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. Like many across the Chamber, I am grateful for the tone and supportive nature of the debate on the issue. As my colleague Peter Martin reflected, it is not a contentious issue, but it is important, and it is important to shine a light on it. It is not often that it gets such prominence, and I am glad that we have been able to shine a light on such a significant issue. <BR /> <BR />One of the stats that really brings it home to us is that the mortality rate among individuals with an eating disorder is seven times higher than that among other people with a severe mental illness. That is a really significant stat that many of us perhaps do not realise or acknowledge in debates about the prevention of suicide and other issues that are prevalent.”
“The other issue that came across very clearly was that the maintenance division is short of staff by about 30%. That is not just maintenance staff; it is also the people who design roads for the future. Therefore, the delivery of new schemes is impacted as well. When will the recruitment campaigns begin? Where will they be focused? Will they make up for the huge shortage that we see now?”
“Minister, I will take you back to the state of our roads, which is one of the most pressing issues that I have in my constituency office every day. I met the southern division recently to discuss the programme and how things were working out. It was indicated to me that the road maintenance budget for the division was spent by the end of the summer, which indicates that, perhaps, there was not a realistic budget for road maintenance in the first place.”
“I thank the Member for taking an intervention. Funding is very important. However, 75% of PEACE PLUS funding, amounting to more than £730 million, came from the UK Government, and only a very small amount came from either Europe or Ireland.”
“It is really important to state — I know that the Member will agree with me — that, during the Brexit negotiations, when things were getting tough for the Irish Ministers involved, we had the spectacle of Leo Varadkar's talking about bombs at customs posts, should the EU acquiesce to anything other than what the Irish wanted. Was that not an absolute disgrace and an indicator that they were probably not acting in Northern Ireland's strategic interests?”
“I thank the Member for giving way. He makes an interesting point about the unstable environment in which we find ourselves, and it is particularly so. It is, however, hard to have common defence if the incoming leadership of the European Union remains neutral and is not prepared to have a defence force to defend itself and other European nations. Does the Member see some conflict in that position?”
“Minister, the one thing that I found encouraging from your statement was that the £5 million will be recurrent funding. However, research from Cancer Research UK tells us that, in general, Northern Ireland has the longest cancer waiting lists and the poorest outcomes of anywhere in the United Kingdom. That is a moral and ethical issue that must be resolved. A couple of weeks ago, Wes Streeting launched a cancer plan for England. Will you launch an action plan on cancer services for Northern Ireland that is separate from the elective care plan? The current model simply is not working.”
“<BR /> <BR />Minister, I also have to mention that you have talked about a safer staffing Bill. Can you say when that legislation might come forward? Allowing staff to have the proper working conditions and the proper ratios of work and work-life balances will help to retain those staff as much as the Bill will.”
“As the Minister said, the Bill prioritises UK medical graduates for foundation training places and UK medical graduates and other doctors with NHS experience for speciality training places. That is also really important, because those speciality training places are difficult to come by in the NHS at times, and it is the speciality training that helps to develop services across our acute hospitals. Many times, we have heard from trusts and from the Minister about the inability to continue services or about there being a lack of sustainability in services because we do not have dedicated people in those speciality training places who want to develop that service in their community. For all those reasons, I am happy to support the LCM. I hope that it will have a positive impact on our health service.”
“For all those young people who have worked so hard and who see their future here, working in the health service in Northern Ireland, the Bill is potentially an important step forward. I understand that we will keep the legislation under review, and it is right and proper that we do that.”
“I add our support for the LCM on the Medical Training (Prioritisation) Bill. <BR /> <BR />Like many in the House, I am concerned about the short time frame and the fact that we had so little time to look at the Bill in Committee. I understand that it was introduced and went through all its stages in the House of Commons in one day — Tuesday 27 January — and that its Third Reading will be this week, on 25 February. There may be a lesson in all that about legislation being introduced efficiently, even if the LCM was a bit late on the go. <BR /> <BR />Minister, I am keen to support the Bill, because, this year in particular, a number of young people have come into my office to say that they are about to graduate or finish training but are unsure whether they will have a job in our National Health Service here.”
“Surely, you have to be interested in that. Surely, we have to get to the stage where we say collectively, "We need to take an independent look at what is happening with those buildings".”
