Diane Dodds
West Belfast · Democratic Unionist Party · Northern Ireland
“Minister, that is a brilliant segue into the question that I will ask. Just over 5% of women who are now seen within the 14-day target for a suspected breast cancer in Northern Ireland. That has happened since the list was regionalised. I get the fact that cancer cases are rising, but —”
“Minister, for Members and those who are listening to the debate, it is important that you tell us what "actively being considered" means on a day-to-day basis.”
“Thank you, Minister. The Muckamore inquiry report demonstrates a shameful period for our health service, and no one involved can, in any shape or form, come out of this with any kind of credibility.”
“Let me be clear: experimental treatment on children that can have lifelong implications is unconscionable. Children of 11 or 12 are in no position to give clear consent to the use of such drugs, especially when those administering the treatments had them banned because of the lack of evidence on their long-term impacts.”
“Once again, I will speak in the House about puberty blockers and the nationwide trial run by King's College. I now understand that the Government will issue new guidance that will allow such a trial to go ahead.”
“It is now anticipated that more than eight out of 10 couples in which the woman is under 40 will conceive naturally, but that leaves two out of 10 who will need additional interventions. Over a lifespan, that is a fairly substantial number of people.”
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“— that is the same across the UK and across the world. What can be done to make sure that women are seen in a timely manner and that that wait of seven, eight or nine weeks is done away with?”
“Minister, that is a brilliant segue into the question that I will ask. Just over 5% of women who are now seen within the 14-day target for a suspected breast cancer in Northern Ireland. That has happened since the list was regionalised. I get the fact that cancer cases are rising, but —”
“Sorry. Given that they were published on 31 March, Minister, can you tell me whether you have adopted them?”
“— you scared the life out of me — were published —.”
“Minister, given that the NICE guidelines —”
“Minister, for Members and those who are listening to the debate, it is important that you tell us what "actively being considered" means on a day-to-day basis. In February 2024, your predecessor said that there were challenges that needed to be addressed before we could move to a second and third cycle of IVF, including increasing the physical footprint of the regional fertility centre and having the appropriate number of specialist staff in place. Again, Minister, I ask you to comment on the progress that has been made on those issues. <BR /> <BR />It is interesting that NICE now indicates that, on the basis of best clinical evidence, three cycles of IVF for women under 40 who have fertility problems is the approach that would be most likely to maximise successful pregnancies as well as being cost-effective.”
“It is now anticipated that more than eight out of 10 couples in which the woman is under 40 will conceive naturally, but that leaves two out of 10 who will need additional interventions. Over a lifespan, that is a fairly substantial number of people. In 2023, over 20,000 babies were born in Northern Ireland via the IVF process, which is up from 8,500 in the year 2000. It is a significant issue, Minister, and one that needs to be dealt with. <BR /> <BR />Earlier in the year, I asked a question about IVF, and you indicated that your Department was continuing to work with the regional fertility centre to explore the feasibility of expanding current capacity and that all feasible options for moving to even a second cycle were actively being considered.”
“Thank you to those in the Chamber and those in the Public Gallery whose human experiences are the nub of the debate. Too often, we deal in just statistics, but those are real people, real families and real lives.”
“Thank you, Minister. This is undoubtedly a worrying time for patients. Out of a population of around 1·8 million, over half a million people are waiting for a first-time consultant appointment. Only 5% of women who have a suspicious breast lump are seen within the appropriate time. Today, therefore, I want to give a voice to patients who are really concerned that strike action will impact on their appointments. Minister, do you believe that the current pay award is sufficient? If you believe that it is not sufficient, what alternatives have you offered to doctors to try to fend off the proposed strike action?”
“Thank you, Minister. I appreciate the fact that you are announcing progress on King's Park Primary School, but it is one of the larger schools in the Lurgan area and is a very vibrant school, and many people are a little perturbed by the length of time that these processes take. Will you agree to meet EA, the school and me to discuss what can be done to try to progress the matter so that we can move through the business case and into more formal design?”
“How will you give accountability for the future to ensure that it never happens again?”
