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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“The standardised dental filling rate in the most deprived areas of Northern Ireland was 37,738 per 100,000, compared with just over 24,000 in the least deprived areas. Being registered with a dentist is more likely in wealthier areas. The standardised dental registration rate is 51,000 per 100,000 in the most deprived areas but higher, at at least 52,000, in the least deprived areas. That is not a situation that we can continue with, and that unevenness in access to dental care is leading to young people being put in the most difficult positions, with families barely able to afford dental healthcare. We need to reverse the trend, particularly when it comes to health inequalities.”
“There needs to be a complete overhaul of the current payment model. Minister, this House needs to ask today: are you convinced that the current model for dentistry is viable? We want to hear the answer in your response. Many dentists would not choose to turn their back on the NHS, but they feel that they are being driven out by an unworkable system. Consequently, hard-working families are not able to access an NHS dentist and may not be able to afford the bills for the alternatives. <BR /> <BR />Again, Minister, I know that you are deeply concerned about health inequalities, and the health inequalities annual report, published on 25 March, demonstrated that, in 2024-25, the rate of dental extractions in the most deprived areas was still more than double that in the least deprived areas.”
“Northern Ireland's dentists earn considerably less than their colleagues in other parts of the United Kingdom — on average, 10% less than their English counterparts and 17% less when compared with Scotland. Of course, as with GPs and other services, that erosion of take-home pay has been exacerbated by the National Insurance rises put in by Rachel Reeves in the October 2024 Budget. In many circumstances, dentists are effectively losing money by treating health service patients and are having to make up that shortfall by treating private patients. The system disincentivises practices from taking on NHS patients, particularly those with complex needs. There is a focus on individual units of activity like filling teeth rather than a more holistic approach to preventing poor oral healthcare.”
“Northern Ireland's dentists want an NHS service that works for all. However, data published last month shows that NHS work is falling more rapidly here in Northern Ireland than in other parts of the United Kingdom. The proportion of dentists spending more than 75% of their time in the NHS is 59% in Scotland and 45% in Wales, but in Northern Ireland it is only 39%. Northern Ireland invests less in dental services per head of population than other parts of the United Kingdom. In 2003-04, government spend on dentistry per capita was £52 in Northern Ireland compared with £56 in Wales and £67 in Scotland.”
“A failure to prioritise dental care will ensure that the service will become totally unviable, and there will be huge ramifications. Sadly, there is a COVID generation of children who have no experience of attending a dentist and who will eventually present with exacerbated dental decay.”
“I would be grateful if you could confirm that that money became available because of an underspend in the allocation due to the lack of NHS dental activity. The allocation is welcome, but it will not address the fundamental issue. It is not sufficient, and it will not stabilise a service that is crumbling around us, with significant impacts on families and communities. <BR /> <BR />We need to see published without delay and in full the cost-of-service review led by Professor Ciaran O'Neill. It was commissioned in December 2024. The findings of that review should form the basis for early engagement with the profession on realistic remuneration for dental care and procedures. With barely a year remaining of the Assembly mandate, the focus must be on making substantial progress.”
“A colossal number of people in my constituency now have no dental check-ups or access to oral healthcare. <BR /> <BR />The number of treatments in December 2025 was 40% lower than in 2018, and, in 2023, the adult oral health survey found an increased level of dental cavities compared with the previous survey in 2009. Last February, the British Dental Association (BDA) referenced the risk of turning to Victorian-era solutions and highlighted reports of DIY dentistry, with people pulling their own teeth and needing emergency surgery due to untreated dental infections. Minister, I hesitate to say this, but I can think of no other way of describing it: that is a shameful situation that will have huge repercussions for many years to come. <BR /> <BR />No doubt, Minister, you will reference the recent allocation of £8 million to the service.”
“Thank you. Minister, National Health Service dentistry faces an existential threat. Northern Ireland has seen the most rapid decline of health service dentistry anywhere in the United Kingdom. Registration with an NHS dentist has plummeted to the lowest level in a generation. It has dropped by 17% over the past year and by 389,000 individuals since early 2023. Only half of Northern Ireland's population — fewer than one million people — are registered with an NHS dentist, yet over two million are registered with a GP. In my Upper Bann constituency, we had the highest level of lapsed registrations anywhere in Northern Ireland in 2024-25. In one year, a staggering 33,923 registrations were closed due to those patients not being seen within a 24-month period.”
