Hospital Parking Charges Bill: Second Stage

Private Members' Business – in the Northern Ireland Assembly at 4:15 pm on 22nd November 2021.

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Photo of Aisling Reilly Aisling Reilly Sinn Féin 4:15 pm, 22nd November 2021

I beg to move

That the Second Stage of the Hospital Parking Charges Bill [NIA 40/17-22] be agreed.

Photo of Roy Beggs Roy Beggs UUP

In accordance with convention, the Business Committee has not allocated an overall time limit for the debate. In recent correspondence, however, the Speaker outlined that, in order to help to manage plenary time between now and the end of the mandate, the Business Committee has agreed to allow an upper time limit for contributions to Second Stage debates on Bills that are not proceeding by accelerated passage. The sponsor of the Bill will have up to 15 minutes to move the motion and 10 minutes to make a winding-up speech. All other Members will have up to 10 minutes.

Photo of Aisling Reilly Aisling Reilly Sinn Féin

I thank all Members for being here for the Second Stage of my private Member's Bill to abolish hospital car parking charges. I look forward to your contributions and will welcome your comments on the Bill. I also look forward to speaking with and working with everyone to ensure that the Bill is passed.

I give a special mention — a míle buíochas — to Fra McCann for his work on the Bill before his retirement. Fra was vital to the research and consultations that were needed to move the Bill forward. I also thank Catherine Kelly and Ciarán O'Connor from the party policy team, the Assembly Bill team and Assembly Clerks who, while dealing with a vast workload, supported me, as the Bill sponsor, and guided me through the process. Go raibh míle maith agaibh uilig.

This is a relatively short Bill of three clauses, which inserts new article 3A into the Health and Medicines (NI) Order 1988, preventing the Department, trusts and other health service bodies from imposing charges for parking for staff, patients and visitors to hospitals. This is a stand-alone Bill that should not interfere with the pay negotiations between the Department of Health and health and social care workers. One measure has nothing at all to do with the other.

The policy objective for the abolition of hospital car parking charges is to provide free parking for workers, patients and their families at all the public hospitals in each of the five health and social care trusts. Free parking at public hospitals will reduce the burden on patients and visitors who are already physically, psychologically and financially impacted on by the experience of ill health. Additionally, it would reduce the financial burden on health and social care hospital workers, many of whom are underpaid for their work in the health service.

Free hospital car parking would provide a fairer and more consistent approach to public hospital car parking policy. Since I have taken over the Bill, I have engaged with the constituents whom it would most affect. In my engagements, I heard several comments on the difference that abolishing hospital car parking charges would genuinely make for workers, patients and families. The charges are, quite simply, an unfair additional tax. Some workers are paying £60-plus a week in hospital car parking charges. Whether to pay the bills, provide heat, put food on the table or go to work should never be a decision that any worker has to make, especially when those workers make such a huge contribution to our society. We talk about valuing our healthcare workers. Let us show that by putting that money back into their pocket and putting an end to public hospital car parking charges.

Patients and their families who are already stressed because they are sick should be focused on their health and recovery as a priority. They should not be further burdened by hefty hospital car parking charges. Car parking charges disproportionately impact those from our rural constituencies, who are, largely, reliant on a car for transport. For many of our rural constituents, public transport connectivity to hospitals is simply not sufficient as a means of getting to work for certain shifts or for accessing treatment at specific appointment times. Similarly, the option of active travel to work, such as walking or cycling, is not practical for people in rural communities, given the longer distances to travel.

We conducted a consultation on free hospital car parking charges via the SurveyMonkey site. It ran for eight weeks, starting on 8 January 2021 and finishing on 8 March 2021. There were 842 responses in total. The outcome of the consultation was that a clear majority of the respondents agree that public hospital car parking should be free for all users. Out of 677 who responded on free parking for all, only 16 respondents answered no, meaning that over 97% of respondents think that hospital car parking should be free for all users.

Our research has highlighted inconsistencies in car parking charges across hospitals and trusts. There are differences in hospital car parking charges across the trusts, but there are also differences within health and social care trusts, which, in themselves, create inequality and pay parity issues for workers, patients and their families. For example, the Royal Victoria Hospital has an all-day fee of £5, the Mater Hospital charges £1 per day, Belfast City Hospital charges £11 a day, and Omagh Hospital and Primary Care Complex charges £1 for up to one hour — four hospitals; four different charges. The disparity in those charges reveals that nurses in one trust pay more than nurses in other trusts, and also that nurses in the same trust are charged differently.

I have engaged with unions, health groups and rural networks on the Bill. Macmillan Cancer Support has called for the end of hospital car parking charges; it called them morally wrong and unfair for those who must attend hospital for treatment, especially time-sensitive treatments. Macmillan reported that four out of every five cancer patients whom it surveyed were worse off because of the charges. Some reported spending up to £500 monthly. Whether you are a visitor to someone who is unwell, or you are working tirelessly to care for patients, free car parking would mean one less thing for you to worry about. It would ease an unnecessary financial burden.

The Royal College of Nursing fully agrees that valuing workers should be a priority and that the charges are causing real financial hardship for some of its members. The Rural Women's Network also fully supports the Bill. It agrees that rural workers, patients and families are disproportionately affected by hospital car parking charges. Unite the Union members in the Royal Victoria Hospital have previously campaigned for free hospital car parking. They cited an example of health and social care workers floating between hospitals to care for their patients being faced with multiple charges to park as they go about their job. Our health and social care workers are among the lowest-paid workers in our society. They do some of the most important and necessary work, but they are paying to park their cars in hospital car parks.

The main theme throughout our engagements so far has been that the charges are causing real financial hardship for patients, their families and workers. We are aware that there are some —

Photo of Paula Bradshaw Paula Bradshaw Alliance

Will the Member take an intervention?

Photo of Aisling Reilly Aisling Reilly Sinn Féin 4:30 pm, 22nd November 2021

If you let me finish, you can come in at the end.

We are aware that some exemptions from hospital car parking charges exist for patients who are receiving radiotherapy, chemotherapy or renal dialysis and their families. Partners and relatives can also avail themselves of free car parking if they are transporting a patient who is receiving any of those treatments. However, those exemptions do not cover all the areas of treatment. For example, according to Macmillan, going to the hospital for associated blood works does not entitle you to free parking. It is also true that members of the same household who travel separately to visit or attend appointments have to pay for car parking, which means that the household does not benefit from free car parking.

I thank the Minister of Health for being in the Chamber. He ensured that hospital car parking charges were suspended for periods during the COVID-19 pandemic. Through that action, Minister Swann recognised the sacrifices that our Health and Social Care workers made for us during the pandemic. We know that it can be done, and, with that political will and creativity, we can abolish hospital car parking charges, as has been done in other jurisdictions.

Scotland and Wales have abolished public car parking charges at their hospitals. They have been able to accomplish that in cities that have much larger populations than ours, with larger hospitals and more traffic. We can learn from the systems that those countries have in place and how they regulate parking. Our public hospital car parks are operated under PFI contracts, just as they were in Scotland and Wales. Scotland abolished hospital car parking charges in 2008 and finally settled the remaining PFI schemes in 2021. In Wales, parking at all NHS hospitals is free.

To conclude, I reiterate that my private Member's Bill to make hospital parking free will take a weight off the shoulders of workers, patients and families, put money back into the pockets of workers and incentivise the recruitment and retainment of our Health and Social Care workforce at a time when it faces an unprecedented shortage. Creating better work conditions for workers and showing them that they are valued and easing the burden for patients and their families should be a priority for all of us in the Assembly.

Photo of Colm Gildernew Colm Gildernew Sinn Féin

I welcome the opportunity to make some initial remarks on behalf of the Health Committee, outlining our consideration of the Bill, before speaking as my party's health spokesperson.

As the Bill sponsor has outlined, this is a relatively short Bill of three clauses that essentially inserts a new article 3A into the Health and Medicines (NI) Order 1988, preventing the Department, trusts and other health service bodies from imposing charges for parking for staff, patients and visitors to hospitals. The Committee was briefed by the Bill sponsor on the principles of the Bill at our meeting last Tuesday. The Member provided the Committee with an overview of the need for the Bill and the consultation that had been undertaken. She also outlined that a significant number of health workers have to pay an additional charge of approximately £60 a week to safely park at their place of work. She indicated that the cost can vary between trusts and even within trusts. For example, to park for the day at the City Hospital costs £11, whereas, at the Royal, it costs £5. That is a significant amount for some of our lowest-paid health workers to pay and has resulted in many staff having to park off-site, which has its own health and safety implications. The Member outlined that parking costs for patients and visitors were adding to already difficult situations when the focus should be on getting better. Aisling also outlined the significant impact that parking charges have on rural dwellers who cannot rely on public transport to attend hospital. Finally, she highlighted that charges have already been abolished in Scotland and Wales.

