Liz Kimmins
Newry and Armagh · Sinn Féin · Northern Ireland
“I do not know how it will have affected North Antrim specifically unless the Member is referring to something in particular. We all have a responsibility in climate change and what we do to try to mitigate its impacts.”
“As the Member rightly said, removal of the zero-detriment policy is for the AERA Minister, and I have engaged with the Minister on that, as well as on the removal of the statement of regulatory principles and intent. I recognise that removing that would have detrimental impact on future development.”
“In response, we recently developed and introduced new appraisal guidance, which represents a significant and deliberate shift in approach. Under the previous arrangements, schemes were largely determined by a monetised cost-benefit ratio threshold where, typically, projects that fell below a ratio of one did not progress.”
“A number of significant issues have led to that scenario. I assume that the Member is referring to waste water capacity. I have said that NI Water has suggested that it needs between £3·5 billion to £3·6 billion for the next price control period.”
“Recruitment is a key challenge faced by all Departments. In questions to the Minister of Health, my colleague from Newry and Armagh referred to the recruitment issue that recently impacted on Daisy Hill. The challenge is not unique to DFI. I want to put a focus on ensuring that we build our internal capacity and improve staffing levels.”
“The Executive and the Assembly agree that the Executive's Budget is not adequate, which is why we are in that negotiation. When it comes to the capital budget, we have to factor in a timeline for the legal challenge that we are going through. It is unlikely that we will get a decision from the court on this side of the summer recess.”
The complete record
Every one of 2,530 lines we hold for Liz Kimmins, in date order, each linked to its source. Free to read, in full, without an account. Page 40 of 51.
“I thank the Minister for his statement. Like other Members, I believe that there is still a lot to digest. We need to read the full report, and we will probably have more questions on the back of that, but I welcome its publication. We have been waiting for it for some time. It crystallises the vital role of midwives and their expertise. That is important, given that they will have an increasing influence in shaping and delivering safety and quality of care and services. <BR /> <BR />Minister, in that vein of safety and quality of care and services, which is a key theme in the report, there is a note that the immediate focus needs to be on the stabilisation of maternity and neonatal services.”
“I thank the Minister for his answer and for giving way. Minister, I want to understand the value of the engagement that has happened. Are you satisfied that that is doing what it should be doing?”
“The value of the provision of the excellent palliative care that is delivered by the Children's Hospice goes much further than just a bed. We must give all the children and their families the highest quality of care at that time of their lives and support them through all stages of that difficult journey.”
“It has consistently ensured that it was as self-sufficient as possible, with a large part of its financial income coming from charitable donations. However, with a hugely challenging economic climate, along with cuts to its non-recurrent funding, its ability to continue to deliver those full respite services has become unsustainable. Palliative and end-of-life care should not be a "would like"; it should be a necessity. It is something that we really must move to secure, especially for babies and children, through some of the most difficult times of their lives. <BR /> <BR />The Assembly recognises the enormity of the budgetary situation, and we will continue to fight for the funding that we are entitled to and deserve to deliver those public services. However, we must not be penny wise and pound foolish.”
“I visited the Children's Hospice on several occasions over the past year and saw at first-hand how critical the service is for those who will, unfortunately, need to use it during their young lives. The importance of the provision of palliative care has been agreed as a priority for the Health Committee, and we intend to launch our inquiry into palliative care in the coming weeks. That important piece of work will include an exploration of the funding models for hospices. <BR /> <BR />For the Children's Hospice specifically, the abrupt decision of the Department in June 2023 to end funding that helped to provide invaluable respite to children and families is one that it has worked extremely hard to manage.”
“<BR /> <BR />The role of the Children's Hospice in the North is therefore vital for the hundreds of babies, children and their families who are cared for each year through its antenatal, inpatient, community, social care and bereavement services. Therefore, any dilution or reduction in those services has significant ramifications for those families who rely heavily on their support whilst they are dealing with their child's diagnosis, coupled with the financial, social, emotional and psychological impacts that come with having a child or sibling with a life-limiting illness. <BR /> <BR />Palliative care should be viewed as a quality-of-life treatment. The specialist palliative care provided by the Children's Hospice should be non-negotiable for the children and their families when it is needed.”
“I thank the DUP for the motion and the Alliance Party for the amendment, both of which we support. The issue has touched all of us, and we understand the huge challenges that surround it. <BR /> <BR />Many parents and family members will become carers for their loved ones who are suffering from terminal and life-limiting illnesses. One in two people is affected by cancer at some stage in their lives, and for many families who receive the devastating news that their child has a terminal illness, their worlds are shattered. That news can come at any time: during pregnancy, after the birth of their child or later in a child's life. It throws parents and families into a whole new scenario that many of them could never have imagined and many subsequently struggle to navigate.”
