Kieran McCarthy
Strangford · Alliance Party · Northern Ireland
“I am pleased to support the Final Stage and to pass on my thanks and congratulations to all those involved in getting us to where we are this evening. It is simple and straightforward legislation, but it offers those in social work additional recognition of their professional standards, and gives greater reassurance to the public.”
“Specialist training and raising public awareness will be essential. There is a much wider issue of ensuring that the Bill itself will be properly resourced. That is perhaps an issue for another day, and, at this stage, our priority must be to get the legislation onto the statute book.”
“It will also cover people who are vulnerable, as well as those, including people in the criminal justice system, who lack capacity. <BR /> <BR />The new legislation will require that, if a person has capacity, they can then make their own decision about their treatment and that all possible support in making that decision will be provided…”
“That includes our Committee staff, our Assembly Research and Information Service and everyone who contributed to making our Health Committee positive and getting us to where we are this evening.”
“<BR /> <BR />I also thank Alastair Ross for his work in steering the Ad Hoc Committee, which I must say was very heavy work for some of us, but we got through it. I thank Alastair for being there to direct and guide us. Of course, he has already paid tribute to the Clerks who serviced our Committee.”
“We thank Professor McClelland for his dedication and hard work in carrying on where Professor Bamford unfortunately left off. <BR /> <BR />I pay tribute to everyone — as has already been said in the Chamber, there were many — who worked hard and together to see this improvement for everyone with a mental health condition or a learning dis…”
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“I thank the Minister for his response. Does he agree that the transformation of, say, Loughries Primary School outside Newtownards would extend integrated provision and therefore accommodate parental choice in the greater Newtownards area?”
“How will the Minister seek to reduce teachers' workloads sufficiently to ensure that professional development is genuinely accessible?”
“I am grateful to the Member for giving way, and I am also very grateful for the response from the Minister. There is one aspect of this problem that has to be taken into consideration, and that is that we are all fully supportive and behind suicide prevention and prevention of self-harm etc. Instances like that can result in leading people in that direction, and that is the last thing that we want to see. I am delighted that the Minister has acknowledged that and is prepared to listen and to try to do something about it.”
“I am grateful to the Minister for giving way. I do not think that anybody would disagree with what the Minister is saying. However, the real problem is the amount of money that is being taken out of the National Health Service to provide for that. Why can more of the operations that you speak of not be provided within the NHS, thereby making a saving?”
“I thank the Member for giving way. There are patients who have been on a waiting list for a considerable time and have eventually got an appointment for treatment and suddenly get a letter in the post to say that, for whatever reason, that appointment has been cancelled. That happens time and time again. Does the Member agree that that is the worst possible scenario and that the Minister and the Department should avoid that at all costs?”
“Unfortunately, waiting times have been getting longer despite the fact that, a few years ago, they were reducing. With the budgetary constraints being forced on all of us for the considerable future, our recommendations in this report should, when implemented, go some way to reducing waiting times for all our patients. I plead with the Minister, who was a member of our Committee not so long ago and went along with how we dealt with the business, to do his best to implement the recommendations as early as possible.”
“<BR /> <BR />Our report refers to the concerns now being expressed regarding the interaction of the National Health Service and the private sector. The private sector has its role, of course, but there are concerns about the sums of money spent in the private sector in an attempt simply to manage waiting lists, the use of the same personnel offering the same treatment, and the potential conflicts of interest and distortions that flow from that. <BR /> <BR />We all want to see an end result that simply cuts the length of time that our constituents are forced to wait for their operations.”
“<BR /> <BR />The Alliance Party and I fully endorse the introduction of referral-to-treatment time measurement. The whole issue of waiting times goes right to the question of public confidence in our health service and the effectiveness of that service in relation to targets. At times, targets can be limited in effect without enforcement. I am sceptical about punishing health providers, particularly about fining them for poor performance in managing waiting lists. If fines are levied against trusts, or anticipated resources not delivered, the reduction in spending power immediately punishes the very patients whom we are supposed to be helping. In my opinion, it would be better to seek to hold managers, at an individual level, more directly accountable. Fines may be levied on them personally.”
