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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“<BR /> <BR />Officials were also asked about any potential harm deriving from unhygienic practices in the use of face coverings. They advised that, on balance, research showed that there remained a net benefit from the wearing of face coverings. <BR /> <BR />Agreeing on the evidence in favour of face coverings, members enquired about plans to widen requirements to use face coverings in indoor settings generally and the extent of the Department's research on international experience and best practice, particularly that of south-east Asian countries that have successfully reduced transmission of the disease and where face coverings have been routinely used for some time. The Committee intends to seek a wider briefing on the evidence in the new year.”
“Members were advised that the percentage of passengers wearing face coverings on public transport had gone up from 10% to 85% as a result of them becoming mandatory in that setting. On that basis, it was hoped that the rule would also prove effective in extending the requirements to post-primary school children on home-to-school transport and public transport. It was suggested that officials consider the inconsistent messaging in continuing to exempt children from wearing face coverings in retail settings. The rationale offered was that social distancing is more feasible in many retail settings, unlike public transport, but the director of population health undertook to consider the messaging point further with the face coverings working group chaired by the Executive Office.”
“<BR /> <BR />The Committee also probed consideration of equality issues in the absence of formal equality impact assessments. Officials advised that the human rights context and the proportionality of restrictions were considered in respect of each statutory rule and that the Department sought to strike a balance between the impact on rights generally and the impact of not imposing restrictions, given the nature of the pandemic. Pressed on the adequacy of the current approach, officials conceded that there was recognition of the need for more granular consideration of equality issues and that how that might be approached was under consideration. <BR /> <BR />I now turn to the face coverings amendment.”
“No assurance was offered on facilitating better scrutiny, something that remains of concern to the Committee. The number of sets of amendments and the volume of technical amendments were also raised. Officials explained that that results from working at speed to respond to rapidly changing circumstances. We were informed that a cross-departmental working group meets weekly to consider the policy detail resulting from Executive decisions but, given the time constraints, gaps are hard to avoid, although they can be plugged quickly via amending regulations such as we have today. It was suggested to officials that further consideration be given to cross-departmental considerations of policy alignment in the current context. One member cited an example of street furniture being installed during a period of restrictions on hospitality.”
“Go raibh maith agat, a Cheann Comhairle agus gabhaim buíochas leis an Aire. Thank you, Mr Speaker and my thanks to the Minister for his statement. <BR /> <BR />The Health Committee was briefed by departmental officials on the three statutory rules on 12 November and agreed to recommend that they be confirmed by the Assembly. With regard to amendments No. 11 and No. 12, to the No. 2 regulations, members raised issues of process, inquired about consultation and alignment between Departments and asked about equality considerations. <BR /> <BR />On process, the Committee asked officials about the potential, moving forward, for the Department to resume its engagement with the Committee at the stage of policy development, although, clearly, that would be subject to a degree of uncertainty, given the circumstances.”
“I thank the Minister for that answer. It is an opportune time to acknowledge the work that teachers do on the front line to protect the well-being of staff, the school community and children. How will the funding complement the work of the emotional health and well-being framework next year?”
“Will you provide us with an update on how the terms of reference for the assurance group were developed and especially whether any urology patient voices are involved at this point? Will you outline the timelines for that urology assurance group and the review by the Royal College of Surgeons?”
“Go raibh maith agat, a Cheann Comhairle, agus gabhaim buíochas leis an Aire. Thank you, Minister, for coming today to make the statement. It is a detailed and concerning statement. <BR /> <BR />I note your reference to the neurology inquiry, and I welcome the fact that it has been translated into a public inquiry. There will be lessons there. I also welcome the fact that a public inquiry has been called into this issue. I also reference the O'Hara inquiry, which probably has information that will be of benefit in how we move forward with this. <BR /> <BR />Minister, I welcome the fact that you said, on 27 October, that you would make the statement, and I have met the Southern Trust on the issue.”
“More importantly, I support the motion because it is the best way to tackle this deadly virus.”
“I recognise that there are parts of a wider strategy that we need other Departments to deliver and lead on, but it needs to be a public health-focused strategy to protect health services and the economy. This is how health and social care staff are supported, with childcare or adequate PPE, so that they can carry out vital services. It is also how they rely on health and social care services. It is vital, in my view, that any strategy or response from the Executive takes account of how their actions and inactions impact on everyday lives.”
