Colm Gildernew
Fermanagh and South Tyrone · Sinn Féin · Northern Ireland
“I thank the Minister for his statement. I have been working with Dungannon Chamber of Commerce and Industry. It will welcome this work, particularly in light of its concerns about vacancy and protecting the retail heart of towns such as Dungannon.”
“I thank the Minister for his answer. Minister, you said that there has been an improvement. However, recently, there were reports of over 1,400 patients waiting more than 28 days. How will you ensure that trusts consistently meet the targets for suspected cancer appointments in particular?”
“However, the Committee will want to examine carefully how any new or amended powers would operate in practice. Powers relating to information sharing, official warnings, directions, removal from office and disqualification can have significant, long-standing consequences for charities, trustees, staff, volunteers and, indeed, public confi…”
“<BR /> <BR />The regulations are consequential to the uprating order and provide the supporting technical changes needed to ensure that the revised benefit rates operate correctly. The regulations increase the earning limit for carer's allowance from £196 a week to £204 a week.”
“In response to those findings, Minister Hargey introduced the Charities Bill, which was enacted in 2022. The legislation put in place many of the review's priority recommendations in the limited time remaining in that mandate. The Charities (Amendment) Bill represents the next stage of that reform programme.”
“The Committee will wish to explore the implications of those changes, including for organisations operating across jurisdictions or delivering charitable activity in or from the North. Our charity sector includes a diverse range of bodies.”
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“I will speak first about the resource budget. The 1%, or £50 million, savings target for trusts, previously flagged as risky, remains a significant challenge, not least in the context of coronavirus but also because of assumptions that previous savings would be recurrent, despite the Department's acknowledgement that there was little evidence to back that up. The Committee has now been advised that the Department is bidding for £15 million of additional resource to address around half of the projected unmet financial pressures in trusts. Officials did state, however, that there can at times be reduced demand towards the end of the financial year, and that may alleviate remaining pressures somewhat.”
“I welcome the opportunity to reflect on the Committee's considerations. Further to briefings that we received in April and June, the Health Committee was updated last week by departmental officials on this year’s financial situation in Health and Social Care. Once again, our briefing was couched in terms of the ongoing uncertainty of the situation given the rising and ongoing COVID-19 pressures. <BR /> <BR />By way of overview, while the budget for 2020-21 saw a rise of 4·7% and the Department has benefited from subsequent in-year allocations, Members will be aware that significant pressures remain. Our lengthy waiting lists are well documented, most New Decade, New Approach transformation commitments remain unfunded, and the pressures on the system continue to rise.”
“Ba mhaith liom buíochas a ghabháil leis an chomh-Chéad Aire as an ráiteas seo. I thank the First Minister for coming to make the statement today. While it is beyond doubt that these measures are now absolutely necessary and, indeed, urgently required, it is also the case that they will, as the joint First Minister mentioned, have implications and knock-on impacts. The system that is in place to test and trace has struggled to cope. Will the Executive use this opportunity to reboot and put in place an effective find, test, trace, isolate and support system and ensure that every element of that system is working so that we do not find ourselves back in this place again?”
“Does the Member agree with me that the recurring issue of fracking and these processes hang like a sword of Damocles over communities in relation to health and safety and well-being, and that legislation is what is needed to deal with this issue?”
“Given that uncertainty, what assurances can the Minister give that the replacement funding will be secured?”
“<BR /> <BR />In my role as Sinn Féin health spokesperson, I reiterate that there is a large body of worrying evidence on the spread of coronavirus and its potential and actual impact on the health service. We know that, in normal years, our health service operates very tight to capacity at times over the winter. We now have the additional element of COVID impacting on admissions and, critically, hospital staffing levels, which will face challenges. We also see an increase in the virus in care home settings. Many of our health services have limited capacity and must be protected. We all recognise the need to protect all the other services, and the Minister has acknowledged that he is working hard to do that. On behalf of the Committee and my party, I indicate support for the regulations.”