Members asked questions during the briefing, including on the financial impact of the Bill. The Member outlined that the annual cost to trusts would be approximately £8·8 million per year. Members asked how trusts could ensure that free parking would not be abused and become an option for commuters. Members outlined that they wanted to ensure that parking was available to those who needed it most. There was a discussion on the use of technology to ensure that parking is not abused. The Member explained that number plate recognition was used in Scotland, which is something that the Department and trusts could consider. There were also questions about current concessions for free parking in hospitals and whether or, indeed, how they could be expanded to include other patients and visitors.

Providing that it passes Second Stage, the Committee looks forward to engaging with stakeholders and scrutinising the Bill in further detail.

I would now like to make some remarks as Sinn Féin health spokesperson. First, I thank my colleague Aisling Reilly for bringing forward this very important Bill. Car parking charges create inequalities for patients and their families who access hospital facilities. In particular, car parking charges cause inequalities for those from rural communities, who have poor infrastructure and cannot easily access buses or trains. A large part of my constituency is rural, and I know that there are constituents who are in poor health and can ill afford charges, with the impact of reduced income, additional travel and all that flows from that. By way of example, in Brantry, County Tyrone, which is in my district, if you do not get on the blue bus at 8.15 am, you are not getting the bus, and there is one bus home in the evening. That highlights the real inequality for those rural dwellers in certain areas who have a lack of access to public transport. Patients and their families in rural areas of Fermanagh and Tyrone who have to access treatment in Belfast, Derry or Enniskillen have significant additional travel costs in fuel and wear and tear to their cars. Asking those families to then pay exorbitant rates to park their car at a hospital is often a matter of asking them to make hard choices in their family budgeting.

Hospital car parking charges are an unfair tax on our already burdened Health and Social Care workers. At a time when we are working to retain and recruit key front-line healthcare staff, passing the Bill would be a practical indication to them that we support them and will ensure they are not being unfairly taxed. It also needs to be set in the context of the number of weekends over the past month or two that staff have been asked to come in from their leave, to leave their families, to abandon their break and to come in to pull the health service out from pressure. For those people to then be faced with a barrier going in and having to pay for parking is an additional pressure that we should address.

The other thing I want to say clearly is that the abolition of hospital car parking charges must be a stand-alone measure. It can have no impact on negotiations for a pay settlement for the health and social care sector. It is entirely separate from that, and it is important that we send a message from the House that we genuinely value Health and Social Care workers, we will demonstrate that value and we will tackle the inequalities that flow from hospital car parking charges.

Photo of Deborah Erskine Deborah Erskine DUP

I support the progress of the Bill to the next stage. The broad aim of the Bill to alleviate the unnecessary financial burdens facing our NHS staff and patients is one that we absolutely support. However, when it comes to achieving its aim, a number of challenges need to be addressed. We must ensure that the arrangements that follow the Bill are sustainable and avoid the creation of additional pressures or problems elsewhere in our system. We, as a party, want to engage constructively with Members from across the Chamber and with interested stakeholders to ensure that any proposals from the Bill are informed and effectively address the issue without the creation of further problems.

As Members have stated, the disparities in car parking fees between trusts have created regional inequalities for those who face a trip to the hospital. The Bill would ensure an end to those regional inequalities, ensuring that patients and staff, regardless of where they live, receive fair and equitable access. However, we have to be open and honest about our budgets. Have the costings been worked through by the Bill sponsor? The Department could be taking on a cost that has to be taken out of our services elsewhere. In 2018-19, it was reported that the health service hospital car parks in Northern Ireland generated around £7·5 million from charges but the cost of operating the car parks was approximately £8·8 million. That is a difference of £1·3 million. Our health service could be taking on a colossal cost, and I would have reservations about that.

Despite that, I fully accept that ensuring that hospital staff no longer face the burden of the extra cost of car parking is a small but symbolic recognition of the critical work that they undertake every day. Ending car parking fees for visitors would also provide the possibility for the loved ones of a patient who is undergoing cancer treatment or palliative care to spend more time with them without the burden of excessive costs afterwards at such a difficult time. For both those circumstances, the Bill is definitely worthy of consideration.

As was mentioned, Scotland and Wales have already taken steps to abolish hospital car parking charges. Where that has been implemented elsewhere, we need to see its full impact. We need full scrutiny of the differences between the model and regional delivery and how we do business in Northern Ireland. When I look at the delivery model in England, I do not believe that full, blanket, free-for-all car parking is in place; instead, there are differences — for instance, for family members who are gravely ill. On the one hand, the complete abolition of hospital car parking charges would address the complexity of the provision of concessions for the patients who most frequently attend appointments for treatment. However, that could, perhaps, shift the problem elsewhere.

Several points need to be considered in greater detail as the Bill progresses. First, the case for waiving fees for patients and staff is stronger than for doing the same for visitors. There needs to be open discussion of whether the use of financial resources for individuals not in receipt of patient care is the most effective use of public money. As the Bill progresses, we need to establish what impact a universal ban on car parking charges would have on our clinical care budgets on a day-to-day basis. If the scheme would cause a shortfall in maintaining car parking facilities, it must be stipulated that the cost must not be borne from funds allocated to support front-line services. That is critical.

Secondly, the Committee will need to explore the potential for free car parking provision to be exploited by commuters for other purposes, particularly when it comes to hospitals in Belfast city centre and other central locations. Free car parking could have knock-on consequences such as, potentially, the obstruction of emergency vehicles, disruption and impediments to disabled patients and visitors. With universal provision, how the aforementioned problem could be prevented is a problem. Universal free car parking should prevent the creation of any administration costs. However, they may in turn be required to prevent commuters from abusing such a provision and to ensure that patients and visitors can avail themselves of the spaces.

Thirdly, it is possible that the Bill would represent a retrograde step away from encouraging better uptake of public transport and sustainable transport by incentivising car usage with free parking. Does that undermine the Executive's commitment to the environment and to tackling emissions?

I am sure that the House will support the Bill's general aim. However, several concerns need to be addressed through engagement with relevant stakeholders to ensure that the Bill is up to the required standard to ensure a lasting and successful outcome for the people whom it aims to support.

Photo of Colin McGrath Colin McGrath Social Democratic and Labour Party

I welcome the opportunity to speak on the Bill. It is important legislation and, if enacted, will go some way to addressing the major issues that our healthcare staff, in particular, face at present.

The Bill's straightforward principle is to:

"Prohibit the imposition by Health and Social Care hospitals of charges for car parking".

I do not think that anyone would object to that principle.

There may be some issues with translating that principle into practice, but I am sure that they are not insurmountable. There will be an opportunity for us to discuss them in Committee and other ways of finding solutions.

We face two important considerations: how the Bill will impact on and affect staff; and how it will affect visitors. Our healthcare system is in a precarious position. The issues that we face predate the emergence of COVID-19. They stem from the mid-2000s. If we look at our nursing sector in particular, we see that several themes are raising their head. Nurses' pay is low, and their career progression is restricted; however, nursing workload just goes on and on and builds. When I say that, to be clear, I know that trusts are doing their absolute best to meet the needs of our nursing staff. We need to look at how to complement that and support the trusts in their support of staff.

Healthcare staff stood on picket lines from 25 November 2019 to call for an increase in pay and improvement in working conditions. Many Members were proud to stand with them. We can be certain that we were shoulder to shoulder with them there. Many argue that those staff were the impetus for this place to come back after three years.

Unfortunately, we have not seen the pay increase that staff require. At present, I understand, a nurse's starting salary in the North is about £24,000, and the average salary is about £31,000. Given their vast workload, that is not much. Compare that with the UK average salary of £40,000. In the South, it is £35,000. In Luxembourg, which is first in the OECD by that measure, the average salary for a nurse is about £78,000. The recent pay increase of 3%, which was lauded as magnificent, works out as a pay cut in real terms.

We now see that the typical age of staff is approximately 45 to 55. In many days —

Photo of Gerry Carroll Gerry Carroll People Before Profit Alliance

Does the Member share my concern about reports released today that nurses and healthcare workers may be leaving the NHS and going to the private sector because the pay is significantly higher there than it is in National Health Service trusts. Is he concerned about that issue too?

