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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“We have all seen the harrowing pictures of the spread of the virus in India. It was good to see that we supplied assistance to India in the form of generators. International solidarity in that respect is hugely important, and we need to remember that, in an interconnected world, if anyone is at risk, we are all at risk. Helping and reaching out to others across the world is the right thing to do at this time, and I welcome that. <BR /> <BR />We welcome the introduction of these rules and the continued easing of restrictions that we see at present, which includes the ability — crucial for many people — to meet more friends. There is also further easing for sports, gyms and hospitality, which we all recognise as being hugely important for our social and mental health and well-being.”
“In that respect, it is worrying that we have now seen cases of the Indian variant here in the North and that they are rising. We hope that the procedures and processes in place will allow those isolated instances to be contained, rather than there being further transmission of the variant. Find, test, trace, isolate and support will be key to that. I note the latest research that seems to indicate that the vaccines are effective against the Indian variant. That is another reason for everyone to ensure that they get vaccinated as soon as possible. <BR /> <BR />Today, our thoughts are very much with those in hospital with COVID-19, all who face this virus across the world and every one of our families and individuals who have suffered the loss of someone as a result of this horrible virus.”
“First of all, I welcome that we have over one million people in the North now vaccinated with their first dose and that over half a million people have been fully vaccinated. The vaccination programme has been a great success and has provided for the gradual easing of the restrictions that we are considering today and will consider in the future. I encourage all those who are eligible to get on to the system and book their vaccine, as it is one important element on the road to recovery and will provide protection to them, their friends, their family and their community as we ease restrictions. <BR /> <BR />It is also important to note that the system of find, test, trace, isolate and support must continue to play a role as we go forward.”
“Will the Minister also accept that any divergence between the European Union and here must also be managed?”
“Let us set about the real work, Members, of rebuilding our health and social care sector, and let us stop wasting time with the cynical political opportunism and fearmongering from the Members across the Chamber.”
“I thank the Member for his intervention, but surely the Member knows that Britain imports 70% to 80% of its medicines from Europe, and up to 90% of its medicines comes from the wider global supply chain. Medicines are not a British issue. I heard reference earlier to the vaccination programme. AstraZeneca, a key vaccine that has helped here, was developed in conjunction with a German and European company, manufactured in Belgium and funded by the European Union. That is where medicines supply and healthcare sit in the world today. <BR /> <BR />I call on everyone here today to reject this attempt at misinformation and misrepresentation and to reject the motion.”
“We could talk about the loss of the cross-border healthcare directive, which is already having an impact, and I am sure, Members, that you are all hearing of constituents who are being impacted by the loss of that directive. Those are also looming crises to our health service, but they are because of Brexit alone and are nothing to do with the protocol. The fact is that Brexit is bad for our health. It is not the protocol that is the problem here; it is the Brexit that the party opposite called for, worked for and connived with English nationalists for against the democratic wishes and interests of our people here in the North. <BR /> <BR />I call on everyone here today —.”
“We should recognise that the supply of medicines and medical devices is a complex undertaking, featuring a series of interlinked processes across Europe and the world. Indeed, it is the reality that 70% to 80% of Britain's medicine supply comes via a European border. We need to maximise the potential of the grace period and work in good faith and honestly, Members, with all partners, including Europe, in that effort. Burying our heads in the sand will not help in that regard. <BR /> <BR />If we want to talk about threats to our health system from Brexit, we could talk about, as has been mentioned, the serious long-term staff shortages in hospitals and care homes that are being exacerbated as a result of the additional red tape around recruiting EU healthcare workers.”
“We would not be here debating this issue if the British Government did not go down a path of a hard Brexit with maximum disruption and divergence. The Tories, enabled by the DUP, chose this hard Brexit, and you must both own it. Innumerable opportunities were available to minimise divergence in medicines regulations, as well as in trade and many other areas. <BR /> <BR />The Members opposite, whose party brought the motion today, may have been fooled, beguiled or bought by the lies of a Tory Government that no more have your interests at heart than they have mine or ours, but we are not fooled, and nor should any Member or party in the House be fooled by the faux outrage and false narrative contained in the motion. Instead, we must concentrate on dealing honestly with the issues that Brexit is raising and will continue to raise.”
