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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“I am very pleased to be a signatory to the motion. I acknowledge the work of Marie Curie and of Joanne Bunting, as chair of the all-party group, in tabling what is a very important motion. <BR /> <BR />Every one of us will agree that those impacted on by death, dying and bereavement should receive the care and support that they need. It is crucial to note that demographic trends predict a significant increase in chronic illness and demand for palliative care in the years ahead. Now is the time to consider how we can address concerns and develop strategies that will lead to a better end-of life experience for people in the North.”
“I believe, given the sensitivity of the subject, that that language is inaccurate, it is inappropriate and I believe that it could and will cause untold harm to people who are struggling with these situations and who are accessing services to which they are legally entitled.”
“On a point of order, Mr Deputy Speaker. Will the Speaker look at the language that was used by Mr Thomas Buchanan in the Chamber earlier in his question to the Minister? I have informed Mr Buchanan that I would be raising this point of order. During his question, Mr Buchanan referred to Members of this House advocating premeditated murder.”
“I encourage everyone in that age range to avail themselves of the vaccine in order to protect themselves and their families. <BR /> <BR />The recent health inequalities report contains data that shows that alcohol- and drug-related indicators continue to show some of the largest health inequalities that are monitored in the North, with rates of drug-related mortality in the most-deprived areas five times those in the least-deprived areas. The rates of alcohol-specific mortality are four times those in the least-deprived areas. What is the Minister's Department going to do to begin to address that ongoing historical trend in inequalities?”
“I thank the Minister for coming along today and giving us this statement. First, I join him in praise and acknowledgment of the Fire and Rescue Service for its work in very difficult circumstances in the Mournes over the weekend. I also acknowledge that many of us, beyond the people who live there, who enjoy and like to visit that area of natural beauty feel a sense of deep regret for that loss. I ask everyone to be conscious of fire safety and the impact that the damage caused by carelessness or, indeed, the deliberate lighting of fires can have. <BR /> <BR />I also welcome the fact that the vaccine programme is now rolling out fully to 35- to 39-year-olds and acknowledge the good work that is being done in that respect.”
“Rather, the strategy must be co-designed and co-produced by its users. <BR /> <BR />The issue of oral health inequalities also needs to be addressed, but I am out of time. I commend and support the motion.”
“The New Decade, New Approach agreement contained a new, 10-year cancer strategy to help cope with the shortcomings in our cancer care. Macmillan estimates that, in 10 years' time, there will be 40% more people living with cancer than there are today, so we must get the strategy right. At its core, the new strategy must be developed through partnership working and reflect the views and needs of patients, carers, cancer charities, cancer experts, medical professionals, unions and so on. If the strategy is to be effective in its task of providing optimal cancer care to patients, it cannot be a top-down approach, with Department heads designing another inadequate service.”
“Like in every other part of our healthcare sector, there were already worrying waiting lists associated with cancer services, and patients across the North were left worried and stressed by delays to their vital cancer treatment. Tory austerity had seen to that.”
“<BR /> <BR />According to Macmillan Cancer Support, pathology data from across the North shows that around 1,300 patients missed a diagnosis between March 2020 and February 2021. During that same period, over 5,000 red-flag cancer surgeries were cancelled. On 25 March, the Minister of Health announced that his Department was finalising a cancer recovery plan to address the backlog that was created by the COVID-19 pandemic. That plan must be fully resourced if cancer patients are to receive the attention that they urgently need. No effort can be spared in providing those patients with relief from the trauma that they have endured. <BR /> <BR />We are aware that, as was mentioned, long delays for services are not totally explained by the COVID-19 pandemic.”
“During all those sessions, there were two very clear themes. The first is the need for significant investment in cancer services, and, secondly, there is a need for a multi-year budget with recurring funding in order to make inroads into the vast waiting lists that patients are experiencing and to give them the opportunity for better outcomes. <BR /> <BR />I will now make some remarks in my role as Sinn Féin's health spokesperson. I take the opportunity to acknowledge the work of various cancer charities and support groups, many of which I have met over the past year. Their work on behalf of cancer patients and their families is important and invaluable. They, in turn, deserve all the support that they need in order to provide their services to patients.”
“It was a good opportunity to listen and to hear at first-hand about the impact that COVID-19 has had on those groups and how they have had to change the way in which they deliver their services. <BR /> <BR />We also held an informal meeting with the Royal College of Surgeons to discuss the disruption and waiting lists. Surgeons are taking a number of innovative approaches under current conditions, which include moving to available theatres in order to maximise the number of surgeries that take place in the North. That is to be welcomed. I hope that that approach will continue beyond COVID. The Committee also had a briefing from the Royal College of General Practitioners and the British Medical Association on GP services. It took the opportunity to discuss cancer referrals and GP experiences over the past year.”
