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. <BR /> <BR />Yes, I am struck by that point. When I talked to some of the staff on the ward in Craigavon, they made the point that it is dreadful to see patients who could benefit but cannot, because of the lack of access to that life-changing service. Many of the staff work with patients over a long period and get to know them and their family well. It is really important that they can offer the best service available. <BR /> <BR />Minister, we long for good news on this.”
“It would be such good news. Given the extent of the Health budget, which is over £8 billion, if £5 million saves lives, transforms patient outcomes and, in the long run, saves the health service, it will be a good day if we can confirm that it is in the offing.”
“The national clinical guidelines for stroke are clear that patients who have access to a thrombectomy centre 24 hours a day, seven days a week, will benefit and have much better outcomes. <BR /> <BR />Minister, a lot has been said here about the cost of a 24/7 thrombectomy service. The figure of £5 million seems to have got into our heads, but I would like you to confirm the cost that, you think, it would be. I was at the Royal Hospital talking to Jennifer Welsh, the new chief executive of the Belfast Trust, and I asked her specifically about the introduction of a 24/7 thrombectomy service. She said that the trust was preparing a business plan for that. As far as I can see, the stroke action plan came about in 2022, yet we are only preparing a business plan in 2026 for a 24/7 service. We would really like to see that plan.”
“I asked the consultant what the number-one issue about stroke that he wanted to be resolved was, and he said, "A 24/7 thrombectomy service". He said that it was like a miracle and that patients left Craigavon Area Hospital in a terrible state but often came back with their functions restored and their outcomes much better. It is so important to recognise that different outcomes are possible with thrombectomy. It is up to us to do it. I was talking to the ever-present Pam Tilson in the Great Hall, who reminded me that we want a stroke action plan, not a stroke aspiration plan, and that we need to get ahead with it because it makes so much sense on every level.”
“Thank you to the Opposition for tabling the motion because this is an important debate. It is an opportunity, Minister, for us to change lives by providing a 24/7 service. That makes sense in every way. It makes sense because of the amazing outcomes that can happen but also because the quality of life of someone who has a major disability after a stroke will be much poorer and their dependence on the health service will be much greater. Therefore, it makes an enormous amount of sense. <BR /> <BR />Like others, I welcome the folks from the Stroke Association and the Chest, Heart and Stroke Association. I was at Craigavon Area Hospital a few months ago where the Chest, Heart and Stroke Association was opening a patients' room. I had an opportunity to talk to the consultant and the multidisciplinary team that deal with stroke patients there.”
“Thank you, Minister. It appears that the dispute is escalating in its intolerance and intransigence. In the meantime, victims are suffering. I am ever so glad that the McNally family will be able to see the justice process starting for their daughter. There is huge trauma for families in not knowing whether a trial will go ahead. Will you confirm for the Mitchell family in Ballymena whether there will be a derogation for their case? When might they hope to see justice for their daughter?”
“— that will have an impact on their whole life. That needs to be addressed.”
“— for adults with ADHD. For children, there are long waiting lists —”
“One constituent had paid a substantial sum for a diagnosis, could not find a GP who would participate in a shared care arrangement and therefore is still unmedicated. On asking whether they could transfer to another GP service, they were told that there were no transfers and no opportunity for any. That is a sad reflection of the situation —”
“That sporadic postcode lottery is also important to clear up. <BR /> <BR />The Department of Health adopted the National Institute for Health and Care Excellence (NICE) guidelines on ADHD but has gone no further in providing a pathway for diagnosis and treatment. It needs to address that. I would like more information, Minister, on the needs assessment that, you say, was completed on 30 November 2025 and on the report that will be published in early 2026. We are now six weeks into 2026, and I would like to think that that report, which will give us more information on the needs assessment of adults with ADHD, will be forthcoming. <BR /> <BR />The other issue that my constituents stressed to me in advance of the debate was shared care.”
“A 2024 study in the British Journal of Psychiatry found that the risk of suicide or self-harm is much greater for those diagnosed with ADHD. The same goes for drug or alcohol addiction, so we have a really serious issue. <BR /> <BR />From recent correspondence from the Department of Health — Minister, it is really important that you clear this up — it seems that our health trusts in Northern Ireland have a sporadic approach to ADHD. Nuala McAllister referred to that in some detail. Some have services; some do not. When I asked about referrals in the Southern Health and Social Care Trust, I was directed to the mental health service, not to a specific ADHD service. My constituent, who is a young adult, was annoyed, because, as they said, "I do not have a mental health problem; I have ADHD".”
