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 not just for one Department to deal with the levels of child poverty that we are experiencing in Northern Ireland. That is very important. It is also very important to acknowledge that many teachers to whom I speak are tired of the expectation that they solve every problem that comes across their desk. <BR /> <BR />We all know that the holiday hunger scheme came about during COVID, but, in order to reinstate it, we must stress today the need for an adequate budget for the Department of Education. If we are to really address the issue — if we are to be serious in addressing it — that underinvestment in education must cease and we must be willing to support the Minister in his drive for additional funds so that he can assess the problem and see how to address it.”
“Research by the Northern Ireland Anti-Poverty Network found that nearly one in eight children — 12%, which is around 50,000 children — is materially deprived, which means that their families cannot afford the basic items and activities that we consider to be essential for a healthy and happy childhood. The ''Northern Ireland Poverty and Income Inequality Report, 2021/22', found that 15% of children in Northern Ireland are in absolute poverty and that 18% are in relative poverty. That means that almost one fifth of children in Northern Ireland are living in those circumstances. The issue of holiday hunger becomes really important in the context of those figures. <BR /> <BR />I stress that, while this is a matter that the Education Minister is here today to deal with, it is important for every Department across the Executive.”
“I add my support to the motion and the amendment. I will say a few words on this really important issue. <BR /> <BR />We have all had to deal with high inflation and the cost-of-living crisis. The cost of food, particularly for families, has rocketed dramatically. In recent times, food inflation has peaked at 19·1%. That is a significant additional burden for families, but it is also a burden for the Department when it is administering any scheme. We also understand that, in Northern Ireland, the number of families now visiting food banks has increased by 175% compared with five years ago. That is an extraordinary increase in the number of families who require additional help. <BR /> <BR />Between 1 April and 30 September, almost 10,000 people were forced to turn to a food bank.”
“I thank the Member for giving way. He has made some important points about democracy and the issue of democratic consent. Does he agree that the greatest democratic deficit is the fact that hundreds of EU laws identified in annex 2 of the protocol are imposed on Northern Ireland, governing our manufacturing industry, our agri-food industry and where the EU customs code is applicable, and we can do nothing about them? Are our Government not responsible for a serious breach of sovereignty and democracy in Northern Ireland? Should that not be rectified?”
“However, we want to see a normalisation of the process, and the issues that I highlighted are extremely important in getting us to that position.”
“I urge the Department to get on ahead with dealing with the issue, and I would like the Minister in his summing up to indicate how the risks of abuse are being mitigated and to tell us how many businesses or operators are moving the final COVID vaccines to providers. It is really important to know that. <BR /> <BR />The vaccine is still not at a stage where we have prefilled vials, and, therefore, there has to be a final assembly. I know that it is dependent on manufacturers, but we would like to see that move on so that we can normalise such operations. That is important. <BR /> <BR />Minister, there is an important issue here in that you have asked for an extension until 2026. We understand that it is a UK-wide extension, that the laws will apply UK-wide, and that we should do that.”
“I thank the Minister for his clarification of some of the issues that I was going to talk about. <BR /> <BR />We should acknowledge that the debate today has fewer implications for personal freedoms than the more draconian powers that the Assembly rejected last week. It is important to put that on the record. I note that we were included in the consultation and that no local objections were raised. That, again, is important. <BR /> <BR />I want to highlight a couple of issues. One is the doing away with the requirement for wholesale dealers to hold a licence. The Minister said that, in normal circumstances, a licence would be required. If I recall rightly, we started to administer the vaccine in very late 2020. What is before us today would extend that to 2026. We really have to ask how long "normal circumstances" apply on the issue.”
“No, I want to finish, and I am running out of time <BR /> <BR />It is one of the most integrated sectors that we have, but it is really important that we treat our schools equally and that parental choice be respected in how we deal with schools in the House. I have visited many of my local controlled and maintained schools, and their needs are just as great, in many cases greater. One school that I visited recently in my constituency has celebrated its 90th anniversary. It is in exactly the same building that was built for it 90 years ago, with no additional classrooms or facilities. The sensory room in that school is a disused disabled toilet with a screen around the toilet, and that is what children in that controlled school have to use. That is just not acceptable.”