“At that point, it expects a detailed update on the progress that the Department has made on dealing with the issues that have been raised. <BR /> <BR />I will now make some remarks as the Sinn Féin spokesperson for health. There is no good Brexit for Ireland, North or South. The majority of people here voted against it. Our membership of the EU was a fundamental component of the peace process and formed the foundation of the Good Friday Agreement. The protocol is not perfect, but it mitigates the worst of Brexit. It is an internationally agreed and binding treaty that prevents a catastrophic hard land border. <BR /> <BR />Brexit itself is the problem. When he moved the motion, the Member talked about drawing a dagger across the throat of long-established markets, but that is exactly what Brexit has delivered.”
“I welcome the opportunity to make some brief remarks outlining the Health Committee's consideration of the issue, before I speak as my party's health spokesperson. At the outset, I point out that the Committee has no agreed position, but I will outline its consideration of the matter to date. <BR /> <BR />The Committee received a number of Brexit briefings from Department of Health officials, who were joined by Executive Office officials at the most recent briefing, on 15 April 2021. During that briefing, the Chief Pharmaceutical Officer outlined how the pharmaceutical industry currently benefits from a grace period for medicines, which was introduced at the start of January to give the industry a further 12 months to prepare for changes. The Committee has scheduled a further briefing on Brexit-related issues for late June.”
“I agree, Minister, that it is crucial work. Given that it is so crucial to building a shared future and, indeed, a better future, will you detail how the impact of the programme's interventions is assessed or measured at community level?”
“I welcome that investment. I also endorse the views of my colleague Jemma Dolan and others that we absolutely need those schemes to be prioritised and progressed. Schemes like those, along with the A5 and others, are crucial to ensuring that our region is sustainable and served on an equal basis as everywhere else.”
“Therefore, the A4 Enniskillen bypass scheme seeks to provide a new link for traffic between the A4 Dublin Road and the A4 Sligo Road. It is widely supported by the local population. By tackling the bottleneck on that section of road, the upgrade would allow businesses to benefit from improved access to their shops and enjoy the improved journey times that would come with that. In fact, it has been estimated that the scheme would improve average journey times by around 50% and take 40% of the traffic on the A4 out of Enniskillen town centre. <BR /> <BR />The total cost of the bypass scheme is estimated to be in the region of £25 million to £30 million.”
“As mentioned, there is no rail, and there is not a single mile of motorway in Fermanagh. Increasingly, there are gaps in broadband provision. All those elements are essential to our population's health and well-being, just as they are to populations elsewhere. We should accept and have nothing less than what is available elsewhere. <BR /> <BR />Currently, Enniskillen offers the only strategic east-west crossing between Upper Lough Erne and Lower Lough Erne. As such, the town suffers from the congestion caused by a combination of local and strategic road traffic. The existing road network has insufficient capacity for current levels of traffic. That results in unreliable journey times for all traffic, driver frustration and dissatisfaction with the town centre environment.”
“Go raibh maith agat. I am sure that the family will welcome that. <BR /> <BR />The bypass scheme seeks to deliver a new road along the A4, from the Dublin Road to the Sligo Road. The benefits of the scheme include providing a strategic link for traffic to bypass Enniskillen town centre; reducing town centre congestion and enhancing the town centre environment; reduced noise and air pollution in Enniskillen town; improving the local economy; improved journey times; and improved road safety for all road users. <BR /> <BR />I join colleagues in reflecting on the fact that Fermanagh and South Tyrone has some of the most dynamic food-manufacturing and engineering companies in the North. We also have some of the best tourism offerings, yet we continue to suffer from underinvestment in infrastructure in our part of the world.”