“One of my young constituents dropped out of university. Those are sad reflections of the state or lack of the service. <BR /> <BR />It is important to remember that ADHD has a social and economic consequence for Northern Ireland. ADHD charities that gave evidence to the House of Commons estimated that 40% to 80% of young people who were not in employment, education or training will have ADHD. They were also confident that 40% of those in youth offender institutions will have it. Therefore, ADHD has a real, knock-on consequence for our whole society. That is important. The charities also estimated that the cost to the economy over 10 years might be as much as £11·2 billion in lost productivity and reduced household earnings. Not having a service has important consequences for the individual and serious consequences for our economy.”
“I thank the proposers of the motion and of the amendment for this important debate. We will support both. This is an important issue and one on which many of us across the House get a lot of attention from constituents. <BR /> <BR />When I think of ADHD, I think of the impact on people. I think of young people I have met who have dropped out of university, young people who have had a private diagnosis and have tried a number of GPs but cannot get into a shared care arrangement and, therefore, still have no medication for their condition. I think of the people who contacted me over the weekend just to talk about the impact of ADHD and the fact that they could not find in the Portadown Health Centre a GP willing to work with the private consultant to make sure that medication was available.”
“— on the flow of patients through our hospitals.”
“My colleagues have rightly focused on the issue of children transferring to adult services, but, for many adults with disabilities, there is a real issue with care packages. In a recent answer that you, Minister, gave to my colleague Diane Forsythe, the position as of 1 December 2025 in relation to care packages that you detailed was startling: over 2,000 people were waiting for a full care package, and over 1,000 people were waiting for a partial care package. The largest number of waits was in the Southern Health and Social Care Trust, in which 764 people were waiting for a full care package. Minister, what will be done about that situation? It impacts on adults with disabilities in particular, but it also impacts —”
“That raises serious questions, particularly when the morale of front-line staff in hospitals is so low and people are working so hard to make sure that our health service functions. <BR /> <BR />Most galling of all is the fact that some of those who will get the automatic pay increase right up to 2029, will have been responsible for the debacle with the new maternity hospital and the new children's hospital, and the fact that we will possibly wait four and a half years before the former can be entered or used in any substantial way.”
“<BR /> <BR />It therefore came as a considerable surprise to me that the Minister should then prioritise the pay of the chief executives of the trusts. The public will be perplexed that the Minister has chosen to do that, particularly in light of the fact that he has still not fulfilled his promise to implement the real living wage for domiciliary care workers. That is the huge contrast that exists on the issue of pay. The salaries that were signed off by the Minister will see the pay of those on the lowest rung of the executive pay scale exceed £100,000 per year, with those on the highest rung receiving almost a quarter of a million pounds per year. Those salaries will dwarf the salaries of our Prime Minister, First Ministers, judges and senior clinicians.”
“Over the last number of weeks, we have had considerable mention in the press about waiting times in our emergency departments, with the median waiting time being 13 hours and 36 minutes. In Causeway Hospital in the month of January, the longest waiting time for a handover from the ambulance to the ED was over 19 hours . <BR /> <BR />The list for first-time consultant appointments in Northern Ireland has now reached 540,000, with those people waiting many years. We need to recognise the progress on the waiting lists for scopes and the reduction in long-term waits, but our cancer waiting lists are the longest and have the worst outcomes in the whole of the United Kingdom. Only 6% of women who are referred for breast cancer investigations will see a consultant within the 14-day target.”
“Minister, people who are listening will be disappointed. Your answers are about what we may be able to do rather than about what we can do. I direct your attention to something that your Department can and should do. Just a few weeks ago, a pothole appeared on the Lurgan Road out of Banbridge, and around eight to 10 cars were seriously damaged. One constituent called into my office to say that the damage to his wheel cost him £1,000 to fix. The damage was reported on 28 January, but he is not expected to have first contact from your Department until 13 February. Moreover, your website states that the average time for payment of claims for such repairs is four months. Will you ensure that your Department speeds up making such payments so that people who are out of pocket because of the dangers on our roads are paid damages sooner?”
