Official Report: Tuesday 18 October 2016
The Assembly met at 10:30 am (Mr Speaker in the Chair).
Members observed two minutes' silence.
Mr Aiken: On a point of order, Mr Speaker. I would like you to rule on the issue of whether it is appropriate for important documents that will have influence on debates in this Chamber to be released to the Assembly first, rather than to 'The Stephen Nolan Show' this morning, as was the letter from the Prime Minister, dated 14 October, to the First Ministers. It was not made available to the Assembly but could have influenced the debate yesterday.
Mr Speaker: The Member will know that I have in the past always encouraged Ministers to come forward to the House when there is something that they believe is relevant to be made available to the House. It will be my practice to continue to ask Ministers to come to the House when they have something to report.
Mr Speaker: The Business Committee has agreed to allow up to one hour and 30 minutes for this debate. As two amendments have been selected and are published on the Marshalled List, 15 minutes has been added to the total time. The proposer of the motion will, therefore, have 10 minutes to propose and 10 minutes to wind up. The proposer of each amendment will have 10 minutes to propose and five minutes to wind up. All other Members who are called to speak will have five minutes. Before we begin, the House should note that the amendments are mutually exclusive. If amendment No 1 is made, the Question on amendment No 2 will not be put.
That this Assembly notes that, in June 2016, there were 37,347 households on the social housing waiting list, of which 22,986 were deemed to be in housing stress and 15,474 were deemed to be statutorily homeless; and calls on the Minister for Communities to commit to providing at least 8,800 new-build social housing units and 2,900 affordable housing units over the term of the Programme for Government 2016-2021.
Mr Attwood: On a point of order, Mr Speaker. I want confirmation that, when the motion that is about to be debated was submitted to the Business Office, it referred to the years 2017-2021, and that, because of the internal procedures of the Business Office in respect of the names of documents — in this case, the Programme for Government 2016-2021 — the dates in the motion submitted by the Ulster Unionists and the SDLP were changed. In so doing, the Business Office did not consult the sponsors of the motion. I accept the ruling that you have made in that regard; namely that, because the motion has been published in that way, it will be debated in that way, but will you confirm that, when the motion was submitted, the effective dates were 2017-2021?
Mr Speaker: I sympathise and empathise with the Member's frustration in the matter. It is routine for the Business Office to correct official titles of documents, as they did in this case. The correct title of the forthcoming Programme for Government is the Programme for Government 2016-2021. However, it is your intention, I assume, to refer during the debate to the dates that you mentioned.
Mr Attwood: Further to that point of order. I thank the Speaker for his comments and clarification. If something is not in inverted commas, which is how I normally refer to an official document of the Government, such as the Programme for Government, the Business Office should assume that the words submitted in a motion are the words of that motion.
Mr Speaker: Again, I accept the point that you have made. However, let me be very clear: the proper procedures were followed by the Business Office. Let us move on.
Ms Mallon: As my colleague pointed out, on 4 October at 11.07 am, the SDLP submitted the following motion verbatim to the Business Office:
"That this Assembly notes that, in June 2016, there were 37,347 households on the social housing waiting list, 22,986 deemed to be in housing stress, with 15,474 deemed to be statutorily homeless; and calls for a commitment of at least 8,800 new-build social housing units and 2,900 affordable housing units over the term of the forthcoming 2017-2021 Programme for Government.".
As my colleague pointed out, that motion, without any consultation with the SDLP or the other signatories, was changed by the Business Office, substantially altering its intention and outworkings. Regrettably, when the error that was made by officials was brought to the attention of the Speaker's Office, it was not corrected, and the motion that appears in the Order Paper is not the motion that was submitted by the SDLP. However, the original motion is the one to which I will address my comments.
There are five human rights that are essential if each of us is to fulfil our potential: the right to food, healthcare, education, work and a home. I have argued, and will continue to do so, that access to a good-quality, safe and secure home is the anchor and the glue that holds the other facets of a person's life together. Having access to a good-quality, safe and secure home increases your life chances multifold, especially when children are involved. Housing is, without doubt, an enabler for health and well-being and it is key to tackling disadvantage, driving economic growth and job creation and building a better environment and a more equal, shared and safe society that respects diversity.
Housing is both an end and a means, yet, sadly, it has not appeared in the draft Programme for Government as a strategic outcome. By the Executive's own figures, as of June this year, as I pointed out, we had huge numbers of people on the social housing waiting list and deemed to be in housing stress. A staggering and shameful 15,500 people are deemed to be statutorily homeless.
The fact is that thousands upon thousands of our citizens are sitting in poor-quality, overcrowded housing not suitable to their needs. Citizens are living for months on end in hostels with their children or they are sofa-surfing at the discretion of friends and families. Meanwhile, their health deteriorates, educational attainment is challenged and economic opportunities are reduced.
Mr Stalford: I appreciate the Member giving way. Would she care to acquaint the House with what the figure for new builds was when the SDLP held the Department for Social Development?
Ms Mallon: I thank the Member for giving me the opportunity. When the SDLP held the housing portfolio, we built more houses than any Minister prior or since. [Interruption.]
Since I was elected to the House, we have debated two housing-related motions. The first was brought in the name of Mr Fra McCann, calling for reform of the common selection scheme, particularly in the area of the award of intimidation points, and the SDLP was fully supportive of that. The second motion was brought by the Ulster Unionists and ourselves, calling on the Executive to detail their structured and timelined response to the reclassification of our 22 housing associations. That was a development of profound financial consequence for housing associations' ability to finance and build critical new homes — the focus of the motion before us today — and the wider financial consequences for the Executive to carry out their functions with an additional £1 billion added to their balance sheet. Perhaps today the Minister will give us an update on how his negotiations with the UK Treasury are going in respect of a derogation; what contingency plans he has in place if legislation is not brought forward within that time frame; and how that might impact on the target of building new social homes.
It is right that we debate the issue that, above all else, is the game changer in tackling our housing crisis: that is, the need to make land available and to build new homes. It is not a vague indicator to "improve the supply of suitable housing", which lacks definition and, as a result of using vague and ambiguous terms such as "improve" and "suitable", leaves this indicator too open to subjective interpretation. We need a clear commitment to build a set target of new homes, which contains within that a commitment to build homes for complex needs and older people. That will ease the greatest pressure on the housing system: the shortage of supply, not least in my constituency of North Belfast.
Of course, to make that happen, land must be identified and made available. In response to a question for written answer that I posed on this issue, the Minister said that he had commenced a public land for housing project, to identify land suitable for reuse for housing. The SDLP welcomes that initiative, and I ask the Minister to provide an update to the House today on the progress of that project and what consideration he is giving to the vesting of land and the use of compulsory purchase orders, where and when required, to tackle the persistent obstacle of land availability to build new homes in real time.
We also invite the Minister today to share with us discussions he is having with local government to ensure that we maximise opportunities in the devolution of planning powers and the development of local area plans and, in particular, what plans he has to bring forward the transfer of regeneration powers to maximise the opportunity that lies within local government.
The truth is that thousands of our citizens are waiting — and waiting — on the housing list. Over 500 disabled households are waiting for wheelchair accessible accommodation, with no certainty or comfort in sight. Those families deserve better. The families living in hostels deserve better. They deserve more than honeyed words. They need to be given certainty and comfort, with a clear commitment to build an ambitious number of new homes each year.
In respect of the land supply issue, the Minister is aware that the Housing Supply Forum brought forward a series of crucial and meaty recommendations. We invite the Minister to provide the House today with an update on that report.
The Executive must give clarity on the impact of welfare reform on the many social housing tenants. Given that almost a half of housing association stock is already at or above the local housing allowance cap, we also ask the Minister to share with us his plans to protect those tenants.
We will undoubtedly face the question from across the Chamber of how we plan to pay for all of this. We have the money drawn down from the European Investment Bank (EIB), with which I know the housing associations that are party to that are keen to get moving. That will allow us to build some 5,000 new social homes. We also brought to the Minister's attention the potential for Barnett consequentials from the home building fund that was recently announced at the Tory party conference. We invite the Minister to give us an update on that today as well.
My colleague will go into detail on the amendments before us, but I will make just a few comments. I have to welcome the honesty in the Sinn Féin amendment. It is the first time that I am aware of an Executive party being open about its failure to deliver, admitting that, since 2007-08, the number of people in housing stress has got worse. Although we welcome the honesty in its amendment, what I cannot understand is why Sinn Féin brought forward an amendment on housing without making reference to a single target of at least one new-build house. That will not bring any comfort to the many people who are struggling and waiting desperately on a new home.
The amendment also calls on:
"the Executive to ensure that the Housing Executive has the powers to allow it to build social homes".
The Housing Executive has that power in legislation, but, again, we have no detail on how the Executive plan to finance that, so I look forward to hearing further detail on that from the party beside me.
I turn briefly to the DUP amendment. It refers to delivering:
"9,600 new social homes and 3,750 new affordable homes between 2016 and 2021."
I am very interested to learn where those figures came from, and I would like to know exactly when and how the Minister made that announcement, because, as far as I am aware, it certainly was not made in the House, which leads one to suspect that it is in direct response to the motion brought forward by the Opposition today.
Leave out all after "notes" and insert
"that since 2007-08 until today the number of households in housing stress has remained constant, averaging around 22,000 per year despite significant investment by the Executive in new social housing; calls on the Minister for Communities to suspend the house sales scheme to ensure that housing can be retained within the social sector; and further calls on the Executive to ensure that the Housing Executive has the powers to allow it to build social homes and to work with housing associations to ensure maximum investment in social housing.".
I support the Sinn Féin amendment to the Opposition motion on housing. The other day, I was reading on the Housing Executive home page that, up to 31 March 2016, there were 37,586 households on social housing waiting lists, of which 22,654 were considered to be in housing stress, and, of those, 12,202 were deemed to be statutorily homeless. I also read in the Department's housing bulletin that, in the year ending March 2016, some 18,628 people presented as homeless, and that, between January and March this year, 4,550 people presented as homeless. That is a drop of 296 over the same period last year.
Those figures hide a frightening figure about an issue that I have raised time and time again, and that is the number of people presenting as homeless who are not accepted as being homeless. They are mostly young people under the age of 25, many of whom are advised to go to the private rented sector, and, with no mechanism for tracking them, it is then difficult to understand the journey that they are forced to travel.
We in the Assembly have a duty to ensure that we do everything in our power to deal with the problem of homelessness. We believe that we constantly need to review how we can develop a strategy that allows us to deal effectively with this difficult and complex matter. Yes, we believe that we constantly need to deliver additional social housing units. Yes, we believe that there needs to be more investment to ensure —
Mr Stalford: I appreciate the Member giving way. He is absolutely right: we do need to build more social and affordable housing. It is important to put on the record that, in the period 2007-2011, 9,192 new units of social and affordable housing were commenced. In the period 2011-16, that figure was 12,359. That directly contradicts the answer that the lady from North Belfast gave me a few moments ago.
Mr F McCann: That certainly does not surprise me. Thank you for the information, and I will deal with that as I go on.
We believe that there needs to be more investment to ensure that new social houses can be delivered, but there are other ways in which we can tackle waiting lists. One such way — again, this has already been mentioned — is to encourage housing associations to look at new ways of raising finance to increase their supply. There are housing associations that have taken that step, and they should be commended for their efforts to increase the supply of social housing.
A chairde, whilst social new builds are seen as the most direct way of providing new, modern and accessible homes, we need to look at other ways of providing much-needed housing. Social new builds are not the only way in which housing providers deal with waiting lists. They also rely on the thousands of relets that become available every year. These relets happen because people give up their tenancies and move on, or because people die and their home becomes available for allocation.
At the moment, social housing providers have over 130,000 social housing units under their control, roughly 88,000 of which are in the hands of the Housing Executive and 40,000 in the hands of the housing associations. If you consider that over 100,000 houses have been lost to this sector because they were sold under the house sales scheme, and then you think of the impact that having these homes still in the sector would have on waiting lists, we believe that the only way to protect what is left of the social housing stock is to suspend the house sales scheme. Many of the problems that we face with social housing supply can be put down to the constant sale of social houses.
Whilst there has been a serious decline in the numbers of houses being sold, any change in that would have serious consequences for the remainder of the social housing stock. Failure to act on this now could see the total collapse of the social housing sector in the years ahead. We should go down the road of the Scottish Parliament, which totally abolished the right to buy in July 2014. Tenants had up to 31 July this year to buy their home. The selling of social housing is now a thing of the past in Scotland.
Action is being taken in Wales by the Welsh Government, who have decided to restrict the house sales scheme by cutting in half the incentive. This is in front of legislation that will abolish the scheme altogether in this mandate. We need to follow this example of protecting what is left of our housing stock for future generations. I know that many in the House see the house sales scheme as a protected species, but we need to look beyond the perceived popularity of the scheme and grasp the nettle which will ensure that we are willing to go the extra mile in protecting what we have left.
The other element of the amendment is the need to look at how we can bring the Housing Executive back into the housebuilding arena. It is my understanding that the Housing Executive retains the power to build but its lack of financial resources prohibits its ability to build. If we could find ways to tackle this problem, we could see the flow of additional social houses into the sector, and that would go a long way in dealing with the housing crisis that we find ourselves in. We need to put a strategy in place that looks at all possibilities. We should rule out nothing. Adopting our amendment, along with other strategies, will move the debate on and send out all the right messages that we are serious about getting to grips with long waiting lists.
Sometimes, it is easy to get up and continuously quote terrible statistics on homelessness and maybe get a few lines in the press, but when we are speaking about waiting lists, we should remember that there are faces behind those statistics. There are families in housing stress who know that, in their area of choice, it will be years before they are considered for a home. There are parents and their children lying in homeless hostels, sometimes for years, waiting to be housed. There are young people who are forced into the private rented sector under the shared room allowance who live their lives in fear because of the conditions and drug abuse that exist in many of these dwellings. Then, there are those who suffer from disabilities and live in social houses that are totally unsuitable for their needs. These are the realities of being homeless.
I encourage the Assembly to throw its weight behind the Sinn Féin amendment. I cannot understand where the Opposition motion came from. Where did they come up with the figures of 8,800 new social houses and 2,900 affordable houses? I have always believed that there are those who will opt for an affordable home, either through co-ownership or other options that might be on offer. I have also always believed that there is a huge difference in numbers between people on waiting lists for social housing and people on waiting lists for affordable housing. However, the selective memory of some, certainly of the SDLP, never fails to amaze me when it comes to the delivery and development of housing matters. To listen to them, you would believe that the huge waiting lists appeared in recent years and this was down to Sinn Féin, but the facts tell a different story.
I was reading a departmental housing bulletin which makes interesting reading. During the reign of the SDLP in the Department for Social Development, between 2007 and 2011, the number of people who presented as homeless in 2010 was 20,158 and in the following year the figure was 19,737. The figure for 2015-16 was 18,628.
I also remember the removal of protections for areas of high demand, such as Derry, west Belfast and north Belfast by the SDLP's Margaret Ritchie, which has impacted in the delivery of social housing. I further remember the removal of grants for renovations, improvements and repairs. That has had a huge impact on the fabric of the homes of thousands of people who relied on those grants for urgent repairs.
These properties are fast becoming the slums of the future. Many of the homeowners are in no position to afford essential works, repairs or major works to bring their homes up to a decent standard. That decision by the SDLP Minister has had far-reaching consequences for —
Mr F McCann: Sorry, I have only a couple of minutes left.
— for the less well off, who depended on those grants because of their financial circumstances. And where do many of them end up? They end up on the waiting lists, made homeless in their own homes.
Under her new housing agenda in 2008, the then Minister, Margaret Ritchie, extended the house sales scheme, which made it easy for people to buy their social homes, thus, again, putting pressure on the waiting lists. So, forgive me for being a wee bit cynical when I listen to the promises made by the SDLP and the figures it has plucked out of the sky —
Mr F McCann: No.
— to cobble together a motion for today's debate. This is like the debate we had last week, when they put a motion together from nothing to give the impression that they are truly concerned and interested in moving the argument forward. We have the same thing today. They come with figures that are questionable, as a colleague across the Chamber said.
Our amendment offers a good way forward, that will allow us to tap into more social houses and the retention of the social housing stock. I support the amendment.
Leave out all after "homeless;" and insert
"further notes the Executive’s success in exceeding the last Programme for Government target by providing 7,669 new social homes and 4,685 new affordable homes between 2011 and 2016; and acknowledges the plans of the Minister for Communities to deliver 9,600 new social homes and 3,750 new affordable homes between 2016 and 2021.".
I should declare an interest in that I spent the formative years of my life with two wonderful parents in social housing accommodation. I believe passionately in the need for social housing. If devolution is to mean anything, it is that we have to do more and better, particularly for those most in need.
It is more in sorrow than in anger that I propose this amendment, given the abject inadequacy of the SDLP and Ulster Unionist motion, which was selling people short in social housing. It was selling them short, and this amendment is coming forward because we have to do better. This party, with this amendment, is not prepared to follow the SDLP and Ulster Unionist line of continuing to sell short the people most in need of social housing.
I support opposition. I thought we were going to get something challenging and invigorating. Instead, we have an amalgamation of the Ulster Unionists and the SDLP to sell short hundreds of people on the social housing list, yet they purport to say that they are their priority. Well, we are not prepared to sell those people short.
We understand the need: 37,347 people on a social housing list; 22,986 in housing stress; 15,474 statutory homeless. Even the figure of 8,800 they gave this morning is still inadequate and not good enough. The message coming from people in social housing need is that the Opposition need to get their act together and do better for them.
When I look at the vision of the —
Mr Bell: Forgive me, but I am actually going to stand up for people in social housing need, not sell them short.
When I look at the vision that people are in —
Mr Allen: On a point of order, Mr Speaker. I take offence at your remarks. As somebody who cannot get up and stand up, I take utter offence at those remarks, and I would ask you to take them back.
Mr Bell: The point I was making is I am standing up, as you well know, for the people in social housing need. That was the only meaning I had in that, and I will continue to stand up for people in social housing need.
You will hear, when I go on, that part of the proposal that I want to see is for more wheelchair accessible social housing. Coming from a family with significant disability within it and with members who are wheelchair-bound, I know that we are not doing enough in social housing. The Ulster Unionist and SDLP motion does not do enough for disabled people. It sells them short.
Mr Bell: Let me point out the inadequacies first. To bring forward the pathetic motion that they have, selling short the need of hundreds of people, speaks to me of people who want to talk the talk. This Government and this Executive are prepared to walk the walk. Look back at the record of what there was — I had the privilege of serving for five years in that Executive. We set ourselves a target of 7,500 new social housing units, and we delivered 7,669. What was achieved in terms of new units and affordability? The target was 2,450, and we achieved 4,700. I suggest to you that that is the reason that the people of Northern Ireland gave us the mandate to govern them. Not only could we set a target but we could over-deliver on that target. Having got that mandate from the people, the last thing that we are going to do, and the last thing that we are going to allow, is for the people who are most in need in this society to be sold short by a so-called Opposition whose self-appointed senior leader and self-appointed, I presume, by definition, junior leader have not even bothered to turn up. They are not prepared to do that.
Let me move on to what we need to do. We need a delivery strategy. We have a First Minister who is focused on delivery, and we have a Minister who has a comprehensive vision not to do just what the audit tells him to do — by the audit, I am referring to the net stock of the Northern Ireland Housing Executive. That audit — welcome to your Opposition — involves some 8,000 people, and the Minister comes to the House not just with the audit of need but with some 1,600 houses in excess of that audit by 2021.
I felt embarrassed for the proposer when she tried to defend the SDLP's record of 2007-2011, because, if you take those four years and the subsequent five years when our party had control, hundreds more new homes were built year after year by these Benches than by those Benches. What do they do? They come today with another record of failure and inadequacy. It is time for ambition. It is time for us to seize the day. It is time for us to look at how we can access money. I encourage the Minister: if we have housing associations, which can build two houses with the different facilities that they have, compared with the Housing Executive, which can only build one house, surely we should focus the energy on the housing associations, their capacity to borrow and the ability to build two houses, rather than focus on where there could only be one.
That is only one aspect. We have to look at finance. There is no unlimited supply of money. We have to look at where land is available, and we have to look at the area of co-ownership. Against targets of hundreds, in the past we have achieved targets of thousands. We also have to look towards how we can provide people who are most in need with the best advice possible tailored to their needs and a person-centred approach to their families.
I welcome and encourage the Minister to continue to put money into the housing advice service. I believe, and I have found it numerous times in my constituency, that when you get the right advice early on, significant problems, including homelessness — one report states that up to 500 people could be saved from homelessness with just the right amount of advice. Yes, people will say, "Why are you paying for advice?". We are paying for advice because we believe that prevention is better than cure.
Housing is fundamental to shaping the needs of our society. The Minister needs to keep his mind open, and, thankfully, we have a Minister with an open mind who is not just prepared to accept an audited target but is prepared to look at possibilities, see what can be done, and exceed that 8,000 target by 1,600 in this mandate by 2021. That is the measure that we will go by. We will go by delivery. We will not accept the failed policies of the SDLP that were evidenced from 2007 to 2011, when hundreds of people, compared with the next number of years, were deprived of adequate need. We will not accept the lack of vision and the poverty of ambition of an Ulster Unionist Party and an SDLP joining together to deliver less than what the Government will deliver. We want more; we want better. The challenge to all of us around the House is to unite behind this amendment because, through it, we will deliver the 9,600 new social homes and the 3,750 affordable homes. I encourage the House to get behind this amendment —
Mr Bell: I will do, Mr Speaker.
By being behind this amendment, we will deliver more and better. Do not accept second best from what purports to be an Opposition.
Mr Allen: Like the previous Member, I declare an interest as an individual who was raised in social housing, so I will not take any lectures from him or, indeed, from any other Member, on the needs of those in social housing. Indeed, I will not take lectures on championing the needs of those with disabilities because I think that I full well understand the needs of those with disabilities. I will not sit here and take any lectures, thank you very much.
On the problem with housing, we need to ask four questions. What is the problem? What is the solution? What is the existing legislation? What are the proposed changes? As we have heard already, we know full well the problem: we have 37,347 individuals on the housing waiting list, of whom 22,986 were deemed to be in housing stress and 15,474 were deemed to be statutorily homeless. As the Member from Sinn Féin pointed out, yes, they are statistics, and I will take no lectures on the reality of those statistics either. I do not quote those statistics loosely. Like the Member and other Members, I see, day and daily, individuals who cannot access social or affordable housing. We, in the House, need to do all that we can to give them the opportunity to access that.
In 2013, the homeless charity Crisis carried out research that identified that Northern Ireland had a higher rate of homelessness than any other region in the UK. Indeed, the SDLP Member and my Opposition colleague pointed out that there are five basic human rights and that housing is fundamental to that. It is well established, for example, that poor housing is one of the biggest detriments to the health of any population.
In fact, recent research by NIHE identified a potential annual saving to the NHS in Northern Ireland of £33 million if targeted improvements were made to housing. Additional research pointed to the cost of homelessness to the NHS as being between £24,000 and £30,000 per annum per individual. Prioritising the prevention of homelessness and the improvement of homes therefore has cascading and multiple impacts on our health and public purse. Indeed, I firmly believe that we need to see cross-departmental working on this issue; we need to see all Ministers stepping up to the plate. As my party leader pointed out, when we had the Programme for Government (PFG) discussions, we should have been around that table, housing should have been put on the whiteboard, and we should have been discussing how we will collectively approach the housing crisis.
Ms Mallon: Does the Member not find it interesting that Sinn Féin lectures the SDLP about its shortcomings when it took the housing portfolio, but, in nine years, Sinn Féin refused to take it because it clearly does not deem it important enough?
Once again, when we debate the critically important issue of housing, the DUP spends most of its time not addressing the substantive issues but attacking the Opposition.
Mr Allen: I thank the Member for her intervention. I think that we will find that, across the House, the Executive parties critique for the sake of critiquing, but we never see delivery. When we start to see delivery, we will work constructively with them. [Inaudible.]
Mr Stalford: Yes, I do; I am happy to come in. The Member made the point that people should have been around the table having discussions. His little lecture would be more believable were it not for the fact that his party could have been around the table but opted instead for irrelevance in opposition.
Mr Allen: The Member knows full well that we were around that table and would have continued to be around that table if he and his Executive colleagues were not escaping to the Castle for their secret talks.
Mrs Long: I thank the Member for giving way. Does he not think that it is ridiculous for the Member for South Belfast to demean his colleagues in Westminster by suggesting that opposition is merely an irrelevance?
Some Members: Hear, hear.
Mr Allen: I thank the Member for that valid point. I sat here not so — [Interruption.]
Mr Allen: I sat here not so long ago listening to a Member on the DUP Benches critiquing the Opposition for the way in which we behaved. [Inaudible.]
Mr Allen: Yes; OK. Thanks very much for that.
In short, we need to build more homes. I will reiterate and point out that it is disappointing that our original motion was changed. I take on board the rationale and reasoning for that, but we should have been consulted. Our motion calls on the Minister for Communities to commit to prioritising at least 8,800 new builds. That is more than the DUP amendment calls for, because ours is four not five, remember.
We have moved to an outcomes-based PFG, and the fact that we have moved to that is a realisation that the previous Government were not working. We have had nine years of the DUP and Sinn Féin not delivering for our people.
I am quite happy to sit here and say that we are not totally faultless. We are quite happy to stand up and take the criticism. We are here and are prepared to deliver, instead of putting things forward when it was made quite clear to the Chamber that our motion referred to a four-year period and Members tried to put that down —
Mr Allen: — based on a five-year period.
In conclusion, we do not support the Sinn Féin amendment as we do not believe in the suspension of the housing sales scheme. We are supportive of a review —
Mrs Long: On behalf of the Alliance Party, I welcome the opportunity to speak on the motion and the amendments. Social housing is an absolutely crucial part of our infrastructure and is a key public service. In my constituency of East Belfast, I have seen at first hand the impact that housing stress and homelessness have on individuals and families in terms of their health and well-being, and I am content to support the motion.
The challenges facing the private housing sector, reform of the common selection scheme and the recent reclassification of housing associations have all been debated in the Chamber, which, I think, reflects the fact that housing is important to everyone in the Chamber. Despite the nature of the exchanges this morning, I think that it would be more reflective of the concerns of people outside if we focused on the core issues.
The motion highlights the global picture on housing need. However, in my constituency, over 1,000 applicants face housing stress and 555 people are registered as homeless. Behind each of those statistics are individuals who are living in entirely unsuitable accommodation for their needs, are in overcrowded homes, are living from day to day sofa-surfing, in hostels and, in a number of cases that I have dealt with, sleeping in cars. That is a failure to protect human dignity, and for two reasons it is an issue that the Executive need to approach with urgency.
First, the Northern Ireland Statistics and Research Agency has documented that the population here is due to rise to 2 million by 2034, therefore increasing the pressure on housing. Secondly, given the financial uncertainty that the sector faces due to the recent decision by the ONS, there is an uncertainty in that sector about how it will continue to do the work that it has done to contribute to new builds.
Mr Allen: I thank the Member for giving way. As my colleague in the SDLP alluded to, perhaps the Minister could give us some feedback on the discussions that officials were at on Friday.
Mrs Long: I would certainly welcome any update that the Minister could provide.
Mrs Long: Thank you. It is important that the financial flexibility that housing associations have be deployed to address housing need.
The Minister has informed the Committee and the House of his intention already to build 1,600 homes next year using the £106 million allocated by the social housing development programme. It was noted at his initial meeting with the Committee that the figure was less than the 2,000 recommended by the Housing Executive. However, Alliance is happy to support today's amendment from the DUP, despite its best efforts to dissuade us, because the amendment shows an increase in its ambition for social housing. If that is prompted by an Opposition motion, congratulations to the Opposition for drawing it out. It is disingenuous for some to suggest that those figures were in the public domain prior to the debate. It is therefore a credit to those in the Opposition who have drawn this out into public discussion and seen that increase in ambition. That is something that we welcome.
Unfortunately, we will not support the Sinn Féin amendment, because it takes a broad-brush approach to what is, I think, a very difficult issue. In some localities, it would be helpful as a short-term measure to protect housing stock. It ignores, however, the contribution that right-to-buy has made in stabilising neighbourhoods and helping people get a foot on the housing ladder. I do not believe that the housing sector is clear that it is not the policy but how it is applied that is the issue. Instead of suspending the scheme, consideration could be given, for example, to reducing the discount available to tenants, ensuring that the debt burden of new builds is cleared before houses are sold, alongside a commitment that every home purchased will result in another being built and that the money will be reinvested in housing stock.
Mr Agnew: Does she not appreciate, though, that continually selling off homes and then reinvesting, given that the homes are sold at less than market value, means that we are forever having to subsidise further, much more so than if we did not have the house sales scheme?
Mrs Long: Yes, we do have to subsidise, but the house sales scheme is good for building viable, sustainable and vibrant communities. It is important that people be able to get a foot on the housing ladder in the communities in which they have grown up and be able to contribute back to those communities. A broad-brush approach to stopping the house sales scheme is not the way forward. That will become clear from what I say next.
Alliance believes that there is a number of things that we can do to tackle the housing crisis that we are in. First, there are 20,000 properties lying dormant across Northern Ireland. A focus on returning them to use would not only add to the housing stock but reinvigorate communities that often find dereliction a real challenge, associated as it is with antisocial behaviour and other problems. A scheme to deal with that would be very welcome. Secondly, to create viable, sustainable and thriving communities, we believe that expanding the emphasis on development of mixed tenure housing is hugely important so that people in social housing are not stigmatised, are not cut off from the services that others enjoy, and are able and encouraged to progress in society. Finally, we need to look at the barriers to people being able to accept housing in which they feel safe. Intimidation, whether sectarian or within communities, continues to render people homeless, and we need to deal with shared housing to allow people to have more choice, not less.
Mrs Long: I will, Mr Speaker. I was disappointed, I have to say, in the Minister's response that this is social engineering. Quite the opposite. It is about maximising the choice —
Mrs Long: — so that any person can live in any home, in any place, in safety.
Ms Gildernew: I am delighted to participate in today's debate. To a certain extent, I agree with Nichola Mallon's opening remarks: housing is a fundamental human right. Indeed, the issue of housing, or lack thereof, is the reason for my involvement in politics.
The Housing Executive was set up after the eviction in Caledon in 1968 and has worked to deliver the building and allocation of social housing for almost 50 years. However, in the SDLP's PFG submissions — six themed documents on poverty, infrastructure, justice, economy, health and childcare — social housing is not mentioned. It makes no mention of housing need or provision in rural areas.
Again, housing in rural areas has always been of great interest to me. I am on record numerous times during my time in the Assembly, in this Chamber and the Committee for Social Development, talking about the level of unfitness, particularly in my constituency of Fermanagh and South Tyrone. I was horrified when the then SDLP Minister removed the Housing Executive maintenance grant scheme and condemned many rural dwellers to live in accommodation that was not fit for purpose. I was aghast to hear that a scheme that was helping to bring houses up to a level of fitness in my constituency was done away with.
