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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“In the same week, Sinn Féin eulogised the IRA man responsible for the Bayardo bombing on the Shankill Road, the murder of five innocent Protestants and the maiming of 60 people. <BR /> <BR />It is clear that Sinn Féin's support for terrorism runs very deep. It does not care about the innocents of the 7 October attack in Israel, the killing and maiming of people on the Shankill Road or attacks in hospitals in Northern Ireland. As we have seen with the Omagh inquiry, the pain and suffering from terrorism run deep in Northern Ireland. It is impossible to heal as a community while Sinn Féin continues its glorification of terrorism.”
“<BR /> <BR />After the Holocaust, the world promised that we would never again allow such slaughter, yet the rights industry and so-called progressive groups and politicians across the world have been notable by their silence on this issue. Where are the women's groups who took up the issue of that young mother and her babies? Shamefully, many in the House cannot bring themselves to acknowledge their pain and suffering. The supposed First Minister for all, in her explanation for boycotting St Patrick's Day in Washington DC, tried to tell us that she was on the side of humanity, yet not one word about the Bibas family, not one word about their suffering, kidnapping and death.”
“On 7 October 2023, Hamas terrorists killed 1,200 Israeli citizens and took over 250 hostage. It was the biggest loss of Jewish life since the Holocaust. The hostages included children, their parents and many elderly men and women. Tomorrow, the Bibas family will bury Shiri, a young mother who was taken hostage with her two babies, Ariel and Kfir. Their father, who has only recently been released from Gaza, will not only bury his family but will do so in the knowledge that Shiri's parents were also murdered on that day. Today, I want to make sure that the record of the Assembly records their suffering and grief. We cannot begin to imagine their suffering in Gaza. I also acknowledge the charade around their handover.”
“The award of that contract resulted in the resignation of two senior members of the service.”
“Minister, I noticed that you did not answer the last question. The Belfast Trust has been given the contract for the regional cervical screening programme for Northern Ireland, despite the fact that it is not yet accredited for such screening. Is the Minister satisfied with the decision to award the contract to the Belfast Trust? During a recent Committee meeting in Daisy Hill Hospital, the PHA admitted that it was short-staffed and was having to send tests to Gateshead in Newcastle to clear a backlog of screening. In awarding the contract in that way, the Minister bypassed two trusts — the Northern Trust and the Western Trust — that are fully accredited.”
“The challenge is to get better outcomes for people, but it is also about managing money better, which is really important. I hope that the Minister will look at some of those figures and ensure that we are more efficient in what we do and more realistic in how the Department spends money.”
“I also draw the Minister's attention to the energy scheme for the Belfast Trust. A total of £9·5 million was spent on an energy project that the Department of Health, in a recent letter to me, stated is red-flagged and cannot be delivered.”
“The investment strategy delivery tracking system report, which is provided to the Committee every month, indicates that the value of the children's hospital contract will be greater than £1 billion. We would like to know the nature of the discrepancy between the figure of £670 million, which is the cost of the contract that was signed, and the figure in the investment strategy delivery tracking system report. <BR /> <BR />We need clarity and transparency on the Department of Health's capital investment. The maternity hospital issues have still not been resolved. It is an amazing building that will make a huge difference to mothers and babies and to families with the most vulnerable children in our society, but we still do not know the cost of making it safe for those babies. That is something that we need to know as well.”
“It seems that about £97 million worth of PPE stock will expire by 2027, yet the Department of Health was seeking more money for additional PPE. It would be interesting to know the reasons for that. <BR /> <BR />We need to be really clear and transparent with the money that we have in the system. Last Thursday at the Health Committee, I quizzed the Minister and the permanent secretary about the current estimated cost of the new children's hospital. The Committee has visited the new maternity hospital, which is an absolutely amazing building, but we were told during that visit that the cost of the contract for the children's hospital had now risen to £670 million. I would be interested in hearing the Finance Minister's view on that.”
“No. I want to make some progress, because I have quite a lot to get through. If the anticipated sums for the immigration health surcharge and National Insurance contributions of employed staff are included, that increases to 11%. We all want to see as much as possible in the Department of Health budget, but, in a time of constrained budgets, we have to be realistic about being able to deliver the best possible outcomes. <BR /> <BR />Some of my colleagues talked about looking after the money that we have in the system. There is a lot of money in the health system, yet it has some very poor outcomes. In September 2024, I asked about the amount of PPE that the Business Services Organisation (BSO) was holding on the Department of Health's behalf, and the answer that came back was quite startling.”
