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. I thank all those Members who contributed to the debate. The fact that there is unanimity on the motion and the amendment is a measure of how much we hear from our constituents about issues with dental health and access to NHS dental care. That is very important, and it is a very significant message for the Minister and the Department. <BR /> <BR />There is absolutely no doubt that our NHS dental services are in an extremely fragile position. That is not just the case for Northern Ireland; all nations across the UK have experienced a drop in access to dental services. However, it is the most significant in Northern Ireland, and it should be addressed. In April 2025, the BBC reported that 53,000 NHS patients were removed from dental lists.”
“— he said that he would ring-fence £76 million. There are many challenges, Minister, and many things to do in the year ahead.”
“I have said this before, and I will say it again: the mishandling of projects needs an independent view from someone who comes in and says what is going wrong and how we can save the health service money. The acute mental health inpatient building in the Belfast City Hospital grounds opened in 2019. It will take potentially millions of public funding to set it right. It is just not right. <BR /> <BR />I turn to waiting lists. Minister, I welcome the ring-fencing of £250 million and the additional £50 million, but the Health Minister said that that would mean his having to find £165 million from his budget. I might be looking at that in a simple way, but I think that the Health Minister's job is to find money in his budget to tackle waiting lists. In his initial brief on the Budget —”
“What a person in the Southern Trust can expect to get is not the same as what someone in the Northern Trust can expect. I do not think that those inequalities are good enough for a modern-day health service. <BR /> <BR />Other contributors to the Budget debate mentioned health estate funding. Minister, I cannot go past the appalling management of capital projects in the Belfast Health and Social Care Trust. It is 15 months since the handover of the maternity hospital to the Belfast Trust. Last week, the Health Committee received a letter saying that the trust could not give us any indication of when the building would be safe to use and safe to be occupied by mothers and babies. That is just not good enough.”
“Much of the rationale for removing the Health and Social Care Board was to reduce bureaucracy and avoid duplication. We went through the pain of abolishing it but have ended up with greater costs and even more staff. That is not an example of reform. We need to find genuine efficiencies, not simply moving people out of one office and into another, and provide more funding for front-line services. That is what people expect of us, and that is what we should be given. <BR /> <BR />I should probably not open this can of worms, but trusts have some really good initiatives. I was reading at the weekend about some in the Southern Health and Social Care Trust, but there is no uniform delivery of healthcare across Northern Ireland.”
“We cannot continue to do the same thing all the time, because we will just get the same or more difficult outcomes. Last year, administrative costs in the health service totalled £305 million, and management costs totalled £264 million. Well over half a billion pounds was spent on bureaucracy. It would be hard to find anyone in Northern Ireland who thinks that they got value for money for that spend. Department of Health staff now total more than 1,200. That exceeds the number of staff who were in the Department and on the Health and Social Care Board (HSCB) before the board was dissolved. The current £109 million in departmental administrative and management costs exceeds the respective joint total for the HSCB and the Department prior to that board's dissolution.”
“Without it, we will continue to let people down. We will continue to let women down. Last week, I got statistics from the Department that indicated that, in the Belfast Trust and the South Eastern Trust, 25,000 children are on a waiting list to see a paediatrician. Those are not acceptable statistics, so we must use the money that we have in the best way possible to get the best outcomes. <BR /> <BR />Departmental officials recently informed our Health Committee that, of the £8·5 billion, £7·8 billion is simply being rolled over. I do not want to think that this is just more of the same from the Health Minister, because that is not good enough. All the nine programmes of care received a similar percentage increase. There was no indication of prioritisation to allow a focus on primary care, acute care or waiting lists.”
“As Professor Bengoa said, without reform, and by doing everything the same way all the time, the Department of Health will soon demand and eat up our national Government's entire funding for Northern Ireland. It is really important, therefore, that we look not only at prioritisation but at reform of health services. <BR /> <BR />We in the Chamber should remember that we spend more per head of population on health than anywhere in the United Kingdom, but we have the worst outcomes and longest waiting lists. Our cancer waiting times are an absolute disgrace. Two thirds of women who discover a lump in their breast are not seen by a consultant within the departmental target waiting time. That is a shame on all of us and on the system that has allowed that to happen over a long time, so reform is not an option; it is an imperative.”
“Like Mr Donnelly, I welcome the Budget, realising that it is not everything that we may have asked for or wanted but that it is a significant platform from which to move forward for our health service. I also welcome the additional £50 million for waiting lists and the ring-fencing of the £215 million. Those are important steps forward. However, it is the allocation of the Budget that will be so important and that will make the difference. It is about prioritisation — the making of decisions on how best to allocate funding on the basis of the needs of our health service and general population. That may require doing things differently or deciding that an alternative approach is necessary. One thing is certain, and it was reinforced by Professor Bengoa when he was here last October: reform of the health service is essential.”