“I welcome the opportunity to discuss the A4 southern bypass. I thank my colleague Jemma Dolan for bringing the issue to the Floor. As she said, Sinn Féin has been campaigning for the delivery of the A4 southern bypass for years. I very much welcome Jemma's bringing a focus to it and the announcement from the Minister, notwithstanding the outstanding questions that Jemma has flagged in relation to that. <BR /> <BR />I would like to extend my sympathy to my constituency colleague Seán Lynch and the entire Lynch clan on the tragic loss of their brother Brendan.”
“However, it is exhausting for carers; trying to navigate their way through the system is wearing them down. <BR /> <BR />I welcome the amendment. I am very happy to support it and to work with everyone. I recognise that massive amounts of work have been done by Members for a long time on the issue. We need to look carefully at how we address improvement. Clearly, some trusts are doing better than others. Can we adopt some of what they are doing and have a more strategic approach? <BR /> <BR />On communication and navigating the system, can we look, even in the short term, at providing a single point of contact for families so that they do not have to repeat their situation and story constantly and can access services? Some of those things might help in the interim.”
“One mother described how her child, now in his twenties, is an adult whose needs are very different from when she started asking her local school for help. She will always consider him to be her child, and she will fight tooth and nail for those services.”
“At this point, however, it is not enough merely to report and acknowledge the problems. We need to see the figures, and we need to see how we can address the problems and create solutions. <BR /> <BR />I want to touch on carers today. Clearly, this has a massive impact on those caring for people with autism. For those who need support, it is often a family member or carer who provides the vast majority of that support. Over the past couple of months, I have met hundreds of people who are at breaking point. They are trying to support their loved ones in a situation where services have been withdrawn and additional pressure put on them, particularly around the difficulties that can be created as a result of autism.”
“Also, we all probably query whether a two-year strategy can address the many long-standing issues that were not fully addressed by the previous strategy or by the Autism Act 2011. The motion calls on the Minister to bring forward a long-term strategy that involves families in a meaningful way in the design, production and delivery of services, putting those families at the centre of that entire process. I acknowledge that this is clearly an issue that affects much more than health services and more than the Department of Health. It will require other Departments to step forward, with the Department of Education being a key one. I urge the Minister and the Executive to look at the cross-departmental element of this and coordinate those services for people.”
“Mothers, fathers and families describe as exhausting the process of engaging with services and getting a diagnosis. It has been said to me in recent meetings, "We are not living; we are barely existing". Other people said, "It is torture for us. We are stuck between a rock and a hard place" and, "Nobody listens, and nobody gives us any help". Those are the comments that are coming back. That is one of the areas in which I hope that we can do something in the short term. <BR /> <BR />On the longer-term issues, I note that the Department published an interim autism strategy for 2021-22. It, however, has no measurable targets, which is important in light of what I said earlier.”
“For example, 670 children received a diagnosis of autism for the quarter ending March 2020: for each quarter after the start of the pandemic, the number was 133 up to June, 83 up to September and 387 up to December. Addressing the backlog of growing waiting lists is not an overnight fix, and everyone here recognises that. It is a complex issue, and I do not want to underplay or underscore the difficulties attached to that area of work. <BR /> <BR />Recently, I heard an example of a young girl with anxiety who faced a waiting list to access child and adolescent mental health services (CAMHS). The family went for a private assessment at a cost of £1,600, and, with that diagnosis, they progressed only as far as the next waiting list for the service.”
“I am concerned that, if we do not capture the growing extent of the problem, it will take longer and be harder to address. Not only are families being forced to wait longer but they should rightly expect to receive that diagnosis through their health service. The Department of Health does not have oversight of how many of those are accepted or what proportion of the accepted diagnoses is private. I urge the Minister to look into that issue and see whether he can examine whether the principle of healthcare being free at the point of need is being undermined, particularly in autism services. <BR /> <BR />I openly recognise and accept that COVID-19 has had an impact on the assessment services and supports that are offered across the entire health service.”