“I thank the Minister for allowing me to intervene. It is a really serious issue, and I will make very serious points about it. We are talking about a maternity hospital that is costing double what it was anticipated to cost and could now, potentially, be four and a half years late in its delivery. That is unacceptable in anybody's book. We are also talking about the mental health unit in the grounds of the City Hospital having to be taken apart bit by bit so that we can look at the damp and mould in it. The trust took that building in 2018. We have the children's hospital, which is late again and hugely expensive. I am told that the regulations have since changed, which will potentially — almost inevitably — require more funding.”
“We owe them a debt, because, as I have said many, many times, they are the glue that keeps our system together and keeps us running. It is up to you, Minister, to allocate the funding; it is up to the Health Minister to make sure that that funding is allocated in the right way; and it is up to the trusts to make sure that every line of their budget goes where it should go so that we stop seeing the waste that we see, particularly in relation to the capital budgets in Health, which I can only call a disgrace.”
“Currently, we leave dying to charity. We fund it at less than 40% of the actual cost, and charities and people who leave money in their will are left to make up the difference. If your family has experienced hospice care, you will want to give back. That is great, but the state needs to look seriously at how we fund palliative care and what we are doing to support people at a really vulnerable time in their life. These should not be things that are optional. They should be core principles and services of the Department and the Executive. It is to our shame that they are not. <BR /> <BR />In closing, there are many, many challenges for the Health budget in Northern Ireland, but there are also some amazing, brilliant things that go on within the health service involving our health staff.”
“Craigavon Area Hospital in my constituency, which was built in the 1950s or 1960s and has not changed, whose windows shattered and came in around people during a recent storm, cannot be rebuilt because we are literally flushing money down the drain with the flushing regime for the maternity hospital. I cannot understand why people do not want to grasp that issue and hold someone to account for it. It will take some kind of independent look at what happened to make sure that we learn lessons, so that it never happens again. <BR /> <BR />I am disappointed that some things have not been acknowledged in the Budget. The Health Committee spent weeks on end discussing the palliative care situation in Northern Ireland. None of us knows when we might need the services of Marie Curie or the hospices in Northern Ireland.”
“It should concern every single party in the Assembly that, if the trust holds even to that 28 months, it will be a staggering four and a half years since the building was handed over, and at a cost of many more millions. The trust openly acknowledges that that timeline is dependent on its fixing the problem. We could be facing a longer delay. <BR /> <BR />Minister, I asked you questions about that in the House a couple of weeks ago. You seemed unconcerned; you said that that was a matter for the Health Minister to sort out. I ask you again: what are you, as Finance Minister, doing to hold the Health Department and the trust to account for that appalling situation? It cannot continue.”
“I have repeatedly called for an inquiry into how the Health Department and the Belfast Trust have handled the new maternity hospital on the Royal site. As the Chair of the Health Committee said, that hospital is long overdue. It is sitting there, brand new, looking lovely and cleaned every day, but it cannot be used. In fact, it is not safe to be used. In March — in another couple of weeks — it will be two years since the building was handed over to the Belfast Trust, but it is not safe for the mothers and babies who need it so badly. My sources tell me that, a few weeks ago, signs went up all over the building, indicating that the water was unsafe to drink. The trust's latest information to the Health Committee indicates that the repair work could take another 28 months.”
“We are told that the available budget will allow work on the new children's hospital to proceed, but I do not see any contingencies for a situation where the budget overruns, which it almost certainly will. We already know that it is in difficulties, because the chief executive of the Belfast Health and Social Care Trust indicated to the Health Committee during her briefing a couple of weeks ago that new laws would mean changes to the contract. It defies logic that Construction and Procurement Delivery (CPD), presumably, and the health estates directorate are signing off on stuff that they know will have to be changed and will cost the taxpayer more money.”
“<BR /> <BR />I will spend a little time talking about the Department of Health estates budget.”
“If we do not give individuals the support and the right to respond to that exercise of power by the state, we will fail those individuals, so I worry that that is an issue as well. <BR /> <BR />I notice that, in the briefings from the Minister and the Health Department, there is nothing in the package about the issue of hospital flow. We cannot get people into emergency departments (EDs) in our hospitals because so many beds are being used by patients who are fit and well and able to go home. Yesterday, that number was 531. At a recent briefing by the Southern Health and Social Care Trust, we were told that over 800 care packages, either partial or full, were still to be fulfilled. We cannot make our health service work if the Minister does not direct his attention and some of the funding to that area.”
