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.”
The complete record
Every one of 2,456 lines we hold for Diane Dodds, in date order, each linked to its source. Free to read, in full, without an account. Page 5 of 50.
“<BR /> <BR />On-site neurology opinion should be available at every acute hospital receiving unscheduled admissions, with patients being seen by a neurologist within 24 hours, in line with recognised standards. We do not have that in Northern Ireland. In fact, one trust does not have a neurology service. <BR /> <BR />In response to a question for written answer on the neurology review, the Minister stated:”
“Almost one in five patients was advised that their original diagnosis was insecure. That illustrates a system that was not functioning properly or offering a high standard of care. Seven years on from the review, it is time that some action was taken to implement fully its recommendations. <BR /> <BR />An estimated 40,000 people in Northern Ireland are living with a chronic neurological condition and rely on regular access to neurology services. The review was clear: we need more neurologists, more neurophysiologists, more neurology nurses and advanced nurse practitioners, and more allied health professionals (AHPs), psychologists, pharmacists and neuropsychiatrists. Yet, for those people in that room that day, it seemed that there had been next to no progress. Some could not even get a diagnosis.”
“Thank you, Madam Principal Deputy Speaker. Minister, just in case you are interested in how we think about health issues and those that we should debate in the Chamber, I recently attended an event at which a lot of neurology patients were present. At that event, I found groups of people who felt abandoned, who have lost hope and who felt that, even though they were able to speak to MLAs, they had no clear answers. So I made up my mind that we would have a debate through which you could, perhaps, give them the answers that they deserve. <BR /> <BR />The review of neurology services, launched in 2018, followed the, at that time, largest patient recall in the history of the NHS. Nearly 5,500 people met the criteria for recall, and over 4,000 patients were reassessed.”
“Thank you for the statement, Minister. It is an important step forward. In it, you indicated that there will be almost £70 million for healthcare workers' pay. I am glad that you have confirmed, through the ministerial direction process, that that will go ahead. However, it may involve an overspend into next year or a three-year Budget. What discussions have you had with the Health Minister about how he will manage the pressures on his budget, given that considerable potential overspend and its implications?”
“Thank you, Minister, for your response. We all want to see a more inclusive economy in which people with disabilities can play a part and be economically active. What further work can be done to lower barriers and provide more help for employers who are willing to look at that route to providing employment?”
“Recommendation 3 is for 100% funding for all hospice services, with an initial 50% of the actual cost of care to be provided in 2026-27 and a sliding-scale increase over the next five years until that 100% funding has been reached, is important. We recognise the public's generosity towards local hospices and our volunteers' phenomenal fundraising, but that should be for top-ups and bringing in extra services, new initiatives, research and so on, rather than for the core service.”
“<BR /> <BR />I will focus first on the need for consistent and sufficient funding for palliative care services in Northern Ireland. Trevor McCartney from the Northern Ireland Hospice outlined the importance of that in his speech at our launch event today. Hospices are currently not funded for the specialist services that they provide. Beds in a hospice are not general medical beds but a specialised service to individuals who are at the most vulnerable time of their life. They are individuals with complex medical needs who can be cared for only in that setting. <BR /> <BR />The importance of recommendations 1 to 3 in the report cannot be overemphasised. Our health service should provide, as a fundamental right, access to equitable palliative care services in Northern Ireland. That needs to be statutory commitment.”
“We need this report to be different, Minister: we need this report to be actioned. I heard some conversation earlier about the fact that the report could prove to be a good pathway for palliative care in the future. We really need to see some progress on that. <BR /> <BR />Some of the key issues that were apparent from evidence that the Committee heard were inconsistencies in provision across Northern Ireland; the need to appoint a clinical lead for palliative care, Northern Ireland being the only part of the UK without one; a sense from families of a lack of information and a need for improved communication; and a lack of out-of-hours support beyond 9 to 5, particularly when it comes to pharmacies and access to medicine and pain relief.”