“Thank you, Minister, for giving way. Mr Donnelly actually covered the point that I was going to make. It makes no sense not to spend £5 million when we will spend many, many millions more on lifetimes of disability and the services etc that will be required for people who cannot avail themselves of a 24/7 thrombectomy service. It is kind of nonsensical to say that we are making a saving by not having the 24/7 thrombectomy service, because we will actually spend a lot more money and cause a lot more suffering, pain and grief for families.”
“Minister, you have said that it is up to the trusts to resolve that issue; to look at their exemptions and to hear what can be done. However, the House would be much more reassured if you indicated that you will ensure that that is done. That would be an important step forward in keeping faith with people. <BR /> <BR />Young families with a child who has been diagnosed with cancer go through an enormously traumatic experience. They spend their lives devoted to that child in hospital, and their income suffers remarkably as a result. We should not add to their burden. I hope that, in your reply, Minister, you will do more than say that a letter on the issue was sent to trusts on 14 April.”
“I ask you this again, Minister, as I have asked you in every debate on the issue and will continue to ask: when will we see that transformative service commissioned? <BR /> <BR />In every one of these debates — I am glad that others have caught up with this issue — I have also asked you about exemptions. I must say that your responses on that are less than convincing. That speaks to some of the reasons why some of the public, who know that we are in dire financial straits in Health, are sceptical, to say the least, about what happens here. <BR /> <BR />Others have said, and it is worth saying it again, that Young Lives vs Cancer indicated last week that 62% of young cancer patients and their families pay for parking despite the concessions.”
“I supported the SDLP amendment, and I believe that transparency is extremely important. <BR /> <BR />Minister, I will make two points on what you said in opening the debate. You said that saving money would not mean that we could introduce new services. I know that you met representatives of the Stroke Association this morning, and I was keen to hear good news from them as they came down the stairs from the meeting. With the savings from the Bill, we could introduce a 24/7 thrombectomy service — 24 hours a day, seven days a week — for Northern Ireland. That would be transformative for stroke patients. It would mean the difference between stroke patients walking out of hospital and their living with huge disabilities.”
“Thank you to the Minister for his remarks on the Bill. Minister, you explained that the deferral in the Bill is due to the precarious position of Health Department finances. I do not think that any of us is going to argue with that, particularly those who sit on the Health Committee week in and week out and hear of so many issues that cannot be resolved because of a lack of money. <BR /> <BR />I agree with the Chair of the Committee in saying that, at last week's Health Committee meeting, we heard of enormous waste of health service resources. One media outlet counted almost £40 million in wastage: money already spent by the Belfast Trust on the maternity hospital, the mental health unit and the energy unit. All of that makes the appropriate use of public finances a very important issue.”
“Minister, this is a catastrophic situation for our community in Northern Ireland. The Royal College of Emergency Medicine indicates that the number of people attending ED has been relatively static since 2016, yet the number of patients who waited 12 hours or longer was 26 times greater in 2025 than it was in 2016 — 132,606 compared with 4,955 — and that more lives are being lost: almost 20 per week. It is clear that care packages and the lack of domiciliary care in the community are some of the most significant issues in trying to resolve this problem. The winter plan was threadbare on that, and you only talk about increasing the living wage. You need to increase capacity within the community. If you do not increase capacity, lives will continue to be lost and more families will be plunged into grief.”
“On a point of order, Mr Speaker. Following the appalling attack in Lurgan last night, where a delivery driver was forced to deliver a suspicious object to outside Lurgan police station, may I place on record the Assembly's condemnation of that act of violence and our support for all those who were affected, including the families who had to be moved and the police officers who had to deal with the aftermath? May I make it clear, Mr Speaker, that the Assembly should speak with one voice in condemning that violence?”
“I will. <BR /> <BR />— but those across Northern Ireland. It is important that the Minister explains to those in the Gallery what is happening.”
“That is Justice McAlinden in his most recent interim report on the A5, which is intricately bound up with how we can progress on the A1. I would like Members to understand that. We need to understand what is going on and why someone as eminent as Justice McAlinden, who handed down that judgement, is saying that two Departments of this Executive are behaving in an "unprincipled", "unacceptable" and "unfair" way and "gaslighting" the court. That really needs to be answered. <BR /> <BR />Minister, we want the A1 to go ahead, and I know that you want the A1 to go ahead. It is essential for the safety of road users, not just those from Upper Bann, where most of this falls into —”
“In a way, I understand the argument that you are putting forward, but the fact of the matter is that Justice McAlinden, in delivering his judgement on the A5, said that it was. We can only go with the judgement that was handed down. Unless the Minister is going to operate at risk and override the judgement, we will have to deal with Justice McAlinden's judgement, in which he said that those climate change targets could not be met if these infrastructure projects went ahead. We have a huge problem with infrastructure in Northern Ireland and the issues that flow from it. <BR /> <BR />Minister, in your response to the debate, I would like you to help us understand what is going on with the current appeal. I understand that Justice McAlinden has been asked to rule on a new point of law. He said:”
“I am glad that the now Minister of Finance spoke in the debate, because we had him out in Banbridge to discuss the road, the new junctions and so on, and we were very hopeful that that scheme would progress and perhaps be started before the end of this mandate. That gave us some hope, but we are now in a situation where a number of very strategic infrastructure projects, whether they are as large as the A5, the A1, the Lagan footbridge or whatever, are now in abeyance while we wait for the judgement in the A5 appeal. It is a bit ironic that the person who secured the debate and the Minister who will respond to it both voted for the climate change targets that are at the very heart of the A5 judgement.”