“<BR /> <BR />The Minister of Health achieved a balanced budget despite his predecessor's dire predictions. The previous Minister engaged in a strange calculation of the figures in the 2024-25 Budget. Guess what? The incumbent Minister is doing that all over again with the 2025-26 Budget. The draft Budget equality impact assessment that the Department published indicates that it is in line to receive only a 2·6% increase on the 2024-25 end-of-year position, but that is not comparing like with like. Compared with the starting position of £7·76 billion in 2024-25, the proposed £8·4 billion allocation to the Department of Health represents an increase of more than 8% on that position. If the anticipated sums —.”
“We will need to see significant reform and transformation of healthcare if we are to avoid a continuation of what we have now. <BR /> <BR />Northern Ireland still has the most expensive health service per head of population in the United Kingdom, yet it has the worst outcomes. Almost half a million people are waiting for a first appointment with a consultant. The most recent figures for breast cancer referrals show that, for women who had discovered a lump in their breast and were waiting for that first consultation, only one in 10 appointments in the Southern Trust met the 14-day target. The corresponding figure was much lower in the Northern Trust and South Eastern Trust. That is not an acceptable place for our health service to be in, so we need to get on with the reform that will drive better outcomes for people.”
“I rise as the DUP's health spokesperson to make a few remarks on the 2024-25 budget for Health. <BR /> <BR />The Health budget of 2024-25 saw huge pressures in Health but also significant in-year allocations. That allowed the Minister to meet the pay requirements for HSC staff. We should say that and congratulate the Minister when he has done a good job. It was an important outcome. As I have said often, the staff whom we have working in Health and Social Care are the glue that holds together a very broken system. It has to be said, however, that the announcement of the pay award was made on the same day that the Minister announced the appointment of a new permanent secretary on an eye-watering salary. Only time will tell whether he is worth that salary. I presume that the Minister of Finance had to OK such a breach of salary rules.”
“Only two thirds of women who are invited for cervical screening respond, and a quarter of those who are invited for breast screening do not take the opportunity. <BR /> <BR />One of the ways that we can improve uptake is by addressing key barriers to participation, such as a lack of awareness that screening is for people without symptoms, feelings of embarrassment and concerns about pain and discomfort. The Cancer Research UK campaign seeks to increase informed participation in screening by addressing those misconceptions. It is an incredibly important campaign, and I hope that we will all be able to publicise it and use it as part of our duty to inform the public about this important service.”
“<BR /> <BR />We know that screening is an important way to help prevent cancer and find it at an early stage when treatment is more likely to be successful. In Northern Ireland, more than 60% of cancers that have been diagnosed through a screening route were caught at stage 1, which suggests that screening is a positive and effective route to finding cancers at an earlier stage. However, we also know that screening uptake could be improved in Northern Ireland, especially for bowel screening, where only 58% of people who are invited for screening take the test. I was delighted to hear the Minister say at the Health Committee last week that he intends to extend the bowel screening campaign.”
“This afternoon, I will highlight Cancer Research UK's cancer screening awareness campaign, which is launching today. Over the next six weeks, Members are likely to see the campaign on television, buses, billboards and in cinemas, providing the essential message that, if you are invited for screening, you should not ignore the letter. Whilst I recognise that some issues about past screening performance have been highlighted over recent months, they should not detract from the importance of attending appointments to get checked out. The Public Health Agency (PHA) has helped to co-produce the campaign so that the right messages are reaching the right people, and GPs have taken time to help inform the campaign.”
“I thank the Member very much for giving way. I listened carefully to his arguments around the tobacco products directive. I was in the European Parliament when we debated it. Of course, the difference between the Windsor framework and the legacy of EU laws and the new laws coming in is that we have no say in the new laws. The Member should note that and be accurate about it. When we debated the tobacco products directive, we were part of the EU. We have since left. Maybe the Member should acknowledge those accurate facts.”
“We have heard a lot of deflection from the Minister of Justice today, and a lot of instances of her saying, "It's not my responsibility". However, there is a responsibility on all of us in the House to uphold the rule of law and to support those officers who uphold the rule of law. Does the Minister accept that the judgement in relation to the Police Ombudsman's office has undermined the rule of law, and has undermined the faith of ordinary policemen, such as those who were attacked by thugs in Londonderry at the weekend?”
“Thank you, Minister. I know that you will agree that the voluntary and community sector directly helps those who are most in need at their point of need. We listened with interest to the Secretary of State's speech last week. Do you think that he has any idea of the impact that his Government's Budget decisions will have on the voluntary and community sector in Northern Ireland, particularly on the most vulnerable people in Northern Ireland?”
