Michael McGimpsey
South Belfast · Ulster Unionist Party · Northern Ireland
“Bearing in mind that the election will be fought on issues around health, spiralling waiting lists, employment, and investment in education, does the First Minister believe that, in the event of a Brexit, 25% of our exports will continue to go to the Irish Republic, or does she believe there is a threat there?”
“I established the Health and Social Care Board and, when I left, there were 335 people working there. That figure is now somewhere over 600. It has been allowed to bloat by, roughly, a factor of two. The Minister needs to clarify whether most of those bodies are going to be moved into the Department.”
“I am disappointed with that answer. I would be surprised if, when my name appeared to ask a topical question, the Minister's officials did not come forward with a suggested list of topics that I was liable to ask about. That is the whole point of topical questions. I remind the Minister that Breda is a school designed for 850 pupils.”
“I will give way in a moment. <BR /> <BR />It is just as clear that response times are key for the Fire Service. The faster the response time, the more likely a successful outcome in dealing with the incident. <BR /> <BR />There is another issue here that I want to deal with.”
“<BR /> <BR />It is quite clear that the funding has been going down. It was £81·6 million in 2011 and £69·7 million in 2015, we are now down to around £65 million. The funding is going down, and it is preposterous to try to say that that will not compromise the service, a crew or the public.”
“There are a number of reasons why you underspend: it may be that it was not allowed to spend, or it may be that there are vacancy controls in place that prevent it from spending money on recruitment to replace personnel. Of course, 80% of its budget goes on personnel.”
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“I thank the Minister for his statement. He called for a mature, open, honest and intelligent debate. I was in his position for over four years, so can I suggest to him that, from my experience, his biggest problem with that open, honest and intelligent debate lies within his own party and that I think that he will have difficulties there when he calls on the rest of us? The fact is that there is not enough money to run the health service. You either increase the money or you reduce the service. Is that not —”
“In referring to the shortage of GPs, at the last Health Committee meeting at which he was present, the Minister told me that approximately 50 young GPs who graduated from Queen's had gone off to work in Canada and Australia. Clearly, it is not sustainable for our health service to be providing that. What specific steps does he foresee being able to take to try and cut down that flow?”
“I thank the Minister for that answer. Does she agree that it is also important to attach priority to creative projects of major significance, such as film, the Lyric Theatre and the Ulster Orchestra?”
“I thank the Minister for that answer. What progress has been made on the adjacent development on the Olympia leisure centre? I realise that that is in partnership with Belfast City Council, but does she have any indication now of a start date, a timeline and a completion date, and what sort of project costs we are looking at?”
“I thank the Minister for that answer. I appreciate and welcome the review that he intends to bring forward. Can he also accept that the number of people employed by the Health and Social Care Board has gone from 365 in March 2011 to 525 in March 2014? That is an increase of 160, and I know and he knows that those are purely administrative posts and represent an increase of around 30%. Bearing it in mind that the annual budget for the Health and Social Care Board is about £20 million, 30% of that represents a substantial amount. Will the review look hard at that and at the issue around the Business Services Organisation, which has put on several hundred people, again on the administrative side? Those are issues —”
“I thank the Minister for that answer. Among the 200,000 people in the public sector, there is clearly uncertainty, anxiety and concern about those issues. Will he confirm that he, as the Minister, and his Department are in discussions with unions and the staff side and that a key feature of any proposals will be voluntary rather than compulsory redundancies?”
“We have seen that year after year, whether it be the pressures in A&Es, pressures on waits or closures at Bangor, Whiteabbey and Armagh. <BR /> <BR />We can all talk about these difficulties that we are having. This House has to be prepared to fund the health and social care Department and fund properly the Northern Trust. I do not blame the Northern Trust or any of the trusts for the steps that they are taking. They do not have enough money to run the services that they have now. We can all point at efficiencies. We can all say, "Save money here, save money there", but the Northern Trust does not have an adequate budget to adequately provide services so that —”
“I appreciate that I have limited space to speak. First of all, of course, I support the motion. MS is a cruel and merciless condition. We need to do whatever we can to alleviate the situation for patients and sufferers. A reasonable service for this condition at Dalriada was one of the remedies that we had. <BR /> <BR />I have to say, however, that this situation was predictable. The result of a Budget that was voted through this House three and a half years ago by many of the people who have been on their feet speaking today is that not enough money has been put into the health and social care budget to run the service. That was clearly demonstrated. The Budget was actually a real-terms cut of 2·4%. This is just part of a general malaise in the health service.”
