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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“It is in that spirit that I offer the amendment and not in the spirit of shutting down conversation about the most important issue that we could address and one that, I know, the Minister has made a priority. <BR /> <BR />We are glad, Minister, to see you back today. We hope that you are feeling reasonably well after COVID, which can be very debilitating. <BR /> <BR />We felt that it was important to emphasise not simply what Departments could do but what other agencies, as well as our crucial community and voluntary sector, could contribute. Appropriate oversight of mental health services has been recommended in a number of important reports in recent years.”
“Thank you, Principal Deputy Speaker. I rise to propose the amendment not to indicate that we do not want to talk about mental health, as the proposer of the motion suggested — I regret some of his remarks — but to slightly broaden the scope of the original motion to talk about general levels of mental health and well-being.”
“<BR /> <BR />The scheme has been helped by the work and assistance of 1,300 childcare providers, including day care, childminders and playgroups, that have signed up and made it accessible to parents so quickly. They should be congratulated on their work and help and the effort that they have put in. I look forward to a more extensive affordable childcare scheme. I am glad that we have got this far. The Minister and the Department are to be congratulated for doing this. We now need to ensure that we extend the scheme to others.”
“In our election manifesto, we promised help for hard-pressed families. Childcare and the cost of childcare has been identified as an area that we need to tackle if we are to help families and improve our economic prosperity. Families' receipt of a 15% reduction in monthly childcare bills has been a significant help to them, and the Minister has worked quickly and efficiently to get this scheme out. The number of people who are signing up for the childcare scheme reinforces how important an issue this is, not just in Upper Bann but right across Northern Ireland. I look forward to Executive colleagues supporting the provision of more funding so that the scheme can be extended and we can fulfil our early education promise of 22·5 hours for every child right across Northern Ireland.”
“As vice chair of the all-party group on childcare and early education, I am delighted to say that almost 12,000 children in Northern Ireland are now registered with, and their families benefiting from, the childcare subsidy scheme. That includes 880 children from my Upper Bann constituency, and I am delighted that, after Lagan Valley and South Belfast, Upper Bann has the highest take-up across the Province, accounting for 8% of all those who registered.”
“Thank you for your answer, Minister. Over the past number of weeks, I have been contacted by a number of parents of young people who have special educational needs. They have had problems getting on to courses in the Southern Regional College (SRC) and with transport, and courses have moved and no one knows what is going on. There may be many different pathways for young people with special educational needs, but do you agree that, rather than having working groups and identifying pathways, the legal entitlement is the most important way of ensuring that we are responsive to the needs of young people with special educational needs? Will the Minister work to ensure that such a legal entitlement is brought forward in legislation?”
“In England, the numbers of delayed discharges are published each day, and we should do the same in Northern Ireland. <BR /> <BR />Thank you for listening to this. I apologise that I did not get finished, but this is something that I am absolutely passionate about. I hope that the Assembly can support the motion.”
“<BR /> <BR />Lord Darzi's report last week stated that 13% of beds in England were lost through delayed discharges. What system can operate under that level of delayed discharge?”
“If there is a problem at the front end with too many patients, there are also problems at other parts. Hundreds of patients today who are fit to leave hospital have to stay there while taking up a vital bed. In mid-March, in a question for written answer, I asked the Minister of Health for the figures for those who were fit to leave hospital but were unable to do so: at that time, it was over 600 people. That is the equivalent of Craigavon Area Hospital and another of our smaller hospitals being consistently out of use. We cannot create an efficient system if that is the situation in our health service. I presume that, during the winter, that might have been much worse. Fixing waiting lists is a complicated issue and requires us to fix social care.”
“One in four adults in Northern Ireland live with two or more long-term health conditions. When patients require treatment, they are not flowing through the system as they should. Staff cannot see as many patients as they would like, and they end up operating old and clunky technology that is unfit for the 21st century.”
“We could include in that Province-wide centres of excellence for rapid diagnostics or scopes, and understand that the very expensive equipment that we use for that should not be simply switched off and shut at 5.00 pm. One of my local hospitals — Daisy Hill in Newry — is a classic example of where we need to ensure that we sweat the asset that we have. For many years, more and more staff have been added, but the number of appointments and procedures has not increased. I do not believe that that is the fault of the staff. The system is far too inefficient, and insufficient emphasis continues to be placed on prevention, leaving too many people with a preventable illness ending up requiring treatment.”
