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.”
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“I thank him for that. <BR /> <BR />One conversation is missing from the whole debate, and it is about the houses and homes that were affected by the flooding. They are part of the economic recovery, so it is pertinent to the debate. A very small number of homes across South Down and Newry and Armagh have been impacted, and they have been absolutely devastated. I have been dealing with a small number of families in my area who have been completely forgotten about. Yes, the nuts and bolts and fixtures and fittings of a home are so important, but, in some situations, it was life and death. I dealt with a family who were right beside Newry canal but were left to get themselves out in the pitch black at 4.00 am, with no response coming to them.”
“We need to find out what worked well and what did not, but that will require all relevant Departments to put their shoulder to the wheel and to make sure that we learn the lessons and deliver to ensure that it does not happen again. <BR /> <BR />I thank my colleague Conor Murphy, the Economy Minister, for bringing forward the scheme. It is important to note that it is now three weeks since the restoration of the Executive and the Assembly, and the turnaround in the scheme has been fairly efficient. Many of the businesses in my constituency have been waiting four months for something to be brought forward. I feel that the Minister has listened to the businesses; he has certainly listened to those that he and I have engaged with on the ground from day 1 and that made very clear what their needs are and how they could be addressed.”
“I want to particularly mention Newry business improvement district (BID) in the city centre, which made a Trojan effort to support all the businesses across our city. Many of those businesses are still closed. As recently as this afternoon, I spoke to some of the businesses in Newry that do not know when they will be able to open due to the damage. That damage is sometimes not only directly in their premises but in adjoining premises, impacting access. <BR /> <BR />It is clear, as others said, that we need a cross-departmental approach for dealing with the situation, because we need to look at so many elements of it. We need to find out why it happened.”
“I thank the Member for securing the Adjournment debate. Like the previous Member to speak, South Down is not my constituency, but Newry and Armagh were particularly badly hit as well by this unprecedented event. Others will agree that it was something that we have never seen before. Parts of Newry city centre and south Armagh saw unforeseen devastation, and they are dealing with it to this day. It will be a long time before they fully recover. <BR /> <BR />It is important to pay tribute to the significant community response that we saw. It was definitely a case of all hands on deck. I was on the ground from the morning of the flooding, and it was incredible to see the community come together.”
“We continue to lose junior doctors to other jurisdictions that can offer better pay rates. In addition to pay, if we want to try to retain the staff whom we currently have, what steps is the Minister taking to address the significant burnout that many junior doctors experience on a daily basis?”
“I thank the Minister for his answer, although it is very disappointing, given that the scheme he referred to is 17 years old, and we are now dealing with much higher costs. A number of families in my constituency are still out of their homes as a result of the flooding and their inability to get flood cover in their house insurance. Will the Minister review his decision and agree to consider a dedicated financial support scheme, as the Department for the Economy is doing for businesses in phase 2, to enable people to get back into their homes?”
“I thank the Minister for giving way. I know that he has a lot to get through, and I take his point about investment. Does the Minister agree that the proposal by my colleague the former Finance Minister, Conor Murphy, of £1 billion as part of a three-year health budget would have gone some way to tackle the situation that we find ourselves in today?”
“I thank the Member for giving way. His time is running out, so I will make just a quick point about access to GPs. As other Members have said, when people are on a waiting list for a long period, they start to develop other conditions that will require them to present to their GP or at an emergency department more often. Does the Member agree that we should use all the tools that are readily available to reduce waiting lists in the here and now, including the reinstatement of the cross-border healthcare directive, which we know has been very successful and works well for our constituents right across the North?”
“I thank the Member for giving way. She raises a very important point, and it comes back to the workforce. Therein lies the problem. To start to address the workforce crisis, we first need a plan to do this, and we need to see that plan. I understand that there are reviews going on, but we need to see a plan published, and we need the proper funding to support this. That is why we need to continue making that case to the British Government to be properly funded here so that we can deliver on all these things.”
