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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“Minister, we are keen to know whether any of the recommendations in that road map will be considered. <BR /> <BR />Members of the local business community have also expressed their concern. They are local employers, who point out that the provision of services is key to attracting the right workforce and to achieving a regionally balanced economy. That is something that we very often talk about in the Chamber. They are calling for a proper conversation to be had on healthcare provision in Fermanagh. <BR /> <BR />Minister, we are all concerned about waiting times, but the reality is that two brand-new operating theatres for the SWAH have never been commissioned.”
“Is the system now more efficient? The Western Trust officials who briefed the Health Committee would like to tell us that it is, but many of the testimonies from those who have experienced the trust's services do not indicate that that is the case. Those are really important issues that our community in Fermanagh deserves to know about. <BR /> <BR />Many people from the local Fermanagh community have joined together to express concern about healthcare provision in the area. I have heard my colleague Deborah Erskine talk many times about issues with Community Pharmacy and accessing GPs and the difficulties that there are in bringing everything together. Save Our Acute Services (SOAS) is a local campaign group that has produced a road map that could be considered for the SWAH.”
“The Regulation and Quality Improvement Authority (RQIA) report expressed concern about ambulance waiting times — patients triaged at the SWAH may need to be blue-lighted to Altnagelvin or elsewhere — and about the use of private ambulances, which are not regulated. Double ED waits, for patients waiting in Enniskillen and then facing another wait at Altnagelvin, were also identified as a problem. I outlined the extent of those waits earlier in my contribution. I asked the people who put together the RQIA report, "If we are looking at doing something about emergency general surgery at the SWAH and taking that to Altnagelvin, why were these processes not ironed out before this was decided?". Today, we need to know whether the processes have been improved. We need to know why it has taken so long to identify them.”
“Many viewed it as positive, but people in Fermanagh rightly want to know how these three processes — the consultation on emergency general surgery, the hospital network plan and the sustainability plan — correlate and work together. Which will come first: a decision on emergency general surgery or the reconfiguration decision? Minister, so many people have travelled from Fermanagh today, and others are listening to the debate. I hope that you have the answers that the community in Fermanagh so keenly await. They deserve to know what health services will be provided for them in that part of Northern Ireland. <BR /> <BR />I will quickly look at another key report on the removal of emergency general surgery at the SWAH.”
“Eleven months after the publication of the plan, we still have no clear indication of the services that will be under SWAH's roof in future or of what your plan is likely to look like. <BR /> <BR />In the middle of all that, Minister, you intervened via the local newspaper, which I have huge respect for — my father-in-law used to write copious letters to it every week; you are laughing, but it is true — to ask for a sustainability plan for the SWAH. There was no communication with elected representatives, despite the fact that Deborah Erskine and others were in direct communication with you before that intervention.”
“SWAH could not meet those standards and therefore could not recruit, which led to a further crisis in staffing at the hospital. <BR /> <BR />The Western Trust is completing a consultation on the closure of emergency general surgery at the SWAH. At the same time as that process has been going on, the Department of Health and you, Minister, have been consulting on a hospital network plan. That consultation was launched in October 2024 — I looked at the date today; I think that it was 1 October 2024 — but we have yet to hear the outcome of the process. Are you, Minister, still pressing ahead with the hospital network plan to change the SWAH into a general hospital?”
“Indeed, concern about the consultation on emergency general surgery (EGS) at the SWAH has been expressed not just by local communities and political representatives but by the Patient and Client Council, which was set up to represent and express the needs of patients in local areas. <BR /> <BR />The temporary removal of emergency general surgery from the SWAH in December 2022 was brought about by an unplanned collapse in services. Many, myself included, argue that that situation was compounded by the fact that, in June 2022, the former Health Minister, Robin Swann, had published the review of general surgery in Northern Ireland, which established standards that hospitals must meet to continue to provide elective and emergency general surgery.”
“That is four days before admission to a hospital bed. At this stage, we should acknowledge that Altnagelvin hospital is also under huge pressure. <BR /> <BR />Minister, you often talk about health inequalities, and rightly so. I hope that we are not insisting on creating another health inequality for rural communities in Fermanagh and, indeed, the general population of the west of Northern Ireland. Rurality needs to be taken into account in the design of services and, indeed, the transformation of our services. <BR /> <BR />It is a fact that we desperately need transformation of health services in Northern Ireland, but, in this case, we are trying to transform services on the back of collapse and a lack of consultation with local people.”