“<BR /> <BR />Thanks are also due to the sector: the hospices, Marie Curie and all those too numerous to mention. I probably should not mention anyone, because I will always leave someone out. They go over and above to provide in times of need and at such a difficult time. Thanks also to our clinicians; to those who provide specialist palliative care; to GPs, who provide the huge bulk of the service at home, helping to fulfil the wishes of the vast majority to die at home in a familiar place, surrounded by their loved ones; and to district nurses and specialist palliative care nurses. We really appreciate your efforts. <BR /> <BR />Committees write many reports, and many reports are just accepted by Ministers with a gracious thank-you but remain on a desk somewhere in a Department and are not actioned.”
“It is a real privilege to discuss the report. The DUP is unashamedly a pro-life party. While we are debating having better and more palliative care services in Northern Ireland, MPs in Westminster are debating assisted suicide legislation. It has never been more important that we provide palliative care for everyone in Northern Ireland. <BR /> <BR />I thank all who have contributed to the report, particularly those who have lived experience of palliative care who have spoken of their journey with their loved ones. I also thank the indomitable Christine Campbell, who makes the point that she is "living" while availing herself of palliative care. I know how difficult it is to speak of such issues, and we owe those people our thanks.”
“Thank you, Mr Deputy Speaker, and I am glad to have the Health Minister's acclamation, completely.”
“As well as giving a list of all of the people with whom you are communicating or with whom you sit on a working group, will you tell us the answers for 1 January, which is in a few weeks' time?”
“Minister, you have given us a long list of people with whom either you or your Department communicate. It seems, however, that you are not communicating with the industry. At a recent Committee meeting in Westminster on the Windsor framework, a representative of the Ulster Farmers' Union said that he was unsure of DAERA's position on veterinary medicines. Mark Little, who is the honorary secretary of the British Veterinary Association, said:”
“We had a very helpful session on that matter with you at the Health Committee last week. You are aware, however, that transformation is also about the transformation of hospitals. You launched the hospital network consultation in October 2024, but, so far, we have not heard the outcome of it. When will we hear about the outcome? Can you perhaps give us a taster of some of the actions that may come from it?”
“It would be morally indefensible to go on as we are. Will you complete a demand and capacity analysis so that money can be properly directed? Will you demand that trusts submit improvement plans for backlog clearance and show their plans to deal with future demand? Will you ensure that the long-term sustainability of cancer services is a priority on the agenda of the Health Department? <BR /> <BR />Everyone in the Chamber wants to see better services for cancer patients. Cancer can touch all our lives. However, too many people struggle to access services, and waiting lists are, as Mark Taylor suggested when he took up his new post, a national scandal. Minister, it is time for action and system reform.”
“Taking £73·5 million away from waiting lists would be a serious breach with the people of Northern Ireland. I hope that you can clarify that for me, Minister, and that you will respond specifically to it in your remarks. <BR /> <BR />Cancer waiting times such as we have in Northern Ireland would not be tolerated in England, and they should not be tolerated here. Sadly, I sometimes think that we have become numbed by waiting lists; the difficulty in getting the right and timely diagnosis; and all the hurdles that health bureaucracy seems to put in our way. We need to see system improvements here. <BR /> <BR />Many patients whom I talk to are grateful for the care that they receive when they get into the system, but, as the debate shows, the real difficulty is with initial diagnosis and treatment. What is the plan, Minister?”
“How are trust chief executives being held to account for trust performance? We need to see every patient's cancer journey tracked and the most urgent cases prioritised. Is there an official in your Department who has responsibility for those things? <BR /> <BR />Of the rest of the £215 million, Minister, I know that £40 million was set aside for those who have been waiting for a procedure for more than four years. However, I have also been informed that £73·5 million has been taken away from waiting list initiatives and allocated to the deficit: is that accurate? The House deserves a straight answer on that important question. It is incredible that money designed to tackle the most appalling waiting lists could be used in that way. I say that with full acknowledgement that the Health budget is in significant difficulty.”