“I thank the Minister for her answer. Acknowledging baby loss in legislation is crucial, so I am grateful for that. Minister, will the scheme go out to public consultation?”
“I thank the Minister for his answer. Early engagement with a second language has benefits educationally and psychologically, as well as for employment prospects for children and young people. If the budget allows this in the future, will the Minister consider reviewing the funding for that?”
“<BR /> <BR />The Committee endorsed the policy merits of the statutory instrument as well as the technical amendments that the instrument makes to the regulations regarding the dissolution of Public Health England and the Health and Social Care Board. On 3 October, the Committee agreed to recommend that the statutory instrument be approved by the Assembly.”
“The Committee sought information from officials at the briefing on 12 September on the model to be used to administer the medicine, and the Committee welcomes the move towards an increasing use of the nasal spray, which is considered to be a harm-reduction model. The Department assured the Committee that the infrastructure is already in place in the North to deal with the expansion of those who can supply naloxone, mainly through work by the Public Health Agency and its take-home naloxone programme, which is a regional scheme that has operated since 2012. The Public Health Agency will have a crucial role in the implementation of the legislation, including the roll-out of training.”
“In 2022, opioids were involved in 60% of drug misuse deaths in the North of Ireland. As the Minister outlined, naloxone was used 1,861 times in 2023-24, reversing an overdose in 1,765 cases. It is sad that we have such high levels of overdose and drug addiction in our society. For families who have, sadly, lost people to overdose, the loss is devastating. The more people in the community who have this medicine, the more lives can be saved. <BR /> <BR />The Committee supports the powers in the legislation being enabling rather than mandatory. They allow the supply of naloxone without a prescription. The Committee supports the inclusion of safeguards that establish mandatory training requirements for new services and professionals.”
“The regulations will allow people who work for the police, the Prison Service, probation services and youth justice services, as well as registered healthcare professionals, to supply naloxone products, provided those individuals have undergone appropriate training. Secondly, national registration services may be established to enable other services and professionals not named in the legislation to register and procure naloxone. Allowing a much wider range of services, healthcare professionals and organisations to supply naloxone on a take-home basis for use in a future emergency that involves opioid overdose could significantly reduce the number of deaths from opioid overdoses. <BR /> <BR />The Committee heard that drug misuse deaths have doubled in the UK since 2012.”
“Officials advised that anyone could administer naloxone hydrochloride in an emergency; that it is considered a very safe medicine for the recipient and the person administering it; but that, although the medicine is widely used, current legislation allows only drug and alcohol treatment services to supply it to individuals for future use, which limits the reach of the life-saving medicine. <BR /> <BR />The Committee is content with the two key changes that the statutory instrument is intended to bring about. First, it intends to expand the list of services and professionals named in the regulations who are able to give out naloxone without a prescription.”
“I welcome the opportunity to confirm the Health Committee's support for the motion. As the Minister outlined, the statutory instrument amends the 2012 Human Medicines Regulations, the set of laws that regulate the licensing, manufacture, wholesale dealing and sale or supply of medicines for human use. <BR /> <BR />Departmental officials briefed the Committee on 12 September and advised that the instrument would expand access to naloxone products: life-saving medication that can reverse the effects of an overdose caused by natural or synthetic opioids.”
“I do not think anyone here underestimates that, but, if we are serious about transforming our health service, a fit-for-purpose, high-quality social care system is key.”
“<BR /> <BR />A number of things need to be addressed if we are to see the reform that is needed, but critical to this, first and foremost, is the workforce. I welcome the ongoing work of the Social Care Collaborative Forum in conjunction with other stakeholders — for example, the Northern Ireland Social Care Council and others — to make the caring profession more attractive but also to place appropriate value on carers as key people in our social care system, which will also allow for career progression and the development of skills. I look forward to hearing further information on the progress of workforce planning from the Minister. <BR /> <BR />I appreciate the huge challenges before the Minister and his Department.”
“<BR /> <BR />The failure of our system to deliver accessible, reliable and quality care for individuals and to support their carers and families cannot be allowed to continue. We need to see the changes that are needed implemented at pace to avoid the further deepening of the crisis unfolding before us. As someone who has worked in adult social care, I have never seen the scale of the challenges that we see now, with families waiting months to secure what would previously have been seen as a basic care package. That is simply not acceptable, and we should not normalise it, particularly as the onus then falls on unpaid carers, who are already giving everything to deliver care for their loved ones.”
