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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“Many sacrifices have been made during the pandemic by our health and social care workers, to whom we are indebted. It is not enough to applaud on a Thursday evening, even though they are richly deserving of applause; we need to make every effort to rebuild our health and social care system, to recruit substantial and appropriate numbers of health professionals and to pay them fair wages. I once again urge the Minister of Health to address the issue of strike pay for health and social care staff. That money has been allocated by the Finance Minister; it should be paid immediately to provide staff with the recognition of our appreciation for their efforts on behalf of us all, during and prior to the COVID pandemic, and in recognition of the serious staffing concerns that their strike action highlighted.”
“During the COVID-19 crisis, we learned of students who could not access learning materials because they did not have the broadband access. There are 97,000 poorly served premises across the North, largely in rural Fermanagh, Tyrone and south Derry. <BR /> Poor broadband and mobile-data services continue to marginalise our rural communities and create another deep inequality in our society. If that is not addressed, it will contribute to increasing problems in dealing with health and the use of technology that could provide benefit in the areas of health and the economy. Students, patients, businesses and families who live in rural communities are entitled to, and must have, equal access to technology as their success is vital to sustaining those rural areas.”
“First, we learned how much we depend on what we formerly categorised as low-skilled workers: those who sell us our groceries; serve our food; drive our buses; clean our buildings; and, crucially, form part of the system that delivers health and social care from the ground up. Surely, part of the lesson, apart from the gratitude that we should and, undoubtedly, do feel, is that those workers deserve better working conditions and fair pay. Those who staff the front lines are the most needed and valuable workers in our communities. <BR /> <BR />Any economy planning must address the deep infrastructural inequalities west of the Bann. Connectivity is regarded by many as an essential utility — a basic utility in any modern society — and we need to provide it across all areas of the North.”
“I have already addressed the Assembly on the Health Committee's considerations, so I will not go over those comments again today. I make these remarks in my role as Sinn Féin health spokesperson. <BR /> <BR />The backdrop to our discussion today on the Budget is an unprecedented health crisis with which we continue to struggle. We face the economic uncertainties that have been brought about by the pandemic and by the instability that is hurtling towards us in the form of Brexit. We are not in a good place — there is no question about that — but we could make progress towards a better place if we had the political will. <BR /> <BR />The pandemic has afforded us lessons that we will, hopefully, learn from.”
“First, I apologise to you, a LeasCheann Comhairle, and to the House for my phone going off earlier. I thank the Minister for the information that he has given and for the undertaking that there will be a review of the processes involved. Will he raise with his Executive colleagues the need for the basic pieces of information that Committees are seeking to apply their scrutiny to be available and for officials who come to Committee to have basic information such as the R number at any given time or the impact of measures on it? That would provide not only the Committees with the opportunity to carry out their scrutiny role but the public with the confidence that the measures that are being taken are necessary and are best-positioned to deal with the virus.”
“Does the Member agree that the quest for evidence is not only to assess whether what was done was necessary, but whether what was done was enough? We need to be very conscious that we should take all the help and expertise we can get, from wherever around the world it comes, and stop this nonsense of trying to unpick the measures as to whether there was enough evidence. We are not an exemplar, and there is plenty we can and should learn.”
“The Minister advised that this will be reviewed by the face coverings working group, but noted that prolonged close contact is more likely on a school bus than in a retail situation. <BR /> <BR />A further issue that came to the attention of the Committee was the current loss of close contact services, such as massage, for those suffering from a range of conditions. Officials advised that, where such services are ancillary to health and social care treatment, they remain permitted. However, written advice supplied after the meeting confirmed that this is confined to services commissioned by health and social care. The Committee further enquired about enforcement, and awaits a reply on this matter.”
“There appear to be a range of circumstances between requiring masks in indoor settings generally and "very prolonged close contact" situations, so I am not sure that this fully addresses the point raised, but I leave it to other Committee members to elaborate on. <BR /> <BR />We are advised that the face coverings working group has considered, but not recommended, free provision of face coverings. The Minister’s letter also restates that evidence overall suggests that the use of face coverings reduces transmission of the virus, but cautions that improper use diminishes or eliminates their benefits, alluding also to limited evidence of harm through individuals paying less attention to other mitigations. Members challenged the inconsistency in junior pupils having to wear face coverings on school transport but not in retail settings.”