“Some already operate in the United Kingdom and the Irish Republic, and our political relationship with the United States should be able to assist us in trying to interest those people in helping us address the crisis in our health service. However, we would need to be willing to offer large enough bundles of procedures to release the efficiencies and ensure that those people would come. <BR /> <BR />Other areas that should be pursued include organising our waiting lists on a regional, Northern Ireland-wide basis to permit same-time access, regardless of where someone lives. There are far too many inconsistencies in the wait times across the trusts in Northern Ireland. I know that our Minister speaks about inequality in health service provision, but this is a structural inequality that needs to be addressed.”
“We need a better answer than simply, "Give us more money" or, "We can't fix this until you give us more money". The motion specifically addresses the issue of money. I hope that money becomes available, although, I must say, as devolution was being restored, we were the only party that said we had insufficient amounts of money. However, we cannot simply sit about and do nothing until more money arrives: we need to look at the alternatives. <BR /> <BR />I have suggested seeking to partner with large national or international providers. There are renowned US non-profit organisations that should be encouraged to take an interest in Northern Ireland.”
“I say this, to the Chamber: simply doing a little more and investing a little extra will not make enough of a difference, and continuing in the old way, with small contracts at the end of the year for the private sector, or when money becomes available, will only have minimal impact. Staff, busy in their NHS jobs, doing a little extra at the weekend or, perhaps, one day through the week, is only playing at the margins. We need a fundamentally different approach. <BR /> <BR />Officials have told the Health Committee that we are not far off having the appropriate capacity to be able to deal with the regular, anticipated workload of routine and emergency cases, year-on-year — that is good — and it is the backlog that is the massive challenge.”
“<BR /> <BR />Last year, there was an increase of 9·4% in the number of people waiting for an appointment with a consultant following their referral by a GP. In many specialities, there is a much, much longer waiting time than there is in others. We need to address those issues. They are very, very significant. We have heard for a long time that Northern Ireland has the worst waiting lists in the United Kingdom, but has the approach that we have tried so far brought us any closer to significant progress? We have made progress at the margins, but not significant progress that will help us to address the issue. Does anyone in the Chamber have confidence that we will see significant improvements if we continue to do the same thing that we are doing?”
“<BR /> <BR />For the debate, I looked at the cancer waiting times in Northern Ireland. There is a 62-day target for patients starting treatment following an urgent GP referral, and only 29·8% of patients with an urgent referral will start treatment for their cancer in that time frame. Imagine the terror and anxiety felt by a woman who discovers that she has breast cancer and realises that, in Northern Ireland, of the patients seen by a breast cancer specialist following an urgent referral — we are supposed to have a 14-day target for that — only 34·1% of women will be seen in the appropriate time. That is obscene and shocking; it is to our shame. It is something that needs to be fixed. Minister, this is not a get-at-the-Minister issue. We want to work to make sure that all of us — collectively — fix these issues.”
“The NHS's founding principle of care being largely free at the point of use means that the length of time we wait tends to serve as an indicator of the state of the service overall. We should reflect on that point, because it is significant: so many people are waiting because so many elements of the service need to be fixed in Northern Ireland. <BR /> <BR />I use the word advisedly, but the waiting times in Northern Ireland have become "obscene". Growing demand, funding constraints and staff shortages have contributed to the fact that none of the departmental waiting list targets has been met since 2014: that is 10 years, and those are the targets that I can verify. The result, tragically, is that people will have much poorer outcomes and many will die because their diagnosis or treatment is delayed.”
“Thank you. <BR /> <BR />The motion is one of the most important that we could bring to the Assembly. It will have a resonance in every family across Northern Ireland. We all know someone who is on a waiting list; we all know someone who is in pain; and we all know someone on the waiting list who will be diagnosed with an illness more serious than that had they been seen earlier. It is a significant yet difficult issue, but the Minister and the Assembly must grasp it in order to make life better for people in Northern Ireland. <BR /> <BR />Waiting for treatment has been a fact of life since the inception of the NHS, with statistics going back to 1949, believe it or not, on the number of patients waiting for routine treatment.”