“That is often due to the unavailability of beds, which is causing bottlenecks in our EDs. That can largely be attributed to the inability to source care packages and care home placements to discharge medically fit patients from hospital. <BR /> <BR />While the motion focuses on the need to make urgent progress on the work of the Social Care Collaborative Forum, it is important that we emphasise that not only is this impacting on individuals requiring care and their families and carers but the knock-on impact on others in need of urgent and unscheduled care is huge, as well as the additional pressure and distress for many staff — in hospitals and in the Ambulance Service — who often feel powerless as they wait to get patients into the hospital, often for a long time.”
“<BR /> <BR />Just last Thursday, I, along with some other members of the Health Committee, visited the Ambulance Service dispatch headquarters, where we heard directly from the people in the control centre taking ambulance 999 calls and calls from paramedics working on the ground. We heard clearly about the precarious situation that the Ambulance Service often finds itself in and about the difficult calls that those staff have to take, which involve keeping people on the line for significant periods while they await an ambulance to attend to them. That is coupled with the prolonged waits outside our emergency departments, and it is shocking that those waits are often for longer than 24 hours, with patients seeing numerous shift changes as they stay in the ambulance until they can be transferred into the hospital.”
“I thank the Alliance Party for tabling the motion and the DUP for tabling the amendment, and we will support both. It is clear that the issue is critical to ensuring that our health and social care systems continue to function efficiently and effectively and deliver a much higher quality of life and better outcomes to people requiring care and to their families and carers. As with the subject of the previous debate, it is clear that the adult social care system requires significant transformation in order to deliver properly for some of the most vulnerable people in our communities. Having a fully functioning social care system will also ensure that our hospitals can sustain an efficient patient flow from the front door to the back door, as the Member who spoke previously outlined.”
“I thank the Member for giving way. Does she agree that the implementation of top-ups not only makes it even more difficult for families who are not in a position to pay those fees but restricts the choice for many people who do not have that family support or whose family simply cannot afford it?”
“That action needs to be taken without drift or delay. <BR /> <BR />I look forward to the debate today. I commend the motion to the House.”
“<BR /> <BR />The Health Committee implores the Minister to take the action that is needed to bring about meaningful and lasting change. As Professor Jones recommends in his report:”
“We all know that reform is needed. Professor Jones's report makes that point clearly. We now need to progress that reform at pace. <BR /> <BR />In the motion, the Committee calls for the Minister to work collaboratively with the community and voluntary sector, which knows the needs of children and young people. Organisations and charities in the sector were the constant in the lives of those children and families. While social workers were challenged and overstretched and changed frequently, the community and voluntary sector was there in the difficult times. We need to utilise the expertise, innovation and agility of the community and voluntary sector to respond to the needs of our most vulnerable children and families.”
“We ask the Minister to commit to driving forward the change that is needed with urgency. The most vulnerable children in our society deserve better. Delay has a profound impact, and change will come too late for many of the young people who need our support. That was heard loud and clear from the review findings. <BR /> <BR />I want to emphasise that the Health Committee does not underestimate the extent of the changes required to transform children's social care services, but the time for change is now. When Professor Jones briefed the Health Committee in June, he said something that resonated with the Committee about the need to drive forward real and tangible change:”
“Professor Jones shared with the Committee his frustration at the slow rate of progress when he briefed us in June. <BR /> <BR />At last week's Committee meeting, we heard from representatives of the Reimagine Children's Collective. The collective is a collaboration of 10 charities working with children and young people and their families. Its goal is to advocate for the implementation of the independent review's recommendations. I thank the collective's representatives for attending last week's meeting and for laying out, in sometimes stark terms, the urgent need for transformation and reform. <BR /> <BR />It is important to emphasise that, despite the challenges described, the organisations that we heard from believe that transformation is possible and that it is possible to make lasting change.”
“We welcome the establishment of the Department's children's social care services strategic reform programme and commend the Department for progressing that in advance of the review's conclusion in order to begin to strategically address the range of challenges that evidently exist in children's social care. <BR /> <BR />At our meeting on 26 September, the Committee noted the most recent update on the work that the reform programme has undertaken since its establishment in April last year, including actions that relate to nine programme work streams. However, as individual members and as a Committee, we have been advised by children's social care stakeholders that the impact of the programme of work is not yet being felt by those on the ground who work directly with children and their families.”