“The Minister says that he is solution-driven, but the reality for the Minister, and, indeed, for all the rigorous implementers, who seem to be out in force today, is that they cannot provide any solutions. The solutions that they think are the right ones are actually made in Brussels, and we are the rule takers. Is there any benefit in having an Assembly, Minister, that cannot legislate for agri-food in Northern Ireland or control the environmental laws that we have in Northern Ireland? That is the reality that you advocate.”
“Will the Minister detail the child poverty statistics and explain how the strategy will help us to drive down those figures?”
“I must say, Minister, that making this type of statement in the House is an interesting way to conduct a negotiation. Minister, do you understand how GPs will view this statement, given that your Department spends well over £0·5 billion per year on the administration of health in Northern Ireland? Do you accept that GPs are entitled to look on £9·5 million as a rather poor settlement?”
“That is a significant list. What assessment has the Department made of the impact of AI on the workforce in Northern Ireland, since it is fundamentally changing the way in which we do business and the way we work?”
“Thank you. Minister, I hope that you have some good news for patients who are on those waiting lists.”
“The Health Secretary and the Prime Minister have announced innovative plans to slash the waiting lists in England, although they are nowhere near as bad as ours. Patients are to be offered community diagnostic centres that are open 12 hours a day, seven days a week, where you can book scans after work or at weekends.”
“The Royal College of Surgeons advises that surgeons want to have more theatre time and be able to operate more. What progress has been made on improving that position? The Secretary of State for Health and Social Care, Wes Streeting, said that, without better productivity and health prevention measures, health costs could "dwarf" other areas of government spending. Indeed, Professor Bengoa pointed out in the autumn that, without reform, our system, which now takes up more than half of the block grant, would soon require all the block grant. <BR /> <BR />While Northern Ireland's performance deteriorates, NHS England confirmed last month that it has hit a key waiting target for the first time. NHS statistics confirm that 80·2% of patients who were urgently referred for suspected cancer were diagnosed or had it ruled out within 28 days.”
“It does not broaden capacity, and I struggle to see the benefits. It does not result in more people being treated: it just means that companies in Dublin will benefit financially. I suggest that the Minister looks again at the proposed scheme. <BR /> <BR />Health and social care (HSC) workforce statistics demonstrate that, in the six and a half years since the end of March 2018, the number of doctors in Northern Ireland has increased by 24%, which is more than 1,000. Over the same period, our number of nurses and midwives has increased by more than 2,500, which is a 17·5% rise. With all those additional staff, why do waiting times, emergency department (ED) performances and other metrics continue to head in the wrong direction? <BR /> <BR />At paragraph 50, the updated elective care framework states:”
“Rather than really tackle root-and-branch reform of the elective care system, the Minister seems to prefer to resurrect a drip-feed reimbursement scheme in the form of the waiting list reduction reimbursement scheme. The Department will pay full price for every procedure as part of that scheme, and it turns the principle of the NHS on its head by allowing the wealthy to jump the queue. What possible benefit does the Minister's Republic of Ireland-first scheme really offer? A finite sum is available for all waiting list activity, so if every person who has the financial means to travel south to Dublin or elsewhere for treatment does so, that money will be gone and will not be available for treatments locally in Northern Ireland. Those who are next in line, who have waited the longest, will miss out.”
“The Minister does not appear, either last Tuesday or at any other stage, to have picked up or embraced the potential for the delivery unit, which is referenced in the motion, to provide assistance. There can often be value in another set of eyes examining problems and offering a different perspective. That is why I have also referenced that in the motion. <BR /> <BR />As I have said before, I fear that the elective care framework is not nearly ambitious enough. I am not alone in that. It promotes more of the same through more small-scale offerings to our relatively modest independent sector, the majority of staff in which are already busy working for local trusts.”
“I note the SDLP amendment, but I fear that it would diminish the responsibility to be placed on the Minister of Health to act in conjunction with his Executive colleagues, unless the Member who speaks to it can persuade me otherwise.”
“Minister, you recently provided me with the startling statistic that almost 25,000 children are on waiting lists to see a paediatrician in the Belfast Trust and the South Eastern Trust. Some 2,000 children are on a waiting list for surgery in the same trusts. I suggest that, by any departmental standards, that represents abject failure. <BR /> <BR />I welcome the ring-fencing of funding for health waiting lists. The issue will require prioritisation in the Health budget and additional funding from the Executive. I hope that, as we progress to having multi-year Budgets, the focus on waiting lists that was promised in the Programme for Government (PFG) will continue.”