“It also records that, for 1,000 women with breast cancer, surgery delayed for four weeks would result in 10 additional deaths. An eight-week delay would equate to 20 additional deaths, and 12 weeks would see an additional 31 deaths. In light of the delay in regional breast cancer lists, Minister, and when it is crystallised in that way by clinicians who operate in the field, that is a serious issue. <BR /> <BR />Minister, your budget contains a ring-fenced budget of £215 million for waiting lists. The House needs to hear how that is being managed. How has the £85 million set aside for red-flag cases been allocated? What is being done to identify the patients most at risk due to long waits and to prioritise them for diagnosis and treatment? What transformation resource is being deployed in the trusts to support waiting-time recovery?”
“Too many cancers are diagnosed late and through emergency admissions: 31·4% of stage 4 breast cancers are diagnosed via emergency admissions, and 56·7% of stage 4 lung cancers and 48·9% of stage 4 colorectal cancers are diagnosed too late. <BR /> <BR />I am conscious of the fact that cancer diagnoses in Northern Ireland are rising, but that is also the case in England and Scotland. Minister, I suggest that we are suffering from a long-term failure to plan for the predicted rise and that, as a consequence, the wait for diagnosis and treatment has become longer and the outcomes for patients poorer. <BR /> <BR />The 'British Medical Journal' records:”
“The target set by the Department is 62 days. <BR /> <BR />That, unfortunately, is not the only story of its kind. It represents the devastating impact that delays to treatment can have. In the quarter to June 2025, 840 patients — more than two thirds — waited longer than 62 days to start treatment. For comparison, 69% of patients in England and 70% of patients in Scotland were seen within 62 days. <BR /> <BR />Our outcomes for two cancers are particularly startling. Of women diagnosed with ovarian cancer in Northern Ireland, 31% will not survive one year after diagnosis. For patients with pancreatic cancer, outcomes are worrying, with the majority of patients being diagnosed at stage 4.”
“As I open the debate, I want the House to hear about one woman's cancer journey. She is not a statistic but a wife and a mother of young children. She is 41 years old. In January this year, she had a mammogram, and all was clear. In June, she found a lump under her arm, had to wait to see her GP and was red-flagged on 5 July. In week eight of her journey, after multiple phone calls, she received an outpatient appointment and had a mammogram, ultrasound and biopsy. In week nine, on 28 August, she had a diagnosis of stage 2-3 cancer. In week 10, she received a CT and an MRI. In week 12, a PET scan confirmed a metastatic diagnosis: her cancer was now stage 4 and had spread to her lungs. In week 15, in October, she started treatment. She had to wait 112 days in total from her red-flag referral to treatment.”
“While patients are waiting, they may lose curative options or become too sick to withstand treatment, and that is a harsh reality for too many. Cancer statistics in Northern Ireland are startling, but, in every statistic, there is a person — a mother, a daughter, a father, a son or grandparents — who are thrown into the scary world of cancer diagnosis and treatment. In the words of one woman who was diagnosed with cervical cancer and who campaigns here regularly, "cancer changes you".”
“In introducing the debate today, I am aware that this is a sensitive issue. A cancer diagnosis is life-altering for both the patient and their family. Life is changed in that instant of diagnosis. I know that the House will treat the debate with sensitivity and compassion. The motion is not meant to diminish the incredible work of the clinicians and all those who work to provide care and support for those on a cancer journey. We know that patients who are receiving cancer care feel well supported by staff, and I put on record our thanks for their incredible work. All that being said, in the hope that we will make diagnoses, treatment and outcomes better for cancer patients, we should not shy away from hard facts. <BR /> <BR />We all know that cancer does not wait. Every day, 28 people are diagnosed with cancer in Northern Ireland.”
“I will indeed. When the Member reiterates this nonsense, I often wonder why he does not want to do his own job, which is making laws that are for Northern Ireland in Northern Ireland.”
“— DAERA is not intervening. Does the Member agree that it is important to make some progress?”