“We must value all schools equally, and there are many good examples of genuine integration in schools throughout Northern Ireland. That principle of choice and diversity must be respected. The controlled sector is one of the most integrated sectors; in fact, it is more integrated in some schools than the integrated sector.”
“and there is no doubt that the independent review is supportive of integrated education. It is, however, equally supportive of shared education and, indeed, of community schools with shared ownership. The chair of the independent review of education, Dr Keir Bloomer, told MPs at the Northern Ireland Affairs Committee recently:”
“Thank you, Mr Deputy Speaker. I absolutely agree. Accuracy is really important so that we are not throwing around words but talking about what the law states, law that was made in the House in the previous mandate. <BR /> <BR />The law is clear that the Department must aim to meet the demand. That is extremely important to the need for sustainable schools, area planning and the allocation of capital funding. Schools in the controlled, maintained and Irish-medium sectors are all in significant need of funding, and the Minister has a duty to ensure equality of treatment for those sectors. It is therefore extremely important that we understand what the law states. As I said, this is law that was made in the House in the previous mandate. <BR /> <BR />The motion further:”
“and I see that the Chair and the Deputy Chair of the Education Committee repeated that inaccuracy. The law states, in section 5(1) of the Integrated Education Act:”
“Today's motion arises out of the considerable anger at the reallocation of £150 million of Fresh Start funding by the UK Government, and that anger is understandable. There must be disappointment for the schools impacted. It must, however, also be acknowledged that, in the overall funding stream, nine new-build projects will be completed, including New-Bridge Integrated College in my constituency of Upper Bann. <BR /> <BR />There are a number of issues with the motion that I will highlight as being inaccurate. The motion talks about the:”
“We all aspire to having a Northern Ireland that is more peaceful and more prosperous and where our children can learn and play together; to having a society in which we value education as the means to a good job; to providing for our families; and to having a decent standard of life, irrespective of our perceived religious, social or political background. I am not blind to the need to make changes to our education system so that it can be more inclusive and provide greater opportunity for those who face barriers in accessing education and so that it is more connected to the needs of the modern economy.”
“As a preface to my comments, I want to repeat words that I have said in the House many times.”
“I thank the Member for giving way. We all sit here in relative comfort — some of us will feel that more than others — but many women across the world suffer violence for their faith. Last week, in northern Nigeria, 200 women were kidnapped by Boko Haram terrorists. Those women will suffer violence, rape and forced marriage. Does the Member agree with me that we also need to look outside Northern Ireland at the issues that women face in many countries today where they are persecuted for their faith?”
“Therefore, we are certainly in a much better position than we would ever have been. <BR /> <BR />To sum up, I confirm that, on these Benches, we are extremely uncomfortable with the legislation. We find it incredibly difficult to support. We would like a more permanent solution. The Minister needs to address the issue, make the solution permanent and come at it as quickly as he can. In the meantime, in common with other Members who have spoken, we do not support the motion.”
“and that flu in our communities is more pressing for the health service at the moment. The officials also said:”
“Members across the House — the Member who spoke previously mentioned it, and many on these Benches have indicated it as well — have said that our constituents find these restrictions undemocratic and, in many ways, draconian in respect of our freedoms and liberties. While they were necessary at the time, I wonder why we would want to retain legislation like that on our statute book. <BR /> <BR />During the Committee meeting, officials from the Department briefed us on the issue. They were asked specifically about COVID, and, as the Hansard report shows, they said:”
“That is where a lot of our problems and difficulties lie. Certainly, on these Benches, we are uncomfortable about extending that precedent, which was meant for extraordinary times, when we are now talking about the lesser threat of COVID. As the Member who spoke previously said, the World Health Organization has, thankfully, downgraded that pandemic. For those on these Benches, that is extremely uncomfortable. <BR /> <BR />When the laws were introduced, we were told that they were time-limited and would not be extended for one moment longer than they were needed. It is important that we all hold on to that.”
“Those were very difficult days for the Minister and the wider Assembly and Executive, but most of all for our constituents, the people of Northern Ireland. We are debating whether we should continue COVID powers: that is a really significant step forward for us and shows that we have, in many ways, left some of this behind. However, we are all mindful of those families who still grieve and those who lost their lives during an extraordinary and terrible time for our community in Northern Ireland. <BR /> <BR />The SR that the Minister has moved asks us to extend the regulations until 24 March. However, the Minister made it clear, in the Chamber today and in his notes to the Committee, that he intends to continue to extend those until, I presume, there is a more fulsome public health solution to the issue.”
