Adjourment debate, Stormont 2/10/12
Mr Beggs: I am pleased to have secured this Adjournment debate on health and social care in East Antrim. The reason that I wanted to secure it can be summed up in one word: equality. Are my East Antrim constituents getting equal treatment when it comes to accessing health and social care provision? I am concerned that many are not.
I will set out the context for the debate. The last time that we debated an East Antrim-specific health topic in the Assembly was February 2008. At that time, the context was a consultation document that the Northern Health and Social Services Board had issued on replacing services in Inver House in Larne. This time, the context is the ‘Transforming Your Care’ report, also known as the Compton report, which was published last December. I will speak on some of its implications later. I will also ask the Minister to clarify the status of this draft population report, its implementation plans and the consultation on those plans.
There seems to have been a plethora of reports and strategy documents on health and social care in recent years. Many have been accompanied by extensive public consultation exercises. However, a recurring theme for my East Antrim constituents is diminishing services and reducing facilities. That is a very strong perception. A number of decades ago, we had the closure of the Moyle and Carrickfergus hospitals in East Antrim. That was done to accommodate the upgrading of Antrim Area Hospital. More recently, Whiteabbey Hospital, which serves the southern tip of my constituency, lost its acute services. It now provides a minor injuries unit.
The designated acute hospital for the people of east Antrim is Antrim Area Hospital. I need hardly remind Members of the problems and difficulties at Antrim Area Hospital over recent years, particularly in the accident and emergency department. However, I recognise that there is major construction going on to improve the facility, and I look forward to its early opening in order to provide a better service to my constituents. Another issue with Antrim Area Hospital is the transportation links. It is relatively difficult to access using public transport from Larne and Carrickfergus, never mind from areas such as Carnlough or Islandmagee.
Down the years, there have been promises of new local facilities and replacement services in east Antrim made by trusts, boards and Ministers, but very little has ever materialised. For example, the Carrickfergus Day Centre closed in the past 10 years, and there was an expectation that a new facility would be built within a short time. That did not happen.
I now wish to move on to the issue of health and care centres. In January 2006, the then Northern Board published, ‘All Our Futures’, which set out proposals for a major reform of health and social care services over the next 10 to 15 years, including investment in new services and facilities totalling £600 million. In Ballymena and Larne, changes were to include the opening of integrated health and care centres in 2010. They were to support an enhanced range of local community services. Obviously, that timescale has been missed, but the funding for Ballymena has been announced and plans seem to be progressing. However, what has happened to the new health and care centres for Larne and Carrickfergus?
Local health and care centres have the potential to provide many more services locally; be GP-led; be much more responsive and convenient; provide better access for patients; be more efficient; have many more services located in the community; and be easily accessible to those who need them. The services that are, I understand, being talked about include a specific diabetes unit and treatment for those with chronic obstructive pulmonary disease and asthma. Those conditions need not be treated in a hospital, and, if they can be treated in the local community, it is much easier for all concerned. That takes the pressure off the hospital and helps to shorten the growing waiting lists for many hospital services.
Another important area is care for the elderly, which is in the Compton report, ‘Transforming Your Care’. I want to concentrate on that for a period. Part of the issue in the report concerns community and nursing and residential care homes. Again, anyone who, like me, has been a public representatives since 1998 will be familiar with the reports produced by the health boards, the trusts, the Department and its consultants. The language in them is sometimes too full of jargon to be understood easily by the layperson, but the direction of travel is clear and consistent. The people who run the health service in Northern Ireland want to keep older people out of institutional care settings, maintain them in their own home for as long as possible and then have the private sector cater for those who need to go into care or a nursing home. Fine, but is there capacity for domiciliary and community care? Can even the current demands of care in the community be met? It was not that long ago that I was approached by a constituent who had a disabled son who could not return home from hospital for many weeks because there were no carers available to meet his needs.
Clearly, that aspect of the service needs to be upgraded. When it bedded down, it was much preferable, and the individual concerned and his family were much more content that he continued to live and be served in his home.
In 2008-09 in East Antrim, along with many other constituencies, there was enormous public reaction to the proposals which, in the Northern Trust area, were called ‘Reprovision of the Trust’s Residential Homes for Older People’. The consultation document proposed that the trust’s residential homes in East Antrim — Lisgarel in Larne, Greenisland House and Clonmore — were to close. That generated a level of public opposition that was unprecedented in my time as a public representative.
