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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“It is appropriate that we take all steps to ensure that this crucial legislation goes on the statute book. It is a credit to all those who have campaigned over many years, and, at this stage, it would be bitterly disappointing for them to see it interrupted as a result of political considerations in the Assembly. I fully support the motion.”
“Minister, do you understand the frustration of those who have had the services of day centres and respite care removed? Given that we are welcoming today the relaxation of restrictions and a return to at least some degree of normality, those people still do not have access to those services. Will you advise us when the trusts will bring forward plans to reinstate the services in full?”
“I plead with the Minister to make his plan public and to act urgently on something that is within his power to provide relief and respite to hard-pressed carers.”
“I look forward to the Health Minister's announcement on the legal advice that he has sought on the making of future regulations. <BR /> <BR />Obviously, a lot of the focus today is on the regulations and the legal powers within them on, for example, the lifting of social-distancing requirements in nightclubs, workplaces and hospitality and entertainment settings. However, I and others are struck by the fact that, more than a week after the Minister stated that he had approved a plan to reopen day centres and respite services, we have seen nothing to date. The current guidance and direction are not contained in legislation, yet, as we ease restrictions on nightclubs and other hospitality settings, day centres and respite services are no better off than they were last week or last month.”
“The Assembly and virtually all Members, at some point or another, have stressed that the restrictions should not be in place for any longer than they need to be. Given the evidence and advice to lift the restrictions, their lifting is, indeed, to be welcomed. <BR /> <BR />I also welcome the clarification of and changes that have been made to the face-covering regulations and the lifting of some restrictions on hospitality. However, the possibility of the further easing of restrictions may be in some doubt. As we debate the lifting of restrictions that affect hospitality and some of the most vulnerable, it has not gone unnoticed that the DUP seems intent on restricting the ability of the House and the Executive to deliver for people.”
“That issue caused the Committee some concern during its consideration of a previous statutory rule, and it welcomes the clarity provided by the amended rule. <BR /> <BR />I ask the Minister to provide some clarity on the process for bringing forward further COVID rules if there is no First Minister or deputy First Minister in place. It would be useful to hear from the Minister what powers there are to bring forward further rules. <BR /> <BR />The Committee considered the statutory rules and agreed that it was content for the rules to be approved by the Assembly. <BR /> <BR />I will now make some brief remarks as Sinn Féin's spokesperson for health. Many of the changes relate to the lifting of restrictions and the easing of some requirements.”
“While it is welcome that we are considering the easing of restrictions, we are not through the pandemic yet. We have a consistent number of people — over 300 — in our hospitals with COVID, and we are seeing COVID-related deaths daily. Therefore, it is important that we all continue to play our part and follow the guidance, including wearing masks, social distancing and having good hand hygiene. <BR /> <BR />The Committee was briefed by officials on the statutory rules on 3 February. The Committee welcomes the clarity provided by the amendment that deals with the wearing of face coverings. That removes the requirement to provide proof of exemption and reinstates the reasonable excuse of severe distress.”
“I thank them for all their work and for the support that they provided and continue to provide to our families and communities throughout the pandemic.”
“We are also at that point thanks to our Health and Social Care (HSC) staff, who cared for our most vulnerable, our families and our friends, often when we were unable to do so.”
“I will make some brief remarks as the Chair of the Health Committee before making some comments as my party's health spokesperson. <BR /> <BR />The Committee welcomes the fact that we are in a place where we can look at lifting restrictions. We have got to that point thanks to the vast majority of the population following the guidance and rules through difficult and challenging times. I thank every one of them for their patience over this period. We are also at that point thanks to the vaccination programme, and I thank all those who took part in the vaccination programme, including GPs and their staff, pharmacies and other vaccinators in our centres and mobile teams. I continue to encourage people to get their vaccinations and boosters when they can.”
“Those on waiting lists and those in our workforce deserve better than stunts and posturing.”