“That is all very interesting, Minister. I note that, in your statement to the House on 12 January, you referenced the delivery of the maternity hospital: are you aware that the maternity hospital is now two years late in that it cannot be used? It is unsafe — signs tell people not to drink the water — and remedial work will start at a cost of £6 million and involve another delay of about 28 months. That will be four and a half years after the handover of the hospital. As Minister of Finance, what are you doing about that scandalous waste of public money?”
“I thank the Member for giving way. He touched on the issue of the First Minister. On the issue of standards and morals, we must remember that we have a First Minister who has told everyone publicly in Northern Ireland that the killing and slaughter of innocents was inevitable.”
“The Craigavon part of my constituency, unfortunately, has a high rate of male suicide. It is very distressing. I spoke to those who came to the last all-party group on suicide prevention: it is devastating for families. What can be done specifically about the phenomenon of young, male suicide? How can we get all the Departments across the Executive to think about that issue as they produce their policies?”
“Minister, I am interested in your assertion that you were aware of the figures and knew the challenges that they would bring, yet you said in the House last week that the people who were bringing the issues to you did not know what they were talking about. Did you mislead the House?”
“Will you outline what those additional areas are and say whether there will be action on them?”
“Thank you, Minister, for bringing a sense of reality to the House on the capacity in the Republic of Ireland to deal with our problems. <BR /> <BR />You said that you:”
“However, I will not vote for the amendment, because the reality is that we need the private sector to take some of the pressure off healthcare waiting lists. Just think of those 540,000 people in Northern Ireland who cannot get a first consultant appointment and have been waiting for many years. Another reason why I will not be voting for it is that this is the same Chamber that regularly votes for, and asks for, more and more money for the reimbursement scheme to send people — where? — to private clinics in Dublin. Anyone who votes for that needs to think very, very carefully about what they are doing.”
“Take the acute-care-at-home service. That is what I mean when I talk about scale. At one of our Committee meetings, Tracey McCaig said that the Northern Trust did not have an acute-care-at-home service. She said that it was being set up in November and would cater for 10 patients. Clearly, that is great for the 10 patients who get it, but it is not being done on the scale that is needed. In addition, how have the pressures on mental health and learning disability beds been improved through the winter preparedness plan? <BR /> <BR />I will say a few words on the amendment. I agree in one sense with the amendment in that we should expand and invest in our staff and healthcare facilities.”
“Over the previous week, 2,768 people waited more than 12 hours. That means that 22·5% of everybody who attended an ED in Northern Ireland waited that length of time. It does not take someone who is incredibly smart or anything else to tell us that, if you cannot get people out of hospital, it will be extremely difficult to find beds for others. Minister, despite all the planning groups that have been set up, that issue still has to be tackled, and we will not see an improvement until we tackle it. That is one of the most important things that we can do. <BR /> <BR />I want to address a couple of the projects in the winter preparedness plan, including geriatric assessment and care plans. Those were to be directed at three practices in west Belfast. How many of the 10,000 medical plans have been carried out?”
“Thank you. I was just about to come on to that, so the intervention is very timely. <BR /> <BR />One of the problems with the winter preparedness plan is that it failed in the scale of its ambition. It did not address and tackle head-on the really big issues. The big issue is the flow through hospitals. If we cannot get patients out of hospital, others will be queued in corridors, waiting for a bed. I looked at Friday's figures. Last Friday, 640 patients were declared medically fit for discharge from our hospitals but were in an inpatient bed. Meanwhile, 350 people in our EDs were assessed as requiring admission to one of those beds and were either sitting or lying uncomfortably in a corridor or some other unsatisfactory space in an ED. They were among the 373 people who waited more than 12 hours in an ED in Northern Ireland.”
“Like others, I start my remarks by recalling a constituent's experience. A couple of weeks ago, I was phoned by a constituent whose elderly father-in-law had fallen. It took 23 hours to get an ambulance to that gentleman, and, 24 hours after that, he was still in the back of the ambulance at Craigavon hospital, leaving him confused and the family extremely worried about him. Everyone across the Chamber can recount a similar story, and that is not the health service that we want to be talking about today. <BR /> <BR />I support the general thrust of the motion, but it misses a quite important point. It is not about the time in which you have to prepare; it is about what you prepare for and the scale of your ambition in preparing for winter, because, as sure as day follows night, we will have a winter and a series of winter pressures.”