“Thank you for giving way. This is really important. Part of the issue is the Labour Government's inability to do or simply not doing the diligence that is needed to improve things. There is no greater testament to that than the issue of veterinary medicines. From 1 January, we will see a significant problem with veterinary medicines, even those that have never been opened in Great Britain but need to come to Northern Ireland, yet, last week, the House of Lords Committee said that the Government were saying, "We are doing nothing about it". Worse still —”
“He also promised last week in the House that he would prioritise pay for healthcare workers and, indeed, provide an upfront payment earlier in the year, even ahead of the pay review body settlements, and he has now promised that he will push the issue of the real living wage into next year as well. We are entitled to ask this: what is the Minister's financial plan for healthcare? It seems that we are kind of making it up as we go along, and that is simply not good enough. This year's pressures translated into next year's will create massive pressures on the healthcare budget. Furthermore, we will not relieve the winter pressures and take people out of hospital if we do not have a sustainable social care workforce, and the Minister needs to plan for that much more carefully than he has done heretofore.”
“However, we now find that, given the issues with the budget, the Minister has moved to a position where he is saying that he is still committed to that but only when it is more affordable — perhaps next year. Providing the real living wage is the right thing to do. In fact, it is the only thing to do. <BR /> <BR />Let us think for a moment about the position that the Minister has got himself into with his budget. There are already huge pressures on next year's budget. We are talking about the potential of him carrying an overspend into next year.”
“I rise this afternoon to talk about the issue of pay rises for social care workers in the independent sector. First, before we get into the meat of the subject, I want to reflect on something. I dare say that there is not a family represented in the Chamber at this time that is not grateful for the work of those care workers, who go in and care for elderly or disabled loved ones at a time when we cannot do it for them ourselves. We owe them a debt of gratitude, and it is right and proper that we put that on the record this afternoon. <BR /> <BR />The Minister of Health did the right thing when, earlier this year, he promised to provide those workers with the real living wage. The permanent secretary doubled down on that at the Health Committee and indicated that that would happen, perhaps even by September.”
“Maybe you will advise the House how, if doing so leads to an overspend, that will be managed in next year's budget. Will that mean cuts to services? The House needs a little more information about how you hope to manage that part of the budgetary process. <BR /> <BR />Winter pressures are not new, Minister. When I read the document, starting from the blank page that you talked about in January, it is hard to believe that this is how little progress we have made on planning —”
“We will not be able to resolve winter pressures if we cannot get people to leave hospital who are fit and ready to do so in order to get other people into the beds. In September, Craigavon Area Hospital had 700 care packages outstanding. That is a huge number. I understand the pressures on the budget, but hospital flow is where the problem lies. Again, Minister, perhaps you will advise the House about that matter, because it is important that we understand, as of this moment, how many people are in hospital beds who otherwise may be able to go home. <BR /> <BR />I turn to the amendment. As I said, I welcome the fact that healthcare workers are to receive their pay uplift. I also welcome the fact that you said in your statement, Minister, that you were going to prioritise pay awards in next year's budget.”
“I will say a few words about the winter plan. It contains some positive but relatively small-scale initiatives that, I worry, will not make a difference for patients who are lined up in hospital corridors or waiting for an ambulance. When we talked about that, Minister, you said, for example, that the Northern Trust, which does not have an acute care at home service, was to start one this November — perhaps you can tell us whether the Northern Trust has done that — but it would initially cater for only 10 people. That is good for the 10 people who get it, but it is limited in scope. It is the same with many of the initiatives in the winter preparedness plan. <BR /> <BR />We know about much of the plan's content. We know about the issues that are involved. The big issue that is not addressed, however, is social care.”
“Thank you, Mr Deputy Speaker. Although part of the motion is somewhat irrelevant now, like the previous Member who spoke, I welcome the fact that healthcare workers will receive the appropriate remuneration. It is important for all of us to have a workforce that is valued and motivated and that we support.”
“Thank you for taking an intervention. I have a process point that is quite important. The additional £100 million for the pay settlement was announced by the Executive on 16 October, yet I understand that the amendment was lodged with the Business Office on 5 October. Can you explain how you knew about the £100 million and how it was communicated?”