Around the same time, other changes in the allocation of the housing budget were to have unprecedented implications for the housing stock. For example, 2,201 house sales were completed during 2006-7, yet, in 2008, Margaret Ritchie chose to extend the house sale scheme. Further to that, she announced that she would provide funding for the purchase of off-the-shelf homes for private developers. Under this scheme, Clanmil Housing Association bought 40 private apartments valued in the region of £7 million, which meant an approximate cost of £175,000 per property. Who benefited from that? The developer certainly did, and so did the tenants, but was it the best use of public funding?
Mr Stalford: Will the Member also appreciate that, as I recall, people in the Village area had been fighting for many, many years to get redevelopment and proper housing, and, at the time when the SDLP Minister was in place, they were told that there was no funding for that, but the same Minister was able to find funding to keep a big wheel at the side of the City Hall?
Ms Gildernew: I am not sure of that. In fairness to the Minister, while I was preparing for the debate, I did actually see references to the Village and her commitment to try to bring the housing stock up in that area.
The difficulty with buying off-the-shelf houses meant that, yes, some tenants in Belfast benefited from it, but there was decimation to the budget that had a knock-on effect across the region. It meant that, in real terms, housing associations had been given more than £130 million in taxpayers' money to purchase 1,400 homes and turn private developments into social housing. The collapse in the property market meant that the average cost of an off-the-shelf home in 2011 dropped to just £60,000; less than half of the original price four years previously, so that was a very poor investment in monetary terms from the public purse.
Taking that along with the extension of the house sale scheme, I found that there was a knock-on effect across the board and much less in the way of social housing available to constituencies like mine. The decimated Housing Executive stock, which, I understand, now stands at around 88,000, means that we do have a knock-on effect, and there is not enough social housing for many of the people who need it most.
Before I run out of time, I would also like to talk about the 70% of adults with learning disabilities who currently live at home with carers. That needs to be properly assessed. I ask the Minister to extrapolate the figures from the different trusts and bring in the need that is there currently; the need not just of people with physical disabilities, of which there are many, but of those with learning disabilities. They need to be factored into the waiting lists to ensure that we have a proper grasp of the need that is out there, and we can then find ways to meet that need and provide quality, affordable social homes for people right across the board.
Mr Robinson: The debate refers to one of the most pressing problems that many people experience today; that of finding social housing that is suitable for their needs and at a price that they can afford. The motion states that a further 2,900 affordable housing units are desirable. I would ask the Member who signed it to read the DUP's 2016 manifesto, which states that my party wants to see 8,000 affordable homes delivered in the Programme for Government period to 2020. That is 5,100 more than the motion states. I am sure that those who proposed the motion will be relieved to learn that. When it comes to new-build properties, there is no doubt that that is an important way of achieving —
Mr Robinson: You had your say.
— what the motion seeks. It is an important way of dealing with the 37,000 households awaiting homes.
I wonder whether those who moved the motion have had discussions with the Finance Minister regarding the funding of the new-build homes. It is an unpleasant reality that all plans need to be funded and that the financial cake that we have in Northern Ireland is already divided thinly. In the previous mandate, 2011-15, £400 million of public-sector money and £315 million of private-sector funding was spent, resulting in over 8,500 social and affordable homes being constructed during the period. That is a respectable record.
We also have to look at bringing empty properties back into use. In my town, I have seen quite a few void properties being repaired and returned to use and there was great appreciation from the families who were awarded them. When I look at this, I understand the value of that approach. There is also merit in looking at developing empty space above commercial premises. I appreciate that people moved out of our town and city centres due to the Troubles but, now that the bombings and firebombings have ceased, the time is right to utilise empty domestic properties in the centres of towns and cities.
There is a need for social and affordable housing, but, to solve the current situation, we must look at all possible solutions. We must ensure that what finance is available is used in the best way to reduce the level of families needing a home.
I cannot support the motion.
Mr Dunne: I, too, welcome the opportunity to speak in support of amendment No 2 today. There is no doubt that there are real challenges that continue to exist as we try to meet the housing needs of our population.
A growing population, which is projected to reach two million by 2034 and 1·9 million in the next five years, reinforces the need to continue to plan and build in a measured and strategic way to ensure that the housing needs of our communities are met. I welcome the Minister's recent commitment to housing when he increased the budget for the social housing development programme, with the aim of creating 1,600 new starts this year. Every day in my constituency office, housing continues to be a major issue for many people, from young people seeking their first home through to the elderly person seeking suitable ground-floor accommodation in a sheltered housing scheme, if available. Demand continues to grow as Housing Executive stock continues to diminish as houses are sold off to tenants. That has given many people a great opportunity to get their first home.
There has been a real transformation in so many estates throughout Northern Ireland with the investment that has gone in through the Department, formerly the Department for Social Development. We should commend all the good work that has been done through housing associations and the Housing Executive as they continue to transform many estates, working with the local communities. In my constituency of North Down, I think of areas like Kilcooley, which is one of the largest estates in Northern Ireland, Whitehill, Bloomfield and Rathgill in Bangor, and West Green in Holywood. They have all benefited from major investment; it has helped to transform those areas. I recently had the pleasure of joining the Minister in Rathgill to see an exciting new Fold housing development being opened. That scheme, which had considerable consultation between Fold and the local Rathgill Community Association, will add to the housing stock in that area. Many new purpose-built quality homes have been constructed to meet the needs of many of our young people, the elderly and those with disabilities. I know how grateful many of the new tenants are who are living in those properties.
As of June 2016, there were 2,045 on the waiting list in North Down, and 810 of those were classed as homeless. This shows that more that needs to be done. However, we must continue to build on the progress that has been made to date.
Mr Dunne: No.
Co-ownership is also a great way to give young people an opportunity to own their first home. I commend the efforts of the Minister with regard to that. It is so important, as young people try to meet the challenge of getting on the property ladder, with property prices still being excessive. We need to see investment in the supply of affordable homes for our young people. A lot of good work continues to be done. I want to put on record our thanks to the Housing Executive in the Bangor office, whom we work with on a regular basis, for the constructive work that they have done and continue to do in helping to meet the housing needs of the local people. More could be done to acquire land in areas of high demand like North Down through cooperation with our councils and other government agencies in relation to surplus land. I support amendment No 2.
Mr Attwood: I have a habit — probably a good habit — of wishing Ministers well, especially Ministers of welfare and housing, and I wish this Minister well. My memory of being housing Minister is that it is one of the most valuable pieces of work that you can do in government. I met the Minister of Education coming here this morning, and he said that he had a series of school visits planned. That tells the tale that going to schools, going to new-build housing or announcing housing plans is part of the best work of any Minister. I wish him well in all of that.
(Mr Deputy Speaker [Mr Kennedy] in the Chair)
I was not planning to do this, but I have to comment on some of the earlier debate by making two remarks — on the new build figures and on waiting lists. In the debate this morning, there was a sense that it was 'Play Your Cards Right': "Higher, higher, higher" seemed to be the claim of some. In order to get clarity and break through the fog, let us look at what a DUP Minister said in reply to a question in the House about new-build social housing, going back to 1998. I will lodge the answer to the question in the Library. I hope that this Minister, from the same party as his predecessor Nelson McCausland, will not dispute the figures of the previous Minister and that nobody in the Chamber will dispute the figures of the previous Minister. What did those figures confirm? They confirmed that, in the years 2007 to 2010-11, when the SDLP had the housing brief, there were 8,394 new-build housing social starts. That includes new build, off the shelf, existing satisfactory purchases and rehab and re-improvement. That is Nelson McCausland speaking. Then he went further and said that, in the four years from 2011 to 2015, the comparable figure was 6,704. The facts from the DUP confirm that, in the four years when we were in the Ministry, compared with the four years since or the eight years before we were in the Ministry, new-build social housing starts were at their height of any mandate, of any Government who had responsibility for this area. I hope that settles the issue about the facts.
Mr Attwood: I will in a second.
I want to turn to what Mr McCann said. He gave us further facts on what housing waiting stress and housing stress were in previous times. The one thing that he did not dispute was the figures in the SDLP motion, the figures that refer to 37,000 and more on social housing waiting lists, 22,000 and more in housing stress and 15,000 and more deemed to be statutorily homeless. He did not dispute those figures, which are the most acute in a generation. Therefore, whatever the figures were when the SDLP was in government, they are far worse now and are deepening as we speak. Those two facts — the achievement in government and the size of lists now — should conclude the argument about facts once and for all.
Mr McGrath: There was also a reference earlier by Sinn Féin that there was nothing in the Programme for Government negotiations from the SDLP. In our submission, did we not propose three Bills on housing? Did we not also have an entire section of our document on housing?
Mr Attwood: I do not know where Michelle Gildernew gets her information; probably where John O'Dowd gets his. Yesterday, he did not know what Martin McGuinness had said the previous day, and, today, Michelle Gildernew does not know what we submitted to the PFG. I wrote part of it, and we set challenging targets for new-build and affordable housing, as, I am sure, the Minister is aware. I hope that Michelle Gildernew will reflect on that.
In conclusion, I want to ask a number of critical questions. If the Minister can answer them in a positive way — if not today, then subsequently — the new targets outlined in the DUP motion might be met. I welcome the new targets. The curious thing about them is that, pro rata, they are virtually identical to the SDLP's amendment. The figures that we propose over four years are, pro rata, identical to the figures that the Minister proposes over five. I think that the Opposition has proven their worth today, because they have smoked out the DUP, without reference, of course, to their colleagues in government, to the point where they have had to put hard figures on the public record in response to the hard figures proposed by the Opposition.
I will write to the Minister with a series of 12 questions that I have, and I look forward to his response, because, in that way, the figures —
Mr Attwood: — the operation and the implementation can deliver to address the stress and waiting lists in our motion.
Mr Eastwood: Thank you, Mr Deputy Speaker. I had absolutely no idea that you were going to call me, but thank you very much; I did not assume that I would be called straight after Mr Attwood.
First, I welcome the fact that this is the first day that we have had joint motions from the Opposition. We hear cries from across the room that the Opposition cannot get their act together, but we have today got at least two motions with names on them from the Ulster Unionist Party and the SDLP. I am also very glad, as Mr —
Mr Allister: Would the Member agree that this debate highlights the division between the two Executive parties? We have a Sinn Féin amendment castigating house sales that the DUP is patently not going to accept. In so far as the debate highlights division, is it not a chasm at the centre of the Executive on housing policy?
Mr Eastwood: I thank the Member very much for his intervention. He must have seen some of the notes that I have in front of me. It is absolutely clear, given the criticism that comes from the other side of the room and sometimes from this side of the room as well that, "God, the Ulster Unionists and the SDLP do not agree on every single aspect of policy" — why would we? — "God, the Ulster Unionists and the SDLP have a slightly different approach to the European Union" — why would we not? [Laughter.]
— "Oh my God, the SDLP and the Ulster Unionists do not have the same manifesto" — why would we? I will tell you what we do: we work together in the interests of democracy and in the interests of the House. That is why I strongly believe that the Opposition are having an impact.
As Mr Attwood has just pointed out, we have seen new figures from the Minister. We welcome them very much. The new figures from the Minister, the new commitment from the Minister and the new understanding that we need to build more social housing and more affordable housing to a level that is appropriate and required all say that the Opposition are working. They are pushing the Executive to do more and better things.
When we went into opposition, we did not say that we were just going to oppose everything for opposition's sake. In fact, we said the exact opposite. We said that we would work with the Ulster Unionists. We would work with any political party, either in government or outside the Government, to make sure that the Executive do the best possible things for the people who need it most.
It is strange; maybe it is deliberate — I am not sure, Mr Allister — but we have seen a real attempt in radio and TV studios and in this Chamber, and I am glad to see the two Government parties working together. Unfortunately, today, somebody did not get the memo. It is strange. It looks a bit like the last mandate. Maybe they have slipped up, and maybe we are going to see more of this to come, but we have two opposing amendments from the two Government parties.
Mr Allen: Would the Member note with interest that, every time you refer to the previous mandate, those on the opposite Benches continually refer to the Ulster Unionists and the SDLP being in that Government, but they now no longer have that cover to blame the Ulster Unionists and the SDLP for their failure, and they will be found out for exactly what they are?
Mr Eastwood: I thank the Member very much for his intervention. Yes, of course we were in the last Government. The SDLP had one member of that Government, and for all the talk of the collegiate, partnership working that we now hear, there was not much of that when we were in government, I can tell you very clearly. There was not much of that. There was not much respect for our mandate, or the Ulster Unionist mandate, or the Alliance Party mandate around that particular Executive table, and if things have changed, I welcome that. I believe —
Mr Eastwood: I believe, Mr Stalford and Mr Deputy Speaker, that it is the fact of an Opposition that is forcing this Government to work together. We will see, when it comes to the final production of the Programme for Government, whether it is just going to be about bluer skies and greener grass or whether we are going to see some real commitments to the people; people in my constituency, people in West Belfast, people in North Belfast and people right across the North of Ireland who have been let down by nine successive years of bad government.
Hopefully, the Opposition will put those guys and these guys in their place and get them finally delivering for the people of Northern Ireland and that will make sure that people my age and of my generation do not have to leave our shores to find work or a university place. Hopefully, it is the Opposition that is putting the Government in the right place once and for all.
We welcome the move from the Minister to take our consideration and our proposals on board to change this desperate situation in which we need to build more social housing for our people.
Mr Deputy Speaker (Mr Kennedy): I call Mr Steven Agnew. Mr Agnew, you have five minutes, if you choose to take it, but an intervention will not give you an extra minute.
Mr Agnew: I had thought that we had moved to the era of outcomes. Unfortunately, this debate has been very much about outputs — arguing over numbers; who built more houses than whom — when the reality is that, whether it was the last five years with the DUP holding the ministerial position or the four years previous to that with the SDLP, effectively there has been little change in housing need, housing stress and homelessness. There may have been some variation on a minor scale.
Effectively, what we have done is to keep a lid on the problem, but we have not got to the point where we have been able to address or tackle it. It is not just about those two parties. We have had five parties in government. Sinn Féin can criticise, but it has been the second-largest party in government for a considerable time. There needs to be collective responsibility but also collective action in seeking to address it.
I do not make those points to criticise the record of any party. I do so just to criticise the tone of the debate, which has not been particularly constructive. Sometimes, it is important in politics that we disagree; absolutely, that is what politics is about. But we actually do not disagree on this issue. We do not disagree that our levels of housing stress and homelessness are too high. We agree that we need to build more housing. We might disagree marginally around the issue of the house sales scheme, and I will come to that, but on the majority of the issues we agree. Yet to listen to the tone of the debate, it sounds as though we are at complete odds, and there is almost an accusation that some parties support homelessness — it is a wonderful thing, and we should have more of it. Nobody subscribes to that view. We all want to tackle the issue, and we should work together to do so.
Different approaches are laid out in the motion and in each of the two amendments. I accept what the SDLP said about how the figures in the motion were arrived at. However, that is the motion that we will vote on, so I am inclined to support the Sinn Féin amendment, because it talks about going beyond what we do currently to doing some things differently. It is my view that we should suspend the house sales scheme. Although house sales are modest at the minute, another boom in the housing market will undercut our investment in public housing. Look at the effect of the scheme over decades: in 1973, there were 155,000 Housing Executive houses, while today the figure is 88,000. In the past few years, when we have been building more than we have been selling, over the course of the right to buy scheme, as it is commonly known, we have sold off more than we built. That cannot continue, so it is right that we suspend the scheme.
It is also right that we look at options for allowing the Housing Executive to finance new builds again. Rightly, a call will go out asking me, "What have you done?". I have commissioned research on what those options should be. Once that research is complete and I have had time to look at it, I will come back with my proposals for how that should happen. Right now, I want to support the principle of giving power back to the Housing Executive. There has been a call — I think that I am right in saying that the Minister, to be fair, is opposed to it — for rent convergence between the Housing Executive and housing associations. The reality that the Housing Executive would be able to borrow at a cheaper rate, given its 88,000 housing assets, weakens that argument. It can also help us to resist any drive to increase social housing rents in the Housing Executive, allowing it to raise finance in other ways, without putting an additional burden on those already on some of the lowest incomes.
Mr Agnew: We have to change what we are doing, but we should be working together, and —
Mr Agnew: — this debate has been regrettable.
Mr Givan (The Minister for Communities): I welcome the opportunity to respond to the debate. From the outset, let me reassure Members that my motivation to deal with housing issues is very much grounded in my experiences as an elected representative — I was a councillor from 2005 — and the experiences of all my colleagues in a party that is very much grounded in the working-class community. My motivation is not based on the Opposition. It is not based on the Opposition tabling a motion to which, within a couple of days, we came up with an amendment that increases the ambition. If the Opposition believe that that is how government operates, that is why they are in opposition.
I want to make clear what my motivation is. My motivation is based on being in Seymour Hill a number of weeks ago and seeing the damp conditions that people in the tower blocks have to live in. It is based on the experience of being in the home of a young girl who, sadly, paralysed and in a wheelchair as the result of a car crash involving her boyfriend, had faced delays in getting adaptions to her home because of the failure of the housing association responsible, which led to my intervention. My motivation is based on Nichola Mallon bringing a constituent to me who is also struggling to be housed. That is what drives me to tackle housing issues, not the politics of responding to the Opposition.
Ms Mallon talks about "honeyed words" not being enough, but you will not get honeyed words from me when it comes to dealing with housing matters. You will get hard work. I appeal to Members: hysteria will not achieve what we want to achieve, but what I heard from some in the official Opposition was more hysteria than a real solution.
The most considered contributions to the debate from oppositionists came from two Members who are not in the official Opposition — Ms Long and Mr Agnew — and they spoke about how we can deal with this.
I appreciate and understand the need for the two official Opposition parties to try to have relevancy. We, as a party, want them to be relevant because we negotiated that there would be an Opposition through Fresh Start, so we want the Opposition to work. I think that Members should reflect on how they have added to the debate when it comes to dealing with what is a very important issue.
Let me get to dealing with the substance around the issues that Members have raised. Hopefully, I will address most of the points that Members have brought to the Floor, and, time permitting, I will deal with some more specific ones.
The motion allows me to recognise the success of previous Ministers in exceeding the last Programme for Government targets on social and affordable housing and an opportunity to set out my ambition to do even more during the current Programme for Government period. Increasing housing supply across all tenures is an important issue. While the private housebuilding industry continues its slow but steady recovery, it remains important for government to provide more than its fair share of new housing supply through additional social and affordable homes. In the last five years, the Executive, including, I acknowledge, the Ulster Unionist Party and the SDLP, did an excellent job, setting ourselves targets of starting 7,500 new social housing units. Not only did we meet that target but we exceeded it, starting 7,669 new social homes over that period. There is a similar story on affordable housing, where we helped almost 4,700 households take the first step to owning their own home, against a target of 2,450. That success should rightly be recognised and applauded, and, for that reason, I support amendment No 2, tabled by my colleagues.
I am keen to build on that success and do even more, particularly around social housing, during the current mandate. The Housing Executive has statutory responsibility for assessing housing need, and, using the net stock model, it has identified a need to build 1,600 social homes a year to meet population change. That equates to 8,000 homes between 2016 and 2021, and I have already committed to building to that level as a minimum. However, I want to be even more ambitious than that, and, as long as enough funding is available, I want to start 9,600 homes by March 2021. To achieve that, we will have to maximise the potential of the existing delivery system, and, for that reason, I welcome the new delivery strategy developed by the Housing Executive in partnership with my Department and the Federation of Housing Associations. As well as improving the way in which the social housing development programme operates, the strategy aims to increase the land bank available for social housing development and encourage housing associations to take on bigger sites.
Amendment No 1 calls on me to ensure that the Housing Executive has powers to build social homes: I can confirm that it already has those powers. However, for reasons of affordability, the Housing Executive no longer builds. It could only build if its income from rent or other sources, such as house sales, allowed it do so. The Housing Executive’s current income falls short of what is needed to maintain its existing 88,000 properties, and I believe that that is where the priority should first be. Also, it does not currently make financial sense for the Housing Executive to build homes. With their ability to borrow commercially, housing associations can deliver almost two houses for every one that the Housing Executive could deliver using grants alone.
Mr Beattie: I thank the Minister for giving way. Has he engaged or will he engage with the Ministry of Defence, which has now scheduled its surplus housing stock in Aldergrove to be demolished next year? That is housing stock that could be used for homeless veterans, families leaving the services in transition or, indeed, given the debate that we had yesterday on domestic abuse, as emergency housing for families involved in domestic abuse.
Mr Givan: Of course, the Executive negotiated with Her Majesty's Government to have transfer of surplus properties, and a lot of that has come from the Ministry of Defence. In my constituency, surplus housing is being provided. That is an ongoing programme that we are working on. The point is well made about making sure that, when the properties become available, they are used. It comes with its challenges. There can be a significant number of houses released, and managing that process is something that a community at large needs to be able to do. I will touch on how we need broader support from the community to make the changes that we want to make.
Amendment No 1 also calls on me to suspend the house sales scheme. My officials have just completed a policy review of that scheme, and I will consider options for its future shortly. Whatever I decide, I am keen to ensure that I support aspiration, helping those with the necessary desire and financial capability to move into home ownership. I am also mindful of the need to ensure that we have sufficient homes available for those who need to rent.
It is right to be ambitious, but delivering 9,600 new social homes over the course of the mandate will not be easy. Money will never be endless, land in areas of high need is in short supply and we face community opposition to social housing development in some areas. Communities sometimes need that extra bit of reassurance, and I would welcome support as we look to build new homes across Northern Ireland.
As the motion recognises, affordable housing can also make an important contribution to meeting housing need and demand. My Department has also been able to secure £100 million in government loan funding for Co-ownership, which helped support 725 families into home ownership last year. We have also extended the number of affordable housing products available through the affordable home loans fund, including a rent-to-own scheme. Taken together, those initiatives mean that I aim to deliver 3,750 additional affordable homes over the mandate.
Ms Mallon: I appreciate the Minister giving way, seeing that he has already given way once during his response. He will be aware that Members have asked for clarity on where the increased figures before us have come from. Will he point us to where he has publicly announced the increased figure prior to today's debate, or will he have the maturity and the honesty to admit that they have come in response to the Opposition motion before him today?
Mr Givan: The Member has met me to discuss these issues, and I note the change in tone when we are in the Chamber compared with when we are in a private environment. It is an issue that we are dealing with. It is one that I have been engaging on throughout the Programme for Government with my officials and in the Executive, and it is a priority for us to deliver more housing. Does the Member really believe that we came up with the figure in response to an Opposition motion? That is not how government works. Mr Attwood, who is very familiar with the need to provide housing, knows that you simply would not be able to provide the figures in response to a motion, when you have to go through the processes of engaging with officials, housing associations and the Housing Executive so that you can provide a credible figure that you can stand over. It is not simply a case, as Mr Attwood indicated, of "Raise me higher" and "Who's got the best cards?". That is not how politics works, and it is not how the delivery of housing works.
Mr Attwood: Would you, at least, concede that it is a curious coincidence that the figures being proposed by the SDLP over four years are in and around the figures that you now propose over five years?
Mr Givan: Curious indeed, Mr Attwood. Mr Humphrey wanted me to give way.
Mr Humphrey: Does the Minister agree that sometimes there is a difficulty with the Housing Executive's role and responsibility on regeneration? Therefore, does he agree, having visited the Building Successful Communities areas in north and west Belfast with me only a few weeks ago, that this is a really good pilot and a good example of how it can be rolled out across Northern Ireland. For example, in lower Oldpark, where 26 derelict houses have been brought back to life, confidence in the community has increased and the environment has massively improved. We have 10 houses being built on the front of the Oldpark Road and 15 affordable planned for Cliftonpark Avenue. This is an example of how the Executive can work when they are supported by the Department to work on the joined-up approach that the Minister talked about earlier in his speech?
Mr Givan: Thank you, Mr Deputy Speaker. That visit demonstrated to me the importance of that programme. One of the arguments made by previous Ministers, when the DUP did not hold the Ministry, was that there was not enough need, whilst areas were allowed to continue into dereliction. Of course, who wants to move into those areas when you are not improving that environment?
The DUP, having implemented this new programme, has regenerated a number of those areas, particularly in north Belfast, and now you have people on waiting lists wanting to get into them. That has been as a result of DUP Ministers implementing that and of the representation made, not least by Mr Humphrey.
In respect of how we can take this forward, I want to do more. Let me finish by highlighting another area. The Department is responsible for the St Patrick's Barracks site in Ballymena, and we are developing plans that include the provision of social, affordable and private housing, all with a shared-housing ethos. I know that Mrs Long is not here at present; she touched on this issue in regard to comments that I made previously. Let me be clear. I support shared housing, but it is about creating the conditions and environment where people want to share housing. It is not about forcing people and it is not about manipulating a waiting list, on the basis of religion, to deprive people who need a house. I am very clear about how I want to see shared housing developed. I am keen to see more mixed-tenure housing of that type. I have asked my officials to develop proposals for how that can be achieved, potentially using money within the Fresh Start Agreement earmarked for shared housing.
Building new housing is clearly important, but housing need can also be met in other important ways. The private rented sector has a role to play, and, later this year, I will publish proposals for consultation on the future role and regulation of the private rented sector. Preventing homelessness is also of critical importance. This year, I am investing almost £1 million in housing advice services, to help over 7,000 households take action on serious housing issues and directly prevent homelessness in almost 500 cases. The Housing Executive is also rolling out a housing options service across its office network. It aims to provide a more holistic service to those with housing issues and take early action to prevent homelessness. Where possible, prevention is always better than cure, and I am also investing funding, through Supporting People and the homelessness strategy, in helping to end the cycle of homelessness for those who have found themselves homeless on a regular basis, including on the streets. I have seen some of that work at first hand, and it helps people to turn their lives around.
In conclusion, increasing the supply of housing across all tenures is a vital issue. I will do all that I can to increase the supply of social and affordable housing, but I cannot do it alone. I need the support of all in the Chamber to encourage local communities to embrace the opportunities that new development brings. I need the support of councils to zone enough land for housing and deliver a high-quality planning service. It will not be easy, but I want to be ambitious and for all in the Chamber to share that ambition and help deliver significant numbers of social and affordable homes over this mandate.
Mr Deputy Speaker (Mr Kennedy): It is always a pleasure to see people in the Public Gallery. It is a particular pleasure for me to welcome the principal, staff and pupils of Bessbrook Primary School to the Public Gallery. All politics is local.
Mr Stalford: I would like to associate myself with the comments the Minister made regarding the contributions from the Member for North Down Mr Agnew and the Member for East Belfast Mrs Long. Whilst I did not agree with everything that both of them said, I thought that they were measured and sensible contributions that had useful ideas in them.
Like the Minister, I spent a long time in local government — 11 years, in fact. Like him, I have long experience of dealing with constituents who have encountered all sorts of difficulties, whether presenting as homeless or seeking improvements or adaptations to their properties. All of us, if we are doing our job properly, have had experience of that: constituents who are plagued with damp-ridden properties and people who have been waiting for a long time to get into housing. Like the Member for North Belfast, I agree that a home is a fundamental right. Stable and secure communities, families and societies are reliant on a supply of housing that is of a high standard. A recent survey showed that 40% of housing on the mainland was insufficient in the quality of housing provided. I do not think that the figure is comparable for Northern Ireland. There is a huge problem not only in the need for new builds but in the need for improvement and adaptation of existing properties.
House-building is important. An important and simple question to ask in the debate is this: is it better to build 9,600 social units or 8,800 social units? If the answer is that it is better to build 9,600 than it is to build 8,800, Members should support the amendment that we have tabled. It is unfortunate that some of the broad agreement — Mr Agnew referenced this — on these issues and on the need for action in these areas has been drowned out by some of the contributions in the debate, but perhaps all will be well when we get back into the Committee and have further discussions on the issues. I think, sitting on the Communities Committee as I do, that there is agreement across all parties on the need for action in these areas. If there is a bit of knockabout in here, that is the nature of the game, and people will see it for what it is.
I agree with the Minister: the notion that a motion tabled by the Opposition would, in some way, direct a Minister to change his housing target is laughable. I think that they know that; when they stand up and say those things, I think that they know that. The proposal from the Opposition shows a lack of ambition. I am glad that the Government are going further than the Opposition hoped, and I therefore welcome the chance to discuss that.
Mention was made in the debate of outcomes-based accountability. I welcome the shift to outcomes-based Government, as it is a positive route to go down. I think that, as a Government, we should be judged at the end of our five years on whether we met the targets that we set. I am happy that our target for house-building is an ambitious one that goes further than the Opposition suggested. I hope that, at the end of our five-year term, we will have delivered on it, and people will be able to look at our record, like a report card, and see that we met that target.
I disagree with the idea of ending the right-to-buy scheme, as the right of people to own their home should be encouraged. We should encourage people who wish to get on the property ladder if they want. I believe in the right of people to own their home and not to live their lives as clients of the state, paying the state rent, and upon their death having —
Mr F McCann: On the right to buy, I have no doubt that it is a popular scheme, but when you look at the destructive impact that it has had on the social housing stock over many years, you can only come to the realisation that it needs to cease. In Scotland —
Mr F McCann: In Scotland, they did a review and changed it, and in Wales, they did a review and changed it. That has to be the way forward for us. It will be interesting to listen to the Minister's review when it is —
Mr Stalford: OK. I will be very brief on that. I believe in a mixed housing market. I do not believe that the state should be the sole provider of housing.
Mr McCartney: We will not be supporting the motion. Having listened to the Minister's contribution this morning, which we welcome, and to the contributions from the DUP, we will be supporting its amendment and not calling a division on our amendment.
One of the striking aspects of the motion is that you get a sense from the SDLP and the Ulster Unionists that they somehow believed that, once they opted for Opposition, all that went before did not exist. It is as if there was no time before a certain date. For them, day 1, year zero was sometime in June 2016.
Mr McCartney: I do not get an extra minute, so the answer is no.
However, the reality is that, no matter how hard they try or no matter how many times they say it, other people will remind them of the positions they have taken on particular issues.
So, even today, the motion states that by 2021 there should be 11,700 new homes — 8,800 social homes and 2,900 affordable homes. We received no explanation or rationale as to why the proposers came to those particular figures. I suppose the secret lies in what they have recently said.
In their May 2016 election manifesto, just a few short months ago, the Ulster Unionists talked about the need to build 10,000 new social homes by 2021. There is no reference as to how they got that figure, but it is premised on a waiting list of 44,000. Today's motion states that the number on the waiting list is lower than that. We are not sure whether the motion is an SDLP motion or an Opposition motion, given the earlier point of order, but we are now told that in a lesser timescale they want to build more houses than was stated in their target in May and we are provided with no explanation. The only thing that has changed is that they are now in opposition and think they can say whatever they want and it sounds good.
(Madam Principal Deputy Speaker [Ms Ruane] in the Chair)
The SDLP held the housing portfolio so, with the benefit of the inside track, so to speak, you would think that its figure would be worth noting. But when you look at its Assembly manifesto, you see that there was no real figure, no approximation. There was a vague, indeed, clever reference to the regional development strategy. It talked about the need to increase provision but there was no reference and no baseline. Now, in October 2016, there is a very precise figure. This world of opposition is a very wonderful place.