“We asked whether it might be beneficial to adopt a more straightforward approach, requiring face coverings in indoor settings more generally; whether any analysis had been undertaken of the impact of improper use of face coverings; and whether there had been consideration of providing face coverings free of charge. Written advice received after the meeting asserted:”
“Officials were not able to provide detail, and the subsequent letter referred the Committee back to the update of 27 October, by which point the R number in new cases was estimated to have fallen below 1, though it was acknowledged that this was likely to have resulted not just from the first 10 days of the North-wide restrictions but from the earlier restrictions in the Derry and Strabane council area. The junior Minister may be able to provide a more up-to-date picture for us in relation to that today, and we would welcome it. <BR /> <BR />Members also considered the further requirements to wear a face covering and made a number of enquiries.”
“The Committee agreed to write to the First Minister and deputy First Minister to request a review of the process of dealing with pandemic-related regulations. The Committee is keen to work in a constructive and timely fashion, but also to perform its scrutiny in a meaningful way. The use of a ministerial statement to announce the restrictions created an opportunity for preliminary discussion and enabled questions to be asked from a range of perspectives beyond health. <BR /> <BR />I turn to the detail of the regulations. The Committee asked a number of questions on Thursday that could not be answered by officials but which have since been addressed in correspondence received on Friday evening. Noting that amendment No. 8 has largely been revoked, the Committee sought to explore the impact to date of amendments No. 9 and No. 10.”
“The 28-day period for scrutiny is designed to compensate somewhat for the urgent process, creating a little breathing space for the Committee to observe the regulations in action, and to question officials on the early weeks of their operation, before coming to a view. That space has allowed stakeholders to contact members with queries and comments that have informed scrutiny and, on several occasions, resulted in subsequent regulations being made to address flaws and issues identified. <BR /> <BR />Members discussed the challenge, particularly in public understanding, of debating regulations a number of weeks after they have come into effect and, sometimes, after they have been superseded. The provision of appropriate supporting documentation is one important step that would assist the Committee in conducting its scrutiny more quickly.”
“<BR /> <BR />As I previously advised the House, the Committee has raised with the Minister of Health and health officials on a series of occasions now the challenge of conducting post hoc scrutiny in the absence of supporting documentation that informs the Minister's recommendations and the Executive's decisions on whether to agree the regulations. Under the current process, the Committee considers it reasonable to expect clear information on the advice supporting the consideration of regulations, including models of their anticipated impact, and it has requested that papers be supplied for such regulations as a matter of course.”
“I will begin by, first of all, acknowledging that we have crossed a very sad milestone, as the statistics agency records on COVID-19 have now gone beyond 1,000 deaths. That is a very sobering milestone to have reached, and it sets the context for our discussion today. <BR /> <BR />I will raise a number of points on the process by which these regulations are made and the impact that that has on scrutiny before I turn to the detail of the regulations. As usual, due to the pandemic, these rules have been made and come into effect subject to post hoc scrutiny. As I outlined before, the absence of engagement on policy development, stakeholder responses to consultation or impact assessment means that the Committee's scrutiny after the regulations are made is both more difficult and more important.”
“I, too, acknowledge the brilliant work done by Middletown. I have had the opportunity to visit it and meet the people involved. <BR /> <BR />Minister, there have been significant failings in special educational needs provision here in recent years, and, as a consequence, thousands of our young people have been seriously let down. Given that SEN provision was discussed at the North/South Ministerial Council meeting, can the Minister tell us what difficulties exist in that area in the South and what can be learned from its response to those difficulties?”
“What other options is the Minister considering to assist tenants into home ownership?”