“The issue of referral-to-treatment times comes top of the list. In its evidence, the Department agreed that the move to referral-to-treatment targets is highly desirable because it better reflects the patient experience and clinical interests. It also removes potential perverse incentives for delays at stages of the journey, which are present with stage-of-treatment targets. <BR /> <BR />The Department also acknowledged that RTT was the direction of travel for those who are at the leading edge. The question is whether we in Northern Ireland wish to be at that leading edge. I say that we certainly do; I do not think that there is anybody in the Chamber who would disagree with that. RTT is the direction in which we will have to go. So that is a fairly positive ideal for the Department, even prior to the Committee's recommendation.”
“We are also grateful to the research staff who provided great assistance, and we thank the individuals who came to the Committee to give evidence of their experience, allowing us to consider the various methods in the different jurisdictions so as to arrive at what we consider to be the best solutions. <BR /> <BR />I am sure that every elected representative has had contact with constituents who have had to wait for far too long for operations. We do our best, as public representatives, to assist. Unfortunately, for various reasons, solutions are out of the hands of elected people in most cases, and thus the suffering and pain continues for the patients. <BR /> <BR />In the report, we consider the submissions of a number of experienced people, and we arrive at five recommendations, as the Chairperson and other members have said.”
“As a member of the Assembly's Health Committee, I am delighted, like other members, to contribute to this very important debate. The Health Minister is present for the debate, and we can but hope that he and his officials will take very seriously the contents of this review and implement our recommendations — there are only five of them — at a very early date. <BR /> <BR />I sincerely thank the Committee staff for the work that they have done to assist us, the members, to compile this report on the problems of waiting times and come up with solutions.”
“On a point of order, Mr Principal Deputy Speaker. I ask you to rule on why the sports Minister did not find the time, given that she had three quarters of an hour, to congratulate the Portaferry hurlers on winning the Ulster senior championship yesterday for the first time in their history.”
“I implore the Minister to find out and go over the reasons for operations not being performed, because they are in the hospital setting.”
“You certainly were not concentrating on your reading at 1·00 am. If you had been, you would have seen that a shortage of beds resulted in no operation for 1,734 patients, broken equipment in hospitals resulted in no operation for 593 patients and — here we go — staff shortages resulted in no operation for 1,570 patients. Surely, that is contributing to enormous stress on our patients I acknowledge what the Minister has said, but —”
“Would the Minister agree that, in the long term, tackling the issue of a divided society will be as important as reaching a sustainable position on welfare reform?”
“Can the Minister come back to the Assembly and tell us that the mismanagement has been identified and rectified?”
“Can the Minister tell the Assembly whether that mismanagement by the former Minister on the budget has been identified? If it has, can he tell the Assembly what is being done and where to make sure that it will not continue? And can he —”
“Like others, I welcome the Minister's first statement to the Assembly. First, I have to express my sadness that we are losing such a service providing cardiac surgery from Belfast City Hospital. That having been said, at least we are having a service on the island of Ireland, which is preferable to having to travel across the water. From experience, parents tell me that they would rather be in this island. <BR /> <BR />My main question is on the financial mess that our health service is in at this time and has been in for some time. I remind the new Minister that the Finance Minister accused the former Health Minister of mismanagement of the budget. That is a very serious accusation, and it seems to be that that is where the mess that we are in is at now. The threat to the quality and safety of our services cannot be underestimated.”
“I am grateful to the Minister for giving way, and I accept the figures that he has just given. Will he agree with me that, despite all those good efforts, a number of people, particularly in rural areas, are being denied community meals? That is simply because the criteria for receiving those meals have reached such a point that a lot of people are missing out. They are out of the loop and are not receiving the community meals.”
“<BR /> <BR />In conclusion, we strongly recommend that the Department does not relabel supported living facilities as schemes for the frail elderly, as has already been mentioned by other Members, given that the purpose is to promote older people's independence and support them in what they can do, rather than focusing on that which older people cannot do. I hope that the contents of the report, which is far-ranging and was well worth doing, will be recognised by the Department and the Minister. I support the motion.”
“<BR /> <BR />Along with other Members, I was delighted to join the Northern Ireland Federation of Housing Associations here at Stormont, last week, to show our support for its present campaign — I will show Members the picture — Let's keep on Supporting People. It is vital that we get behind those efforts to protect and strengthen this vital programme. Every year, Supporting People assists some 26,000 vulnerable people throughout Northern Ireland in a wide range of accommodation-based and floating support services. Among those helped are older people, people with learning disabilities and homeless people. A wide range of support is provided to help people live as independently as possible. That is the important aspect of what we are discussing today: improving quality of life and reducing demand on the health and social care systems.”