“It will also require the Minister to settle his disputes with general practitioners and to make sure that we have a sound footing for that model going forward. <BR /> <BR />We are also currently considering the Adult Protection Bill. The Minister has submitted bids in relation to that, and I understand the need to ensure protection for the most vulnerable. The scandal of Muckamore Abbey Hospital and Dunmurry Manor Care Home has heightened that need for change, so I accept that entirely. However, the Minister has also indicated on numerous occasions that he can implement the Bill only in bits and pieces, as and when he has the funding to do so. That would be a really difficult way to proceed. The Bill allows the state to exercise significant power over the lives of individuals.”
“Implementation of that reform will ultimately require the transfer of funding from the expensive hospital model to care in the community. I understand that trusts have been asked to make sure that they transfer 2% of their budget in the next year to begin that process. In my view, it should be about new or expanded community services that actively take the burden from secondary services in hospital into the community, but I fear — we already see some of the trusts talking about this — that it may end up being a repackaging under the neighbourhood model of existing services. If we want to see transformation, we need to make sure that the money follows the transformation. That can be done only by trusts ensuring that they transfer money from expensive secondary care into the community.”
“However, if we consider that the savings on that might allow us, for example, to introduce a full-time, 24/7 thrombectomy service for Northern Ireland, those are choices that we must face up to. That service for stroke sufferers would not just save lives but change lives. Many consultants tell me that access to a thrombectomy a short time after a stroke is the difference between walking out of hospital and a lifetime of disability. It is estimated that 160 lives a year could be saved by the introduction of that full-time service. Surely, it is important for us to make those obvious, evidence-based choices and not just simply grasp at what is popular. <BR /> <BR />The Minister has also indicated that he has put in high-priority bids for the reform of primary care and his neighbourhood health model.”
“Only 6% of women in Northern Ireland who discover a concerning lump in their breast are seen within the departmental target time. In England, the Secretary of State for Health and Social Care is introducing a cancer plan: surely we need a specific action plan for waiting lists. While the Minister argues that that is within his elective care plan, it is clear that it is not working. <BR /> <BR />The prioritisation will also require political parties in the House to make difficult choices. The Health Committee has been told that the implementation of the Hospital Parking Charges Act will cost £7 million. I know that the Minister wants to defer the implementation of the Act but cannot get agreement on the matter, particularly from the party opposite.”
“Over the past six years, spending on that centre has doubled from just over £3 million in 2019-2020 to £6·5 million in 2024. The centre also uses consultancy firms. It is unclear how the centre's delivery of value for money is evaluated. We need much greater transparency from the Minister on that issue. Of course, the Minister has told us that he will introduce a Bill on a duty of candour: we could certainly have more candour on departmental spend. <BR /> <BR />Management of the Health budget will require prioritisation and difficult choices. I have led debates on our cancer waiting times, which are the longest in the United Kingdom. That is not just a clinical issue but a moral and ethical one. Cancer cannot wait.”
“There is certainly plenty that can be done to make sure that we deliver value for money. There are plenty of questions that can be asked to make sure that the trusts and the Department are working to make that a reality. <BR /> <BR />I will give an example of something in which we are completely unsure about and have no evaluation of such spend and its value for money. I recently asked the Minister about the leadership centre. It is a rather obscure centre in the health service; I do not know how many have heard of it. The centre has 326 associate consultants. They have experience in a range of issues: for example, 194 are listed as having experience in facilitation; 176 have experience in investigation of grievances; and 167 have experience in report writing. My goodness, if a star was given for report writing, we would get it.”
“<BR /> <BR />The interrogation of trust and Department of Health budgets must also include a prioritisation of funding that is aligned to the key objectives of reform and delivery. We need to see the Minister outline his priorities in the Budget, rather than continually asking for more funding from Executive colleagues. Like the Chair of the Health Committee, I was heartened to hear the new permanent secretary in the Department of Health indicate that they all acknowledge that. All of us in the Chamber — I know of no one who would demur from this — want to see more done in healthcare, but other services matter too. When we have an Executive Budget that is under such pressure, each Department must do its best to protect services and deliver value for money.”
“Such figures need much greater interrogation. <BR /> <BR />There has been much discussion about savings and how to meet pay commitments, deliver change and reduce waiting times. This year, to be fair to the Department and the Minister, trusts were able to make significant savings on a range of service delivery options. Importantly, those included a reduction in the use of agency and temporary staff. That kind of interrogation needs to continue in order to see not just savings but long-term investment in staff and service delivery. Investing only in agency or locum staff is not good enough. We need the long-term investment in health service staff that will enable us to build services in Northern Ireland rather than just manage where we are.”