Photo of Colin McGrath Colin McGrath Social Democratic and Labour Party

Yes, and I know that we are rehearsing issues with nurses' pay and conditions that many of us know about. We want to see improvement, because we can see how that directly impacts on the amount of money that nurses have and their ability to pay for things such as car parking that add to the drain on their money.

On any given day, our nurses may have to get their kids up in the morning, get them washed and fed and drive them to school. They then have to travel to work, and, depending on the trust that they work in, they may have to park on-site. In considering the conditions that healthcare staff had to work through during the pandemic, it should be noted that Minister Nichola Mallon led the way by establishing a free parking facility for NHS staff at Crumlin Road Gaol and by providing free public transport for staff.

Looking back at those really awful days last year, however, we see by comparison the position that we are in now. Car parking charges have been reintroduced, and staff are living with the physical, psychological and emotional effects of the pandemic. For some, it has been noted, it has been akin to the symptoms of PTSD. Anything that we —

Photo of Trevor Clarke Trevor Clarke DUP

I thank the Member for giving way. On the point about what Nichola Mallon did, did she continue to allow free transport? What did the Minister do about a better timetable for staff to permit them to use the car parks? Surely that would have been the better form of action, as opposed to encouraging people back to their cars. The Member previously made a point about public transport; surely Minister Mallon could have put on a better timetable for staff to suit them and, indeed, members of the public.

Photo of Colin McGrath Colin McGrath Social Democratic and Labour Party

I thank the Member for his intervention. In a debate in which we are all coming from roughly the same direction, it is great to see that he did not take the option to be divisive and political. Any significant drain on the budget required by Translink and others would require a whole-Executive approach and funding to be made available to the Department. I am sure that the Executive can have that discussion.

Support, however, for the abolition of car parking costs at hospitals should in no way be seen as a substitute for implementing the proper pay increase that is needed. There are some internal trust imbalances, and the Bill sponsor has referenced and highlighted the fact that there are issues in the Belfast Trust. In the South Eastern Trust in my area, there are no costs if you work at the Downe Hospital, but there are costs if you work at the Ulster Hospital. During the pandemic, many staff were relocated from the Downe Hospital to the Ulster Hospital, which meant that, when costs were reintroduced, staff had to pay car parking charges that they would not have had to pay had they been working in their original workplace. Although the Bill will be of great benefit if enacted — I hope that it will help people — there is still much work that needs to be done for our healthcare staff.

I have no doubt that the Bill will be of tremendous benefit to patients and visitors to hospitals. If we look at the period 2016-19, however, we will see that visitors paid almost £13 million to our trusts for car parking. I appreciate that there is a financial cost for operating and maintaining the car parks. The Bill's explanatory and financial memorandum notes:

"In 2018/19 ... the cost of operating the car parks was circa £8.8m".

It would be helpful if we could get some clarity about from where those costs are coming. It would be particularly helpful for the Department to see where it might need to find additional moneys and what it might ask Finance Minister Murphy to provide to help alleviate those costs. Today's report by the Comptroller and Auditor General, however, has shown that we have incorrectly paid out £9 million through the localised restrictions support scheme. If we can claw back some of that money, it will help if that could go to the Department.

The final area on which I seek clarity from the Bill sponsor is how we ensure that the scheme is not abused. Essentially, how will we prevent our hospital car parks from becoming free park-and-ride facilities? Some of them are located very close to town and city centres —

Photo of Colm Gildernew Colm Gildernew Sinn Féin

Will the Member accept that the Bill sponsor has indicated that, in Scotland, number plate recognition is being used to address that issue.

Photo of Colin McGrath Colin McGrath Social Democratic and Labour Party

Absolutely. My notes were written before the speech was made. I am sure that it is something that the Committee will be able to address. It will want to get that type of clarification so that it can get full support for the Bill's progression.

In conclusion, if the past eighteen months have taught us anything, it is that money can be found for essential legislation, and quickly. It can be done. If the political will exists, and given that we are approaching the legislation with the right intentions, there is no reason that the funding for it cannot be found. It would be appreciated if we can get clarity on the points that I have highlighted. I look forward to further scrutinising the Bill in the Health Committee. I wish its sponsor well with its progression. She has certainly hit the ground running since becoming an MLA. I am content to support the Second Stage of the Bill.

Photo of Alan Chambers Alan Chambers UUP

I have sympathy with the concept of the Bill. It is certainly well-intended. I have reservations about some of the suggested logistics for its implementation, however. I know that 97% of the people who responded to the consultation agreed that it was a good idea. It would therefore be a popular idea. I have a lot of sympathy for free car parking for staff. There have been some very well made points about what it costs nurses and healthcare staff, particularly those who are working overtime and are having to fork out to park their car. I have a lot of sympathy for that. Those well-made points will not be lost on the Minister.

It is also critical that we can guarantee that staff who are going to a hospital have a safe car parking space available to them. The thing that worries me a little bit about the Bill is the opportunity for abuse. Hospital car parks could become park-and-rides. That would be completely unacceptable. As I said at the Committee meeting last week, the concept of on-street car parking charging is to guarantee that people will not stay in a car parking space for any longer than they need to. They will go to their high street, go into a shop, spend their money, come out, get into the car and go away, and that opens the space for somebody else to come behind them. In any car parking situation, it is vitally important that there is turnover and that you do not have people taking up spaces for long periods and preventing other people from being able to use the car park.

At the Health Committee meeting, we talked about the various logistical solutions that would be available. I thought that we were a bit light on detail, but no doubt, as the Bill progresses, we will get more meat on the bones, as it were, as to how it could be implemented and how it would work. Number plate recognition was mentioned. We were told that that works very well in Scotland. Maybe they have bigger car parks — I do not know — but those are the sorts of things that we need to look at. We also need to know how much it is going to cost to introduce new logistical schemes and systems.

We also have to explore the unintended consequences of free car parking at our hospitals. There might be consequences for visitors coming to the hospital. They will have to wait for a space due to either intentional or unintentional abuse of the car parking. People who come for an outpatient appointment at the Royal Victoria Hospital or the Ulster Hospital might arrive in what they consider to be good time — maybe 45 minutes or half an hour before their time — but find themselves in a queue with 50 cars in front of them, praying that another car will come out so that one more car can go in and they get closer to the top of the queue. Inevitably, they will end up going into the outpatients department 10 or 15 minutes late, have their blood pressure taken, and it is through the roof. I use the excuse of the white coat syndrome, but maybe there will be a new condition here — car park syndrome — for high blood pressure readings when you eventually get into an outpatient department.

It could also have implications for —

Photo of Colm Gildernew Colm Gildernew Sinn Féin

I recognise the point that the Member is making around capacity. However, does he agree that it is not up to the sponsor of this Bill, necessarily, to deal with the capacity issues, and that, by and large, no one is parked at a hospital unless they need to be there, either by reason of visiting a loved one, receiving treatment or working, so the capacity issue is one for the Department to address? Does he agree that the unfair taxation on workers and those people who have to access the car parks by car is more for the Department?

Photo of Alan Chambers Alan Chambers UUP

Thank you for that. I accept the Member's points.

Free car parking could also have a knock-on effect, albeit it would be an unintended consequence of the Bill, on the routine of clinics. If people are routinely turning up late because of issues around the car parks, that could have an impact on the good working of the clinics.

The other issue that I raised at the Committee meeting, and to which I do not think we have had an answer at this stage, is, if you go into the car park, having applied the day before through the number plate recognition system, or whatever the methodology is, I do not see how there can be a compulsion on you to leave at a particular time. There could be two or three people in the car, with one going to the outpatients department, and when they come out of there, they could say, "It would be a good idea to go down into the city centre and do a bit of shopping, or maybe get a bit of lunch. We'll just leave the car here because it's not costing anything". That is another issue that will need to be addressed as the Bill moves forward.

Another issue that I have not heard any talk about is the fact that, at the moment, trusts may be tied into contractual arrangements with an outside operator who is operating the car parks.

The Minister may be in a position to tell us whether such contracts exist, how long they have left to run and the costs of buying the operator out, if we wanted to move to free car parking; no doubt, there would be a penalty clause. That all adds to the cost of introducing such a scheme. We will tease out all those questions as the Bill moves on to Committee Stage, but, although it is well intentioned, it will require quite a bit of scrutiny to find a scheme that works.

Photo of Paula Bradshaw Paula Bradshaw Alliance 5:00 pm, 22nd November 2021

I thank the Bill sponsor for introducing the Bill. Unfortunately, I was unable to get to the Health Committee meeting, as it clashed with another meeting. I have some queries that, no doubt, I could have asked at that stage, but I look forward to engaging with the Bill sponsor going forward.