“Absolutely. I fully agree with the Member. <BR /> <BR />The review's first recommendation is very significant, in that it deals with the establishment of a new definition for supported living. We say that the Health Department should consult representatives of our elderly population, and there are many — the Age Sector Reference Group, the Pensioners Parliament, Age NI and others, including the Older People's Commissioner for Northern Ireland. The Department should also consult and work with, as has been said, the Northern Ireland Federation of Housing Associations and other relevant stakeholders.”
“In addition, beyond the consideration of resources, there is a need to ensure that provision is in place to combat social isolation, particularly for older people who do not have relatives or close friends living nearby.”
“<BR /> <BR />Today's motion is about supported living in the context of the Transforming Your Care blueprint. Our review, as the Chair has already said, concluded with 11 recommendations that we ask the Assembly to endorse and the Department to accept and implement at an early date. <BR /> <BR />It was clear from the evidence received by the Committee that there is a lack of an agreed definition in this area and, even worse, that different agencies are themselves working to different definitions. We welcome the increased policy focus on the delivery of services in the community, in common with other aspects of Transforming Your Care, but, critically, that must be backed up with resources.”
“It is a pleasure. We will expect positive results. <BR /> <BR />Like others, I wish to put on record my sincere thanks to the Committee Clerk and her staff for all their work and the help that they gave members, the research staff here in Parliament Buildings and of course all those who gave evidence as we proceeded with our review. At this point, I have to declare an interest in the subject and say how important it is for the Assembly to show its appreciation to senior citizens for the contribution that they have made to this society. We have a duty to ensure that, when people reach pension age, they receive proper help and assistance, whether that is housing or anything else, and that the Assembly can and will rise to the challenge.”
“Like others, I am grateful, as a member of the Health Committee, to say a few words this afternoon in support of this important motion. Indeed, I take the opportunity to welcome the presence of our former Health Committee colleague in the form of Mr Jim Wells, who is now our Minister. We can expect nothing but positive results and responses, I am quite sure.”
“<BR /> <BR />Members can be confident that the Bill, with all its safeguards and the Minister's record, will ensure that decisions on the granting of legal aid will be taken in the way in which they should be taken: independently and without political interference or influence. Rather than increasing the role of the Minister, the Bill transfers some responsibilities that currently rest with the Minister to the new director of legal aid casework. <BR /> <BR />In conclusion, the Assembly can vote to pass the Final Stage of the Bill and be confident that it is backing moves to secure and strengthen independent decision-making, to protect access to justice and to improve financial management at a time when it is desperately needed. I support the Bill and commend the Minister for his ongoing programme of work.”
“<BR /> <BR />In the Bill's early stages, the Assembly debated at length and in detail Members' desire to ensure that, when the Legal Services Commission becomes the legal services agency, the independence of decisions over granting legal aid will be protected. <BR /> <BR />Members should be well aware of the Justice Minister's determination to respect and protect the structures and procedures of the justice system, which are designed to prevent political interference in what should be independent matters. The Justice Minister repeatedly reminds Members of the importance of his respecting the independence of the judiciary and the Public Prosecution Service, the operational independence of the Chief Constable, the role of the Policing Board and so on.”
“Like others, I welcome the Bill reaching its Final Stage this afternoon. The Bill is yet another stage in the Justice Minister's wide-ranging and far-reaching reforms of our justice system. In an Assembly in which we are often criticised for passing too little legislation, our Justice Minister, as expected, has consistently advanced an ambitious legislative programme. <BR /> <BR />The new structures should allow more effective financial management and forecasting, providing much-needed confidence that everything that should be done to manage the legal aid budget in a time of severe financial pressure is being done.”
“I must say at the outset that I am very disappointed by the tone of the Minister's responses to questions. When you start to use derogatory language and call people names, it seems that the argument has been lost. Perhaps the Minister, along with the First Minister, is now starting to regret taking the £100 million or even asking for it, which will clearly come off next year's allocation. Does the Minister agree that a more sensible approach to borrowing is to make an investment for the future or to create breathing space for reforms? How does the decision that the Executive took to borrow £100 million from the Treasury meet either of those tests?”