“<BR /> <BR />While we can blame the pandemic for the disruption and cancellation of cancer services over the past year, it is not the sole reason that waiting lists are lengthening. We also need to look at the delivery of cancer services in the North and ensure that we are doing all that we can to deliver reactive and responsive services to those who are most in need of them. Services are a key priority for the Committee. It is concerned that a number of cancer diagnoses have been missed, which will lead to cancers showing late, worse outcomes, inevitably, for patients and more difficult treatments for health services to provide. That has been outlined to the Committee on a number of occasions. Last Wednesday, the Committee held an event with a number of cancer charities and support groups.”
“I start by thanking the Deputy Chair for tabling this important motion. I welcome the opportunity to make some initial remarks on behalf of the Health Committee before speaking as my party's health spokesperson, if I may. <BR /> <BR />As the motion outlines, there is no doubt that COVID-19 has had a negative impact on cancer services, including diagnosis, treatment and surgery. As MLAs, we are only too aware of the experiences of our families, friends and constituents who have been impacted by the disruption in accessing cancer services. Our thoughts are with all those families who have lost loved ones to cancer over the past year. It has not been easy for them, and we feel their sense of frustration.”
“I thank the Minister for his statement and for meeting the Deputy Chair of the Committee and me earlier about it. <BR /> <BR />The neurology inquiry has again revealed more examples of a lack of transparency and deficits in governance arrangements and accountability in the health service. People's lives have been impacted on. Indeed, some people's lives have been devastated as a result of this scandal. I have met families and know that the lack of answers has been hugely traumatic and caused great anxiety. <BR /> <BR />What does the neurology inquiry and scandal tell us about how patients have been treated in the past by trusts? More importantly, what does it tell us about what lessons we need to learn and what changes we need to make and implement in future?”
“Although the Bill itself is relatively small and technical, it does have larger and far-reaching ramifications. A number of areas that the Committee will want to consider in much greater detail have already been identified and include the process for the commissioning of services, tackling health inequalities, retaining local and regional expertise, and engagement on the commissioning of services. The proposed extension will allow sufficient time for that detailed consideration, balancing that with work on considering other Bills. Although an extension to 1 October has been requested, I again assure the Assembly that the Committee will endeavour to complete Committee Stage earlier if possible. I commend the motion to the House.”
“The Committee also has a private Member's Bill at Committee Stage and, as I mentioned, is expecting a large and complex adoption Bill in the coming weeks. To allow sufficient time to scrutinise the Health and Social Care Bill in the detail required, it was therefore agreed by Committee members that an extension was needed and that that extension should allow for some flexibility in the Committee's consideration of the Bill.”
“As outlined in the previous proposal to extend, the Committee has an extremely heavy workload at this time, with ongoing consideration of COVID regulations, COVID recovery in the health and social care sector and key priorities in other areas of which Members will be aware.”
“<BR /> <BR />Following commencement of Committee Stage and to assist us in our consideration of the Bill, the Committee agreed to issue a call for evidence through notices in the main newspapers, on the Assembly website and on the Committee's web page. We wrote to a list of key stakeholders and organisations to highlight the consultation and to seek written submissions. The Committee agreed a five-week consultation period, which closes on Friday 23 April. <BR /> <BR />At our meeting on 25 March, the Committee considered a draft timetable for consideration of the Bill and agreed a motion to extend Committee Stage to 1 October 2021. The Committee made that decision on the basis of a number of factors.”
“The Health and Social Care Bill passed its Second Stage on 16 March 2021 and was referred on for Committee Stage the following working day. The objective of the Bill is the dissolution of the Regional Health and Social Care Board and the transfer of its legislative functions. The Bill has seven clauses and three schedules. Overall, the clauses provide for the dissolution of the regional board and the transfer of its functions and require the Department to make transfer schemes for its assets, including its staff and liabilities. A further clause provides for necessary transitional provisions. The remaining clauses provide for interpretation, commencement and the short title.”
“In order to allow sufficient time to scrutinise this Bill in the detail required, it was agreed that an extension was needed and that it should allow for some flexibility in the Committee's consideration of the Bill. The Committee looks forward to considering the Bill in more detail following the close of the consultation period. <BR /> <BR />The proposed extension will allow sufficient time for that detailed consideration while balancing the Committee's consideration of other Bills and priorities. While an extension to 19 November has been requested, I assure the Assembly that the Committee will endeavour to complete Committee Stage earlier if possible. <BR /> <BR />I commend the motion to the House.”