“Anyone who knows the geography of that most westerly part of Northern Ireland knows that travel time from somewhere like Rosslea to Altnagelvin Area Hospital is almost two hours. For people in Fermanagh, distances are long, roads are challenging and alternatives are not as feasible as they are for people in urban areas. That is the stark reality of rural healthcare. <BR /> <BR />As if that were not enough, the Western Trust is proposing a permanent hospital service change based on the premise that the current arrangements at Altnagelvin are suitable and coping well. They are not. On 28 August 2025, the Royal College of Emergency Medicine released figures for emergency waiting times that show that patients in the emergency department (ED) at Altnagelvin wait between 19 hours and 89 hours.”
“I spoke to Deborah today. She wanted me to put on record her thanks for the way in which she has been treated. She is very grateful for all the work of the local community midwife right through to the hospital consultants. It just shows that while, sometimes in the House — the Minister will smile when I say this — we focus on the things that are wrong, really need to be fixed or are urgent, there are everyday people doing tremendous work in our hospitals. <BR /> <BR />Emergency general surgery at the SWAH is not just a local issue; it is a regional one. It is an issue that has deep significance for how we transform our services and the basis on which we proceed. For families in Fermanagh, the South West Acute Hospital is not just another hospital option; it is the only acute hospital that is accessible within a reasonable time frame.”
“Thank you, Mr Deputy Speaker. I echo your words and welcome everyone from Fermanagh today. It is a long way up the road, but we will discuss a lot of long journeys as we go through the debate and try to make some progress. At the outset of the debate, I just want to say that my colleague Deborah is extremely disappointed that she is unable to be here. She is a passionate advocate for Fermanagh and South Tyrone and the South West Acute Hospital. I am sure that we wish her all the best at this difficult time.”
“I will address your first point. I find it a bit rich of you to say that you did not have a demeaning attitude. You were the person who told us to "grow up" and sort it out. That attitude to what is a fundamental question for unionism shows us all what Alliance, the SDLP and Sinn Féin are all about. <BR /> <BR />Let me be clear about the Windsor framework. It continues to drive up costs, reduces consumer choice and diverts supply chains, which goes back to your point.”
“I will if you give me one minute to finish this point. <BR /> <BR />The result was inevitable: no challenge to the Irish Sea border; no demand for the repatriation of powers; and no recognition that genuine change will require fresh legal arrangements with the EU. In short, the Murphy review ducked the fundamental question of how to restore Northern Ireland's full place in the United Kingdom's internal market. It was a tick-box exercise rather than a serious attempt to resolve constitutional and economic damage.”
“The constitutional difficulty is the imposition of foreign law in this part of the United Kingdom without democratic consent. That is the truth of the matter. <BR /> <BR />The review was hamstrung from the beginning, because its terms of reference insisted that any recommendations carry cross-community support. In practice, that gave nationalists a veto over the outcome, hence the attitude that we see in the Chamber today.”
“That is why this is important, and that is why we will hold to our mandate to restore Northern Ireland's full and equal place in the United Kingdom. <BR /> <BR />The findings of the Murphy review confirm what we suspected all along. Instead of tackling the root issues, the report fell short. It avoided hard questions, and it failed to challenge the core assumptions of the protocol. Lord Murphy and his colleagues described some of the problems that businesses and consumers face, but shining a light on a problem is not the same as solving it. The central difficulty is a constitutional one — yes, the Member is laughing. I know that you do not like that, but, in a respectful debate, you would acknowledge that it is important to this side of the House. That laughter is appalling.”
“I thank the Member, and I will come to some of those issues. <BR /> <BR />At a time when people expect unionists simply to, "Suck it up", the tone from the Members opposite in the debate has been appalling. The Windsor framework and the protocol were imposed without the support of unionism. They handed lawmaking powers in vast areas of our economy to Brussels, and they drove that trade border through our internal market in the United Kingdom. What was heralded as a solution has left us with a core problem. Let us be absolutely clear and honest today: the core problem is that EU law still has primacy in Northern Ireland. Therefore, businesses face obstacles, consumers still pay the price and the democratic deficit is as glaring as ever.”