“When other things are happening in our constituency in future, he might take a minute or two to invite those who have been campaigning for years for them. It seems from the local press that other people jump in and take the credit.”
“The Minister and Mr Lamb did not invite me or my Alliance colleagues to a photo shoot at the recent start of work on a footway on the Old Shore Road in Newtownards. We have campaigned for that footpath for years. We are delighted that it has gone ahead, but we might at least have had an invite from the Minister when he went to cut the first sod.”
“We all know of the outcry, some years ago, when the main streets in our towns were not gritted during the heavy snow. <BR /> <BR />Much depends on the outcome of the October monitoring round. We know of the huge demands on all the Departments, but let us hope that there is a fair distribution of whatever funds are available. We also have concerns about the annual Budget process, but, as we are now into the last year of that, we can accept it and a more transparent breakdown of the allocation of resources. <BR /> <BR />I thank Mr Kennedy and Stanley Lamb and Stephen Duffy from the Roads Service section offices for the new works that have been completed in the Strangford constituency, particularly in the Ards peninsula, where the roads had been neglected for so long. There is, however, one thing that I must express disappointment at.”
“We must always seek to make improvements where necessary. <BR /> <BR />At the Committee meeting I referred to, the senior officials went over the consequences of the Department not benefiting from the October monitoring round. All the Committee members were disappointed at the decision not to renew the contracts of contractors, who, as Mr Dallat informed the Assembly, are engaged in work on footway and carriageway maintenance, grass cutting, environmental works, gully emptying, road marking and traffic signals. Those are the basics that keep the roads at least half safe, and all that work is vital to ensuring road safety in all our areas. <BR /> <BR />Another important aspect of keeping our footways and roads safe is the gritting schemes that are carried out during the winter. Even those operations may now be cancelled.”
“<BR /> <BR />As a former member of the Committee for Regional Development, I attended a meeting a couple of weeks ago at which senior officials painted a very gloomy picture about funding shortages. That was despite the fact that DRD got some extra £12 million from the June monitoring round. <BR /> <BR />Our roads simply have to be maintained. The last thing any Member wants is to see further road deaths as a result of lack of maintenance or, indeed, whatever else. At this point, I am sure that Members will join with me in offering our deepest sympathy to the latest victim of our roads, a young man from Bangor called Mr Barbour, who lost his life on the road between Greyabbey and Ballywalter only last weekend. We are all too aware of the increased number of fatalities on our roads, and those simply cannot continue.”
“Repairing roads can be a dangerous profession, with traffic whizzing past and always in a hurry, without regard for the safety of staff who are engaged in that essential work. <BR /> <BR />Like all other Members, I was disappointed a few weeks ago when Minister Kennedy informed the public that his reduced budget would result in potholes on our roads network not being repaired and, of course, street lights not being repaired because of a lack of money for replacement light bulbs. What has this place come to? Northern Ireland cannot afford to keep our streets lit, as we cannot afford a few bulbs here and there. If it were not so serious, it would almost be a joke.”
“I, first, thank Mr Dallat, Mr Byrne and Mr McGlone for bringing this very important issue to the Floor. On behalf of the Alliance Party, I support the motion. I welcome the Minister's presence in the House. I sincerely hope that he and his Department will be able to secure the funding to provide a decent roads maintenance programme. That, in turn, will assist contractors to do the work and, thus, prevent the loss of jobs. <BR /> <BR />I want to pay tribute to all those who are engaged in providing better and safer roads throughout Northern Ireland. It can be a pretty tough job being out there in all weathers. They do very necessary work, not always with the blessing of the travelling public.”
“I thank the junior Minister for her response. Can she, on behalf of the deputy First Minister, explain why he and the First Minister decided to reduce disproportionately funding to the Victims and Survivors Service by somewhere between 15% and 20% while the Department saw a reduction in its budget of 1·4%?”
“What action is the Minister taking to ensure not only rural proofing but shared future proofing for all her policies and programmes?”