“This means breaking the chains of transmission by finding the virus even where it does not show signs or symptoms. It means increasing testing capacity and increasing the speed at which we get results to people. It means increasing the capacity and effectiveness of contact tracing and ensuring that those who have to self-isolate do so and are fully supported in that. <BR /> <BR />The current departmental strategy, test, trace, protect, dates from 27 May. It talks about needing an effective strategy to suppress the virus until an effective vaccine arrives. However, in elements, it falls short of a full FTTIS strategy. We are now, for example, on to our twenty-second amendment to international travel restrictions, yet travel restrictions are not mentioned in the overall strategy.”
“With your permission, a Cheann Comhairle, I will make a few remarks in my role as Sinn Féin spokesperson for health. This motion was agreed at the Health Committee through consensus, and I thank each and every member for that. The benefits of an agreed message, strategy and approach go a long way in effectively tackling the spread and damage of this virus. It helps to protect lives, jobs and our fragile health service. <BR /> <BR />A new strategy from the Department of Health, which is central to a wider Executive strategy, must place public health as a driving force to avoid further lockdowns and all the negatives that are associated with that. We cannot get sidetracked by attempting to make a pitch that is perfect. We do not have time for that, frankly, but we need to demonstrate and deliver the doable.”
“I trust that he views our scrutiny and advice in the spirit in which they are offered, and I wish him and his Executive colleagues well as they lead us through the days and weeks ahead.”
“However, with individuals playing their part on hands, face and space, an effective and well-resourced find, test, trace, isolate and support strategy still holds out the best hope for us to escape or reduce a cycle of lockdowns and ease the pressure on the health and social care system in the context of the wider Executive strategy to support those who are impacted across society. <BR /> <BR />I acknowledge the collegiate work that has been undertaken by the Committee, including in drafting the motion. It remains committed to providing constructive input based on continuous engagement with constituents and stakeholders. I also acknowledge the frequent engagement with the Minister. He carries a heavy burden on our behalf with integrity and dedication.”
“We know that those in low-paid work are less likely to be able to work from home, more likely to contract the virus and more likely to lose out financially if they have to self-isolate. It is crucial that we address that and communicate clearly as well as deliver effective support to those who need it most. <BR /> <BR />In terms of the wider Executive, the Committee appreciates that no single element of the motion can defeat COVID-19. It is true to state that the strategy and response to COVID-19 is only as strong as its weakest component. Chains of transmission of COVID-19 can be effectively disrupted only with properly planned, resourced and functioning chains of suppression. We cannot rely on restrictions indefinitely, nor can individuals stop transmission on their own.”
“Again, while no support was expressed for any type of mandatory use of dedicated isolation facilities, it is clear that domestic transmission in households remains an issue. Could isolation facilities be explored as a means of addressing that, particularly for larger households and those in multigenerational families or high multiple-occupancy housing or for those with vulnerable family members? Other countries, including New Zealand, requisitioned hotel facilities for isolation purposes or made available dedicated health facilities to support that. <BR /> <BR />Although the support payments that were introduced here are very welcome, we must consider the level of payments and support versus the loss to individuals due to self-isolation.”
“The World Health Organization and the European Centre for Disease Prevention and Control have tools for advising on workforce requirements, depending on a range of variables. It would be useful to hear from the Minister whether or how such tools have been used, to what effect and whether or when we will reach those recommended levels. <BR /> <BR />Effective self-isolation is, clearly, key to stopping transmission. Committee members have been contacted by individuals who were unable to isolate effectively in their home due to sharing bathroom and bedroom facilities. Given the infectiousness of the disease, sending a COVID-19-positive person home to isolate in such circumstances creates a very high risk of onward transmission in the home.”
“The issues with testing remain the scale and timeliness of getting a result, given what we are seeing internationally in mass and rapid testing, which I know that the Minister is looking into. Mass testing will be particularly important for Health and Social Care and key workers, such as public transport staff, on a regular and ongoing basis. <BR /> <BR />There are differences of scale in and approach to contact tracing that we could explore. Back in May, Germany had a target of five contact tracers for every 20,000 people, which equates to around 450 here in the North. Other sources indicate that even higher levels may be desirable or necessary in that context. However, by late October, we had only 88 full-time equivalent staff, with more being recruitment. That demonstrates that we still have some way to go.”
“<BR /> <BR />Having acknowledged that progress and recognised the role and responsibility of individuals, it is necessary and important to ask this: given our circumstances, how do we still differ from the countries that have had the most success in containing this highly infectious virus? What more can we do to avert or mitigate the need for restrictions in advance of a vaccine? I emphasise that the Committee is putting forward those questions for consideration rather than providing definitive answers on those matters. While differences in testing and tracing might primarily be questions of degree, when it comes to isolation and support, wider differences can be seen.”