“Mr Speaker, I apologise: my phone went off; I forgot to put it on silent. <BR /> <BR />The protocol and its successor, the Windsor framework, have overshadowed political and economic life in Northern Ireland for far too long. We have heard a range of views on that today. We have seen the sneering — I see it again from the Member opposite — from nationalists, with unionists expected to, "Suck it up". We have experienced all those things in the Chamber today, but we will continue to talk about the Windsor framework and the protocol because that is important. It was heralded as a solution —”
“I thank the Minister. This is a sensitive and difficult subject. I reflect on the fact that we were not on our own in expressing some concerns, given that two very senior members of the Minister's own party expressed the same concerns. My question is very specifically about consent, because that is a really important issue for parents. If a young person is referred to the gender identity clinic, as it is now constituted, before the Cass review, do they have to have parental consent? The Minister said that "very few people" were recommended for surgery, so will he elaborate on that a little bit more and tell the House how many were actually recommended for life-altering surgery, bearing in mind that the vast majority of people in Northern Ireland believe biological sex to be a reality in fact?”
“Deputy First Minister, many of us are really angry at the Secretary of State for running to Dublin for an agreement on legacy but not addressing the fact that Dublin has never admitted its role in IRA terrorism. It has not cooperated with the Omagh inquiry, and there has been no justice from the Dublin Government for, for example, the families of Ian Sproule and Lord Justice Gibson or the Hanna family. Will you assure us that you will do everything that you can to make sure that the issue of legacy addresses the core principle of justice?”
“I thank the deputy First Minister for her reference to the conference that we attended on Friday. One of the issues that is really important to families who have experienced that type of terrible violence is the justice system and, in particular, the length of time that it takes for cases to come before the courts. That causes those families such anxiety. Will the Minister work in the Executive to ensure a much swifter response for those families?”
“Thank you very much: you are always generous in giving way. <BR /> <BR />I recognise that, when the Member was in Downing Street, as he often tells us, he was fulfilling the Tory party's wishes at that time. That may not have been his personal wish, but it is what he was doing. It is interesting, however, to hear nationalism in the Chamber today confirm that only majority rule is what it wants. Is that really what you see for the future?”
“I thank the Member for giving way. You have described very eloquently the cost of border posts and the implementation of the agreement. However, that is only one element of it; we also have the Trader Support Service and all the ancillary services. We are probably in the region of £500 million now for costs. Do you agree that all that money would be better spent on enhancing trade within our internal market?”
“Thank you for giving way, Minister. I appreciate that, because, in the context of the Belfast Trust, the whistle-blowing manager, as I understand it, is responsible to HR. I would really like to see a separation of roles so that whistle-blowers are completely protected. Those are things that we should look at. Thank you for acknowledging the issue.”
“I would like you to place in the Assembly Library information on the arrangements that are made for releasing information on adverse incidents and, indeed, serious adverse incidents and on the circumstances in which that information is released, because to keep families in continuous suspense and having to fight continually on that issue is just wrong. I know that the Minister will give that matter his attention, because it is deeply disturbing. <BR /> <BR />I thank the Minister for the introduction of the Bill's Second Stage. This is a good step forward, and I look forward to the scrutiny of the Bill.”
“A number of us will have received an email from a family who were deeply involved in the Muckamore Abbey Hospital scandal and have been trying, over a period of probably two years, to get information from the Belfast Trust on adverse incidents that relate to their son. I would like you to give us some assurance — I will forward the correspondence to you — that the matter will be dealt with, not post the legislation but now. It is an extremely stressful situation. Some of the emails that the family sent were not acknowledged, and others have been kind of thrown into the long grass, for want of a better phrase.”
“<BR /> <BR />Minister, in the DUP's 2022 Assembly manifesto, my party promised to support new adult safeguarding legislation. We will stand over that promise. As I have said, I have concerns about the overall funding for the legislation. I hope that it can be brought through the House in a timely manner and that you and your officials will listen and respond to the concerns — not just the concerns but the praise, I have to say — that have been levelled at the Bill in the debate. <BR /> <BR />One of the reasons why we need the Bill is the fact that is difficult for families to get information about their loved ones, if they are concerned about how those loved ones are being dealt with by health and social care trusts.”
“It would be like the Mental Capacity Act (Northern Ireland) 2016, much of which still has not been implemented. The feeling of the House is that it is too important not to be implemented. We would like your assurance, Minister, that you will seek extra funding for that implementation. We will give you our support for that. That is hugely important. <BR /> <BR />I just want to check that the costs of the Bill are accurate, because, in autumn 2021, I was led to believe that the Bill's estimated start-up costs were over £800,000, with £821,000 annually for implementation. That is a significant divergence from the costs in your current estimates. Can you shed any light on how those costs have risen so dramatically to £12 million a year and how we can scrutinise that part of the Bill?”