“I am grateful to the Minister for giving way. I know that he is coming to the end of his speech, but will he and the Assembly join me in offering our deepest sympathy to the family of Kellyanne Teggert from Portaferry who was a student at Magee College in Derry and who lost her life in a very tragic situation?”
“I am glad that the Minister mentioned corporation tax. Does he agree that a lower rate of corporation tax, by itself, will not be effective and that we would need to invest in other drivers, such as skills, to take us into the future?”
“Does the First Minister agree that among the things that make the present arrangements not fit for purpose, as he would say, is the misuse of petitions of concern by him and the DUP? That gives the public reason to be disillusioned with the Assembly in its entirety.”
“I thank the Minister for her statement. Item 29 refers to the relevant budget provisions, and item 33 talks about indicative budget provisions. Can the Minister assure the Assembly that, given the very serious financial situation across the island, there will be sufficient budgets to carry out the duties that the Loughs Agency is set up to do?”
“I hope that the Minister will give assurances today that these will be provided.”
“<BR /> <BR />Let us remind ourselves of all those in our society who are crying out for cancer drugs, our multiple sclerosis, ME and muscular dystrophy patients and our elderly dependants. Let us remind ourselves of the shortages in our A&E departments and our community meals schemes, all of which are at risk. The list goes on. It simply would be a dereliction of MLAs' duties — in fact, totally obscene — if we have to return moneys to Westminster coffers when we know the need is desperate at home. <BR /> <BR />Alliance is open to considering additional resources for health and social services, but that has to come in the context of a proper strategic review of expenditure across the board by the Executive.”
“Although problems have been building in the health service over time, it is difficult to understand how things can tip into crisis on the basis of a funding gap. <BR /> <BR />The failure of the Executive and the Assembly to agree the way forward on welfare reform means that money has to be handed back to Westminster that could otherwise have been invested in health. This is a shameful, disgraceful and unforgivable situation; no one in this House supports the welfare cuts. I desperately appeal to both blocs in the Executive to come together and agree a way forward for the benefit of all our constituents to ensure that no funding has to be handed back to Westminster.”
“I am, however, disappointed that these items have appeared on the Minister's proposals for so-called savings. Many of the proposals he has set out are, in fact, false economies; short-term measures or deferred expenditure will simply delay opportunities to do things better. <BR /> <BR />It is difficult to have this debate in isolation from the wider financial situation facing the Health Department and the Executive as a whole. First, there are major questions to be asked about how the Department ended up in this situation. This pressure has clearly been building up over several years and the fact that a mess has arisen now predates the crisis in welfare reform as, no doubt, we will hear. Secondly, what is presented by the Health Minister needs to be properly scrutinised.”
“There is a very strong logic to this; we are all too familiar with the scourge of cancer on our society and the very real difference that early diagnosis and effective treatment can make to prospects of recovery and full life expectancy. Moreover, the siting of such facilities at Altnagelvin Hospital is strategic in nature. In particular, the radiotherapy unit holds out the prospect of effectively servicing a wide catchment area that significantly spans the border counties. We have also taken advantage of support from the Dublin Government. <BR /> <BR />Many of us have regularly stressed the opportunities for a more efficient use of resources through the shared delivery of services on a North/South basis, and this is surely a golden opportunity for that.”
“Thankfully, after the 2011 election, promises were given to build these new facilities but once again, in the context of the massive Budget uncertainty, this is back in question as the Minister has indicated that development of projects such as the Altnagelvin radiotherapy centre and cardiac centre, along with others, may have to be delayed in the short term or even longer term. <BR /> <BR />Although the Health Committee, the Assembly and others will want to scrutinise what the Minister is saying in general about the overall health budget and the potential or otherwise for reform, today provides an opportunity for us to restate our commitment to these investments in the north-west.”
“I welcome the debate and I am happy to support the motion. These investments in the north-west are matters of huge importance but have always been marginal in the budgetary commitments. The project was in major jeopardy at the end of the last Assembly mandate, as has been mentioned already. In fact, as I understand it, the project had been withdrawn at that time. Indeed, at the time, the local people and their representatives were shocked and dismayed, despite the fact that the then Derry health chief said that these developments and the operation of the satellite radiotherapy unit at the Altnagelvin site were vital. <BR /> <BR />At that time, there was cross-party support in the Health Committee for the service, which also had the support of the Dublin Government.”