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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“Thank you, Mr Deputy Speaker, and thank you to colleagues for what has been a thoughtful debate. More importantly, however, thank you to our GPs, allied health professionals, health and social care workers and all who do a sterling job in that front-line service of primary care. <BR /> <BR />Every person in Northern Ireland is registered with a GP, and we all expect an enormous amount from those GPs. The debate has never been about bashing anyone, the Minister or GPs; rather, it has been an opportunity to discuss the problems in a rational, thoughtful way, and I thank colleagues for that today.”
“Thank you. That is encouraging. We have spoken about this at length, and it is a really important project. In light of that, will the Minister share with the House what other projects he is considering in the Upper Bann constituency in the short to medium term?”
“Thank you, Minister, for your answer. That is an important programme whereby we can enhance the environment and really do something quite special. Over the next five years, how much will it cost the Department to meet the climate change targets that were set by the House? As his Department is responsible for the policy, has he had negotiations and conversations with his Executive colleagues so that we understand how much this will cost across the whole of government?”
“Thank you. I will step down. <BR /> <BR />We also, importantly, need a register of foster carers.”
“<BR /> <BR />Minister, we need to hear what you are doing about the allowances for foster carers in Northern Ireland and to make sure that those allowances are increased in line, at least, with the rest of the United Kingdom. I understand that there have been proposals about a foster carer recruitment and retention strategy and a greater development of foster carers' skills. That will also benefit the system. Most importantly, foster carers want to feel valued. They want to feel like part of an overall care team. They need to be involved in meetings and decisions about the children they live with and work with daily. I would like you to consider how the whole team of foster carers, children and social workers can work together to the benefit of those children.”
“The Member has made an important point about children with special needs. <BR /> <BR />In general, I have looked at the table of allowances for foster carers, and it is lower in Northern Ireland than in other parts of the United Kingdom and significantly lower than in the Republic of Ireland. Foster carers who take on the added responsibility of children with special needs need to understand how they will be supported, both financially and with advice; that is hugely important. Minister, on top of that, we need to look at foster carers who are fee-paid to take in young children and the transparency around the award of that amount of money. <BR /> <BR />Thank you for your question, Ms Brownlee; I know you have been contacted by constituents in advance of the debate.”
“<BR /> <BR />Northern Ireland has higher rates of referral for children in need and children with child protection plans than other parts of the United Kingdom, with an over-reliance on kinship care, which does not suit every child because of difficulties in the family situation. However, kinship placements have increased from 25% to 45% since 2010. Minister, what are we going to do about a situation that is in danger of running out of control for the most vulnerable children in our society? The first thing we must do is value the foster carers who give their time. Foster carers in other parts of the United Kingdom were advised about the annual uplift to their foster allowances for this financial year, but Northern Ireland foster carers have been left in the dark.”
“That is an incredible number of looked-after children in Northern Ireland. In the UK as a whole, every 20 minutes, a child comes into care. Some children who come into care will experience multiple moves that will impact on their attachment and development. In Northern Ireland, some children in care will live far from their families, their social network, their school and the environment they know. They will either have to change school or be transported to the school on a long journey every day. The families I was involved with were going to face a 30-mile journey every day just to get to school: it was a 60-mile round trip.”
“They are looked-after children who cannot live with their families for a multitude of reasons. Removing a child from a family must always be in the best interests of that child, but it is often difficult and traumatic. It is estimated that we need a further 261 foster carers to meet the growing need, because we have more looked-after children now than we have ever had. <BR /> <BR />Retaining foster carers is a huge challenge. Let me put that in context: during 2022-23, 419 foster carers who had been recruited by the trusts ceased to be foster carers. You can see the magnitude of the problem that is faced by foster carers, the trusts and, most importantly, the looked-after children. The number of children in care increased by 5% in the last year and by over 35% in the last decade.”
“We have had lots of those since the restoration of devolution. I really want the debate to be a call to action to support some of the most vulnerable and traumatised children in Northern Ireland. It is a call to support foster parents, who give their time and guidance to those children. The motion has actions that I intend to monitor closely, and I will look at their implementation by the Health Department. Some of the actions that I will outline are eminently achievable. They are not hugely costly, but they would make a substantial difference to the people who foster and the children who are looked after. <BR /> <BR />Foster carers care for about 83% of children in the care system. In March 2023, 3,154 children in Northern Ireland were being looked after by a total of 2,562 trust foster carers and 265 independent providers.”
