Colm Gildernew
Fermanagh and South Tyrone · Sinn Féin · Northern Ireland
“I thank the Minister for his statement. I have been working with Dungannon Chamber of Commerce and Industry. It will welcome this work, particularly in light of its concerns about vacancy and protecting the retail heart of towns such as Dungannon.”
“I thank the Minister for his answer. Minister, you said that there has been an improvement. However, recently, there were reports of over 1,400 patients waiting more than 28 days. How will you ensure that trusts consistently meet the targets for suspected cancer appointments in particular?”
“However, the Committee will want to examine carefully how any new or amended powers would operate in practice. Powers relating to information sharing, official warnings, directions, removal from office and disqualification can have significant, long-standing consequences for charities, trustees, staff, volunteers and, indeed, public confi…”
“<BR /> <BR />The regulations are consequential to the uprating order and provide the supporting technical changes needed to ensure that the revised benefit rates operate correctly. The regulations increase the earning limit for carer's allowance from £196 a week to £204 a week.”
“In response to those findings, Minister Hargey introduced the Charities Bill, which was enacted in 2022. The legislation put in place many of the review's priority recommendations in the limited time remaining in that mandate. The Charities (Amendment) Bill represents the next stage of that reform programme.”
“The Committee will wish to explore the implications of those changes, including for organisations operating across jurisdictions or delivering charitable activity in or from the North. Our charity sector includes a diverse range of bodies.”
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“The Public Health Agency, in common with many agencies, has been greatly challenged by the significant demands of COVID-19. Will the Minister ensure that the lessons learned and experience gained over recent months is retained so that the Public Health Agency emerges from this crisis with greater and wider capacity?”
“As a follow-up to John O'Dowd's question earlier, I am concerned about the roll-out of the vaccinations. The Minister said that 1,700 were done over a seven-day period. The first delivery of 25,000 vaccines will, I presume, do 12,500 people, given that it is a split dose. At that rate, we would be looking at some six weeks. I presume, therefore, that there will be significant scaling up. How long does the Minister expect it to take to do the first 12,500 vaccinations?”
“It was also confirmed that enforcement powers were in place from the time that the rules have effect. <BR /> <BR />The Committee's concerns centre on matters outside the particulars of these regulations, and we continue to press for further, better and more timely engagement on policy development ahead of the making of further regulations. In closing, once again, I remind those listening to please consider the pressure on our health and social care workers as they try to stretch, yet again, their reserves of strength and resilience for the winter months before the vaccinations take effect. I urge everyone not to waste this year's efforts: limit your social contact, keep your distance, wear a face covering and keep washing your hands.”
“Officials advised that the imposition of restrictions on a particular sector did not necessarily imply evidence of impact on that sector and that it was difficult to disaggregate the net effects beyond confirming that the evidence showed that transmission was higher anywhere where people congregate in enclosed spaces. <BR /> <BR />The timely communication of frequently changing rules to enforcement bodies was also raised. The Committee was advised that, for main sets of amendments, extensive engagement was undertaken in advance of regulations being made, but the official conceded that, perhaps, where small adjustments were made to rules, such as in the amendment (No. 18) regulations, further work was required to update the police and others.”
“I thank the Member for his intervention. I agree that the figures are certainly worrying. There are differences between rates here and in the South, and I urge that the maximum cooperation is undertaken as a matter of urgency in relation to testing, tracing, communication of messaging and all of that on a North/South basis. The continued high level of transmission is a concern as we face into Christmas. <BR /> <BR />The Committee raised the monitoring of effectiveness of measures and again placed on record its concern about the processes for doing that. In relation to monitoring, members acknowledged that transmission rates appeared to be stubborn, and it was suggested that monitoring of the effectiveness of the restrictions on each sector was therefore important.”
“Go raibh maith agat. <BR /> <BR />Colin McGrath is not in his place, but normally he would be here. As Chair of the Health Committee, I acknowledge the work that Colin has done on the Committee through a very intensive time. I thank him for that. I also welcome Cara Hunter to the Committee and look forward to working with her. <BR /> <BR />The Health Committee was briefed on the regulations on Thursday 10 December. The Committee is conscious of the significant restrictions on people's freedoms imposed under the two-week circuit breaker but also of the persistently high levels of infection in the community and the continuing pressure on our hospitals and on health and social care workers, who face into a very dark winter after, probably, the most arduous year that any of us have ever seen.”