“The Committee agreed a seven-week consultation period, which closes on 7 May. <BR /> <BR />At its meeting on 25 March, the Committee considered a draft timetable for consideration of the Bill and agreed a motion to extend Committee Stage to 19 November 2021. The Committee made that decision on the basis of a number of factors. The Committee has an extremely heavy workload, with ongoing consideration of COVID regulations, COVID recovery in the health and social care sector and key priorities in other areas. The Committee has another Bill at Committee Stage, which will be discussed in a few minutes' time, and expects a large and complex adoption Bill in the coming weeks.”
“The Severe Fetal Impairment Abortion (Amendment) Bill passed Second Stage on 15 March 2021 and was referred on for Committee Stage the following working day. The objective of the Bill is to remove the ground for an abortion in cases of non-fatal disabilities. The Bill is very short, with two clauses. The first clause amends regulation 7 of the Abortion (NI) (No. 2) Regulations 2020, and the second clause is the short title. <BR /> <BR />Following the commencement of Committee Stage and to assist the Committee in its consideration of the Bill, the Committee agreed to issue a call for evidence through notices in the main newspapers, on the Assembly website and on the Committee's web page. The Committee wrote to a list of key stakeholders and organisations to highlight the consultation and to seek written submissions.”
“Go raibh maith agat, Minister. I thank the Minister for her commitment to the project and her Department's significant investment. I went to school in the border village of Caledon. During that entire time, we were effectively cut off from Glaslough, just a mile or two on the other side of the border, with the result that I know very few people from that community even though we are side by side. Does the Minister agree that projects like that are crucial because the border has artificially stunted the potential of the communities that straddle it?”
“That is a fairly minimal approach, and, basically, it does not include some other very important sectors. What commitment can the Minister give that these plans were developed with staff and patients in the genuine spirit of co-production and partnership working, as promised in the Bengoa report and 'Delivering Together'?”
“Gabhaim buíochas leis an Aire as a ráiteas. I thank the Minister for his statement. I note and share the Minister's concern around elective care waiting lists. As he rightly points out, those are concerns for us all, particularly the, approximately,145,000 patients who are waiting for a diagnostic test. Such a wait puts further pressure on those individuals and, potentially, the health service, due to the increased treatment that will be needed. <BR /> <BR />We have seen good examples of considerable partnership working on rebuilding and reconfiguring services, including cancer services, particularly breast cancer, and strokes. I note that several plans are to be published on emergency departments, elective care and cancer recovery. I am somewhat concerned to see in the reference to the cancer strategy that it has:”
“Does the Commission agree that it is important to ensure that workers employed by catering and other contractors do not suffer as a result of the Assembly's response to the COVID crisis?”
“Go raibh maith agat. I thank the Member for raising that point. Does the Member agree that that is indicative of the need to develop a robust all-Ireland strategy for dealing with this?”
“As further restrictions are lifted, the risk of increased contact at work or between households could lead to further outbreaks, clusters and surges. I am very disappointed to note the latest figures for the contact-tracing complement, with only 46 contact tracers employed on a full-time basis, 100 part-time staff and 170 who work on a bank basis. Minister, the Assembly supported the Committee's motion asking for a significant scaling up of the system, and these figures do not suggest that that has happened. As we move into the next period, that needs to takes place urgently.”
“We need provision of improved find, test, trace, isolate and support services to manage and to press down aggressively on future outbreaks. Last week, I met the COVID-19 contact-tracing team from the Public Health Agency to offer our continued support for a robust system and to seek assurances that it is ready for the lifting of restrictions. Effective contact tracing has an invaluable role to play in stopping transmission, which becomes more important as restrictions are lifted. <BR /> <BR />I have long called for a new public health-led strategy that is centred on find, test, trace, isolate and support. It is also important to bear in mind that, this time last year, the COVID-19 contact-tracing service was stood down by the Department of Health during the first surge only to be re-established in April.”
“I will make a few remarks now. I may get through them OK. Thank you, a Cheann Comhairle. <BR /> <BR />As the transmission of the COVID-19 virus slows and we start to ease the restrictions, we must remain on our guard. Out and about in our communities, we need to continue to practise safe levels of distancing and hygiene even as the vaccination programme continues to be rolled out across communities. There is a huge job of work to be done by the Department. There must be strategic planning for restarting full health and social care services and addressing backlogs, and waiting lists that preceded the pandemic must also be tackled. Addressing the waiting list challenges will require the Department of Health also to address the staffing shortages and the low pay for far too many of our health and social care workers.”