Nichola Mallon talked about the great need in North Belfast, and Colum Eastwood is to be congratulated for perhaps the most impromptu speech he ever had to make. To have your name down for a motion and then say that you did not know you were going to be called to speak is some admission in itself. However, he went on to say that there was also a great need in North Belfast, West Belfast and in his and my constituency of Derry. There once was ring-fencing for social housing in those three areas because of the need, which was well-identified. Fra McCann pointed out that many people thought that it was the sensible approach; where there was great need, to go after it. That scheme was brought to an end by the SDLP, initiated by Margaret Ritchie and then processed through by Alex Attwood. In case Colum feels left out, he was the undersecretary at the time.
For us, it is a very clear statement. We are part of the Programme for Government. In our manifesto, we set a minimum of 10,000 social homes, and that is what we will be tested on. That is what setting outcomes in the Programme for Government will do. We will be tested on what we say. It is very important for the SDLP and the Ulster Unionists to learn this about opposition. They remind me of the story of the person who grafted a hump onto a horse, called it a camel and expected everybody else to believe it was a camel. When you bring a motion to the House, it will be tested and scrutinised, and you will be reminded of what you have said in the past. We will certainly call your camel a horse because it is a horse.
Mrs Palmer: At the outset, I welcome the Minister's intention to give an undertaking to build more new houses in this term. Although the causes of and the solutions to the issue that the motion grapples with are complex, the issue itself is simple. There is a desperate need to increase housing supply. There is not one person here who would disagree with that statement.
Every day, in every constituency office amongst us all, there are people who are in desperate need of housing and housing needs. We have families who have no homes and do not feel as though their children can be raised in a normal societal settlement. The lack of supply is having a dire impact on their health and education and is causing social problems. I thank Nichola Mallon for raising that issue.
There is only one way in which to address the problem: we must build more homes. We must increase capacity for the many thousands in housing stress. At the moment, we are delivering too few new developments, and the slow pace of public land release, coupled with the inflexibility of needs assessment, means that we often build 10 homes when we need 100.
Northern Ireland's status as a low-wage economy complicates the issue. The recent scandal of the much-lauded government-supported help-to-buy ISA scheme, which provided very little help to buy owing to a fatal flaw with the bonus, only exasperates the situation. The increasing private rental costs and shortfalls in housing benefit combine in a perfect storm to maximise housing need. Once again, it seems as though the Bank of Mum and Dad must rescue young families hoping to buy their home or pay rent. That is not an acceptable position. When we consider the prevalence of one-year tenancy agreements, it is hardly surprising that so many feel that their house is not their home.
There is a need for innovation in housing supply. We need more one-bedroom flats for older people and more two-bedroom houses with expandability. Again, the inflexible needs analysis needs to be modernised. Why can Northern Ireland not lead the way in exploring smart home technology that reduces crime, delivers energy-efficient outcomes and adapts to the needs of families and the disabled?
Housing should be backbone of local regeneration. It can be the catalyst to support inward investment in construction, infrastructure and employment and to build communities. Now is the time to look at the potential of pension schemes to finance housing programmes.
Nichola Mallon highlighted the cry from some DUP Members about there being financial constraints. There was certainly no difficulty in squandering over £1 billion on the renewable heat incentive. Just imagine how many homes that might have built.
Some Members: Hear, hear.
Mrs Palmer: Perhaps the Minister can update the House on the progress of the long-awaited review of the Housing Executive.
Mr Allister: The Member may be interested in an answer to a written question from me yesterday on the renewable heat incentive scheme, which states that the anticipated cost in the upcoming year is £37 million.
Mrs Palmer: I thank you for that intervention.
Forgive me, Madam Principal Deputy Speaker, for being a little bit parochial for one moment, as the Minister was. I would like to talk to the Minister as a fellow Lagan Valley representative. Minister, in our constituency there are 988 people in housing stress. There are 159 social houses being built in Lagan Valley. We must build more for the sake of those 829 people, and the many more across the Province. Fra McCann gave us the figure of 22,654 households being in housing stress. That just shows how important housing is.
Minister, housing is a plural, and you have the opportunity to give a massive boost if you are bold and brave enough to embrace new solutions that support people and offer them a home.
I thank Alex Attwood, who certainly put to bed the nonsense about statistics and damned statistics across the Chamber. All Members had statistics to suit themselves, but the statistics here are as Alex Attwood stated. Yes, we can all play games around statistics.
I pay tribute to my colleague Andy Allen, who took some abuse from my left. It was pretty hot at times, but he held his own in determining that he works solidly on social housing in his constituency.
I admire it that a man who has the disability that he suffers from champions disability and social and affordable housing in his constituency.
I remind Mr Bell of the figures that are being debated in the Chamber. The period 2007-2011 was a four-year term, and 2011-16 is a five-year term. You can work it all out, but I do not want to get fixated on figures; I just want to have a sensible debate here today about how we move forward and about the importance of delivering new solutions for housing in Northern Ireland. The Minister said that the Northern Ireland Housing Executive had the right and the power to build, but, unfortunately, at the time of the existence of the Housing Executive —
Mrs Palmer: I will in a second. Unfortunately, at the very beginning, the Housing Executive was funded fully from the public purse, and the decision was taken that the Housing Executive would not be able to avail itself of full housing funding. There is an opportunity here to split the Housing Executive into two entities. One would become one of the largest housing associations, de-shackled, along with the housing associations, as we move forward. I believe that the Office for National Statistics is setting the scene for where the housing association movement will be. Why not de-shackle the Housing Executive as well and allow it to bid like anyone else for the new build programme and reduce the housing association grant and make it more competitive for all developers to challenge to build new and affordable social housing. I bet you any money that social housing would be built at a far better price. I am happy to give way.
Mr F McCann: I thought that I had moved into the SDLP there. Your last statement is correct. Whilst the Housing Executive retains the right to build, the lack of capital or financial resources means that it cannot, but it could be a game changer.
We are all talking about statistics this morning, but I said that behind the statistics are faces of families, young people and children in hostels and overcrowded homes. That is why we should never lose sight of the fact that this is happening. It is faces, not statistics, that we should be dealing with.
Mrs Palmer: I hear what you say. The Northern Ireland Housing Executive has a stock of 88,000 and, as one of the biggest commercial small business portfolios, would have the capacity to borrow on the strength of that if the shackles were removed to allow it to become an independent housing association as a charity, just like all the other housing associations. It is all in the detail, and it is for the Minister to solve that detail and to try to deliver far better housing for Northern Ireland. I welcome the motion today.
Madam Principal Deputy Speaker: Before I put the Question on amendment No 1, I remind Members that, if amendment No 1 is made, I will not put the Question on amendment No 2.
Question, That amendment No 1 be made, put and negatived.
Question, That amendment No 2 be made, put and agreed to.
Main Question, as amended, put and agreed to.
Resolved:
That this Assembly notes that, in June 2016, there were 37,347 households on the social housing waiting list, of which 22,986 were deemed to be in housing stress and 15,474 were deemed to be statutorily homeless; further notes the Executive’s success in exceeding the last Programme for Government target by providing 7,669 new social homes and 4,685 new affordable homes between 2011 and 2016; and acknowledges the plans of the Minister for Communities to deliver 9,600 new social homes and 3,750 new affordable homes between 2016 and 2021.
Mr E McCann: On a point of order, Madam Deputy Speaker. In terms of the Standing Orders of the House, can you explain why, again, neither Member from People Before Profit has been called in the debate? The same thing happened yesterday in relation to the debate on withdrawal from the European Union, on which we were very anxious to speak because we have a distinctive point of view, different from that of other parties, and we want to be able to express it. Can you tell me whether the ruling comes from the Speaker's Office? Has it been imposed on the Speaker's Office by a Committee of the House? Is it based on precedent? Is it based on protocol? Will you explain this to us? We have 13,000 first preference votes between us. We believe that that is a mandate to express our point of view in the House. We are not being given the opportunity to do that, and I would like an explanation.
Madam Principal Deputy Speaker: The Business Committee has agreed the principles of the debate. In a debate, it is not possible to get all Members in, but I am happy to take your points to the Speaker.
Mrs O'Neill (The Minister of Health): On a point of order. It is on the debate that we are about to begin. I believe that there are factual inaccuracies in the motion that has been tabled for discussion, namely the fact that it refers to 6·7% of breast cancer patients missing the 14-day target. That is wholly misleading. The true picture is that the 6·7% is for urgent referrals for suspected breast cancer and not for people who have been diagnosed with breast cancer. That is not to mention the inaccuracy of stating that our services are in crisis. Four of the five health and social care trusts have extremely strong performances against breast cancer targets. The Southern Trust has a strong track record in meeting the 14-day target and has had a well-publicised dip in performance in recent months. The reasons for that are due to previously highlighted staffing issues, including the untimely and tragic passing of a senior doctor in the Southern Trust. The motion also quotes 392,000 as the total number of people on waiting lists. Again, that is little more than a back-of-the-envelope calculation, adding up all waiting list figures for outpatients, inpatients and diagnostics. That misrepresents published statistics. For those reasons, I ask the Members opposite to reflect on the inaccuracies that I have highlighted and ask them not to move their motion on the basis of the fact that it is highly inaccurate.
Madam Principal Deputy Speaker: The Minister has put her point of order about a potential inaccuracy on the record. It is a matter for the proposers of the motion whether they wish to move it.
The Business Committee has agreed to allow up to two hours and 30 minutes for the debate. The proposer of the motion will have 15 minutes to propose and 15 minutes to make a winding-up speech. All other Members will have five minutes.
That this Assembly notes the recent publication of cancer waiting times, which revealed that the crisis affecting cancer services in Northern Ireland is continuing to deteriorate; further notes with anger that, in June 2016, only 6·7% of breast cancer patients in the Southern Health and Social Care Trust area were seen within 14 days, despite the target being 100%; accepts the importance of timely diagnosis and treatment of cancer, as any delay can reduce the likelihood of a successful outcome; notes that these figures are symptomatic of the wider unprecedented crisis engulfing the Northern Ireland health service, with 392,000 people now on waiting lists; and calls on the Minister of Health to intervene to ensure that patients receive swift, safe and sustainable healthcare and to ensure that patient safety is not further compromised.
I welcome the opportunity to move the motion in the Chamber today. I also welcome the fact that the Minister is here to respond. When I moved a motion on cancer waiting times last October, no Minister was available to respond. It was at the time of the in/out Ministers. Now that the Executive have found a newly forged unity and we, alongside the SDLP, have formed the official Opposition, it is wholly right that we raise in the House the issue of cancer waiting times, their impact on all our people and the actions taken to address the waiting times crisis.
Last November, much was made of the additional £40 million that was secured in the monitoring rounds to specifically tackle waiting times; indeed, the then Minister, Simon Hamilton, claimed that it would allow an extra 10,000 to 15,000 operations and treatments to be progressed. It is with absolute exasperation, however, that the Ulster Unionist Party has now learned that £18·5 million of that £40 million was not spent on waiting lists and instead was redirected to plug the gap on other pressures in the health service.
My party warned at the time that the trusts were not given enough time to use the money on waiting lists and, sadly, that appears to have come true. That is an absolute disgrace, and all those responsible for raising patients' expectations only for them to be later dashed should be ashamed of how they played politics with our health service.
The people with suspected or diagnosed cancer, whose lives are entirely in the hands of our health service, are often genuinely terrified about what the future holds for them. They simply will not care about what MLA from which party said what. These are men and women, young and old, who are going to be given a diagnosis that will rock them and their loved ones to their very core. They will experience a sense of fear that they never knew they could. This debate should be held in a manner that we would be comfortable with any one of those people sitting in the Public Gallery above us watching and observing.
One year on from our motion that called on the Health Minister to ensure that cancer services are adequately organised, funded and resourced, we received the most recent figures from the Minister, which show regression rather than progression. That performance in relation to breast cancer waiting times has been described by the Minister herself as "shocking", and she has expressed her regret at those figures. That was two weeks ago in the House, when a question for urgent oral answer highlighted that, in June of this year, only 6·7% of breast cancer patients in the Southern Health and Social Care Trust were seen within 14 days. Later today, in Question Time, we will likely hear the number of women who were not seen within the target of 14 days and who then were tragically given a breast cancer diagnosis. We know that that number is 121 in the Belfast Trust for last year, but the Minister has so far refused to answer as to the situation in the Southern Trust.
Of course, as the motion suggests, the reason that targets exist is because any delay can lead to a reduced outcome. Failure to diagnose cancers at an early stage can mean much harsher treatment is needed. It can make the consequences of treatment that much more difficult, and it can severely impact the chances of someone recovering and living well when their treatment ends. That is especially the case for cancer, a truly wicked disease that thrives in a vacuum of delay.
The recent Northern Ireland statistics show that, between 2010 and 2014, 18% of cancer patients were diagnosed at stage 4 and had a one-year survival rate of just 33%. In comparison, 22% of patients were diagnosed at stage 1 and had a much higher one-year survival rate of 95%. For breast cancer specifically, Cancer Research UK states that around 99% of women will survive for five or more years after diagnosis if diagnosed at stage 1, compared to just 15% at stage 4. It is all fine and well to talk about statistics, but, as I have indicated, delays mean the difference between life and death.
Yes, the delays for breast cancer patients in June in the Southern Trust were particularly awful, but they were by no means the only problem. The Northern and Belfast Trusts have also experienced frankly appalling cancer performances. The problem there, like the problem in the Southern Trust, primarily came down to personnel rather than capacity. A single vacancy or absence due to sickness quickly snowballs into intolerable situations, such as that experienced in the Southern Trust, where only 15 of the 224 people were seen within the red-flag period in June. Of course, when one trust recruits a new key staff member, the problem often transfers to the trust that he or she has just come from. The issue of displacement is one that I feel has not been properly investigated by the trusts and the board. I urge the Minister to look into that point.
Something as simple as ensuring that each trust has an effective succession plan for key posts could prevent many of these delays developing in the first place. Until such fundamental measures are taken, the system will remain crippled and broken due to its lack of resilience.
I remember well, as I stood in the Chamber to move my private Member's Bill, the Human Transplantation Bill, being told not to bring emotion into the Chamber. I remember well the cries that went up, "We cannot bring legislation based on emotion". That is what is wrong with the Assembly: there is not enough emotion; there is not enough care for those whom we are elected to represent. Given the very real pain being forced on our constituents because of decisions taken or, perhaps, most importantly, not taken by Ministers, from whatever party, it is right that we, as elected representatives of the people, bring their emotion into the Chamber. I make no apologies for standing up for the mother who waits week on week, month on month, for scan results or for the grandmother spending months waiting on surgery. We all know that cancer tears the heart out of families and shows no mercy whatsoever. While I can speak from the perspective of losing my grandmother at the age of 41 and my best friend in January, who was only 48, I know that some Members can speak from personal experience. Cancer touches too many lives — far too many lives.
I want to put on record my appreciation for the work of Professor Mark Lawler and others in pioneering research. I had the privilege of viewing their work first-hand over the summer. Whilst we have expert nurses, consultants and cancer specialists, they are being placed under mounting pressure.
It is fitting that we are having this debate in Breast Cancer Awareness Month, when our fantastic charities, including Cancer Focus, Macmillan and Action Cancer, put their shoulder to the wheel across Northern Ireland to fundraise and to raise awareness of early diagnosis. There are far too many charities and charity heroes to name here today, but you all know who you are and the life-saving work that you are doing in October and throughout the year.
However, their efforts are not being matched by Government when it comes to diagnosis and treatment. For instance, I ask the Minister whether she is content that an integrated plan is in place to balance expectations raised by the public health campaigns and the need for people to be seen by the right person at the right time. There certainly does not appear to be a balance. We know that in October there is an increase of around 40% in the number of women coming forward for a breast cancer check-up. That is to be welcomed. We cannot then feign surprise when there is a dramatic spike in diagnostic demand following those major awareness campaigns. Better patient safety and better cancer outcomes are exactly why money is targeted at the campaigns. However, what really galls me is when bodies, such as the Health and Social Care Board, sordidly —
Mrs Dobson: — try to use that increase in demand as some form of twisted justification for a subsequent reduction in performance. I appreciate that the trusts will take part in a workshop next week to look at longer-term solutions. However, workforce planning, led by the Department, is absolutely critical here. The right cancer specialist, in the right place, is what is needed to banish, or at least to lessen, the worry and concern that all families with a loved one waiting on a cancer result or treatment experience. More importantly, there needs to be a reduction in the period between initial discovery, diagnosis and treatment to improve outcomes.
Time and time again, the issue of cancer waiting times has been raised in the Chamber. We heard the words "disappointed" from Minister Wells in 2015, "silence" from Minister Hamilton in last October's debate, and, last week, "shock" and "regret" from Minister O'Neill. When, after all those condemnations of the service that they lead, will they turn from words to action?
When are these actions going to turn back the tide of lengthening waiting times and reduce the pressure on key front-line staff who, along with patients, bear the brunt of ministerial and departmental dithering?
In her response, the Minister will no doubt explain that, next week in this House, she will publish the Executive's plan to reform the local health service, but when will we see the longer-term stable budgets that will allow health managers to effectively plan for future service delivery; longer-term budgets that will allow cancer consultants and specialists to know that support will be there for them and that short-term funding solutions, which lessen the problems only for them to return again, will become a thing of the past? The fact that, as we stand here today, people are having their health compromised should be enough to shame the Department of Health and the Health and Social Care Board into action. The fact that these words were spoken in the Chamber 12 months ago and that the most recent figures show waiting targets being failed by the trusts is a matter of shame hanging over the Executive.
People who are living with cancer cannot afford to wait. Indeed, the Health and Social Care Board is on record stating that:
"increased waiting times for assessment may result in delayed diagnosis of a serious or life-threatening condition with reduced likelihood of a successful outcome."
We are dealing with matters of life and death, but the most frustrating thing is that we and the public across Northern Ireland are simply being asked to accept failed targets; accept that another 12 months have passed without improvements; and accept the regret of the current Minister of Health and the disappointment of the last. Words become hollow when actions do not follow. In the House today, we should be primarily focused not on lists, percentages and spreadsheets but on the humans behind the statistics; the young woman who faces delay with her breast cancer treatment or the grandmother who watches her children knowing that she may not be around to see them grow up. I am sure that every MLA in the House will come down with case after case of constituents who are all desperate and have been told that they must wait a lengthy time. I know that I am. Each case tugs at the heartstrings.
I have only skimmed over one of the problems facing the local health service. If I had much longer, I would not be able to cover the sheer scale of this unprecedented crisis. I am sure that many Members wish to speak. They will understandably each raise situations that affect their constituents. It is not the intent of the motion that the Minister takes any concerns that are raised as personal criticism; rather I ask her to acknowledge that in addition to those who, every day, receive the earth-shattering news that their fight against cancer has begun, the 225,000 outpatients, the 70,000 inpatients and the 100,000 people who are waiting for a diagnostic test deserve better than they are getting now.
I will leave my final word for the staff who are emotionally drained and demoralised. They are in no way to blame for the crisis. They are the very people who hold the system together. Collectively, they form the final line of defence against total collapse.
I take no pleasure whatsoever in speaking on this topic in the House. I commend the motion to the House in the hope that action will be taken to resolve this crisis.
Ms Seeley: Cancer touches the life of so many on this island and indeed right across the world. In recent times, I have lost three relatives to cancer. I have no doubt that I am not alone in that. I would like to take this opportunity to commend the sterling work of the Marie Curie nurses who look after the terminally ill. It is also worth noting that this month is Breast Cancer Awareness Month. I want to commend the work of Action Cancer in its screening efforts. I encourage all women, particularly those who are over 70, to book a screening appointment today. I have also been hugely impressed by the lobbying efforts of Margaret Carr, public affairs manager for Cancer Research.
From charities to nurses, surgeons and clinicians to health trusts and, indeed, the Department of Health and Minister, tireless efforts are being made, day and daily, to improve the health outcomes of cancer patients. We should never underestimate the commitment and dedication of our healthcare professionals. However, that is precisely what the motion does. Its focus is on statistics that the Minister herself published as part of an overarching report on cancer waiting times earlier this month; statistics that she admitted in this very Chamber were simply not good enough; statistics that she was extensively questioned on and provided detailed answers to a matter of days ago. Sadly, our friends in the Opposition were not listening on 4 October when the Minister addressed the very issues detailed in the motion before us today.
The Assembly has already noted the recent publication of cancer waiting times. Indeed, the Minister noted that the figures are the result of wider systemic pressures in our health service — pressures that she has committed to alleviating. Let us not kid ourselves: this is not an unprecedented crisis. The trends of increased and sustained demand are due to an ageing population and increased referrals, and that goes back years. That is largely due to increased awareness resulting in early detection and enhanced outcomes.
Ms Seeley: As the Minister stated, four out of our five health trusts are doing better than the targets set.
I will give way.
Mr Beggs: Is the Member aware that, in the previous year, in March 2015, only 27% of those requiring urgent breast cancer referrals in the Belfast Trust were seen within 14 days? This is not something new; it is repeating itself. Does she accept that there is a problem that needs to be addressed?
Ms Seeley: Thank you. I thank the Member for his intervention. Of course I accept that the problem is not new. The Minister accepts that the problem is not new. I welcome the fact that the Minister will address the problem with much gusto.
The Minister has already been questioned on Southern Trust figures. She not only detailed actions taken but noted subsequent improvements — improvements that the motion chooses to ignore. That is nothing short of appalling. I took the time to contact the Southern Trust. It assured me that the problem highlighted in the motion was a temporary one as a result of staffing issues and that the matter has since been resolved. The trust is now back at 100%. It is for that reason and because of its flawed nature, not to mention the complete lack of proposals in the proposer's opening remarks, that we are unable to support the motion in its current form.
The Opposition seem to be keen to cry from the sidelines, offering nothing by way of substantial proposals to problems that they identify. It is hugely unhelpful to scaremonger by suggesting that patient safety has been compromised. Frankly, it is an insult to our hard-working and devoted healthcare staff. The recent actions of those in our health trusts to address issues in the Southern Trust are an example of what can be achieved when trusts work together, providing additional clinics and extending working hours. That, of course, highlights the need for cooperation, as opposed to competition, between our trusts. Trusts need to help each other out, sharing resources and good practice for the well-being of all. Health outcomes should not be a postcode lottery. However, when trusts do exactly what we ask — responding to and dealing with perceived crises in a positive and timely manner — they should be commended, not ridiculed, in the Chamber.
I welcome the Minister's response to the question for urgent oral answer on 4 October on this very report, in which she assured Members:
"everything is being done to ensure that those referred are being seen as soon as possible." — [Official Report (Hansard), 4 October 2016, p52, col 2].
That is the message that we should be sending out from the Chamber today. It is a message of assurance to all those with suspected cancer and their loved ones that our Health Minister, health trusts, healthcare professionals and hospitals are not only aware of the issue but doing all that they can to improve the outcomes for those diagnosed with cancer.
Despite huge changes to our demographics over the past 20 years, our health service has remained static. That is the real issue. I therefore welcome the Minister's comments from earlier this month when she said that she is minded to work towards the delivery —
Ms Seeley: — of a cancer strategy. I urge the Minister to move swiftly to transforming how we deliver services to ensure better outcomes for all.
Mr Poots: Cancer is such an important subject to discuss. When discussing it, we should not engage in political bickering. We need to look for solutions and look to address the issues at hand.
As someone who has served in the role, I wish the Minister well in tackling this issue on behalf of all of us. It is critical that we continue with much of the good work that has already been achieved.
On the first day of the previous Assembly, I recall that I was confronted by the Pink Ladies, a group which many people from the city of Londonderry will know well. They were here wanting to know why Altnagelvin cancer unit, the radiotherapy unit, was not proceeding. I agreed to go and meet people in Altnagelvin and to look at the finances. The first decision that I made as Minister was to proceed with that cancer unit and change the decision that had been taken by the previous Minister, because cancer is too important to play politics with. The money was there to do it. It is being done, and it will deliver a service, not just for the people in that vicinity but for people in Donegal. It will also relieve the radiotherapy service that is available in Belfast City Hospital. The truth is that this unit in Altnagelvin is not just a service for people in the west of Northern Ireland; it is a service for all the people in Northern Ireland. People from the west were travelling for two hours to get 15 minutes of radiotherapy and then travelling for two hours back. People were telling me that, when it snowed, it was actually an all-day route for 15 minutes of care. Those people will not be using that service, and therefore it will create greater availability for people in greater Belfast and the eastern part of Northern Ireland. It was absolutely critical that that happened. With the growing numbers of people who actually require cancer care, we simply could not have coped if we had not proceeded with that particular facility.
I would like to pay tribute to the people who are carrying out research in Queen's University and work very closely with the people in the Belfast City Hospital cancer unit. For around 20% of those key cancers, research-based drugs are being made available to people. That is one of the highest anywhere in the United Kingdom. For breast cancer, which we have referred to, we have amongst the best results anywhere in the United Kingdom, and the message should not be going out there —
Mr Clarke: I appreciate the Member giving way and the point that he is making about the best results. However, in this motion today, and I think that the Minister has outlined its flawed nature, we are not talking about people with a diagnosis, we are talking about people actually going to be diagnosed or otherwise. We are not talking about the sufferers here.
Mr Poots: We are achieving the best results in the United Kingdom. Do not let the message go out there that we are providing some second-class cancer care services because we are not. It is critical that we do not rest on our laurels and that we still focus on delivering better care and better results. Any trust can have a particular problem at a particular time because they are dealing with people who have key specialisms. When someone has a specialism in oncology, you just cannot go down to the local broo office and pick up someone else to replace them. It is not as simple as that, and people should not make contrived simplistic arguments about that. These are people who have key specialisms and who are incredibly hard to replace, and trusts will work very hard to replace them as quickly as possible because that is their responsibility.
We are spending more on cancer drugs than ever before, and there are some absolutely superb drugs coming onto the market. We are doing more with the cancer treatments that are available. For example, a few years ago, stereotactic radiotherapy was not available in our radiotherapy units; we were sending people to England to get that. Now that is available in Northern Ireland. Tremendous strides have taken place, and I think that there are huge opportunities.
I just want to say something on staff morale. My wife has worked in cancer care, in oncology and haematology, for over 25 years, and I do not detect this low morale from her or her colleagues. I do detect a huge commitment to provide the care for people who really need it. Whenever we bump into people in the streets who receive that care, as we regularly do, they say how wonderful our staff are, how wonderful the care is and how brilliant the treatment for cancer is here in Northern Ireland. We can always do better and we need to support the Minister —
Mr Poots: Thank you. We need to support the Minister to ensure that we continue to do better.
Ms S Bradley: I welcome that the Minister is here during this critical debate. I am acutely conscious that there will be people who are inside the two-week window and are living with the torture of not knowing whether they have cancer. I am sure many of us in the House have travelled that pathway with people, even if it is not at first-hand, and the two-week window cannot be overlooked. In many cases, people get the good news that they do not have cancer, but let us not brush over the fact that they are trying to get on with their daily lives. They are mothers, fathers, sons and daughters, and there is a whole plethora of stories behind each one of those individuals, and nobody is here to suggest that the care that they get, when they finally make it to the healthcare system in Northern Ireland, is not second to none. Not only are they getting good healthcare, they are receiving a caring service. Having spoken with professionals along that path, I could not fault it anywhere: from going through the door, through the treatment, the service that was afforded by Health and Social Care here in Northern Ireland, and I would not want any slight on the debate to suggest otherwise.
During the two-week window, when people are living in that torturous situation and are asking, "Do I have cancer or do I not?", they have access to very little. Remember, most of them will already have had their third or forth appointment with their GP before the referral was made. Away from that, they are trying to carry on with everyday life. They have no news to break because they do not know what is happening and they are doing their own, if you like, Google research. We have all been there; we have all done it. They look at the stages of cancer and find themselves asking, "If I have it, what stage is it at?" There is a delay.
Most people outside the House are not watching what the 14-day target might be; most people are unaware of it. It is not something that they talk about casually, day to day. Most people would like to think that, once their doctor has noted them as an urgent case, they are in safe hands. Quite frankly, this is one figure that I just cannot get past: 6·7% of women presenting with possible breast cancer as an urgent referral in the Southern Health Trust have been seen. That figure cannot be overlooked.
Mr Sheehan: Will the Member accept, therefore, that the 6·7% refers to people with possible breast cancer, but that is not how it is worded in the motion. It states:
"In June 2016, only 6·7% of breast cancer patients".
Do you accept that that it is wrong?
Ms S Bradley: Thank you. The 6·7% refers to the people who have possible cancer.
Mr Sheehan: Is it wrong or is it not? Is the motion wrong —
Ms S Bradley: Are you suggesting that the two-week window is of no importance to the group of women who are not in that 6·7%? I think not. That two-week window, when those women are trying to get on with their daily lives not knowing — not knowing — whether they have cancer; not knowing whether they have stage one, two, three or four; not knowing what their future is —
Ms S Bradley: No, I will not give way because my time is limited on this.
— and not knowing what is ahead of them: that is where the health service is not meeting their need. That is where the fall-down is this Government is. There are people in Action Cancer and Marie Curie who are lifting those women through that difficult time. They are the point of contact. This is the point where the health service is failing people in Northern Ireland. I suggest that, rather than get into defensive mode, we at least acknowledge that that is happening and it is not good enough.
We have heard about that 6.7%, although the Member for Upper Bann did remind the Minister that these are her figures that she is questioning. These figures have been released by the Department, as she rightly said. The Minister cannot come here and question her own figures and try and put a slant on it. It is time. The time is not tomorrow; it is not next week. The time is now that we deal with this problem. The time is now that we bring the solutions to the table, rather than going into defence mode and saying that it is not actually a problem. It shocks me that I actually am listening to that type of rebuttal across the Floor of this Chamber. I know and accept — I have a certain level of sympathy with the Minister — that this is not an easy Department, but the Minister will forgive me if I reserve the greater part of my sympathy for those women who are not getting the help and care that they need from this Government and this health service at this moment in time.
Madam Principal Deputy Speaker: The Business Committee has arranged to meet at 1.00 pm. I propose, therefore, by leave of the Assembly, to suspend the sitting until 2.00 pm. The first item of business when we return will be Question Time. This debate will resume after Question Time, and the first Member to speak will be Kellie Armstrong.
The debate stood suspended.
The sitting was suspended at 1.01 pm.
Mrs O'Neill (The Minister of Health): With your permission, I would like to answer questions 1,11 and 13 together. I can confirm that the Justice Minister and I received the working group's report on 11 October and are actively considering its proposals. You will understand that the Justice Minister and I will want to take some time to consider and reflect on the recommendations. When both the Justice Minister and I are content, the report will be submitted to the Executive for their consideration and then their approval. It is not intended to publish the report or its recommendations until the Executive have concluded their deliberations. The report of the working group on fatal foetal abnormality was developed in line with the terms of reference for the group: to consider issues relating to cases of fatal foetal abnormality, including matters addressed in the previous consultation by the Department of Justice; and to provide a report to the Justice Minister and me with recommendations, including on potential legislative change for termination of pregnancy as necessary.