“Last year, a very difficult precedent was set for the health service budget: £73·4 million allocated to waiting lists went instead to paying off the deficit. That means that we are still not reducing waiting lists at the rate at which we should be and that people continue to wait in pain for a long, long time. While I am on that issue, I say to the Executive and to the Finance Minister, since he is in the Chamber, that the Committee was briefed on waiting lists by the Southern Health and Social Care Trust two weeks ago. They told us that they had interrogated the waiting lists in their trust area and reduced them by 40%. You are the Minister concerned with ensuring that we have accurate data to assess what is going on in Health and with the Budget: surely we should be able to do much better than that.”
“For too long, the Minister and the Department have left that issue until the end of the year, and salary increases that were paid some time ago in other parts of the United Kingdom have been left to the very end of the financial year in Northern Ireland. We will, however, need to see much more detail on public-sector pay, and I hope that the Minister will soon be in a position to provide that detail, particularly on the real living wage for domiciliary care workers. An important promise was made, and the Minister must address the issue. <BR /> <BR />Equally, waiting lists should be prioritised in the budget. The funding in the budget that is directed specifically at waiting lists should be delivered at the outset of the year.”
“I do not know how long I will take, but I will certainly not wander into the Celtic mists of everything being fine with the health service in the Republic, where you have to pay to see the GP. <BR /> <BR />As health spokesperson for the DUP, I will spend my time talking about the Health budget and the position in which we find ourselves. The Health Committee was briefed on the budget position last week. At first glance, it makes for dispiriting reading. On the positive side, however, the outline figures contained all the anticipated wage pressures. I am pleased that, unlike in the current financial year, the Minister has, at the very beginning of the next financial year, turned his attention to the health service's most valuable asset: its staff.”
“Thank you, Minister. It is my understanding that our national Government — the UK Government — have amassed a £10 million fund for a defence growth deal for Northern Ireland. What specific engagement have you had with the Secretary of State for Defence in order to ensure that investment and jobs are provided in that important sector in Northern Ireland?”
“— in trials or at any other time on children who are so vulnerable.”
“Drugs that are unsafe should not be used —”
“I am glad that the DUP has had a clear and consistent policy on the issue.”
“It was not the evidence; the change was caused by pressure from the DUP and the fact that the Health Minister could not ensure the support of all of his colleagues, particularly his Member from Upper Bann. <BR /> <BR />The "First Minister for all" then decided that the decision was "disgraceful". There was no thought for the safety of children, just blind adherence to a woke ideology no matter how much damage that ideology caused. I had the pleasure of debating the issue with the deputy leader of Alliance on the BBC. Absolutely nothing matters to Alliance but the woke agenda. When it is pointed out that the safety of vulnerable children is at stake, it has a "Carry on regardless" policy. <BR /> <BR />I have to ask this: was there a deal to ban the drugs and then make them available to a small number of children in that trial?”
“Interestingly, our Health Minister, who asked for the ban, then asked Hilary Cass to review Northern Ireland's gender services. Interestingly again, in her review, she talks about the Health Minister's support for her conclusions, including the King's College trial. On Thursday 12 February, the Health Minister and his Ulster Unionist leaders came out in strong support of the puberty blocker trial, saying that it involved only a small number of children. After pressure, on Friday 13 February, the Ulster Unionist Party and the Health Minister issued a statement to the Belfast 'News Letter' withdrawing Northern Ireland's vulnerable children from the trial. What changed between Thursday and Friday?”
“Children in the United Kingdom are safer this Monday afternoon since the UK medicine authority expressed concern about the long-term impact of puberty blockers and paused the King's College trial. Let us remind ourselves who those children are in Northern Ireland. Hilary Cass describes them as vulnerable young people who have experienced bullying and trauma in their lives. Interestingly, she also says that they often present as clusters from the same schools. <BR /> <BR />Drugs that were deemed unsafe were banned by the Health Minister, and that was agreed to by the Northern Ireland Executive. How drugs can be unsafe one day and then used in a trial on vulnerable children the next should be a matter of huge moral and ethical concern for the House. <BR /> <BR />In that context, what did the parties in the House say about the issue?”
“In response to a question that I submitted, I was told that we had occupancy of up to 123%. There is a reason why space is required: the more pressure the wards are under, the poorer the outcomes we tend to get. <BR /> <BR />I hope that we can make progress towards getting a better set of data on mental health. It will be good not just for patients and for people who suffer from mental ill health to have trust in the system, but for helping us to decide what services work, what services provide value for money and what services we should continue into the future.”