“Thank you, Minister. The Muckamore inquiry report demonstrates a shameful period for our health service, and no one involved can, in any shape or form, come out of this with any kind of credibility. In your statement this morning, we have an apology, but it lacks detail about the specific actions that you will take to ensure that there is accountability. One senior member representing the autistic community said that your statement was an absolute slap in the face to the many autistic people who had been subjected to immense harm. <BR /> <BR />Minister, how will you ensure accountability not just for past wrongs, including the criminal charges, which, of course, are a separate issue, but for the managers who turned their back, did not look and did not want to find out what was happening in Muckamore hospital?”
“After an enormous amount of flip-flopping on his part, we eventually got the Minister of Health to the Chamber to say that Northern Ireland would not be part of the trial. We need reassurance from him that that position stands and that Northern Ireland's children will be protected from such experimentation.”
“Let me be clear: experimental treatment on children that can have lifelong implications is unconscionable. Children of 11 or 12 are in no position to give clear consent to the use of such drugs, especially when those administering the treatments had them banned because of the lack of evidence on their long-term impacts. We know that children who want to access those drugs are some of the most vulnerable children in our society. Why would we want to damage them further? Our Government are talking about a ban on social media for young people under the age of 16, and, while that may be a good thing, they are in the same breath talking about administering life-altering drugs to children of 11 or 12. The Government have surely lost their moral compass. <BR /> <BR />What does it mean for us in Northern Ireland?”
“Once again, I will speak in the House about puberty blockers and the nationwide trial run by King's College. I now understand that the Government will issue new guidance that will allow such a trial to go ahead. It is very concerning that the new guidance will potentially allow young girls aged 11, so still at primary school, and young boys aged 12 to participate in the trial and to access puberty blockers with parental consent. The guidance goes on to talk about other issues with puberty blockers and reasons why the trial could be stopped, such as if there are concerns about effects on bone density, the impact on brain function or vaginal bleeding. <BR /> <BR />Originally, Dr Cass talked about the science behind gender clinics as being on shaky foundations but then decided that the trial was necessary.”
“I know that many healthcare professionals value Encompass for how they can access patient records much more easily. Is there a central policy document to protect healthcare professionals in scenarios in which they access Encompass, or is that something for which individual trusts are responsible?”
“I do not think that anyone can doubt that this is a good news day, particularly given the investments that you have announced for the Department of Health. While the money is welcome and very much needed, I would warn that, without sustainability in the pharmacy sector, we will have a continuing problem. How do you intend to monitor the programme of delivering e-prescriptions, given that Encompass took many years and there were many problems with it before it was fairly successful?”
“An estimated six to nine gunmen took part in that attack, and the rocket was launched from the Republic of Ireland. There has been no justice for his wife and six children. Of course, on 16 June, it will be 40 years since Terence McKeever, a Dublin-based businessman, was shot and his body dumped by the IRA, because he carried out electrical contracting work for the security forces in south Armagh. There has been no justice for Terence McKeever or his family. It is shameful indeed.”
“There was always an alternative to murdering your neighbours. <BR /> <BR />Of course, the motion is also about the Republic of Ireland and its failure to cooperate and give justice and information to those who were the subject of collusion or to the victims of a murderous campaign that the IRA launched from that state's territory. It will be no surprise to anyone in the Chamber that, today, in remembering those victims of violence, I will talk about Ian Sproule, a young Protestant who was shot outside his home in the village of Killen. Allegations of collusion have never been investigated. I have gone with John Sproule to Dublin and met politicians there, and they refuse to investigate and uncover the truth. It is shameful. <BR /> <BR />Bobby Keys was murdered 53 years ago in an attack on a police station in Belleek.”
“Thank you, Mr Deputy Speaker. <BR /> <BR />The Member is absolutely right. We have attended many commemorations of what happened to those soldiers. They have had no justice. Is the Scottish First Minister asking questions of Sinn Féin about justice for those three Scottish soldiers? Does the Scottish First Minister agree with Michelle O'Neill that there was no alternative to the violence of the IRA? The SNP should distance itself from the glorification of terrorist criminals that Sinn Féin and the First Minister regularly engage in. <BR /> <BR />It is time that the United Kingdom had stronger laws to deal with hate marches in London and those who continue to glorify the murder and mayhem carried out by terrorist criminals. You cannot claim to be the "First Minister for all" but eulogise those who murdered and maimed in our community.”