“If we do not have the staff required to deliver the services that are needed — that means the domestic staff in our hospitals, theatre nurses and doctors, specialist surgeons and consultants, auxiliary staff, domiciliary care staff and rehab staff; all those staff, who cover a wide variety of roles, with whom a patient will come into contact on their journey before, during and after they receive the surgery or treatment that they have been waiting for — the problem will only get much worse. <BR /> <BR />It is positive that the Executive have prioritised public-sector pay, and I hope that that will go some way to ensuring that we can retain the fantastic staff that we have and, in the longer term, attract staff to fill the thousands of vacancies that continue to exist in every corner of our health service.”
“I thank the Member for her intervention. That point is critical. As she said, Daisy Hill is a hospital that is close to both our hearts, but it is a very important hospital in our hospital network. It can offer so much to tackle the issues that we are dealing with today, with the fantastic staff and services and, most importantly, its key location in an all-island respect. That is a very important point. <BR /> <BR />Fundamentally, if we are to tackle the huge problem of waiting lists, we need to address the workforce crisis impacting across our health and social care system.”
“People face unprecedented waits for the surgeries and treatments that they badly need, inevitably causing their overall physical and mental health to decline further and creating additional pressures on our already struggling health service. <BR /> <BR />In 'New Decade, New Approach' (NDNA), commitments were made to prioritising tackling waiting lists, yet five years later, not least due to cuts to the fund by over £30 million in an effort to manage budgetary pressures and as a direct impact of the COVID pandemic—”
“It will mean learning from best practice across our trusts and from further afield. It will mean the need for a fully resourced multi-year budget. It will mean training and recruiting more surgeons, doctors and nurses. <BR /> <BR />In the coming weeks, the Committee will hear about waiting lists from the Minister, the Department, the trusts and other key workforce stakeholders. The Committee will undertake its scrutiny role, and we look forward to considering any action plan that is brought forward by the Minister to address the issue. <BR /> <BR />I will now make some remarks as Sinn Féin health spokesperson. As we have discussed, waiting lists have continued to soar, particularly in the past years. We have seen some shocking figures over a short time.”
“Waiting times can be a bit of a postcode lottery. For example, if you live in the Belfast Health and Social Care Trust area, 33·8% of people will wait longer than 26 weeks for diagnostic tests, whereas it is only 13% in the Northern Health and Social Care Trust area. We need transformation of the health system and long-term investment in the health service to allow the capable and committed surgeons, doctors and nurses to deliver the services that they want to deliver. We need to ensure that we have the right infrastructure and resources to treat our most vulnerable people. <BR /> <BR />We cannot allow people to go on waiting lists and get progressively worse while they wait for the treatment that they need, but that means that we need to take tough decisions on services.”
“Unfortunately, due to the size of the lists, people are waiting for record times. The number of people who have to wait over 52 weeks for an initial appointment or treatment is at an all-time high. The figure for people waiting over 52 weeks for ear, nose and throat treatment is as high as 69·8%. As individuals wait on the lists, their conditions get worse. People experience pain, and they are understandably concerned about their condition. That has an effect on well-being and mental health.”
“<BR /> <BR />Owing to the size of the lists, it can be easy to get lost in the statistics, but, in reality, each of the numbers is an individual in our families and communities. Each case is on a list for a reason and needs to be seen by the experts as quickly as possible.”
“We therefore cannot keep doing what we are doing and expect lists to get shorter. <BR /> <BR />As of the end of September 2023, 428,858 patients were waiting on a first consultant-led outpatient appointment. That figure is up from 127,095 in March 2014. That means that, in nine years, almost one in four of our population is waiting on a first consultant-led outpatient appointment. We have 115,929 patients waiting for inpatient or day-case treatment, which is up from 49,341 in 2014. That is one person in every 16 of our population waiting for treatment. We have 188,850 patients waiting for diagnostic tests. That is over twice what the number was in 2014, which was 69,042. That is one in 10 of our population waiting for tests.”