“That is all welcome, Minister. We look forward to looking at the Bill clause by clause and helping the Department to get the balance right for the future. Like others in the House, however, I am concerned that the business case has been approved by the Department of Finance only on the basis that the legislation will not be enacted until such times as funds become available. In essence, that means that implementation could be delayed. That would be very disappointing for the families whose loved ones have suffered the horrors of Muckamore and Dunmurry Manor. <BR /> <BR />We will want to look further at the costs of the Bill. The Health Committee received a paper estimating those costs to be £12 million a year over the next decade. Without extra funding, it may be the case that the Act would simply sit unimplemented.”
“We need to know that the duty to report comes with safeguards for those who are doing the reporting out of goodwill and concern for the people who are at risk. I will be interested in seeing how those elements of the Bill will intersect with any duty of candour. It is really important that we have synergy in that regard. <BR /> <BR />The adult protection board will have the power to conduct serious case reviews. I believe firmly that accountability and independence will be key to that board. I hope that we will see that safeguarded and strengthened in the legislation. <BR /> <BR />The Bill creates offences around ill treatment and wilful neglect, and, of course, we will all scrutinise the use of CCTV.”
“I hope that we can work with the Bill, and with the Minister and the Department, to strengthen those important areas. <BR /> <BR />The duty to report and cooperate would place a duty on several bodies and establishments to report to the relevant HSC trusts in cases where, they believe, there is reasonable cause to suspect that an adult meets the criteria of an adult at risk. Again, that is very important. I will back up Colin McGrath's comment: if there is a duty to report, there must be protection for those who are doing the reporting and whistle-blowing. There have been significant conversations in the media recently about whistle-blowers and the impact on them personally and on their career prospects.”
“In essence, it will bring us into line with the rest of the United Kingdom. The seven key principles, which others have outlined, all seem sensible and important. Importantly, the Bill places a duty on organisations to report, make enquiries and cooperate. Given the issues at Muckamore, there will be a duty on HSC trusts to follow up in all cases where it is brought to their attention that someone is suspected of being an adult at risk. We, as a Health Committee, met families who are going through the serious adverse incident (SAI) process. The way that that process is drawn out by health trust officials is, at times, scandalous. The search for information is very stressful for families who have been so deeply affected. All those things are important and will be welcome.”
“I, like others in the House, welcome the Second Stage of the Bill. Minister, in your concluding remarks, you said that we should never hesitate to protect the most vulnerable. We all agree with your sentiment. However, it is a pity that it has been such a long time coming; that the Bill is only now starting to address the gaps between here and the rest of the United Kingdom and the Republic of Ireland; and that it has taken the harrowing circumstances of Muckamore and Dunmurry Manor to bring the issue into the public domain. Many people, particularly the families, await the outcome of the public inquiry with trepidation. <BR /> <BR />As others have said, the Bill has come about through the independent report and other reports on the deficits in Northern Ireland legislation.”
“Will you tell the Chamber whether you or your predecessor had to give a ministerial direction in order to move forward with the project ahead of the result of the legal challenge, or did you have the agreement of your permanent secretary? Will you clarify whether the A1 project will go ahead as a major safety project for Northern Ireland?”
“I associate myself with the remarks of condolence to the families who have lost loved ones on the A5 — it is important to say that at the outset — but, Minister, this is a mess. It is a mess of the creation of those who voted for the climate change targets, but it is also the Infrastructure Department's mess.”
“I must say that everyone in the Chamber shares your frustration, Minister. You say that it will be another 28 months, and it is already 15 months since the handover of that building, so we share your frustration. <BR /> <BR />I will turn your attention to another issue relating to the Belfast Trust, Minister. Can you explain to the House how significant the fire safety concerns are that the Northern Ireland Fire and Rescue Service has about the Royal Victoria Hospital? When was the trust first advised of the concerns? Is the Fire and Rescue Service pursuing an enforcement notice in relation to this?”
“Further to what you have said to us, Minister, can I ask about the assessment and support model for students? You say that it will be a statutory assessment. Will it have the same legal clarity as a statement of educational need?”
“Thank you, Minister, for your statement. Like others, I thank Alma and all those involved in the campaign. Like me, they will have mixed emotions about the statement. We are interested in some of the things that are the responsibility of the Department for the Economy, but we realise that there is a whole swathe of young people with difficulties and learning disabilities who are excluded and have not particularly been mentioned. Their problems are outlined, but the solutions to those problems have not been. We would really have loved a whole-Executive approach.”
“I am glad that the Member referenced the creative industries. Will he join me in congratulating the Deluxe Group in my constituency, which has received the King's Award for Enterprise in the category of international trade?”