“<BR /> <BR />The other issue is the retention and recruitment crisis within the workforce. For years now, throughout the pandemic and before it, we have been asking our workforce to go beyond what we should expect it to do. Our workforce does not have the luxury of walking off the job. Instead, people are putting on PPE and walking into hospitals and social care settings to care for our loved ones. Yet, seemingly, we are willing to countenance a situation where, as a result of not having a Budget, the retention strategy that is being worked on will not be funded, and the recruitment that is needed will not be funded. <BR /> <BR />So, I have to say this to the DUP: where you are stepping down, staff are stepping up. It is incumbent on you to reflect on the impact that your actions are having on our health service today.”
“I would like to address the impact on the health service of not being able to approve a Budget. We are all acutely aware and understand, or we should understand, that our health service is in crisis. The COVID pandemic has worsened that crisis, but we were already seeing huge difficulties in waiting lists and in our workforce. <BR /> <BR />At this particular time, with one in four people on waiting lists, it is an absolute disgrace that people have brought down the Executive and taken action to ensure that we will not see the long-awaited three-year Budget that would enable us to start the transformation journey. That must be addressed. Instead of transformation, as a result of the actions of the DUP, we are being offered stagnation, and we will see no progress of the kind that is required to address those waiting lists.”
“A climate office and commissioner would be in an excellent position to liaise with similar bodies across the rest of this island to ensure that our efforts are complementary, cooperative, all-island in scope and effective.”
“An expert body based here and focused on the issues specific to us would be an invaluable support. Our unique flora and fauna are not bound by political divisions, and the measures that we take to protect and promote them should not be either.”
“<BR /> <BR />For our part, Members from Sinn Féin, as set out in our amendment, would like to see the creation of a climate office and climate commissioner in order to oversee the implementation of the legislation, report on the progress of the overall target and interim targets, and offer advice to Departments on how best to meet their climate obligations. <BR /> <BR />While the commissioner's role as a watchdog would obviously be vital — we have proposed further amendments indicating when and where such a commissioner should be consulted — it is also important that we have a local source of advice and expertise on climate issues here. Our island is a single biogeographic unit, with its own unique environment and biodiversity. As such, it has its own unique environmental challenges and opportunities.”
“While I commend the Assembly on supporting ambitious and necessary climate targets, it is vital that we ensure that those targets are adhered to and that Departments attempting to adhere to them are given the advice and support that they will require. To that end, the creation of an independent advisory and evaluation body is essential to the success of our efforts to tackle climate change. The necessity for that can be seen in the sheer number of amendments that all propose variations of the same core concept.”
“I am finishing up. I have heard several interventions of a very similar nature, and, after the first repetition or two, it was clear that they did not add much to the debate. We absolutely need to speak up for rural communities and protect them, but we also need to protect the climate.”
“I also agree that we need to play our part to the full and not look for excuses about why we should reduce our targets. We should go for targets that are credible, realistic and achievable. We should support farmers, rural communities, small businesses —”
“Those targets are important, and it is crucial that we ensure that they are achievable but also challenging. It is appropriate that they are challenging, given what we have learnt in the past and given the more our understanding has grown of the severe issues that are going on with the climate.”
“My own experience in business taught me that, if you did not have a target, and if it was not challenging, you did not know where you were trying to get to and could not build in the steps that you needed to take.”
“However, I think that farmers and small businesses actually see themselves as being at the cutting edge of how we move forward and develop solutions. Even 20 years ago, in our own business, we had already moved on to manufacturing environmental and recycling products. We have an entire industry in the south Tyrone and mid-Ulster area that exports environmental and recycling equipment all around the world. Innovation, ingenuity and those types of solutions will, I believe, be brought to bear here. <BR /> <BR />We speak to farmers every day of the week. It is clear that they are up for the challenge. They are family people too. They want their children and grandchildren to grow up in an environment that is fit to support them, where they can thrive and that they can enjoy. We are talking about targets in this section of the Bill.”
“It has been an interesting debate. I come from a faming background. My father is a farmer, and my brother continues to run the family farm. I live in a rural community, and I ran a small engineering business in a rural community for many years. I am concerned that, to some degree, it appears that this is almost being set up as a choice between taking action on the climate and farming. It actually has to be both. It is absolutely clear that we need to take action to deal with the climate crisis that we face, but it is equally clear that we cannot do that in a way that is unjust or that impacts unjustly on anyone, including farmers and small businesses. <BR /> <BR />Farmers will actually bear the brunt of the impact of climate change. They can see that happening all the time.”