The focus of the working group's outreach work was to capture the broadest possible spectrum of views of women, the partners and families impacted by a diagnosis of fatal foetal abnormality and the health professionals providing their care, including representatives of the Royal College of Obstetricians and Gynaecologists, the Royal College of General Practitioners, the Royal College of Nursing, the Royal College of Midwives and the Royal College of Psychiatrists. In considering the trauma that can be suffered by women and their families where a diagnosis of fatal foetal abnormality has been made, the group was guided by the wishes of women, their partners and their families regarding any engagement. Women willing to engage and share their experience, whatever that had been, were afforded the opportunity to communicate their experiences to the group, whether personally, in writing or through the Public Health Agency (PHA), which has undertaken work with women and families who have been directly impacted.
The Chief Medical Officer and the Chief Nursing Officer also met women and took account of the views of women who had engaged with the PHA through their work. Some women continued their pregnancy to term; some did not. I am grateful to the women, their partners and their families who took the time to relay their experiences either directly to the Chief Medical Officer —
Mrs O'Neill: — or through the Public Health Agency, as that cannot have been easy for them.
Mrs Long: I thank the Health Minister for the attention that she, I know, has given to this difficult and sensitive issue. She said that she wanted time to consider the report and to take it to the Executive. Why cannot the report be published now so that the public are at least aware of the basis on which the Justice Minister and the Health Minister will approach their Executive colleagues and what the recommendations are?
Mrs O'Neill: I am happy to discuss the report's recommendations with the Member and other Members in due course. I received the report only last week — I think that it was last Tuesday evening — so the Justice Minster and I want to give it consideration. That is normal practice. We will then, on the basis of the recommendations, bring it to the Executive for discussion and, hopefully, chart a way forward for how we will support women who need our support. I look forward to being able to progress the report as quickly as possible. I was keen to make sure that we completed the work of the working group and were able to move forward to provide the assurance that people are asking us for.
Mr Aiken: Thank you, Minister, for your reply. Many of the points were raised by the previous Member to speak, but I would like you to re-emphasise whether you will give a public commitment that the findings will be put to us as soon as possible through the Assembly and not leaked to the media or any other forum, which seems to be the purpose of this Government at present.
Mrs O'Neill: It is unfortunate that the Opposition are again trying to use a really sensitive, complicated and emotive issue for anyone who finds themselves in that scenario. I have the best will and intention towards the women who need our support, and, with that best will, I will bring a paper to the Executive, as I have just said. I will consider the recommendations of the professionals and of all those who found themselves in this scenario and gave information to the working group. It has been good work, and I look forward to bringing the proposal to the Executive and making sure that we have in place fit-for-purpose structures and supports that will allow women who find themselves and their families with a diagnosis of fatal foetal abnormality to receive first-class support.
Mr Agnew: Does the Minister agree that this is very much a health issue and should be treated as such? Notwithstanding what she said about the recommendations of the report, will she seek to progress that this becomes a medical issue and not a criminal justice issue?
Mrs O'Neill: Yes, I think that it is so important that we look at how we as a health service provide, and, obviously, we are where people turn to for help and support. Where those women turn to for help and support, they need to have adequate and appropriate supports in place. I am glad to be part of this work. I am glad that the Justice Minister and I have been able to progress it as soon as we took office. Now that we have the report, we will work our way through the recommendations, and we will bring forward what we need to in terms of legislative change on the basis of the report. It has been a very collaborative piece of work, and I thank the Member for his continued interest. I look forward to updating the House on the way forward as soon as we can.
Mr Ford: I entirely accept that the Minister — indeed, the two Ministers — cannot take action on the issue without Executive approval, but it is entirely within their gift to publish the report that has been presented to them. Given the sensitivity of the issue and the widespread public concern, will the Minister commit to discussing with the Justice Minister the immediate release of the report before any action can be agreed by the Executive?
Mrs O'Neill: As legislators, we have a duty to legislate, and we have to do that on the basis of the evidence that we have before us. The Justice Minister and I have had the report for only a week, and we said that we would look at it collectively. We have nothing to hide. The report has been done by professionals, and it is work that has also been informed by the previous piece of work — the consultation that you were involved with as Justice Minister. We have taken into account all of those factors, and we have taken into account as wide a range of views as possible. It is very important that, when we move forward and take decisions that are in the best interests of women, we do so on the basis of the evidence that we have before us. I am happy to say to the Member that I will not be found wanting in trying to bring the issue to the fore as quickly as we can. It has been in the ether for far too long, and we need to resolve it.
Mrs O'Neill: With your permission again, a Phríomh-LeasCheann Comhairle, I will answer questions 2 and 14 together.
'Building on progress' is an important contribution to my work to champion mental health, which is one of my top priorities. I was pleased to meet a delegation from the Royal College of Psychiatrists recently to discuss it in detail. The report acknowledges that there have been improvements in provision in recent years, and the commission found many good services. It highlights issues in relation to funding, treatment access, community and specialist services, structures and data. It makes eight recommendations for improvement, including the key point that mental health must be given equal priority with physical health. The findings are largely consistent with my vision for mental health. I intend that my plans, based on six principles, will contribute to improvements in line with an outcomes-focused Programme for Government.
First, I am committed to moving forward towards parity of esteem. Secondly, I want to develop and sustain a recovery culture. Thirdly, involvement by people with lived experience in the design, delivery and evaluation of services is essential. Mental health is leading the way in developing co-production: collaboration between people who provide care and people with lived experience. That has resulted in the development of networks and the employment of people with lived experience as recovery consultants. Just last week, I launched another recovery hub in the Southern Trust, which was a really good example of that co-production and co-design.
The fourth principle that I wish to adhere to is service development where resources allow. The Bamford evaluation, which is going to report to me imminently, will outline the needs and gaps in services. Emerging findings include a need for more emphasis on carers’ provision and crisis support. My officials are developing options on the physical monitoring of people with mental illness; a regional perinatal service; child and adolescent mental health services (CAMHS) and improved early intervention; eating disorder services; psychological therapies; mental trauma; personality disorders; provision in the justice system; safe places for people suffering from dual diagnoses; and implementation of the Mental Capacity Act. The fifth principle is structural reform and performance management. The board is leading on that area of work.
Finally, I plan to closely work with Ministers in the South to explore the potential for developing some of these services on an all-island basis. I think that that will make it more feasible to allow us to develop some of the services in a more timely manner.
Mr Douglas: I thank the Minister for a comprehensive reply. Can she update the House on child and adolescent mental health services, please?
Mrs O'Neill: Child and adolescent mental health services are delivered under a stepped care model, and the Health and Social Care Board leads a reform process under the auspices of the stepped care model implementation review. Much progress has been made, but more needs to be done, particularly in relation to investment in community and specialist services, workforce planning and recruitment. CAMHS investment now exceeds £20 million annually, and I am considering reform and investment options across a range of mental health services, including child and adolescent mental health services.
That will include work with other Departments on comprehensive early years support.
Regional acute inpatient services at Beechcroft are frequently under pressure. An independent review in 2014 concluded that the current 33-bed model is appropriate but that, crucially, that is dependent on the further strengthening of crisis resolution and home treatment services.
In addition, and in line with the independent review's recommendation, a managed care network of acute child and adolescent mental health services is being established. That will bring acute services into one managed system, ensuring greater consistency across the region and streamlined access to Beechcroft.
Mr Durkan: I welcome the commitments that the Minister has given on the work that she will do on mental health. What percentage of her budget is allocated to mental health services?
Mrs O'Neill: We have an improving picture. In the past decade, the annual allocation to mental health services has increased from £200 million to over £250 million. On the basis of last year's commissioning plan, the figure was confirmed as being approximately £250 million, which represents just over 5·5% of the departmental expenditure limit of £4·7 billion.
The Participation and the Practice of Rights (PPR) campaign said recently that only 8·5% of the overall health budget was allocated to mental health for 2015-16, despite evidence suggesting that the mental health amount equates to about 25% of total cases. That is broadly accurate, and, despite increases in the annual allocation to mental health services from £200 million a decade ago to £250 million now, it is clear that more investment is needed. I have already highlighted how I intend to take that investment forward.
Mrs Dobson: As we know, there have long been calls for parity of esteem between physical and mental health services. That is something that I have fully supported, and the report simply adds to the appeals. What are the legal barriers to parity currently?
Mrs O'Neill: It is not about legal barriers but about proper access to services. Parity of esteem can sometimes be taken to mean applying the same amount of money to physical health and mental health, but that is clearly not what the report states and that is not my intention. My intention is to improve the picture and invest in all the service developments that I have included. One of the things that is going to inform that process is the review of the Bamford evaluation, which will give us the evidence to move forward.
I have highlighted mental health as being one of the areas that I want to prioritise. We can do more. We have excellent services out there: a brilliant community and voluntary sector and so many partners that want to work together to deliver better outcomes for all those people who find themselves mentally ill.
We also have a lot of good work being done on the positive mental health and well-being message. Last week, for World Mental Health Day, we were able to launch the anti-stigma campaign. Stigma and people being afraid to talk about mental health and to ask for support are still key factors. The sayings were, "It's OK not to be OK" and "It's OK to ask for help". That is important for mental health. I have clearly prioritised that as being an area in which I want to work towards parity of esteem, but it is important that people understand what parity of esteem means for mental health.
Mrs O'Neill: Ensuring that the right services are in place for treating and supporting women and their families during what can be a very distressing time is of great importance to me. I am pleased to be able to say that, following work by the Public Health Agency (PHA) with trusts and patient groups to consider issues of variation across early pregnancy services, a commissioning intention and a referral pathway were developed and issued in June this year. The commissioning intention asks the trusts to ensure that they have appropriate arrangements in place to facilitate rapid access to care for women with problems at any stage of pregnancy.
In line with NICE guidance, trusts have been asked to ensure that, for problems in early pregnancy, a system is put in place to enable women referred to an early pregnancy assessment service (EPAS) to attend within 24 hours if the clinical situation warrants that. Those arrangements are now in place in two trusts, and the PHA will be reviewing progress with all trusts in December this year.
Ms Lockhart: I thank the Minister for that very positive response. You will be aware that one in five pregnancies miscarry. Women who present at A&E — particularly at weekends, when early pregnancy clinics are not open — are often subjected to long waits and toilet facilities that are not appropriate. Can the Minister give assurances to the House that she is going to prioritise the suggestions made by the Patient and Client Council and improve the overall service offered at this difficult time?
Mrs O'Neill: I thank the Member for her comments, and I absolutely agree that we need to support women who find themselves in that scenario. We must absolutely take on board the guidance and suggestions that have been made by the Patient and Client Council, and we are actively doing that. All trusts provide services and support, probably in varying degrees, according to what trust area you are in, for women who have miscarried. It is important that we have consistency and that people know what support is there and how they can access it.
A lot of good work has been done. Our midwives and obstetrics and gynaecology staff have all been given written information to guide them as to how to support those women. It is important that we continue to build on that and listen to the patient's voice. That is certainly going to be my mantra for going forward: we have to listen to the voice of patients, carers and families and make sure that we design supports and services for people who need them.
Mrs Barton: Experiencing problems during pregnancy can be a stressful time for any expectant mother. Does the Minister accept, however, that for a seven-day service to work, women absolutely need to be able to self-refer in order to avoid getting caught up in the current turmoil in general practices?
Mrs O'Neill: Women obviously attend when they need to through various routes, perhaps through GP referral or by going straight to A&E. It is important that all clinicians have the guidance in place that allows them to support women who find themselves with a miscarriage. We need consistency across all the trusts, and the guidance helps us to achieve that. We should have 24/7 access and support for women who find themselves dealing with a miscarriage. We are listening to patients and considering the work that was done with the Patient and Client Council. The fact that the guidelines are in place shows that we are listening and that there is an improving picture.
Ms Dillon: Can the Minister detail what services are available for women who experience recurrent miscarriage, given that this obviously carries with it an awful lot of distress?
Mrs O'Neill: All trusts have pathways in place for women who have had previous early losses or a history of a previous ectopic pregnancy, with women referred to a maternity or gynaecology team or a dedicated clinic, as required, on assessment of individual needs. As part of the implementation of the strategy for maternity care, 2012-18, actions are being taken to standardise services for women who experience recurrent miscarriage by clarifying and standardising referral criteria and pathways and developing guidance for GPs on appropriate referral.
That work is under way, and the board and the Public Health Agency, as I have said, have engaged with the Patient and Client Council in relation to issues raised by service users. It is so important that women know what services there are, particularly if they find themselves in a recurrent miscarriage situation. They need to know that they are going to be supported and how they can get that help.
Ms S Bradley: Does the Minister have any plans to introduce routine screening for group B strep?
Mrs O'Neill: It is something that I am certainly considering. There is quite a lobby and campaign for it. Obviously, we have limited resources, and we have to make sure that we target them at those most in need, but, yes, I am considering it. I am actively looking at the issue.
Mrs O'Neill: Decisions about the provision of services at Causeway Hospital are a matter for the Northern Health and Social Care Trust in the first instance. As I said in the recent Adjournment debate on health service provision in North Antrim, the Northern Trust has no plans to move away from the model currently in place, in which acute hospital services for its area are delivered from the Causeway Hospital and Antrim Area Hospital. The reconfiguration of services is an important and complex matter that goes beyond individual trusts and hospitals. I have given careful consideration to the implications of the expert panel’s report and will publish it and my response on 25 October 2016.
Mr Allister: I suggest that the Minister could do better. Her predecessor was able to commit in the House to the continuation —
Mr Allister: — of acute services. The fact that she has been unable to do that today will be very disconcerting for my constituents.
Mr Allister: Why is she even anticipating reducing the level of service at a hospital that provides for much of North Antrim and East Londonderry. She could, as I suggest, do better.
Mrs O'Neill: I suggest that the Member could do better to listen. What I clearly said was that the Northern Trust has no current plans to move away from the model currently in place.
I have said that, and I said it in a recent debate. I will rehearse it again: the Northern Trust has said that it has no plans to move away from the model currently in place. To say that we can never change anything, that we can never reconfigure services or that we can never do better is a bit of an ostrich mentality — stick your head in the sand and say, "Let's keep doing things over and over hoping for better outcomes". That is not what we can continue to do in health and social care.
I have clearly set out that, on 25 October, I will set out how we are going to transform health and social care across the board. What is most important is that we deliver better outcomes for health and social care and make sure that people live longer. People are living longer, with more complex conditions, and the reason they do is that our health service is good and is delivering, day and daily, services that support people. Members of the House would do well to recognise that more and more. Moving forward, I have set it out that we will clearly have to reconfigure how we deliver health and social care. That does not mean that we have to have every service in every hospital; it means that we deliver first-class outcomes that we can stand over and people are content with. That is the transformation piece that I will be announcing and discussing in the House next week.
Mr M Bradley: Does the Minister agree that the Causeway Hospital is an integral part of the north-west's health infrastructure and that many tourist-based events, such as the North West 200, need the support that the hospital lends for the success and safety of such events?
Mrs O'Neill: There is no doubt about the current services at the Causeway Hospital. It is the trust's view that its acute hospitals at Causeway and Antrim are developed to support each other and work collaboratively to provide a strong, sustainable model for acute services. Those two hospitals also network with other acute services, especially in Belfast and in the west. The two hospitals need to be right-sized and properly resourced to meet the demand now and in the future to support the events that you refer to. The trust has never shied away from saying that it sees it as a valuable and integral part of its health and social care provision.
Mr McGuigan: I thank the Minister for her comments about the two hospitals. How prepared is her Department for the pressures of winter in the months ahead?
Mrs O'Neill: As we enter the winter period, there are the annual pressures that all our hospitals will face. I have allocated £13 million from the June monitoring round for unscheduled care and winter pressures. That funding will be invested in a number of areas to improve patient flow in unscheduled care, including winter pressures, capacity expansion on acute sites and staffing in emergency departments.
The Northern Trust share of the funding is £1·697 million, and some of it will be used to increase capacity for short-stay, fast turnaround for appropriate patients who come to the emergency departments in the Antrim and Causeway hospitals. That includes the development of a direct assessment unit in the Causeway Hospital to enhance assessment capacity and to improve emergency department flow. Other measures at Causeway include improved discharge processes and increased pharmacy support.
Measures outside the hospital setting include expanding the trust's nursing home inreach service, improving access to starting new domiciliary care packages at the weekend, managing the community rehabilitation bed-based services and working with care homes to ensure that there is capacity for short stays as well as long-term placements over the winter period.
Mrs O'Neill: An Adoption and Children Bill has been drafted. It is principally intended to modernise the legal framework for adoption in the North and place children's welfare at the centre of the adoption decision-making processes. The current law on adoption is the Adoption Order 1987. It is based on English legislation drafted in the early 1970s and therefore reflects practice that is effectively 40 years old. The Bill will deliver a framework for adoption that is more consistent with the principles and provisions of the Children Order 1995 and international human rights requirements.
The substance of the Bill relates to adoption, although I propose to also make changes to the Children Order. The Bill will be substantive. The current draft contains approximately 140 clauses and five schedules. In the main, the Bill is based on policy proposals consulted on in 2006. However, it also contains new provisions not previously consulted on but which I consider will deliver improved outcomes for children and young people, both in relation to adoption and children's social care. As part of the consultation on the Bill, I will also seek views on a number of further proposed changes to adoption, safeguarding and children's legislation.
I firmly believe that it is extremely important that an Adoption and Children Bill is introduced as soon as possible. The Bill is long overdue. I therefore intend to seek Executive agreement to consult on the draft Bill, with the intention of introducing it in the Assembly as soon as possible in the current mandate.
Mr Murphy: Go raibh maith agat, agus gabhaim buíochas leis an Aire as an fhreagra. I thank the Minister for her answers to date. I am sure that most people will be pleased that there is movement on the issue. Will she outline what policy proposals in and around this she is preparing to consult on?
Mrs O'Neill: Professor Alexis Jay undertook a review of the Safeguarding Board in April of last year. The review report was submitted to the Department, and I accepted all the report's findings in August this year. One of that report's key recommendations was that, in the longer term, the creation of a statutory child protection partnership should be considered as a replacement for the Safeguarding Board, with wider safeguarding sitting within an overarching Children and Young People's Strategic Partnership (CYPSP). I intend to consult on whether to include additional provisions in the Adoption and Children Bill to establish a statutory child protection partnership and place the CYPSP on a statutory basis.
I also intend to consult on the duty of the Health and Social Care Board to provide information about adoption support services; to introduce a right for the descendents of adopted people to access records and intermediary services; to place arrangements for duly approved placements — that is, individuals or couples approved to foster or adopt — on a statutory basis; to amend the Children Order 1995 to strengthen arrangements in respect of private foster carers; and to seek views on the introduction of contact/no contact orders to ensure that the authorities are clear that their duty is to safeguard and promote the welfare of looked-after children when making contact arrangements.
Mr McKee: Is the Minister aware that many adopters in Northern Ireland view themselves as third-class citizens when they see the greater support for those who adopt in other regions of the UK? Will she give a commitment that any new adoption legislation will rectify that, so that adoptive families here will receive the support they deserve and require?
Mrs O'Neill: It is extremely important that we support adoptive parents. That was one of the issues that was discussed when I met Adoption NI recently. One of the things that the Bill is looking at is defining adoption support services to mean that we provide counselling, advice and information for adoptive parents. It is also about other services that are prescribed by regulations in relation to adoption. The Bill will give us an opportunity to strengthen the supports for adoptive parents, and it places a statutory duty on adoption authorities to make sure that arrangements are put in place for the provision of support services that are specified in regulations. The Bill is timely, and it will support parents who adopt children and need all the support that we can give them.
Ms Bradshaw: Can the Minister assure the House that the consultation process around the legislation will be in keeping with Equality Commission guidelines and that the questions in it will not be leading and biased towards heterosexual married couples from the same religion?
Mrs O'Neill: I will always be guided by equality principles. I can assure the Member that, when I go out to consult, that will be very evident in the consultation paper that goes forward. There has been a lot of talk about this, and there have been a lot of court cases. It is about time we moved on and put it on a statutory footing.
Mr McPhillips: Does the Minister's Department have any plans to increase the number of foster carers here?
Mrs O'Neill: We are continually looking for more foster carers to come forward. We have about 2,200 children in care who need our support, and we need more people to come forward. We are actively involved in working with other Departments and key stakeholders to make sure that we raise awareness about how rewarding and fulfilling foster caring is and to ensure that we provide more support, particularly in relation to kinship; we are doing a lot of awareness work around that also. We have to continue to do more to make sure that more people come forward who want to adopt. Anybody I have encountered who fosters or adopts finds it very rewarding, albeit very challenging. That is why they need the support that we talked about earlier. It is so important that more people come forward and provide a loving home for children who find themselves in care.
Mrs O'Neill: The question is very timely. As Members will be aware, we are in the process of debating the issue of cancer services this afternoon. The performance figures for breast cancer in the Southern Trust for June are entirely unacceptable, but it is important to understand the full picture of what lies behind those statistics.
Of the 209 patients who waited longer than 14 days for a breast cancer referral in the month of June in the Southern Trust, 12 subsequently had a confirmed diagnosis of breast cancer; 94·3% did not have a cancer diagnosis. All of the 12 patients with a confirmed diagnosis have commenced treatment. Ten patients received their first definitive cancer treatment within 62 days, which means that the initial delay in diagnosis had no negative impact on their receiving treatment within a reasonable amount of time.
One received their first treatment at day 63, just outside the 62-day target. The final patient was a more complex case, and treatment did not commence until day 81.
I reassure people who may have sick loved ones or may be unwell themselves that the level of care they will receive from doctors and nurses here is second to none. My Department is working with colleagues in the Health and Social Care Board and the trusts to do everything possible to improve performance. The arrangements that have been put in place for other trusts to help with Southern Trust's breast cancer referrals have already had a positive impact. Provisional information shows that performance management has greatly improved to 78% in the Southern Trust in September, and I believe it is up to 100% today.
The trusts continue to work with the board to seek to resolve issues, and a workshop is scheduled for 26 October to identify options for delivering a sustainable, high-quality breast cancer service.
Madam Principal Deputy Speaker: Unfortunately, there is no time for a supplementary question. That ends the period for listed questions. We will now move on to topical questions.
T1. Mr Allen asked the Minister of Health whether her Department has any policies in relation to accessible healthcare information for those people with sight loss. (AQT 356/16-21)
Mrs O'Neill: I believe we do have strong policies in place, and I will clarify that for the Member when I leave after Question Time. If we did not, I would certainly rectify that situation.
Mr Allen: I thank the Minister for her answer. Minister, I have been engaging with the RNIB, which is promoting accessible healthcare information, and it believes there are difficulties for individuals. Would you be content to meet me and the RNIB to discuss that?
Mrs O'Neill: Yes, I am content. If the Member wants to drop me an email, we can arrange something.
T2. Mr Attwood asked the Minister of Health, following her answers to earlier questions, when she referred to women who had suffered miscarriages, to outline her views and the plans that she has to enhance IVF provision beyond current limits for those women who require multiple cycles of IVF in an effort to conceive a baby. (AQT 357/16-21)
Mrs O'Neill: It is disappointing that the health service at this stage is not able to provide the optimum three cycles. That is obviously something I want to work towards. I have said that publicly and was saying it when I was on the Health Committee many years ago. We have only one cycle in place now, which is not the optimum number; NICE guidelines clearly state that the optimum number is three. I will certainly want to work towards that. Obviously, one of our biggest challenges in the health service is funding and being able to resource all the things you want to, but it is my intention to work towards being able to provide the optimum three cycles.
Mr Attwood: I thank the Minister for her answer. Could I press her a bit further? I welcome her commitment to the optimum number of cycles. Are there any plans in her Department or in the Programme for Government (PFG) to move, even on a phased basis, to three cycles of full treatment compared with the one cycle of less than full treatment that women in Northern Ireland have at the moment?
Mrs O'Neill: The Member will know that the approach of the Programme for Government is outcomes focused. It talks about building better lives for individuals, so that could mean an awful lot of things to an awful lot of people. For me, I want to work to a point where anybody struggling to conceive gets the best support from the health service, and I will certainly work towards that.
As I said, my biggest challenge in IVF and being able to provide that support is financial. There are so many things I want to do as Health Minister, and so many things I wish I could change tomorrow. If you find yourself in that scenario, you are asking for support. Not everybody can afford to pay for additional cycles, so the optimum three cycles are what I want to work towards.
T3. Mr Easton asked the Minister of Health what plans the South Eastern Trust has to deal with any additional winter pressures, especially on beds. (AQT 358/16-21)
Mrs O'Neill: As I said in answer to a previous question, I allocated £13 million for winter pressures, which will deal with a range of things not only in the acute setting but with other things we can do in the community to help people to prevent needing to use acute services. I do not have the breakdown of figures for the South Eastern Trust, but it received its allocation of the £13 million to help it adjust to deal with what is an annual problem in all our health and social care settings.
Mr Easton: I thank the Minister for her answer so far. Would she consider reopening the Bangor GP ward to deal with any additional bed pressures?
Mrs O'Neill: That is an operational issue for the trust. It is not something I have looked at before, but I am happy to provide information to the Member in writing on the trust's intention to look at it.
Mr McNulty: The Minister will be aware of the real pressures on GP practices, especially in rural south Armagh and rural Fermanagh. This pressure has now reached urban areas, with many practices at risk of collapsing —
Mr McNulty: As of last week, a large practice in County Armagh is operating with ad hoc locum cover —
T4. Mr McNulty asked the Minister of Health to give an urgent assurance that she will support and invest in front-line services and GP practices. (AQT 359/16-21)
Mrs O'Neill: Indeed, I can, and I have done so on many occasions in the House. The issues that we face in GP services include the ageing profile of GPs. A number of GPs are retiring, so we have to look at workforce issues and how we can address that picture. One of the things that I am considering is the GP workforce action plan, which has come forward to me. I am actively considering that and looking at how we can support GPs.
We have not been found wanting in supporting GPs. Over the last year — 2016-17 — we have seen significant investment of £1·6 million per annum to commission an additional 20 GP places. We are in the process of a five-year investment to bring pharmacy into GP practices, and we will put close to 300 pharmacists into GP practices. So, for me, it is about investing in primary care. Many reports over the years have told us that we have to invest in primary care if we are to improve the picture. It is not just about GPs: it is about multidisciplinary teams; it is about the allied health professionals; it is about the community health visitor; and it is about the district nurse. It is about all those people working in partnership to make sure that we have first-class primary care.
Mr McNulty: Your predecessor announced £10 million capital funding, of which more than £9 million has not been drawn down and returned to the Treasury. What will you do for GPs now by way of a rescue package that can go into front-line general practice before large areas of my constituency are left without a GP?
Mrs O'Neill: I think that I have already answered that. I have said that we have not been found wanting in investing in GP surgeries. GPs are under pressure for the reasons that I have just highlighted, so we have to work with them. We now have the working group, which has reported and identified a number of issues, particularly in relation to increasing the number of GP training places.
My whole focus will be on investment in primary care. It is not just about the GPs; it is about the whole picture in primary care.
T5. Mr Middleton asked the Minister of Health what involvement she has had in a crisis intervention service for the north-west, given that she will be aware that the Foyle constituency has some of the highest suicide rates in the UK. (AQT 360/16-21)
Mrs O'Neill: I have not visited the crisis intervention centre yet, but we all need to do more on suicide prevention. It is about a holistic approach. It is not just about the Department of Health's approach; it is about education and whether people have a job or access to a home. It is about all those things.
I am consulting on the new Protect Life 2 strategy, which is bringing all the partners together. That will be key for setting out our new direction of travel, what has been working well and what we can do more of. I encourage anybody who has not responded to that consultation yet to do so. Let us improve what we do for suicide prevention in a holistic, collective way.
Mr Middleton: I thank the Minister for her answer. The Minister may not be aware that the council has costed a proposal for a service at a value of £170,000, £40,000 of which it has committed —
Mr Middleton: Is the Minister willing to meet the council to look at how it can source funding for the service?
Mrs O'Neill: Yes. I am always happy to discuss proposals, but we need people to come at it from a collective, creative point of view. We do not have an unlimited pot of money to do all the things that we want to do, so it is important that we tailor our resources towards the things that are most effective and which we can prove deliver better outcomes. I am always very happy to work in conjunction with councils and other partners to make sure that we collectively knock our heads together and do things better.
T6. Mr Stalford asked the Minister of Health how successful she assesses that the unscheduled care direct admissions unit for the elderly in Belfast City Hospital has been. (AQT 361/16-21)
Mrs O'Neill: I do not have particular information in relation to that, so I will have to provide it to the Member in writing, but I think that we need to focus on unscheduled care. That will help people from being distracted. If they are on a waiting list and are due to go in tomorrow morning and something happens and other people need to be seen first, that interrupts the surgery. So, it is important that we look towards how we can deliver scheduled care more efficiently and make sure that we take the pressure off acute services and A&Es.
Mr Stalford: I am grateful for the Minister's response. The Minister will be aware that the future of the City Hospital lies in becoming a centre for specialisms. Does the Minister have any plans for additional specialist care fields that can be provided out of the City Hospital?
Mrs O'Neill: I think that all our hospitals can do more and could be become specialists in various fields. That is one of the things that we need to do better in the time ahead. We cannot continue to provide everything in every hospital, but we could make every hospital a specialist in something and, where possible, make every hospital able to provide first-class outcomes, whether it be for stroke services or urology. No matter what it is, if you can get better outcomes, I think that people will be prepared to travel that wee bit further to get them. I do not have the detail of the individual plans for the Belfast Trust for the future, but, again, I am very happy to give that to the Member in writing.
T7. Mr M Bradley asked the Minister of Health for an assurance that existing services at the Causeway Hospital, such as maternity, will remain and that services such as orthopaedics will return in the near future. (AQT 362/16-21)
Mrs O'Neill: I answered a question earlier on the trust's current plans and said that it did not have any major plans to change. In going forward, during the whole transformation and in making sure that we reconfigure services that deliver better outcomes for individuals, we need to be clinician-led. The decisions about where we should provide services should be done in conjunction with patients and carers but should be clinician-led, because, if a doctor tells me that I will get a better outcome if I go to, for example, Craigavon for stroke services or to the Belfast City Hospital for another service, that is what we should be guided by. In going forward, we will make sure that decisions are taken based on better outcomes for individuals so that we have a better and healthier population.
Mr M Bradley: I thank the Minister for her answer. I do not want to put the Minister on the spot, but would she consider visiting the Causeway Hospital in the near future?
Mrs O'Neill: I am quite sure that I will make my way there at some stage. I have had many invitations. I have a very large inbox of invitations. I want to get out and I want to be a Minister who engages. I believe in listening to people on the front line and to staff, patients and carers. I am quite sure that I will be able to take the Member up on that offer at some stage in the future.
T8. Mr F McCann asked the Minister of Health whether she will give evidence to the pay review body in relation to the 2017-18 pay round. (AQT 363/16-21)
Mrs O'Neill: Yes, I will. We have started that work, and I intend to feed into that in the time ahead. We provided the pay review body with a mandate for the 2017-18 pay review round in respect of all staff paid under Agenda for Change and all doctors and dentists in August. I will shortly issue evidence to support and inform the body's recommendations.