“Before I address the SR, I want to say that the Minister did an incredible amount of work during the COVID pandemic.”
“I thank the Member for giving way. He speaks, quite rightly, of the need for a skills fund and to build apprenticeships. One of the things that frustrates industry most is the fact that the apprenticeship levy is collected but does not come back to fund apprenticeships in Northern Ireland. It goes into the general overall financial position that Northern Ireland is in. Does he agree that it would be helpful if we could retain some of the apprenticeship levy and direct it specifically at a skills fund to build skills and apprenticeships in Northern Ireland?”
“Like everyone else in the House, I am relieved and gladdened to hear of that extension for Nexus. What worried most of us was the loss of that specialist service for people who have suffered in such a violent and terrible way. <BR /> <BR />Will the Minister assure the House that, going forward, we will not think of putting people who have suffered rape or violence on to general mental health lists? That would be the worst outcome. We really want to see the Minister and the Department build up that specialist advice and help for people who have suffered.”
“Minister, your strategy indicates that you will require a total of £145 million or more each year in order to fully develop the strategy towards its end. That, obviously, increases through the years, starting from 2022. Will you ensure that the funding is ring-fenced in your budget, so that we can continue to improve cancer services?”
“I thank the Minister for her answer. It is very positive that we have additional funding from the UK Treasury in order to take the first steps in relation to this. Does she also recognise that it is important to support childcare providers in the extension of the childcare strategy?”
“Thank you. Minister, I know that you know this, but it is not just an Education issue; it is a cross-departmental issue, and it is a matter for the Department of Health. I hope that you are able to work with the Health Minister in that respect.”
“That is simply not where we need to be, and we cannot have that happen again. We need to explore how those special provision units are inspected to ensure that the quality of education is appropriate for children with special educational needs. <BR /> <BR />I turn briefly to the capital needs programme. We need to separate that from the general capital needs programme, so that special educational needs schools are constantly monitored and having their needs met.”
“I am glad to hear that, but our children need to be appropriately placed in the right setting with the right support and the right teachers. <BR /> <BR />Last year, we created over 100 additional classrooms for children with special educational needs. We created them in a hurry. We created them in a state of panic, and, this year, I am told that we might need another 75 classrooms. Our children deserve the right support and the right setting, but they also require it at the right time. They need to know at an appropriate time that they will have a place in school and know where that school is. This year, some of the children who required placements in special educational schools had a place but did not get to attend school until this January, when the special provision was opened at Saintfield for Oakwood School and Assessment Centre.”
“Our support staff are the backbone of everything that happens in a special educational needs setting. I know that the Minister is working on the business case for the pay and grading review. I hope that it can come to a fair conclusion relatively soon. <BR /> <BR />I turn to access to special educational needs places. We in the Chamber all know that the chaos of last year cannot be repeated. As I said to some of the Minister's departmental officials whom I met a couple of months ago — they are here today — we cannot be surprised twice by the number of children who require a place in a special educational setting. I heard some talk on the radio this morning that we would need over 1,000 places. If that is so, it indicates some degree of planning, which is different from where we were last year.”
“<BR /> <BR />I welcome the tone of the debate. If we are, as the Member for Lagan Valley said, to be an inclusive, compassionate society, we must show that inclusivity and compassion to children and young people with special educational needs and their families. There have been some well coordinated speeches today, but I want to reflect on some of the issues that have come to my attention as I have spoken to families and teachers and visited schools. <BR /> <BR />First, let me talk about staff. Teachers in special education schools tell me that they are under more pressure than ever before. Many feel the impact of that pressure and that crisis, and many of the children are presenting with more complex emotional and behavioural needs. There is a constant pressure on staff and family.”
“Thank you, Madam Principal Deputy Speaker, and I hope that I have got your title right this time. <BR /> <BR />The mission statement of the Minister's Department states that all pupils should be "happy, learning and succeeding." That applies equally to all young people, including those who have special educational needs. For those young children to be "happy, learning and succeeding", they require the right support from the right people at the right time and in the right place. We need to measure that and take remedial action where we are failing. The Minister has said that the reform of special educational needs is a priority, and we thank him for that. At the moment, however, we cannot say, hand on heart, that we are delivering all those things for young children with special educational needs.”