“The Department also accepts that change will create the conditions that encourage social workers and social care workers into a career in children's social care. The Committee agrees, and that is why we have made children's social care services a priority in and a focus of our work programme. As a Committee, we believe that we can use our role to maintain focus, emphasis and pressure to ensure that the reform that is needed is progressed by the Department. The Committee can think of no better priority than to support the changes that will improve the lives of our most vulnerable children and families.”
“His passion to see the review recommendations taken forward to effect real change was evident to Committee members. The report contains 53 recommendations. Whilst the majority of the recommendations fall within the responsibility of the Department of Health, the Committee recognises that a number of recommendations cross into the policy responsibility of other Departments. A number of the recommendations are significant, including recommendation 7, which is to establish a region-wide children and families arm's-length body, and recommendation 39, which is to appoint a Minister for children and families. <BR /> <BR />The Department has acknowledged that the review report provides a robust road map that will facilitate improvement and deliver better outcomes for some of the most vulnerable children and young people in our society.”
“The report, which was published in June 2023, was the culmination of 16 months of endeavour that included wide consultation and engagement across the children's social care sector. It is very evident from the review report that the contribution of the children, young people, parents, carers and social care workers with whom Professor Jones engaged heavily shaped the review's conclusions and recommendations. Professor Jones and the children's organisations that we have heard from emphasised that children and young people want to be involved and engaged in the ongoing outworkings of the review. We ask the Minister to ensure that his Department makes that commitment going forward. <BR /> <BR />In June this year, Professor Jones briefed the Committee on the findings of the review.”
“<BR /> <BR />The Health Committee knows from its meetings and contact with children's stakeholders that our services are overwhelmed and struggle to meet the demand. It is therefore unsurprising that the independent review of children's social care services carried out by Professor Jones found that we have a higher rate of children being referred to children's services than England, Scotland and Wales; a higher proportion of children in need of help; a higher proportion of children with child protection plans in place; and a record number of children in care. None of that is anything to be proud of. <BR /> <BR />I put on record the Health Committee's appreciation for the work of Professor Jones, his advisory panel and the secretariat that was involved in carrying out the review of children's social care services.”
“One of the most alarming consequences of that is that a total of 1,479 cases were still waiting to be allocated to a social worker: that is 1,479 children. Following that, when the Committee met representatives of NIPSA in June this year, we heard harrowing reports of how matters had deteriorated further since the publication of the review report. That included reports of instances in trusts of no existing social work teams, children not having a social worker assigned to them and, in other trusts, social work teams operating with a less than 50% complement of staff. The Committee agreed that the situation puts children and staff at immense risk and cannot continue, and we subsequently wrote to the Health Minister to ask that that be addressed as a matter of urgency.”
“We understand from a recent written briefing from the Department that the latest unpublished figures show that the number of children in care has risen since March 2023, and the figure now sits at 4,134. That is an increase of almost 9% in just 18 months. Growing demand for services, increasing complexity of need and serious workforce-related pressures, including high levels of staff vacancy and high absence rates, all add pressure to an already struggling service, and, without a workforce, no plans will be deliverable. <BR /> <BR />At our meeting on 21 March this year, the Committee was extremely concerned to hear from Department of Health officials that, at the end of January 2024, there was a combined vacancy/absence rate of 358 social workers across the five trusts.”
“Let me begin by first acknowledging that the scale and magnitude of the challenges in children's social care services are well rehearsed and widely accepted. The pressures and challenges that exist in the provision of children's social care services predate the damaging impact that the COVID pandemic has had. Indeed, in the independent review of children's social care services, Professor Ray Jones, who led the review, observed that the difficulties in children's social care services were both "systemic and endemic". <BR /> <BR />The report outlined that children's social care statistics showed that, on 31 March 2023, 22,875 children in the North were known to social services as a child in need; 2,171 children were listed on the child protection register; and 3,801 children and young people were in care.”
“Minister, given that the neurology scandal saw the biggest patient recall on the island, what lessons have been learned about the lack of oversight and management of Michael Watt? Will the Minister consider bringing forward an individual duty of candour for all Health and Social Care (HSC) staff?”
“Minister, you will be aware of a very serious situation that occurred over the weekend of 21 September, when Daisy Hill Hospital maternity unit was forced to divert all admissions to Craigavon Area Hospital until the Monday morning. The Southern Trust cited staff shortages as the reason. What urgent steps will the Minister's Department take to ensure that the maternity service workforce at both Daisy Hill and Craigavon is stabilised and secured for the long term to ensure that that situation does not arise again?”
“Will the Minister therefore confirm that the key performance targets will be based on patient, clinician and, importantly, nursing and healthcare staff experience as well as focusing on securing better outcomes? We need that breadth of knowledge to deliver the framework properly and ensure that we achieve what it sets out to do.”