“While it is right that healthcare workers are paid appropriately, it is also right that the Minister explains how he will handle this really important issue. Cuts to manage an overspend next year would not be acceptable. <BR /> <BR />Our National Health Service is nothing without the people who get up every morning, go to work — at times, in a chaotic system — and care for us at the most vulnerable times in our lives. They deserve fair pay. The pay award should have been made after it was indicated. While there are issues with timing and budgeting, it is right that our healthcare workers are paid properly and valued for the huge contribution that they make.”
“The Health Minister has a budget of £8·6 billion, yet he indicates that it is difficult to meet pay awards. I sit, week in and week out, monitoring those issues at the Health Committee, and I understand the pressures on the budget. However, with 52% or 53% of the block grant, those issues could be resolved. <BR /> <BR />I note that the Minister, in his statement on the issue, has promised to prioritise pay in next year's budget. However, that begs the question of why he did not prioritise pay in this year's budget. Public sector pay rises are a bit like winter pressures in the health service: they are well known, and they come round every year. <BR /> <BR />We are also left with the questions about the impact on next year's budget if there is an overspend this year.”
“I welcome the announcement that healthcare workers are due to get the pay rise that they deserve. Our healthcare workers are the glue that has bonded a broken system, and it is they who go above and beyond in times of crisis. We cannot be seen to have been clapping for the NHS during COVID but failing to get to grips with fair pay for healthcare staff. All other healthcare workers in the rest of the United Kingdom have been paid that rise, and Northern Ireland should be no different. However, I hope that the pay rise will be supported by a clear plan for workforce sustainability, better working conditions, safe staffing reforms and improved patient outcomes. <BR /> <BR />Of course, there are questions to be asked about the handling of the pay award.”
“Minister, you indicated that Mr McEntee was not allowed to visit the Portadown area. How can you be sure that he was not within the Portadown area on the four occasions when he was unaccompanied?”
“I am glad that we are going back to the drawing board on the legislation, and I urge the Minister and his Department to ensure that the principles that I have outlined are fundamental to any new public health Bill.”
“<BR /> <BR />We are clear that sweeping powers should not be handed to the Minister of Health to impose restrictions that would directly impact on private and family life, education, employment and movement. Having lived through the experience of the COVID-19 pandemic, we understand that such powers and the lockdowns that they enabled led to major social and economic disruption, had serious impacts on personal health and derailed the educational and emotional development of many children and young people. In particular, we will continue to reject mandatory vaccination or plans to compel citizens to undergo any form of medical treatment against their wishes. Any future public health framework for Northern Ireland must be underpinned in law and practice by the principle of informed consent.”
“I rise to outline our opposition to the public health Bill, which the Minister has now withdrawn and on which he has told his officials to go back to the drawing board. First, I state clearly that no one doubts that public health legislation that dates from 1967 should be revised and that that should be done as soon as possible and that it should be up to date. We must also ensure that it tackles the issues of today. However, the public health Bill did not meet our criterion for such a Bill, which is that it strike a fair balance between fulfilling public health objectives and defending personal liberty as the cornerstone of a democratic society.”
“Yes, thank you. Many women across Northern Ireland need to have a service that they can have full confidence in. A public inquiry will uncover the truth.”
“The Department of Health is responsible for the performance management of screening programmes and related diagnostic and treatment services. The PHA is responsible for maintaining the structures and systems that support quality improvement and coordination across screening programmes. Therefore, I hope that you can tell us today, Minister, what exactly the PHA is doing to hold the Belfast Trust to account for those failures. What is the Department doing to hold the Belfast Trust to account for performance management failures? You and your Department need to consider the future very carefully. Many women across Northern Ireland —.”
