then make some brief remarks as Sinn Féin's health spokesperson. <BR /> <BR />From the outset, we should acknowledge that, once again, this has been a difficult and very challenging year for our health service. COVID has continued to wreak havoc on departmental and trust spending plans, and a number of important priorities have been pushed back as the Department continues to deal with the pandemic. Throughout the financial year, we have seen a number of COVID-related allocations to the Department so that it can deal with issues including track and trace, testing and vaccination.”
“I would have loved to see him as a Speaker in the Dáil because they would not have known what hit them. He would have rattled cages and ruffled feathers in his own imitable way that would have left a mark. To be quite honest and frank, us Nordies could have been doing with him there at an odd time as well. <BR /> <BR />Christopher is a loss to the Assembly. The one word that keeps occurring to me when I think about him is "smiling", because, every time that I saw Christopher, whether it was across the Chamber, in the Chair or outside, I came away with a smile from meeting him. He is a huge loss to us. Go ndéana Dia trócaire ar a anam. May he rest in peace.”
“<BR /> <BR />One of the other places where I met Christopher, and deeply appreciated meeting him, was at the Ulster final between Donegal and Fermanagh in 2018, to which he accompanied Arlene Foster. That was huge measure of Christopher as a leader, and he was a leader. He was prepared to take risks and to stretch himself. I could think of nothing during that entire game other than how bad a game of football it was. I was thinking, "We'll never get him back here with this display". <BR /> <BR />His role as Principal Deputy Speaker has been mentioned. He was uniquely suited to and talented at that role, and he would have been a Speaker here in the future. Claire Sugden mentioned him potentially being a Speaker at Westminster, and he would certainly have been capable of that as well.”
“<BR /> <BR />On the occasion that we met the ambassador, despite being much younger, he was the political veteran, but he immediately put me at ease. That was an icebreaker, and after that he never passed me in the corridors of this Building or in the car park without stopping for at least a few seconds for a conversation. He always made a point of stopping to speak, and I always appreciated that deeply. <BR /> <BR />He had the ability to make a point without making an enemy or making it hurt, and he engaged in the rough and tumble without ever making it personal. As someone said earlier, when Christopher made an intervention in your speech, you knew that you had better be on your game because it was going to be a good one and one that you were going to have to respond to.”
“I also extend my condolences to Christopher's family at this time. What they are going through is unimaginable. <BR /> <BR />My first time meeting Christopher in the Assembly was at one of the ambassadorial dinners that took place here. To be honest, I had been following Christopher for many years before that because, as William said when he called him "Tory Boy", he seemed to have almost dropped fully formed into the political world, ready to hit the ground running. He wore that persona, which was so large, so lightly. For many years, I had followed him with interest and with a sort of fascination. I also noted that, over many years, as Paul Givan said, he often was the person who would go out in difficult times, which we all have, to defend his position or his party as required.”
“There will be huge responsibility on the reviewer to represent the difficulties and to represent the whole sector, which is complex and diverse. It is, as has been mentioned several times, a spectrum, and that brings additional complexity, so the role will be considerable. <BR /> <BR />To conclude, this is a great day — or night, as it is now — for the Assembly. I accept that this is not the end of the journey, nor, indeed, as was set out, the start of it, but it is an important staging post in what is a very significant journey and one that impacts so many of our people. I hope that the Bill will help to put some important steps in place for people outside the Building who need them so badly. I thank all Members and conclude with that.”
“In particular, the greater inclusion of carers and families is a huge and welcome change. Sinn Féin has met a range of groups and individuals in connection with the Bill, including Autism NI and the National Autistic Society. I am glad that the Committee agreed to include physical health alongside mental health as a component of future strategies. I am speaking in my Sinn Féin role in that respect. <BR /> <BR />On the funding reports, it is important to say that there could be difficulties with measuring the full extent of the funding and how it is spent on autism and autism services. A strategy without funding, however, is just empty words. We need to ensure that the strategy has teeth and can make a real difference. The autism reviewer role is huge, and I welcome it.”
“Last year, Michelle O'Neill and I hosted an online public meeting on autism services and the strategy, and we committed to listening and to doing whatever we could. That is part of our work here tonight: supporting the Bill that Pam has sponsored. <BR /> <BR />The same issues come up over and over again. They have been touched on, so I will touch on them again only briefly. They are the waiting lists to get an assessment and then a diagnosis; having to pay to go private; a postcode inequality for support; and — this came across very strongly and is one of the most important issues — carers and parents being absolutely exhausted from having to fight every step of the way for every piece of support and recognition. That cannot continue, Members. We need to provide the supports.”