“<BR /> <BR />Given the high numbers of asymptomatic cases identified through regular staff testing in care homes, we had asked about scaling up wider testing of all Health and Social Care staff. I am sure that Members will welcome the Minister’s recent announcement to introduce mass testing. <BR />While the focus of the motion is on scaling up the initiatives that will reduce the need for lockdown measures, it, rightly, reminds us of the role that each and every one of us can play and the impact that our decisions and behaviour can have on transmission. I urge everyone, once again, to wash hands regularly and well, wear a face covering, observe the 2-metre social-distancing rule and cooperate fully with the contact tracers.”
“In recent months, while hearing positive news about progress, we have also heard about staff exhaustion and stress across the system, particularly given pre-existing workforce shortages. What has also clearly come across is staff dedication and their continuing readiness to go beyond what we should reasonably ask of them. <BR /> <BR />The Committee has welcomed regular engagement with the Minister and senior officials, and would readily acknowledge that we are in a totally different place now compared with February. Testing has increased considerably, and contact tracing has been established, is public health-led and supported by an app with international and cross-border interoperability. The workforce appeal has brought significant interest and staff back to the front line, and, for that, we will always be grateful.”
“<BR /> <BR />Since the early days of the pandemic, the Committee has dedicated most of its meeting time to considering and responding to issues connected with this health crisis and, particularly, hearing from and about the most vulnerable groups in our community. <BR /> <BR />Some of our first sessions focused on care homes and their urgent efforts to cope, the fear and confusion around an early lack of PPE, staff shortages and new and changing advice. The Committee heard about the significant impact on children, particularly those on the at-risk register or in care, as visiting became more difficult and children were out of sight of those adults who normally helped to teach and to care for them.”
“The Committee for Health tabled this motion for a number of reasons. It is to mark and acknowledge the loss suffered by so many and the extraordinary dedication and service of our Health and Social Care staff; to encourage each of us to recommit, on a personal level, to do our utmost to bring down transmission; to acknowledge the progress made since February; and, importantly, to create a vehicle for constructive discussion on how best we can now move forward, given the difficult situation in which we find ourselves once again in terms of cases, hospital capacity and the resulting socio-economic restrictions that are impacting so heavily on so many.”
“I thank the Minister for her answer. I am sure that that will be a great relief to business. I ask the Minister to consider extending the scheme to photographers, who are largely unemployed, not directly but due to the businesses that they serve as part of the supply chain.”
“Go raibh maith agat, a Cheann Comhairle agus gabhaim buíochas leis an Aire. I thank the Minister for his statement, and for discussing it with me and the Deputy Chair of the Committee this morning. I also thank him for acknowledging the efforts that staff are making at present in dealing with the pandemic. When did the Minister first bring these restrictions, closing non-essential retail and hospitality, to the Executive?”
“Legislation is not the complete answer; the training is the part that adds the real value.”
“I know that we have achieved much and have much more to do, but I think that training makes the difference in the implementation of many of these types of legislation. I had the benefit of significant and valuable training in my social work role, as part of multidisciplinary teams, in the recognition of domestic abuse and coercive control. I was struck on several occasions by the fact that, around the table in that multi-professional setting, some of the most valuable peer-training experiences that I had were with members of the police, because they got it. They recognised the problem because they were trained in how to recognise it, how to spot it and how to engage with it in order to deal with it. <BR /> <BR />I wanted to share that in order to highlight the value of training.”
“He raped her. That woman escaped out of the upstairs window of a two-storey house, ran naked to the police station and told them what had happened. She was wrapped in a jacket and put in a police car by a policeman and a policewoman and returned to the family home, whereupon they knocked the door, got the abuser out of his sleep and asked him whether he had raped her, which he, of course denied. Then, in front of her abuser, they asked her whether she was happy to remain and stay at the home. She told me — this has stayed with me since — that with her mouth she had to say, "Yes, I am happy to stay", but with her eyes she was trying to tell the policewoman to take her with her. <BR /> <BR />I raise that because I do not think that legislation makes the difference in a case like that.”
“I was reflecting on Linda Dillon saying that, while some of us may not be experienced legislators, we have experience in all sorts of ways that are relevant to the debate. I want to share with Members an experience that I had while I was training for my social work role. <BR /> <BR />I worked with a woman who, as I got to know her and she explained her story to me, set out in detail something that I found truly shocking but that I was further shocked to find out is not as uncommon as many of us would like to believe. This goes back to when the woman got married 25 or 30 years ago. She married her childhood sweetheart. She had known him for many years. In her words, "You could not meet a nicer fella", but that was until the day that they were married. As was the tradition at the time, they returned to the family home after the wedding.”