“Thankfully, we got the situation resolved with foster carers in the locality, meaning that the children could continue with their social circle and their school. <BR /> <BR />Some people have asked me why I chose to raise the issue of foster carers and looked-after children. Minister, I acknowledge that there are huge issues in the health remit and that your Department has many challenges. Many of them will require Executive agreement and huge amounts of money, but there are other issues in your Department that you can deal with much more quickly. In the context of a healthcare budget of over £7 billion every year, setting to rights the issues around fostering and looked-after children should be a relatively simple and small task for your Department. <BR /> <BR />I do not want this to be just another nice debate in the Assembly.”
“I want to recognise and thank Kathleen Toner from The Fostering Network NI. Her knowledge, advice and professionalism are much appreciated, and I look forward to working with her in the future. I also look forward to Foster Care Fortnight in May, during which the network will celebrate and try to recruit foster carers in Northern Ireland. We wish it well in that endeavour. <BR /> <BR />In my constituency advice centre — I am sure that many others have experienced this — I have recently supported families and foster carers who are providing a loving home for children who were removed suddenly from their own home and threatened with a placement in a residential home in a trust unit far away from their own environment.”
“Foster parents give that love and support to children in often traumatic and difficult circumstances. The children may have been removed from their home because they were at risk of harm or simply because of difficult family circumstances. Fostering is an incredible service given by ordinary families in some extraordinary circumstances. Their duty of care is an immense service to children and young people in Northern Ireland.”
“I start the debate by offering thanks to those who give so tirelessly of their time, their care and their love to so many of the most vulnerable children. I think that all of us in the Chamber will have the privilege of knowing the effort, care and love that we put into looking after our own children — in my case, it is my grandchildren, too — and our nieces and nephews.”
“Thanks to the Minister. I know that he is personally aware of the huge role that faith-based organisations play in our community. Too often, they have to sort of have their faith as a secondary element in order to ask for grant support either from government or from wider agencies. Will the Minister commit to looking at that element of the support for faith-based organisations and acknowledge the significant community services that they provide?”
“Yes. Thank you, Mr Deputy Speaker, for allowing me to go on. <BR /> <BR />We need greater coordination between the services, and I appeal for the Minister to look at that as well.”
“Thank you. I absolutely agree that it is totally key and extremely important. <BR /> <BR />To close, I will speak a little about dual diagnosis. That term is used to describe the concurrence of a mental health problem alongside substance misuse. It is a significant issue for the health service. Up to 70% of people in drug services and 86% in alcohol services also experience mental health problems. It is really important that we look at and deal with the issue of dual diagnosis. Many of those people are young. Between 64% and 88% of adolescents with substance misuse disorders have at least one co-existing mental health issue. Therefore —”
“<BR /> <BR />We also need to look at how we prevent and tackle the issue by trying to get it at source before it becomes a huge problem. In 2020, the Northern Ireland Audit Office (NIAO) report, 'Addiction Services in Northern Ireland', showed that the Department of Health spends £900 million each year on tackling drug and alcohol misuse but only a small budget is allocated to combating the issue: £8 million for implementing the drug and alcohol strategy and £8 million for statutory addiction services. I suggest that, if we are to prevent the huge amount of money that the health service spends on that very important issue, we need to get into the prevention space much more quickly and effectively.”
“Mr Chambers mentioned the Preventing Harm, Empowering Recovery strategy, on which a report was published last month. In that most recent report, 33 actions — 58% — are currently set as green, so they are progressing as planned, which is good news in many ways. However, 24% are not and are set as amber, since they require the confirmation of additional funding. <BR /> <BR />Before the restoration of devolution, I attended a meeting with community groups whose funding has been cut. One issue that was cited was the fact that community groups that deal with drug addiction and the misuse of drugs have had a lot of their funding cut. We need to look at restoring that. I appreciate, Minister, and understand the difficulties. That is why I support the amendment, because that issue is very important.”