“— within five years. Thank you, Mr Deputy Speaker.”
“— of the consultant workforce is expected to retire —”
“It is not just in the Republic of Ireland that the service is in crisis. In the United Kingdom, 37% of paediatric pathology consultant posts are vacant. That is a huge gap in the workforce. There are only 13 resident doctors currently in training posts. That crisis will be exacerbated by the fact that 25% —”
“Minister, I will be interested in any ongoing discussions that you have with your counterparts in the Republic to determine whether there is even capacity for the South to take on some of the work or, as with children's heart surgery, to have a joint service.”
“That would aid in the issue of separation and would speed up the release of the child to the family. <BR /> <BR />I am interested in the Republic of Ireland's ability to aid us in bringing forward a solution to the problem. We should explore all solutions. We should not play politics or play around with this. It is so important and so difficult. I note that, in August, the 'Sunday Independent' reported that grieving families in the Republic were experiencing significant delays in arranging for loved ones to be buried because of a nationwide shortage of pathologists. For example, Justice Minister Jim O'Callaghan said that there was a crisis in pathology services in the South. Some Dublin hospitals have pulled out of the service. It is important that we evaluate that.”
“It is important that parents receive those results, not just to know what happened to their child but, particularly for young parents who may be planning to have other children, to diagnose the conditions that may have been present. <BR /> <BR />We have a suboptimal situation that we should not tolerate in Northern Ireland, and it is traumatic for parents. In this difficult situation, as Mr McGuigan said, it is important that we explore any alternatives or even digital solutions that we can — whether we need to have a specific autopsy; whether we can do some investigations through X-rays, ultrasounds or CT scans; and whether we actually need to take children to Alder Hey. I am absolutely no expert, but experts tell me that, increasingly, we should be able to do some of the work remotely.”
“I thank the Member for highlighting the issues. There is nothing worse than to hear of the death of a child, then to be put in the position of needing to have a post-mortem carried out on that child and then for that post-mortem to have to be carried out in Liverpool at Alder Hey Hospital. The separation, anxiety and trauma are almost unbearable. <BR /> <BR />The current service for families in Northern Ireland has been provided, as has been said, through Alder Hey Children's Hospital since January 2019. If there is a positive in the middle of this really difficult situation, it is that it seems to be a relatively efficient service where parents receive results more quickly than before.”
“Minister, I have said many times that the neighbourhood model, which delivers healthcare closer to people in their communities, is the right way forward. However, it will take a lot of time, and we need a health service that is working and functioning for patients in the here and now. <BR /> <BR />I really would like some clarity on a message that I got earlier today, which told me that the Northern Ireland Ambulance Service is about to call a critical state and that there are currently 160 emergency and critical calls from those who are waiting for ambulances that cannot be answered. Can you provide clarity for the House?”
“— that we will not see that again? What accountability will there be around such a figure?”
“Thank you, Minister. I note that your statement mentions £526·8 million for the mother and children's hospital, including a new maternity hospital. As I noted during Question Time, that hospital has been on site for two years and is still unsafe to use. I am extremely disappointed that there is no mention of a rebuild of Craigavon Area Hospital, which, I know, is important to both of us and our constituents. <BR /> <BR />The £495 million for waiting lists has to be welcomed, but, in the previous Budget, after you allocated money for waiting lists, £74·3 million of that was taken away from waiting lists and allocated to the deficit in the Health budget.”
“In the same context, it would be helpful for those of us who are not on the Finance Committee but who take an interest in such things if the Minister were to lay a letter about the matter in the Library so that other Members can see it. <BR /> <BR />Will the Minister indicate whether any work has been done on allowing small businesses to access the procurement system more readily?”
“Minister, over the past week, you have been telling individual Ministers to examine their budget to see what money can be saved. In respect of the capital budget, will you tell the House what you have been doing, particularly with the Health Minister, in relation to the sheer and wanton wastage of money on capital projects. Some £10 million has been spent on an energy centre, but not one brick has been laid. A maternity hospital was due to be handed over two years ago this March, but it still cannot be used. We need to take some action in relation to such projects.”