“Being forced to go private for an assessment adds another pressure on families and those with autism to fork out money that they simply may not have, so they borrow, which puts them into debt. Worryingly, there are also developing and increasing inequalities. Not only is the cost prohibitive and creating a two-tier service for those who can afford to go private but there is the growing postcode divide that I mentioned. <BR /> <BR />Ten years ago, the trusts did not accept a private diagnosis. I asked the Department how many private assessments or diagnoses for autism were accepted by each of the trusts and was told that that information was not collected. If we do not know the scale and extent of the problem, it is more difficult to develop the solution. I was shocked by that. An old business adage is, "What gets measured gets done".”
“Both of them had time, resources and skills and knew the system, and they struggled. They have told me that they went into a very dark place as a family. I use that example just to highlight the fact that it affects many people. I hear that constantly. We hear constantly the analogy of people "battling" and "struggling" all the time with regard to autism services. <BR /> <BR />I highlighted that the 1,457 children who have been waiting over 52 weeks for an autism assessment came from only three of the trust areas. We must look at the element of it that is a postcode lottery and at how we can address that.”
“The answer is a simple no. As we can all see and know now, many citizens do not have access to the health services that they need, free at the point of access. Over the past number of months and weeks, in particular, I have heard countless stories of families being told that they face years on a waiting list but could get a diagnosis sooner if they went private. I have been working with the family of a young man in my constituency whose autism difficulties, while they were not emerging for the first time, became clear when he went to university. He is a capable young fella and had been top student in his school in fifth year. Pádraig and his parents struggled to get through the system and to get help. For context, his mother is a retired nurse and had been a nurse all her life; his father is a retired nursing lecturer.”
“<BR /> <BR />In April, Minister, you announced plans for rebuilding trusts and stated rightly:”
“At the end of February 2020, 997 adults were waiting for an adult autism assessment. Too often, the wait to get a diagnosis is just the first step; there is a lifetime of struggling ahead for the families of those with autism. Although the motion is focused on the unacceptable delays in getting an assessment and diagnosis, it is important for us all to remember that wider needs and pathway issues also need to be addressed. A longer-term strategy that is produced alongside those with autism and their families can directly influence the development of pre- and post-diagnostic support and intervention. We know that early intervention is key, but what hope is there for effective and successful early intervention services if the waiting list for a diagnosis stretches years into the future?”
“I welcome the debate. I certainly hope that it engenders a sense of unity and purpose on what is an extremely difficult issue for many thousands of people in our community who struggle to access autism services or to deal with the lack of access even to the diagnosis process, let alone the supports that potentially should flow from it. <BR /> <BR />In the quarter ending in December 2020, 1,010 children were referred for an autism diagnosis, and 387 received a diagnosis. As of that date, 4,495 children were waiting for an autism assessment, and, of those, 1,457 had been waiting for over a year. Those 1,457 children came from three trust areas: the Belfast Trust, Northern Trust and Western Trust areas. It is important to remember that delays in receiving a diagnosis affect adults as well as children and young adults.”
“Will the Minister acknowledge that, even in recent weeks, we continue to see hospital services here under tremendous pressure? At times during recent weeks, capacity has been over 100%. We need to ensure that we are cautious in how we abide by and adhere to all the regulations to take as much pressure as possible off the hospital services and to retain that, in order to allow the hard-pressed staff to get a rest.”
“We need to be clear with these and all other regulations. <BR /> <BR />Our efforts across the island must be intensified. As the relaxation of travel begins and as we progress into the summer months, when people will want to move around more freely, it is vital that the relevant Departments in Belfast and Dublin coordinate their efforts to ensure that all data is shared as necessary. Our efforts on travel locator forms, the movements of those who travel and quarantine measures must be in sync if we are to contain the virus at its current levels and, indeed, continue to drive down levels of transmission right across our island to protect lives, health and well-being and to allow our hard-pressed health workers the respite that they have so richly earned via their efforts on behalf of us all.”