“I welcome the Minister's statement. As he knows, we have been waiting for it for some time. It is a positive step forward, and I welcome that he has said that there will be engagement with a range of people. <BR /> <BR />The draft framework states that it will require:”
“It is not only changing the lives of thousands of people for the better but is undoubtedly saving our health service huge amounts of money in the meantime. <BR /> <BR />The cuts to the core grant funding programme have, once again, left the sector under intense pressure, and we all saw how detrimental that was when the European social fund ended last year. We run the huge risk of losing excellent services and, even more importantly, experienced and highly skilled staff who cannot be expected to continue living with the uncertainty that stop-start funding brings. In the grand scheme of things, this is a relatively small amount of money that goes a long way, and it is essential that it is protected; otherwise, the cost to society and to our health service will be much greater.”
“They responded by developing bespoke services that, I have no doubt, have saved many lives since their inception. Just last Friday, I was delighted to attend the Crisis Café's open day in Newry. That service is led by young people to deliver mental health support to other young people. We heard the testimonies from some of the young people who had previously engaged with the Crisis Café's services when they were struggling with their mental health. Following the success of the support that they received, they are now helping to support others when they experience similar difficulties. To me, that shows the real value of our community and voluntary sector. We simply cannot afford to lose the professionalism, the expertise and the efficiency that the community and voluntary sector delivers, needless to say, often at low cost.”
“Not only that, but the community and voluntary sector is extremely agile and, more often than not, can shape the services that it provides to meet the changing needs of the communities that it operates in. We saw that during COVID, and I see it every day on the ground in my constituency and across the North. That is particularly important in mental health provision, where statutory services are stretched beyond capacity and the community and voluntary sector has stepped in to deliver bespoke mental health services to meet the needs of the people in the area. <BR /> <BR />We have some of the most effective and impactful services, such as the Crisis Café and PIPS Hope and Support in Newry and The Well in the Mournes in South Down, which recognise the serious crises that are affecting the communities around them.”
“The community and voluntary sector is a crucial part of our health service. It delivers services that not only fill the gaps in service provision but are often a lifeline to the many people whom they support at the grassroots in all our communities. In my constituency of Newry and Armagh, we are lucky to have a community and voluntary sector that is extremely vibrant and plays a significant role in strengthening our communities and supporting some of the most vulnerable people in our society. It often does that on a shoestring budget, time after time demonstrating value for money and effectiveness in tackling the core issues that affect people's lives.”
“I thank the Minister for his answer. There have certainly been benefits where the zones are in place in my area. Will the Department consider Killean Primary School in my constituency as part of the roll-out of any future tranche of such zones? We have been lobbying for some time.”
“I thank the Minister for his answer, particularly as we approach the first anniversary of the flooding, which decimated Newry city and parts of South Armagh. Will the Minister give some more information on the regional community resilience group, please?”
“What preventative actions will be taken as a result of the framework and delivery plan to help end violence against women and girls?”
“Gabhaim buíochas leis an Chéad-Aire as ucht an fhreagra sin.”
“<BR /> <BR />Last week, we had a debate about the transformation of our health service, and that will undoubtedly be hugely challenging in the financial climate. However, there are lots of things that we can do, and one of the key focuses is workforce, because without a workforce — I mean a stable workforce — we will have no services. We see the implications of that every day across our social work services and in nursing, where we see staff shortages and their consequences for services and for delivery to patients and service users. Whilst we appreciate that the Budget is difficult, that the Finance Minister has done an incredible amount of work and that the Health Department has the largest amount from the Budget, we have to ensure that we maximise that to achieve the greatest potential for all our citizens. I will end on that.”
“I thank the Minister for bringing the Bill forward again. <BR /> <BR />I do not want to rehash previous debates, but we are in a position that, as a result of Tory austerity, is undoubtedly very difficult, and we see, with the current British Government, that the situation is not looking positive now either. However, it is important to remember that we have to make sure that we work with the financial envelope that we have, particularly from a health perspective, which is the area that I am party spokesperson for and am dealing with through the Committee. We need to see plans, and we need to ensure that the financial envelope that we have is put to the best use so that we can deliver for patients and staff across the North in the short term.”
“I thank the Minister for giving way. That point is important, because proper consultation and engagement are vital to bringing communities with us. If people understand what to expect and what the outcomes will be, they are more likely to appreciate the reason for change. Does the Minister agree, given his recent visit to Daisy Hill Future Group, where he saw the impact of proper co-design, that that is valuable?”