“I acknowledge the seriousness of what the Minister has said. It is a concern, given where we are with the levels of spread. I note that the Minister said that it was hoped that the variant would respond to a vaccine, but I am not clear about whether that is the vaccine that is currently available. These are worrying times. I reiterate the message to the public at large to do everything that they can personally to protect themselves and others by reducing their contacts at this time.”
“Go raibh maith agat, Minister. Thank you, Minister, for the statement. I want to acknowledge briefly how much I welcome the consultation on a soft opt-out system for organ donation that you have announced. It is brilliant to see that progressing. <BR /> <BR />Minister, there are considerable areas of potential cooperation between North and South, many of which you have set out. Did you take the opportunity to discuss the lack of paediatric pathology in the North and to explore the possibility of having those services available on an all-Ireland basis? Can you outline what plans there are to build on the good work of CAWT, which you referenced, considering the fact that €37 million has been allocated?”
“In light of that, does the Minister agree that, notwithstanding the useful debate that we have had about evidence, process and the need to carry out these emergency measures hastily, there is some evidence that has to be considered that is crucial and beyond dispute? One is that our hospitals today are at 102% capacity. More people are in our hospitals today than there are beds. Only a very small number of ICU beds are available, and we have had 1,073 deaths. People need to bear those things in mind when they are making decisions over the time ahead.”
“Let us continue to do all that we can, individually and collectively, to stop the spread of COVID-19.”
“That matter has been addressed multiple times in the Assembly. <BR /> <BR />However, we are where we are. One constant feature of the COVID-19 pandemic has been the ever-present lack of time. Therefore, it is to be expected that some of the technical amendments that tidy up the original intentions of the decisions are brought forward. It has to be said again: no one wants the restrictions to be in place for any longer than they have to be. Unfortunately, however, the case for restrictions is often being better made in the corridors of ICU wards, on the countless calendars marked with crucial missed appointments for other health matters, and by families that have had to resort to making FaceTime calls instead of visiting family members as a result of the restrictions. <BR /> <BR />I support the amendments.”
“I cannot help but think of the absolute mess, when public health proposals were voted against in the Executive, created by using a cross-community vote and of where we could be now had the Executive been able to act quicker. <BR /> <BR />However, we are where we are —.”
“We have called for a new COVID strategy, developed by the Department of Health and supported by the wider Executive, in order to end the cycle of lockdowns. That was passed last month in the Assembly, and, as we enter the early phases of Christmas and the vaccination programme, it will be timely to hear about progress to date on any development of that new robust strategy. <BR /> <BR />With your permission, a Phríomh-LeasCheann Comhairle, I would like to address Members briefly in my role as MLA and Sinn Féin spokesperson for health. I am sure that many Members will make similar points as the debate goes on, but I am concerned about the steady increase in the number of new cases that are announced daily. To put it bluntly, we are not seeing the drop in case numbers, admissions and, sadly, in deaths, that we hoped for.”
“None of that evidence and information can be ignored. <BR /> <BR />Despite reservations arising from some unanswered questions, the Committee agreed to lend its support to the measures. The Committee recognises that the regulations are cross-departmental and has written to the Health Department, which is the drafting lead, seeking to have its concerns heard and addressed in future sets of regulations. Indeed, the Justice Minister could directly comment in her response whether the Department has been consulted directly at this time in developing a new COVID-19 strategy or even whether the Executive have seen the new detailed strategy that includes the pillars of finding, testing, tracing, isolating and supporting the public. That was a Health Committee motion that was agreed by consensus in the Committee and again in the House.”