“Minister, I also welcome your commitment. Can you outline a timeline for us? Those families are already extremely hard-pressed. Can you give definitive times for when families will have services restored?”
“It needs to publish the review and set out a plan and a timetable for the full restoration of those vital services. Many of the families are not at breaking point; they are beyond it. There is an absolutely urgent need to restore those badly needed services to them.”
“Countless questions and pleas for support have been heard. Nearly seven months after the Minister asked the Public Health Agency to review the guidance, there has been no announcement or light at the end of this dark tunnel. At present, there is no plan or timetable for the full resumption of respite and day-centre services, despite restrictions and lockdown measures being lifted elsewhere. Virtually nothing has changed for those who attend day care or respite or for their families and carers. <BR /> <BR />Last week, I wrote to the Public Health Agency, each of the trusts and the Department to ask hard questions about when we will see a plan to restore day centres and respite services. The Department of Health needs to wake up urgently to the plight of some of the most vulnerable people across our communities.”
“Those words could describe the situation of any number of people who rely on respite and day-care services and short breaks or those who attend local day centres. The pandemic started nearly two long years ago. The initial closure of services was eventually followed by cautious guidance and instruction. That, effectively, turned off the tap of support for so many families, carers and service users. Since then, respite and day-care services have never returned to anywhere close to pre-pandemic levels. That is despite the roll-out of vaccines, changes to self-isolation requirements and access to rapid mass testing. Put simply, users of day centres and respite services have been left behind. <BR /> <BR />We know that the trusts and the Department of Health are fully aware of the situation.”
“I ask Members to reflect on the following words:”
“With the GP workforce growing older, it is clear that steps need to be taken to increase the number of GP training places, and greater efforts need to be made to attract GPs back into the system to ensure safe delivery. <BR /> <BR />While it is encouraging that the school of medicine at Magee is open for its first cohort of students, we need to ensure that ongoing funding is in place to get the most out of that resource. We need to make sure that medicine and GP studies are attractive to those who will form the health workforce of the future. I welcome the Minister's agreeing to meet the Student Health Heroes campaign about that. We have to be mindful that, with an ageing population, we need ever greater numbers of GPs. There is a huge urgency now to do the planning and recruitment needed to support the service.”
“It is clear that GPs are under significant pressure, and at times there are maybe not enough hours in the day to do the vaccinations as well as the core work, which they are doing with fewer and fewer staff having to deal with more patients and more complex cases. <BR /> <BR />Over recent months alone, GPs administered over half a million booster jabs, ensuring that their patients had the best possible protection against COVID-19. In terms of workforce, like many roles in the healthcare system, planning or lack of planning has become one of the biggest issues that GPs face. The mantra goes — it is very true — "No staff, no services".”
“We can see the pressures in A&E departments. If MDTs were fully operational, you would imagine that the strain put on A&E departments would surely lessen when patients' needs could be addressed within their GP practice. <BR /> <BR />Can the Minister indicate whether there is any further clarity on when the road map that was mentioned a couple of times will be available and, indeed, whether there will be capacity within that to prioritise areas that have poor provision in the roll-out of MDTs? <BR /> <BR />Another key issue in provision was time constraints due to responsibility for vaccination delivery. There has been an immense effort across the entire system, particularly from GPs, to assist with that vaccination roll-out, which has been so essential.”
“The cancellation of out-of-hours GP services in some trust areas and growing crises in A&E departments across the North are, in turn, undoubtedly putting increased pressure on GPs in the community. We have seen that, as I said, particularly in parts of Fermanagh and South Tyrone. <BR /> <BR />Many Members who spoke mentioned MDTs. A clear outcome from the survey is the need for that continued roll-out of multidisciplinary teams into GP practices. It undoubtedly has been and could be a game changer where it has been effective, although it also presents challenges along the lines of workforce, recruitment and the issue of robbing Peter to pay Paul. The underlying workforce shortage impacts on that as well. <BR /> <BR />Many patients reported having had to go to A&E when they could not get an appointment with their GP.”