Mr F McCann: I thank the Minister for her answer thus far. Can she provide an update on the 1% pay award?
Mrs O'Neill: Yes, I can. The payroll team in the Business Services Organisation has provided assurances that the majority of staff will receive their uplift and arrears in their November pay. The pay will be awarded and backdated to 1 April this year. A number of people who require manual uplifts will receive their payments in December or January, but the vast majority will be paid in their November pay.
T9. Ms Seeley asked the Minister of Health to clarify her intentions for local bursary support, in the light of the British Government’s announcement of their intention to replace student nurse bursaries with loans. (AQT 364/16-21)
Mrs O'Neill: Yes, I can say, for one, that I am very proud of our local nursing and midwifery staff, and I think that it is entirely right that we continue to support student nurses through their preregistration training. Therefore, I am very happy to confirm that I have no intention of going down the route that is being followed in England. Bursary support for student nurses and midwives will continue.
Ms Seeley: I thank the Minister for her response and welcome her intention. Given the current shortage in nursing, will the Minister consider increasing the numbers of student nursing places at our local universities?
Mrs O'Neill: The Department increased the number of student places for the 2016-17 academic year by over 100, and I am committed to maintaining that level as a minimum in 2017-18. I am also considering options for even further increases as I develop my Department's budget for the coming year.
T10. Ms Dillon asked the Minister of Health for an update on the first meeting of the strategic health partnership forum that was held last week. (AQT 365/16-21)
Mrs O'Neill: I chaired the inaugural meeting of the strategic health partnership forum last Wednesday, and it was attended by my Department's senior management team, trusts' chief executives and nine staff-side representatives. The meeting was a first step and was very positive in contributing to the strategic direction of health policy. I look forward to working in the forum as we develop and shape policies for the future that deliver a first-class health service. The first meeting was a positive one, at which we discussed and agreed terms of reference. I look forward to working with the forum in the years ahead.
Ms Dillon: Go raibh maith agat. Will the Minister confirm whether the forum will discuss the transformation in the aftermath of the publication of the Bengoa report?
Mrs O'Neill: Yes. I have committed to chairing the next meeting next month on the back of my announcement on Professor Bengoa's report.
Mr Hazzard (The Minister for Infrastructure): We are reliant on our airports and seaports to access key markets and destinations, whether that is for pleasure, business or education, or simply to visit families and friends. The connections to our airports and ports will be increasingly important in creating the conditions for prosperity and will be key to our ability to compete in a global, skills-based and innovative economy, not simply for markets but for investment and talent. The City Airport has an important role to play in providing that access and already has a significant market share of short-haul domestic services, aided by its accessibility to the city centre.
There are currently no plans to provide a new rail halt at George Best Belfast City Airport. My immediate railway priorities must be to maintain and improve passenger capacity and remove bottlenecks on the existing rail network. However, that does not preclude new halts where passenger demand justifies it and additional finance is obtainable.
I have started preparations for the development of a new Belfast metropolitan transport plan. The plan will provide an opportunity to consider the roles that private cars, trains, buses and taxis can all play in connecting Belfast City Airport. However, linking the airport more directly by rail may not necessarily be the best way to serve this important gateway in the shorter term, particularly as it is currently served by a very frequent, recently upgraded bus service to and from the city centre.
Mr Easton: I thank the Minister for his answer. Will he agree with me that the best way to attract foreign investment is to have the best transport infrastructure in place? Would a train halt outside the George Best Belfast City Airport not help to do that and increase passenger numbers?
Mr Hazzard: It does not necessarily follow that, if you have a train halt, you will provide a better service for business and investment. A very successful bus service runs to and from the airport, and many investors who come in and out of the city use it. Indeed, I have used it. It is very reliable and a very welcome service for those who want to invest in the city and the region.
Mr Chambers: I ask the Minister whether there is a shuttle bus service from the Sydenham halt to the airport. If not, will he give consideration to introducing such a service as a short-term, interim measure?
Mr Hazzard: I thank the Member for his question. As I understand it, the airport provides an on-demand shuttle bus service between the airport terminal and the railway halt at Sydenham.
Mr Stalford: In his response to Mr Easton, the Minister outlined some of the immediate priorities for the Department for Infrastructure. Can he assure the House that one of those immediate priorities will be the delivery of the Belfast transport hub over the next five years?
Mr Hazzard: I thank the Member for his question. The Belfast hub is a flagship project for the Executive. I look forward to working with Belfast City Council colleagues in delivering what I think will be a transformative project, not just for the city of Belfast but for the entirety of the North. It is key to developing our public transport network, and I very much look forward to doing all that I can in the years ahead.
There is no doubt that Brexit and the EU referendum result is a huge challenge. The Belfast transport hub is one project that would likely have benefited from up to 40% funding from the EU, and that is money that will now have to be found from elsewhere. It is a challenge that I am up for meeting, because, as I outlined to the Member, the project has a transformative effect.
Mr Milne: What is the current position with the Department's transport plans?
Mr Hazzard: As I stated previously, I am commencing work to refresh the full suite of my Department's transport plans.
Work on the regional strategic transport network transport plan will begin in the very near future. That will be followed by a series of local transport plans, including the Belfast metropolitan transport plan, which I mentioned earlier. The plans will be developed to coordinate with the delivery of local development plans. Local transport plans will be developed in my Department but working closely with council officials.
Ms Armstrong: I go back to the issue of the airport. What discussions have there been with Translink and the airport about improving access, particularly to early flights, to enable interconnectivity for business travellers?
Mr Hazzard: I thank the Member for her question. It is probably better to ask Translink what discussions it has had with the City Airport. I point the Member in that direction.
Mr Hazzard: I am fully committed to the delivery of Belfast rapid transit (BRT), including not only the current phase, which connects east Belfast, west Belfast and the Titanic Quarter via the city centre, but future extensions to the north and south of the city. I regard Belfast rapid transit as a transformational public transport project for the city. It represents an exciting opportunity for Belfast going forward, and it is a major commitment for my Department in support of an Executive flagship project.
The implementation of Belfast rapid transit is progressing well. To date, my Department has completed the new Dundonald park-and-ride facility and sections of the routes on the Falls and Upper Newtownards roads, including the introduction of new peak hour bus lanes. The new peak hour bus lanes support a more reliable and attractive bus service for passengers using these busy arterial routes. Since the introduction of the new peak hour bus lanes, there have been substantial increases in passenger numbers and improvements to journey times.
The detailed specification for the BRT vehicles has been finalised. This process included engagement with the disability and elderly sectors through the Inclusive Mobility and Transport Advisory Committee (IMTAC). The diesel-electric hybrid BRT vehicles will provide a high-quality, accessible environment for passengers in terms of comfort, space, security and on-board information.
I am pleased to say that the BRT system remains within budget and on target to become operational in September 2018.
Mr F McCann: Go raibh míle maith agat. The Minister has already touched on the question of the transit vehicles. Could he elaborate on when the vehicles will be ready? There seems to have been some delay in the process.
Mr Hazzard: The contract was awarded in November 2015. Since then, my Department has finalised the detailed specification for the vehicles in conjunction with Translink and the manufacturers, Van Hool. The process included engagement on accessibility with the disability and elderly sectors through IMTAC. The BRT vehicles will be 18-metre, diesel-electric hybrid, articulated buses with a capacity for around 100 people. They will provide a high-quality, accessible environment for passengers in terms of comfort, space, security and on-board information. The first Belfast rapid transit vehicle is being assembled by Van Hool. Once completed, it will be subject to extensive road testing before being delivered to Belfast in 2017. Subsequent vehicles will be delivered prior to the system going live in September 2018.
Mrs Palmer: I thank the Minister for his update on the rapid transit system. Given that Belfast was found to be the United Kingdom's third most congested city yesterday, is the Minister content that enough is being done to address the problem, in particular through the York Street interchange, which would be transformative for dealing with congestion?
Mr Hazzard: Congestion is an issue that faces not just our city of Belfast but Derry and Dublin. I was recently in China, and it is the same, on a very different scale, in places such as Beijing and Shanghai. The BRT has been designed to have a transformative effect, and I think that it will. I will also bring forward bicycle strategies in the next number of months. We have seen the success of the Comber and Connswater greenways. These are hugely transformative active travel and public transport projects that, given time and the public appetite, which is there, will have a transformative impact. The strategic importance of a project such as the York Street interchange, is clear, but, as I outlined to Members across the way in relation to the Belfast hub, Brexit and its implications for the funding of projects such as the York Street interchange create a substantial hurdle.
Mr Humphrey: I thank the Minister for his answers so far. I welcome his reassurance to the House about the Belfast transportation hub. That is a welcome commitment. I also welcome the investment to date in the Belfast rapid transit system and the fact that work has started. The Minister will be aware —
Mr Humphrey: — that the work actually relates to east and west Belfast. Does he have a timescale for when it might be extended to north and south Belfast?
Mr Hazzard: I thank the Member for his comments at the outset. He will be aware of the timescales involved for this particular phase. I assume that similar timescales will be involved when we extend this to north and south Belfast. I think that there is a level of excitement around this particular phase that will only be matched with the north and south Belfast route. It is a route that I travel often. Certainly, I do not think that it takes experts in the field to realise that, again, this will be a transformative route between the north of our city, through the city centre, to the south and out to an area such as Carryduff. I think that it would be much welcomed. It is something that I certainly hope to progress at some point in this mandate.
Ms Bradshaw: I think that the Minister has just answered my question.
Mr Hazzard: A wide range of memorials to deceased persons has been placed on or close to property owned or controlled by my Department over many years. Most of them relate to fatal incidents occurring on or near roads. While a small number of these incidents are directly related to the conflict in the North over the past 40 years or so, most are not. These memorials comprise many different formats, from permanent structures or temporary floral tributes to the so-called ghost bikes. Given the transient nature of many of them, it is not possible to state how many there are across the whole of the North with any certainty. My Department does not endorse any of them but the long-standing practice has been to not remove any such memorials unless road safety is directly compromised. Any memorials on the property of my Department's arms-length bodies are matters for the boards of those organisations.
Mr Allister: So it is the official policy of the Executive and Department to do nothing about terrorist memorials on public property. Is that a complacency borne of empathy with the glorification of terrorism, which these distasteful memorials represent?
Mr Hazzard: The Member will be well aware that there are memorials to the UDR, the British Army —
Mr Hazzard: The Member will be aware of the plethora of memorials across the political spectrum; for the British Army, the UDR, the police and different groups across society. As I outlined, there are also memorials to those who have died at roadsides. The Department's toleration policy was developed as a result of its experience in dealing with illegal roadside memorials and the desire to avoid exacerbating the problem or putting the safety of staff or contractors at risk. Examples of where toleration is similarly exercised include issues such as flag-flying from street lights or cafes and bars placing tables and chairs on the public footpaths where space permits.
Mr Clarke: I feel as though I do not really want to thank the Minister for his answer. Can he differentiate between terrorists and the forces who were actually murdered by terrorists and tell us the difference between those monuments?
Mr Hazzard: I do not think that the question has any relevance whatsoever to my responsibility as Minister for Infrastructure. As I have outlined already, there is a plethora of different types of memorials on roadsides, including floral tributes and, as I have mentioned, ghost bikes for people who have unfortunately been killed as a result of a road traffic accident. It is not my responsibility to get into that.
Mr Hazzard: I will shortly hold a public consultation on my draft Belfast bicycle network plan, the first of a series of plans to help to bring coherent, continuous and comfortable bicycle infrastructure within the reach of most people within our towns and cities. This is part of the vision in the bicycle strategy to give people the freedom and confidence to travel by bicycle for everyday journeys and to significantly increase the number of shorter journeys that we make by bicycle.
One of the three pillars of the bicycle strategy is to build a comprehensive bicycle network. The Belfast bicycle network plan will provide a framework for the development of safe, attractive cycling provision throughout Belfast over the next ten years. It will do this by bringing good quality cycling routes within 400 metres of around two thirds of residents of the Belfast City Council area.
The Member will be aware of a number of cycle schemes that are currently being built in the city centre as flagship schemes to demonstrate the kind of cycling infrastructure that will be delivered. I am keen to deliver more of those segregated cycle routes in the future. The network plan approach will contribute to several outcomes of the draft Programme for Government, such as connecting people and opportunities through our infrastructure and supporting and encouraging long, healthy and active lives.
Mr Lyttle: I thank the Minister for his answer. I welcome his support for and shared belief in the social, health and economic benefits of cycling to our community. Of the MLAs returned to the Assembly, 70% supported the Election Cycle campaign, one of whose aims was to have a budget of at least £10 per head of population for cycling infrastructure. Will the Minister be able to increase the spend per head from the amount last year, which was only £1·30, to that target of £10?
Mr Hazzard: I thank the Member for raising the issue. I think that I was one of the MLAs who signed up to the various pledges. We need to see an increased spend and budget when we look at active travel and our cycling infrastructure. It is a generational project. My greenways strategy will be generational. I have mentioned that it is over 10 years; that is the approach that we have to take. I want to work in partnership with our local councils. Some of them have been doing sterling work. I have already mentioned the likes of the Connswater greenway, which is a great success in the east of the city. I am certainly determined to do my best to work in partnership with Belfast City Council on that.
Ms J McCann: The Minister mentioned the benefits of cycling: how many people currently cycle in Belfast?
Mr Hazzard: The Belfast Bike Life report shows that 7 million journeys are cycled in Belfast every year. My Department's most recent research on cycling to work reveals that 5% of Belfast commuters already use the bicycle to travel to and from work. The momentum to continue growing is demonstrated by the success of the Belfast bike share scheme, with over 300,000 journeys having been taken in the last 18 months. I am confident that that growth in cycling will continue as we continue to invest in better cycling infrastructure, both in urban networks and in the development of our greenways.
Mr Kennedy: What practical steps does the Minister intend to take in rural areas outside Belfast to further develop the cycling revolution that I initiated?
Mr Hazzard: I thank the Member for getting the wheels of revolution turning. It is a reputation that I want to build on, and I will do what I can over the next mandate to continue it. The bicycle strategy, as the Member is no doubt aware, envisages a comprehensive network for the bicycle not just in Belfast but across the North. The strategic plan for greenways is one element of that, and the urban network plans are another. My intention, following the publication of the Belfast plan, is to learn from the experience and roll it out to other urban centres.
Mr Humphrey: I commend what the Minister said about the Connswater greenway. The Committee was there a couple of weeks ago. In terms of extending that sort of initiative, which is a great collaborative approach with government, the Big Lottery Fund and the city council, can we have similar facilities across the city? I know that they are expensive, but such an investment, even one not on that scale, would be hugely beneficial to our people across Belfast.
Mr Hazzard: Yes. I was in Victoria Park and around that area and in Orangefield. We have examples of where Rivers Agency and the city council are working together. The projects that they are delivering are first-class. It is a model that there is much value in, and I am certainly more than happy to work with it.
Mr Hazzard: Utility companies are required to notify Transport NI of all works on roads and footpaths through the street works registration and notification system. Transport NI inspects a 10% sample of all utility openings within six months following completion and a further 10% sample within the last three months of the reinstatement warranty period. That is to ensure compliance with the specification for reinstatement of openings in roads. The cost of the inspections is recovered from the utility companies.
Of course, Transport NI also identifies defective reinstatements through routine road condition inspections, inspections in response to third-party reports and a six-monthly core survey, where core samples are taken from visually compliant reinstatements. Where a reinstatement fails to comply with the specification, the utility company is notified and required to carry out repairs. Follow-up inspections are carried out to ensure that remedial works have been completed. The cost of those follow-up inspections is also recovered from the utility company.
Transport NI uses sample inspection results as a key performance indicator for utility companies and informs those companies of performance on a monthly basis. Progress is also discussed at quarterly meetings of the NI Road Authority and Utilities Committee. In the event that an individual utility company's performance becomes unacceptable, Transport NI has powers to increase the number of chargeable inspections until such time as performance improvements have been achieved.
Mr Anderson: I thank the Minister for his answer. Minister, I am sure you are well aware of the state of many of our roads and footpaths following reinstatement by service providers and contractors. In my constituency of Upper Bann and across Northern Ireland, we see many examples of poor reinstatements, the most annoying being new roads and pavements being dug up, that could have been avoided with proper forward planning.
Mr Anderson: Is the present reinstatement specification outdated and in much need of change?
Mr Hazzard: I thank the Member for his question and, indeed, his interest in this. It is something I am currently looking at. I share the Member's frustration and, indeed, that of the wider public. We see public realm schemes come into place in many of our regional towns and villages, and then, six months later, there are maybe kerbs or flagstones being lifted. There is a sense that people, especially traders, are asking, "Why could this not have been done six months ago?". It is something I am looking at to examine whether more needs to be done to the policy, and, if that is the case, I will be more than happy to do that.
Mr Kearney: Minister, how much has your Department charged utility companies for unsatisfactory reinstatement of paths and roadways?
Mr Hazzard: My Department charged utility companies just over £100,000 for follow-up inspections carried out in 2015-16 to ensure defective reinstatements had been adequately repaired.
Mr McNulty: I thank the Minister for his answers to date. What are the guideline specifications that the utility companies must adhere to, and what is the timescale by which they must comply for the reinstatement of footways and roadways?
Mr Hazzard: I do not have the guidelines in front of me, but, if the Member wants to write to me, I will be more than happy to share them with him.
Mr Ford: What powers does the Minister's Department have to ensure greater coordination between other agencies that have the right to dig up roads, specifically if there is injury or damage caused? Is the contractor held liable, or is the Department for Infrastructure liable?
Mr Hazzard: Transport NI exchanges details of the programmed work with the utility companies to ensure any potential issues are identified at as early a stage as possible. Notifications of planned works are also placed on the street works registration and notification system, which identifies potential conflicts. Where a conflict is identified between planned resurfacing works or other major road works and planned utility works, Transport NI will liaise with the utility company to ensure that the utility company works are completed in advance of the resurfacing scheme, where at all possible. That is the case with our rural roads initiative, where, in a number of locations across the North, work is being held back until the utility companies are finished, and the rural roads initiative will take place later in the year.
Mr Hazzard: My Department's costs for street lighting arise from three main areas: the new provision and renewal of street-lighting installations; street-lighting operation and maintenance activities; and street-lighting electricity costs. For all those areas of work, my Department uses competitive tendering to ensure that street-lighting materials, labour and electricity are procured in a way that delivers best value for money. The costs for new provision and maintenance activities are relatively straightforward to calculate. They are simply the product of the applicable contract rate for the various items of work done multiplied by the quantities delivered by the contractors.
Calculating the costs for street-lighting electricity is a little more complex. Unlike most commercial, industrial or domestic electricity supplies, street-lighting electricity is not metered. That is typical of most public lighting supply arrangements across the world. Instead of metering, my Department maintains a comprehensive inventory of all street-lighting assets, from which the electricity consumption can be calculated. The electricity costs are arrived at by multiplying the number of each type of street light by the respective wattage, by their annual operating hours and by the relevant supplier's tendered price per kilowatt-hour.
Mr Clarke: I thank the Minister for his comprehensive answer. I am sure that he will agree that many people are concerned — we are all concerned in our own homes — about energy wastage. Given that we see street lights lit on many occasions when they should not be, and, someone has to bear the cost, what will the Minister do to reduce the cost of the energy being used?
Mr Hazzard: There has been an investment of £3 million during the last financial year to retrofit approximately 15,000 street lights in the Banbridge and Craigavon areas with new LED lanterns, which has resulted in significant energy and maintenance cost savings of over a third of a million pounds per year.
Ms Archibald: I thank the Minister for his responses. How much does the electricity for street lighting cost each year?
Mr Hazzard: The annual cost of electricity for street lighting varies from year to year, depending on the prevailing cost of electricity, the number of street lights and their associated wattage. In recent years, the annual cost has typically been in the order of £10 million. Fortunately, like many other electricity consumers, my Department has seen a reduction in the unit cost of electricity in the last year. Taken over the past five-year period, the approximate cost of providing and maintaining my Department's street lighting assets averaged as follows: £6 million per annum for new provision and renewal of old street lighting systems; £7·3 million per annum for routine maintenance and inspection, testing and safety repairs; and £10 million per annum for electricity.
Mr Hazzard: One of my key priorities as Minister for Infrastructure is to redress the North’s infrastructure deficit, particularly west of the Bann. The A5 scheme will provide a high-quality road link between Derry, Strabane, Omagh and Ballygawley and will unlock the potential for future economic development in those areas.
Following the public consultation into the draft orders and environmental statement for the scheme, my Department appointed the Planning Appeals Commission as the independent inspector to administer a public inquiry. The inquiry opened on 4 October 2016, and the hearing is scheduled to close in mid–December 2016, with the inspector’s report expected around May 2017.
My Department will consider the report’s recommendations in detail before I make a decision on whether to proceed with the scheme and make the necessary statutory orders. In late August 2016, the Alternative A5 Alliance applied for leave for a judicial review. My Department is opposing the application for leave, which has been listed for hearing in November 2016.
Subject to the successful completion of all the statutory procedures and a satisfactory outcome from the inspector’s report, it is anticipated that construction can commence in late 2017 on phase 1A in line with the Fresh Start Agreement. I am engaging with departmental officials to explore options to maximise delivery of the A5 during the current mandate.
Mr McAleer: I thank the Minister for his comprehensive answer. I can say with certainty that the overwhelming majority of people are looking forward to the scheme progressing. Can the Minister tell me whether a contractor has been appointed for the A5 dual carriageway project?
Mr Hazzard: Yes, three contractor joint ventures have been appointed to the integrated delivery team, with each joint venture awarded one section of the scheme. Subject to satisfactory completion of the statutory procedures and the making of the order, the joint venture contractor for phase 1A, Balfour Beatty/BAM/FP McCann, will be instructed to complete the detailed design and construct the scheme.
Mr Robinson: Can the Minister give an update on the A26 project, and does he envisage any delays?
Mr Hazzard: No delays are envisaged. Work is ongoing, and I will be visiting the scheme soon. I expect the work to be completed next year.
Mr Durkan: I will bring the Minister back to the A5. Following the delays that the project has encountered thus far, how confident is he that, this time, the i's are dotted and the t's are crossed and that the Department has a robust case that will not be brought down in the courts by opponents to the scheme.
Mr Hazzard: The Member is right when he mentions the length of time that the communities in those areas have been waiting. I am confident that all has been done in my Department's case to dot the i's and cross the t's. We must respect the statutory processes and the will of the court. Certainly, as the hearing progresses, I will do all that I can to ensure that this scheme begins. Those in the west have been crying out for the scheme to commence, and we wish them all well in that.
T1. Mrs Barton asked the Minister for Infrastructure, with winter just around the corner, to state what budget he has allocated for the winter treatment of roads in each of the four divisions. (AQT 366/16-21)
Mr Hazzard: I thank the Member. The Member may be aware that we are currently bringing into place a data analyst to guide the Department when it comes to weather; certainly to give a more in-depth and scientific report than what we might be used to each evening on the 6.00 o'clock news. We also work closely with the Rivers Agency, which has a very detailed team that can work with the weather.
The Member can rest assured that all is in place now with the winter service; certainly, with the collection of salt and ensuring that we have the services in place for the winter period and the inclement weather that is likely to come.
Mrs Barton: What budget have you allocated to those areas?
Mr Hazzard: We are still finalising the terms of the final budget. We are going ahead with bringing into place the data analyst to guide us, but this will certainly not hold up any of the winter services as we proceed.
T2. Mrs Dobson asked the Minister for Infrastructure, after paying tribute to her former colleague Sam Gardiner and Mr Hazzard’s predecessor as Minister, Mr Kennedy, for their determination, to update the House as to why the Millennium Way project has been further delayed, given that he will appreciate that, for the people of Lurgan, the Millennium Way project has been coming for what seems like a millennium. (AQT 367/16-21)
Mr Hazzard: The scheme had several unintended problems when it came to certain junctions. The scheme had been progressing well. Due to an intense number of utilities that were discovered and have to be dealt with in a timely manner, the scheme is now delayed. I will be working with Department officials and those in Transport NI to ensure as little disruption to traders in the busy Christmas period as possible.
Mrs Dobson: I thank the Minister for his answer. I appreciate the circumstances, and I think that he is saying that the main sticking area seems to be with the utility providers. Will this delay mean any additional costs being associated with the eventual completion of the project?
Mr Hazzard: I am not aware of any additional costs. I am due to get a briefing later in further detail around what is likely now to be a delay of a few months to the scheme. At the outset, certainly before I have had that, I am not aware of any additional costs.
T3. Ms S Bradley asked the Minister for Infrastructure whether he has any intention to reach out to those rural network roads that have not been fixed, particularly in relation to road markings and painting those markings that have all but disappeared, given that the £10 million that was set aside for rural roads, whilst very welcome, did not, once carved up, seem to go far enough. (AQT 368/16-21)
Mr Hazzard: The Member is correct. When you consider that we have somewhere in the region of a £1 billion backlog in road maintenance, £10 million towards rural roads is a drop in the ocean. Divisional managers have now identified roads, such as Mullaghgariff Road in the Member's constituency, which have not seen resurfacing in more than a decade if not longer.
The £10 million will have gone some way to addressing that. There are communities that have always felt isolated and that they have never got a piece of the pie. Certainly, I am under no illusions — I do not think that anybody is. In no way or stretch of the imagination are we going to address a £1 billion backlog in road maintenance in my time as Infrastructure Minister over the next five years. There needs to be a more strategic, generational approach to how we do this and how we budget and finance for roads maintenance. It is one thing to design new roads projects, but we also have to be mindful of the road network that we currently have, and I will be doing all my power to set in place a new strategic framework for how we finance roads maintenance.
Ms S Bradley: Is the Minister aware that a section of the A2 dual carriageway, from Newry to Warrenpoint, is in particular need of resurfacing? If so, has he any plans to carry out that resurfacing?
Mr Hazzard: I am not aware of any current plans to resurface it. I am well aware of the road, however, which is one that I travel often. I would say that all Members have a list as long as their arm of roads, especially in rural areas, that need resurfaced. This is not a sob story, but our budgets are under pressure, as has been the case for a number of years, and we have to do what we can with the money available to us. When it comes to road maintenance, we need to think about the long term. I said during a recent Adjournment debate on the subject that we need to take a far more strategic and long-term approach.
T4. Mrs Long asked the Minister for Infrastructure, in the light of Brexit, what recommendations his Department is bringing forward to guide future waste water treatment directives, given that he will be aware that EU directives have driven much of the investment and improvement in waste water discharges into the environment. (AQT 369/16-21)
Mr Hazzard: The Member is correct: much of it has been because of that. Much of the heat and much of the debate has been around funding, but, of course, my Department also has responsibility for regulation. Waste water is certainly part of that, and something that we will take forward. I have not seen any information that relates to the Member's specific question, but, if she wants to correspond with me, I will be more than happy to do so.
Mrs Long: I thank the Minister for his response. In Westminster, a "Great Repeal Bill" will replace legislation that currently governs such issues with locally agreed legislation. Will there be a similar process in the Assembly to go through the legislation that currently governs issues such as waste water treatment?
Mr Hazzard: I am not aware of the exact governance process that we will go through. I have a briefing with officials next week, and a Brexit team in my Department is looking at a number of these issues. Although the initial conversations revolved around funding and immediate situations, I know that regulation is one item on the agenda.
T5. Mr Kennedy asked the Minister for Infrastructure whether he has considered availing himself of any additional expertise to more accurately predict weather patterns in the coming winter period. (AQT 370/16-21)
Mr Hazzard: No. As I outlined to the Member's colleague earlier, there has been a tradition over the past number of years of working closely in tandem with Rivers Agency. As the Comptroller and Auditor General's recent report identified, the flood risk maps very accurately detail the risks, and it is the same with the weather. If the Member has any ideas or suggestions, I am more than happy to listen to them.
Mr Kennedy: I thank the Minister for his response. On winter services as well, I ask whether he has any plans to increase the number of grit piles in rural areas of my Newry and Armagh constituency to support the communities there.
Mr Hazzard: As a representative of a rural constituency, I probably championed the cause of grit piles to the former Minister in previous years. I am all too aware of the need. We know of the treacherous journeys that commuters from rural areas sometimes have to make. When it comes to grit and salt during the winter months, we know that there is much correspondence with the Department. The former Minister will undoubtedly know that. It is something that I look at. The Member specified Newry and Armagh, and we need to look at the issue constituency by constituency and on the basis of need, rather than strictly geographically. As I said before, we have to take cognisance of the fact that we are operating under limited budgets and have to do as much as we can with them.
T6. Ms Seeley asked the Minister for Infrastructure whether he feels that there will be any potential investment or shared knowledge following his recent trip to China. (AQT 371/16-21)
Mr Hazzard: I thank the Member for her question. At the outset, I thank Tim Losty and staff of the NI Bureau for facilitating many of the meetings that I had in China over the past week. I put on record my thanks to the Confucius Institute, particularly Dr Yan Liu, who assisted us greatly on our visit and certainly helped to open a lot of doors that will, I think, be of great benefit in the future.
On the first leg of the question, around investment, I was delighted to have the opportunity to meet the president of the China Investment Corporation, President Tu, and the Asian Infrastructure Investment Bank in Beijing last week. It is very clear that not only are they interested in building relationships and building friendships with the people of Ireland, they are certainly interested in investing in some of our infrastructure projects over the next number of years. I very much look forward to meeting them once again, back here in Ireland, to discuss these projects in further detail.
I think that shared learning is perhaps an area in which we may be able to work quickest, certainly by having discussions with the Beijing municipal authority around congestion and car parking. A number of initiatives in public transport and active travel are occurring now in Beijing that we can certainly learn from. As I mentioned earlier, the scale is, of course, very different. They are dealing with a city of over 20 million people, and we are not dealing with that. Many of the problems, issues and solutions are very similar, so I think that we can build on that in the future.
Ms Seeley: I welcome the Minister's response. Does he agree that, if Brexit does mean Brexit, China will become a very important ally in building the economy here in the North?
Mr Hazzard: Even before the EU referendum result, there was no doubt that China is a global superpower. You only have to cast your eye across Europe to see a number of the large-scale, and even smaller, infrastructure projects that China is investing in. There is no doubt that the axis of global power is tilting east. Many political commentators say so. I took the opportunity to visit Hubei province, where there are cities that, perhaps, some people have never heard of, yet they have populations of 10 million, 12 million or 15 million. There are hugely ambitious infrastructure programmes, and there is a lot that we can learn. I think that the best thing for us is that there is a willingness on the part of the Chinese to join us in that campaign because they have much to learn from us also.
Mr Durkan: Can the Minister tell the House how many bicycles there are in Beijing? [Laughter.]
T7. Mr Durkan asked the Minister for Infrastructure to outline his view of LED street lighting. (AQT 372/16-21)
Mr Hazzard: There are not enough bicycles in Beijing, I think it is fair to say. All joking aside, you touch upon that, and we were shown images of the bicycles in Beijing in the 1980s, and they absolutely outnumbered all the cars. As the growth in the economy happened in Beijing, the bicycle disappeared and the car took over. That is the exact same problem that we face here when it comes to congestion, and it is something that they are also tackling. Again, there is much to learn from that.