“I thank the First Minister for that answer, and I find it encouraging, but of course the proof of the pudding is always in the eating. It is a situation that we have been looking at for a number of years, and we appear to be unable to make progress. Therefore, will he, through his position, take a personal interest in this, given that, across 11 Departments, every permanent secretary is male, and the situation is almost as bad at grades 3 and 5, which is wholly unacceptable? All of us should endeavour to ensure that when he says that there is no glass ceiling we can demonstrate and prove that.”
“Have you considered forming a ministerial task force, along the lines of the ones we formed to combat suicide and protect life, to ensure that the Departments that are relevant — Education and Justice — are fully committed and are fully supportive and do not simply allow the Health Department to carry the can?”
“I welcome the report. It is an important piece of work and points the way forward. We will get an opportunity at tomorrow's Committee meeting to examine the report and its implications further. I have questions about membership, time frame, budget and so on. <BR /> <BR />This is a very important challenge. First, it is about protecting children and ensuring that abusers are identified and brought to justice. There are two key elements in that. The Minister of Justice has given his full support, and it appears that the Minister of Education has done similarly. This is something that the Health Department cannot do on its own: you need the support of other Ministers and other Departments.”
“I thank Dr McDonnell for giving way. Would Alasdair McDonnell agree with me that, whilst we can get into the specifics of Dalriada and so on — very important as they are, and we will have a debate on that next week — the crux of this is the fact that the health service was not properly funded through the 2011 Budget; that that Budget was supported by the DUP, Sinn Féin and the Alliance Party; that his party and my party voted against it; and that we are now seeing the chickens coming home to roost as a result of a health service running out of money at the end of four years?”
“I thank the Minister for that answer. He will be aware that the concern is that the elderly and vulnerable will not receive the services that they require, therefore putting them at unmanageable and unacceptable risk. Can he assure us that that will not happen?”
“I understand exactly where the Minister stands. What efforts did the trusts make to make you, as Minister, aware that they were coming forward with the proposals at Bangor, Dalriada, Craigavon and so on? Has he asked them for their alternatives? As they are the ones delivering the services, they will have a range of alternatives — or did they simply plump for the ones that are now in the public domain?”
“We have 11 Departments headed up by 11 permanent secretaries, who are 100% male; 77% of grade 3s are male; 58% of grade 5s are male. In the past, the deputy First Minister has agreed with me that that situation is totally unacceptable. Bearing that in mind, when can we expect to see balance among the permanent secretaries to properly reflect the gender balance in the Civil Service?”
“<BR /> <BR />Given that the figures are so bleak — the five-year and even the one-year survival rates— it would be a serious dereliction of our duty if we were not looking at what we can do with what is available to us to improve in these areas. It is also about how our health service works and learning from the experience of other parts of the Kingdom, the Republic and internationally in how we go forward to look for some form of screening. We need to find a solution that improves the survival rate and extends life expectancy so that, when individuals get this diagnosis, it is not one that is inevitably terminal in the short term.”
“It is clear that age, smoking and family history are factors. Therefore, public awareness plays a very important role. The Public Health Agency has a very important role to play, so we need to look at how it can take forward a public awareness campaign. <BR /> <BR />There is also the issue of research. One of the key ways of improving survival rates of cancers such as bowel cancer and breast cancer is screening. As I understand it, screening is not available for pancreatic cancer at this time. That is an area for research, and it is vital that we look at the opportunities there. The Minister has confirmed that any applicable drugs are already available through our health service.”
“The GP, as the gatekeeper to the service, has a vital role to play. It is about investment in that service, awareness for GPs and specialist training.”
“Much of what needs to be said has been said. It has been a sobering debate — bleak at times — as we listened to the information coming forward. We must always remember that this is about individuals. Oliver reminded us that pancreatic cancer diagnosis is almost invariably terminal. The five-year survival rate of 3% has been mentioned. That is an appalling figure. When we see that the survival rates for a number of other cancers have improved, it is clear that a great deal of work and investment is needed. <BR /> <BR />A couple of points are clear. The survival rate is much improved if pancreatic cancer is caught early. There is a difficulty in diagnosis, but, if it is caught by a GP, survival rates improve dramatically in the short term. If patients wait until they are at the point of pain and go to A&E, their chances are greatly reduced.”
“— the new Minister giving us his assessment for the first time.”