“<BR /> <BR />Stakeholders flagged the issue of under-reporting and communication issues around domestic abuse incidents and the fact that the Protect Life 2 suicide prevention strategy acknowledges domestic abuse victims as an at-risk group. The Committee, therefore, recommended that statutory guidance and associated training be provided to front-line responders on the implementation of clauses 8 and 9, in particular. Again, the Committee has not formally considered the particular wording of the amendments that deal with training, but it would support the objective in principle, and I note that the Minister will not move amendment No 15. <BR /> <BR />If I may, a Cheann Comhairle, I will reflect on some of my experiences of this in order to explain in part why I am so pleased to be part of the debate.”
“I want to speak to the elements that the Health Committee looked at with this group of amendments. Again, I emphasise that the Health Committee is very much aware that this is largely a piece of work for the Justice Committee and one that the Health Committee has welcomed. <BR /> <BR />The Health Committee looked at the implementation and operation of the offence and welcomed debate on the need for additional training for front-line workers. The Committee welcomed discrete recognition in the Bill of the damage that can be done to children and young people by their seeing or hearing domestic abuse or by their being involved in abuse, such as when a child is used to contribute to emotional or psychological distress. That connects with the cross-cutting policy area of adverse childhood experiences.”
“Before the Question is put on clause 12 stand part, I would like to put two questions to the Minister, based on stakeholder concerns raised with the Health Committee. First, will she outline the safeguards that are in place to protect victims with mental health conditions from the inappropriate use of the reasonable person defence? Secondly, does she have any plans to review the operation of the clause?”
“The Committee was concerned that consideration should be given to help to avoid situations where people stay in abusive relationships through fear of losing their home. I welcome, therefore, the indication given in the Chamber that the Minister for Communities is considering that issue. <BR /> <BR />I thank the stakeholders who assisted the Committee with its deliberations around the parts of the Bill related to health. <BR /> <BR />The Health Committee has not formally considered amendment No 13 but would wish these objectives to be achieved by that or other means.”
“Paid leave could alleviate that pressure somewhat. <BR /> <BR />Thirdly, a key concern highlighted by stakeholders is the risk of homelessness. The Committee noted the inherent problem in expecting the victim to move out of the family home — often with children — as a key step in dealing with abuse. There is an added difficulty where, for example, the home is adapted to cater for disability. The Committee also acknowledged that the absence of sufficient refuge places could also limit effectiveness of the Bill. The Committee heard evidence from Women's Aid that refuges are usually running at 100% occupancy, while the Men’s Advisory Project stated that there are no refuges for men experiencing domestic abuse.”
“<BR /> <BR />First, the Committee agreed that the case has been made for speeding up and streamlining the handling of domestic abuse cases from start to finish. The victims of these crimes are particularly vulnerable. The abuse has a high and enduring impact, which can be compounded by protracted proceedings. A commitment to a shortened time frame could encourage people to come forward and make use of the new offence. <BR /> <BR />Secondly, the Health Committee was persuaded by the stakeholder evidence of the need for paid leave to facilitate victims of domestic abuse making arrangements to separate from their partner. For a victim to extricate themselves from such a situation creates enormous upheaval, and worries around finance and job security can tip the balance away from making the right choice for an individual or a family.”
“The Committee took evidence from Women’s Aid, the Men’s Advisory Project and the NSPCC, who flagged the range of areas in which more could and should be done to support survivors of domestic abuse, to ensure that the justice system does not exacerbate an already difficult situation for victims and to reduce the risk of people staying in abusive and dangerous relationships due to practical fears around financial support or losing their home. The regulation-making power proposed in amendment No 13 could create an opportunity to address some of the deficits identified, and I would like to set out three areas where this power could usefully be considered as a means of providing support.”
“<BR /> <BR />In speaking as the Health Committee Chair, I recognise that the vast majority of the work on this has been done by the Justice Committee. I am impressed by the level, quality and rigour of the debate tonight on every element of the Bill. It is a fascinating process to see the work that goes into that. <BR /> <BR />As Chair of the Health Committee, I wish to speak to amendment No 13, in particular, in this group.”