“I welcome the opportunity to make some remarks as Chair of the Committee for Health, before speaking as my party's health spokesperson. <BR /> <BR />Tackling waiting lists will be a key priority for the Minister of Health in the coming years. The Audit Office report 'Tackling Waiting Lists', published in October 2023, outlines some of the key challenges for the Department and the Minister. It states that waiting time targets have not been achieved since 2013-14 and:”
“The workload for unpaid carers is skyrocketing in the absence of proper and proportionate support. <BR /> <BR />The long-term impacts of not addressing all of these issues are already being felt and will be far-reaching, not just for our health service but across all Departments. The health and well-being of our people is paramount in enabling the creation of a prosperous society, and we need to see a fundamental acknowledgement by the British Government that they must deliver a more equitable funding package moving forward to ensure that our Ministers can bolster our public services, especially our health service, and properly deliver for the people of the North.”
“<BR /> <BR />Properly funded services will ensure better pathways and better outcomes for patients, and we must work together to obtain the funding needed from the British Government. Every aspect of our health service is suffering as a result of 13 years of Tory austerity and the decision of the British Government not to provide a block grant that reflects need. Until that is addressed, our health service will struggle for a prolonged period. <BR /> <BR />The consequences of that also impact on our social care system, which is continually being diluted due to staff shortages and underfunding, with families finding it increasingly difficult to access the respite services that they need. It also causes major shortfalls in the provision of domiciliary care packages, which, in turn, puts additional pressures on our hospitals and services.”
“If we want to attract staff to work in our health service and, most importantly, if we want to retain those staff to create stable and sustainable service delivery for patients and service users, we need more investment. <BR /> <BR />The availability of workforce will underpin the ability to deliver on many of the crucial strategies that continue to sit with the Department unfunded, including the cancer, mental health and elective care strategies, all of which are hugely important but, without proper investment, will inevitably be impacted. Patients simply cannot wait any longer. As waiting lists grow, the needs of patients will also continue to grow, resulting in even further increased pressures on our health service.”
“It is key that every effort is made to recruit and retain more doctors to improve access to GP services. GPs face incredible burnout and are over capacity. Without proper investment to deliver on that, we will undoubtedly see the growing pressures on GP practices continue. Many have already had no choice but to close their doors, and the implications of that are felt across all of our communities and even more acutely in our rural communities. <BR /> <BR />Workforce is one of the most fundamental issues impacting on our health service, with thousands of staff vacancies across the North. That continues to contribute to unprecedented waiting lists. Whilst I anticipate that the pay settlement for workers that we, hopefully, will see in the near future will go some way to tackle that, it will require much more investment in the long term.”
“There is wide concurrence that a multi-year Budget would enable the health service to plan ahead and to deliver more stable and sustainable services, which cannot be done in the same way when operating under an annual Budget. <BR /> <BR />I am pleased that the Finance Minister and the Executive have prioritised public-sector pay, which will include our health and social care workers, and it is crucial that the Health Minister takes action to get that into the pockets of workers as soon as possible and that all workers get the fair pay that they truly deserve. However, there remains a huge plethora of issues facing our health service more imminently. Today, GPs have voted overwhelmingly for strike action next month, and significant challenges are being faced across primary care and our GP practices.”
“We must continue to make our united voice heard in order to secure a more equitable and sustainable funding package, in strong opposition to the Secretary of State and the Tory Government's concerted effort to add to the huge financial burden that many families and households are currently trying to deal with. Our health service in particular requires significant investment, and that need continues to grow as trusts and the Department operate in the context of a deficit budget that could have been avoided had the budget proposal of my colleague and the former Finance Minister, Conor Murphy, in 2022 of £1 billion for the health service over three years been progressed.”
“I support the Second Stage of the Budget Bill. Let us be clear: the Budget that we have before us is the result of a harsh Tory-led initiative that continues to decimate our public services year-on-year. The Budget comes in the final weeks of the financial year, giving little to no opportunity to address or reverse the harm that has been done across all Departments. However, I commend the efforts of the Finance Minister, who has made difficult decisions in a difficult context to ensure that public-sector workers are at the heart of the Budget and, to the best of her ability, to offset the serious pressures that all Departments are experiencing. <BR /> <BR />It is known that the Assembly is united in the view that we are and continue to be underfunded on the basis of need by the British Government.”