“I do not disagree with what the Chair has to say, but I make the point that strategic money coming in, in a budget that you can see several years ahead, is far more valuable to you than money that comes in at the last minute through in-year monitoring or has been announced in the new Budget today. Of course I welcome that £150 million very much, but it is better to know that it is coming so that you can plan to use it. <BR /> <BR />I understand the position Jim Wells is in. I understand where the Department is, and I believe that there are major improvements that can be made. However, I do not expect that simply introducing all these recommendations will do the trick. Therefore, I look forward to listening to —”
“Until the health service is properly resourced — I am making some of Jim Wells's arguments for him — and we are not talking about huge extra amounts —”
“Thank you, Deputy Speaker. I agree with Kieran McCarthy. I have had patients in my constituency office who have had that experience of going through all the pressure, stress and trauma with their family of going for a procedure only to have the operation cancelled on the morning of the day it is due to take place. That is appalling and, of course, is not down simply to resource. It is also down to how we manage lists. <BR /> <BR />The fact is that the resource does not exist here at the minute, and Members have to face up to the reality that supply has to meet demand. If you have a certain demand and the supply does not meet it, you have a problem. If supply is less than demand, we have these waits. That point has been made over and over again, and we in the House are inclined not to properly face that reality.”
“Upholding the rule of law and protecting life and property may be the number one priority, but, as far as I am concerned, cradle-to-grave health and social care that is free at the point of delivery is the second key thing that we do. It is more important to spend the money there than in many other areas in our Departments.”
“When we look at the target for 80% of people to be seen within nine weeks, the actual figure is down to just over 60%. When we look at the target for nobody to wait more than 15 weeks, the actual figure is around 80%. Clearly, there are issues that need to be addressed, and investment is needed. When we look at the figures, we see, unsurprisingly, that the worst offender is the Belfast Trust. The Belfast Trust is a very big fish in a very small pool, and it is finding it most difficult to address the need. <BR /> <BR />We had a discussion today on the Budget. The Finance Minister said how difficult money was, and everybody said that more money was needed, but there are certain key things that we have to do as a Government and cannot escape from.”
“The recommendations will help, but, in my experience — I am sure that the Minister will make this point in due course — it is difficult to do anything without the proper resource to run your health service. The Chair referred to certain things having to happen to get the recommendations in place: policy, resource and technical ability. Policy is delivered and determined by the Minister, and you can create technical ability, but for both you need the resource. The resource is clearly not there as far as the health service is concerned. It has been seriously underfunded over the four years of the current Budget, and, despite large amounts of investment coming through in in-year monitoring — several hundred million, I think — it still has not reached the required level. This is a perfect indication of where we are with the health service.”
“As a new member of the Committee, I was not involved in the drafting of the report, but I support the motion and the recommendations in the report. It is important to reflect on what we are about, which is patient outcomes and giving the best care that we can to patients who present to the health service. Many's the time I stood in the House in Jim Wells's position, he stood in mine, and we discussed these issues. As far as I am concerned, this is a team game. It is not about politics; it is about all of us working together to deliver the very best outcomes for our patients. <BR /> <BR />In the recommendations, the Committee has rightly looked at elective care and the waiting times in those areas, because they are a good indicator of how well we are addressing patient need.”
“It is the key area where we can see partnership, representing our community where we are all proud of the achievements of our sportsmen and women and we can all get behind them. They are such an important cohesive force in our society in bringing our communities together. Fairness is another key element in this and in ensuring that barriers to access do not exist, as far as possible. We invest, and we support. We have much to celebrate and much to be thankful for in the achievement of our sportsmen and women.”
“One of the boxers who achieved a medal in Glasgow was a Sandy Row boxer, and there are youngsters in that area and in other areas who would love the opportunity to represent their country. The fact is that that boxing club is currently not allowed to access funding because it is not affiliated with the boxing federation, which oversaw the sectarian abuse in the first place. We have a situation in which that boxing club is excluded. This is an issue of fairness. I have to say to the Minister that, if it was a boxing club in her constituency, I do not think that I would be talking about it in these terms; I think that it would be dealt with properly. <BR /> <BR />It seems to me that sport is the key area where our society can come together.”
“That demonstrates that we have huge potential. When you look at our achievements in the past and you look at people like Tony McCoy, the greatest jockey in the world, or Carl Frampton, a world champion, you see that we have a pantheon of achievement in sport. <BR /> <BR />The key thing is ensuring that barriers to access to sport are broken down, that we have fairness, equality and investment in areas and that no one feels disadvantaged. I have to remind the Minister of the situation of Sandy Row Amateur Boxing Club, which has been subject, over the years, to sustained sectarian and racist abuse, proven by an independent review, on a number of occasions. The point is this: where are we going from here?”