“Sorry. Thank you very much, Madam Principal Deputy Speaker.”
“That is evident when we talk to others. A couple of weeks ago, we had the Royal College of Surgeons at the Health Committee. They are frustrated by the lack of coherence in the system, which means that productivity in theatre sessions can sometimes be very curtailed. That is incredibly important. <BR /> <BR />I hope that the Minister's bid to the transformation fund is successful. However, the Northern Ireland Audit Office (NIAO) has said that, even if it is not successful, the Minister should reorganise in order to find the money for multidisciplinary teams (MDTs) in our general practices. Having listened to the raw emotion of GPs at the Committee last Thursday, we know how important that is. It is about not just workload but delivery for patients in Northern Ireland. <BR /> <BR />Finally, the predicted income at the start of the year —.”
“We really have no answer to how we will deal with that backlog so that people will not always be waiting for hip replacements or knee replacements or whatever it is. <BR /> <BR />The Minister has moved on breast cancer but only after performance against breast cancer waiting time targets had collapsed to indefensible levels. That was evident in the published figures in June of last year: in the South Eastern Trust, I think, only 4·6% of women were seen within the 14-day referral period for a first appointment after discovering something wrong that needed to be investigated. Those are time-limited and life-saving things that need to be done, and we need to get on and do them. <BR /> <BR />I have pointed out many times in the Chamber, in the Committee and in questions for written answer the need for greater productivity.”
“There are deep structural inequalities in the health system in Northern Ireland, different levels of interventions in health trusts and different responses on social care, particularly respite care for young adults with complex needs. <BR /> <BR />Our workforce is organised to deal with the regular annual workload. That is fine, but it will not clear the backlog. We perhaps need more honesty in our debates about the unavoidable requirement for much of the elective backlog to be carried out by staff outside of our local trust staff. The Department's elective care framework envisages additional hundreds of millions of pounds still leaving waiting lists extending into years, yet normal business in the health service continues to grow.”
“Eight years on from the Bengoa report, the Minister's officials should be clear about what represents the best configuration of services for Northern Ireland. It simply requires the Minister and the system to get on and deliver that. <BR /> <BR />In Northern Ireland, we have the largest-ever number of people waiting for a first-time consultation. Frankly, waiting times are a disgrace, yet, sometimes, when officials appear before the Committee, it is a bit like there is an acceptance of long waiting lists and a sense that they are inevitable given the situation that we are in. Many of my constituents and, indeed, MLAs talk about a two-tier health system where those who can afford to go private can go private, but I think that it is more broken than that.”
“Thank you, Madam Principal Deputy Speaker. Lots of people, when asked for their opinion on devolution, say clearly that they had high hopes for change, particularly in the health system. The motion and the amendment reflect the frustration and, indeed, the cynicism out there at the pace of change. Minister, it is not a reflection on you personally. The system is difficult and ponderous. It is like turning a tanker a little bit at a time. However, the most significant paper that has been published is now subject to a long consultation period, and people struggle to understand why consultation is necessary. It is hard to find what is novel in the 'Hospitals - Creating A Network For Better Outcomes' document. We have had high-level principles many times. Everyone knows that change is required.”
“<BR /> <BR />Andrew and the Stroke Association are encouraging adults of all ages to have their blood pressure checked regularly. That will equip them with the knowledge of whether they are at risk of having a stroke, so that they can take steps to reduce their chances. Blood pressure checks are available via GPs and many pharmacies. I encourage Members to share the social media messaging from the Stroke Association about the prevention of the catastrophic illnesses caused by strokes.”
“Perhaps more concerning, 36% of people who have experienced a stroke, through either their own diagnoses or that of a loved one, did not know that high blood pressure was the biggest risk factor. To mark Stroke Prevention Day, the Stroke Association is encouraging people to have their blood pressure regularly checked. <BR /> <BR />While stroke is most likely to impact on those over the age of 65, it can happen at any age. My constituent Andrew Oliver from Lurgan had a stroke in 2017 at just 22 years of age. Eighteen months prior to his stroke, Andrew was hospitalised for having high blood pressure at twice the recommended limit. At the time, he was unaware that high blood pressure is the cause of almost half of strokes.”