“Go raibh maith agat, Minister. It will be no surprise that I will mention Fermanagh and South Tyrone, parts of which have huge housing stress. I welcome the statement. This is truly a once-in-a-generation shakeup of housing here and is long overdue. <BR /> <BR />Minister, I know that you recognise the problem of homelessness and that not all homelessness is necessarily rough sleeping. However, at the start of the pandemic, your Department's efforts in relation to homelessness were second to none. What work is being done now to ensure that the tackling homelessness strategy is not just successful but sustainable?”
“Does the Member agree that we have heard several times of parents choosing to opt for transfer? However, in many instances, it is not really a choice in that if your classmates, your friends, your cousins and everybody from round your neighbourhood are going to a particular school, it is really the only choice. Therefore, it should not really be considered a choice at all.”
“Gabhaim buíochas leat, a Aire, as an fhreagra sin. Obviously, we would much prefer to see the Stormont House Agreement mechanisms implemented in full, owing to the pressures that legacy puts, as you said, on the resources of the PSNI and the Police Ombudsman. However, I am sure that the Minister understands that many of the families have been waiting for many decades for the investigations to be completed, including the family of Roseanne Mallon in my constituency. Will the Minister confirm whether any funds are ring-fenced to deal with legacy and whether any of that will fund the Police Ombudsman?”
“Can the Minister update us on the work that is being undertaken by the Executive to strengthen the messaging on enforcement and compliance in order to combat COVID-19?”
“Given the importance of access to vital equipment, including ventilators and extracorporeal membrane oxygenation (ECMO) machines, with all the adequately trained staff that are required to operate that equipment and to deliver that care, can the Minister outline how he intends to ensure accessibility to this vital equipment and care as we move into the second surge?”
“I thank the Minister for his answer. I, too, would like to acknowledge the commitment and work of Alex Easton on the Health Committee, and I welcome Jonathan Buckley to the Committee. The situation today is that we have now had 624 deaths as a result of COVID. I want to pass on our condolences to each and every family that has lost a loved one as a result of the virus. I am acutely conscious that, as we stand here today, we are now at 95% occupancy rate in the hospital system and that we have only 16 ICU beds available.”
“Will the Member acknowledge that a Minister from his party shared in the Chamber yesterday the information that there have been 1,500 positive cases in schools?”
“Our role and responsibility in the Assembly and in the various Departments through which we work is to improve outcomes, including health outcomes, for all.”
“Proactive spending on preventative programmes such as smoking cessation, early childhood intervention and health education are cost-effective measures, as they save significant amounts of money further down the line. <BR /> <BR />Previously, Sinn Féin asked for the population needs assessment across a range of areas. We received a high-level needs report that did not tell us much about the particular needs of people. Without knowing what those needs are and without some idea of where we can get the best outcomes, there is a real possibility that money will not be spent effectively. The central question, for me, when devising a health budget is this: does the budget address the prevailing and persistent issue of health inequalities? <BR /> <BR />Everyone is entitled to good physical and mental well-being.”
“The ambition of Delivering Together is to guarantee that the user of the health and social care system is listened to as they play a central role in developing and implementing new services and care pathways. Any serious effort to transform our health and social care services must be thorough and must be resourced. There can be no satisfactory health and social care transformation process unless the deep and lasting health inequalities across the North are tackled. With nearly half of the Executive's Budget being spent on health, it is vital that we ensure value for money. In health, value for money must be about reducing health inequalities, improving life expectancy and improving the quality of life. A little well spent goes a long way.”
“They provide support, often on an unpaid basis, for thousands of older people and those with disabilities. Carers suffer higher levels of ill health. Almost one in five carers provides substantial care of over 50 hours per week and feels that they are in poor health, as compared with 14% of the non-carer population. It is remarkable and disgraceful that carers are one of the few groups in our society that have received no additional support to date throughout the pandemic. I know that you are prepared to look at that issue, Minister. Today, I appeal directly to the Minister of Health to bring forward measures, as a priority, that will make a real difference for carers right now and in the weeks and months ahead. <BR /> <BR />I move on to transformation. Michael Marmot, in his famous report on health inequalities, stated that:”
“The COVID pandemic has had a disproportionate impact on people from Black, Asian and minority ethnic (BAME) groups. Recent statistics from the Intensive Care National Audit and Research Centre (ICNARC), including data from England, Wales and the North, show that, since the start of September, 38·6% of individuals who are critically ill in intensive care with COVID are from BAME backgrounds. Individuals from those groups are also more likely to face housing challenges, which may exacerbate COVID-19 transmission, morbidity and mortality. They are also more likely to work in key worker jobs with a higher risk of exposure and to report being more likely to use public transport to reach their place of work. <BR /> <BR />Carers are also hugely important in our society.”