“He explained that "community transmission" was a broad category, comprising a range of settings, including sports and hospitality but not workplaces. The Committee has requested a further breakdown of the evidence on transmission, although we understand that it is often impossible to be categorical about where the virus was acquired. We will discuss the information gleaned through contact tracing with the Public Health Agency this week. <BR /> <BR />I reiterate the Committee's unwavering commitment to working constructively with the Minister and our solidarity with all those working to provide leadership and clear public messaging at this critical time. I again encourage everyone to stay informed, to reduce their social contacts, where possible, and to continue to observe the basic precautions of washing hands and social distancing.”
“They further pointed out that a "vulnerable person" was deliberately undefined, to allow for reasonable interpretation. <BR /> <BR />A member suggested rightly that isolation, as distinct from pure caring needs, should be further considered in terms of the exemptions and current limits to forming linked households. The Chief Environmental Health Officer again offered to give that issue further thought. <BR /> <BR />The Committee discussed with officials the growing body of evidence regarding transmission of the virus. The Chief Scientific Adviser told us that, whereas it initially seemed that the majority of infections resulted from household transmission, at present, the largest volume of cases appeared to occur through community transmission.”
“<BR /> <BR />The Committee sought and received an assurance from officials on the communication of future directions. <BR /> <BR />Considering the rules on linked households or "bubbles", the Committee discussed with the Examiner of Statutory Rules the necessity and proportionality of prohibiting a household from forming a new bubble with a second household, should a first bubble break down. While members recognised that the exemption would be open to abuse if there were no restrictions, we asked officials to consider the merits of amending the legislation to enable a new bubble to be formed after a safe time had elapsed. <BR /> <BR />Helpfully, officials reminded the Committee that, in addition to linked households, a further exemption existed to allow a vulnerable person to receive care and support in their home.”
“Again, that must be considered in the light of my earlier point about access to departmental analysis. <BR /> <BR />The Committee would want me to stress, I am sure, our understanding of the need to be agile in such difficult circumstances, but the question is whether this is the right balance between agility and scrutiny. Further to discussion, we remain uncertain that laying new SRs to adjust the restrictions, as has been the case in dealing with all other restrictions, would be unworkable. The Committee has asked the Department to look again at that approach and to use directions only where absolutely essential. I note that the increased restrictions in Derry and Strabane were brought in by statutory regulation, and, on behalf of the Committee, I welcome that approach, which is sounder.”
“The second challenge for the Committee is that the regulations provide that subsequent changes to the list of postcodes covered could be done by direction. As Members know, that means that there is no Assembly or Committee oversight; indeed, the directions listing new postcodes were placed on a website and not even copied to the Committee. The Committee might have had less concern if the directions were making minor technical arrangements, but they have a significant impact on people's families and lives. I want to be clear that the issue is not the merits of the enhanced restrictions or their legal validity but how reasonable it is to extend significant legal obligations to different communities by simple ministerial decision without any possibility of the Committee or, indeed, the House asking questions or taking a view.”
“For the avoidance of doubt, I say that that scrutiny allows us to play a role in assessing what measures have had an impact and what lessons can be learned for the future. We are not undermining the fact that many of the restrictions are necessary; we are saying that we want to be able to learn and to implement the lessons as a result of having good evidence and applying our scrutiny function. Moreover, in view of the impact that the regulations have on people's lives, there are benefits to be gained in being as transparent as possible about the underpinning analysis on which the regulations are based in terms of securing and maintaining all-important public buy-in at this undoubtedly difficult time.”
“The Health Committee believes that it should be equipped with all relevant information so that it can perform its statutory duty to scrutinise the legislation that comes before it.”
“Whenever regulations come before the Executive, Ministers weigh up the merits of the proposals based on advice from senior departmental officials, who, we are advised, trawl a range of scientific papers and present a summary indicating the rationale and, presumably, modelling, anticipated costs and impact of the measures. <BR /> <BR />The Health Committee, on the other hand, has been asked to come to its view without access to that critical information. That is all the more important, given the haste with which some measures are having to be put in place, with no time for consultation. Despite challenging the adequacy of the information that was provided on a series of regulations, officials could not advise whether the Committee's request for access to relevant papers has been relayed to the Executive.”