“Thursday 30 January was Stroke Prevention Day. In Northern Ireland, around 4,000 people every year suffer from a stroke. Worryingly, that number has been increasing over the past 20 years, particularly among people of working age. Strokes change lives in an instant. It is important that we have the most up-to-date treatments available for patients in all parts of Northern Ireland to ensure the best outcomes. The Department of Health seems to have been consulting on and contemplating stroke services for a decade. We now need action. <BR /> <BR />A Stroke Association survey last month showed that 43% of people did not know that high blood pressure was the leading risk factor for stroke.”
“The test of any political party, however, is how it deals with those circumstances when they come to light. It is clear that, in Sinn Féin, a cultural change needs to take place in order to promote and elevate the rights of the most vulnerable above any warped sense of loyalty to the party, its members or its employees. <BR /> <BR />The motion implies that audits are not currently conducted under the 2016 determination: that is not the case. A robust audit schedule is in place for payments to Members and political parties. Ernst and Young (EY) randomly samples 25% of Members as part of an annual internal audit review process. The Northern Ireland Audit Office (NIAO) also reviews the costs incurred by Members as part of its overall audit of the Commission. That is right and proper. The DUP will continue —”
“Sinn Féin has still not explained the full detail of its cover-up, the role of its former HR adviser in facilitating references for Michael McMonagle or the flagrant disregard for basic safeguarding practices that that involved. Indeed, Sinn Féin's response — the varying accounts of what happened and the inability to see people in the Great Hall — gives a sense of a party struggling to defend the indefensible or, more likely, of a party implementing the republican code of omertà in response to any questioning of its actions. <BR /> <BR />Ultimately, how Michael McMonagle was paid is only one aspect of the Sinn Féin safeguarding scandal. We will continue to throw a spotlight on the failings, because it is the right thing to do and because, without a step change, history will repeat itself. In all walks of life, there are rotten apples.”
“There have been separate criticisms of the report. As other Members have said, that is not a reflection on the Assembly official who conducted the review in difficult circumstances. The review was conducted largely as a paper-based exercise, however. Why was that so? Why was no attempt made to engage Michael McMonagle in order to hear his side of the story? Why was undue credence given to the Sinn Féin side of the story, particularly when we know that members of the media have documentary evidence attesting to Mr McMonagle's position? <BR /> <BR />I want to focus my remarks on this part of the debate. While all those concerns are legitimate, we must not lose sight of the bigger picture.”
“Central to the motion today is the fact that Michael McMonagle carried out work that amounted to up to 80 hours a week and was likely to have been the subject of three separate contracts of employment in a three-month period between 2 March 2020 and 31 May 2020. Sinn Féin has legitimate questions to answer. How, when we are told that Sinn Féin had a central HR team responsible for recruitment, was that even possible? Are we really expected to believe that Michelle O'Neill, as the leader of Sinn Féin in Northern Ireland, was not across the detail of who was employed by the party and by her during that period?”
“First, let me stress the obvious: it is absolutely right that public money allocated to Members to pay allowances and provide central party research support is held to the highest standards of propriety, transparency and accountability. The DUP will engage constructively with the Assembly Commission and other parties on the recommendations of the review. In particular, no party and no Member should fear regular and robust auditing. <BR /> <BR />The facts of the case are well known and have been trailed through the media on many occasions.”
“I thank the Minister. I absolutely agree that the new children's hospital is an imperative for us in Northern Ireland. I spent many years of my life in the old children's hospital, and the conditions there have not improved significantly since that time. <BR /> <BR />In reply to a question for written answer that I submitted to the Minister, which I received just this morning, the Minister stated that consultancy fees for the children's hospital are in the region of £25 million so far. Can he explain what that money was spent on and how we might prevent excessive — if that figure is not excessive — amounts of money from being spent on that element of the build?”
“— very difficult things. The debate has been good, and I commend the Members who tabled the motion.”
“That is someone who is a leader in her field in mental health, talking about attitudes towards mental health and stigma. We must erase those attitudes. It is really important. <BR /> <BR />A number of Members referred to different sectors and their impact on the relief of mental health issues and their associated stigma. Let us also commend the voluntary and community sector. So many of our groups work at a community level, day in, day out, with those who suffer from mental health issues and fear the stigma that is associated with that. <BR /> <BR />Robbie Butler mentioned the Prison Service. We also must acknowledge the difficulties with mental health that are associated with serving in the public sector. Staff in the ambulance service and PSNI officers — people who see —”
“<BR /> <BR />When I was reading around the issue, I found a quote that was incredibly instructive about how we deal with mental health, particularly in the public space. The quote was from Charlene Sunkel, the founder of the Global Mental Health Peer Network and co-chair of 'The Lancet Commission on Ending Stigma and Discrimination in Mental Health'. She said:”
“I am glad that, now, we recognise the persistent difficulties, particularly experienced by women in menopause and in that period of their lives, with mental health and anxiety. That is really important. <BR /> <BR />I think that we have three types of stigma: public stigma, which involves the attitudes of others at work and out and about in social situations; self-stigma, through the internalising of stigma within one's own self, the feeling of shame and not being good enough and so on; and structural stigma, which is systemic in the like of government and organisations' policies. That is where the mental health strategy comes in. I know and acknowledge that the Minister has done an enormous amount to promote mental health during his time as an MLA. Campaigns that tell people that it is OK not to feel OK are really important.”