“We must also acknowledge the fact that taking on the role of running a GP practice is a huge commitment to a community and personally for a general practitioner. There is some scope in looking at how we employ people. Young GPs coming out of training often do not want to run a business; they just want to provide care. We can look at that. <BR /> <BR />GP shortages are also making it difficult for people who live in towns and cities to access services, where health needs, such as mental health, cancer, addiction services and so on, are often greatest. The pandemic has exacerbated those problems, with patients often unable to contact GPs directly or by phone, and that can lead to frustration.”
“The survey received almost 600 responses, which shows the depth of feeling in communities, and it laid bare the need for decisive action to ensure that service delivery and patient confidence are improved. Some of the difficulties outlined in the survey about accessing GPs clearly existed before COVID-19. However, the pandemic has put additional pressure on GP services and health services generally, which impact negatively on our communities. <BR /> <BR />Shortages in the GP workforce and practice closures have caused ongoing problems for accessing GP services. That has been an issue across parts of Fermanagh and South Tyrone and in Dungannon in particular. Vacancies caused by retiring doctors are often not being filled in sufficient numbers due to difficulties in attracting GPs to rural areas.”
“I thank Deborah for securing the debate today and the Minister for attending and listening to us throughout. Those of us from Fermanagh and South Tyrone know the issues in the primary care system very well. They are wide-ranging, and, in particular, there are severe shortages in GP cover, especially out-of-hours GP coverage. The out-of-hours system, as it stands, is not fit for purpose on many occasions, and it is in need of attention. <BR /> <BR />From June to August last year, the Sinn Féin health team and I undertook an extensive GP survey, in which we sought views from patients on the issues in GP provision across the North. We asked people what their experiences were and whether the anecdotal issues that we had been hearing about were manifesting in larger swathes across each trust area.”
“I urge everyone to continue to abide by the guidance as a minimum and to do everything else that they can to protect themselves in the time ahead as we continue to navigate our way through COVID-19. <BR /> <BR />We all hope that there will come a day when we are beyond the pandemic. It is, however, still being dealt with and is still creating difficulties out there, so we will support the health regulations.”
“I recognise that COVID-19 has created a series of challenges, not least in providing public health measures and regulations to protect the public, often when time is not in great supply. I recognise that it is important that measures are taken and taken quickly when needed. As the Minister stated, it is important that measures are dynamic and continue to be reviewed.”
“We have heard stories of people having to divulge very private and personal information to explain why they are unable to wear a mask. While the Committee understands the importance of wearing masks and encourages everyone who can wear one to do so, it has difficulty with putting vulnerable people in positions in which they have to explain what may be difficult circumstances for them. <BR /> <BR />I am aware that a new regulation has now been laid on the issue, and the Committee will scrutinise it in the coming weeks to ensure that it is fit for purpose. The Committee approves amendment No. 20 and amendment No. 21 and has not taken a position on amendment No. 8 on the wearing of face coverings. <BR /> <BR />I will now comment briefly as party health spokesperson.”
“The Committee is disappointed that it could not come to a position on the rule, but that highlights the need for decisions to be clearly thought out and backed by evidence and that the information is clearly set out, not just for the Committee but for the public. <BR /> <BR />At its meeting last Thursday, the Committee agreed that, if it received further information on the rule, it would meet urgently to consider that information to see whether it could come to a position on it. However, no further information was received. Issues like this and the lack of clarity around rules can have an effect on public confidence, cause considerable confusion for people and has caused people to be put into difficult positions.”
“Officials advised that the issue was still under consideration. At the same meeting, officials advised that the rule would be amended but could not provide any information on how it would be amended. The Committee requested that officials attend its meeting on 20 January to brief it on the issue. However, officials were still unable to provide any clarity on the next steps and advised the Committee that the issue was to be considered at the Executive meeting later that afternoon, as the Minister outlined. It left the Committee in the difficult situation that it could not come to a position on the rule due to lack of information and clarity on whether the rule would be amended or revoked and that it did not have sight of the new policy direction.”
“At a briefing on 13 January by officials from the Department of Health, the Executive Office and the Department of Finance on these regulations, the Committee raised concerns around the commentary from the Executive on amendment No. 8 and specifically on placing the onus on a person to provide proof of exemption for not wearing a mask. Ministers outlined in the media that this was unworkable, and the Committee heard from officials that, following discussions with GPs, they would be unable to provide letters of exemption. Therefore, it would be difficult for people to prove their exemption. <BR /> <BR />At its meeting on 13 January, the Committee also highlighted concerns around putting the onus on a disabled person to provide proof of exemption and that this could be considered as disability discrimination.”