“I was talking today to organisers from the South East Fermanagh Foundation (SEFF), which is a victims and survivors organisation. They will protest tomorrow, along with political parties in Scotland, and join like-minded politicians who will stand up against terrorism and against those who caused so much carnage in Northern Ireland and beyond. I am glad that questions are now being asked of John Swinney and the SNP. Many of the questions are being put forward by the campaign surrounding the three Scottish soldiers who were murdered and left in Ligoniel. We have been at many remembrance services for those Scottish soldiers.”
“The First Minister, John Swinney, told innocent victims in Northern Ireland and in Scotland that we must all move on from linking Sinn Féin to terrorism. Of course, the problem for Mr Swinney and that idiotic statement is that Sinn Féin continues to eulogise the terrorist criminals who caused so much carnage and harm in Northern Ireland. I listened last night to Baroness Foster in the House of Lords. She said:”
“The debate has thrown up some interesting issues. I will start by saying that I will unapologetically talk about innocent victims of terrorism. I agreed with Patsy McGlone when he said that innocent victims of terrorism, no matter where they are from, demand truth and justice. However, innocent victims of terrorism also demand something more from politicians in the House. They need and should have people in the Chamber who will not stand for the rewriting of history and are prepared to challenge a narrative that wants us all to move on and to allow the eulogising of terrorist criminals and accept it as part of the so-called peace process. <BR /> <BR />There have been some interesting contributions from politicians on the issue in recent days, particularly from Sinn Féin's new-found friends in the SNP in Scotland.”
“He went to school from 8.15 am; was home at 4.30 pm; and went to a youth club two nights a week. When he finished at 19, his provision was two half days in an adult day centre. That is an indictment on all of us and something on which we need to work to rectify. We have an education system that puts its arms around our young people and provides so much for them, but then they transition from that and have little or nothing. <BR /> <BR />I will say one thing in closing. Minister, you have come to respond to the debate — that is good — but, in many ways, your work is about the young people who can go on into further education. There is a large and growing cohort of young people with complex needs who will not be able to access that. That is where we need Health to step in and do the work.”
“Thank you, Mr Deputy Speaker. <BR /> <BR />I think that you are better than that, Mr Burrows. I will proceed. <BR /> <BR />It is an issue that will not go away. It is not going to go away, because we have an increasing number of children with special educational needs in our schools, so we will have an increasing number of children and young people post 19. We need to provide for those young people, and we need to provide a pathway. One of the greatest health issues that I come across all the time is the fear of the transition from children's services to adult services. What we have and what we are talking about today is the same fear. <BR /> <BR />I will tell the story of a friend whose young son went to Fleming Fulton School. He led a very full life.”
“Post-19 provision falls mainly in two Departments: the Department for the Economy, which has done a revision of post-19 provision; and the Department of Health, which has said in a way that was difficult for the people in the Public Gallery and particularly Alma to hear, "You know what? There just isn't enough time to be bothered to do this". I do not think that that is the mood of Members generally. It is something that we should revisit time and time again until we get to a situation where Health accepts that responsibility and does something about it.”
“Before I make my remarks, I, like other Members, acknowledge the work of Alma White — I could not quite see her in the Public Gallery — and Caleb's cause. We would not be debating this today were it not for the people in the Public Gallery. We owe them a debt of gratitude for highlighting the issue. <BR /> <BR />Such is the support for the issue across the Chamber that the people in the Public Gallery would be right to wonder, "Why on earth has nothing happened?". I was astounded at the leader of the Ulster Unionist Party. The debate is about post-19 provision.”
“— about the need for care packages. That must be addressed as well.”
“That assumes that, in Northern Ireland, we have free GP appointments. One of the greatest complaints that I hear during my constituency work is that we need more appointments. The 8.30 am call to GPs is loathed across my constituency. That is also important. <BR /> <BR />While we are doing that, we should not forget that there are issues that we really need to address in the here and now that will improve the experience for patients who are trying to access immediate support or advice. I refer to the Royal College of Emergency Medicine survey and those long waits in EDs. This morning, I also took the opportunity to talk to the Southern Trust —”
“What is the Scottish experience of the 111 service? They say that, for the majority of respondents who ended their call to the National Health Service, it was again because of long waiting times. If we are to have a 111 service — there is a really good argument for it — it will have to be more efficient, properly staffed, properly resourced and able to meet the expectations of the people who need it. That is the key thing in delivering health services, because, too often, things are set up and people experience failure — failure to deliver appropriately is maybe a better way to say it. That is hugely important. <BR /> <BR />We will also need much better communication across the systems. You gave the example of someone calling in and being able to identify free GP appointments that that person could be slotted into.”