“As outlined by the Minister, these regulations put in place the enhanced restrictions that initially applied to a limited number of areas that were defined by postcode and that have since been extended. <BR /> <BR />While it is acutely aware of the need for effective measures in order to curb the rising infection rates, the Health Committee found these regulations challenging and considered them on two occasions before coming to a view. While we agreed to lend our support today, the Committee also agreed that I should put on record a number of concerns. The first challenge was access to the evidence, modelling and advice behind these and other coronavirus regulations.”
“I want to start by reflecting on the very grave situation that the Minister outlined on the number of cases and the doubling of some of the key metrics at a rate that is of significant concern. I give my condolences to everyone who has lost a loved one since the start of this as a result of COVID-19, and our thoughts are with those who have tested positive in recent times, given all the anxiety, stress and difficulty that that brings to them and their family. <BR /> <BR />I thank the Minister, his officials and the wider health and social care workforce for their relentless work on our behalf to tackle the pandemic, keep us safe and protect our health service and the vast array of services that are delivered daily without fanfare.”
“Joanne Bunting has steered it, and I am privileged to be included as part of it. It is an area that we need to give some really serious consideration to. <BR /> <BR />I also know that you, a Cheann Comhairle, have worked with Marie Curie on issues arising from that. The motion is in keeping with our party's policy, and I certainly support it.”
“We all know of people who were told that they had a particular length of time to live: some did not live to see that time; others far outlived it. This is an area where we really could make a difference. <BR /> <BR />We have had recent debates in the Chamber on dementia and a number of other conditions. Largely, we speak with one voice on many of these very difficult issues. I know that the Minister will be looking at how we can change things here. It is not straightforward. I understand that Scotland has been looking at its approach, although it is not quite there yet. However, I am sure that we will take advantage of all the learning that comes from best practice, wherever that may be, and seek to apply it here. I welcome the fact that we have recently seen an all-party group being set up in the Assembly.”
“I support the motion. I acknowledge the work and the long campaign undertaken by Marie Curie, the Motor Neurone Disease Association and others. <BR /> <BR />I have experience, similar to Paula's, of working with families in this situation in my social work role. Often, I was struck by how many things were going on at any given time with families. They were trying to plan for what was a very difficult situation. They were trying to juggle their finances. Carers often ignored their own appointments and care needs. Sometimes, they could not get around to thinking about benefits and trying to navigate their way through that system. <BR /> <BR />It is true that many people do not want to know how long they have left. Anyway, the information can be so inaccurate that, as mentioned, it is meaningless in some cases.”
“In closing, I am sure that colleagues will join me in expressing solidarity with a workforce that has endured so much and that is now buckling down to help us to meet the challenge of the coming weeks, as the virus is spreading and circulating. I ask everyone to consider all the front-line health and social care workers and their protection and to protect themselves and each other.”
“It essentially encourages young people to take a chance and exhorts older and vulnerable people to take themselves out of society in order to protect themselves, and those are not approaches that we can accept. <BR /> <BR />I ask the public to continue to abide by the restrictions. I recognise that they are difficult, onerous and not to be taken lightly. The Committee for Health does not approve of them lightly; it is because they are necessary to deal with the pandemic. Faoi dheireadh, a Phríomh-LeasCheann Comhairle, tá mé cinnte de go mbeidh gach duine d'aon ghuth liomsa agus ár ndlúthpháirtíocht a chur in iúl don lucht oibre a d'fhulaing an oiread sin agus atá anois ag tabhairt aghaidh ar an dúshlán atá amach romhainn.”
“The Committee has had and continues to have regular briefings from the Minister, and it is seeking to play a constructive role in scrutinising the response to the pandemic while promoting an adherence to the regulations and guidance and helping to assist in the communication of changes to the rules. <BR /> <BR />I will make a few remarks in my role as Sinn Féin's spokesperson for health. I think that it is notable today that the Minister has set out some of the impacts that this has had. It makes me angry when I see people on street corners extolling people to not take this seriously and to not abide by the regulations because it is all some kind of a conspiracy, and I think that that is extremely dangerous.”