“While restrictions are being eased, we still outline the importance of following guidance on the wearing of masks, social distancing and good hand hygiene. It is important that we all play our part on the road out of restrictions. I encourage people to continue to get vaccinated when they are called and to get their booster jabs in order to keep protection at the highest possible level. <BR /> <BR />There is a slight difficulty with the rules before us today because some of them impose restrictions when new rules have already been laid to ease the same restrictions. The Committee was generally content with amendment No. 20 and amendment No. 21, and it approved those. The Committee agreed, however, that it was unable to take a position on amendment No. 8 on the wearing of face coverings.”
“I pay tribute to our health and social care staff, who have had to deal with the brunt of the pandemic over the past two years. They had to work extra shifts and were not able to take leave, yet they still provided the care and support that patients needed in such difficult circumstances. <BR /> <BR />In the current situation, it is welcome that the Executive are considering what restrictions can be lifted at this time. We welcome the initial data that seems to indicate that, while the omicron variant is more transmissible, it is less virulent, especially for those who have been vaccinated and boosted. I hope to see a reduction in the number of people in hospital and in intensive care with COVID over the coming weeks.”
“I will make some brief remarks as Chair, and then some brief comments as my party's health spokesperson. <BR /> <BR />We are now into 2022. Since the start of the pandemic, over 3,000 deaths have been linked to COVID-19, each one of them an individual and personal tragedy. Our thoughts are very much with the families of those who have passed away as they continue to grieve for their loved ones.”
“Again, that feeds into what is being described as overprovision. I do not think that that takes account of people actively choosing not to travel because the journey would be so dangerous, take so long or just be unmanageable and the road inaccessible. <BR /> <BR />I welcome the focus on the issue today, and I thank everyone for taking time to stay on to debate it. It is imperative that construction starts on the project as soon as possible.”
“That is why Declan McAleer's point about providing the proper dual carriageway system and giving the community back the cohesion that it had in previous years before the volumes of traffic rose to a degree where the A5 effectively became a barrier right down the middle of that community is so important. <BR /> <BR />I am glad to see support for the scheme from so many of the representatives here. It is clear that the Minister has work to do to get everything as ready as possible so that we can overcome the hurdles. It is vital for investment, as I said, but also for social inclusion. I will give you an example. I live close to Aughnacloy, and I can be in Dublin City University almost as quickly as I can be in Derry. It impacts people at both ends of the road. People just do not travel it.”
“I recognise that you were quoting from a document. However, the problem with assessing this as overprovision is that it does not recognise the impact of underprovision over many decades. I live in a constituency that the A4 and A5 go through. Parts of the constituency are in Fermanagh, which is the only county of the six that does not have an inch of dual carriageway. Our part of the country is as entitled to investment as everywhere else. <BR /> <BR />Those roads not only devastate lives but divide communities. There will be times when people will not attempt to cross the A5.”
“It is clear from what we have discussed in the Chamber that that is probably, if anything, an underestimation of the devastation that will arise should we not see progress. It is absolutely vital that we see that. I heard the Member for East Antrim talk about overprovision, which will jar badly in my constituency, where we have —”
“The long-awaited upgrade would put 85 kilometres of dual carriageway from just south of Derry, at Newbuildings, down to Aughnacloy in County Tyrone. It would enhance social connection and access to services by better connecting communities, but, most importantly, it would save lives. The 42 individual tragedies that have taken place since 2006 have been mentioned several times. That is not only 42 lives lost; it is 42 families devastated. Forty-two social and community connections of families and friends have been devastated by the impact of those deaths. <BR /> <BR />The Department has projected that the new A5 could prevent 2,877 casualties and 19 fatalities over 60 years.”
“It is a vital infrastructure project, and, indeed, a flagship project that has been mentioned in the Executive and continually recognised in important agreements such as Fresh Start in 2015, and, most recently, New Decade, New Approach in 2020, yet we do not have the start of the project.”