“Thank you, Minister. We are all aware that we had a debate this morning on the impact of waiting lists on people. I know that it is early days, but does the Minister have a sense of what the industrial action will mean for patients in the coming days, should it go ahead if pay negotiations are not successful?”
“Thank you, Minister. I look forward to working with you to realise how we can address the issue. I think of, for example, the Emmanuel Church in Lurgan and the counselling services that it provides. Those services are very important, and I invite the Minister to come down and discuss the matter with them.”
“Oh, right. Sorry. Thank you. <BR /> <BR />We need to sweat our assets. Can I take two seconds, Madam Principal Deputy Speaker —.”
“Yes. I had assumed that I would get an extra minute because of the intervention.”
“There is undoubtedly a political and broader interest from the US in Northern Ireland's affairs, and perhaps there are ways in which we can encourage that and harness it for genuine practical benefit and for the welfare of our patients. <BR /> <BR />We should not underestimate the anxiety that people experience when waiting for a diagnosis, nor the impact on loved ones. We recognise that additional money alone is far from being the answer, as Northern Ireland already has the highest per capita spend in the whole of the UK, but we must maximise the outcomes from investment. We must see more procedures proceed. It is surprising that that can happen in the private sector but not in our NHS. There must be clearer separation between emergency and planned care.”
“Some in the Chamber may have an aversion to considering working alongside the independent sector, but I am not necessarily suggesting that we have to pursue private providers. There are a number of non-profit organisations from the United States, for example, that operate internationally. The University of Pittsburgh Medical Center is a global non-profit health enterprise with 92,000 employees internationally, 40 hospitals and 70 cancer centres. It has partnered with a number of hospitals in the Republic of Ireland, providing state-of-the-art radiotherapy treatment in Cork and Waterford, and is also involved in hospitals in Kildare and Kilkenny.”
“I thank the Member for his intervention. I am not interested in playing politics on this one today. It is extremely important for Northern Ireland that we go forward with a plan to sort out this issue. Every day those people, who are in pain, want us to do that. <BR /> <BR />Northern Ireland can only do so much by itself. We must seek to partner, on a much larger scale, with national or global providers that can work alongside us to provide the additional skilled staff that are required in the short term, as we enhance our capacity. Let me be clear: investing in our own staff and infrastructure is my preferred option, but the needs of our waiting lists and the urgent requirement to address capacity will take radical short-term solutions.”
“I will shortly, if you just let me finish this point. <BR /> <BR />Continuing in the old way, with small contracts at the end of the financial year, will have only a minimal impact. I was very concerned when I was contacted by one private sector provider who indicated that patients who it had been anticipating this month for urgent red-flag endoscopies had not been forthcoming due to trust financial concerns. They had made arrangements to carry out 2,000 endoscopies and 1,000 urology procedures in the six weeks leading up to the end of the financial year. Have those red-flag patients simply ended up on another waiting list? I can only imagine their fear and concern. <BR /> <BR />I will give way to the Member now.”
“<BR /> <BR />We need to be realistic about the extent of progress that the system in its current form can achieve. Clearly, we do not have sufficient capacity, and all the training and recruitment efforts in the world will not turn that around in the short term. We need to find partners who can assist us, and we need to look beyond our usual local providers. The small independent sector in Northern Ireland will undoubtedly have a role to play, but it is dwarfed by the volume of the additional capacity that is needed.”
“However, funding is not the only solution. Recruitment and investment in staff are vital. I hope, Minister, that you will be able to reverse the decision taken last year to halt the recruitment of nurses onto university courses. We trust that you will be able to reach satisfactory agreements on pay so that staff can feel valued, and that you will work with trusts to ensure that staffing levels are safe and appropriate. <BR /> <BR />While there is a need to increase the number of staff, that must be accompanied by an overhaul of inadequate, out-of-date and poorly maintained physical and digital infrastructure. Those investments will lead to more efficient delivery of services. Other options that must be delivered include the use of primary care for routine elective procedures and tackling the extreme pressures on social care.”