“Closing up those gaps in the central median and the provision of the new junctions will make an enormous difference to the safety of my constituents as they try to exit or cross that road. I appreciate that the Minister, in extending the restricted period, has kept the A1 scheme almost on life support while waiting for the outcome of the A5 project. However, Minister, I cannot overemphasise the dangerous nature of the road and the fact that, as I come to Belfast in the mornings, there are regularly accidents on that piece of road.”
“It is 25 kilometres between Loughbrickland and Hillsborough, but it is the main arterial route linking Belfast and Dublin. It is a route that carries over 40,000 cars every day — it is a hugely busy piece of road.”
“I thank my constituency colleague for securing the debate. It is a subject that the Minister and I have talked about many times. She has answered many questions in the Chamber on the A1. I live along the side of the A1. It is my route on to the carriageway that carries so much danger every time that it is used. <BR /> <BR />As Eóin has said, when you live in Banbridge, the A1 is one of those topics that is constantly on the agenda, because it is so dangerous. Traffic is fast, and those middle turns are a very, very dangerous way of getting across the carriageway, particularly because lorries, for example, try to use them and then block the oncoming traffic. <BR /> <BR />The A1 junctions phase 2 project has been on the go for a long time. It is a relatively small project, if you think about it against the A5.”
“I was just reflecting on your colleague's comments about transparency and about how setting things out properly matters. Minister, during the Second Stage debate, I asked you to look again at the concessions that are available to groups. We all received an email this morning from families of children with cancer, and only 62% of those families are receiving free hospital car parking. You should at least consider promising the House that you will look at those concessions so that those types of people are not impacted by this decision.”
“I will not be as long-winded on the amendment as the leader of the Opposition was. We will support the amendment, because it is important to have transparency in the operation of government and the operation of democracy. Of course, there is a cost to not implementing the Bill and there is a cost to implementing it. It would be great if the Minister could outline those costs to us. That would be useful. <BR /> <BR />I will make a couple of remarks on the amendment and the "waste of money" comment. It is important that, when we debate amendments like this, we do not use throwaway lines. I do not believe that the Bill was ever a waste of money, but I do believe that, when finances are tight, priorities matter.”
“Minister, we all welcome the reduction in waiting lists, and those are really important, valuable and good steps forward. However, recently at the Health Committee, we had presentations that talked about large reductions in waiting lists of those who had been waiting for four years and more. The South Eastern Trust came in two weeks ago to tell us that it had a 60% reduction in its waiting list. The figure had fallen from around 20,000 to around 8,000; I do not have the exact figures in front of me. When I asked the representatives to detail for us how many of those people had been treated, they said that they did not know. Do you not think that data, particularly data around waiting lists, needs to be accurate, transparent and full of information?”
“Thank you, Minister, for the statement. I know that you will agree that preventing alcohol harm is part of a whole suite of measures and not just one measure. To be absolutely clear, it is 18 months since the independent review of tier-4 drugs and alcohol addiction services in Northern Ireland was published, and there is still a lack of targeted detox and rehab services for young people, women and their children. Will you outline, Minister, when you are going to address those situations?”
“Thank you, Minister. I am encouraged that things have progressed and that there is agreement to progress this important issue. However, this afternoon, I was disappointed to hear politicians in the House question the need for such a body. We are fortunate that that is not the position of the education sector. For the advisement of the House, will the Minister outline the views of the Council for Catholic Maintained Schools (CCMS) on the initiative?”
“Yes, I will. Thank, Mr Deputy Speaker. That still has not been resolved, which is shameful.”
“Colleagues, compare that with the disjointed and delayed service that women in Northern Ireland experience. <BR /> <BR />The mover of the motion referred to the British Heart Foundation's heart attack gender gap research that concludes that women are under-aware of coronary heart disease, under-diagnosed and under-treated by their GPs. <BR /> <BR />I want to finish by saying that I spoke in the debate two years ago about the cervical smear scandal in the Southern Trust.”