“While the Committee did not raise any specific concerns in relation to this rule and agreed to support its confirmation, the focus of discussion remained, as it has for some months, on the clarity, communication, rationale and data underpinning the overall approach to restrictions and their relaxation. <BR /> <BR />Tá an Coiste i mbun cainte go fóill leis an Aire agus tá siad ag iarraidh tuilleadh sonraí faoin fhianaise ar a bhfuil cinntí sna rialacha reachtúla atá ag teacht chun tosaigh bunaithe. The Committee remains in dialogue with the Minister and is seeking to obtain more detail on the evidence base that underpins the decisions that are reflected in the statutory rules that are coming forward.”
“Go raibh maith agat, a Phríomh-Leas-Cheann Comhairle. Seo muid arís i mbun díospóireachta ar srianta a mhaolú nuair atá líon na ndaoine ionfhabhtaithe ag méadú agus srianta eile á maolú. Once again, we find ourselves debating relaxations to restrictions at a time when, sadly, infections are rising and further restrictions are actively under discussion. <BR /> <BR />The Committee for Health considered this statutory rule on 24 September and was advised that it amends the regulations by removing soft-play areas from businesses, services providers and premises that are required to close. The briefing and discussion addressed this rule and another which is to come before the House at a later date.”
“<BR /> <BR />Can the Minister tell us more about what is different for care homes this time around and what plans are in place to ensure, for example, safe discharge from hospital into what we recognise as the very vulnerable setting of care homes?”
“I welcome the ongoing work on the dedicated day-case and orthopaedic centres and the commitment to protect services from shutdown as much as possible while recognising that there are issues with orthopaedics in the Western Trust. <BR /> <BR />Minister, the Committee has heard that one of the key differences in places that have fared better than here in suppressing the virus is the availability of isolation facilities to provide people, such as those in high multiple-occupancy houses or younger people, with support where they find it difficult to isolate at home or to return home to isolate. Is the Minister willing to look into that? It may be something that we can improve upon.”
“Go raibh maith agat, Minister, for coming to the Assembly to make the statement and for taking the time to meet me and the Deputy Chair earlier to discuss Health issues. <BR /> <BR />I join you in offering condolences to all who have suffered the loss of loved ones as a result of this horrible virus. I also recognise that, hopefully, we are in a different place this time. While we face a very worrying situation, we have an active test-and-trace system in place. It is crucial that it keeps pace with demand in the time ahead and meets the challenges that it is facing. I also hope that we are in a different place with PPE.”
“Minister, given how vital healthcare workers are to dealing with the pandemic, what plans do you or your Department have to expand testing to all staff and not just to test those who are symptomatic?”
“In relation to the point that Keith Buchanan has just raised, I note that today, as a civilisation, we have crossed the horrendous threshold of 1 million deaths around the world from COVID-19, so it is clearly not false. <BR /> <BR />I acknowledge that, by and large, the majority of people are abiding by the restrictions, which are onerous in themselves at times, and we should recognise that. However, it is clear that the test-and-trace system, which is a key component of fighting this virus, has been under pressure in recent times and may well come under additional pressure as we move into the winter months. Are there any plans to develop and build bespoke additional capacity in the system here to deal with the pressures that we are now facing?”
“<BR /> <BR />The motion rightly focuses on the urgent need for early diagnosis for the young, but I am sure, a Cheann Comhairle, that you will not mind my mentioning that it is also important that older people get access to timely audio diagnosis. Just last week, we debated a motion on dementia, and the Assembly was supportive of the need to develop dementia-friendly communities. However, there is growing evidence that late diagnosis and intervention for older people experiencing hearing loss can be a factor in the onset of dementia. I hope that the Minister will keep that in mind. I welcome the support from all sides of the House for the motion and urge everyone to support it.”