On LED street lighting, the retrofit scheme, to a large extent, has been successful. There were a number of issues that caught people by surprise in that the amount of white light was not as much as that from the old system. Once people get used to that, it will allay a lot of fears. Again, it is something that I want to look at. I mentioned earlier the savings that are involved and the expense of having the old system. It is something that I am looking at because I do believe that it is a project worth pursuing.
Mr Durkan: I thank the Minister for his answer so far. I recognise the problems that have existed in some places where schemes have been carried out. However, does the Minister recognise the environmental as well as the economic benefits that such lighting brings and perhaps the possibility of replacing more street lights? We do know the pressure that the Minister's maintenance budget is under, but there might be more access to capital for such an environmentally friendly scheme.
Mr Hazzard: Certainly, and we know, for example, that there may be opportunities through the invest-to-save initiative. I am continuing to look at that in the Department, and we have discussed this. If it is feasible and affordable to roll out in the future, I am more than willing to look at it.
Madam Principal Deputy Speaker: That completes Question Time to the Minister for Infrastructure. Members may take their ease while we change the top Table.
(Mr Speaker in the Chair)
Mr Nesbitt: On a point of order, Mr Speaker. I am sure you will agree that the House should be first to know when the Executive have something important to say. Nothing could be more important than the Programme for Government, and yet, even if the draft were published today, the eight-week consultation would take us to 13 December, beyond the point at which this House goes into recess. If the Executive honour their commitment to publish the final draft by the end of the calendar year, this House will be the last to know. Surely that is not right.
Mr Speaker: I take notice of your point of order. I will reflect on it and come back to you.
Mrs Long: On a point of order, Mr Speaker. I apologise for not being in the Chamber earlier when the Minister for Communities responded to the debate on housing, which I had participated in. Unfortunately, I was detained in another meeting. I meant no discourtesy, and I would like to pass that on.
Debate resumed on motion:
That this Assembly notes the recent publication of cancer waiting times, which revealed that the crisis affecting cancer services in Northern Ireland is continuing to deteriorate; further notes with anger that, in June 2016, only 6·7% of breast cancer patients in the Southern Health and Social Care Trust area were seen within 14 days, despite the target being 100%; accepts the importance of timely diagnosis and treatment of cancer, as any delay can reduce the likelihood of a successful outcome; notes that these figures are symptomatic of the wider unprecedented crisis engulfing the Northern Ireland health service, with 392,000 people now on waiting lists; and calls on the Minister of Health to intervene to ensure that patients receive swift, safe and sustainable healthcare and to ensure that patient safety is not further compromised.
Ms Armstrong: I have thought very hard about how to respond to the motion today, because it deals with an extremely important and emotive subject. I start by confirming that the Alliance Party supports the motion but with reservations, because, as we have heard, the figures provide a snapshot. I also declare an interest, because I completely and totally hate cancer. I detest the disease in all its forms. Cancer causes pain and suffering and, in many cases, ends lives. I support the fight against cancer and have taken part in Race for Life events here in Stormont and raised funds for research.
I am extremely thankful that, in 2015, Cancer Research UK confirmed that more than 50% of people diagnosed will survive their cancer for more than 10 years; an all-time high. More people are surviving, and thank goodness for that. It is down, in quite a large part, to the staff who work in our hospitals to protect and care for people who are diagnosed with cancer, and their families, at a time when they are at their most vulnerable.
The motion talks about the crisis affecting cancer services, but we should not forget the people, the human beings, affected by cancer, including the almost 400,000 people on waiting lists and those who sometimes fail to receive early diagnosis. I thought I would share a quick story about what it is like to live without early diagnosis. In this case, a woman started to feel unwell around her 40th birthday and was back and forward to her GP on many occasions, a scenario that others have highlighted. The GP checked her and could not find out what was wrong. She was losing a lot of weight — not pounds but stones — without dieting.
Over the following couple of years, her eyesight blurred and her appetite left her. That person was in pain and was scared. She was frustrated and worried about her family and her children. She felt that she was not being listened to, that she was being dismissed and that she was not important; and she was angry. She was in and out of hospital, and her family were worried sick for her. The diagnosis finally came. The consultant called her husband to the side and confirmed that she had cancer. He told her husband that it was so advanced that she had days rather than weeks to live and that he should prepare for her funeral. That was on the Tuesday; she died on the Saturday, the day before her 43rd birthday. Her name was Geraldine McGrattan and she was my mum.
I know first-hand the impact that cancer has on the person and on their family. Cancer can kill, but waiting for a diagnosis or being on a waiting list is torturous and unacceptable. The Minister confirmed that it is unacceptable: she knows that. If we are to receive swift, safe and sustainable healthcare to ensure patient safety and patient treatment, I urge the Minister to ensure that the expected cancer services framework includes a mechanism to systematically reduce waiting times and stringently monitor lists to ensure they do not increase to the levels we have today, where one fifth of our population are on waiting lists. We are all affected by cancer.
Mr Sheehan: I welcome the opportunity to speak. It is important that any debate of this nature should be balanced and fair. It is right that political representatives should highlight deficiencies in the healthcare system, but it is also very important that we accentuate the positive aspects of healthcare and that we are judicious in our language. We should be judicious because there are patients out there who are fearful, and we should not do or say anything that would make people who are already vulnerable or apprehensive feel even more insecure. Likewise, we need to be careful that our words, even indirectly, do not demoralise healthcare professionals and workers.
However, it is clear that the Opposition do not concur with those sentiments. The motion that they have brought to the Floor of the Assembly today is, quite frankly, a dog's dinner. It contains inaccuracies and misinformation. It is loaded with hyperbole and is an exercise in scaremongering. Breast cancer is the hook that the Opposition have used to hang this motion on and, to do so, it focuses on one small geographical area at one short period of time. In short, it is just a snapshot.
Mr Sheehan: No, I will not.
That in itself is unfair, as statistics should be used to discern patterns over longer periods of time. Let me offer the Opposition a statistic which Edwin Poots mentioned earlier: clinical outcomes for breast cancer patients are better here than in any other jurisdiction in these islands.
I return to the motion. It says that:
"only 6·7 per cent of breast cancer patients in the Southern Health and Social Care Trust area were seen within 14 days".
These were not breast cancer patients. They were people who had gone to their doctor and been referred to a breast clinic. They may have had a cyst or some other issue. The vast majority of patients who are referred to breast clinics are not diagnosed with breast cancer.
Mrs Long: I thank the Member for giving way. As Kellie has already mentioned, we have reservations about the detail of the motion but not the general thrust. Whilst I accept the point he is making, does he agree that, for those women who are referred, whether it be for a cyst, benign growths or cancer, there is a huge amount of stress for the period of time that they wait? Therefore, it is relevant to raise the issue of waiting time, whether those women are breast cancer patients or are simply not aware of their current status.
Mr Sheehan: I thank the Member for her intervention, and I agree wholeheartedly with what she says. Waiting for a diagnosis is a difficult time. Why then did the Opposition, when it was forming its motion, not try to be accurate, instead of introducing this exaggeration and hyperbole? If that is the Opposition that we are going to face over the next few years, God help us all.
I was very disappointed with Jo-Anne Dobson earlier this morning. She said, "there is not enough emotion" here, and, "There is not enough care" among our representatives. Let me say this. I first visited the Bridgewater suite in 2002, when my wife was diagnosed with breast cancer, and I made many visits there, and to the cancer centre, between 2002 and 2006, when my wife died. So do not stand here and tell me that I do not care, and do not presume that nobody else in this House cares. We have listened to enough Members today to hear all of them say how they have been affected by cancer. All of us care.
If people really care, they should work together, be judicious in their language and be accurate with their emotions. The best way to improve the health system we have is for everybody to put their shoulder to the wheel and not make petty political points, because cancer does not discriminate along party political lines. Sin a bhfuil agam.
Mr Middleton: I will begin by recognising the magnificent and life-saving work being carried out by our clinicians and medical experts, who are, of course, working on the front line day and daily delivering a first-class health service. Like many others — Mr Sheehan outlined his personal circumstances — I know that cancer has affected many of our family members and friends. Of course, it does not discriminate; it affects all of us, whether old or young, male or female.
The way the motion has been tabled is unfortunate. Together with the inaccuracies, it has been done in quite a knee-jerk fashion not, of course, to improve the situation or provide solutions but to scaremonger and to score political points. That is really sad. The motion focuses specifically on one trust and one month. Unfortunately, unforeseen circumstances — I know my colleague will touch on this in a few minutes — caused that issue. Nobody is trying to justify the figures or the waiting times, but, at the same time, we have to recognise the pressures in the system as a whole. Conveniently, it was not mentioned in the motion that 100% of cancer patients have been seen on target in the Western Trust area. Of course, there are better situations in other trusts. That has been achieved by the commitment and dedication of staff and a focus on providing the best possible care.
Ms S Bradley: Does the Member accept that it is a postcode lottery, given that, as he referred to, the Western Trust is able to supply healthcare, while the Southern Trust cannot?
Mr Middleton: I thank the Member for the intervention, but I do not agree with that. At times, there can be particular pressures in a trust, and that is where you see issues arise, sometimes not in a fashion that you would have seen previously. That creates situations the likes of which we have seen in the Southern Trust, but those can be rectified. The Minister and the previous Minister have worked to alleviate the pressures and ensure that people are not waiting. One of the ways we have done that, particularly in the north-west, is through the opening of the radiotherapy centre at Altnagelvin, which our party was very supportive of. Thankfully, the Minister is working on that as well to reduce waiting lists. When motions like this come before the House, the signatories need to be careful about the language being used and make sure they truly think through exactly what they want to achieve by tabling it.
This morning, I attended an event and chaired a conference in the Stormont Hotel, hosted by the Policy Forum for Northern Ireland, on the reform of the health system. It was refreshing to hear from the over 150 delegates who attended it. The medical professionals talked the health system up rather than talking it down. Yes, there are challenges, and they recognise them, but they were there to work collectively to come to a solution. If the people out there — the health professionals — are working together to come to a solution, we in here should do the exact same rather than trying to score political points.
Do I believe there is a deterioration in cancer services? I do not. I believe we have one of the best systems in the world, but we can do better.
The motion calls on the Minister:
"to ensure patient safety is not further compromised."
Of course, that language again deliberately scaremongers and causes concern for people.
Mr Beggs: Does the Member accept that, with 392,000 people on waiting lists — one in five people in Northern Ireland — there are risks involved?
Mr Middleton: I accept that. Nobody is trying to justify the number of people on the waiting lists, but I question the figure of 392,000 that was stated. That is not specifically cancer-related; it is related to all conditions. The way in which the motion has been proposed is deliberately misleading. Opposition Members cannot, on one hand, say that heads should roll yet, on the other hand, say that we have great staff who should be complimented. If you want to do something for staff morale, start being thankful for the service that we have and recognise the challenges but work together to get reform. That is something that our party and the Executive and, no doubt, the Minister will do.
Ms Lockhart: I support much of what my colleague has already said. Cancer is a thief and a home wrecker. It steals people away all too quickly, as we have heard so eloquently today. It is no respecter of age; it is a parasite and a plague on our society. Unfortunately, it has become a word that we all hear all too often, and it is often associated with children and the death of loved ones. However, we also hear about the victories against cancer, and that should be the message of today. We are encouraged by those victories. I do not defend the indefensible, but I congratulate, commend and encourage all the staff, consultants, nurses and scientists as well as all the charities that are involved day and daily in saving lives from this terrible parasite. Just recently, Paint the Town Pink, a fantastic event in my constituency raised thousands of pounds in an effort to save lives.
Today, I want to talk to people and reassure them. The motion, unfortunately, is specific to one cancer, which does a disservice to people throughout our Province who suffer from many different forms of cancer. For instance, it was brought to my attention recently that there is no robotic surgery for urology treatment, and I am working with the Minister to resolve that. I am very content that she recognises that there is a problem with prostate cancer treatment and is working to address it. With over one hundred forms of cancer and one in three people suffering, there is a very real need for a cancer strategy that will address the overall associated problems, be it waiting times or dealing with this epidemic.
I was very disheartened and somewhat surprised by the form that the motion took. Even the title, with its talk of deterioration, will strike fear, dread, concern and anxiety into women across the country who will see these figures, which, we have been told, are incorrect. It has whipped up hysteria around this. The motion also mentions the Southern Trust, which is most unfortunate. Craigavon Area Hospital, which is in my constituency, operates in the Southern Trust. It is a fantastic hospital that runs the Mandeville unit. I encourage anyone to look at the services that the Mandeville unit provides, and they will see clearly the excellent work that is ongoing. Members should realise that the figures are very specific to a time in the Southern Trust diary when one of its members — a leading consultant — passed away. Unfortunately, you cannot plan for that. I encourage people to be reassured that the trust is back to its 100% performance on its 14-day, red-flag targets for breast cancer referrals.
We are all too aware of the fact that Northern Ireland has areas of specific speciality, and it is difficult when there is movement of staff or, as I alluded to, illness or death. In fact, we are not dissimilar to the rest of the UK and Europe in that sense. My aim today, as I said, is to provide reassurance to the women who will have concerns from today: you will be seen by the Southern Trust, and, if you are in need of surgery, you will get it.
Amazing work has been going on and continues in Northern Ireland. Since the Campbell report in 1995, cancer treatment services and diagnosis have been nothing short of transformational, and that is very evident in the survival rates.
In fact, back in March, it was reported that over 54% of all cancer patients survived five years after diagnosis between 2004 and 2008, an improvement in comparison with 1993 to 1999, and it is improving in 2010 to 2014. You have to look at the improvements in bowel cancer since the bowel screening programme began in 2012. There is no doubt that there are more cases of cancer appearing in men and women, but we have the City Hospital and places like the Mandeville unit. My colleague referred to the radiotherapy unit at Altnagelvin. We also have the cancer research lab that is doing amazing work.
The message today for the Minister is that there needs to be a wrap-around service for cancer. It is not that people are scathing of the service that they receive. Their concerns are the financial hardship, the travel costs and the counselling needed for children who lose their mums and dads early in life. That is the message that the Minister needs to hear.
Ms Lockhart: To those who are suffering from cancer, fight on. We are here to support you and to work with the Minister on this important issue.
Mr Beggs: I support the motion, which highlights the Northern Ireland health crisis. As I said earlier, 392,000 people are on waiting lists. This issue has not been referenced by the Back-Benchers from the Sinn Féin/DUP Government. They seem to have skated over this. The failure to address the pressures on our health service has led to this intolerable situation, with one in five of the population being on a waiting list.
This is a failure to address a basic need: healthcare. To the Health Minister, the Finance Minister and the entire Northern Ireland Executive, which is in its sixth year of being led by DUP/Sinn Féin, I say that this is unacceptable and it is time that it was addressed. What have you done about it?
Like others, I commend our health staff for the treatment that they give when patients eventually get to the top of their waiting list. However, that is the problem: too many are parked on waiting lists.
The waiting times summary report of August 2016 for the Northern Health and Social Care Trust, which covers my area, shows quite concerning figures, with 17,888 patients waiting more than nine weeks — ie 64% of patients — and 1,620 waiting for more than a year to be seen or treated. Areas of concern are ENT, gastroenterology, general surgery, gynaecology, neurology, pain management, rheumatology and thoracic medicine, with many patients waiting more than 45 weeks.
Early diagnosis and treatment will reduce the suffering of patients and produce better long-term outcomes. With lengthy waiting lists, we also get increased pressure on GP services. We get additional unplanned A&E admissions to hospitals, and there are pressures on staff because patients are not being treated in an orderly, efficient manner.
Ms Lockhart: I thank the Member for giving way. Will he just confirm that the figure of 392,000 referred to in the motion is not specific to cancer and that it actually is the entire waiting times? It is important to clarify that, given that we are discussing cancer.
Mr Beggs: If the Member waits a moment, I will come exactly to that point. If you notice, I have been talking all about the waiting list, and there is a reason for it.
In GB, they operate using referral time to treatment. It is not how long you have been parked on one of the multiple waiting lists that Northern Ireland patients have to move along; it is your treatment plan from when you see your GP until you get treated. We operate a different system, which hides many people within the waiting system. Because we are not using that referral time to treatment, the system does not look at how to better plan and improve the patient's journey. When will Northern Ireland come out of the dark ages and adopt that modern method to improve our system and bring about efficiencies?
There are 392,000 local patients on the waiting list, but the question is this: how many of them have a more serious ailment lurking in the background that may emerge when they are on the waiting list? No blame is intended on heavily pressed GPs or specialist consultants. Indeed, some illnesses are very difficult to diagnose, but the longer that someone is on a waiting list and not being regularly seen and reviewed by the specialist, the higher the risks. Indeed, some individuals end up moving to several different specialists along their journey of diagnosis.
I can think of one constituent who was parked on such multiple waiting lists and whose long journey of diagnosis has taken some six months. Only recently, it was identified that he now has a suspected cancer. Therefore, having waited six months and visited a whole range of specialists on different waiting lists, finally a suspicion of cancer has been highlighted and an operation is planned. I hope and pray that delays will not prove to be significant to his long-term health. That is a problem with the 392,000 people on the waiting list. Many of them have different ailments, some of which may be cancer, so we ought to deal with the problems in our entire health service, as referenced in the motion but not addressed by many. Once cancer spreads, it becomes very difficult to treat. Therefore, early treatment targets are there to try to prevent that from happening.
In the Northern Trust area, I see that —
Mr Beggs: — 75%, 64% and 63% of people with an urgent breast cancer referral were seen within 14 days in April, May and June. That is not acceptable. We need to improve our service. The service is far below that in England and Scotland.
Mr Beggs: We need to address our health service.
Mr Milne: I begin by recording my thanks to the research team here at the Assembly for the information pack provided in advance of today's debate. I also use this opportunity to acknowledge the work and dedication of healthcare staff, who, despite the challenges and pressures, continue to work day after day to deliver the best possible outcomes for people. They are supported in that work by organisations such as Macmillan, Marie Curie and Cancer Focus, to name a few. In my area, Charis Cancer Care does exceptional work supporting patients and their families through their cancer journey.
Just two weeks ago, we had the opportunity to discuss the Department's report, which highlighted the waiting times for first consultation and, in particular, the performance in the Southern Health and Social Care Trust. Many of the facts, concerns and figures have already been heard and responded to by the Minister, so I am conscious that much of the motion has already been covered.
(Mr Deputy Speaker [Mr McGlone] in the Chair)
Many factors can contribute to extended waiting times. Some will be understandable or unavoidable, while some will be unacceptable and need to be improved on. Whatever the reasons, there can be no doubt that the waiting adds to the anxiety and stress that comes with the news that you have been red-flagged.
There are very few families untouched by cancer. Everyone understands the impact on the lives of individuals and families when cancer is thought to be a possibility. There is, quite rightly, that sense of urgency to find out whether it is or is not, and, if it is, to know exactly how serious it is and what needs to be done.
We can all agree that performance figures reported for the Southern Trust are not good enough and fall short of the targets that we all want to see achieved. We must also be careful to avoid scaremongering and adding to the anxiety by suggesting that the service is, to quote the text of the motion, experiencing an "unprecedented crisis" or is somehow unsafe. Headline-grabbing phrases such as those do nothing for the morale of the staff at the coalface who regularly go above and beyond the call of duty.
They do not praise the success of awareness-raising campaigns that encourage people to seek advice and referral at the earliest possible opportunity or the significant improvement in outcomes over the last number of years.
The Minister, in her previous contribution, acknowledged that there are challenges in our health system. They are not new and have been the subject of much debate in the House for many years. They exist not just in cancer services but in waiting times across many aspects of the service. There are issues relating to budgets, workforce planning and many other areas. Long life expectancy, early detection and treatments are a credit to medical science and to all those involved in public healthcare, but there is no doubt that the additional demand — a demand that is predicted to increase — places pressure on the service.
I welcome the commitment given by our Health Minister, Michelle O'Neill, to not just look at the potential of a cancer strategy but bring forward proposals to transform how health and care is delivered here in the North. Like other Members who spoke before me, I urge everyone in the Chamber to set aside party politics and work together to create a better health service with better outcomes for everyone.
Mr Mullan: I, too, welcome this opportunity to discuss these very important matters that affect people right across my constituency of East Derry and, indeed, people in local communities in every other constituency in the North of this island.
I would like to focus my comments on cancer care provision in Northern Ireland. At the moment, it is failing so many patients. The rate of cancer diagnosis has continued to rise, and, in 2014, some 9,000 people were diagnosed with cancer in the North. Sadly, almost 4,000 people die each year due to this horrible disease.
Like many Members, I know people who are currently suffering from cancer, have been cured of cancer or have, sadly, died from cancer. However, it has to be said that Northern Ireland has come a long way with cancer treatment and research and that there has been improvement. In 1993, breast cancer screening was established throughout the North. In 1994, the cancer registry was established. In 1999, the first cancer incidence data was compiled. In 2004, the Cancer Network was established, and, in 2006, the cancer centre was opened. The new radiotherapy unit in Altnagelvin will, hopefully, open next month. The work of individuals such as Joe O'Sullivan and Paddy Johnston has been instrumental in driving forward this change, which has been hugely beneficial for local cancer sufferers.
Those are all evidence of a progression that I welcome and one that is evermore important considering the prevalence of cancer in Northern Ireland and the increasing number of patients diagnosed every single year. However, Northern Ireland's position as a world leader in cancer research and treatment is now in jeopardy following what seems to be a crisis at the heart of the health service that is negatively impacting upon cancer services.
Some 95% of patients with an urgent GP referral are supposed to be seen within 62 days. However, since records began six years ago, the target has never been met, and the latest figures show that, between April and June this year, only 70% were seen in this time.
Breast cancer treatment targets are also falling by the wayside. The percentage of women seen within 14 days of urgent referral for breast cancer has also fallen sharply since last year. Just 64%, which equates to 914 out of 1,433, of referred patients were seen on time, compared to 80% in June 2015. In the Southern Health and Social Care Trust area, 93% of patients waited more than the target of 14 days for a first consultation following an urgent referral for suspected breast cancer.
Those figures demonstrate the very stark reality we face and show that a dark shadow is hanging over cancer provision here. The failure to meet these treatment targets is a damning indictment of the very real pressures that the wider health system faces. Rather than the Health Minister hiding behind the Bengoa report, I call on her to publish it. We can all hide behind rhetoric but these crisis conditions are literally putting people's lives at risk, and that, in itself, is unacceptable.
Time after time, we have had reports such as 'Transforming your Care: A Review of Health and Social Care in Northern Ireland' or the Donaldson review, but I have yet to witness any positive change emanating from them. The Minister should not hide behind another review. It would be more appropriate for her to commission a cancer strategy to ensure that cancer services are properly invested in and developed.
There is also a huge gap in the provision of cancer treatment here; it concerns cancer drugs that are available in Great Britain but not in Northern Ireland. Forty drugs have the potential to extend the lives of many cancer sufferers here but, rather than establishing a specialised medicines fund like they have in Scotland, a previous Health Minister decided to review —
Mr Mullan: — the punitive individual funding request (IFR) process and prescription charges.
The Minister needs to take notice of the motion, take action, commission the cancer strategy —
Mr Mullan: — and offer cancer patients equality of treatment in the North.
Mr Aiken: I support the motion. Along with the others you have heard from, I add my concerns for the many people on waiting lists. Indeed, any delay in a cancer diagnosis has a significant impact on an individual, their family, their workmates and society as a whole. However, when our cancer services work, they can work well. In my case, I did that most unusual thing for a husband and listened to my wife, who told me that I had to go to my GP. The process for the investigation, diagnosis and surgery for my bowel cancer two years ago met all the NICE guidelines. While I understand that many have concerns about the level of care that they have received in hospitals, my care, which was delivered fully through the NHS, was first-rate. Indeed, I cannot praise the medical staff at my GP's surgery and Antrim Area Hospital, my consultant, Mr Burns, and my wife highly enough.
Based on feedback received from throughout my constituency, I am very conscious that many people feel that cancer care provision is not only limited in some areas but that there appears to be a postcode or even regional lottery in treatment and in the provision of drugs regimes. As British citizens, many people find it difficult to understand how medicines that are available in, say, Birmingham cannot be provided here. I am also concerned that levels of service between different trusts in Northern Ireland are demonstrably of concern. Indeed, some cancer sufferers living within 10 miles or so of two or three health trust areas will be even more frustrated.
As a party, we have called for a cancer strategy for Northern Ireland that is primarily based on prevention and on early diagnosis. The need for education and changes in people's lifestyles, with a healthier approach to alcohol, tobacco and other drugs, is well recognised. However, it is to an approach to early detection that I wish to turn.
I welcome Mr Poots's earlier statements on Queen's University. Its Centre for Cancer Research and Cell Biology is a globally leading research centre. As well as looking at specific treatments for various cancers, it is also looking at how diagnostics can be improved. The Ulster University's globally leading Biomedical Sciences Research Institute, which is particularly looking at gene nutrient treatments, is similarly able to do diagnostics. Furthermore — as an MLA for South Antrim I cannot resist it — in Randox we have a great company that is implementing testing procedures to identify people at risk and the early stages of the disease. It is significantly boosting our global exports while it is at it, especially to the US, where it has achieved over £1 billion in sales this year. Unbelievably, Randox cannot sell any of its services to the health services in Northern Ireland. Those testing approaches may result in real benefits but I and many in Northern Ireland cannot understand why, with globally leading research centres and one of the globally leading diagnostic companies based here, the Health Minister is reluctant to take the initiative and set up a properly resourced cross-Northern Ireland cancer education and early cancer screening process.
We cannot continue with the current failing approach; we need to evolve our cancer care rapidly. We encourage our Health Minister to adopt, at the earliest opportunity, our policies for cancer education and early cancer screening, which are set out in our cancer care document dated March 2016. As added benefits, they would also help boost the position of our great universities and companies and would be truly transformational for all our citizens by providing more effective treatment for patients already suffering from cancer and, more importantly, by enabling us to prevent cancers from presenting or reoccurring.
Mr McNulty: Standing here, my blood boils when Members in the Chamber accuse the Opposition of political point-scoring, scaremongering or being negative in tabling this motion. That is the stock answer. You have all been well coached. That does not wash when it comes to cancer services. It has already been said that there is no home or family across this region that has not been touched by cancer. I have to empathise with those Members who have lost loved ones and who have been touched by cancer. Whilst the survival rates across the range of cancers are constantly improving globally, if you have lost a loved one those survival rates are cold comfort at a time of great loss.
Ms Dillon: I find it deeply offensive that you would say that anything was rehearsed or coached. I point specifically to Pat Sheehan's remarks during the debate. You are talking about people who have lost family members as though he is not one of them. Show a little bit of respect for everybody involved in this situation, please.
Mr McNulty: Forgive me: I empathise with all Members who have lost a loved one, and my empathy rings true.
The motion refers to the crisis affecting cancer services in the North and, in particular, the fact that only 6·7% of breast cancer patients in the Southern Health and Social Care Trust area were seen within 14 days during June of this year. Mr Deputy Speaker, if you or your loved one has been referred to a cancer specialist, be it for breast cancer or any other cancer, even 14 days seems too long. The agony, the worry and the anxiety must be terrible as a patient. If your father, mother, wife, husband, son or daughter is going through that anguish, it must be heartbreaking. We as a legislature must step up and tackle the issue.
The Southern Trust covers the area I have the privilege of representing. I know that the Minister will tell us that, as we speak, those figures have improved; in fact, 100% of patients referred are seen within 14 days. The Minister will assure us that the dip in performance in June and July of this year was due to unforeseen circumstances. Whilst I appreciate that may be the case, for those waiting for those appointments in June and July, that delay only added to the worry and anxiety.
The services offered to breast cancer sufferers at the Mandeville unit or the Macmillan cancer care unit in Craigavon Area Hospital are second to none. The compassion and care on offer are shining lights. Time and time again, families tell me of the love, the care and the attention given by the staff there. Cancer care, however, is such a specialist field. Often, the care is administered by a small specialist team; any discontinuation of health personnel can have a big impact. We are all too aware of the staffing challenges facing the different areas of our health service, from GPs in rural practices to consultants in emergency departments to nursing staff in our hospitals. I experienced the pressure on an emergency team in Newry with a loved one in the last month. I saw the pressure under which they functioned, and it was extraordinary to see the care and attention on offer from people who were working at breaking point.
I fundamentally believe we need to take a much stronger and strategic approach to workforce planning. I understand that, in this case, there is a 1·5 whole-time equivalent breast surgeon's post vacant, as well as two vacancies for breast screening radiologists in the Southern Trust area. Can I ask the Minister for an update on the recruitment to those posts? We cannot allow workforce planning issues to continue to impact cancer services, particularly in the way we have witnessed to date. Cancer care is a top priority for the people we all represent. We must see improvements in the care we offer.
Mr Lunn: I thank the proposer for bringing forward the motion. We welcome that it was done on a cross-party basis. We are, of course, fully supportive of the motion and the manner in which it is being presented. It demonstrates that the Executive can and must be challenged in a constructive manner to deliver on behalf of the people. I suggest that, perhaps within the next year on another Opposition day, we bring a similar motion to check on actions and progress.
Of course, the issue is not just a mechanical one about targets not being met, but sometimes, that is the way it seems to be approached when discussed. The issue is that human beings — close relatives, friends and carers — are being left with huge uncertainty about their well-being. That means that not only does successful treatment becomes less likely because time is passing on a waiting list but there is additional strain that only makes their health worse. There is a tendency in the Chamber and elsewhere to talk grimly of figures but not of human lives, long-term plans delayed, big life events put off or the stress and strain of uncertainty. There is also a tendency to not talk even of people who found they were clear of cancer but whose mental health had deteriorated very badly while they were waiting to find out. I would certainly exempt Pat Sheehan and Kellie Armstrong from any criticism of just talking about figures: I thought they both spoke extremely bravely today.
I am cautious about repeating the word "crisis" too often, because it serves to create the impression there is nothing right about our health service. Many thousands of people every year are superbly treated by the service and the people who work in it. Many of the outcomes are nothing short of miraculous, but that is not to say that that word is out of place here. Clearly, when a fifth of the entire population is on a waiting list, something is not working the way it should.
I asked the Health Minister — I think it was in January 2015 — about the extent of the waiting list. The figure at that time was just over 180,000. It is now double that and more at 392,000. To put that another way, there is a tendency to see solving waiting lists by allocating more resources to the people on them when, in fact, the fundamental problem is that too many people are put on waiting lists in the first place. The resources are needed so that primary care services limit the number of people who are referred at all by intervening early to identify and solve the problem. When we say:
"patients receive swift, safe and sustainable healthcare",
it needs to mean it happens at the very outset. We cannot just keep dumping thousands of people on to waiting lists and then rely on secondary care, often in the independent sector, to intervene long after the issue should have been dealt with.