“While it is important to try to think outside the box, and try to do things that are new and innovative and will help people reach appropriate care much quicker, it is also important to build on and develop best practice from those who are already there.”
“<BR /> <BR />We had a version of a 111 system during the pandemic, if I can raise that again: the Phone First service. That aimed to answer 95% of calls within the first minute. Therefore, if we are to introduce such a measure, it should build on some of our existing knowledge and expertise in the area. As others have suggested, the 111 approach is not without its problems. When looking at information ahead of the debate, I discovered that, last year, around 3·7 million calls to the NHS in England were dropped because it took too long to get through. Almost one in five callers — 18% — gave up before they got to speak to anyone. The average time it took to get through was around 25 minutes, according to information in December. There are also queries about the robustness of the data and how the service's effectiveness is measured.”
“Thank you to the Opposition for the motion. It is always encouraging when parties in the House are willing to think about ways in which we can do things better. I welcome that, although there are issues that we would need to iron out before such a process or provision would be necessary. That is important. <BR /> <BR />It is also important that we recognise that we have increasing problems in emergency care, be that in access to GPs or access to appropriate care in our emergency departments. There are far too many long waits. The Royal College of Emergency Medicine's report a few weeks ago painted a catastrophic picture for patients and the health service, stating that many of our patients wait for 12 hours, and more, for appropriate care in our EDs.”
“She wants to know how any desktop review of other reviews can give a voice to those directly affected and how it can ensure accountability in a health service that now seems to have lost that very central tenet.”
“I will continue, Minister, from where you left off. I spoke directly to Sandra Courtney over the weekend. She wants me to ask the question that, she said, was not answered on Thursday when you met the Ladies with Letters. In fact, she went further and said that she was not individually invited to the event on Thursday but was told about it by the Ladies with Letters group. In her question, which she says you did not properly answer, she says that Lynsey died after a smear test was misread. She said that that is not an abstract systems failure; it is a life lost and a family devastated, and serious questions are still left unanswered.”
“Thank you, Minister. One of the things that frustrates us greatly — you will understand what I am talking about, because we have spoken about it — is the length of time that it takes significant planning applications that have an economic impact to get through the system. What are you doing to measure the length of time taken versus the economic impact, or does the NIEA simply exist in a vacuum? It never responds to MLAs, including me, about planning applications. It is an appalling service.”
“— and that we will see real change. Thank you.”
“When the Minister is demanding that 2% of the trusts' budget is taken to implement his neighbourhood model, which will deliver care to people in their own communities, he needs to reassure the House that it will not be a rehash of things that they have already done, that there will be a proper auditing process of the 2% —”
“We do not know what happens to them because Northern Ireland does not have a pathway that takes patients from their referral to treatment that gives us data on how many of them went on to receive further treatment or simply joined another waiting list. That is an important point, because, if we are to spend money appropriately and effectively, we must have the data to help us do that. We also have the waiting list reduction scheme, which the Minister introduced at the cost of £10 million. Only £4·49 million of that was spent. The remainder was reallocated, but I suggest that, in future, the Minister looks at his priorities in that regard. <BR /> <BR />I will finish on two points around the neighbourhood model.”
“Our cancer waiting lists are by far the worst in the United Kingdom. Only 5% of women see a consultant within the 14-day target from when they discover a suspicious lump. That is an untenable position for Northern Ireland, and we are failing women very badly. I use this debate to say that we need an emergency action plan for cancer patients. We can, and must, do better. <BR /> <BR />I am glad of the work that has been done on waiting list reductions, but we do not know, for example, what happens to patients who have had scopes for a particular condition, which is the area in which there has been the greatest reduction.”
“If we cannot take tough decisions on £7 million — Sinn Féin and the SDLP were spooked by that — I am not sure how we will take other tough decisions, particularly in light of the fact that Sinn Féin continues to introduce private Members' Bills that are uncosted and for which there is no identifiable funding. I would like to hear from the Finance Minister on whether he believes that that is a sensible way forward. <BR /> <BR />The Health budget continues to take over half of the total block grant for Northern Ireland. I am glad that the Health Minister has decided to prioritise staff pay this year; that is right and appropriate. I was also glad to hear the permanent secretary in the Department say that prioritisation in the Health budget must include the key objectives of reform and delivery. There is so much to be done.”