“<BR /> <BR />While we all deserve the sense of relief that the relaxation of restrictions brings, we must continue to take these steps cautiously. While encouraging a safe reopening of our businesses, it is also important to remind ourselves of the public health messaging around hand hygiene, social distancing and mask wearing, which are crucial measures and which I appeal to everyone to continue to maintain as best they can in the time ahead. It is vital that all public health messaging is clear and well communicated in all settings, particularly as we reopen more venues over the coming weeks. The "stay local" message, for example, needs to be clarified. When we ask people to stay local, are we asking them to stay within village, town or county boundaries, or are we permitting inter-county travel across the island?”
“I thank the Member for his intervention. It is our understanding that these regulations reside primarily within the Department of Health and that the drafting and evidence is provided to the Executive by that Department. <BR /> <BR />I will now make some remarks as Sinn Féin spokesperson for health. Yesterday's data from the Department of Health reveals that we are indeed moving in a better direction in our battle with the COVID-19 virus. The bank holiday weekend saw communities all over the North reopening. One could not help but feel happy to see some semblance of normality, with people returning to socialising with family and friends and, indeed, our hard-pressed businesses starting to see some trade. We recognise that this has been a hugely challenging time for communities and business right across the island.”
“As I mentioned, the Committee also raised concerns with officials in relation to the guidance and regulations for hospitality and the seemingly confusing information and enforcement of those regulations. The Committee agreed to write urgently to the Health Minister and the Executive Office to underline its concerns in relation to the issues that had been raised by the sector and the difficulties that it was facing in reopening its businesses. We got a response from the Minister of Health late on Friday evening outlining the definitions currently used and saying that the Department of Health would be content to consider alternative definitions of "outdoors". I would appreciate it if the Ministers could outline any ongoing work in that area.”
“The Committee looks forward to receiving from the Department that clarification on the level of fines associated with these regs.”
“<BR /> <BR />There was also a discussion of the wearing of face coverings indoors. The Department advised that that was being considered as decisions were being made to open indoor venues. The Committee further discussed the information that accompanied the regulations and concluded that some thought could and should be given to including public health reasons for the decisions that are made. That would provide the public with understanding of and evidence on why particular decisions are made and a level of confidence in those decisions. <BR /> <BR />The Committee awaits information on the fines related to the regulations.”
“I ask Ministers, as restrictions continue to ease over the coming weeks and months, to consult Committees at an early stage through a return to the SL1 proposal stage that would allow that scrutiny and input to take place. <BR /> <BR />The briefing that we had from the director of population health on the regulations gave members the opportunity to discuss the regulations in more detail, and a number of issues were raised. Members raised the issue of the change in messaging from "stay at home" to "stay local". There were concerns about the definition of "stay local" and about how that would be enforced by the PSNI. That issue was raised again by the Committee at its meeting on 29 April. There were concerns that there was still no definition of "stay local". We would appreciate Ministers' clarification of that today.”
“At times, the Committee has the feeling that all it can do is to rubber-stamp the rules, as opposed to scrutinising them and having an input into the process. The Committee has raised the issue on a number of occasions in the Chamber and with the Department. We understand the tight time frames that are involved. However, the role of the Committee is to scrutinise legislation, and the current process leaves the Committee unable to effectively undertake that role. That was highlighted last week by the significant confusion about guidance issued for the hospitality sector, which resulted in the Committee urgently writing to Ministers to seek clarification of the guidance.”
“The Department must focus on and urgently address those issues over the coming months. The Committee held an informal event with cancer charities and support groups; there is significant concern that late presentations of cancers are resulting in much worse outcomes for patients and more difficult and expensive treatments for the health service to provide. Following the rules allows our health service to focus on those very important issues. <BR /> <BR />The Committee was briefed on the regulations on 22 April 2021 and raised some issues with officials on 29 April. There is increasing frustration among members of the Committee about the limited opportunity that the Committee has to consider COVID-related rules.”