“What will the Minister tell the Secretary of State when she meets him later today about why he should unpause the Mid South West and Causeway Coast and Glens deals and rectify what would be a great injustice and a great harm to regional equality?”
“There is great consternation about the pausing of the deals across the Chamber but particularly among those of us whose constituencies are affected by the continuing pause in the Mid South West deal. That deal is important to Upper Bann, particularly its agri-food element, because of the large manufacturing base and the rural constituency that we have. We are concerned that the Secretary of State is not aware of the harm that could be caused to the growth in Northern Ireland's economy. <BR /> <BR />I have to point out that more than the north-west have areas that suffer great deprivation, and I was glad to hear you say that.”
“I thank the Minister for that, because it is really important that our constituents hear that reassurance. The problem that has occurred is a particular one, and my colleague asked for a timescale for resolving it. Does the Minister have such a timescale?”
“— and stop the double-talk and the gaslighting of innocent victims in Northern Ireland.”
“He was 23 years of age when, on 13 April 1991, gunmen lay waiting for him. They fired 41 bullets into his car. Shortly after that, his father received a phone call from the Provisional IRA telling him to go out to the yard and see the mess that they had left for him — it was his son. There are significant reasons to believe that the gardaí officers in Donegal passed erroneous information on Ian Sproule to the Provisional IRA. I have been involved with the case for many years. Along with John Sproule, I met the Irish Government in relation to the case, and there has been a blank refusal to carry out an investigation. The Irish Government should come off the fence —”
“Thank you, Mr Speaker. Thirty years of terrorism and evil perpetrated by paramilitaries in Northern Ireland have left a shocking legacy of pain and tears. Last week, the Government's actions of granting a public inquiry into only one death and citing the "exceptional" issues in that case perpetuated that legacy. Today, we should think of those for whom there is not the truth or justice that should be the hallmarks of a democratic society. The Government's hypocrisy and double standards were reflected in the actions of the Irish Government when, last week, they welcomed the inquiry into one evil act but did not acknowledge the collusion between the Provisional IRA and the gardaí. <BR /> <BR />I make no apology for again raising the case of Ian Sproule. He was a young loyalist from Killen, near Castlederg.”
“— of value added was through agri-food. What does that say about the AERA Minister's priority on farming, and will the First Minister and deputy First Minister work with us to ensure that those areas are included meaningfully in the Programme for Government?”
“I thank the deputy First Minister. I must say that I am disappointed overall that the AERA Minister has not had a greater focus on farming, rural communities and the agri-food industry. Seventy to seventy-five per cent of our land mass is managed by farmers. We need them to provide good environmental outcomes. In 2021, £4·9 billion —”
“If not, will the First Minister guarantee to the House that that will be a priority for the Executive?”
“I thank the First Minister and deputy First Minister for answering questions and for the production of a Programme for Government. It is an important way forward. I welcome the focus on health waiting lists. I do not know of any constituency office or area that we represent that will not be impacted by that fundamental issue. <BR /> <BR />A previous Member to speak referred to funding for health waiting lists, but does the First Minister recognise that there are structural problems and inequalities in the health service that will require huge decisions by the Executive and the wider Assembly? Will the First Minister tell the House whether the Health Minister has presented his plan for the transformation of the health service to the Executive?”
“The Minister said yesterday in the House that health is a personal issue. It is personal to every one of us, to our families and to our communities, and we need to work together to fix a system that is essentially broken. Too many of our constituents are on waiting lists and in pain. We on this side of the House will not be found wanting in working together with the House to ensure that we fix the problem within the term of the Assembly. While this is an extremely challenging Budget, we hope that we will see better times and better funding so that we can direct it towards those most in need.”
“<BR /> <BR />Our Health Ministers have been good at telling us what they cannot do, but they now must tell us what they can do with the 52% of the total budget that is allocated to Northern Ireland. We need to know what those priorities are. On 15 April, in the House, I asked the former Health Minister when he would bring forward his plan for restructuring the health service in Northern Ireland. He told me then — it is on record — that it would be in a couple of weeks' time. We still do not have that plan. We in the Health Committee cannot hold the Department and the Minister to account if we do not see the plan. We need to see it. <BR /> <BR />In closing, I stress that I acknowledge how difficult the Budget is for all Departments, particularly the Health Department.”