“I spoke this morning with someone who is involved in the hospitality business and who reports that that is a very difficult thing to establish. <BR /> <BR />Responding to a question on the distinction between retail and office settings, officials explained that health and safety legislation deals with workers, whereas the present suite of regulations is aimed at protecting the public. <BR /> <BR />The Committee, as ever, seeks to not only be constructive but to provide the appropriate scrutiny on behalf of the public. One source of data that informs the Committee on a regular basis, along with all the other pieces of information, shows, unfortunately, the new daily case rate, the figure for hospital admissions, the ICU capacity, which today sits at 99%, and, sadly, the daily reported deaths which, as of today, are 1,059.”
“I thank the Member for his intervention. Yes, that is one of the issues of concern, and the Committee is increasingly seeking to ensure that, whatever vehicle is used, maximum consideration is given to that. As we move further into what should be normal ways of operating, equality impact assessments should be done or some attempt made to address the lack of those assessments. <BR /> <BR />On a practical note, the detail of the information to be gathered by hospitality settings was raised. A member suggested that requesting addresses might support businesses wishing to comply with the rule restricting the number of persons at a table to no more than six and from no more than two households. I recognise that complying with that is difficult.”
“<BR /> <BR />I am quite sure that these questions are asked —.”
“I thank the Member for his intervention. I have been consistent in saying that we need to see good information being provided to and good engagement happening with whichever Committees are relevant to the scrutiny of the regulations. I will deal later with the fact that, in normal circumstances, we would not be considering legislation or changes to rules in this way, but it is pertinent to note that, although we recognise that these are unusual situations and circumstances, it is incumbent on all Departments, and everyone concerned, to provide the required level of data and analysis. If, as the Member indicated, Committees are being asked to support regulations, they should be provided with a clear sense of why those regulations are needed and why a particular approach versus another is best. They should then be able to assess that.”
“Officials said that they would have to come back to us on that. We asked about affordability issues with masks, and we were again advised that officials would take the matter back.”
“Go raibh maith agat. I thank the Member for her intervention. I agree with her. It is essential that it start with communication, and then engagement and encouragement. In some ways, enforcement demonstrates a failure of the other steps. We need to work from that basis and understand that some people will potentially struggle to abide by the restrictions because of a lack of income and because, in some senses, they are difficult to understand. <BR /> <BR />Officials also outlined the continued approach to using enforcement as a last resort, which is in keeping with the Member's intervention, but could not provide detail on trends or fines relating to enforcement. We wanted to know about the evidence base for anticipated improvements in compliance underpinning the increase in fines.”
“Among matters considered were affordability issues relating to masks and the differential impact that increased fines could have. Although officials assured the Committee that such matters were taken into account and agreed that there could be potential inequalities, they could not provide detail, and they advised that they might not be able to come back to us with it, as the Executive papers are confidential.”
“Officials also advised us of a strategic level working group that had been established by the Executive to look at compliance with coronavirus regulations. We were advised that the working group is chaired by junior Ministers and brings together a range of agencies and that it has conducted a rapid review, since September, owing to concerns about rates of transmission and a desire to ensure effective deterrents from breaching the rules. <BR /> <BR />Provisions relating to increased penalties prompted questions around rationale, necessity, the evidence base and equality considerations. The remaining questions centred on practical outworkings. Given the absence of a formal equality impact assessment of the higher penalties, Committee members probed the consideration given to the issue.”
“I appreciate the Minister's being here to address the Assembly on these measures. <BR /> <BR />The Health Committee considered the first four sets of regulations on 26 November, but the amendment (No. 16) regulations were included in the final Order Paper without the Committee being given prior notice. They were therefore added late to our agenda last Thursday. A briefing on the first four SRs was provided by a cross-departmental group of officials, who gave an overview of the main provisions. Those provisions included the extension of the schedule 2 restrictions, subject to modifications; additional requirements for premises selling food or drink; new premises improvement notices; and changes to penalties, including penalties for failure to wear a face covering.”
“Does the Member agree that, in order to provide accessibility and to build community support, it would be of value to talk to community groups such as the GAA or rugby clubs that provided good support at the start of the pandemic?”
“— and the ability to find, test, trace, isolate and support must be central to that plan.”