I am sad to say that, although, during my time as an East Antrim MLA, we had worked together on cross-party lines, it appeared to me that party politics crept in on this issue at that time. One MLA issued press releases while the consultation process was still live and resting with the trust. That MLA labelled the process the “McGimpsey cuts”. The current Minister of Health, Social Services and Public Safety was also enormously critical of his predecessor, the Member for South Belfast. On 23 February 2009, Mr Poots led a debate in the Assembly, proposing the motion:
“That the Assembly expresses its opposition to the proposed closure of residential care homes by a number of Health and Social Care Trusts; and calls on the Minister of Health, Social Services and Public Safety to intervene and listen to the concerns of the community and take appropriate action to minimise the pain, stress and anxiety that this uncertainty has created among elderly care home residents, their families and health workers.”
His speech was full of emotive and pejorative language. He said:
“Does the Member agree that, when a trust asks an elderly person whether he or she would prefer to live in his or her own home or in a residential care home, the question is loaded? It will almost always elicit a response in favour of living in one’s own home. For many people, who are not ready for a nursing home but who cannot stay at home, residential care is the only real and practical choice. If we go down the route of doing away with statutory residential care, we could end up with a situation similar to that in England, where care in residential private nursing homes is of a much lower standard than we would expect for our elderly people.”
[Official Report, Bound Volume 38, p134, col 1].
I have one simple question for the Minister. Does he stand by what he said in the House at that time, or was he merely playing politics with this most sensitive issue? Is he now presiding over a policy that he apparently emphatically opposed just three years ago? If that is the case, he needs to explain to the House why that has happened.
Ultimately, Minister McGimpsey did listen to people in East Antrim at that time. Lisgarel and Clonmore were saved from closure. Greenisland House, with its multiple levels and difficulty of mobility about it, was to be replaced with new accommodation. It is three years since the closure of Greenisland House was announced, and I learned through the press that no more patients were being accepted into other local residential homes as permanent places were being reserved for residents of Greenisland House. However, after three years, no information was available in the public domain about how funding had been earmarked for that replacement. There was no information about which housing association would be developing it or, indeed, of any having been appointed or on any planning permission. The community was very concerned that, once more, local health facilities were being closed and that nothing was being put in their place. When I highlighted the issue, I was pleased to receive, eventually, confirmation that capital funding has been earmarked. However, when I contacted the Housing Executive at the start of this month, some three weeks ago, I was told that, at that time, no housing association had been appointed. Perhaps the Minister might be able to tell us whether there has been any development on that issue since then.
I also wish to relay my personal experience of two of my extended family members who required support from the health service over the summer months. These were two elderly patients who required hospital treatment, and they were very rapidly returned to their own homes to receive domiciliary care.
In those instances, I had a feeling that it was much too fast, and there was concern in the family at the speed at which both of them had been returned home. Sadly, within a short period, both had to be returned to hospital, to the accident and emergency unit. Interestingly, after they had recovered in hospital, they were discharged to Clonmore House residential care home, where they received at least a full week of rehabilitation and support each. I visited that home at that time, and I have to be complimentary of the staff and the home. When both patients returned home to their normal setting, they were able to adapt and adjust with the support package that was available and with family support. However, I express concern that they were perhaps discharged from hospital too rapidly and without sufficient rehabilitation.
‘Transforming Your Care’, which is known as the Compton report, was published in December 2011 and contains some 99 recommendations. A draft population plan has been published on the Northern Health and Social Care Trust website, but the Minister has indicated that there is a certain level of doubt over the status of that report. I understand that it was to be considered over the summer period and that adjustments may be made before the end of December before going into consultation.
One recommendation in that report was for all statutory residential care homes, of which there are 11 at present with 220 permanent residents, to close. It would be helpful to have clarity on the position of that report and the position of the care homes in my constituency and the others that will be affected. There is concern in the community, and I am sure that the Minister is aware of it. It is unfortunate that a draft plan has been put out and left hanging for so long, yet there is uncertainty about its status and whether or not that is exactly what is planned.
It is also unfortunate that, while MLAs in East Antrim used to meet together to get updates on health, it now appears that DUP MLAs meet separately with the health trusts, and others then meet separately as a group and are content to do so. I would much prefer for us all to meet together and work together for the benefit of all our people.
Health is too important an issue to play politics with, and I ask you to ensure that the needs of East Antrim are catered for.