“Therefore, I urge you, Minister, to ensure efficient monitoring so that all allocated funding is utilised for the benefit of those on long waiting lists, waiting for care packages or red-flag cancer patients who have difficulty accessing prompt healthcare. <BR /> <BR />We all want a Budget that is fit for purpose, and I and my colleagues will not be found wanting in working to achieve that. Having outlined that, I also want to put it on record that funding is but one part of a complex set of problems and issues that require solutions in order to have a health and social care system that is fit for purpose. We need a comprehensive plan for the restructuring of services.”
“Thank you, Mr Deputy Speaker. I respect your ruling. <BR /> <BR />Minister, as you are here in the House, I want you to acknowledge that there is work to do with the Health Department to avoid its continuous underspends. The Northern Ireland Audit Office report published on 24 May records that, in 2018-19, the underspend was £32 million; in 2019-2020, it was £69 million; in 2021-22, it was £25 million; and, in 2022-23, it was £27 million. In total, £153 million that could have been spent on health was handed back. That included £88 million of non-ring-fenced resource DEL that could have been used for the benefit of our health and social care system. We all know that that funding would have made a difference.”
“That is work in progress, and I know that the MPs from my party will take it up with renewed vigour after the general election.”
“We now have a more generous settlement, but, if we are to rebuild our public services and really make them fit for purpose, it will take all of us in the House working together to secure that objective of additional finance.”
“<BR /> <BR />I welcome the additional £122 million from the June monitoring process. As my colleague said, that represents about 57% of the funding that was available. I look forward to the Health Minister giving an update on the impact of the additional funding, just as the previous Health Minister was so keen to give us his letter on the funding gap. I hope that the new Health Minister will work with Executive colleagues to secure more funding from Treasury and not continue the sham fight on the issue. <BR /> <BR />As colleagues have said, it was my party leader, Gavin Robinson, who started the work on getting a better settlement from His Majesty's Treasury because he recognised that Northern Ireland was not funded on the basis of need.”
“No, I want to make progress. <BR /> <BR />I have absolutely no doubt that this is a difficult Budget for all Departments. The Health budget accounts for 52% of the total block grant to Northern Ireland and, in the Budget allocation, was awarded over 50% of the additional funding that was made available to Northern Ireland. In the last couple of years, the Health budget has seen a considerable increase in its allocation, yet some in the House have tried to indicate something different by comparing an end-of-year settlement with a beginning-of-year settlement. I warn Members: our constituents are not fooled by that nonsense and are clear that, whatever the problems in health are, that kind of wrangling is of little use to them. They want the issue sorted, and they are tired of the nonsense.”
“<BR /> <BR />In the last few contributions, we have heard political manoeuvring around the Health budget, but, as someone who has been consistently out on the election trail for a number of weeks, I have to warn people: our constituents have little time for this, and they recognise that there is a considerable amount of work for us all to do to sort out what are fundamental issues for the health and well-being of our society.”
“I welcome the opportunity to contribute to the Budget debate, and I will confine my remarks to my policy area of health and social care. <BR /> <BR />As a first step, I reiterate my and my party's priority for our health and social care system. I believe that, despite the political wrangling, all of us across the House want to see a health service that is fit for purpose and serves us and our families in times of need in an efficient and practical manner. It is important to stress those issues when debating the Budget Bill.”
“Minister, you will agree that early detection for cancers is extremely important. Recently, I met Cathy Brokenshire, the widow of the late James Brokenshire. We do not have early screening for lung cancer in Northern Ireland, despite lung cancer being one of our most prolific killers of people with cancer. Will you look at the idea of having screening for lung cancer and come back to the House with proposals on that vital aspect of healthcare?”
“Thank you, Minister. My question follows on from what your statement said about cancer. We all know that cancer does not respect boundaries, persons or anything else and that all-island cancer research is a good thing, but we need our own cancer research strategy for Northern Ireland. Will you commit to bringing one forward in this mandate?”