“The vaccine must be delivered through the public health system with community support. It must be made available to all equally, regardless of age, location or financial means, free of charge, with priority given to the most vulnerable: the elderly, those with underlying conditions, those in areas of high deprivation and front-line workers. It is important that that work be clinically led to ensure that the vaccine is rolled out in a way that maximises its protection. <BR /> <BR />This horrendous pandemic has shown that we need to transform our health and care system and that austerity has no role to play. A key part of rebuilding must include preparations for any public health emergency that may occur in the future. We must have the staff, equipment, systems, training and preparedness built into the health and social care system —”
“Yes, there is significant emerging evidence that that is the case, and we should look at that. We look forward to welcoming a panel to the Committee on Thursday who might give us more information. <BR /> <BR />We must also guard against community complacency at this time about the need for basic precautions to be maintained, including washing hands, maintaining social-distancing requirements and reducing our social contacts where we can. That is particularly challenging as we enter the Christmas period, but it remains as vital now as it has since the outset of the emergency. I appeal again for everyone to do all that they can in that regard.”
“Vaccines have all but wiped out smallpox, rubella, typhoid, measles and polio, which we witnessed in Belfast a number of years ago. Those are illnesses that can cause immense death and suffering. <BR /> <BR />The science behind any COVID-19 vaccine must be transparent, and there must be no doubt about the safety of the medicine. While the successful development of a vaccine is very welcome, we must ensure that it does not lead to complacency. It cannot be a reason to lose focus on the crucial find, test, trace, isolate, support and communicate strategy that is so badly needed to stop the transmission of COVID-19.”
“While a lesser amount will now be required to fund the administration of the vaccine, officials stressed that a high degree of ongoing uncertainty about COVID-related costs remains more generally. The Committee welcomed those positive developments and will continue to monitor the next steps. <BR /> <BR />I would now like to make a few comments in my role as Sinn Féin health spokesperson. We all understand the grave nature of the COVID-19 pandemic and the devastating effects that the virus has had on the health and well-being of our citizens and economy. We understand that an effective vaccine is the best way to combat the virus at this time and to allow our citizens and our communities to return to more normal activities. Around the world, incalculable numbers of lives have been saved by widespread vaccination.”
“The Committee was updated on the consultation responses and was advised of changes made in response, including commitments to review the relevant regulation within a year; to specify that a person of appropriate expertise will consider any question of loss of immunity for liability where conditions are breached in respect of vaccine authorisation; and to enhance supervision arrangements for the expanded workforce administering the vaccine. <BR /> <BR />During discussions on the budget last week, the Committee enquired about costings associated with COVID-19 and the vaccine in particular. We were advised that an initial £140 million had been allocated towards the vaccine but that the British Government had since indicated that it would be purchased by them and that the charge would not be passed on to the Executive.”
“We were advised that that was to ensure that an unlicensed vaccine, once it is deemed safe and effective, could be given temporary authorisation pending the licensing process and subject to strengthened controls. It was also designed to allow a wider range of trained personnel to administer the vaccine, allow for promotion of the vaccine and facilitate its transportation. <BR /> <BR />The Committee sought information on consultation responses and enquired about liability in the case of any adverse impact of a vaccine. In October, while the Committee was assured that all safety checks were proceeding as normal, we were advised that an individual would be able to claim against the vaccine damage payment scheme, should they meet the eligibility criteria.”
“After so many difficult months, I very much welcome the opportunity to consider some much yearned-for positive news, albeit that it will undoubtedly bring additional challenges of its own. <BR /> <BR />The Health Committee has briefly considered legislation and funding associated with the vaccine and will be briefed in further detail at its meeting on Thursday on plans for the roll-out of the programme. In August, the Committee received correspondence advising us of a consultation on proposed amendments to the Human Medicines Regulations 2012 to support the rapid and effective roll-out of a COVID-19 vaccine and an influenza vaccine.”
“I, too, acknowledge the individual and family tragedy of every one of the 1,011 deaths that we have sadly recorded to date.”
“I have no difficulty whatsoever in totally disagreeing with what the Member just said about the protocol. It is not the protocol that is creating the problems here; it is Brexit. The protocol became necessary to try to mitigate some of the negative impacts of Brexit for business. <BR /> <BR />We have been left to the whims of a pessimistic and inward-looking Government whom many of us here in the North reject and who will create serious problems.”