As a party, we will support the Bill today, although we have some queries and, I will go so far as to say, difficulties with some of the principles in the Bill, not least because we are debating it in the very week following the conclusion of COP26. We certainly endorse the Member's contention that the financial burden on patients and visitors, who are already physically, psychologically and financially impacted by the experience of ill health, should be reduced and that we should do all that we reasonably can to reduce those burdens. However, more needs to be done to address those issues in a fair and targeted manner, and, indeed, the way in which we achieve that may not necessarily be through legislation. As I said, that does not mean that we oppose the Bill. It means that we think, as others said in their contributions, that more thinking and scrutiny around it is required.

The Bill sponsor is correct to say that there is an element of lottery, given the differentials in charges between trusts and, in the Belfast trust, between hospital sites. It seems very unfair that staff who work in one trust and earn the same wage for the same work may face car parking charges at one location but not another. It is worth emphasising that the nature of health and social care work can be shift-based, thus a public transport system that is based primarily around nine-to-five working may not always present a serious option for them to get to work. That is where the argument arises that car parking charges are something of a tax or levy, charged effectively at random.

It may be noted that car parking charges are not necessarily an effective way to raise income, given their administrative cost. If the purpose was to raise money, other things such as on-site advertising would be considered. We can see, therefore, that charging does not exist for the purposes of significant revenue raising. Although the Bill sponsor did not take my intervention, it was around her mention of having had significant engagement with people who use car parking and the unions who represent them, but I did not get a sense that she had had significant engagement with the trusts about how they manage their estates. The Bill sponsor used the word "creativity" around the matter. There is the potential to raise revenue in other ways, so I wonder whether the Bill sponsor, who I know adopted the Bill, or her party have considered other ways in which the costs could be recouped, as opposed to coming directly out of the trust's pocket.

Ultimately, the question arises about whether the legislation solves the problem or creates others. Mr Chambers indicated some of the problems that, I agree, exist and certainly need to be teased out. First, taking steps towards abolishing car parking charges would be to the advantage of those who have cars, even if it were done in a targeted way, which, in fact, is not what the legislation does. The Bill sponsor's constituency has some of the lowest rates of car ownership in the UK. Those people without access to a car, who are, perhaps in many instances, reliant on taxis to get to and from work, are not helped at all by the legislation and, in effect, end up subsidising those with cars.

Of course, that brings us to the main issue with the legislation: prohibiting fee-paying car parks near hospitals will simply lead to them being used for other purposes. At the Health Committee, I want us to look at the costs of the car licence-plate recognition system and how that would be enforced in law. I know that I am comparing apples to pears, but, when it was introduced in Forestside shopping centre a few years back, many constituents got a penalty notice and wondered whether it was legally enforceable. There are, potentially, lots of headaches for the trusts with people appealing penalties that arise from misuse of the scheme.

It should be emphasised that, in Belfast, the City Hospital is on the railway line, and the Ulster Hospital and the Royal are directly served by Glider halts. A general prohibition on car parking charges could discourage people from using public transport alternatives, even when they can. In the case of those with no access to cars, that must run contrary to Executive policy; someone from the DUP Benches mentioned that earlier. I have no doubt that my colleague John Blair will pick up on that.

The other issue is that the Bill does not demonstrate any clear evidence that all options have been considered. It looks like the options are either do nothing or total abolition. I wonder whether the Bill sponsor looked at abolishing charges just for workers and not for visitors. That said, I have spoken publicly about my father's experience when my mum was in the last months of her life. He was going up twice a day to bring soup, clean pyjamas and whatever; in some ways, he was almost like an unofficial carer, taking the burden off the staff. He had to pay the cost of car parking twice a day, which he did not mind, because he was in a position to do that. However, I recognise that, where people have to stay in hospital for a long time, the charges can mount up for their relatives.

Fundamentally, the issue is about whether legislation should be used to dictate how trusts, with funding from the Department of Health, manage their estate. That is where we have a bit of difficulty with the proposal being in legislation as opposed to policy. We are concerned about unintended consequences, the unclear financial impact, including the potential, in practice, for poorer workers to be subsidising better-off workers, and the anti-environment impact of the Bill as it stands. Those concerns show clearly that the Bill needs a good bit of work. If legislation in this area, such as it is, is to be supported, it must not remove the flexibility of the Department and the trusts to manage their estates as they see fit, and it must focus on the actual issue. I will leave it there.

Photo of Jemma Dolan Jemma Dolan Sinn Féin

I welcome the opportunity to speak on Bill, and I congratulate the sponsor, Aisling Reilly, for taking it forward. It is an issue that may affect some of us more than others but it will affect all of us at some point. We all have many constituents who, unfortunately, have to attend hospital frequently and who know only too well that car parking is very costly. For example, on average, cancer patients make 60 trips to hospital from initial diagnosis through to treatment and follow-up consultations. For patients and their family members, those charges place unnecessary stress on people who are in ill health.

Looking at the issue from a worker's perspective, removing parking charges will reduce the financial burden on hospital workers, many of whom are underpaid for the work that they do as it is. Parking charges at hospitals are an unfair tax on workers; it is an unacceptable situation that needs to change. According to the RCN, some nurses are paying up to £18 a day for parking at hospital facilities in Belfast. As has been said, there are considerable inequalities and inconsistencies in charging rates across the North.

The offer of free parking during the pandemic proved that it can be done. When the Health Minister, Robin Swann, made the announcement that free parking was coming to an end, he said:

"Due to the challenging financial situation facing the health service at this time it was simply not possible to continue to provide free car parking".

Surely if the staff who were receiving the free parking are struggling to pay for their parking, the health service would not be able to function. Upon that announcement, Dolores McCormick, the associate director of the RCN in the North, said that nursing staff would be:

"deeply disappointed at the reinstatement of car parking charges across health care trusts ... this will do nothing to improve morale or retain staff."

As has been said, with the crisis that our healthcare system already faces, we need incentives for staff, not barriers. The abolition of car parking fees at all hospitals would also address another deep inequality between the experiences of rural and urban patients, due to the lack of available and efficient public transport in rural areas. For rural patients who are attending an appointment, usually in a hospital in an urban setting, costs include running a vehicle, in addition to hospital car parking charges. To use my constituency as an example, the South West Acute Hospital is on the outskirts of Enniskillen and, even for Enniskillen workers and patients, getting there involves at least one bus journey. For someone coming from my home area of Belleek and Garrison and surrounding areas, getting public transport simply is not an option.

At the weekend, I was talking to one of my constituents whose little boy requires a lot of hospital appointments due to his medical condition. The doctors in the local hospital cannot treat him. Therefore, he is being treated between the Royal and Altnagelvin. She lives 65 miles from Altnagelvin Area Hospital and 92 miles from the Royal. She told me that 20 minutes in Altnagelvin car park last week cost her £1. She reckons that car parking charges at hospitals are higher than at shopping centres. She said that, between fuel and car parking, it really was brutal, and that was on top of the worry about her little boy's condition.

Abolishing hospital parking charges will promote equality of access for rural patients and workers. A major concession that those of us who work in the Assembly enjoy is free car parking. It is only appropriate that those who use hospital car parks enjoy the same concession. Charities such as Macmillan have called for the end of hospital car parking charges, calling them morally wrong. Therefore, I ask you all to support the Bill.

Photo of Harry Harvey Harry Harvey DUP

First, let me be absolutely clear: we share the same common purpose as the Bill sponsor, that being to alleviate the cost for those who work day after day in the health service and for those who, in the midst of illness and requiring the health service, also face hospital car parking costs when attending for care. That is a commendable objective. We do need to support staff. My goodness, after the 18 months that they have endured, they deserve absolutely everything that we can possibly do to support them. For those visiting hospitals or other care sites, we want no obstacle — certainly not a financial one — to their attendance and receipt of the care that they need.

We look at the Bill and say, "Yes, we support the objective, but do also look at the Bill". As it is right to do with any Bill that has such financial implications for the public purse, we have to ask ourselves whether this is the best approach. If it is feasible, what are the unintended consequences of the Bill's admirable aims?

I want a fair system, and the current system is unfair. We have disparity in costs between sites, with someone in Ards paying a different fee from someone in Armagh or Antrim. That is wrong. After all, the health service is about equal access to healthcare. The Bill would streamline arrangements across the board and ensure that patients and staff, regardless of where they lived, the distance they travelled, the nature of their illness or the length of shift, received fair and equitable access.