“<BR /> <BR />According to the Office for National Statistics, patterns of death from COVID-19 also correspond with patterns of deprivation, with deaths in more deprived communities more than double those in the least deprived communities. The ONS data shows that differences in risk of death from COVID-19 are partly the result of socio-economic disadvantage and other unexplained factors. Department of Health figures reveal that the infection rate in the 10% most deprived communities is one fifth higher than the 10% least deprived communities and that the infection rate among those aged over 65 is almost two fifths higher in deprived areas. That amounts to 1,027 per 100,000 versus 750 per 100,000 population between the most and least deprived areas.”
“Those living in the most deprived areas have about 60% to 80% more heart and respiratory disease and strokes. In addition to that, significant alcohol, smoking and drug-related inequalities continue to plague the North: for example, alcohol mortality and alcohol-related hospital admissions in the most deprived areas are four times that of the least deprived areas. We are all aware of the famous study that demonstrated that you can board a bus in Belfast, travel a short journey across the city and expect to live a significant number of years longer and more healthily as a result of where you live. Those issues must be tackled.”
“Large inequalities continue in mental health indicators, with rates of suicide and self-harm almost three and a half times higher in the most deprived areas. Prescription rates for depression and anxiety are relatively high across the entire North, although the rate in deprived areas remains two thirds higher than in the least deprived areas. <BR /> <BR />The 'Bamford Review of Mental Health and Learning Disability' found that poor mental health affects one in every four citizens here. The review concluded that there is clear evidence of inequalities in the investment associated with mental health and learning disability over many years compared with England, Scotland and Wales, despite higher levels of mental ill health in the North.”
“Various public health studies have found that health is strongly linked to education, employment, housing and income. <BR /> <BR />In my comments, I am merely trying to provide a snapshot of the health inequalities experienced by different communities across the North. Men and women in more affluent areas can, on average, expect to live longer than their peers in more deprived areas. Those living in the most deprived areas have about 60% to 80% more heart and respiratory disease and strokes, a twofold excess of accidents and a threefold excess of lung cancer. Across the North, there are alarming levels of disparity in incidences of infant mortality, childhood obesity, oral ill health, pulmonary and respiratory disease, substance abuse and addiction, and mental health and well-being between the most and least deprived communities.”
“Having addressed Committee issues yesterday, I speak today in my role as Sinn Féin's spokesperson for health in order to address health inequality issues of which we are all conscious. Health inequalities can be adequately addressed only by focusing our actions and our allocation of financial resources on the wider social, economic and environmental determinants of health across various Departments. Health inequality here remains a costly scourge on our health services and our communities, and it must be tackled through targeted funding and programmes that will enhance the health of all our people. Tackling health inequality must be central to any forward planning to rebuild our health services in the North. Poor health limits people's ability to develop life skills through education, careers and professional development.”
“Maybe it is now time to revisit the test, trace and protect strategy and to put in place a robust and fit-for-purpose find, test, trace, isolate and support strategy that works with industries, businesses, communities and the public in a way that meets the needs of a rigorous and appropriate public health response to COVID-19.”
“Although limited, it gives an insight into new cases per postcode area. A quick glance should be enough for anyone to see the correlation between deprivation and the current high levels of cases in those areas. It is, perhaps, telling that some Members have ignored poverty and deprivation and, unfortunately, chosen instead to attempt to focus on religion or politics. It is important that those who are opposed to increased restrictions and the current circuit-breaker approach recognise that the measures are necessary to buy time, to reduce the chains of transmission and to give our already hard-pressed public health services the time that they need to rebuild in order to stay ahead of the virus.”