“Thank you, Minister. Will it require legislation to create a separate body for the controlled sector? Is that, potentially, in the long run, the only way forward to ensure that there is equity between all education sectors?”
“Thank you, Minister, for that. It is really important. A large ecosystem of companies across Northern Ireland, including my Upper Bann constituency, supplies to bigger companies such as Spirit. Have you had contact with those companies, and do you recognise the importance that that large employer has for their survival?”
“I thank the Member for taking an intervention. I am always astounded that people put so much emphasis on cross-border healthcare. Will the Member agree that there is an inherent inequity in that people who want to avail themselves of that service have to provide the money up front before they can claim it back and that, even then, they may not be able to claim all of it back? That is an inequality in the whole set-up. I would like to hear the Member's views on that.”
“In commending the amendment to the House, I hope that Members will recognise that the intention is not to damage the motion but to widen it and give voice to all the types of collaboration and research that we should be looking at in the fight against cancer.”
“In Northern Ireland, companies are also able to tap into a wealth of experience from academics to get better access to biobanks, product development or analysis and to equip researchers with future skills. The overall goal is to generate new therapies and diagnostics through an integrated pipeline. <BR /> <BR />To conclude, we have to recognise that cancer knows no boundaries, be they social, political or geographic, and that the world of research is getting increasingly smaller with greater collaboration across the world. As one who, for many years, was involved with the Horizon project — from my time in the European Parliament — I understand the benefits of research on a global scale as well as research, North and South, and within the United Kingdom.”
“<BR /> <BR />We should not forget the development of the future medicines institute initiative, a joint vision of the Northern Ireland Precision Biomarkers and Therapeutics Consortium, which is a group involving industry and our universities. Through that, we can develop new technologies, drive productivity and de-risk research and development efforts through collaborative working and the sharing of technologies and resources. Under the planned model, the future medicines institute will operate as a research hotel that allows companies to gain rapid access to shared resources. The Belfast region city deal represents a timely and neat fit with that kind of visionary work.”
“Cancer research at Queen's has led to a number of breakthrough treatments, including the DNA sequencing of tumours of 70% of all Northern Ireland cancer patients, which enables novel cancer therapies to be more available to more than 4,000 cancer patients a year in Northern Ireland. The breakthrough treatments include practice-changing radiotherapy trials, including one that reduced the number of radiotherapy cycles needed to treat prostate cancer from 39 to five. That means not only much greater convenience for patients but considerable savings in time and funding for the NHS. Such treatments are exceptional in such a small place as Northern Ireland.”
“We are fortunate that, in the United Kingdom, our universities regularly feature in the lists of the top 10 universities in the world. Northern Ireland is part of the UK Clinical Research Collaboration (UKCRC), a partnership of the main stakeholders that fund clinical research in the United Kingdom. <BR /> <BR />In tabling the amendment, we want to recognise that we share research on the complexity of cancer across all tumour sites not just north and south of the border but throughout the United Kingdom and, indeed, the world. We should also recognise that Northern Ireland is recognised internationally for the quality of cancer research here, which translates into better care for cancer patients delivered through the Patrick G Johnston Centre for Cancer Research at Queen's University.”
“It recognises that we cannot offer every service that we might wish to offer in Northern Ireland and that patients will sometimes need to travel for more specialist services. Sadly, that can too often be the case for children's oncology services. <BR /> <BR />As the proposer of the motion said, one in two people will develop cancer during their lifetime. That is a frightening statistic. While there are huge opportunities, North and South, the battle against cancer is a worldwide one. Our experts need to share and collaborate with their colleagues and counterparts throughout the world. For an issue in which research and innovation are so critical, in Northern Ireland, we benefit from access to the very best academic institutions.”
“I know that that is suggested in the broader Northern Ireland cancer strategy, but, as the Queen's University briefing paper for this debate indicates, we need to see cancer research as a necessity and not a luxury that we can dispense with or do without. The cancer strategy proposes implementing the recommendations of the oncology service transformation project and extending acute oncology services throughout the weekend. Those are practical things that we can do fairly simply. The strategy also supports increasing the per capita spend on cancer research and the number of Northern Ireland patients participating in clinical trials and receiving access to novel therapeutic agents and techniques.”