“I would be interested, Minister, to know whether the 21-day target for the return of the results of those tests has been met. The specification for the new regional lab was to deliver 130,000 HPV tests and 23,000 cytology tests each year. Minister, how many of those tests has the Belfast Trust managed to deliver in the past year? What is the cost to the Belfast Trust of sending tests to Gateshead, and how is that cost being met? Will the Department recover costs from the trust for not meeting its performance targets? Have there been other times that are not in the public domain when tests have been sent to Gateshead? That is the information that is necessary for the House to judge the performance of the Belfast Trust and the new regional service. <BR /> <BR />In finishing, I want to return, Minister, to my theme of accountability.”
“The Public Health Agency (PHA) described the awarding of the contract as being in line with best practice, and it talked about the need to concentrate expertise and staff resources in one specialist laboratory. That is extraordinary in light of what we now know about the performance of the regional screening service. <BR /> <BR />At the very start of the contract, the Belfast Trust, which is a trust without accreditation, was sending tests to the labs in Gateshead, Newcastle. The result of that was extremely long waits for results, which extended to months. I have had an update on the figures since tabling the amendment, so we now know that, since 30 September, the Belfast Trust has sent 13,500 HPV tests to Gateshead. The trust said that that was due to an equipment failure.”
“The Western Health and Social Care Trust and the Northern Health and Social Care Trust were already accredited for HPV screening, yet, despite that and the committee's recommendation, the contract was awarded to the Belfast Trust. That seems even more bizarre when we consider that the Belfast Trust did not have accreditation for HPV screening. Indeed, it had its screening accreditation removed by the UK's screening accreditation service. One reason for that was the lack of record-keeping. We know from subsequent reports that important slides were lost and that some were found down the back of a filing cabinet somewhere. Surely, that would move us to action on the issue. That ultimately led to the resignation from the screening programme of two leading clinicians.”
“What of their managers and supervisors, however, who were responsible for the service and were allowing screeners to work huge volumes of overtime, thereby jeopardising their efficiency? Do they continue in management and leadership roles in our health service? Minister, I hope that on Wednesday, when you publish those reports, you will be on the side of accountability and transparency. That is essential, but, so far, it has failed. <BR /> <BR />Our amendment seeks clarity on the Belfast Trust's handling of the new regional human papilloma virus (HPV) testing service. The Minister knows that I have asked many questions about the awarding of the multi-million-pound contract to the Belfast Trust. We know that the committee that was set up to advise on the awarding of the HPV screening contract advised that it be set up on two sites.”
“It is quite simply extraordinary that when those who were found to be failing were provided with extra training, no one seems to have checked whether that made any difference to their work. It turns out that some were still not achieving adequate standards even after receiving additional support. That is a whole-system failure — a failure not just of the screeners but of the managers and supervisors who failed to recognise the problem. <BR /> <BR />Again, it is unfathomable that some screeners were not reported to their professional body by trust managers and supervisors. We have been advised that individual screeners who were found wanting have moved beyond the Southern Trust and that some are working in different disciplines while others have retired.”
“Whistle-blowers need protection and, in this case, commendation. <BR /> <BR />At the heart of the scandal is a real lack of transparency, accountability and responsibility in health service delivery. The Southern Trust recalled 17,500 smear tests dating back to 2008. During that time, some screeners from the Southern Trust were underperforming in relation to those smear tests. Those screeners, some of whom were underperforming at a very substantial rate, were not sufficiently managed, nor was their performance monitored. Looking back at that, it now seems unfathomable that trust arrangements for the monitoring and performance of screeners were not robust. <BR /> <BR />It seems absurd that trust managers could find a colleague's annual performance to be inadequate but not want to know how that compared with previous years.”
“<BR /> <BR />I also want to acknowledge a very tenacious group of women whom I have had the pleasure to work alongside. The Ladies with Letters group has been a support to those who need it, but it has also been willing to question the narrative and spend time creating a campaign that has highlighted this injustice. It wants a statutory public inquiry to uncover the truth and make sure that this can never happen again. We support that call, and I hope that the Minister can give us answers today. <BR /> <BR />We also owe a huge debt of gratitude to the very courageous whistle-blower who, when he came into post, saw the problem and took action. His actions saved lives. He risked his own position in order to uncover a very great harm. The trust should reflect on his subsequent treatment.”