“Improving their economic prospects lifts people out of poverty. As we have discussed in the Assembly, inequality harms the individual primarily, but it also harms the community and our economic development, which is relevant across the sphere. Poverty is a costly alternative to early intervention for life changes, future health profile and public health. I am aware that there is significant research evidence in the United States and elsewhere that every pound invested in early years can, over a lifetime, save up to £17. That is a crucial area for intervention. <BR /> <BR />I note that the National Deaf Children's Society has noted its disappointment at the lack of detail in trusts' phase 2 plans for audiology and implant services.”
“I had started out believing that deafness and hearing difficulties were an absence of sound, but, actually, they can also be confused or intermittent sounds that can be very disorientating and could easily, as was mentioned, have an impact on mental health. That is a concern as well. <BR /> <BR />Studies show that early access to language, whether through sign or interventions that improve hearing, allows a child to develop an understanding of how language works. That means that they are hearing or reading-ready when they begin school and can map their understanding of how language works onto the written page. If we give a child the right tools and support, they will close the gap between non-hearing and hearing pupils and, as a consequence, improve their future economic chances.”
“It is something that we can and should do something about. I recognise that the Minister has, in Committee and in other places, flagged up his interest in dealing with health inequalities. I also recognise that COVID-19 has impacted on our ability to deal with health inequalities as we would have liked. However, I ask that we guard against people slipping further back, as Alex said, and that we try to protect those who are vulnerable at this time. <BR /> <BR />The development of language and communication skills is vital to children. During my training as a social worker, we had the benefit of sensory impairment training.”
“I welcome the interest shown in the motion and the tone of the debate. I would welcome any reassurance that the Minister can give the Assembly, the deaf community and the wider public that any backlog in diagnostic audio testing, which is fundamental to gaining access to interventions such as sign, cochlear implants or other social or medical support, will be identified and addressed as quickly as possible. For young people, the earlier the intervention, the better the outcome. I think that that is widely recognised across education, health, in communities and all sorts of areas. The earlier we get in, the greater the impact and the greater the difference. <BR /> <BR />There is evidence that many children with hearing impairments do less well in education than their hearing peers. That is not inevitable.”
“I thank the Minister for her answer. Does the Minister agree that the appointment of the new commissioner presents a renewed opportunity to progress all the Hart recommendations, particularly with a focus on the apology?”
“On a point of order, Mr Speaker. I would like to draw your attention to an issue that arose in the Chamber last Tuesday. Mr Allister made assertions about me that were completely unfounded and untrue. When he realised that I had not attended the Thomas Clarkes game, he made further assertions, which were equally unfounded and untrue, that I had attended a public gathering. I ask that those assertions be withdrawn and apologised for unequivocally in the same manner in which they were made, and I would like the Speaker to rule on that issue.”
“The best tribute to those who have died and promise to those who are suffering must be that we act together to prevent further incidents at all costs. I wish the Minister well and look forward to detailed engagement.”
“In keeping with that, the Committee will want to see the report of the inquiry as soon as possible and support and highlight the lessons learned and key public health messages arising. It is also important to state that, as we see increasing transmission of COVID-19, learning the lessons of outbreaks will be vital. <BR /> <BR />I have been contacted by families, and it is not an exaggeration to say that they have been devastated.”
“The Committee will want to know what has been learned or is still to be learned about the type and use of personal protective equipment (PPE) in these circumstances, for example, or about other infection control measures, the interaction between health professionals or the approaches to testing and monitoring: essentially, what is required to ensure that patients and staff have the protection and support that they need as we face into the coming challenging months. <BR /> <BR />The Committee has sought to play a positive role in scrutinising the pandemic response, feeding through the challenges on the ground and seeking to hold public bodies to account while making a constructive contribution to decisions.”