“Those statistics are taken from the Northern Ireland Statistics and Research Agency (NISRA) report that was recently released. In 2022, two thirds of those who suffered from drug-related deaths were men. That is a really sad reflection on society and the increasing use of drugs, but it would be remiss of us not to say today that we all support removing the scourge of drug dealers from our communities. They bring nothing but pain and death. It is incredibly important that we look at that. <BR /> <BR />The proposer of the motion rightly spent her time reflecting on some of the stories and the humanity behind drug misuse and addiction. I will look at some of the strategies and the wider areas that we, as policymakers, also need to look at and reflect on.”
“As the previous Member did, I offer my sincere condolences to those who have lost loved ones. I thank the proposer of the motion for the beautiful poem, which describes the chaos and difficulties of someone caught in the trap of addiction. <BR /> <BR />I start by reflecting on the number of drug deaths in Northern Ireland and the fact that we have seen an explosion in those deaths over the past 10 or 15 years. We have seen a 98% increase in drug-related deaths since 2012. In 2022, there were 154 drug-related deaths, which represents a 40% increase from 2014. In 2022, the underlying causes of 82·5% of drug-related deaths were substances that are controlled under the Misuse of Drugs Act 1971, with heroin and morphine being the most prevalent ones listed.”
“<BR /> <BR />I know that the procurement process for operators for the car parks and so on has gone ahead, but I also ask the Minister to tell us whether there is a capital expenditure in buying further land at some hospitals for car parks. I have heard that mentioned a couple of times, and I want to be clear on it as well.”
“When I met the Northern Ireland Children's Health Coalition, its representatives were absolutely clear that what is available is not adequate to address the needs of families with children who have long-term conditions, such as cancer, and who may be in hospital for weeks on end. They need better supports. Parking is a significant issue for them, and I want the Minister to come back and tell us clearly about that and not just repeat what he said last week. In the interests of being reasonable and practical, I would like the Minister to answer the questions and tell us whether he can shorten that time frame.”
“<BR /> <BR />On that reasonable and practical issue, we want to know this: is there a way that the Minister can truncate his desire to withhold the measure for two years and give us the opportunity to implement the Act earlier? I hope that, by the time that a year has passed, the Finance Minister will be able to have a multi-year Budget, and, therefore, the Minister will have some clarity on the Budget. I hope that the Minister can clarify those issues for us and that we will be able to implement the measure much sooner. <BR /> <BR />I asked the Minister this question in the previous debate on the issue, and he answered it, but will he clarify whether he will look again at the range of options that are already there?”
“As the Member who spoke before me said, we do not — I made this absolutely clear last week — resile from the original Bill. That Bill was voted through with our support, and we do not resile from it. We cannot state that clearly enough. We supported the aims and objectives of that Bill. However, we are in politics to be practical and reasonable. It is important that, if a Minister says, "I cannot deliver in this particular time", we look at what is reasonable and practical. For that reason, we will not support Mr Carroll's amendment. We want to be clear with people. We do not want to raise expectations for something that we simply cannot deliver and that we cannot ask the Health Minister to deliver.”
“They are not just extremely concerning; some of the organisations listed were being assessed for criminality. We need to support teachers with broad, balanced information rather than information that reflects only one view of society. The Member for Mid Ulster indicated that we should all learn from this. Of course we should, but perhaps she will also learn that describing puberty blockers as a health right for teenagers is also wrong, given the Cass report and the damage that has been done to children and young people by gender identity clinics.”
“That was reflected in the RSE legislation that was brought forward in England relatively recently. We appear to say in the motion, "Do what I say, and that is all that you can do". We need to respect the rights of parents. We need to respect the rights of teachers. Not all teachers will want to teach a standardised curriculum. They will want to teach according to their conscience. <BR /> <BR />The motion refers to supporting teachers in the delivery of RSE. In November of last year, I wrote to the chief executive of the Council for the Curriculum, Examinations and Assessment (CCEA) because I was concerned about the number of references to organisations in the RSE hubs, some of which —.”