“Would you prefer that I wait until after the break?”
“I welcome the clarity provided by the official that youth support services may continue to operate and provide support for persons if they are at risk of illness, injury or harm. Members also discussed that there may be a need for targeted guidance for young people to manage and mitigate risk when they are meeting. We were advised that work is being undertaken by the Department on assessing adherence and behaviour more widely. The Committee agreed to ask for an update from the Department on that work and, in particular, in relation to an assessment of youth behaviour. The other measures, including allowing a customer's carer to accompany them when picking up a Motability vehicle, are practical steps, and the Committee was content with the rule. <BR /> <BR />A Cheann Comhairle, I will now make some remarks as a Sinn Féin representative.”
“One of the areas discussed was the regulation allowing click and collect in limited circumstances. The Committee welcomes the extension of click-and-collect services to baby equipment, clothing and footwear. However, members raised some concerns about the practicality of buying baby items such as prams and car seats without physical inspection. The same issue was raised in relation to children's footwear and the need for children's feet to be measured properly. There was a suggestion that an appointment-based approach could be used to address some of those issues. <BR /> <BR />There was also a discussion on the increase to the limit on outdoor gatherings, concerns around restrictions affecting youth diversionary workers and that the current restrictions prevented youth workers from meeting with more than one or two young people at a time.”
“Members are aware that a review took place last week that will result in further regulations that we will debate again in a number of weeks' time. We have concerns about the limitations of post hoc scrutiny and the continuing approach of legislating without formal consultation and impact assessments. It is acknowledged, however, that this opportunity for debate allows Members to place on record their views, and we trust that it will inform subsequent regulations. <BR /> <BR />The briefing session with the director of population health last Thursday was very useful in that regard. It gave the Committee the opportunity to discuss the regulations in more detail and to seek further information on the work that the Executive are undertaking on next steps.”
“We pay tribute to our health and social care workers, who have helped to bring us through what, we hope, has been the worst of this pandemic, and we hope that, over the coming weeks, as some restrictions are eased, those figures will continue to improve. We need to get to the point in the coming weeks where we are able to start our health recovery, reopen a range of services to patients and allow the Department to make inroads into the very lengthy and frustrating waiting lists. <BR /> <BR />The Committee was briefed on the regulations at its meeting last Thursday. It is a cause of frustration for Committee members that we are debating rules today that have already been in place for a number of weeks.”
“I would, however, like to join you, Minister, in reflecting on the impact that COVID has had to date, including on those who have lost family in the four weeks since we last debated the regulations. I note that, to date, across the island of Ireland, 6,693 people have lost their lives to COVID, and every one of those deaths is an individual tragedy for every one of those families.”
“Go raibh maith agat, a Cheann Comhairle. First of all, I note the continuing improvement in the daily reported statistics. We see more people vaccinated, fewer reported cases of COVID-19, fewer people in our hospitals and, ultimately, lower numbers of people passing away from COVID.”
“First Minister, thank you for your statement. The relaxation of rules on meeting will undoubtedly be welcomed by those who have felt the strain of separation over the past period and, indeed, by many who have felt the impact of loss. I send our condolences to all those people. <BR /> <BR />This afternoon, I met the senior team in the Public Health Agency (PHA) that is responsible for contact tracing. We wish them all the best now that that service comes back into the spotlight, as you said, to try to prevent us from ever having to go back. I am sure that we all wish them well and hope that the system is fit for purpose. How crucial has the vaccination programme been in enabling this particular change?”
“Minister, I am concerned that you have identified that just over half of the homes have put in place the care partner scheme. Do you understand the comments from the Commissioner for Older People, Eddie Lynch, when he said that he is not convinced that the Department understands the full extent and impact of the lack of visiting access at present?”
“I look forward to drilling down into those issues in more detail at Committee Stage.”
“In restructuring the healthcare administration, there must be an effort made to protect the jobs of those within the structures. Redeployment must be assured for all, and the Minister has indicated that that will be the case. <BR /> <BR />Key issues that the Committee will be concerned about are the very important social care and children's functions. When such issues are talked about, it is crucial that we see continuity and no gaps in those areas. We look forward to discussing how the effective and innovative approach can be enhanced. <BR /> <BR />I wonder about what the Minister said about the staff being under the direction of a senior civil servant. In the light of the fact that the staff will be dispersed to trusts, the BSO and, in some cases, the Department, how will that be achieved?”