“If a duty is to be placed on the public and on the hard-pressed hospitality sector to collect information, there must be a concurrent responsibility on public health authorities to use it effectively and with purpose and urgency. <BR /> <BR />I have mentioned the reality that the regulations have been affected by the changing circumstances. The rates in the North continue to be deeply concerning, in particular the impact on lower-income earners and areas with higher levels of deprivation. As of today, Members, we have 820 new confirmed cases and 261 inpatients with COVID-19. We have 80 care homes with active outbreaks and 29 people in ICU with COVID-19. It is also interesting that additional information has now been made available by the Department of Health dashboard.”
“Recently, it moved to a "Digital First" approach, which is essentially a text message to tell someone that they have to self-isolate for two weeks. It does not provide any support or advice, and there is no human voice to reassure and direct people to further necessary support services. <BR /> <BR />We also have the concerning issue of identifying how many numbers and contact details that have been given to the hospitality sector are incorrect or where contact tracers were not able to get through to someone, leading to gaps in knowledge for tracing efforts and impacting on our efforts to break the chain of transmission. I illustrate that concerning fact to highlight that none of the regulations can be taken in isolation; they must interlink to provide an effective suite of measures to fight the spread of COVID-19.”
“That is important, as it shows the lengths that we have to go to for a joined-up, effective strategy to tackle the spread of coronavirus. <BR /> <BR />Maybe it says something that, over seven months into the public health crisis, there is only now a requirement to collect contact-tracing information. However, what I am concerned about is that, as the hospitality sector has additional responsibilities and requirements placed on it, the public systems, such as contact tracing, are not being built up to support it. Just last week, the Health Committee heard how the Public Health Agency had grossly underestimated the demand on contact-tracing services. It estimated 300 cases a day, but, in reality, as we now know, contact tracers face some 900 cases a day.”
“Although the rising number of COVID-19 cases has superseded the regulations, it is still important that they are considered in full, given the aforementioned impacts that they will undoubtedly have. I will refer to all the regulations together as, although they make different changes, they mainly relate to hospitality premises: our pubs and restaurants. <BR /> <BR />Requirements on seating arrangements, the playing of music and dancing are not to be taken lightly. I understand the impact that the regulations have on the hospitality sector and on many communities and livelihoods, including those of the singers, musicians and artists who rely on live performance for their income. I refer in particular to the creation of a requirement to collect visitor information, names and contact details.”
“While, once again, the Committee fully recognises the extreme pressures under which the Health Minister, the Executive and all officials are working, the Committee was unable to complete its role and regrets that it is, therefore, not in a position to advise the House today. <BR /> <BR />I would now like to make a few remarks in my role as Sinn Féin's health spokesperson. It is no coincidence or surprise that the vast majority of the House's time has been taken up in dealing with the COVID-19 health protection regulations. It is a fast-changing and dynamic situation with serious impacts for all our society and across the community. I speak as the Sinn Féin health spokesperson, as the Committee did not take a view on the regulations.”
“<BR /> <BR />The Committee asked whether it would not have made more sense to revoke the regulations before us today and remake them at a time when the Executive deem them safe to bring into force once more. The Committee would then be in a better position to consider that question on the basis of conditions at that time, which remain very uncertain. The official stated that that was a possible approach but could not say more. <BR /> <BR />In light of the limited information before us and with no assurances in terms of criteria for reopening wet pubs, the Committee therefore declined to come to a view.”
“<BR /> <BR />We also enquired about the period during which the regulations were in operation and how their impact was monitored and measured. The official advised that the Chief Scientific Adviser and the Chief Medical Officer provide a weekly update to the Executive but he does not have sight of that advice. He could not comment on any consideration given by the Executive to the Scientific Advisory Group for Emergencies (SAGE) advice of 21 September in relation to the risks associated with reopening wet pubs. The Committee restated its previous concerns at the lack of supplementary evidence and advice coming to the Committee to facilitate our scrutiny of the regulations. The official undertook to see what evidence he could provide of the impact of the regulations to date.”