Again, we cannot miss the point here that the expert panel chaired by Professor Bengoa presented its report to the Minister some months ago. Since that time, the concern is that she has been busy trying to fudge the outcome by focusing solely on the needs of some of those working in the service rather than those who use it. That is no way to start the process of real, meaningful reform on behalf of the public that, frankly, should have been started after Transforming Your Care and the Donaldson report. We will wait and see what Professor Bengoa has to say, if that is ever revealed to us.
When nearly 400,000 people are on a waiting list, that means you have a systems failure. The system is broken. Just throwing resources at it will not make it less broken. In fact, by failing to recognise this is a systems failure, we are insulting the many people who do such a miraculous job on behalf of patients every day.
The fact remains, however, that reform means change. That has to be managed carefully and sensitively so that, at the end of the decade, the system is fixed by broadening primary care, ensuring that expertise is shared at single locations for entire local areas and making sure that we never again have a fifth of the population on a waiting list. I doubt that that could happen anywhere else in the world.
We have said from the outset that we are not here to oppose for the sake of doing so. The Minister will receive our support where she reforms in line with expert advice but absolutely not where she fails to do so. We will judge the Bengoa report on its merits, not on the Minister's view of it. We warmly commend the motion to the House.
Mr Deputy Speaker (Mr McGlone): Just before I call the next Member, I remind Members to speak directly towards the microphones. Broadcasting has advised us that it is having difficulty picking up some of the transmissions.
Mrs Barton: Over 660 cases of cancer are diagnosed in Fermanagh and South Tyrone each year. One third of cancers is caused by smoking, and it is those cancers that have the poorest survival rates. Therefore, Minister, it is essential that there is early diagnosis to start treatment as soon as possible before health further deteriorates.
The most recent statistics from the Northern Ireland Cancer Registry show that there has been an average of 205 deaths each year in Fermanagh and South Tyrone from cancer over the last five years, with the most common cancers being bowel, prostate and breast. While the Western Trust is one of the highest-performing trusts, with an average of 91% of patients first treated following an urgent GP referral for suspected cancer, it is still below the ministerial target of 95%. However, I commend the Western Trust for achieving 100% in relation to the number of patients first being treated within the 31-day target and for the 100% target being reached for the number of patients first seen by a breast care specialist following an urgent referral for suspected cancer within 14 days. While the Western Trust has reached its targets, there are still approximately 200 deaths too many from cancer in Fermanagh and South Tyrone.
Dr Gavin, a founding director of the Northern Ireland Cancer Registry, projected that cancer rates in men would remain steady in the years ahead but, among women, we would see a 7% increase by 2020 and a 13% increase by 2035 due to medical advances and people living longer. Given that information, it is essential that the Minister look immediately at a specific cancer strategy for Northern Ireland, including further screening for older people and younger people, the recruitment of extra consultants so that targets set can be further improved and the provision of extra specialist cancer nurses.
As Fermanagh and South Tyrone is registered as having the second highest number of cancer cases each year, serious thought must be given to increasing the services offered at the South West Acute Hospital, including a cancer treatment unit there. After all, Fermanagh and South Tyrone has an ageing population, and its people have the furthest to travel for day treatments. Many patients also have no direct transport to the north-west and frequently have to leave home at 6.30 am or 7.00 am to travel to Belfast, eventually returning home 12 hours later. That journey for seriously ill patients is debilitating; for them, it is unacceptable in the modern world. Given that cancer incidence in Fermanagh and South Tyrone will only increase, I appeal to the Minister to consider a third cancer treatment hospital in the south-west.
Mr Allister: The rising scourge of cancer in our generation is, frankly, quite frightening. I am sure it is the experience of us all that we constantly hear of individuals we know, family members or acquaintances who have got the dreaded news of a cancer diagnosis and then of their passing. Indeed, as the debate started, I got a message that a friend and member of my party in Ballymoney had this morning lost his battle with cancer. That is a persistent theme that we encounter many, many times.
The Macmillan organisation provided us all, before the Assembly election, with the Macmillan manifesto. It identified for us that, every day, 30 people get the diagnosis they dread of cancer — that is to say that twice a week we could fill the Chamber to overflowing with those diagnosed with cancer — and 4,000 people a year die from this hateful disease. Therefore, doing all that can be done is an unavoidable imperative for us all.
We should also be mindful of the dedication way beyond the call of duty of so many who tend to cancer patients, of our excellent clinical nursing staff and people like the Macmillan nurses, who bring palliative care when it is needed most. Indeed, when you watch and see the work of people like that, each one of us in the House should realise that our job here is a doddle in comparison.
Mr Robinson: Would the Member include the Foyle Hospice in his congratulations?
Mr Allister: I include all hospices that give the end-of-life care that is so needed; it is done so tenderly and with such sensitivity. We all should recognise that.
Given the all-embracing nature of the issue that we are discussing — it is no respecter, like death itself, of anyone — I have been somewhat disappointed by the ill-judged, knee-jerk reaction of some Members in the House. I understand that the Executive have a very low threshold of toleration for criticism, but some of the observations made today have been so ill judged in their churlishness and in their resentment of anyone daring to point out that things could be done better that, really, they do not speak well of those who have taken that stance. It is a fact — an unpalatable fact — that there are huge waiting lists in the Province.
Mr Stalford: I am very grateful to the Member for giving way. I think that he is right about the tone of the debate: given what we are talking about, it is important that it is struck correctly. Mr McNulty had the good grace to apologise to Mr Sheehan for the comment that he made about people being coached. Does the Member agree that, when comments like that are made, leading members of the Opposition should not be sitting tee-heeing and laughing?
Mr Allister: I have no knowledge of what the Member refers to, but I will say this: Members from the Member's party should not be too quick to get on their high horse about this issue, because, last year, when we were debating cancer in the House, they absented themselves, pretending that they were objecting and marking an IRA murder — a pretence that, of course, soon fell apart when the lure of office once more overcame them.
Therefore, before too many get on that particular high horse, they should remember that, when we last debated this subject, they did not even think it worthy of contribution. The fact that this motion refers to the huge waiting list is not something to be resented, as Ms Lockhart seemed to resent it, for it is a fact that there are approaching 400,000 people in this Province on waiting lists of all varieties.
Mr Allister: That is an indictment of this Government, and of the Executive.
Mrs O'Neill (The Minister of Health): I am very grateful once again to have the opportunity to set the record straight about a number of things that have been said throughout today's debate on the provision of cancer services. I thank all those people who shared their personal cancer journey and stories. It is not easy to get up in the House and do that.
I raised a point of order at the start of the debate, a LeasCheann Comhairle, because I believe that the motion is wrong. Not only is the spirit in which it is presented wrong but the facts noted in the motion itself are wrong. The Opposition, through the motion, seems intent on talking down our health service and the all the men and women who work really, really hard to provide that service. Let me start by saying up front that I am proud of the service that all those men and women provide day and daily to the people with cancer here and all the other people who need health and social care. I am proud of the dedication and hard work of the highly trained doctors, nurses and other medical professionals who provide such a high level of care to all our people. I am proud of the quality of the full range of health and social care services that we provide, not just for cancer but across the board.
Mrs O'Neill: The Opposition have had two hours now to debate things, so let me get into what I want to say in response to all the comments made throughout the day. I am sure that I will answer everything that you have set out in your contribution.
Are things perfect? No, they are not. I have never stood once in the House and said that things are perfect. There is a recognition right across the piece that we need to tackle waiting lists and deliver better outcomes for people. That is the job of government. I consistently say that there are areas in which we can improve, but unlike the Members who tabled the motion, who ducked the responsibility of choosing to take tough decisions and make things better, I am not going to be found wanting in trying to fix the problems that we have in our health and social care system. I am determined to work with colleagues who want to be constructive. I am determined to work with stakeholders to make sure that we do more to deliver the improvement that we need.
It seems unbelievable that the Opposition would put forward a motion that is factually incorrect., but they have, and it falls to me today to correct a number of issues that were highlighted in the debate. The motion:
"notes with anger that, in June 2016, only 6·7% of breast cancer patients in the Southern Health and Social Care Trust area were seen within 14 days".
That is wrong. The 6·7% figure is for urgent referrals for suspected breast cancer cases. There is a very important distinction, so let me be very clear: that statement is wrong. It would be highly irresponsible, if not outright scaremongering, to send out a message that all people given urgent referrals have cancer. Thankfully, that is not the case. We need to be very, very clear, and I am not for one minute trying to diminish poor performance. I have said before and I will say it again that any underperformance needs to be tackled. In this instance, it is important that we also correct the false impression that is being irresponsibly created by the Members who tabled the motion. Allowing politically motivated misinformation to spread is bad for the health service and demoralising for patients and staff.
I understand the worry and concern that long waiting times can cause for patients and families. Performance has not been strong enough in many, many areas, but I am committed to dealing with the problem, because that is what you do in government.
I will set out my vision for health and social care next week, and it is going to include specific actions to deliver improvements in this area. I hope that, at that stage, the Members of the House will be as up for discussing all those issues with me and that they will be up for tackling the vital tasks in the time ahead.
It is absolutely right to hold Health and Social Care to account for the level of services it provides. That is why my Department sets targets for cancer services that are so challenging, because they can drive improved performance. But the kind of inaccurate, overblown criticism contained in the text of this motion does nothing to deliver improvements for patients or for staff. Instead, it creates fear and worry in the minds of those people at home who fear that the services they need will not be there for them when they need them or that their loved ones will not receive the level of care that they need. Blanket condemnations of public services and public servants is nothing more than Project Fear politics, and I believe they have no place in any discussion of the health and social care services that our people deserve.
Improvements have been made. Cancer services have been reorganised in recent years so that professionals with an expertise in treating the most common cancers can be brought together. Patients who are treated by professionals who specialise in cancer and work together as a team have a better outcome than those not managed by such teams.
There are five cancer units for the management of patients with more-common cancers and the provision of local chemotherapy services. Specialist radiotherapy services in the North are currently provided by the cancer centre at Belfast City Hospital, which opened in March 2006. The cancer centre will, next month, be supplemented by the £66 million investment in the new radiotherapy service at Altnagelvin. This is an example of my Department's commitment to delivering the best possible services to patients. The new radiotherapy service is a significant boost for our cancer service infrastructure. It will provide radiotherapy services to 90% of clinically suitable patients in the north-west region.
I am particularly pleased that the new development at Altnagelvin brings a welcome cross-border dimension to cancer services, with some €19 million in funding coming from the South. This is a small island, and it is so vital that we work together as much as we can to pool resources, share experience and deliver the best possible outcomes for our people.
Meeting the challenges that have been posed by cancer will continue to be a key priority. I believe we have made great strides in tackling cancer and have seen significant progress in the past. I wish to see that progress continue, and I can assure Members that I will continue to give due consideration to the need for a comprehensive strategy.
The recent underperformance in the breast cancer service in the Southern Trust is due to staffing issues. The trust has had issues in recruiting key surgical staff, and I am also sorry to say that the untimely passing of a senior doctor was a further blow. In that context, it is unsurprising that there was a significant drop in performance. It is so disappointing that politicians would seek to gain political capital from such circumstances. The Opposition should be ashamed of themselves. I am not interested in the Opposition's empty rhetoric of anger. It is empty rhetoric; it means nothing. I am not sure who that serves. Instead my focus —
Mrs O'Neill: Let me just get through my points, and if I can, I will give you some time towards the end.
Instead, my focus is on delivering everything I can to drive improvement and ensure that the high standards we set for our services are met. Twelve out of the 209 patients in the Southern Trust who waited longer than 14 days for a breast cancer referral in June were subsequently diagnosed with breast cancer. Thankfully, 94.3% did not have a cancer diagnosis.
All of the 12 patients with a confirmed diagnosis have commenced treatment. Ten received their first definitive cancer treatment within the target of 62 days, which means that the initial delay in diagnosis had no negative impact on their receiving treatment within a reasonable time. One received their first treatment at day 63, just outside the 62-day target. The final patient was a more complex case, and treatment did not commence until day 81.
This is not to try to downplay the seriousness of the situation, especially for those two patients who did not receive treatment within the 62-day target. While I am far from satisfied with the level of service, I want to acknowledge the sterling service that the trust’s clinical team provided for their patients and to show the public that things are not as bad as they may first appear. I want to reassure people at home who may have sick loved ones or may be unwell themselves that the level of care they will receive from the doctors and nurses here is second to none.
Of course, there are issues in the system. I am committed to working with all parties in this Chamber who are interested in that collaborative approach to address all these issues. I hope my approach will be reciprocated on all sides.
Whilst I can always take on board and fully understand any concerns that are absolutely genuine, the future of the health service is too important for one part of the system to be debated as a knee-jerk reaction or in the heat of the moment. Instead, I acknowledge that performance is not where we want it to be, and I want to work hard with partners across the system to make sure that everything that can be done is done to improve it.
The decline in performance was first reported to my Department in June this year. As soon as I became aware of the issue, I asked the board to work with trusts as a matter of priority to find ways of improving the situation for patients. The board and the trusts have now put in place innovative solutions to work together to provide additional clinics to address the poor performance in breast cancer while maintaining safety for patients. In addition, the trust has extended its working hours, and that has facilitated the operation of a fourth breast clinic. It is early days, but there are signs that their efforts are having a positive effect. The latest provisional information indicates that performance in the Southern Trust has improved to 100%. I will continue to keep the situation under review, but I want to put on record my sincere thanks to all the staff and management in the Southern Trust and beyond who have worked so hard to recover the situation.
The issues in the Southern Trust highlight the challenges that exist across the system in maintaining acceptable levels of performance. That is why a workshop will take place on 26 October, bringing together breast cancer specialists from across the North to identify options for delivering a sustainable, high-quality breast cancer service for the future. I look forward to receiving the proposals put forward by the workshop and will ensure that they are given the priority that they deserve.
I pay tribute to the staff — I thank all Members who joined me in that — the management in the board and the trusts and, most of all, the doctors, nurses and technicians on the ground, who have come together to take action to improve the situation for their patients. It is easy for others to sit in the Assembly and talk about their anger; it is another thing to be on the front line delivering the services and putting structures in place to improve patient outcomes. These actions reassure me that our system continues to function, despite the picture painted by the Opposition. Of course, it is right to keep monitoring performance and to bring any problems to attention, but we do our health service and healthcare staff a massive disservice when we ignore the actions that they take daily to deliver their services.
The picture painted by the Opposition of our cancer services bears no relation to reality. They see a crisis that is "continuing to deteriorate", whereas, in reality, our cancer service is better than it has ever been. We treat more people for cancer than ever before. The number of patients treated for cancer has risen by 32% in the past five years. The latest comparative study of international breast cancer survival rates — I thank the Members who pointed this out earlier — show that the North has the best survival rate of anywhere in Britain and Ireland. Despite the increase in waiting times, we treat more people within the timescales than ever before. The five-year survival rate for women with breast cancer has improved over time, with survival increasing from 75% in the 1993-99 diagnosis period to over 80% in the 2005-09 diagnosis period. When adjusted for age and population change, the female breast cancer mortality rate has decreased by 1·3% a year.
The Opposition talk about a "wider unprecedented crisis" in the health service and bandy about a figure of 392,000 people on waiting lists. At best, that figure is the product of a woeful misunderstanding of the statistics published by my Department; at worst, it is a mischievous attempt, once again, to scaremonger. The Opposition appear simply to have added up the waiting list figures for outpatients, inpatients and diagnostics, despite the fact that the published statistics warn against doing that. It is clearly stated on the publication. For example, 19,919 endoscopy patients are included in both the inpatient and the diagnostic waiting times. That is just one of many examples.
Of course, as I said, I recognise that our service is under strain and that the arrangements put in place to help the Southern Trust are short-term solutions. The problems that affect cancer services are the same as those that affect the wider health and social care service: the challenge of rising demands on services linked to an ageing population and the finite resources available to meet that demand. I have been making the same case for cancer and for all other health services since I took up office five months ago.
There was a 17% increase in the overall number of red flag referrals for cancer between 2014-15 and 2015-16. That includes a 25% increase in breast cancer referrals and a 21% increase in lower gastro-intestinal (GI) cancer referrals. Why did that happen? It is testament to the good work being done across our health and social care system to successfully raise awareness. The campaigns taken forward by the Public Health Agency can make a significant difference to the level of referrals in any one year. One recent campaign contributed to an increase in referrals from 13,225 to 16,312, and I think that that shows that there is a real, meaningful difference being made in relation to awareness. October is Breast Cancer Awareness Month, and I encourage all women who are invited for breast screening to consider attending.
A growing, ageing population means that the number of people who will require cancer treatment in the future will continue to rise, with consequent pressures on health services. The ever-increasing number of new technologies and treatments for cancer, whilst good news in terms of early diagnosis and treatment, also contributes to those pressures.
The focus of the motion is on cancer services. The waiting lists are not good enough. Our people have a right to have the services there for them when they need them, and I will do everything that I can to make sure that that is the case. However, as Minister for the health service, I cannot pick one service over another, and nor can I prioritise one group of patients over another. The problems causing long waiting lists for cancer patients also affect every other part of the health and social care system. We have more people living longer lives, which is something that we should celebrate and be proud of, but it inevitably puts more and more strain on our health and social care services. We have no choice but to think again about how we deliver those services and to make sure that we make the funding that is available to us work hard to deliver the best possible outcomes for our people. That means radical transformation of all of our services, using the best clinical expertise to tailor services that are patient-centred. It also means giving renewed focus to areas like mental health that have not always been given the attention they warrant.
As I have said previously in the House and during the debate today, I will announce my vision for the future of health and social care services next week. It will set out the kind of health service I want to see for our people. Success in this will depend on everyone. It will depend on us all here as politicians working together to put the needs of our people first and not seeking to protect special interests. Put simply, it will take political leadership. It depends on our excellent doctors, nurses, clinicians, technicians and other medical professionals. It will depend on the third-sector organisations that do so much to help in their own areas of interest. It will depend on our people too to get involved in shaping the services they want to see for the future. Delivering improved cancer services as part of a transformed health and social care system is a significant challenge, but it is one that we do not shy away from. It is one that we will face up to.
In conclusion, a Cheann Comhairle, thank you for the opportunity to correct some of the mistruths and scaremongering that have been put out in relation to the motion. We should all concern ourselves with being constructive, delivering better outcomes and not trying to alienate and, I suppose, put pressure on the healthcare professionals who work day and daily to deliver better services. The Opposition's time would be much better used being constructive and offering alternatives, but I did not hear one alternative here today. All I heard was them sitting on the sidelines from the safety of opposition and not being prepared to take the hard decisions that need to be taken. The Executive are committed to taking the decisions and delivering better outcomes, and I think that that is a better outcome for all of the people who elected us to come in here and make a difference.
Mr Durkan: I rise to wind up on the motion. I thank all Members and, indeed, the Minister for their contribution to what should have been a largely constructive debate on an issue that should unite us all. I thank and pay particular tribute to those who shared personal and painful experiences with the House.
This is Opposition day, and our role as the official Opposition and, I am sure, that of members of the unofficial opposition is not to oppose everything that government does. We recognise and acknowledge the good work that has been done and the good work that is being done, and we certainly recognise the unbelievable and heroic work of people in our health service: doctors, nurses, nursing assistants, porters, the whole shebang. We could not ask for more from them. Our role is to challenge government to do better, to deliver more, to deliver better and more efficient services and, on this matter, to provide better care for people living here. There is no doubt that we can, we should and we must do better.
There has been much derision — misplaced, in my opinion — from the Government Benches about motions brought by the Opposition thus far. This is not about politics; this is about people.
We do not just want to talk about issues that matter to people; we want to see changes that have a positive effect for and on people. It is difficult to think of a more positive effect than ensuring that people get timely access to quality healthcare when they need it and reducing the number of people who need that healthcare in the first place.
The motion makes specific reference to cancer services. Yes, we heard from the Minister in the Chamber today and recently in response to a question for urgent oral answer from me on cancer services. We have had questions for urgent oral answer, but patients — people — want to see urgent action. I call on the Minister to implement the recommendations of Cancer Research UK's report on cancer services here in Northern Ireland. The Executive should conduct a review of diagnostic capacity, including direct access for GPs, and outline steps to ensure that capacity can meet rising demand.
The health service needs to develop national data sets for chemotherapy and radiotherapy. That would support ongoing evaluation of how services are performing or, in some cases, sadly, not performing. The Department should review workforce capacity and treatment services to understand where there are shortfalls in staff and set out how they will be addressed. The Department, with the trusts, should undertake work to clarify why operating standards for cancer are not being met.
Crucially — a few Members referred to this; indeed, the Minister herself referred to it — we need a new, comprehensive cancer strategy that sets ambitious goals and allocates sufficient resource to ensure that cancer services can improve outcomes, meet rising demand and reduce the undeniable variation in care that exists across the North. I welcome that the Minister has now committed to such a strategy. Obviously, she has given it the due consideration she said she would.
I will touch on some of the contributions Members made. The motion was proposed by Jo-Anne Dobson. She referred to an announcement by a previous Health Minister of £40 million that was allocated specifically to deal with waiting lists, but it was later revealed that £18·5 million of it was spent elsewhere. She spoke of the sense of fear and dread and of the impact that a cancer diagnosis has on someone and appealed for a calm and measured approach to today's debate. She highlighted the very real and serious impact of diagnosis being delayed and how that can result, ultimately, in fatal outcomes. She described the performance of some trusts as atrocious. Indeed, on occasion, they do give cause for concern. That is what led to the motion. But we all have to recognise, which we do, when trusts are doing well, and I pay tribute to the Western Trust specifically in this regard. She spoke of her own experience at the hands of cancer, and everyone in here will have their own harrowing tales of loved ones lost.
The SDLP family lost someone very dear to us; a member of staff in this Building, Stephen McKiernan. He fought a very long and hard battle with cancer. Sadly, he ultimately lost that battle. So many Members from so many parties have attended in the two years since his death coffee mornings we have run in conjunction with Macmillan in his memory. That is cancer bringing us together and making us unite. I know how touched and appreciative his wife, Julie, is that there is support for that event from right across the political spectrum.
Ms Dobson says we need to be equipped and ready to respond to the increase in demand brought about by public awareness campaigns. Indeed we do. There needs to be proper workforce planning. We need the right people in the right places, and we need enough people in every place. She spoke of the importance in that regard of longer-term budgets. That is important in the long term, as people living with cancer cannot afford to wait. She outlined, as did many contributors, the fact that there are humans behind the statistics and that people deserve better.
In her contribution, Catherine Seeley began by commending the Marie Curie nurses, and I certainly echo that commendation, having seen at first hand the tremendous work that they do. She urged women to book a screening as part of Breast Cancer Awareness Month, a call that I also echo. She spoke of the tireless efforts made by staff and the Department. We also recognise that, but, I am sorry, the figures do not lie. "This problem is not new", the Member said; therefore the problem has been not solved. We need to see it solved and we need to work together to get it solved. She actually described the motion as:
"an insult to ... hard-working ... healthcare staff"
That is completely off the mark and, in my opinion, out of order. Nobody says more about the problems in our healthcare system than our hard-working healthcare staff, and nobody wants to see them fixed more than they do. I do not know if the Member has seen any of the comments of her party colleagues in the South on waiting lists there. Are they attacking workers in hospitals and doctors in the South?
We had a very positive contribution, I thought, from Edwin Poots, a former Health Minister, who wished the current Minister well, as do I. He spoke of his role in giving the go-ahead for the radiotherapy unit in the north-west. I again thank him for that. He spoke of the work of the Pink Ladies Cancer Support Group in my constituency. They, and many other groups like them, do invaluable work; it is often unheralded and I take this opportunity to pay tribute to them too. He outlined the rationale behind his approval of the centre and said that it was not just for the people of the north-west; it was part of an overall strategy to ensure easier access to cancer services for people across the North. He spoke of the good performance here on breast cancer and the need to constantly strive to improve — that is what we are doing.
(Mr Deputy Speaker [Mr Kennedy] in the Chair)
My party colleague Sinead Bradley made a very emotive contribution. She is conscious of people waiting on lists, and the stories behind those lists, where people are living in a vacuum, awaiting a diagnosis, and then there is the tendency to cyber-self-diagnosis. She reiterated the fact that we are not, in any way, attempting to fault or slight workers. She urged the Minister, and her Government colleagues, not to go into defensive mode; but that plea has obviously fallen on deaf ears. I really cannot understand this circling of the wagons that has taken place.
Ms Dillon: Go raibh maith agat. I do not think that there was any defence of the waiting lists. The Minister was very clear that the waiting lists are unacceptable. The defence was around the wording of the motion and the fact that it is incorrect. There are inaccuracies in it. If we are talking about temperate debate, it would be more prudent of the Opposition to bring forward a motion that was factually correct and which everybody in the House could possibly have supported.
Mr Durkan: I thank the Member for that intervention. It is clear that, in some cases, even attack has been seen as the best form of defence, because of the number of attacks that were launched, not just on the content of the motion but on the spirit in which it was brought. Any study of today's debate in Hansard will clearly show that it was the tone and content from the Government Benches that was less than conciliatory.
Kellie Armstrong spoke of the human impact from first-hand experience. I welcome her contribution and commend her courage.
Pat Sheehan said that every debate should be balanced and fair. We should be "judicious in our language" and refrain from trying to score political points. He then proceeded to a critique of the motion in language that was a wee bit less than judicious and certainly not short on political point-scoring. I sympathise, albeit belatedly, with Pat on the loss of his wife. I am sure that that is something that hurts greatly and always will.
The best way to improve the system is to work together, and that is precisely why the motion should be supported by everyone here.
Gary Middleton said that the Opposition cannot have it both ways: we cannot praise workers and criticise services.
I did not hear anybody saying that heads should roll. When it comes to having it both ways, perhaps the Member should cast his mind back to when a Minister from his party was trying to close care homes, and they were protesting outside them.
Carla Lockhart said that the motion was too specific to one form of cancer. I have never heard any motion opposed in here on the grounds of being too specific. Other parts of her contribution were excellent, and I concur entirely, particularly on the cancer strategy.
I will move on a wee bit. Many Members made many valid points; unfortunately, I do not have time to cover them all. The Minister said she was grateful for the opportunity to set the record straight. She is proud of those working in healthcare: I think what we have established today is that we all are. She said that the Opposition ducked responsibility by not taking the Ministry. Again, I will ask this: did her party duck responsibility in the South? She has promised to set out her vision for health and social care next week, and we look forward to that. We regret, however, that the public have not had time to read the Bengoa report in advance of her vision being made public. She outlined some of the undisputed good work being done in tackling cancer here. That is great, and we all want to see more of it. The Minister's attack on the motion, its proposer and its supporters was, in my opinion, ill judged. I am not going to get dragged into a slanging match with her. We will work with her and with others in transforming the health service, if she will let us, because, every day, we see and hear more compelling evidence that it needs to be transformed.
In conclusion, I would just like to ask this: which part of the motion are Members opposed to and voting against today? Members raised and, yes, the Minister addressed the Southern Trust figures, and she described them as unacceptable. The motion notes those "with anger"; maybe it should have been more in sorrow than in anger. We have said not that cancer services are deteriorating but that the crisis affecting them is. Is it not? Have we not to respond to that crisis?
We ask that the Assembly:
"accepts the importance of timely diagnosis and treatment of cancer, as any delay can reduce the likelihood of a successful outcome".
I have not heard anything today to suggest that the Assembly does not accept that fact. The motion says that this is:
"symptomatic of the wider unprecedented crisis engulfing the ... health service".
Yes, it is a crisis and, yes, it is unprecedented. Has there been a time before when there have been 400,000 people on waiting lists, regardless, Minister, of how that is computed? The Minister said that the problems facing cancer services, increased demand and workforce planning, are reflective of pressures right across the health and social care system. We ask the Minister to intervene. Will she not? Why are parties voting against the motion today? Now, that really is opposition for opposition's sake.
Some Members: Hear, hear.
Question put.
The Assembly divided:
Ayes 32; Noes 62
AYES
Mr Agnew, Mr Aiken, Mr Allen, Mr Allister, Ms Armstrong, Mrs Barton, Mr Beattie, Mr Beggs, Ms S Bradley, Mr Carroll, Mr Chambers, Mrs Dobson, Mr Durkan, Mr Eastwood, Dr Farry, Mr Ford, Ms Hanna, Mrs Long, Mr Lunn, Mr Lyttle, Mr E McCann, Mr McCrossan, Mr McGrath, Mr McKee, Mr McNulty, Mr McPhillips, Ms Mallon, Mr Mullan, Mr Nesbitt, Mrs Overend, Mrs Palmer, Mr Smith
Tellers for the Ayes: Mr Aiken, Mr Mullan
NOES
Mr Anderson, Ms Archibald, Mr Bell, Mr Boylan, Ms Boyle, Mr M Bradley, Ms P Bradley, Mr K Buchanan, Mr T Buchanan, Ms Bunting, Mrs Cameron, Mr Clarke, Ms Dillon, Mr Douglas, Mr Dunne, Mr Easton, Ms Fearon, Mrs Foster, Mr Frew, Ms Gildernew, Mr Girvan, Mr Givan, Mr Hazzard, Mr Hilditch, Mr Humphrey, Mr Irwin, Mr Kearney, Mr Kelly, Mrs Little Pengelly, Ms Lockhart, Mr Logan, Mr Lynch, Mr Lyons, Mr McAleer, Mr F McCann, Ms J McCann, Mr McCartney, Mr McCausland, Mr McElduff, Mr McGuigan, Mr McGuinness, Miss McIlveen, Mr McMullan, Mr Maskey, Mr Middleton, Mr Milne, Lord Morrow, Mr Murphy, Ms Ní Chuilín, Mr Ó Muilleoir, Mr O'Dowd, Mrs O'Neill, Mr Poots, Mr Robinson, Mr Ross, Ms Seeley, Mr Sheehan, Mr Stalford, Mr Storey, Ms Sugden, Mr Weir, Mr Wells
Tellers for the Noes: Mr Milne, Ms Seeley
Question accordingly negatived.
Order. I ask Members, if they are leaving the Chamber, to do so quietly. Thank you.
Motion made:
That the Assembly do now adjourn. — [Mr Deputy Speaker (Mr Kennedy).]
Mr Deputy Speaker (Mr Kennedy): In conjunction with the Business Committee, I have given leave to Mrs Naomi Long to raise the matter of development at the Titanic Quarter. The Member will have 15 minutes.
Mrs Long: I am very pleased to be able to raise the issue of Titanic Quarter as a driver for the Northern Ireland economy in the Chamber today. I want to thank Minister Chris Hazzard for attending today to respond to the issues. I know that he is probably slightly jet-lagged, having been in China, and I appreciate him giving time at the end of today to respond to the debate.
The development of Titanic Quarter in East Belfast is of significance not just to my constituency but to the city of Belfast as a whole, and beyond to the surrounding economy in Northern Ireland. As someone who grew up in the shadow of Samson and Goliath, whose family located to East Belfast from north Antrim to avail itself of the employment opportunities there, whose father and grandfather both worked in Harland and Wolff and whose first work experience as a schoolgirl was in the apprentices' workshop of that same company, I, like many other people in East Belfast, feel a very strong very connection and attachment to the site.