“On the supply of medicines, we still have no guarantee; the only thing that we know for sure is that we have been given an extra year to try to arrive at a solution, but the solution is not apparent. <BR /> <BR />We are left at the whim of a Government who have told the world that they have no difficulty with ignoring or breaking international law. We have been left at the mercy of the worst instincts of an English nationalism that is pessimistic —”
“We trust that the Minister will engage with the Committee on these matters in the future. <BR /> <BR />Now, I will make some very brief remarks as Sinn Féin health spokesperson. Although this is largely a technical issue, a series of such issues faces us in the days, weeks and months ahead. It must be very challenging for the Minister to have to deal with COVID-19 and the secondary tsunami of Brexit, which is coming down the tracks at us. There is very little good for us from Brexit. It creates uncertainty, difficulty and, potentially, unforeseen consequences. <BR /> <BR />We did not vote for Brexit in the North, and what we face, regardless of the protocol, is a loss of freedoms, a loss of rights and other immeasurable losses to our citizens brought on by the unwanted exit from the European Union. We have no guarantees of anything.”
“However, in view of the importance of the issues addressed by the amendments, the Committee agreed that it was content to support the motion in relation to human medicines and medical devices. <BR /> <BR />The Committee notes the recommendation of the Cumberlege review that a central patient-identifiable database should be created by collecting the key details of the implantation of all devices at the time of the operation and acknowledges the role that the MDIS will play in patient safety in the event of a recall of a medical device. The Committee also supports the inclusion of the statutory duty on DHSC to consult the Minister of Health on any regulations made in connection with the MDIS and welcomes the improved scrutiny of regulations that is provided by the proposed amendments.”
“The Department advised that there are long-term implications for the supply and regulation of medicines in the North and referred to the recent agreement between the British Government and the European Union to allow the pharmaceutical industry 12 months from 1 January 2021 to comply with the new regulatory requirements, which, as a consequence of the protocol, will apply only here in the North. The Committee also raised that issue with departmental officials in relation to Brexit, and it will continue to keep a close watch on that in the months ahead. <BR /> <BR />The Committee has ongoing concerns about the impact of Brexit on medicines and medical devices. The pressures of COVID-19 have restricted the time available to the Committee to scrutinise the motion that is before us today.”
“The Department referred to a number of actions that, in its view, will mitigate the risk of divergence in regulations for patient data, such as the inclusion in the Bill of a statutory duty to consult and the non-legislative commitment by the DHSC to engage with the Minister of Health. The Department also advised that, as the EU does not require the storage of patient data at a central level, it is not the case that we would be subject to two different information-sharing systems. <BR /> <BR />Finally, the issue was raised of the supply of medicine and medical devices and the attractiveness of the North, as referred to by the Minister, as a favourable location for clinical trials.”
“The Department confirmed that medical devices appear in the list of subject areas in annex 2 of the protocol and that it had given consideration to whether the amendment to provide for an MDIS may be subject to a different regime here but stated that that will not be the case. <BR /> <BR />The potential for future divergence, as touched on by the Minister, was also considered by the Committee. The Department advised that the North's involvement in the MDIS will not be affected as the Medicines and Healthcare products Regulatory Agency will continue to regulate devices in the marketplace, which should mitigate any potential divergence in standards.”
“I thank the Member for the intervention. Yes, I agree that the security and protection of data is absolutely essential, and I am sure that the Minister will address that issue. <BR /> <BR />The Department also advised the Committee that it was content with the assurances received. <BR /> <BR />Members raised a number of issues relating to Brexit and the protocol on Ireland/North of Ireland in relation to the MDIS and whether any of the amendments to the Bill had implications for the protocol and the contingency planning around that. The Department advised that there were no such implications for the amendments for which legislative consent was being sought.”
“<BR /> <BR />In the Department's response, it advised that the purposes for which data can be shared and the types of organisations that can receive that information will be specified in the regulations made under the powers in the Bill. The Department further advised that the Minister will be fully consulted in the making of the regulations, which will determine the scope and limitations on data sharing. <BR /> <BR />The Committee asked whether the Minister was content with assurances received from DHSC on governance arrangements and patient safety issues around the MDIS. In the Department's response, it referred to the statutory duty to consult Ministers in Scotland, Wales and the North, which will be written into the Bill.”