This party recognises the need for reform. We regret that free parking offered to healthcare staff at the start of the pandemic was withdrawn by the Minister. That was premature and, at a time of such pressure, exhaustion and self-sacrifice by staff, sent the wrong message. Nurses and others on the front line look at car park charging policy and say that it would mean a lot if parking was free. It would be a gesture that reflects our gratitude to them. We should be looking at that. It would be a timely boost to terms and conditions and an added incentive to attract more people into the service. Let us not forget that our cars are parked outside this Building free of charge, so why should a nurse pay while on a 12-hour shift of mayhem?

We need to consider the service user, too: the patient and, indeed, their loved ones. Do the concessions that we already offer go far enough and include the right people? Might a better approach be to look again at the concessions available and seek to increase them, rather than lose all the revenue garnered through charging some users?

I believe that we need to do much more research into the impact that these charges could have, and we should look at an options paper that considers possibly listing a range of free users and those who would continue to pay. We need to see how that would work in practice and look into the administration of such a scheme while being cognisant of its cost burden. Certainly, the case for staff and chronic care patients is much more robust than that for irregular users and occasional visitors.

Of course, behind those questions lies this one big question: what is the impact of losing that revenue stream from the services provided by our health service? We cannot ignore the fact that while our desire is zero cost, zero cost does not come with zero impact on income and zero impact on how that income is then spent on delivering care. We need to establish how a blanket ban on charging would impact on clinical care budgets on a day-to-day basis. At the very least, there needs to be a stipulation that any shortfall in funds for maintaining free parking facilities cannot be made up from funds allocated to front-line services. The Committee might wish to explore that during its deliberations on the Bill.

I suspect that another consideration that may need attention is how hospital car parking, if free, would be policed. In many towns, HSC sites are in locations that are tempting for shoppers or commuters, with many car parking sites under capacity pressures. Their use would only exacerbate the problem. We need answers about how that would be managed in order to ensure that the generosity offered to staff, patients and families will not be abused. Furthermore, as we seek to entice more people out of the car and on to public transport, it may be counterproductive for how we green that journey to the hospital.

I will conclude my remarks. I trust that we can tease out some of the issues further in consultation with staff and all other stakeholders. Our ambition through the Bill is to have fairness for all users of the health service, but we need to look more closely at how that is best delivered and protect our services. As we transform our healthcare, the conversation can be had across a range of services. We are up for that debate, and we hope the Minister can lead the debate sooner rather than later in order to bring about the changes that are so badly needed.

Photo of Liz Kimmins Liz Kimmins Sinn Féin 5:15 pm, 22nd November 2021

I thank my colleague Aisling Reilly for bringing forward this important Bill today, and I commend her for her work on it. I also commend Fra McCann for his work on it previously.

As others have said, every Member has publicly commended, and rightly so, the fantastic health and social care staff we have working across the North in our health service, yet many of those staff are having to pay a fee in the form of car park charges to enable them to carry out the invaluable roles of caring for patients and saving lives in our hospitals. As others have pointed out, we would be having a very different conversation if we were talking about the implementation of charges on car parks outside this Building. By the same token, patients and their families, particularly those who have to make frequent visits to hospital, are faced with huge parking costs, which mount when accessing that hospital care.

I know that some Members have expressed concerns about the cost of removing car parking charges at hospitals, but the reality is that it is an unnecessary tax on healthcare workers and a disincentive for recruiting and retaining staff. Putting money back into the pockets of our workers will go some way to make staff feel valued and encourage them to want to work in our health service.

(Mr Speaker in the Chair)

In an ideal world, as many have said, public transport networks would enable the majority of staff, patients and families to travel to and from hospitals with ease. However, that is not the reality. Our infrastructure is not adequate, and many people have no option but to travel by private car. Daisy Hill Hospital in my constituency of Newry and Armagh serves a significant rural area across south Armagh, south Down and, indeed, serves cross-border patients and workers from nearby Louth and Monaghan. The vast majority of patients and staff travelling from those rural communities will have no choice but to do so by private car and are essentially penalised for doing so. Workers who are working long shifts saving lives and providing essential care for us and our loved ones should not be faced with additional costs. Patients who travel for cancer treatment, dialysis or other regular medical treatments, or their families who assist them and provide much-needed support during their illness, should not have to pay for car parking.

Like many in the House, I have close family members who, unfortunately, have had to go through extensive cancer treatments, spending months on end visiting hospitals and in hospital, which has a massive impact on household income for the patient and, in many cases, their spouse, who has to take a lot of time off work while faced with additional car parking costs every day over long periods. At a stressful and anxious time for many patients and their families, we should do all that we can to alleviate additional pressures. Having to worry about the financial implications of being sick should not be a factor for anyone.

Another issue in my area is car parking outside hospitals, which impacts on local residents as staff, patients and families have to park in nearby residential areas because they simply cannot pay the costs incurred in the car parks. We also need to take the impact on nearby local communities into account.

It would be remiss of me not to mention the fantastic home to hospital service provided by Bolster Community in Newry. It is a volunteer-led service that brings patients from rural areas across Slieve Gullion and the Mournes to hospital appointments because of the barriers faced in accessing hospital care from rural areas. I know at first hand of the huge benefits of this service. However, it is a limited resource, and, if anything, it identifies the crucial need for better connectivity to our hospitals, which requires significant investment and longer-term planning.

The Bill presents a real opportunity to support our health and social care staff in hospitals, making them feel valued, and to support patients and families during some of the most difficult times of their lives. I encourage all Members to support the Bill throughout each stage.

Photo of Trevor Clarke Trevor Clarke DUP

When it is this late in the debate, it is hard to say something that other Members have not said. I support my colleagues' contributions, which indicate that our party supports the principles of the Bill. However, we have reservations.

Hospital car parking charges have been in existence for a long number of years now, and I was concerned when they were introduced. However, the Chair of the Committee responded to Mr Chambers by saying, basically, to disregard the consequences and let someone else pick up the bill. Mr Chambers was teasing out some of the issues, which is what Members are supposed to do. It was disappointing to hear him closed down by the suggestion that the House should decide what it will do and someone else will foot the bill. That is reckless. One could be forgiven for suggesting that we are a few months away from an election and that this is a popular thing to do at this time.

Photo of Trevor Clarke Trevor Clarke DUP

I will indeed.

Photo of Colm Gildernew Colm Gildernew Sinn Féin

My intervention was not about that; it was about capacity. The suggestion was that charging might be used to manage capacity rather than developing the necessary capacity.

Photo of Trevor Clarke Trevor Clarke DUP

I understood the intervention differently from the way in which it is now being explained.

As a representative of the Antrim area, I remember when hospital car parking charges came in. At the time, I thought that excuses — I described them as such — were being made for the introduction of charges. It was said that people were using hospital car parks as long-stay car parks in order to commute to work or for any number of reasons. However, I have to say that, when charges came in, we went from having to park almost at the roundabout near the hospital to parking in the car park. The car parking charges met their intended purpose: they helped those going to the hospital to help their loved ones.

I have the greatest sympathy for the staff. I do not believe that they should ever have to pay. However, I enjoyed Mr Chambers's contribution, and, as he said, we have to look at all the consequences. Ms Bradshaw made the same points. What are the consequences? Where does the money come from? How do we fund it, and what do we end up with afterwards? Those issues greatly concern me.

I have the greatest respect for the staff, and I do not believe that they should ever have had to pay. However, if you make the car park free for staff, there is another consequence. Will the public car park and the staff car park be free? There was a time in Antrim when many staff parked in the front car park and the back car park was left unused, narrowing the window of opportunity for people who had only a limited time to see their loved ones. That was at a time when you could visit people in hospital. Those who were late, rushing in at the last minute for an appointment, could not get those car parking spaces.

Whatever is done on this and whatever the Committee agrees and brings back to the Assembly, I have the greatest respect and sympathy for the staff. It would be easier for the Committee, as it takes forward its deliberations, to provide free car parking for staff, but I do not know, and I stand to be convinced, how we can have an entirely free system. As a regular user of hospital services, I baulk at the thought of going in to see a consultant and paying £1·00 when I come out. However, I pay it, because I know that I can park conveniently to the hospital, I can get in and out, and it costs £1 or £1·50.

We have to be very careful of the consequences of these decisions. Without teasing out all of those consequences between now and the Bill's next stage, we run the risk of bringing in very bad legislation, because it is ill-thought-out legislation. Indeed, take the Chairperson's point: infrastructure comes at a cost, but who will pay for it?