“I appreciate the Member giving way. You make some important points, particularly around the idea of new thinking about how to manage our budgets and progress reform. That is very important, and we look forward to meeting Mike Farrar to get the detail. You also make a point about the budget shortfall for Health. I recognise fully how challenging that budget is. Do you agree that it is important that we have accountability from the trusts on how they spend their budgets — particularly from the Belfast Trust, where we have seen a huge amount of wastage in the capital programme?”
“I thank the Chair for giving way. He mentioned the Department's capital budget. We have seen huge waste and misuse of funding in the capital budget. Does he agree that the mother-and-baby unit could have been built by now had we not been wasting money in the Belfast Trust in relation to all the other building programmes and that it is imperative that the Executive and the Minister get behind the build of the mother-and-baby unit?”
“I hear the Member talk about the Belfast Agreement, yet his beloved EU set aside and then shredded the Belfast Agreement when it agreed to a majority vote in the maintaining of the Windsor framework/protocol arrangements. How is that supporting the Belfast Agreement?”
“Thank you very much. I know that the Member is passionate about the EU. He and I will always have a strong disagreement about that, but will the Member agree that his wanting an EU office in Belfast in order to petition the EU to do something that he should be doing as a Member of the Legislative Assembly — that is, making laws for Northern Ireland — borders on the ridiculous?”
“Minister, this is a good day for many communities across Northern Ireland in many sectors, and I thank you for the statement. You talked about money being tight and having to be careful with money: what will be the potential cost if we do not have regard to the recent Supreme Court ruling?”
“Minister, first, will you publish the report and lay it in the Assembly Library for Members to see, so that we can scrutinise and measure the work of the Belfast Trust? Secondly, will you tell us why and how on earth the problem was allowed to continue over such a long, long period? I know that the review started in 2024, but the problem has been ongoing.”
“Minister, the report is shocking. There has been a litany of problems and a culture of bullying and poor behaviour. At one stage, an operation was cancelled because of "interpersonal differences in theatre". It reveals that four surgeons were working from home. What really concerns me is the report's conclusion:”
“— including the Happy Smiles scheme, but they are bits and pieces. We need the overall strategy to improve dental health.”
“<BR /> <BR />Minister, we need work on the cost-of-service review, and I note that you said that that will be done in this financial year. Dentists in particular would like to understand how the metrics will be applied to the allocation of the £2·5 million, which we acknowledge that you have allocated for the increase in National Insurance. We acknowledge all the other schemes that you talked about —”
“That is an extremely low figure. I think that she said that it is 17% less than the average across Northern Ireland. Indeed, the description of that area as being a dental desert is pretty apt. As Colin McGrath said, we really need to think of dentistry not as a luxury but as an absolute necessity. <BR /> <BR />I thank my colleague Claire Sugden for acknowledging the issue of dental access and women's unique health challenges. Sometimes, I think, we gloss over that particular idea. The Women's Institute did a report on it recently, and it gave evidence that said that women have unique oral health challenges and have poorer oral health in comparison with men over their lifetime. Again, those are the inequalities in access that need to be cleared up.”
“As you said, Minister, it is more likely to affect children who are in deprived areas, who are more likely to have extensive or severe dental decay. I know that health inequalities is one of your priorities, and that needs urgent attention. <BR /> <BR />It is also clear that, as colleagues on the Opposition Benches outlined, dental examinations are about more than just fillings; dentists check for oral cancers. Again, it is more likely to be prevalent and a more serious issue if we cannot have that examined in areas of highest deprivation. That is extremely important. <BR /> <BR />I will say a bit about access to dentists in rural areas. It is a significant problem, and I thank my colleague Deborah Erskine for bringing it forward. In the Fermanagh and Omagh District Council area, only 49% are registered with an NHS dentist.”
“However, if we dig into that figure a little bit more, we see that 12,924 patients were removed in 2023 and 40,980 were removed in 2024. The situation is escalating, and it requires urgent attention. Clearly, it is a very fragile situation. <BR /> <BR />Minister, you talked about the enhanced child examination scheme, and I acknowledge the funding that has been put into it. You indicated that 37,000 children were registered with the scheme last year. That is good, but the number of children who are registered with an NHS dentist has still dropped. In quarter 3 of 2023-24, it was 332,012 children. In quarter 3 of 2024-25, it was 317,000 children. Therefore, even with the scheme, the number of children who have been able to register with an NHS dentist continues to drop.”