“We can only conclude that nothing is happening in Northern Ireland in line with that guidance and advice from the royal college. We should all reflect on that. <BR /> <BR />Where is the response to Getting It Right First Time's review of gynaecology that was published in 2024? I am particularly interested in one of the recommendations in the report that mentioned women's health hubs. Those have been rolled out in England as part of the women's health strategy. The contrast between what is provided here and in England is quite significant. Dr Janet Barter, head of Tower Hamlets women's health hub, described the service that they provide:”
“At the weekend, I looked up the most up-to-date waiting times in the South Eastern Trust. For gynaecology, for example, the wait for a routine first outpatient appointment was 112 weeks. After waiting for 112 weeks, there was a subsequent wait before being admitted for treatment of 139 weeks. That is a wait of almost five years from first being placed on a waiting list to admission for treatment. Waiting times in the Northern Trust and the Belfast Trust are significantly longer. Shamefully — I take no pleasure in saying this — a woman can wait almost 10 years for a diagnosis and treatment of endometriosis. Importantly, the Royal College of Obstetricians and Gynaecologists said:”
“Two of those years have now elapsed, and there is still no sign of an action plan or a strategy. <BR /> <BR />The Minister often reminds us that he is not that fond of strategies, because we have plenty of those, and nothing is happening, but we do not even have an action plan. Until we start to plan for how to deal with the structural inequalities in women's health, we will not get to the nub of dealing with them. That is an important point that I want the Assembly to take on board.”
“On 13 February 2024, the Department of Health released a media statement entitled "Minister Swann outlines Women’s Health Action Plan", which stated that the:”
“I thank the proposer of this important motion. It is a pity that the motion has been moved when the Health Minister is not here to respond to the debate, because we need to have answers from the Minister. <BR /> <BR />One of the first debates in which I spoke following the restoration of the institutions was on this exact issue: a strategy and action plan for women's health. It has been two years since that debate, and little has changed in the interim. The issues of women's health and the inequalities in accessing healthcare are regularly discussed in the Chamber. It is very frustrating that so little has happened to take away the structural inequalities or to even put in place a coherent plan to deal with them. Where are the strategy and the action plan that were promised in February 2024?”
“Thank you. Minister, will the open-book exercise look at the sheer waste of public money? Answers to questions that I have asked the Health Minister indicate that £17 million has been given to the contractor of the maternity hospital because of delays. That is an inescapable and inexcusable waste of public money.”
“I reiterate, however, that the saving must go into front-line services. It must help to protect services and aid the delivery of services by health service workers, who have been at the forefront of a challenging period for our health service.”
“<BR /> <BR />At the Health Committee — this is something that I want you to explore, Minister — officials indicated that they looked at the possibility of extending the existing exemption charges and categories. I am keen to hear whether that is something that you will explore and support. Officials talked about extending those to people with mental health and addiction issues in particular. I wonder whether you see that as a sensible way forward. I appreciate the fact that the £5 million that has already been invested will aid car parking flow. We need to address the car parking issues at the Royal Victoria Hospital in particular. <BR /> <BR />There are some issues that we need to address, but, on the whole, we will support the Bill, which facilitates a difficult but necessary choice.”
“For some stroke patients, it would be the difference between walking out of hospital and a lifetime of severe disability. It makes no sense that a measure that could save lives, reduce disability and, ultimately, save NHS resources and time has not been introduced. If we are talking about competing priorities, such as £7 million on free hospital car parking, the introduction of a full-time thrombectomy service will always have my vote. I hope that you, Minister, will be able to announce that life-saving service in the very near future. Parties in the Assembly are helping you to make necessary choices so that you can make life-saving choices later in the financial year.”
“I have said many times in the House that our cancer waiting times raise moral and ethical concerns. We must do better. <BR /> <BR />In a health service under that level of strain, priorities matter. Minister, those priorities mean that the £7 million that you identify as savings from not proceeding with free hospital car parking must be used in front-line services, rather than simply disappear into a kind of unaccountable black hole in the health service finances. To give a real-time example, I revert to my contributions on having a full-time 24/7 thrombectomy service. At the Health Committee, we regularly receive updates on that service. It is estimated that the delivery of a 24/7 thrombectomy service would cost the health service £5 million every year and that it would save 160 lives.”