It is also interesting to note that the Bill sponsor's party leader in the House was the Minister of Health, but she never thought of bringing forward such a proposal in her time. Maybe, when the current Minister of Health speaks, he can indicate whether the suggestion of removing hospital car parking charges was brought to the Executive previously. I look forward to his contribution.

As I said, we support the Bill's principle, and we will certainly not stand in the way of its going to the next stage. We have the greatest respect for the staff and think that something should be done for them, but we need to be very careful about how we take this forward.

Photo of Pádraig Delargy Pádraig Delargy Sinn Féin

I thank my colleague Aisling Reilly for sponsoring the Bill. Of course, I also acknowledge the brilliant work that Fra McCann did to bring it to the Assembly.

As a representative of Derry, I often meet health and social care workers from Altnagelvin Hospital. A lot of my friends and relatives are junior doctors or nurses in the hospital and across the city. I know that workers in the sector are exhausted, drained and have very low morale.

The Bill, which will abolish hospital car parking charges, is for everyone. It is one of a list of Bills that my party will bring to the Assembly to address the challenges that our constituents face each and every day. One of the Bills that I am sponsoring and that I will bring to the Assembly in the coming weeks is about the disconnect that workers should have from their workplace. Gemma Dolan will sponsor a Bill on zero-hours contracts. We are committed to making a real change in people's lives, to bringing Bills to the Assembly that protect workers and families, and to continuing to work for the betterment of people across our society. What those Bills have in common is a desire to put money back into the pockets of our workers, particularly those who went above and beyond throughout the COVID pandemic.

I have constituents who travel to Belfast and other centres for healthcare each and every day. This week, I was in contact with a few constituents who travel up to see relatives and loved ones in hospital many times a week. Hospital car parking charges come on top of the burden of the price of accommodation and the cost of petrol to get up and down the road. It is yet another cost for them when they get to the hospital.

Finally, with the unprecedented workforce pressures that we face, we need to be creative about how we attract and retain workers in our healthcare sector. Retaining experienced workers with the skills and knowledge that they have developed over the years is vital in attracting young people and making sure that not-so-young people can become nurses, doctors, specialists and so forth. It is as important now as it will be in the years to come as we rebuild our workforce. We have a better chance to recruit and retain workers who are well paid and have good working conditions.

Abolishing hospital car parking charges will have a significant impact on people's lives, for the better. That is why I support the Bill.

Photo of John Blair John Blair Alliance 5:30 pm, 22nd November 2021

I have no intention of hindering the Bill's progression to Committee Stage. From the outset, however, I want to outline my concerns at some of its principles. Those concerns are in common with those expressed often in the Chamber when we discuss climate challenges. I address them for every service and sector, and, to be honest, I express them not to be popular but to be consistent, in the light of what I have just said about climate challenges.

Like previous Members to speak, I acknowledge the huge contribution made by our NHS workers to all our lives, not only in recent, COVID times but at all times. There is, however, a wider conversation to be had on free parking and how it conflicts with efforts to reduce the use of the car. It is as simple as that. It is a conversation that we have to have.

I fear that steps towards abolishing car parking charges, as outlined in the Bill, would promote driving and discourage public transport use. Free parking comes at a price, and it is a high environmental cost. Transport has become the largest contributor to UK greenhouse gas emissions, contributing 28% of UK domestic emissions in 2018. Locally, transport accounts for 35% of all consumed energy in Northern Ireland and 23% of all greenhouse gas emissions. It has to be said that the majority of that comes from private car use as a result of chronic underinvestment in public transport over the years, which has created a highly car-dependent society in Northern Ireland, where over 70% of all journeys are made by motor car. If we are serious about a green recovery, and I hope that we are, Northern Ireland must contribute to UK commitments and move to decarbonise our transport sector. Significant infrastructure investment will be vital in the transition to a clean, sustainable transport system that works for everyone.

Parking has an incredibly powerful impact — we have seen it illustrated today — on people's decisions on whether to drive. Studies have found that underpriced or free parking encourages people to drive, even in areas where there are good alternative transport options. That, in turn, leads to increased congestion and pollution. It could therefore be suggested that a general prohibition on car parking charges at hospitals would discourage people from accessing public transport links to them. The Belfast City Hospital is on a railway line. The Ulster Hospital and the Royal Group of Hospitals are on the same Glider route. In my constituency, the Antrim Area Hospital is serviced by Goldline Express and Ulsterbus, as well as being within walking distance, albeit not a short walk, from the local rail station. I should, however, point out, and I accept, that there are challenges for workers under the current systems. Not all shift patterns at my local hospital are adequately serviced by public transport. That is one of the examples of the new thinking, coordination and forward planning needed.

The debate on actions required to tackle climate challenges is not limited to the health sector. Rather, it is relevant to all areas of public service and all sectors. The debate needs to be for every service, every car park and every associated public transport route. Rather than subsidising free car parking and creating an excess, we should be moving towards investment in our public transport links and making systemic changes to the way in which we get around, in order to curb carbon emissions in line with net zero commitments. As the time that we have left to limit the impact of the climate crisis effectively dwindles, every ton of greenhouse gas that we do not emit counts, and counts seriously.

I am, along with Alliance colleagues, happy that the Bill proceed to the next stage. I sincerely hope, however, that those global issues will be considered alongside local issues as we try to protect our planet in the reviews and debates ahead. Processes should, in every way, be interdepartmental and joined up.

Photo of Carál Ní Chuilín Carál Ní Chuilín Sinn Féin

Ar dtús, ba mhaith liom mo bhuíochas a ghabháil le hAisling agus le Fra as ucht an Bhille. I thank Aisling and Fra McCann for bringing forward the Bill.

None of us pays for car parking here. Anyone who works on this estate does not pay, in old money, a sprasey for using the car park, so the idea of poor or really sick people paying for infrastructure, although the infrastructure needs to be considered, is slightly bizarre. Not one red cent do we pay for the privilege of coming to work, and we are very well paid. I have to say that I baulk at the idea. I understand some of the concerns that Members have raised; they are valid. That is what you do when you debate legislation. Some Members, however, are dancing on the head of a pin. They talk about the impact of climate change, yet they drive here to work and do not pay a penny for the car park.

Anyway, I will go through some of the other issues. The Bill has three clauses. Aisling and Catherine came in front of the Committee last Tuesday. I thought that some of the questions that were asked were really reasonable, because they are the questions that we are all going to be asked. Again, I am sure that Aisling will take away some of the comments made at Second Stage and provide answers where she can. There is probably some heavy lifting for the Department and the Minister's officials to do in scoping out the potential cost. I imagine that the five trusts will, equally, put out an estimated cost of either running down or buying out a PFI and what their infrastructure will look like. I also think that the trusts will do as much as they can to support the workers and the families who use their services.

I live right beside the Mater. I do not know anybody who would go near the Antrim Road, the Crumlin Road or Clifton Street around visiting time, let alone abuse the car park — I am just saying that — even at £1. Even if the car park was free, they would not go near those roads. It is absolute bedlam. Unfortunately, when people are looking to park to go into town, they park in constituencies like mine, rather than going near the hospital. I want to put that on the record. It is the same for the Royal. Anybody who goes to the Royal, or any hospital, does so because they have to. I do not know anybody who would go to a hospital for the craic, to sit in the car park and read the paper or drink a coffee. No one goes to a hospital unless they need to. Even though visiting has been reduced because of the pandemic, with health and social care staff saying that there has been a noticeable difference, there are still queues into the car parks, particularly at the big regional hospitals like the Royal and the City, which has the cancer centre. The City car park is £11 a day. That is where you will see a big difference for people in terms of the money in their pocket. I honestly do not think that it will be abused, based on the experience at the minute. We have to get more detail on the Welsh and Scottish examples to try to allay some of the fears. From my experience living beside the Mater Hospital, I do not think that anybody would throw their car in the car park to dander into town. It just does not happen, as far as I am aware. If it ever did, you would be talking about 0·01%, because the traffic in the area is that bad.

I want to make a distinction. Macmillan and others have been saying this for a long time. They were saying this about car parking charges when we were suspended. Unfortunately, this place only lasted for, I think, eight months before it was suspended, so the honest answer is that I do not know whether Michelle O'Neill was ever going to bring it forward, but I know that Fra McCann was determined to try to do it. When Fra himself became ill, he spoke to many people in the hospital and their families, and none of whom were local to Belfast. They came from everywhere. If any of us were ever on Zoom with the Health Committee, we saw Janette, Fra's wife, who is a constant feeder. Fra would invite people to his home to feed them — Alec knows him well — simply because of the costs that some families were facing in travelling in for specialised treatment, particularly for cancer, as well as for blood treatments that they needed that are not exempt at the minute. It is a really big burden on people.