“Those were tabled in response to concerns raised by the Delegated Powers and Regulatory Reform Committee about the scrutiny and oversight of the use of delegated powers in the Bill. Those include increased requirements on consultation and reporting on proposed regulations and a move from negative to draft affirmative or confirmatory resolution for regulations made under the Bill. <BR /> <BR />The Committee raised a number of issues with officials, mainly around the operation of the MDIS and the transfer of data from the Department of Health to NHS Digital. Specifically, the Committee enquired whether the Department had any concerns about the collection and sharing of patient information with NHS Digital and data security and ownership of the data.”
“Those include: the power to establish a medical devices information system (MDIS); provision for an information-sharing gateway to allow for information to be shared with overseas regulators; and a statutory requirement that the devolved Administrations be consulted on any regulations made regarding the amendments. <BR /> <BR />Officials advised the Committee of the non-legislative commitment from the British Government's Department of Health and Social Care (DHSC) to engage with the Minister of Health on the MDIS policy and operational discussions and the development of any draft regulations. <BR /> <BR />Members were also briefed on the amendments to the Bill that were tabled in the House of Lords.”
“The Minister of Health first wrote to the Health Committee on 15 July advising us of the need for a further legislative consent motion to take account of a recommendation included in the report of the Independent Medicines and Medical Devices Safety Review, chaired by Baroness Cumberlege. <BR /> <BR />The Minister wrote to the Committee on 5 October and again on 15 October, advising Members of further amendments to the Bill being considered by the House of Lords, which would also require legislative consent. The memorandum was laid on 5 November, and departmental officials briefed the Committee on 12 November. <BR /> <BR />The briefing from the Department focused on the amendments to the Bill, as outlined by the Minister.”
“I wish to speak on the Committee for Health's report and summarise our consideration of the matter. First, I want to thank the Committee for Agriculture, Environment and Rural Affairs for its prompt consideration of the legislative consent motion and contribution to the report. I will leave it to my colleague, the Chairperson of the Agriculture Committee, to address the issues around veterinary medicines. <BR /> <BR />This is the second legislative consent motion on the Bill. The Committee did not come to a view on the first one due to the limited time available for scrutiny.”
“We know that the contact-tracing model and preparations were inadequate to meet the increased demand at the start of this surge and that the inadequacies stemmed from poor modelling. Has the Department now addressed that inadequacy?”
“That, for example, means supporting business with grants, providing workers with statutory sick pay and ensuring that people have masks or something to cover their nose and mouth where needed. When people are struggling financially, we need to consider the cost of masks. <BR /> <BR />As we enter the winter months, those remain some of the challenges and tests that will not go away. We must work together effectively to meet the challenges in the weeks and months ahead.”
“<BR /> <BR />Two things are vital: communicating a plan, purpose and strategy; and, importantly, putting in place the means to achieve that strategy. I welcome any clarifications that can be made. It is better that they are not needed, but, when they are needed, it is right to get them made and put through. <BR /> <BR />On achieving the desired outcome, I raise the issue of compliance. We have heard how, with face coverings on public transport, we saw compliance increase to an estimated 85%. I would like that to be further increased where possible, which means enforcement. It also means — this is a crucial point — that we need to ensure that everyone is aware of what is required and, importantly, that there are no barriers to compliance.”
“<BR /> <BR />On foot of questions about the links between sets of regulations, officials confirmed that almost all regulations on face coverings are now separate and will not fall with temporary additional restrictions. <BR /> <BR />If I may, a Cheann Comhairle, I will say a few words as Sinn Féin spokesperson on health. The statutory rules were made and came into force in late October and early November, with much of the content relating to clarifications, for example, on close-contact services working in TV and film production. The House must take the measures and restrictions seriously, as they impact in many ways on the lives and livelihoods of the public, even if those restrictions are time-limited and subject to change in a few weeks' time.”