“<BR /> <BR />In their latest funding offer, the UK Government said that they will grant an additional £34 million to tackle waiting lists. However, the Northern Ireland Audit Office report indicates that £909 million would be required to reduce waiting times substantially. The elective care framework estimated that £707 million is required to ensure that, by 2026, waiting times do not exceed one year. The Department has now conceded that those targets cannot be met. I know that you are very soon in post, Minister, but is that still your view? <BR /> <BR />Stabilising this fundamental public service will require significant investment. Minister, we need your Department to provide robust figures on the cost of stabilising the service, and we will be watching the future budget proposals for investment.”
“Their quality of life will have been reduced by spending protracted time waiting on tests, treatment or surgery. <BR /> <BR />There is deep concern about the prevalence of late diagnosis. Between 2012 and 2017, one quarter of cancer diagnoses were made in emergency departments and not in primary or elective care. It is morally unacceptable that we are allowing patients to reach that stage in their journey before serious illness is detected. <BR /> <BR />Minister, we all know that that is not a sustainable position. We know that Northern Ireland has the worst waiting lists in the United Kingdom. Simply doing a little more or investing a little extra will not make a significant difference. That is why it is imperative that you and Executive colleagues have a clear plan to reduce waiting times.”
“There are huge regional variations in the statistics, with some trusts performing much better than others. That postcode lottery of treatment is unsustainable and unfair. In the Southern Health and Social Care Trust area, the wait for a routine urology assessment is 153 weeks. There is a potential further wait for treatment of 151 weeks. The wait for a rheumatology outpatient assessment is 201 weeks, and, for neurology, it is 172 weeks. I have used figures from my local trust; other figures are available, and the wait times are just as shocking. <BR /> <BR />It is long past the point where we can call this a service. It is clear that very poor waiting time performance is significantly increasing the number of patients at risk of developing serious conditions and illnesses.”
“The equivalent of 26·3% of the Northern Ireland population is on a waiting list compared with 12·4% in England. That means that, compared with England, more than twice the proportion of our population are on health and social care waiting lists. In Northern Ireland, 51% of those on a waiting list were waiting over 52 weeks for assessment or treatment compared with 5·4% in England. From the Department's waiting time statistics, we know that 87·9% of patients diagnosed with cancer received their treatment within 31 days versus the 98% target, with gynaecology having the poorest outcome of 78·1%.”
“I would like to make some progress. <BR /> <BR />Minister, I understand and appreciate that you have a challenging brief, and I hope that, in highlighting the issue in the Chamber today, we will lend weight to your arguments for resources to tackle the problem. Equally, Minister, the issue will not go away, and we will hold you and your Executive colleagues to account on the progress in tackling it. <BR /> <BR />In bringing the motion, I want to be clear on the uncomfortable truths about waiting lists. The Northern Ireland Audit Office (NIAO) report of 2023 makes for stark reading. No formal waiting time targets have been achieved since 2014. Between March 2017 and 2023, patient waiting lists exceeding maximum waiting time targets have increased exponentially.”
“We cannot fudge the issue or talk about everything else but not address that most fundamental of issues that impacts on our constituents every day.”
“Thank you, Madam Deputy Principal Speaker — or whatever way round that is. <BR /> <BR />I am pleased that we have the opportunity to discuss this important topic, and I thank the Health Minister for his attendance in the Chamber. I am sure that every MLA in the House can attest to the fact that, every week, we meet constituents who are ill, in pain and on a waiting list. They have lost hope and faith in the very NHS that was meant to look after them from the cradle to the grave. Let me reinforce my belief that a well-funded, properly functioning NHS, free at the point of delivery, is my sincere goal. It saddens me that we are very far from that objective. Tackling waiting lists is one of the pivotal issues on which the success or failure of the Executive will be judged.”
“I thank the Minister. I do not know whether to be heartened or sorry for him that the report is his bedside reading. <BR /> <BR />A couple of questions arise from what he said. Many of the people to whom I speak in the industry are concerned that officials went ahead and changed the advice without the normal process of consultation. I would like to hear what the Minister has to say about that issue. I am glad to hear that he is to publish a new strategy. In the meantime, however, we cannot have a variety of areas doing different things in terms of planning applications. We already find that in the planning process at the moment. The Minister needs to ensure that there is consistency for the industry.”