“If any Sinn Féin Members want to tell me different, I will be happy to give them time to do so. The weight of the cuts in the Budget will be borne by Health, Education and Communities, impacting on the care of the most vulnerable, the education of the young, and the building of houses for families. <BR /> <BR />A Budget process must go alongside fair and sensible decision-making. Today, I have heard from the opposite side of the Chamber much talk about being up for taking tough decisions, yet they got themselves incredibly spooked by the SDLP when it came to the deferral of hospital car parking charges.”
“It is acknowledged across the Chamber that there are very difficult decisions in any forthcoming Budget process, and there are responsibilities to be borne by politicians in the Assembly as well as by our national Government at Westminster. We all agree, and I have heard it across the Chamber during the debate, that we still suffer from underfunding. I hope that, in the middle of the chaos that is the current Labour Party, there will be an understanding of the needs of Northern Ireland, and that there will be room for this part of the Kingdom in whatever the Prime Minister's reset is going to look like. <BR /> <BR />It has become clear that the Budget that has been produced by the Sinn Féin Finance Minister is not supported by any party in the Chamber.”
“We have been talking about a women's health strategy and action plan since devolution was restored, so I am glad to hear that there will be progress, even if it is late in the day. Women's health and the attitude to it are marked by inequalities. There are inequalities in Northern Ireland, but there are also inequalities across the United Kingdom. Will the Minister tell the House when he plans to introduce the new injectable cancer immunotherapy drug — it is called Keytruda, I think — for women and men in Northern Ireland?”
“I have had a number of representations from domiciliary care workers who simply state that it is impossible to go to work because the cost of doing so is exorbitant. <BR /> <BR />This morning's news about the Southern Trust is very concerning. I will be meeting domiciliary care workers from the Southern Trust shortly. They talk about a reduction in time spent with clients, a reduction in the number of —.”
“<BR /> <BR />Not only is it a failure to look after our most vulnerable but it puts enormous stress on families across Northern Ireland. I am sure that I am no different from any other MLA across the Chamber in receiving many emails about this issue in any given week. The statement from the care sector that it may have to withdraw services in rural areas is heartbreaking for those who deliver the care. They do the job not for the money or the glory but because they care about their patients, their community and the elderly within it. Last year, the Minister made promises to deliver the real living wage to the domiciliary care sector. Unfortunately, we have not yet seen that done. That is a signal failure. The crisis has been exacerbated by the rise in fuel prices. We need to see the trusts in particular address the issue.”
“Once again, a crisis in domiciliary care is being talked about in the news cycle. This time, an independent provider is saying that it will withdraw services in rural areas. I wish that I could say that this is a new crisis, but it is part of a continuing crisis that, I am sad to say, the Minister has refused to address. No action has been taken on this issue, despite many promises having been given. In many ways, that is symptomatic of the way in which the Health Department works: refusing to address issues that are of primary concern to our constituents across Northern Ireland. Sadly, the impact of that failure will be felt by the most vulnerable in our community, including the disabled and the elderly. That is particularly the case in rural areas, where it is very difficult to find those additional care packages.”
“I thank the Member for giving way. I omitted to say that we will support the amendment.”
“The cost-of-service review is a key step, and rapid progress is required in the weeks and months ahead to get dentistry back on a more stable and sustainable footing in Northern Ireland. <BR /> <BR />Finally, Minister, I have spoken to many people in the profession and even more who come into my constituency office. Many fear that you are simply running down the clock on the issue. I urge you that making progress before the end of the mandate is a must. I trust that your response will be encouraging to thousands of families and young children in Northern Ireland who have no NHS dentist and find it very difficult to access appropriate dental health services. So many deserve so much better.”
“<BR /> <BR />What is being done in Northern Ireland does not compare favourably with actions that are being taken in England, where there is an expansion of dental places, with 50 more dentists trained every year. Many more dentists from overseas are being fast-tracked into the system so that England will have even more dentists by 2028-29, and patients are benefiting from millions more dental appointments, as new figures show that 1·8 million additional dental treatments have been provided in England in just the last seven months. In Wales, a new NHS dental contract based on need and risk has come into effect this month. <BR /> <BR />Minister, I have presented a picture of a key National Health Service service that is in the most extreme of circumstances. There is no time to wait. There is a great deal to be done.”