“Does the First Minister agree that this public inquiry is particularly important for addressing the concerns of those who lost loved ones during the pandemic and that providing answers for those families should be the primary concern of everyone in the Chamber?”
“I thank the Minister for his statement. I am pleased to see the focus on affordable childcare and on paying childcare workers. That is good news, especially as the Executive have agreed it as a priority. Given that the 30-hour scheme in Britain has not been successful — we have heard the reasons — what sort of scheme do you envision being delivered locally?”
“The Committee will work with and support the Minister and the Department where it can and, where needed, will hold the Minister and the Department to account on the key priorities that are brought forward. We will see where that balance is, but I trust that it will be a beneficial working relationship. I ask Members throughout the Chamber to support the motion and the amendment.”
“It is important that, as that work is progressed by the Minister and the Department, the voices of women and girls are heard and listened to. Any plan or strategy that is brought forward must reflect their views and seek to address the disparities and inequalities that they face across the health and care sector. While any plan or strategy will be primarily for the Department of Health, I appreciate that there may be some overlap with functions in other Departments. I encourage other Ministers and Departments to work collaboratively with the Department of Health to address this important issue. <BR /> <BR />As the incoming Chairperson of the Committee for Health, I want to ensure that there is a clear focus on a women's health strategy.”
“I cannot emphasise enough the first-class care that my baby son and I received, from my first scan to the aftercare that I received in the community from the amazing midwives and health visitors. The wide-ranging and growing complexity of the care that maternity services provide cannot be overstated. We now have a real opportunity, as part of this strategy, to underpin improving the health outcomes for mothers and babies, prior to and during the time that they are being cared for by those who are working in maternity services. That will have lifelong benefits for women. <BR /> <BR />As many Members who spoke today have outlined, there is a clear and immediate need for the development of a women's health strategy.”
“That is why we must also see the implementation of the cancer strategy, which will undoubtedly help to tackle those issues. <BR /> <BR />As others have highlighted, there needs to be a strong focus on maternity services, as we see increasing numbers of women accessing maternity services across the North. The strategy must recognise the need to ensure the delivery of high-quality, safe services for women and families. The progress on the mother-and-baby unit is also very welcome. The needs and health of women who use maternity services are changing rapidly, and, if improving women's overall health is at the heart of the strategy, that will ensure better outcomes for expectant mothers and their babies. <BR /> <BR />Just a few months back, I had the pleasure of using the fantastic maternity services in Daisy Hill Hospital.”
“We are all too aware of the many complex health issues that women and girls face, and those have been described perfectly here today. There needs to be a clear focus on women-specific issues, as is highlighted in today's motion. <BR /> <BR />We saw headlines at the start of the month that outlined the fact that more than 37,000 women were on waiting lists for gynae services, with many waiting over three years for treatment. Just last week, we heard that breast cancer referral targets were being missed, with only 52·9% of urgent referrals being seen within the 14-day target. That means that, during the quarter ending in September 2023, 1,566 women were not seen within the target date. We need to do better for those women and girls. Early detection of breast cancer is key for targeted treatment and for increasing survival rates for women.”
“Tackling disadvantage in the context of women's healthcare as a result of deprivation must form part of any forthcoming strategy. <BR /> <BR />Over the past three years, we have seen other parts of these islands bring forward women's health plans. A women's health strategy for England was introduced in the summer of 2022. In the South, the Irish Government have introduced a women's health action plan. The Scottish Government introduced a women's health plan in August 2021. NHS Wales published 'Women's Health in Wales' in November 2022. Unfortunately, we have fallen behind the other jurisdictions at a time that we are aware that, although women on average live longer than men, they spend a significantly greater proportion of their lives in ill health compared with that for men.”