“Sadly, that definition, too often, prevents those who have mental health difficulties from asking for help and leads to them feeling completely distressed and alone. People view mental health in different ways. We have talked about the kind of inadvertent stigma that people who have a mental illness can face, but it can also contribute to how they feel at work. People are worried about their chances of promotion, or how it will impact on their work, if they say anything about it. In social situations, they fear that they will be treated differently. Colin talked about past attitudes to mental health. When I was younger, many people whom I knew, particularly women, were told, "Snap out of it. It just happens. Get on with it".”
“I thank those who tabled the motion, and I thank those Members who have spoken for the tone that they have used and the issues that have been raised in the debate. It is good to see the Assembly united and speaking with one voice about the stigma with mental health difficulties. <BR /> <BR />In my few remarks, I want to focus on the word "stigma". In preparing for the debate, I looked it up to see what it means. The definition that I looked at describes "stigma" as:”
“First Minister, the victims of IRA violence will listen carefully to what you have said but will realise that they are hearing the same old platitudes. You could change that today in the Chamber. Given that your party did not cooperate with the Kingsmills inquest, will you call on the Police Ombudsman to release the report on the Kingsmills massacre and ensure that the families get justice?”
“It is good for women and girls, and it is important that our society reflects that.”
“I will briefly put on record my party's support for this move. Reducing period poverty is hugely important in our society. It is important that women and girls not be excluded, either from the workplace — in this case, healthcare workplaces — or from treatment as a result of period poverty. I therefore look forward to the effective implementation of the regulations. I am glad to hear, as the Health Minister pointed out, that the Northern Ireland Ambulance Service, although not named in the regulations, will also undertake to provide free period products. <BR /> <BR />I note that, as yet, there has been only a best estimate of how much this will cost. I appeal to the Health Minister that, as soon as the figures become available, we be made aware of the cost of implementing the regulations. This is a good move forward, however.”
“— across the curriculum. That is the type of exciting innovation that we need for the future.”
“We should all be encouraged that, in the wider review of the curriculum, the Minister has confirmed that those issues can be integrated —”
“Over 13,000 people responded to a recent consultation exercise that the Department of Education conducted on the teaching around abortion in the RSE curriculum. That is one of the largest consultation responses that, I am sure, you will get anywhere. It confirmed the need for the RSE curriculum to be developed and consulted on in a local setting and in partnership with parents, teachers and school governors. That is also important. <BR /> <BR />Mr Carroll talked about the DUP. In the consultation responses, there were parents who also argued for the right to opt out if they wanted to do so. It is important that we acknowledge parental choice on the issue. <BR /> <BR />We have talked a lot about the issues of consent and how we deal with them.”
“No, I am sorry. I do not have any time. <BR /> <BR />All those things are hugely important. However, when we, as a body of politicians, are here deciding on a motion and even on legislation, the evidence that we use should be wide-ranging and broadly based. I thank the young people who are referred to in the text for their contributions. It is massively important to hear from young people, but we also need to hear the outcomes of, for example, the RSE inquiry that the Education Committee is taking forward and from many other groups. I think that there is consensus among some in the Chamber on that. <BR /> <BR />It is really important to talk to young people; I have said and emphasised that. That is massive. It is also important to talk about and acknowledge the role of parents, teachers and governors in developing the RSE curriculum.”
“To the proposer of the motion, it is important to say that we need to help young people and, indeed, adults. The Health Committee spent some time talking about older adults and the issues of consent and coercive control.”
“There is an understanding and a broad consensus on the need to help young people to understand what loving, healthy, respectful relationships are and how they can be part of one.”
“Thank you, Mr Deputy Speaker. If we look at the positives from the debate, we could say that the Chamber is committed to a society where violence against women and girls is a thing of the past.”