“No, I will not. <BR /> <BR />The motion usurps the role of parents, teachers and boards of governors in taking a holistic view of their school, their ethos and what they will teach in RSE. <BR /> <BR />An element of the debate pits children's rights against parents' rights. Much has been made of the rights of the child. I have just looked at article 2 of the first additional protocol to the European Convention on Human Rights, which makes it clear that:”
“The Member for Upper Bann should remember that 13,500 people responded to the recent consultation on RSE. They were certainly not from the far right. As other Members have said, it is important to acknowledge that, in that consultation, many parents said that parents were best placed to discuss the issues with their children. There is evidence that, if parents discuss these issues with their children in a well-formed, loving home situation, that makes for the best outcome —.”
“— no; I have a lot to get through — have a general, broad Christian ethos and that children are taught within those values. That is for the good of society and will stand them in good stead as they go forward. I regret that the motion does not refer to parents. Perhaps it is reflective of the Upper Bann representative's contempt for parents, grandparents, teachers, pastors and ministers that he referred to their gathering to discuss RSE in Portadown as:”
“However, while RSE is a compulsory part of the curriculum — we do not automatically get that from the motion — there is an obligation in our society and our education system to deliver RSE in conjunction with the school principal, the board of governors and the parents of pupils of a school. It is primarily because of the exclusion of parents that I am opposed to the motion. Schools have an ethos. I am thankful that schools in our community —”
“We all have to acknowledge that never before in our society have children been under such pressure and had such difficult choices to make. It is up to us to help support them in every way that we can. RSE is a tool that can be used. It can be taught in a sensitive manner, encouraging children and young people to have self-respect and the ability to make safe, responsible and well-informed decisions so that they can form healthy, respectful relationships, in their teenage years and into the future. They need to know, as the Member for East Londonderry said, when they are being coerced, when to give consent and when it is appropriate to say no. I do not disagree with any of those sentiments.”
“Minister, this is a complex issue, and the picture is developing; I accept that. However, will you confirm that Northern Ireland will be subject to the EU CBAM rules unless the UK Government deny that or if the UK Government align with the European Union's CBAM? It seems to me that this is an example of the lack of democracy and accountability that Northern Ireland and this House cannot have those adjustments made.”
“Thank you, Minister. Reflecting on that incident with the Metropolitan Police, I am sure that you will agree that the language that we use is extremely important. Your colleague from Upper Bann referred to a meeting in Portadown on relationships and sexuality education (RSE) and the people who attended it as a "dog whistle to the far right". Does the Minister think that that is acceptable language? Will she clarify whether the PSNI will interview her colleague, under her proposed hate crime legislation, for that remark?”
“I accept, as I said to you earlier at a meeting, that you are operating in a really difficult budgetary situation and that it is difficult, at a time of extreme pressure, to ensure that every need across the health service is met. Nevertheless, this is an important issue and I look forward to hearing your responses.”
“When they looked at abolishing fees, they put down some markers on what they would do to achieve that. Those were to make sure that hospital car parks are not misused by commuters or shoppers, that you balance the needs of different groups and that you are encouraging the use of public transport, where possible, to get to hospital. As a Member for Upper Bann, I am aware that that is not always possible in rural areas. They were, of course, careful to protect spaces for the disabled and those who are very sick. <BR /> <BR />I do not think that we have an insurmountable task in front of us. I hope that it will not take two years to get the 2022 Act into operation.”
“<BR /> <BR />They say that all politics is local, and you referred at length to the City Hospital and the Royal Victoria Hospital. However, I assure you, Minister, that car parking at Craigavon Area Hospital is in just as serious a position. Even at times of day that are not busy periods, it is almost impossible to get a space at Craigavon Area Hospital. There is life outside Belfast, and we need to stress that those of us in other parts of Northern Ireland experience these issues as well. <BR /> <BR />Minister, you very kindly answered a question from me in the Chamber yesterday on the reconfiguration of hospitals. In implementing the Act — hopefully, as soon as possible — will you take that into consideration and let us know how that will work? <BR /> <BR />We could also look at the Scottish and Welsh Governments.”
“We have always said that accessible spaces should be available for those who require them the most, such as those who are under stress, those who have received a difficult diagnosis and those who are visiting an ill relative. The Chair of the Health Committee referred to meeting the Children's Health Coalition, which I too have met. Something needs to be done about the hidden costs of long-term hospitalisation for families who have children who are ill over a long period. Many children with a cancer diagnosis are in hospital for a very long period, and their families require support. I hope, Minister, that when you are looking at measures to alleviate the pressure in the interim, you will look at that particular issue. It is very important that that happens.”