“Go raibh maith agat, LeasCheann Comhairle, and congratulations on your new role. I welcome the opportunity to speak on this important motion to improve healthcare for women and to address the health inequalities that many women face. I am pleased to hear the Minister's commitment to deliver for women's healthcare. <BR /> <BR />We have heard about a broad range of issues that impact on women, including how some conditions that affect both women and men have a much more detrimental impact on women. We must ensure that those issues do not fall between the cracks any longer. It is abundantly clear that significant gaps exist in women's healthcare, but those gaps are far greater for those women who live in areas of high deprivation.”
“As the Minister will know, I spoke to the Children's Hospice just this morning to understand better the situation that it is in. Based on the Minister's answers, I will ask him a question. He mentioned the differentiation between adult hospice funding and the Children's Hospice funding. Will his Department look at the current funding model for the Children's Hospice to ensure the long-term sustainability of that vital service? As we know, it is much more than just palliative care, and the implications of ensuring that that service stays in place will be far-reaching.”
“We need proper funding that will enable us to do what we have committed to do to deliver on the issue of childcare and early education. We need to continue to speak with one voice when lobbying the British Treasury on this, because, if we want to do this, we want to get it right and ensure that we are properly resourced to do so. Once we have the proper resources, we can do so much more, and we will be able to deliver properly for the people whom we serve. <BR /> <BR />I thank everyone who has spoken in support of the motion today. The motion has set an ambitious tone for the new Assembly, and key to that, as I said, is working together to deliver quality, affordable, accessible and sustainable childcare. I ask all parties to support the motion.”
“I thank the Member for raising an important point, and we can look at that in every area of our work. If we can get it right at the earliest possible stage, we will see the benefits elsewhere. It is not all about cost; it will have far-reaching benefits and efficiencies that we will see further down the line. <BR /> <BR />I agree with Members who talked about childcare as a cross-cutting issue. From our perspective, we have heard how Ministers around the Executive table are all up for this, and it will require cross-departmental working. However, it is important to recognise and acknowledge that, as was unanimously agreed in the Chamber last Tuesday, we are chronically underfunded and the British Government have a role to play in ensuring that we have the proper funding to deliver what is needed.”
“In health, education and infrastructure, positions can be fulfilled predominantly by women, yet, largely, those are the people facing the barriers that we have talked about today. Many have talked about the significant cost, and the Minister referred to the cost of investment in childcare to date, but it is important to understand that, if we get this right, we have a real opportunity to transform society for the better. Whilst there will be initial costs, and those must not be understated, there will be benefits across every sector.”
“The provision of affordable childcare that is accessible to all — not just for those who can afford it and, as others mentioned, not just for those who have children of a certain age — will have a huge impact in boosting economic activity, particularly for women, which is important not only for our economy but for the well-being of parents who can get back into the workplace and an adult environment. I know from when my children were maybe nine months to a year that you cannot wait to get back into the workplace and have that balance in your life. <BR /> <BR />The strategy will also help, as we have discussed, the vast workforce challenges that we see across our key public services.”
“As we have heard from many Members today, we cannot continue to push the rising costs on to already hard-pressed parents and families, and we need to put in place the right support to stop that cycle. Investment in a childcare strategy that is co-designed with families, providers, trade unions and workers to fully address the challenges that they face will have far-reaching benefits across society. The huge cost of childcare for families is untenable for the vast majority of parents, and we need to work together to deliver on this critical issue.”
“Highly qualified, experienced workers are being lost to other jobs with better pay and conditions, and it is becoming increasingly difficult to attract and maintain staff, as we have heard on countless occasions and even in this debate. We need to ensure that staff working across the sector are properly valued and respected for the excellent work that they do, which has an increasingly wide and complex range of responsibilities. It is no wonder that many of them are walking away from a job that they love, a job that is, it is fair to say, a vocation for many, to jobs that offer better pay and conditions but maybe do not give them the same satisfaction and value.”
“<BR /> <BR />As a working parent, like many others have described, I am acutely aware of the huge challenges in accessing childcare, due to the lack of capacity, and the challenges that providers and those working across the sector face because those challenges continue to grow. That includes the rise in energy costs for self-employed childminders operating from their own homes and those in childcare facilities trying to pay their staff fairly in the context of competing pay, which is forcing them, as we have seen in the last week alone, to close their doors.”