“I am delighted to speak tonight on this important legislation. Earlier in the debate, someone mentioned that this is possibly some of the most important legislation that will be considered during this mandate. That is absolutely true. In my previous career as a social worker, I became aware of the hugely pervasive and pernicious nature of this type of offence and behaviour in our society, so I am glad. I am also struck tonight by recalling that the first meeting that I attended officially after becoming an MLA was, in conjunction with my two colleagues here, Jemma Dolan and Seán Lynch, with Women's Aid in Enniskillen. We committed to try to do something, as MLAs, on the issue. I am pleased and proud to, at least partially, do that tonight.”
“Are there plans to bring that service to locations other than marts or to some of the harder-to-reach rural areas, Minister?”
“Go raibh maith agat, agus ba mhaith liom buíochas a ghabháil leis an Aire. What discussion is the Minister having with the Irish Government to mitigate the disastrous impact of Brexit? As he outlined, we are going into World Trade Organization terms in some situations. What discussion is he having to mitigate the impact of Brexit by ensuring that the North can benefit from current and future EU trade deals? I know that Mr Coveney has also raised that issue.”
“Paragraphs 7 and 8 of the statement make reference to the European Union. Given that we are still in the EU regulatory zone and, thankfully, retain full access to the EU market, does the Minister appreciate the importance of continuing to align with EU policies in order not to disadvantage our local farmers compared with farmers in the South and in other parts of the EU?”
“Will the Minister commit now to bringing forward a new health strategy to replace the failing test, trace and protect strategy?”
“I thank the Minister for his answers to those questions. I will observe, given the Minister's last answer, that our health service reached 106% capacity some weeks ago. The Minister is aware that the surge plan is to address a surge in hospital cases and transmission in the community; however there also needs to be a plan to suppress the spread of the virus in the first place. The first people who need that plan are the hard-pressed staff on the ground, and we owe it to them to deliver on that plan. I recognise what the Minister said about the inability to quickly scale up the vacant nursing posts or the ICU nursing, but what we could do and what we need to do, in my opinion, is to increase our testing capacity. We could recruit and train contact tracers at a quicker level.”
“I thank the Minister for coming to the Chamber to answer questions. Minister, you have referred to modelling and planning. What specific modelling and preparation did the Department do for the demand and uptake of the flu vaccine this year? When was that completed and by whom?”
“Go raibh maith agat, joint First Minister. Given the serious impact that the measures have on business and the fact that they are absolutely necessary in the absence of other public health measures, what supports are in place locally for business?”
“We have, as you said, heard from one company that has made progress. Can the Minister explain how that vaccine will be rolled out for those 255,000 people and what priority groups he is considering for it? Would it be for care home residents, Health and Social Care staff or those who were previously advised to shield?”
“We must now invest in our people's education, health, prosperity and well-being for the future and return that hope for the future to all of our communities and, in particular, our young people.”
“<BR /> <BR />Surely the lesson of COVID is that we must endeavour to do things differently. Perhaps, for a moment, we should be more optimistic and look at where society is now as a blank canvas, where we can be creative, thoughtful and humane in the policy decisions that we make from this point and build in the lessons and the understanding of inequality that we have developed as a result of everything in recent times. Although we do not have all the money that we would like to have, surely we owe it to our communities to create a new, more equal society by addressing the deep inequalities that confront us every day and returning hope for the future to all our people, but especially our young people, who have suffered so much at this time. Austerity is not the way forward.”
“They are a consequence of deep Tory cuts to the NHS over time. When the pandemic arrived, the devastation was worsened by the catastrophic cuts that we have all been talking about for 10 years and which, cruelly, came home to roost. Those are the same cuts that have caused workforce shortages, a lack of equipment and a crumbling health and social care system that is barely fit for purpose. We now urgently need to invest in and rebuild an effective public health system. That will require longer term planning, transformation and longer term funding. In that respect, I, too, am disappointed at the retraction from the commitment to longer term planning; health, in particular, requires longer term planning and budgeting to allow it to transform and deliver the service.”
“That remains a key area of concern that adds to pressure on staff each and every day. <BR /> <BR />As we navigate our way through the COVID-19 pandemic, we have been challenged by the deep structural problems in our economy and, in particular, in our health and social care system. We must now invest in and resource a properly functioning public health system that is able to deal with the pandemic. That will require investment in find, test, trace, isolate and support systems to a level that will operate at any given time and will be able to flex to meet the needs of positive cases that we see in the community in order to build in the protections for the health system. <BR /> <BR />The structural difficulties did not start with COVID-19, but they have been cruelly exposed by it.”