“<BR /> <BR />Because of the fast-moving situation, the Chief Environmental Health Officer was not in a position to advise the Committee whether today's regulations would be revoked in light of Wednesday's announcement or whether the new regulations would require an amendment to the provisions under consideration today. The Committee asked about the circumstances in which they would become operable — in other words, the criteria, whether defined by R rate, prevalence of the disease or other factors being used to determine when it will be safe in public health terms to reopen wet pubs. The Chief Environmental Health Officer advised us simply that the decision would be taken by the Executive on the basis of a basket of indicators.”
“Because of the nature of the confirmatory process, the regulations reopening and regulating so-called wet pubs were in force for a period before consideration by the Committee last week. By last Thursday, however, they had been overtaken by events, in that, on Wednesday, the new four-week restrictions were announced. Members were keen to understand the implications for the regulations and the circumstances in which they would resume operation. The Committee is acutely conscious of its responsibility to play its part in considering the merits and implications of the many regulations being brought forward to manage the crisis.”
“Go raibh maith agat. Thank you for that answer. What lessons have been learnt over the past eight weeks in order to improve support for schools with high absences and to help schools to keep functioning when they return from the extended break?”
“The resources are required to cover PPE, the Nightingale hospital, surge planning, testing, staff costs, rebuilding services and the digital rebuild, which is a range of IT solutions to enable HSC to resume services in a way that is safe for patients and staff. <BR /> <BR />Needless to say, there remains much uncertainty about the further costs of the pandemic in the months to come. The Department has therefore advised us that its capacity to rebuild services will depend on the nature and severity of the pandemic over those coming months. <BR /> <BR />I conclude my remarks as Health Committee Chair there and will contribute as Sinn Féin's health spokesperson in tomorrow's debate.”
“Pre-existing workforce shortages have been exacerbated, and that is an issue that takes years to solve, given the long lead-in times, despite a touchingly positive response to the workforce appeal, which has brought hundreds of workers out of retirement at a time of need and at a time when we deeply appreciate that effort. <BR /> <BR />The current estimated cost of the crisis is around £900 million. In addition to previous allocations, the Department hopes to draw down a further tranche of £526 million of funding from a centrally held pot now that it has completed a required needs assessment. The Department has identified unmet capital pressures of £33 million to deal with COVID pressures and has submitted a bid for further resource in that area.”
“It exceeds, although not by much, the £81 million projected requirement to stand still, but officials also stated that transformation has become an element of all services, not just the dedicated transformation projects. Transformation remains key to safeguarding the future of our health and social care system. That level of funding is simply incapable of delivering the scale of change required. Nevertheless, some comfort can be drawn from the undoubted innovation and determination seen in continuing efforts to transform services even while we are in the midst of a pandemic. <BR /> <BR />It is clear that the entire budgetary discussion is dominated by COVID-19 pressures. Those pressures impact on capacity, irrespective of how much money could be allocated in the coming months.”
“<BR /> <BR />The Committee has been advised that, owing to a failure to secure end-year flexibility on funding for the Encompass project, the resulting requirement to absorb the £48 million cost from this year's capital budget has created unmet pressures for estate maintenance, equipment and fleet. The Department is therefore bidding for additional resource in that area. Officials acknowledged that current uncertainties create major risks to projects at or near building stage, where the Department may not be able to spend as planned. <BR /> <BR />The Department now expects to spend around £94 million on transformation projects. Although that is a tiny fraction of the £6 billion budget, it is significantly more than the Department expected to have available at the start of the year.”
“<BR /> <BR />Upon the return of the Assembly, we were advised that £30 million was required to address red-flag and urgent cases of elective care, plus a further £50 million to clear the backlog of long-waiters, yet the Department sought and received only £10·3 million in June for that purpose, because of COVID pressure on capacity. It is now seeking a relatively small additional amount of £1·5 million. <BR /> <BR />The Committee has sought an updated projection of waiting times and hopes that the dedicated day-procedure centre at Lagan Valley Hospital will help ease some of the pressures. Pressures from staff costs have resulted in a further £6·7 million bid for resource for an inflationary pay increase being implemented across here, England, Scotland and Wales.”