We need to make a difference for health and social care workers. This is not to supplement the 3%. It is not about that. We need to make that clear. The calculation on the 3% is probably around an additional £45 a month. In her opening comments, Aisling said that — I think that this was from RCN — some are paying £18 a day and that, for some health and social care staff, that could amount to £60 a week. That is what we are talking about here, and it is a lot of money. It really is a lot of money. I mean this sincerely: God help anyone, let alone their family, who has had to go to a hospital daily and pay for the car parking. By the time they travel in, particularly from Derry or Fermanagh or whatever it is, there is a cost. When someone is unwell and there is a lot of uncertainty around their life, the last thing that people need to be worrying about is money to pay for car parking charges.

Yes, there are consequences for us all. We need to look at better infrastructure so that we can have better park-and-ride facilities. We need to have lots of things to get us from one point to another in our lives, whether we are going to hospital, work, school or wherever else. This policy has worked well in other areas with far bigger populations than ours, and, while I am hearing that most Members will not oppose the Bill at this stage, they reserve that prerogative for a later stage. Again, that is legislation. It is really, really important, after all that our health and social care staff and, indeed, their families have been through, and what visitors have been through, particularly in this pandemic, that we factor that in.

We also need to factor in the differences between car parking at the RVH, the Mater and the City in Belfast and car parking at hospitals in other trusts. I imagine that that is down to PFI arrangements, which I believe are wrong anyway. Financing using PFI and PPP for what should be essential public services needs to be examined.

Having come out of COP26, I am not being flippant about climate change, but people who do not have a car are going to rely on public transport. If we do not have enough public transport, we are back to somebody stepping up to give a lift to somebody who is ill. That is what families do, particularly families living in rural communities. Colm outlined that, if you are not on the 8.15 am bus in the Brantry, you do not go anywhere. I am lucky enough to live on the doorstep of the city centre, but I know what it is like from talking to other people through the course of life. I know that it costs them £30 to get up the road, before they even put money in the meter for the car park, and that is before they even buy a sandwich. These are real things for health and social care workers who are getting called in by trusts as we go through this surge and into a deepening crisis with health. We are calling staff in and asking them to forgo their time with their family at the weekend, and a lot of them have done it. We are also asking them to pay for the privilege. This is like an additional tax. It is like a stealth tax on health and social care staff, and I do not believe that anybody in this House could support that.

I pay tribute to Aisling for stepping in. I was going to say that she has stepped into Fra's shoes, but you cannot. In a matter of weeks, she has stepped in to sponsor a Bill. Deborah has joined the Committee, and she has been hit with a raft of legislation. One of the good things about the Health Committee is that, even when members disagree, we always try to get a good approach and a good outcome. I believe that people want us to deliver good outcomes — that is what legislation is about — and health and social care workers and their families deserve nothing less.

Photo of John O'Dowd John O'Dowd Sinn Féin

Apologies to the Bill sponsor and others who have contributed to the Bill that I have not been in the Chamber throughout the debate. I commend Aisling for stepping forward and taking this Bill forward. Anybody who deals with legislation knows what an onerous task it is. I had to mention Fra because if I had not, he would remind me of that. So, I have mentioned his name. Well done, Fra.

The principles of the Bill have to examined. I was listening to Trevor when I came into the Chamber, and it is quite right that Members will scrutinise and ask questions about the Bill as it goes through Committee and the various stages. That is what the scrutiny phase is for. Members should seek to find any unintended consequences of this Bill, but I do not think that anybody can argue against the point that healthcare workers should not be paying for parking at their place of employment to go in and deliver healthcare.

When I look at Craigavon Area Hospital and the widespread catchment area, not only for patients but the staff who work at that hospital, I can see that public transport is not an option.

Colm mentioned the Brantry: people travel from the Brantry not only to seek care in Craigavon Area Hospital but to work there, and public transport is not an option for them. For constituents in Upper Bann — from Banbridge, Derrymacash, Derrytrasna, Lawrencetown or Gilford — public transport is not an option at many hours of the day, so those workers and patients have to drive to the hospital. If I succeed in my campaign to get a rail halt built in the centre of Craigavon, maybe that will assist many people to travel to the area by train. At the moment, however, driving is the only option available to them. When they get there, should they be charged? They should not.

No one will park at Craigavon Area Hospital to do their shopping. There are a few local shops round there and I commend those local shops, but nobody will travel to Craigavon Area Hospital, park up and leave the car there to go into Portadown, Lurgan or Rushmere to do their shopping. That is just not feasible or practical. It is difficult enough to get a parking space at Craigavon Area Hospital when you pay for it. I do not think that there will be a widespread rush to park at Craigavon Area Hospital if you do not have to pay. Those concerns need to be examined by the Committee, but I do not think —

Photo of Trevor Clarke Trevor Clarke DUP

I accept the Member's point about Craigavon, but the legislation is uniform in the way that it is framed. What happens in Craigavon will be different from what happens at Antrim. Antrim Area Hospital is right on the edge of the M2. Given its convenience for the M2, the consequence there will be entirely different from the consequence at Craigavon. Does the Member accept that there is disparity from site to site?

Photo of John O'Dowd John O'Dowd Sinn Féin

As I said, Trevor, it is only right and proper that the issues are raised and that the Committee examines them. From some of the information that I have at hand, I know that Scotland and Wales, which have introduced free car parking, do not see the system being abused at their hospitals. If the Bill passes through all its stages, the Department will have to look at that to ensure that the system is not abused. I hope and trust that the general public will not abuse it.

I do not intend to speak for too long about the matter, other than to say that I support the principles of the Bill. It has a worthy purpose, particularly in supporting our healthcare workers. Carál mentioned some of the costs involved for parking, and they are just not acceptable. In this day and age, it is just not acceptable to charge healthcare workers those rates to park at the site of their work, particularly given the hours and unsociable hours that many of them work.

I commend the sponsor of the Bill. I hope that the Bill gets through to Committee Stage, and I look forward to the Committee examining it in greater detail.

Photo of Gerry Carroll Gerry Carroll People Before Profit Alliance

I say "Fáilte romhat" to the Member. I know that she has been here for a while, but I have not been in direct debate with her. I wish her well in her role as an MLA.

I welcome the legislation. We in People Before Profit have been calling for this since before the pandemic. With the added toll on health workers during the pandemic, however, there is even more reason to remove hospital car parking charges. The Minister should never have attempted to reintroduce those charges, especially not before the pandemic was over. I hope that we can see them scrapped for good.

I will put car parking charges in the wider context. Health workers and their unions are demanding a fair pay offer. What they have been offered is, effectively, a slap in the face after the work that they have done over the past two years. Again, the Minister should never have gone along with that and the disrespect that it represents. I recently tabled a proposal to the Health Committee to reject that offer in favour of a better one. Shamefully, that proposal did not get the support of other parties.

From A&E to ICU to GP offices and beyond, our health staff work under immense pressure. The pandemic has intensified that pressure, but underfunding, low pay, privatisation and a failure to bolster staffing levels over 10 years are at the heart of the conditions that our health workers face. In essence, the neoliberal agenda at Stormont and across the water at Westminster means that the Executive spend £1 million per day on PFI and public-private partnership (PPP) schemes. Moreover, with fuel price hikes and absolutely no action from the Executive to protect people, thousands on low pay in our health service will be hit hard. Many of those workers rely on the welfare system when they should not have to. Every time the welfare system is cut back by the Tories or the Executive, those workers suffer again. That constitutes a litany of attacks on health workers, and those on the lowest pay will be the hardest hit. It is an added affront that they are also expected to pay into NHS car parks just to get into work. This — clear and simple — is a cut against wages. Of course, it is also an unnecessary burden for those who are ill or visiting sick relatives. For those who can afford to pay it, it may seem like a small burden, but, for many who are looking down the barrel of one of the hardest winters in years, it is a financial burden that they should not have to face. I support the Bill; it would put that right. Moreover, we would like to see public transport for hospital workers being written in to law instead of being offered temporarily. As Members have said, many healthcare staff cannot travel to work via public transport, which is a failing of the Executive, not those workers. Workers who are able to use public transport should be encouraged to make that choice.

I have a final question for the Member who is sponsoring the legislation. The Bill is, obviously, clear in stating that it prevents the Department, health and social care trusts and other health service bodies from imposing charges for car parking by workers, patients and visitors to hospitals. Does the Member know whether any private organisations are imposing charges at car parks in any health service facilities across the North? If so, would that be allowed to continue if the Bill were passed? I would appreciate an answer on that, if not today then maybe in writing.