“The Member who spoke previously stated that all the parties in the Assembly supported the original Bill. I reiterate our support for it; we do not resile from it. I say to the Minister that we are disappointed that we are having to defer the provisions of the Act. There are genuine questions to answer about how much work has been done in the interim period to get the systems into operation. As the Member who spoke previously said earlier today, we are where we are, but it would be good to hear some of the explanations for the delay in getting the provisions to proceed.”
“— be good to hear from the Health Minister on the issue. <BR /> <BR />In closing, I want to say: thank you, Kellie, for sharing your story. You make a massively important point about the cut-off date, and I hope that the Finance Minister picks up that point in developing the scheme.”
“It has gone on now for five or six years, and that is far too long for it to have persisted. Perhaps it would —”
“The second part of the motion is about the lack of a child pathology service. I think that all of us in the Chamber agree — I will not labour the point — that, as Robbie Butler said, it is cruel to not have that service in Northern Ireland, or least have access to it on a wider all-island basis. That is important, and we should be working towards it. If we see ourselves as a compassionate society, it is important to do that. <BR /> <BR />There has been a failure to address these issues. There are many huge issues that the Assembly must address. We must have a Budget, a Programme for Government and all these things, but it is sometimes the simple things that actually make a difference. That is very important. I want us to ensure that we look at all options to ensure that this issue is resolved.”
“I have heard the loss of a baby through miscarriage be referred to as a "clinical episode" or by some other term that is cold. We really must get away from language that takes away from the loss. There are some absolutely brilliant examples of training for midwives, for example, but more training and more knowledge will be required to make the process better for everyone. We should look at not only the baby loss certificate, which is important in itself, but the training that we give and how we address the issue with parents. As our colleague Cheryl Brownlee indicated, to simply be sent home from hospital with a leaflet is a fairly brutal experience for new parents.”
“One thing that all of us in the Chamber have agreed on is that we must do better to support those who are affected by early baby loss. We all know, when we hear of a pregnancy, that that is the start of hopes, dreams and all that is so important, but we have also heard in the debate that, in the United Kingdom, an estimated 25,000 pregnancies end through miscarriage. It is the most common complication of pregnancy, so it is a really significant issue that we have to deal with. A certificate for those who have had a miscarriage or lost a baby through an ectopic pregnancy prior to 24 weeks is therefore a small but important acknowledgement of that child's life. <BR /> <BR />We have also all agreed on this: a certificate is not enough. We must look at how clinicians support mothers and parents.”
“In addressing the motion and winding up on the amendment, I not only acknowledge the importance of the issue but agree with our colleague Mark Durkan whose contribution indicated that there are two separate issues and that it would perhaps have been better had we dealt with them separately so that the Health Minister could have been here to deal with the issue of the lack of a paediatric pathology service in Northern Ireland. We are where we are, however, and we support the motion and, obviously, the amendment. <BR /> <BR />The issues are emotional and difficult, and we should acknowledge and thank the Chair of the Health Committee, Liz Kimmins, for bringing to the fore the stories of so many people who had contacted her.”
“Thank you, Mr Speaker. Will the Minister tell the Chamber when he proposes to bring forward his plan for the reconfiguration of hospitals in Northern Ireland?”
“Minister, last week, the publication of the Cass review's final report caused a significant degree of concern. What action is your Department going to take in light of that report's publication, and can you explain how puberty blockers, which were introduced in the UK merely for research trials, could come to be prescribed for routine clinical use despite not being licensed for such use or there being any meaningful evidence about their safety? How many children in Northern Ireland might those have been prescribed to?”
“— such as Mourneview, and, in particular, Brownlow House. How can the Executive Office support those communities?”
“Does the Minister agree that there are other communities who do not live along the border but who feel just as marginalised? I think of communities in south Lurgan —”
“I thank the Minister for her response. In fact, her response was fairly general. I specifically wanted to know about communities that were marginalised and communities, like the Kingsmills families, that felt the brunt of the IRA genocide that was experienced along the border.”