“I hope that it soon will. <BR /> <BR />It is a process, however, and I urge everyone to follow the guidance and regulations rather than push or bend the rules at this important time. It is crucial that we follow the rules and guidance as they are eased, as the process of easements will ultimately allow us to move more quickly to the point at which COVID-19 has less of an impact on our lives. We all look forward to that time. <BR /> <BR />The easing of restrictions and the reduction in numbers of COVID cases and patients allow the Department of Health to shift its focus to recovery from COVID-19. Over the last year, we have seen our waiting lists grow longer, health inequalities widen and the health and social care workforce stretched to, and indeed beyond, breaking point.”
“We all welcome the opportunity to see more of our friends and family in outdoor settings. I am sure that many of us have taken advantage of the opening of hairdressers' and barbers' businesses, although I am sure, a Phríomh-LeasCheann Comhairle, you see that that does not include me”
“First, I note the improvement in the daily reported statistics. We all welcome the fact that a significant number of people are being vaccinated, with the programme now open to 30- to 34-year-olds. The vaccination programme has been a success, and we welcome the impact that the speed of that programme is having on cases. The downward trend in the number of cases identified on a daily basis is welcome, as is the significant reduction in the number of COVID patients in our hospitals, although our thoughts are with those patients with COVID who are in hospital. We wish them a speedy recovery that will see them back home with their families as soon as possible. <BR /> <BR />The easing of restrictions is welcome, and we hope that the rules that we are discussing today start to bring us along the road to recovery and normality.”
“With all those resources in place, we can — we must, Members — ensure proper symptom management, active and considerate planning and quality of care and choice as we tend and support our loved ones and their grieving families through the end phase of life. <BR /> <BR />I support the motion, and I urge Members to do likewise.”
“While we all acknowledge and value the work that those organisations do, a more statute-based strategic and commissioning process is needed. <BR /> <BR />Facing the end of our life, or that of a loved one, is a sad event. However, it is unavoidable and therefore must be planned for. We know our demographics; we know that our population across the island is aging. That will ultimately require practical, emotional and spiritual needs to be addressed as people face the final times of their life. Therefore, we have a duty to prepare. That preparation must take into account the financial resources that we need and the practical and emotional support and assistance needed for families.”
“The recommendations were all accepted by the Department, and we look forward to discussing this issue further with the Department. <BR /> <BR />I want to make some remarks as Sinn Féin spokesperson for health, a Phríomh-LeasCheann Comhairle. I was disappointed with the response that I received from the Department to a question about bereavement services. I think that it will come as something of a surprise to Members and the public. In relation to a question on the commissioning of bereavement services regionally or within the health and social care trusts, it stated:”
“It is crucial that these conversations are on an individual basis, are supported by the appropriate professional — ideally, the one who knows the person best — and take into account the unique needs, preferences and changing wishes of the individual. It is also important that these conversations do not happen only once but are an ongoing, dynamic process. <BR /> <BR />The Committee made a number of recommendations on advance care planning, including:”
“I pay tribute to all the health and social care workers in our community, care homes, hospices and hospitals, who have provided support to those most in need over the past year when restrictions have made it difficult for families to provide that support themselves. We thank you all for your work and emotional support in what have been very difficult times for patients and their families and, indeed, for you, their carers. We recognise the impact that it has had and the contribution that you have made. <BR /> <BR />During the Committee's inquiry into COVID-19 and its impact on care homes, the issue of advance care planning was raised on a number of occasions. Everyone who responded outlined the importance of sensitive and compassionate conversations about advance care planning.”
“If we do not start to make changes now in how we deliver end-of-life care, difficulties will result in the coming years, especially in relation to end-of-life care in the community and capacity issues for care homes and hospices.”
“I recently chaired a research launch event by Marie Curie and Queen's University that outlined how it is expected that, by 2040, there will be a 30% increase in demand for palliative care and how the population of over-85s is predicted to increase by approximately 100%.”