Photo of Alex Maskey Alex Maskey Sinn Féin

I call the Minister of Health, Robin Swann. The Minister has up to 15 minutes to respond.

Photo of Robin Swann Robin Swann UUP

I congratulate Miss Reilly on her willingness, as a new Member, to take on the difficult task of sponsoring a private Member's Bill. Legislation is no easy responsibility — nor is following Fra McCann, as, I am sure, she is well aware — but it is what the House does best.

The current policy — as Ms Bradshaw pointed out, it is policy, not legislation — on car parking provision and management in the Health and Social Care sector was published in 2012 and has not been amended since. It sets the direction for car park management, including charging. The policy states that it is for each health and social care trust to determine the way in which the car parking policy is applied to each of its sites to enable it to take account of local issues. That is why the picture varies across Northern Ireland. It is only the Belfast Trust and the South Eastern Trust that charge staff for parking: the Northern Trust, the Southern Trust and the Western Trust currently do not routinely charge staff for car parking. However, there are voluntary pay schemes in the Northern Trust and the Southern Trust, and some staff have chosen to pay £30 a month for a designated car parking space. I appreciate that that variability can, at times, be a source of frustration for staff and patients, but it is important to clarify that.

While I do not for one moment doubt the good intentions behind Mr McCann and, now, Miss Reilly's Bill, we need to ensure that, during its consideration, all factors and possible consequences of any decisions are carefully reflected. Legislation should not be developed or delivered in isolation and without considering further implications. For instance, charging for car parking in hospital sites where physical space is limited has been utilised as an effective mechanism in encouraging turnover in the use of spaces, which, in turn, helps to ensure that parking is available for patients and visitors. I look to the Royal Victoria Hospital in the Member's constituency as an illustration of that. While I fully recognise the current parking pressures at the Royal, the situation would possibly be even worse if the existing parking were free.

I note the Chair of the Health Committee's comments about the development of infrastructure being the responsibility of the Department. Given the capital spend pressures that are currently on the Department and are devolved to the trusts, I know where I would rather concentrate capital spend, rather than building more car parks. We have a large sustained underinvestment in the capital infrastructure of our hospitals and the equipment that we could be developing and using.

The policy on car parking provision and management includes the criteria for the provision of free and concessionary parking for patients on a particular care path, such as cancer. In addition, our health and social care trusts can exercise discretion to apply the eligibility criteria in other situations where the duration and/or frequency of visits leads to significant charges being incurred by patients or their relatives.

That includes a patient who has a number of outpatient appointments over an extended period; a patient who may benefit from lengthy or frequent visits from relatives or friends in order to help them adjust to a new environment; a patient who falls outside the prescribed treatment categories, who has to make lengthy and/or frequent visits for treatment; or someone who attends in a voluntary capacity, for example, as a blood donor or as a member of the volunteer driver service for patients. People in those circumstances should fall within the free car parking eligibility criteria.

All trusts have advised that they have the above free and concessionary plans for parking in place. The hospital travel cost scheme helps people who are on low incomes or income-based benefits and who may be able to reclaim car parking charges or other travel expenses for hospital treatment. Another point to keep under consideration as the Bill takes its further steps is that, if universal free car parking is provided for patients, visitors and staff, the full cost of running the hospital car parks will have to come from the Health budget. Whilst car parking charges should not be considered to be a revenue-raising tool, they generate around £9 million per year, which is then reinvested into the maintenance and security of our car parks. If that money does not come from charging, it will have to come from elsewhere in the budget. Has the Bill sponsor considered where the money would come from? Reference was made to the removal of car parking charges in the last financial year due to COVID, but I utilised COVID support moneys in order to do that.

Photo of Alex Maskey Alex Maskey Sinn Féin

I will just interrupt the Minister for a moment. As the business on the Order Paper is not expected to be disposed of by 6.00 pm, in accordance with Standing Order 10(3), I will allow business to continue until 7.00 pm or until it has been completed. I thank the Minister for taking that interruption.

Photo of Robin Swann Robin Swann UUP

No problem. Thank you, Mr Speaker.

The Bill raises a number of reasonable questions, which have been articulated in the Chamber. I welcome the Bill sponsor and the Committee being given the opportunity to engage further with my Department and the trusts directly on the possible environmental and financial implications that the Bill may bring as unintended consequences.

Photo of Aisling Reilly Aisling Reilly Sinn Féin

I thank all my Assembly colleagues for their contributions and remarks on my Bill. I extend a comhghairdeas mór to Gerry, who became a daddy in the past couple of weeks. I also welcome Deborah. I know that we spoke at the Health Committee, but I want to welcome you.

The debate has created great dialogue, and issues were raised that I will certainly take away and look into, because we want to make the Bill work. I have an extensive list here, and I want to touch on some of the concerns that people raised. If there is anything that people need further information on, I am happy to iron any issues out in the coming days and weeks.

Most Members raised the possibility of the abuse of free car parking. We need to remember that workers, patients and families are going to the hospital because they have to and need to, whether it is to go to work for a gruelling shift, to access emergency care, to attend a follow-up appointment or to visit a loved one. As Carál touched on, it is very unlikely that people are heading to hospital for a day out, to meet friends, to have a coffee or to read the paper. I certainly do not know any constituents of mine who do that. Their main objective is to get into work or to get in and out as fast as they can, either for treatment or an appointment.

During my engagement with Unite, I was informed that staff have passes to get in and out of departments and to access wards, so with political will and some creativity, car parking can maybe be accessed in a similar way. We can also look at how Scotland and Wales regulate their free car parking. It was mentioned that they use automated car registration technology, which is one avenue that could be explored. I have been looking for evidence that car parking abuse is a problem in Scotland and Wales, but I have not found any to date, which is remarkable considering that their cities are much larger than ours.

The possibility of increased environmental congestion and climate concerns was touched on a few times. I stress again that the Bill is not enticing or encouraging any more people to go to hospital than those who already have to go to hospital. People travel to hospital out of necessity, and they are being unfairly charged for that necessity. We absolutely should encourage people who are able to to walk, cycle, use public transport and be more environmentally conscious when they go about their daily lives, but we cannot penalise those who simply have no option but to drive due to the poor public transport services that they endure. That is especially true for our rural constituents.

The loss of revenue and the potential to take away from front-line patient care was also raised. It is not for workers to pay an additional tax simply to go to work. It was touched on several times that Members do not pay to park here, so I do not think that it is fair that health and social care staff should pay to park to go to work.

Patients who are ill and receiving treatment or are in the process of receiving a diagnosis should not pay. Families who visit, care and are with their loved ones day after day should not pay. Sometimes, that can be day after day — five, six, seven days a week — for weeks upon weeks.

The Executive have been prioritising Health in their Budget. I want to iron out the issues that were raised and work with other Members and the Department of Health so that we can ensure that the money that is needed is set aside.

I am conscious that I do not want to keep you much longer.

Photo of Paula Bradshaw Paula Bradshaw Alliance

On the point about the abuse of car parking, I represent South Belfast, and you will be aware of the geography and the layout of the City Hospital site. You come off the motorway, up the Donegall Road, and there is a big multistorey car park there. I do not suspect that any patient, visitor or member of healthcare staff would abuse that, but how would you prevent people from driving in, parking in the car park and walking into the city centre? That is my concern about the abuse of the car parking facilities, given the pressure on the Donegall Road at present with people doing that already.

Photo of Aisling Reilly Aisling Reilly Sinn Féin

I thank the Member for that intervention. I will take that away. We can look at that issue further and scrutinise it as the Bill progresses, but I really do not know anybody who would park in the hospital car park and go about their shopping and have a coffee, but that is not to say that it could not happen. You are right: it needs to be looked at.

I mentioned that I will not keep you much longer, so, just to wrap up, we are still very much in the midst of a pandemic, and now we are facing a global energy crisis that is causing prices to soar and is adding hardship to many families who really are facing financial hardship.

Our health and social care workers, who stood on the front line day after day during the pandemic and make enormous sacrifices for us all every day, deserve the best that we can possibly do for them. The Bill is an acknowledgement of their dedication to us all.

Question put and agreed to. Resolved:

That the Second Stage of the Hospital Parking Charges Bill [NIA 40/17-22] be agreed.

Photo of Alex Maskey Alex Maskey Sinn Féin

That concludes the Second Stage of the Hospital Parking Charges Bill. The Bill stands referred to the Committee for Health. Congratulations, Miss Reilly.

Adjourned at 6.03 pm.