“Like many in the House, I rise with mixed feelings to support the Bill. I acknowledge that there is broad support for free hospital car parking, and we approached the Bill in good faith. However, I also believe that the public want decisions about our health service to be based on and rooted in the reality of the financial situation in which we find ourselves. We have to be honest about the pressures within which the health service currently operates and the difficult and necessary choices that flow from that. This party acknowledges that the Health budget is under sustained strain. Front-line services are stretched, staff are operating under significant pressure, and waiting lists remain far too long. Waiting times in emergency departments are, and have been over the winter, quite horrendous.”
“Thank you for that answer. It is good to hear that there is now a preferred company in place to take forward the work. How much will that work cost, including the cost of providing scaffolding from 2024 onwards?”
“Minister, thank you for your answers. You have outlined a severe issue in funding and in whole-Executive cooperation to enable you to do that housebuilding. Do you not find it a bit strange that the Communities Committee, which is chaired by a Sinn Féin MLA, has endorsed the earmarking of funding to meet the Programme for Government commitments but that Sinn Féin in the Executive has not?”
“It is sometimes subtle and sometimes not subtle at all, but it definitely impacts on very many people. <BR /> <BR />I thank everyone for the tone of the debate. That is really important. If I did not mention you, it is simply that I did not have the time. Alan Chambers made a contribution about the stigma involved with mental health issues, particularly eating disorders. We need to help people get over that stigma. We should be able to talk about the issue, and I hope that the debate has, in some way, helped with that.”
“Again, that is hugely important. We had a debate on data and the provision of mental health services a couple of weeks ago. On this specific issue, it is really important that we capture relevant data more accurately so that we can design services that meet the need. <BR /> <BR />In finishing, I want to talk about social media. We talk a lot about banning social media, and I notice that the UK Government have announced a consultation on social media for those aged under 16. Social media is really important in relation to people who are at risk of developing eating disorders. We could respond to the consultation by highlighting the harmful, almost pro-anorexia content that sometimes circulates on social media: there could be more bans and restrictions on that.”
“That is how most of the data is captured, but that ignores the level below, which is people with mild to moderate eating disorders. Data is not captured on them. I therefore emphasise the fact that we cannot design and deliver services that are effective and that meet the needs of people in our communities if we do not have the data that will help us do so.”
“<BR /> <BR />Minister, I am encouraged by what you said about the partial implementation of the business case for enhancing the regional eating disorder service and about the leads who have been appointed to the regional eating disorder managed care network. I note that you said that you need roughly £2·5 million for the full business case. I encourage you to find some way of finding that money so that we can drive forward. That is important. <BR /> <BR />Another issue that strikes me is something that will not fill the House with clamorous voices, but it is one that is important for the delivery of services that are tailored to meet need, and that is the data that we have on eating disorders. For many years, people who are diagnosed with an eating disorder have received their diagnosis during an emergency in a hospital setting.”
“Surely that is an indication of how really good community services can help prevent people being admitted to hospital and instead bring care for people closer to their own communities and closer to their families. They are also much more cost-effective, but, more importantly, they are much more effective in aiding people's recovery from their illness. When we are considering how to move forward, such provision is one element that we would like the Department to consider substantially. We would also like it to consider establishing services that mean that children, young people and adults do not have to travel outside of Northern Ireland, away from their families, to receive treatment. That is hugely important.”
“When looking at some of the stats in preparation for the debate, I was struck by the fact that 29(d) in the mental health strategy mentions talking therapy hubs and intensive day treatment facilities that are in line with NICE guidelines and that would fulfil the ambition of bringing care closer to home. <BR /> <BR />The Royal Free London NHS Foundation Trust's eating disorder intensive service demonstrates that very well. Between April 2022 and March 2024, the service treated 78% of patients who were assessed as being at risk of a specialist eating disorder and inpatient admission, yet only 13 of those patients — 17% — ended up requiring inpatient admission.”
“It is therefore extremely important that we have had this debate. <BR /> <BR />Minister, I will refer to a couple of things that you and other Members raised, one of which is the implementation of the mental health strategy, particularly the community element to treating eating disorders. I think that every party in the Chamber supports you in your ambition to shift left and to provide care closer to home and acknowledges that those measures will be not only more effective but less costly for the health service. I do not think that there is any real debate to be had about that among political parties here, but we do want to see it done in a coordinated and ordered way that people will understand.”
“It has been a really good and supportive debate, and it is important that we shine a light on the issue. <BR /> <BR />During the debate, I was very much struck by an issue that was raised by Colin McGrath — yes, Colin, you. He mentioned that a young person said that they do not talk about eating disorders in school. Maybe we do not talk about those things enough so that young people understand the dangers and, sometimes, the hidden and lonely journey that people may be on.”