“Thank you, Minister. One of the most vulnerable sectors of our school population is children with special educational needs. Over recent years, there has been a huge increase in the need for capital spending and spending on teaching to facilitate those children's needs. Will you outline what spending has been incurred already and projections for the future? What impact would the draft Sinn Féin Budget have?”
“<BR /> <BR />Those who suffer from neurological conditions, such as Parkinson's disease, epilepsy and the wide range of other such conditions, deserve something better than what is being provided. I would like you to address the waiting lists and the issues with the workforce. Unless we can address those two things in the debate, we will not give answers to the many thousands of people who are on waiting lists, without hope and in pain.”
“A shortage of specialist nurses and allied health professionals means that many people go directly to consultants when other options may have been more suitable. I again plead with you on the issue of GPs. Your instinct to shift care to the community is right, but there will be great difficulty with that if GPs do not have the support to manage neurology patients who have complex needs. <BR /> <BR />The report on the neurology review recommends the development of a broader skill mix through extended roles such as advanced nurse practitioners and advanced practice AHPs. That would ensure a more efficient use of resources. I presume, Minister, that the roll-out of the multidisciplinary teams in your reset will help with that as well.”
“<BR /> <BR />The figures are probably an underestimate, not just because they are based on 2019 data but because the study considered only 10 common neurological conditions, whereas, in fact, there are many. The impact of those waiting lists on people who are unable to secure a diagnosis, or even, as one person at that event explained to me, on people who have obtained a diagnosis privately, is that health services are almost impossible to access as well. I cannot emphasise enough, Minister, how much we need to invest in the neurology workforce and the introduction of minimum standards to ensure that all trusts provide timely access to care. Consultant time is not being used efficiently, because the workforce lacks the right mix of skills.”
“Direct costs include ambulance call-outs, emergency admissions and longer hospital stays, while indirect costs due to lost productivity and the impact on informal care contribute to that economic burden. A 2024 study by the Economist Intelligence Unit estimated that 14·5 million people in the UK live with neurological conditions. The total direct and indirect burden was calculated as 4·3% of GDP, or £96 billion per year, as far back as 2019. Presumably, that figure is much higher now. The same study suggested — this is the most interesting part for us all — that timely intervention and timely and improved access to care could reduce those costs by a third.”
“<BR /> <BR />Northern Ireland has only 25 full-time equivalent neurologists, with limited 24/7 emergency cover beyond the Royal Victoria Hospital. Only two of 138 core medical training places are allocated to neurology. How are we going to make up the deficit? How will we get more people in place to tackle the backlog of that terrible waiting list? <BR /> <BR />The lack of timely access to neurology care causes deterioration in health conditions and a preventable rise in disability across Northern Ireland. Delayed access to neurology treatment can also be life-threatening. The economic implications as well as the implications for individual well-being are significant.”
“The figure was exactly the same in the Southern Trust. In the Western Trust, it was 263 weeks. According to the website, those figures were up to date at the weekend. That is just over five years for a first routine neurology appointment. Minister, can you confirm the waiting time for routine appointments in the South Eastern Trust? At the weekend, the My Waiting Times NI website stated that that was 16 weeks; previously, it had been 14 weeks. I would like to know whether that is accurate, particularly in light of the figures in every other trust. The referral time for urgent cases is twice as long, at 35 weeks. Those figures do not seem to be quite right, but I would be delighted if they were correct. I would like the Minister to give some answers on those.”
“I am disappointed that it seems to have become the norm for the Department of Health to have a new strategy, plan or service development, and even to have the adult protection legislation that we are considering, but to have no idea where the funding is to come from to implement them. As an Assembly, we should agree to end that approach, because we are promising people something that the Department is not delivering. The responsibility for review and reform lies firmly with the Department and the Minister. We cannot expect everybody else to fund those initiatives. That priority must be within the Department. <BR /> <BR />At the weekend, the My Waiting Times NI website showed that those referred for a routine neurology outpatient appointment were waiting 192 weeks in Belfast — 192 weeks.”