“A key element of this is that we have sports that we show we can do well in. We can be proud of our achievements at the Commonwealth Games, but there is huge potential still waiting to be given the opportunity. For example, at the Commonwealth Games, we had the ability to put in a Northern Ireland rugby team, but that did not appear. Yet, look at the investment that the House has made in rugby in Northern Ireland in the past two or three years — around £15 million in the Ravenhill stadium alone. Hockey is another sport in which our men and women excel and are known internationally. Of course, there has been mention of golf. The Ryder Cup is a biennial tournament and is one of the most important in the world. It was led by two of our golfers — Graeme McDowell and Rory McIlroy, the world number one.”
“It is not only about public health and fitness in the general population; it is about targeting and concentrating on the individuals who can represent at that very high level. We have seen that at the Commonwealth Games, and we have seen that not least with Paddy Barnes and the boxers but with other sports as well.”
“I support the motion. It is a valuable one that highlights the value and importance of sport in our society among our young people and our population as a whole, the importance of strategies around fitness and the need to seriously engage in physical activity to promote good health. When I was in the Department of Health, we had a policy called Fit Futures. It was very much about encouraging our population to engage in physical activity, not least because of the challenge of cardiovascular disease, diabetes and other serious conditions. <BR /> <BR />The Commonwealth Games are about more than that. They are about promoting elite sports. They are about the best and the brightest in each of the sports coming forward to represent their country. It is important that we invest in that.”
“All right, thank you Mr Deputy Speaker. I ask that the Minister meet local representatives to discuss the issues and drive forward some development that will be acceptable to the local community.”
“I thank the Minister for that answer and what I read as a call to action as far as this vacant site is concerned. He will be aware that it is not the only vacant, derelict site in the Sandy Row area. We are now getting a proliferation of applications for housing, but not social housing; it is for student accommodation. That goes very much against the grain as far as that community is concerned. I ask the Minister to meet local representatives to discuss the way forward, because he is aware that this is a well-known arterial street, close to the city centre, and is —”
“I also congratulate Mr Storey on his promotion. I have no doubt that his elevation will come as a great relief to the Minister of Education.”
“Listening to the Minister's answer to Mr Attwood, it appears that we are very clearly hearing his view, and the concern of course is that his view is the one that the review will come up with in the end. Will he be satisfied with a review finding that is at variance with his viewpoint and with that of his party? Will he ensure that there is proper consultation within the various colleges so that no one feels that they are being disenfranchised in what appears to be a very long and convoluted process?”
“I thank the Minister for his answer. Of course it is not simply a police issue, and we are aware of that; it is a societal issue. However, one very strong arm against the drugs trade is the courts. Is the Minister satisfied and comfortable with the punishments being meted out by the courts when cases are brought before the law, or does he consider that an increase in the tariffs would now be appropriate? Will he look at the options for stiffer penalties through the courts for those found to be peddling what are, effectively, instruments of death?”
“Bearing in mind the stress that many staff feel in attempting to deliver the service for patients and the fact that one of the key ingredients is having the right number of people in the right place at the right time with the skills necessary to address the needs of patients, is it wise to allow a situation to develop that may cause staff to consider industrial action concerning the proposed 1% pay rise, which is, let us face it, a very small amount?”
“<BR /> <BR />I repeat the question, as he keeps telling this House how concerned he is about working-class Protestant children from disadvantaged communities: when will the children of Sandy Row, Donegall Pass, the Village area and the Lisburn Road get proper investment in their education at primary school instead of this continual prevarication and delay year after year ?”
“For four years, the Belfast Education and Library Board sought permission to spend £16,000 on a planning feasibility study and that was blocked by the Minister's predecessor. It was not allowed and was only freed up when the Minister's predecessor left office. The Belfast Education and Library Board regards this as a high-priority capital project and asked the Minister, almost a year ago, to include it on his list of capital priorities. The Minister failed to do so in his June announcement.”
“I thank the Minister for that answer. I have to say that I am surprised to hear that the reason is to prevent additional cuts, since there already have been cuts. My concern, of course, is about how we manage this, how the accounting officer accounts for it, how these bodies are to continue to operate and to work their finances, how those are being evaluated and who is going to be held responsible for any potential overspends or underspends.”
“I thank the Minister for her answers. Can she assure us that, bearing in mind the great success that we had in Glasgow, not least in boxing, all boxing clubs will be able to access any grants that are available, access facilities and participate freely in those facilities and will not be subject to sectarian harassment, as was proven to be the case in the past with Sandy Row boxing club? Can she assure us that any grants and support will be tied to such assurances?”