“Phríomh-Leas-Cheann Comhairle, I congratulate you on your new role. You have handled it very well today. I want to thank all the Members who have spoken today. It has been a really positive debate. <BR /> <BR />My party tabled the motion as childcare is a significant priority for us, but it is also safe to say, given the unanimous support across the Chamber, that it is a priority for all parties. The point has been well made on just how important early education and childcare are. There is strong evidence to show how crucial that window in a child's life is to their development. It is also a crucial opportunity to identify issues or difficulties that a child might have and is key to getting the right support in place at the earliest possible stage.”
“<BR /> <BR />Today, we have an opportunity to ensure that never again will women have to run the gauntlet of protesters when trying to access healthcare or when going to their work. I sincerely hope that Members across the House will make the right decision to show that we take the rights of women seriously, that we respect women's choices and that we are serious about our commitment to tackling violence and abuse against women and girls.”
“I also thank all the women who contacted me and shared their personal stories, some of which were very harrowing. I thank them for trusting me with those stories. They included women who are patients, women who are staff, women who are parents and women who have just encountered these protests when going about their daily lives. Those protests have had a significant impact on them, and they want to see this change made. <BR /> <BR />Finally, I pay tribute to Cara, Fiona, Angela and Sharon and the whole Supporting Women Newry group. For almost two years now, they have been steadfast in their commitment to standing up for women week in, week out and to trying to support women when they are accessing John Mitchel Place in Newry and Daisy Hill Hospital. I hope that their efforts have not been in vain.”
“I, too, will speak in full support of the Bill at its Final Stage. Despite the protracted attempts of others to block progressive change this week, if the Bill passes today, it will be another momentous day in the Assembly. It will be a day on which we send a strong message that we are committed to protecting women from abuse and intimidation; that we are standing up for women at one of the most vulnerable times in their life; and that we are listening to the resounding calls from across the North that women have the right to access healthcare safely and free from intimidation and harassment. <BR /> <BR />I, too, thank Clare Bailey for bringing forward the Bill and congratulate her on pursuing it to the end, which has been a very challenging task.”
“<BR /> <BR />This Bill will help to reduce the financial pressures on the staff and patients who access Daisy Hill, which is in my constituency, and to ensure that staff have access to safe and secure parking close to their place of work. That will hopefully reassure them, particularly in light of recent incidents, that we are listening and that we value and care about them. <BR /> <BR />I am so delighted to see the Bill reach its Final Stage and that it has such vast support across the Chamber. I look forward to seeing the legislation in action in the time ahead.”
“First, I thank my colleague Aisling Reilly, her predecessor Fra McCann and all of our Sinn Féin team for their work on this really important Bill. This definitely is a good day for the Assembly. Sinn Féin is committed to standing up for workers and families. This Bill will help to reduce the burden on health and social care workers and on patients and their families as they access essential healthcare services. <BR /> <BR />There must be no more platitudes. Our health and social care workers and the most vulnerable in our communities deserve to see more actions like this that support them effectively. We can do more, and hopefully, in the next mandate, we will do more, to improve staff pay and conditions and to ensure that there is better workforce planning to help to support staff in their jobs and all of our healthcare services.”
“I thank the Minister for his answer. My Newry and Armagh constituency has significant labour shortages in manufacturing, transport and health and social care, yet any of the city deal funding that we have seen has been directed towards the 10X Economy strategy and jobs in digital industries and financial services. In order to address the need that exists, will you ensure, Minister, that your Department also invests in upskilling people for jobs in the areas that I have outlined?”
“I know from my family experience the toll that it can have when patients are required to attend hospital for full days and things like that. That can have such an impact on the household income, particularly when the household may already be experiencing reduced income owing to the impact of a person's illness on their ability to carry out their employment and on other family members who accompany them to appointments and provide important support. When we look at it in that context, it is something that we really need to think about. <BR /> <BR />I reiterate my support for the Bill and welcome the support of others. Hopefully, we can get the Bill through to its Final Stage fairly quickly.”