“I also understand that the Scottish Government are taking forward some work in that area. I see no reason why, when we have Encompass and the ability to do some of those things, we should not be able to produce a dashboard that gives us up-to-date information in relation to mental health. <BR /> <BR />At the end of the day, all of this is about the choices that you make as Health Minister. In Northern Ireland, despite there being a population with very poor mental health and many mental health issues, and a Minister who, to be fair, has said that he prioritises mental health, we only spend 7% of our budget on it. That means that the wards in our hospitals are consistently overoccupied. The Royal College of Psychiatrists recommends an upper limit for bed occupancy of 85%.”
“Thank you. <BR /> <BR />That question is really pertinent to the debate. When we get cancer waiting lists, for example, there are always exemptions. There is always a problem that means that Encompass is not able to fulfil its purpose. I hope that, when it settles, it will, but that is really important. <BR /> <BR />Halfway through the mental health strategy, we still do not have the outcomes framework that was promised. It is really important that we make some progress towards that following the debate. I also want to draw attention to the NHS mental health data hub and mental health dashboard that is prevalent in England as a way of providing information about mental health in a more open, transparent and understandable way. That is something that we should consider in order to provide the data that we need.”
“The Public Accounts Committee reported in 2024, so this is not a new issue. What is persistent in all of those examples is the lack of real progress in trying to join the dots and make the data available, whether that is from the Department or from the trusts. Encompass will help us to do some of that, but only if we can significantly interrogate the data and have outcomes that are transparent and available.”
“It highlighted the issue particularly in relation to mental health services. It also highlighted the fact that the Department and the health and social care trusts cannot determine whether services are value for money or whether they improve patients' lives and have good outcomes if they do not have an appropriate dataset against which to measure them. <BR /> <BR />In 2023, the Northern Ireland Audit Office also reported on the issue. It concluded that there were:”
“Mr Deputy Speaker, I apologise for not being in my place at the beginning of the debate. <BR /> <BR />As the previous contributor said, data is a really important issue not just for the outcomes that it might improve for people but for the services that we provide now and in the future. It is about assessing whether those services provide value for money, for example. Do they do what they are supposed to do? What are the positive or negative impacts on patients? The debate is on a very important issue. <BR /> <BR />I was looking at the issue for the debate, and I came across the fact that, in 2021, the Office for Statistics Regulation highlighted significant limitations in mental health data in Northern Ireland, with the scarcity of robust data leading to significant gaps. Again, that comes back to a point that has been made.”
“Minister, you have spent what is probably a record amount of time in the Chamber saying nothing, denying everything and having no knowledge of anything. Did you get a briefing from your officials before you came here? If so, will you make that briefing available to the rest of the Members so that we can see what your officials told you about the illegal Sinn Féin billboard?”
“I think that most of the public who are looking on will find this debate particularly unedifying. I live not that far from the billboard in question. In fact, I pass it as I go to Daisy Hill Hospital in Newry, as do other members of the community. On Saturday, the billboard was alive and well at the Egyptian Arch. It did not have a poster on it, but the structure was certainly there.”
“If it required DUP pressure and a formal intervention from the Education Minister, how can parents have confidence in your judgement or the safeguards that you and your Department apply to children? <BR /> <BR />I ask you, Minister, to do the right thing: withdraw Northern Ireland's most vulnerable children from the trial.”
“Thank you, Minister. The one thing that we agree on is that our children deserve and need our love, support and reassurance at a time in their lives when many are insecure and unsure. <BR /> <BR />On Thursday, you and the Ulster Unionist Party claimed that the experimentation on children with puberty blockers was not only necessary but central to securing Sinn Féin and Alliance support for the ban. On Friday evening, you issued a further statement that implemented a pause in Northern Ireland's involvement in the puberty blocker trial. As far as I know, no new evidence or clinical data emerged in those 24 hours. Minister, if the decision to be included in the King's College London trial was unwise on Friday, why was it acceptable on Thursday, when you and your party strongly defended it?”
“The brevity of the answer and the style in which it was delivered explains a lot to many of our people. First Minister, will you explain to the innocent victims of IRA violence, many of whom still live with life-changing injuries, and the brave members of our armed forces, who stood in the gap during a terrible terrorist campaign, why you can find endless ways to show respect to convicted IRA criminals but cannot deliver on the most modest task of ensuring housing, job opportunities and support for our armed forces?”