“It promises to create a more effective and efficient healthcare system, with improved structures that, in turn, will hopefully improve the delivery of health and social care services. The HSC Bill is an integral part of the wider transformation agenda. It proposes to demarcate simply and clearly the structures in the healthcare administration, thus increasing transparency and accountability, which is much needed. Reducing the levels of bureaucracy in any organisation is a positive development. There is little point, however, in simply reorganising the deckchairs. Rather, the transformation of healthcare structures must result in simple and clear lines of responsibility and accountability. There must be a clear chain of command for that accountability.”
“There was some discussion about the transfer of staff from the board to the Department and about the roles and responsibilities of officials and their lines of accountability to the Minister. Members again highlighted the need for early engagement with trade unions and staff to ensure as smooth a transition as possible. Provided that it passes Second Stage, the Committee looks forward to engaging with stakeholders and scrutinising the Bill in further detail. <BR /> <BR />I will now make a few remarks as Sinn Féin health spokesperson. The Health and Social Care Bill is an effort to reform and address some of the weaknesses across the health and social care sector.”
“The Committee also sought further information on how the Department will ensure that there is a smooth transition when the functions are transferred and the board closes. Members highlighted to officials the importance of enhancing engagement with key stakeholders and asked how the Department will ensure that there is that enhanced engagement with them, including trade union representatives, on the commissioning of health and social care services. Given that the board and its non-executive directors and committees have significant expertise in and knowledge of the prioritisation and commissioning of services, that is especially relevant. The closure of the board may therefore result in an expertise and knowledge gap.”
“Moreover, the New Decade, New Approach agreement included an Executive commitment to deliver health and social care reforms. The Committee wishes to see the transformation agenda driven forward by the Minister and the Executive. The Bill indicates a step towards the streamlining of decision-making. <BR /> <BR />The Committee first considered the Bill at its meeting on 4 March, just before its introduction at First Stage. I thank the Minister and his officials for their early engagement on the Bill and for the briefing on its principles. The briefing was a useful session for the Committee. A number of questions were raised with officials. Members sought clarity on how the Bill will improve accountability and decision-making in the Health Department and on how the Department will manage performance management.”
“The aim of the Bill is to simplify the healthcare administration's structures. In the current challenging climate of the pandemic, with its unknown long-term physical and mental-health impacts, and with ever-increasing waiting lists for surgery, any advancement of the transformation agenda is to be welcomed. Indeed, in recent weeks, the Committee has heard evidence from the Department and other stakeholders that there are concerns that the transformation agenda will not be able to be progressed without significant additional resource for the Department of Health. That is disappointing, given that the Programme for Government clearly outlines how the transformation of the health service will contribute to Programme for Government outcome 4, which is:”
“The decision to close the Health and Social Care Board stems from 2015, following Sir Liam Donaldson's report 'The Right Time, The Right Place'. The report highlighted a number of weaknesses in the health system and outlined the need for change that would allow more effective and efficient structures for the delivery of health and social care services. That decision was reaffirmed in 2016 by the then Health Minister, Michelle O'Neill, who confirmed the closure of the board as part of the wider transformation agenda.”
“Gabhaim buíochas leis an Aire. I thank the Minister for coming to the House this morning and making his remarks on this change. I welcome the opportunity to make some initial remarks on behalf of the Health Committee, outlining the Committee's consideration of the Bill, before speaking as my party's health spokesperson. <BR /> <BR />As the Minister outlined, the Bill gives effect to the decision to close the Health and Social Care Board. It transfers the responsibility for the board's functions to the Department of Health and transfers board staff to the Business Services Organisation.”
“I will not. He has failed to do so despite the change in the law almost two years ago. Members, we cannot continue to force women to go on long, torturous and expensive journeys to England and elsewhere to seek the healthcare that they need and to which they are entitled. It is inhumane treatment and should not be allowed to continue in light of the current legal position. <BR /> <BR />I support my colleagues in Sinn Féin who will bring forward a proposal to the Executive this week to ensure that the healthcare services so desperately needed by many women are delivered.”
“As the DUP attempts to undermine women's right to access legally entitled health services, the Minister of Health has refused to commission those same healthcare services, and women, again, are suffering as a result. This DUP private Member's Bill does not distract anyone from the fact that the Minister of Health has the responsibility and the power to provide those healthcare services for women.”