“While we must allow the SAI to run its course and not prejudge its findings, nevertheless, I hope that the opportunity will be taken for early and widespread sharing of any preliminary lessons learned, with a view to reducing the risk of outbreaks elsewhere. I was pleased to note the Minister's commitment to that rapid learning process in the Chamber yesterday. <BR /> <BR />The Health and Social Care workforce and leadership have been on a rapid learning curve with the virus since the start, and so much more is known now than six months ago. That mindset has never been more valuable.”
“Having worked tirelessly throughout the pandemic, the workforce must be feeling demoralised and upset that harm should come to the very people that they are trying so hard to help. I realise that they are also bearing greater pressure due to the resulting staff absences. <BR /> <BR />The Committee has welcomed the announcement of the level 3 serious adverse incident inquiries in the Southern Trust. The process, however, can be lengthy and has been challenging for families in the past. It is important that families are involved centrally from the outset, updated regularly throughout and provided with all the support that they need at this time and in the future.”
“Go raibh maith agat, a Cheann Comhairle, agus go raibh maith agat arís, a Aire, as bheith i láthair. I thank the Minister for attending the Chamber on what have certainly been a couple of very long days to address major health issues. On behalf of the Health Committee, I extend sincere sympathy to those who have contracted COVID-19 in Craigavon and Daisy Hill hospitals and, in particular, to the families of those who have died following hospital-acquired infection. I know that their loss is compounded dreadfully in these circumstances and that there is so much hurt and understandable anger among relatives. <BR /> <BR />I must also acknowledge the distress and disappointment felt by the health care staff and leadership, dozens of whom have also been infected in the line of duty.”
“We have discussed the theme of confusion. Can I highlight the issue of the many foreign nationals who work and live here, and who are already struggling to keep up. They are often some of the most marginalised and vulnerable in society. I know you have indicated that materials have been issued in some languages. In my constituency of South Tyrone, there are, potentially, fourteen languages, though some are spoken by smaller pockets of people. What direct engagement has there been with those communities, or can you expedite communication directly with their leaders?”
“Go raibh maith agat to the Minister for coming to the Chamber to answer this important question for urgent oral answer, which is reflective of people's views and concerns. Given the new restrictions and measures that have had to be taken now, does your Department plan to review or revisit the guidance around visiting in care settings, particularly maternity services and care homes?”
“The Member should note that the GAA makes a fantastic contribution to our communities. If he takes a look at Dungannon's COVID response, he will see that Thomas Clarke's club provided assistance to vulnerable people throughout the pandemic.”
“The Member should check his facts before he comes to the House and makes assertions. I was not at the game.”
“I am just reflecting on what you said about these being common sense. It needs to be said that, while there are elements of common sense, we must be conscious that we are asking the public to do things that are extraordinary. These are unprecedented times, and we should not minimise or dismiss the impact that it is having on the public. We should provide a clear rationale and provide them with the support that they need.”
“Go raibh maith agat. I thank the Member for giving way. The clarity of the messaging has been mentioned several times today, as has the level of support provided to people to self-isolate. However, I previously asked the Minister a question about his Department's spend on the public messaging campaign. He has not had an opportunity to answer, but maybe he can give us some information on that today, as well as information on what has been spent on providing support for people who need it to self-isolate.”
“Our response should be led by public health, and I welcome any co-operation between the health agencies and the PSNI that emphasises that message. <BR /> <BR />Finally, we could easily get stuck into the details and the exemptions. It is important to keep in mind the real and lasting impact that the regulations have on members of the public, but we must also bear in mind the risk of further spread of the virus and work together to do what we can about that.”
“<BR /> <BR />We also need to keep it in mind that, when the Assembly introduces restrictions and duties, it must also provide support, whether that be providing masks or supporting the delivery of vital public services. I am conscious today of the situation at Daisy Hill Hospital and Craigavon Area Hospital. We have many front-line workers fighting the virus every day, and they deserve our support and encouragement. Hospitals are dealing with COVID cases, and we are worried about them. However, we will support them to get the equipment, guidance, policies and principles that they need to protect themselves and their patients. <BR /> <BR />It is one thing to put in place restrictions and the means to enforce them, but it is sometimes more difficult to provide a comprehensive system of support.”