However, growing up in the 70s and the 80s, the glory days were over and, sadly, I experienced a place in decline. Indeed, my father was made redundant during that period as Harland and Wolff restructured and changed its business from being one of the world's most famous shipyards to what is today a smaller but more sustainable heavy engineering business. That was a difficult and challenging time for the business, for the supply-chain companies and above all for the community, which relied very heavily on the yard for employment and opportunity. However, with that challenge came fresh opportunity.
The site that is now known as Titanic Quarter became the largest waterfront site for potential redevelopment in western Europe, with the potential to again be a place of innovation, creativity and world-class endeavour, and a place that could generate education, training, employment, wealth and opportunity for the people of Belfast and far beyond. Over the first 10 years of development, we have started to see that potential unlocked, despite a property crash that occurred during that period, which impacted on investor confidence and on the demand for residential accommodation that drove some of the development of the site.
The development of Titanic Quarter relies heavily on positive working relationships with political, public, private and educational sectors, and has done so over the past decade of development. Through partnership with local and central government, Titanic Quarter Ltd is developing regeneration and investment to realise Belfast's ambition as a globally competitive city. In contrast with the period of decline, 18,000 people now live and work in the Titanic Quarter and over a million people visit the site every year. Those people are contributing to the economic, educational and social regeneration of Northern Ireland. The success of Titanic Belfast, which is now recognised in a series of awards that have listed it as one of the world's top tourist attractions, has transformed the scale of opportunities available to grow our tourism industry in Belfast and beyond.
It is fascinating to watch large cruise ships, private yachts and tourist buses coming into Belfast and to see people from right across the world descend on the site and experience what is an incredible visitor facility. However, what is increasingly encouraging is that people from the area and many tourists remain on-site to visit the other maritime heritage assets that have been retained and reused on the site, such as the pump house, the dry dock, the slipways and the Nomadic, among many, many more. Even as we speak, work is ongoing to restore and repurpose the old Harland and Wolff drawing offices to provide much-needed hotel accommodation on-site.
Over 100 national and international organisations are established in the Titanic Quarter, including Citi, Microsoft, HBO and many others. The public-sector investment in Belfast Met is providing educational opportunities in what is an inspiring and high-quality environment, and I believe that that reflects the quality of education and training that is accessed inside. The work being done at Catalyst Inc in driving forward knowledge, supporting innovation and encouraging entrepreneurship is re-establishing Belfast as a world leader in science and technology. Titanic Quarter Ltd has invested £21·5 million in the enabling infrastructure on the site to make development to date possible. Crucially, £425 million has been invested in Titanic Quarter over the past 10 years, with a rates gain per annum of £4 million. Clearly, that is good news for East Belfast and the city of Belfast as a whole, but, crucially, it is good news for Northern Ireland, as the regional portion of those rates allows the Executive to redistribute the benefits to other areas.
Developing the site and doing so in a timely and energetic manner is hugely important to unlocking the wider potential of the city and Northern Ireland. Not to do so will inhibit our ability to provide the required office accommodation for those who are considering bringing foreign direct investment into Northern Ireland. When I have met representatives of such businesses, they have raised a number of issues that are crucial factors for them in making investment decisions. Availability of a suitably skilled workforce and the cost base of the location are, of course, important. However, high on their list is the need for high-spec office space in central locations.
Equally, if we are to grow and expand business and leisure tourism, it is imperative that we increase the number of hotels available in the city to accommodate those who visit. The need for accommodation has been highlighted to me on a number of occasions of late, when businesses that have sought accommodation for staff visiting Belfast midweek found that the only available rooms with a week's notice cost £350-plus per night, almost double the comparable room rates in London and Dublin. Clearly, that raises the cost of doing business in Northern Ireland and is a disincentive for those who want to visit and, more importantly, to extend their visit beyond a day trip to take in the other sights and experiences Northern Ireland as a whole has to offer.
It is imperative that the impetus and partnership working that has driven the development thus far continues to drive it into the future. Sadly, over the last while, progress has slowed, so I thought the debate was a timely reminder of the potential of that site and the need for continued pressure to make sure progress is delivered.
It is projected that a further £365 million of investment will be made on the site in the next five years. That will create permanent employment of around 9,000 jobs, or, to put it in cash terms, jobs with an employment value of £285 million per annum to the local economy. That is in addition to the 1,000 construction jobs per year and the rates payable of £4·5 million per year that such a development could generate. The benefits of that are far-reaching for our economy, our public finances and our competitiveness internationally. It also offers huge gains not just in the greater Belfast area but for businesses in the supply chain across Northern Ireland, promoting tourist and heritage assets and growing services businesses that can regenerate communities far removed from Titanic Quarter in collaboration with those host businesses. The increased rates gain allows that benefit to be felt by those who use our public services, wherever they are accessed.
Recognising that the city of Belfast and Titanic Quarter can be economic drivers for the wider economy makes it all the more crucial that any impediments to progressing swiftly with the development of the site are addressed. Planning approval has already been given for a further 3 million square feet of residential, hotel, office, tourism and leisure facilities. It is that blend of uses — that mix of residential, tourism, education and retail — that has provided us with a successful and vibrant quarter. The focus on creating a shared and inclusive space in which everyone feels safe and welcome, in which everyone can pursue their ambitions and from which everyone in East Belfast and right across Northern Ireland can benefit is critical to its success. The inclusion of the Dock cafe, which is a multi-denominational project of a coffee shop that operates on an honesty box principle, has brought heart and spirit into the site, fostering a sense of community on what was previously a wasteland.
It is clear that there are significant opportunities going forward. However, if those are to be unlocked, it will require a continuation not just of the driving vision behind Titanic Quarter but of the close partnership working with local and central government, private sector bodies and public-sector bodies and the local community in East Belfast and beyond to ensure the necessary positive relationships between the various stakeholders on the site are fostered and maintained going forward.
Working across sectors is challenging, but with that challenge comes huge reward. I extend to the Minister an opportunity and an invitation to meet the stakeholders, including Titanic Quarter Limited and the harbour commissioners, on the site, hear their experiences and consider how his Department and those of his ministerial colleagues can support those endeavours. I hope that the Minister, on behalf of the Executive, will also be able to commit to doing all within his remit to ensure that the pipeline of investment continues and the full potential of what is a unique site is finally unlocked for all Northern Ireland.
Mr Douglas: I thank the Member for securing the Adjournment debate. First of all, I want to declare an interest: I am a trustee of the Titanic Foundation, which delivered the iconic Titanic building in 2012. I was a trustee even before I entered politics. I also want to say a word of thanks to Titanic Quarter for giving me some of this information. The only problem is that it has given me the same information that my colleague has. I trust that the honourable Member for East Belfast will forgive me if I regurgitate some stuff; hopefully, I will spot it and move on.
I was in the Titanic Quarter recently with some of the directors when they talked about their projections for the future and some of the plans that they have. Pat Doherty, who hails from Donegal, has been the driving force behind Titanic Quarter; he is a real man of vision. I met him in the early days. In one of my first experiences, I had a good fight with one of his staff, who suggested that we take down the iconic Samson and Goliath cranes, put them somewhere else in Belfast and build apartments. Thankfully, the cranes are now listed, and I am delighted about that.
In the early 1990s, I took my father for a drive round Queen's Island. As we looked at the neglect, the decline and the blight, he was in tears, because he had fond memories of working there over the years. He had been a red-leader at the yard in the 1950s and 1960s, and, like me, although I had been down a number of times, he was shocked to see how the area had declined. This morning, my friend and colleague Maurice Kinkead and I cycled round the area, now known as Titanic Quarter. All I can say is that, for visitors who have been coming to Belfast over a number of years, it must be remarkable to see the very positive developments that are taking place there. I am in that area most days, and, as Van Morrison would say, it is my source; it is somewhere I feel at home and at peace. I have fond memories of going down to get my father's wages before he went on the drink. Those are great memories.
As the honourable Member said, apart from the hugely successful physical developments, 18,000 people now live in that area and over one million people visit every year. I looked at the Titanic website earlier today. It says:
"Titanic by name, Titanic by nature, Belfast’s Titanic Quarter is one of the world’s largest urban-waterfront regeneration projects. Master-planned over 185 acres on the site where RMS Titanic was designed and built, Titanic Quarter is redefining what it means to work, live, play and stay in central Belfast."
Of course, it has been a huge success. One of the things that I and some other MLAs have been trying to do is connect Titanic Quarter with the working-class areas of east Belfast, the areas where the people who worked in the yard worshipped, went to the bookies and had their drinks. My friend and colleague, the Reverend Mervyn Gibson, is minister of Westbourne Presbyterian Church. They have a great plan to transform that church — the shipyard church — which, at one time, had about 1,800 people there on a Sunday. As a church, it was about the shipyard. I know that he has been in touch with my colleague the Finance Minister trying to get a wee bit of help and support.
We could not talk about the Titanic Quarter without highlighting Titanic Belfast, recently named as Europe's leading visitor attraction at the prestigious World Travel Awards held in Sardinia, Italy, in August, during which we welcomed our 3,000,000th visitor and experienced our busiest month since opening. It saw us beat off stiff competition from Buckingham Palace, the Guinness Storehouse in Dublin, the Eiffel Tower in France and the Roman Colosseum in Italy. Is it not tremendous that we were able to beat them off? Titanic Belfast opened in 2012 on the 100th anniversary of the sinking of the Titanic. The business plan projected 425,000 visitors, of whom between 130,000 and 165,000 would come from outside Northern Ireland. A lot of people said that it would not work and that, with 50% of its funding from the Executive, it was a threat to taxpayers' money. In the first year alone, there were 807,000 visitors. What a success story. I think that the iconic Titanic building says it all about the area. It has been regenerated and is a place that people want to visit to work and play, but we need to make those connections with inner East Belfast.
Mr Allen: Like the previous Member, I thank our colleague in East Belfast for bringing the Adjournment debate before the House and indeed the Minister for giving up his time to respond to the debate. Like the previous Member, I will attempt not to cover areas that have already been covered.
Belfast's Titanic Quarter is a 75-hectare brownfield site of largely cleared land located at Queen's Island within the Belfast harbour estate, close to Belfast city centre. The site was once part of the Harland and Wolff shipyard, which, at the height of its success, employed over 30,000 people. On that point, I think that, if you went throughout East Belfast and indeed other parts of Northern Ireland, you would struggle to find people who did not have a direct affinity with the shipyard. I have an affinity with it because my stepfather worked there. I remember, unfortunately quite a number of years ago, which is a crying shame, having the opportunity to go to a fun day in the shipyard and see the sheer scale of it in action. I very much enjoyed that; indeed, it was an annual event that the shipyard put on for the children of its employees. I very much looked forward to that event.
The Titanic Quarter is a large-scale regeneration waterfront comprising historic maritime landmarks, film studios, education facilities, apartments, a riverside entertainment district and the world's largest Titanic-themed attraction centred on land in Belfast harbour. Known until 1995 as Queen's Island, the 185-acre or 75-hectare site was previously occupied by part of Harland and Wolff. With 1·5 million square feet completed and a further 3 million square feet with planning approval, the Titanic Quarter's sheer scale allows it to offer a diverse range of modern workspace accommodation. The already completed 130,000-square foot Gateway Offices, located at the entrance of Titanic Quarter, is a template for the rest of the development. Fully occupied by Citi, the LEED "gold" building is one of Europe's most sustainable and environmentally friendly buildings, providing space for 1,300 workers.
The largest development is the £97 million Titanic Belfast visitor attraction, which holds the record for the island's largest-ever single concrete pour — 4,300 cubic metres for its foundations. The building opened on 31 March 2012. I acknowledge my colleague for East Belfast's contribution to that. I congratulate and thank him for bringing that forward because it is a massive asset to East Belfast. The attraction had over 800,000 visitors in its first year. It is owned and run by a charitable foundation. The architects said:
"we have created an architectural icon that captures the spirit of the shipyards, ships, water crystals, ice, and the White Star Line's logo. Its architectural form cuts a skyline silhouette that has been inspired by the very ships that were built on this hallowed ground."
As the proposer of the Adjournment topic pointed out, the further development of the site has economic value for Northern Ireland as a whole. A rates dividend will extend from that, on top of what has already been secured. I look forward to continuing to work with our colleagues. In the House, we agree or disagree on things, but this is an area on which we can unite and work together to secure further development on the site. I look forward to hearing the Minister's remarks; indeed, I look forward to working with the Minister in any way that I can to help promote Titanic Belfast.
In finishing, I reiterate what the previous Member to speak said: it is imperative that we continue to link Titanic Quarter with the working class of East Belfast and wider east Belfast. Like us, they are stakeholders in trying to develop the area.
Mr Lyttle: I welcome this opportunity. I thank my colleague Naomi Long for bringing forward this important topic for debate today. It allows us to set out the importance of Titanic Quarter as a key social and economic driver for East Belfast, Belfast as a whole and Northern Ireland. The Assembly and the Executive have rightly set out to achieve the regionalisation of economic development in Northern Ireland, but, as my colleague said, Titanic Quarter will be absolutely vital to ensuring that we achieve that. We want to ensure that our Executive Ministers continue to prioritise Titanic Quarter in Belfast as key to achieving that aim.
As many Members have said, Titanic Quarter is one of the most exciting development spaces in Northern Ireland. We have heard that 18,000 people live and work there, with over one million people visiting every year. We have had three million visitors to Titanic Belfast. Over 100 national and international organisations are established in Titanic Quarter, generating rates per annum of around £4 million. There are exciting future plans for the site, and we want to ensure that our Ministers take heed of them and give their support to them.
We have seen a decade of development at Titanic Quarter that has made it a world-class tourist destination, an education, film and media campus and now a growing residential community, with space for the grade-A premium offices that are so badly needed in Belfast to drive our development. Of course, it is also a site for business and scientific innovation. Titanic Belfast is at the centre of that. Further to it being awarded the title of Europe's leading visitor attraction, we now have the opportunity to vote for Titanic Belfast to become the world's leading tourist attraction. I encourage all Members to promote that opportunity by directing people to titanicbelfast.com/vote and #VoteTitanicBelfast. I believe that voting remains open until 24 October. If we can garner enough public support, we can ensure that Titanic Belfast takes its rightful spot as the official number one world tourist attraction.
It is important to note that Titanic Belfast has struck the balance between the respectful commemoration of a tragic loss of life and human fallibility and the celebration of the historic human endeavour and innovation that has inspired people at that site for many years. It has also inspired the type of innovation that we are now seeing and for which we want to seek further support for its development.
At Titanic Quarter, we also have extremely exciting projects such as T13. T13's anchor tenant is Belfast Urban Sports. People such as Liam Lynch do fantastic social entrepreneurship in that area. They host fantastic local media production companies such as Stellify Media, involving local people such as Kieran Doherty and Matt Worthy. They have produced a prime-time game show called 'Can't Touch This' that people may have seen on Saturday evenings. It was made in T13 in Titanic Quarter, Belfast. As my colleague Naomi Long said, it is vital that we work with local and regional government to ensure that the huge potential of the sites across Titanic Quarter is used to nurture the creativity that we have among our people in Northern Ireland.
The Dock Café, the Dock Market and the Arc apartments and, of course, the Reverend Chris Bennett have all been mentioned and have brought heart and soul into Titanic Quarter. We have the SSE Arena, led by the Odyssey Trust and home to the Belfast Giants, which has given us a real shared sport that everyone in Belfast and Northern Ireland has been able to get to.
There are key links from Titanic Quarter into East Belfast to sculptures like the Yardmen, in inner east Belfast. It is vital that we continue to ensure that there is infrastructure in Titanic Quarter that links it to the local communities, not least by some of the impressive cycling infrastructure that was previously supported by you, Deputy Speaker, in your time as Regional Development Minister. Hopefully, we can see more of that to link those communities.
There are exciting plans in place for Titanic Quarter, with a possible further 1,000 construction jobs per annum, permanent employment of 9,000 jobs and payable rates of £4·5 million with a mix of residential, community, tourism, education, retail and innovation available. We want to see our Executive get behind that and make Titanic Quarter the local engine room for international economic growth, employment, creativity and innovation that it can be and, indeed, make it the shared space that can inspire a united and prosperous Northern Ireland.
Mr Ó Muilleoir: Tá áthas orm páirt a ghlacadh sa díospóireacht seo anocht. I am delighted to take part in the debate tonight. Chris Lyttle did not leave much for the rest of us. He gave us a virtual tour of the Titanic Quarter. Like my colleague Mr Douglas, I have a connection to the former shipyard and to East Belfast because my father worked in the shipyard. He recalled working in a blizzard of asbestos at a time when they were cleaning old heating units on ships that had been decommissioned. I suppose he was fortunate because there were not a lot of people from Ramoan Gardens or Andersonstown working in the shipyard at that time, but I have always felt a great connection to the shipyard. I was delighted to see rising from much of where the shipyard was — I know that Harland and Wolff is very much still in business — really a new Belfast, where everyone is welcome, diversity is treasured and prosperity is the goal.
I really want to echo some of the points that Chris made and maybe mention some different people. He mentioned the Dock Café, and I think the generosity of the Dock Café is a great symbol of the new Titanic Quarter, of the new East Belfast and of the new Belfast. I want to mention the Cast and Crew restaurant because we really know that the revitalisation of an area is taking place when you see an art gallery or a restaurant. In another part of East Belfast, we have seen the ArtisAnn art gallery in Bloomfield Avenue opening recently. When Cast and Crew took over what was an old bank building, Niall and Joanne McKenna invested their own money, turning it around. I have met cyclists there early on a Saturday morning, stopping to have their breakfast. Also, late at night, some nights, they bring life back into the area. The entrepreneurs who are the pioneers and put the first stake in the ground are those we need to reward and acknowledge.
Mr Douglas: I am sure the Member will agree that in Cast and Crew you get some of the best porridge in Belfast. On a more serious note — I have seen the Member running up and down Titanic Quarter — do you agree, and hopefully the Minister will pick this up, that one of the weaknesses at the moment is that we have one road in and one road out? We definitely need new infrastructure there if it is going to expand and grow.
Mr Ó Muilleoir: Hopefully, as the peace process between the harbour and Titanic blossoms we will see that bridge. We definitely need another bridge across to the new Hyatt hotel and to the Baker and McKenzie offices and so on. I agree with him on improved infrastructure. I also want to say that we need to see more entrepreneurs investing there. I want to talk, in a second, about the large business projects that are there, but we need to find ways to encourage entrepreneurs to go in. When the new hotel opens in the drawing rooms, that will be a great lift. However, I would like to see more indigenous entrepreneurs have a go at making a living off the back of the tourism and the other people who visit Titanic Quarter every day.
The only other group that I want to mention is Catalyst Inc, formerly the Northern Ireland Science Park. The leadership of Dr Norman Apsley, Steve Orr and Alan Watts is absolutely exemplary; they are true pioneers. Their focus is on job creation, and they are determined to create a reputation for us as a hotbed of innovation, research and cutting-edge technology. I really love their approach; they just get things done, and the force and conviction they bring to their mission is absolutely inspiring. I met them earlier this year at a meeting with the board of Catalyst Inc, after its rebranding, to hear the ambition and scale of their plans. It gives you great heart and, when you meet them, they tell you, "Here's the plan we need help with immediately and, by the way, we've another one in two years' time". They are particularly good at spreading the love and want to get involved in other projects outside East Belfast, and I commend that.
I am really hopeful in the short time ahead — I have discussed some of this with Mr Lyttle — that we will see more cranes above Titanic Quarter; that we will see an additional hotel go in — as well as the boutique hotel that is going into the Titanic drawing rooms — perhaps in front of Titanic Belfast; that we see additional grade-A office space beside the wonderful offices of Citigroup; and that we see another building go in for the cutting-edge knowledge economy jobs that Catalyst Inc are bringing to the quarter. These are just some of the projects, and I have no doubt that they will be complemented by other people, but the drive will have to be to increase the pace of the transformation that we have seen in that part of the city.
Last word — Belfast badly needs an art gallery. We know that Pat Doherty is a great fan of the arts, and of art. They had a plan on the table some years ago, but whether it is at Titanic Quarter or is for Belfast City Council to consider, I am not sure where this 21st century European-class art gallery should go in Belfast. Certainly, I would be very supportive of anyone who comes forward with more cultural and arts projects for Titanic Quarter.
Mr McGrath: I begin by apologising on behalf of my Belfast colleagues who cannot make it this evening due to ill-health and the passing of a party colleague.
Like all the other Members who are speaking this evening, I acknowledge and celebrate the achievement of the Titanic experience. It is now rated as one of the best tourist facilities in the world, and it proves the value that there can be in signature tourism projects. In that regard, it would be remiss of me not to mention — just as a little drop-in — other possible signature projects, such as the St Patrick's project, and, of course, Downpatrick would like to be able to join in some of the success there. Turning to Titanic Quarter, I suppose —
Mrs Long: I thank the Member for giving way. It is hugely important that we use Titanic Quarter as an opportunity to signpost exactly those kinds of things and make sure that when people come they do not arrive on a cruise ship and then disappear but stay in a hotel in Titanic Quarter and visit places as far away as Downpatrick.
Mr McGrath: Thank you, and I welcome the intervention. Of course, I would say that they should visit Titanic Quarter and then come to Downpatrick and stay in a hotel. A hotel development in Downpatrick may be the subject, hopefully, of a future debate.
It is connectivity, not isolation that I want to gently touch on. We support the proper and full development of Titanic Quarter. It is a huge land mass and it has immense potential and an immense future that will create a great part of the city. However, we would like to see it very much as part of complementing the development of the whole city, using its connections to ensure that each part of Belfast gets the opportunity to develop. Care needs to be taken to ensure that we do not concentrate all our investment and development in one part of the city. I think that there can be a bit of a sense in north and west Belfast, maybe, that there is not as much support going there as there could be. So, whilst we certainly welcome the development of Titanic Quarter and do not want to deprive it of the development that it should get, we want to see it as being part of a wider development of the whole city and a wider strategy.
It would be really good to see within the city centre the development of things such as John Lewis. We must make sure that we do not concentrate things like that on out-of-town-centre areas. There is a bit of concern amongst traders that everything could move out to the peripheries of cities, and it can sometimes be at the expense of city centres. We would like to see the development of Titanic Quarter, but as part of an overall project.
Mr Douglas: I thank the Member for giving way. The Member made the point about other areas of Belfast getting support, which I certainly encourage, but does the Member not agree with me that Titanic Quarter is a regional area for a whole range of different projects? An example is the Titanic slipway, where you have had the BBC Proms, Carl Frampton fighting and, this year, the Euro fanzone for both the Republic of Ireland and the Northern Ireland fans. That is regional, in any sense.
Mr McGrath: I thank the Member for his intervention. It is articulating what I am saying as well: we want to see all of that development in Titanic Quarter, but as part of a wider strategy that allows for the development of other parts of the city that may feel they are not being as well developed.
The Odyssey Trust, which was a millennium project, has well served the city. It is an education trust and a big business. The SDLP believes that more of its profits should be invested in the trust's stated objective, which is education. Imagine what more of its balance sheet invested in East Belfast in educational intervention could do to areas such as the Short Strand, the Newtownards Road and Dee Street, which are a hop, skip and jump away from that Titanic Quarter area. We would like to see that happening. It will allow greater connectivity between the local people living in the area, and these regional facilities that are centred within the Titanic Quarter. However, I am advised that the Odyssey Trust is one of the least accountable organisations in Northern Ireland, and that its balance sheet deserves closer scrutiny. It should spend more of its money on educational provision. It was set up to do that, and it should do more.
In general, the harbour estate is a strategic asset for Belfast and Northern Ireland. The concentration of economic development in the harbour estate, particularly in the waterside of the Lagan, is sometimes a matter of grave concern. Whilst we certainly welcome investment, a concentration of investment in Titanic Quarter and the harbour can create economic imbalance in the city and deepen economic partition for the north of the city. With the Queen's University and Titanic Quarter corridor at risk of receiving all economic investment, meaning that it becomes concentrated and not diversified, it can leave areas such as the north and west of Belfast being denied investment. We must develop all parts of the city — Titanic Quarter for sure, but also the other parts.
Mr Deputy Speaker (Mr Kennedy): I call the Minister for Infrastructure, Mr Chris Hazzard, to respond and conclude the debate. Minister, you have up to 10 minutes.
Mr Hazzard (The Minister for Infrastructure): I thank Mrs Long for bringing the topic to the Assembly. She said at the outset that I have just returned from China, and I saw at first hand the interest not only in Titanic — they are building a complete replica of the Titanic in China, which shows the worthiness and the value they place on it as a model to attract investment — but also 'Game of Thrones'. Here we have two massive investment opportunities centred right on the very location that we are talking about this evening. I am more than happy to be here to discuss this.
The redevelopment of Belfast waterfront has been a key feature in the economic regeneration of the city. It has resulted in the transformation of the Lagan and the reclaiming of the river as a key feature of the city centre — a social, as well as an economic, asset benefiting local communities. No one in this Chamber would dispute the importance of that transformation. Where once we had derelict sites, we now have thriving businesses and communities. The significant investment which the Government and others have taken forward in recent decades has allowed us to create the type of dynamic, urban environment central to attracting high-value businesses and investors. It has also been key to building the sense of pride and ambition within our communities along the Lagan.
I believe all of us in this Chamber recognise that the redevelopment of the harbour estate, and in particular Titanic Quarter, has been a key strand of that transformation. Since the Titanic Quarter master plan was launched in 2005, we have seen investment of some £358 million, and the successful delivery of major commercial, tourism, residential and education schemes, some of which, such as the award-winning Titanic signature project, have come to define Belfast internationally.
We now have over 18,000 people living, working and studying in Titanic Quarter, and over one million visitors per year come to what was, little more than a decade ago, a derelict former shipyard and building land.
We have film studios and major financial and IT employers, all of which raise the profile of the North of Ireland and all of which, just over a decade ago, few of us would have anticipated.
The progress that has been made reflects the high level of commitment and support the Executive have provided to the redevelopment of Titanic Quarter, including investing £50 million in Titanic signature-related projects in recent years. That is part of our ongoing commitment to develop the tourism potential of Titanic Quarter, and it includes Tourism NI support towards the restoration and development of the historically significant HMS Caroline as a visitor attraction.
Further Tourism NI investment is planned for early next year with the construction of the Titanic waterside pathway, which will improve the connectivity between key heritage sites in the area and enhance the overall visitor experience in Titanic Quarter. That will benefit significantly from the investment the Department for Communities and the Belfast Harbour Commissioners have taken forward in the cycling and pedestrian infrastructure along the Lagan and through the harbour estate.
It is important we recognise the Executive's commitment and support for the redevelopment of Titanic Quarter, including that of my Department working with Titanic Quarter Ltd (TQL) to address the infrastructure challenges associated with major development. Indeed, the introduction of the new Belfast —
Mr Lyttle: I thank the Minister for giving way. While he is on the topic of developing fit-for-purpose infrastructure, perhaps I can bring to his attention — he may already be aware of this — the need to improve the Dee Street roundabout/Sydenham bypass junction that leads to the Sydenham Road and into Titanic Quarter. Hopefully, that is something he can keep on his agenda as well.
Mr Hazzard: Absolutely. As the Member across the way from me suggested, to develop a lot of the stuff we are talking about here, we need the infrastructure to be in tandem. Otherwise, we would be simply wasting our time, and there would be congestion and gridlock that we would not be able to deal with. I will, of course, be keeping such projects on the radar.
The introduction of the new Belfast rapid transit (BRT) system will greatly assist in opening up further opportunities by providing high-quality public transport connections between Titanic Quarter and Belfast city centre, as well as to our major population centres in west Belfast and east Belfast. This goes back to my South Down colleague's comments about ensuring that all of Belfast and, indeed, the wider North can generate prosperity from Titanic Quarter. There has been criticism in recent years that Belfast city centre was moving east. It is important that we do not have a situation where investment and opportunity are sucked into a particular quarter, meaning that we do not have the ability to expand. The BRT system will link east to west through the city centre, so it is vital that the Casement redevelopment and the Andersonstown leisure centre — those are just two projects that come to my mind — progress well and that we have the flow of people, goods and services that the Programme for Government says should be right across our city.
It is equally important that we recognise the role of others, in particular the Belfast Harbour Commissioners, in supporting and enabling development at Titanic Quarter as an integral part of the wider regeneration of the harbour estate. That regeneration, of course, is not limited to Titanic Quarter. It includes over £60 million of investment by the commissioners in key projects such as City Quays 1 and 2, the City Quays Hotel, the Science Park and cruise terminal, among others — projects that are central to Belfast's ability to attract the high-value investment we seek.
I recognise, as we all do, that over the years there have been tensions in the relationship between the commissioners and TQL. It is unfortunate that too often that distracted from the positive contribution both parties have made to the regeneration of Belfast, particularly given that the tensions were not a result of different levels of ambition for the regeneration of the quarter. The commissioners and TQL have worked together for more than a decade to deliver projects and realise the ambition of the agreed master plan for the redevelopment of the quarter. We would not be where we are today without the hard work and dedication of both. In supporting the development of Titanic Quarter, however, it is important we recognise that the harbour commissioners have a responsibility to have proper regard to the public interest and commercial considerations. It would be entirely inappropriate for the commissioners to operate in a way that was not consistent with that obligation or, indeed, for the Government to seek unnecessarily to influence commercial negotiations.
Tensions in any relationship, particularly commercial relationships, are to be expected. It is the ability to resolve these and to continue to work together in the common interest that is important rather than ignore their existence. In that context, I think that we can all agree that the signing of the memorandum of understanding (MOU) between the harbour commissioners and TQL in May this year was a very welcome development, as it provides an opportunity to reinvigorate Titanic Quarter and resolve outstanding differences. I believe that we are already seeing the fruits of that, with progress made on the exhibition centre, hotel accommodation and new film studios.
In signing the agreement, both parties recognised that Titanic Quarter is a major economic opportunity for the North of Ireland. Both also committed to act with the utmost good faith to reach agreement to facilitate viable current and future development projects. That is to be welcomed. The signing of the new MOU has prompted the review of the previous Titanic Quarter master plan, which is under way. This provides an opportunity to consider not just the respective roles and responsibilities of the commissioners and TQL but to look at the infrastructure requirements to enable the further development of the Titanic Quarter site. Looking forward, while differences will emerge at the level of individual projects or investment proposals, the agreement provides an appropriate framework to resolve those through negotiation.
I welcome the opportunity to respond to the Adjournment debate today. The comments from Members today reflect the importance that we all attach to the development of Titanic Quarter. I can assure you that I will do everything that I can to support that development, and I conclude by welcoming the commitment of the Belfast harbour commissioners and TQL to driving forward the development of Titanic Quarter. I also congratulate Members for their obvious display of passion and dedication to a project that really does have the ability to transform not just our city but our inner-city communities that really need that transformation. Finally, I am more than happy to meet the Member and the people whom she wants me to meet in the months ahead.
Mr Douglas: I suggest that, during that visit, you go on the wee tram that Reverend Chris organises. It is a fabulous wee tour and takes only five or 10 minutes. I will pay for you if you want to go on it. [Laughter.]
Mr Hazzard: On that bombshell, I am more than happy to retire.