“<BR /> <BR />Minister, in the response to my question for written answer that you provided on 7 October 2024, you explained previously announced plans to regionalise breast cancer waits into a single list. I hope that you have good news for us today, and I ask whether you can provide an update on that regional list and how effective it is proving to be. We hope that that is proving to be much more effective than the previous system, as indicated by the percentage of 31·7% for the 14-day referral target. If the regional list is not fully in place, the House deserves an explanation for its slow progress. <BR /> <BR />I will digress ever so slightly to give a voice to children in Northern Ireland who languish on waiting lists.”
“Minister, in your response to the debate, perhaps you will explain the issues that specifically relate to skin cancer treatment in the first quarter of this year. <BR /> <BR />Percentages for the 62-day treatment target for GP referral were worse. The target time was achieved in only 37·9% of cases, which falls far short of the 95% required. For the 14-day breast cancer target, 31·7% of women were seen within the target time, against a specified target of 100%. That means that less than a third of women are seen within the target time, and that figure is down further on that of a year ago. Just imagine the fear and distress of a woman who finds a lump in her breast and then has to wait a significant time before being seen by a consultant. The situation is letting down women in Northern Ireland, and it must be rectified.”
“I want those who are dealing with a cancer diagnosis or who have lost loved ones to cancer to know that the Assembly is determined to do better and that we will continue to hold the Minister of Health to account on that very important issue. For us to do anything less would be a failure of our duty as the scrutiny body of the Executive. <BR /> <BR />Cancer touches everyone in Northern Ireland, with half of us expected to receive a cancer diagnosis in our lifetime. The most recent cancer waiting times, published last month, reveal that 87·5% of patients started treatment within 31 days of diagnosis, against a target of 98%. The percentage decreased from that in the previous quarter and that in the same quarter of last year, with the poorest-performing areas being urology, gynaecology and skin cancer treatment.”
“How long we wait for healthcare services is an indicator of people's view of the overall state of our health service. I specifically wanted to debate the topic of cancer waiting lists because I am extremely concerned that, although the Department continues to issue appalling statistics for Northern Ireland, those statistics get only a cursory mention in the press or in the House. <BR /> <BR />Cancer Focus Northern Ireland indicates that none of the departmental targets for cancer has been met since 2012. Are we now so immune to such shocking statistics that they pass us by without our noticing them, or have we decided that that is just the way it is?”
“Thank you, Mr Deputy Speaker. I welcome the opportunity to debate what, I think, is a hugely important issue for everyone in the Chamber and in Northern Ireland. I submitted the motion last month. It was agreed by the Business Committee and was included in the provisional Order Paper that was circulated on 30 April. I was a little surprised, albeit delighted, that the Minister came to the House last week with his statement on waiting lists and the unacceptable times that people wait. I am sure that the timing of his statement could only have been coincidental.”
“What about a person who has been on that waiting list for a very long time but cannot get the money and will not be able to access the scheme? How is that bringing equality to health provision in Northern Ireland, and what can we do about that? That is —”
“Thank you, Minister. This is a welcome statement that says all the right things, but, of course, we need to see the plan and how it will be implemented. That is the most important thing. <BR /> <BR />I will rehearse a question that I have asked many times before. The waiting list reduction reimbursement scheme will allow a reimbursement for someone who wants to go to Dublin, Galway or wherever to have their hip fixed if they have been on an HSC waiting list for longer than two years. However, that assumes that that person can get the money up front to pay for the treatment. What about a person who has been on an HSC waiting list for eight years? I received a letter from the chief executive of the Western Trust that stated that the average waiting time for a routine hip replacement there is nine years.”
“— by trying to eradicate diabetes and by managing it through the technology that is available to us.”
“We could relieve a lot of the stress on parents and on family life —”
“Surely it is sensible for us to know the key metrics in order to help us identify service gaps and to have the data to enable us to enhance outcomes, reduce complications and ensure that there is equitable care across Northern Ireland. We really want to see the Minister make progress on trying to have Northern Ireland included in the audit. It is important that we get a timeline for participating in it. <BR /> <BR />I will finish by quickly mentioning something that Órlaithí talked about, which is the impact on families with children with type 1 diabetes. Many of those parents fear for their children, particularly those children who do not have a hybrid closed-loop system to help them manage their diabetes. Children are less able or perhaps less careful when it comes to identifying the symptoms that they have.”
“By GP federation area, the raw prevalence rate ranged from 53·8 per 1,000 in south Belfast to 82·6 per 1,000 in Ards. I do not know whether the Minister has an insight into the reason for the variations, but it would make for an interesting study. <BR /> <BR />Many of those who have spoken, including my colleague when introducing the debate, have talked about technology and the care improvements that it can bring. While that is undoubtedly the case, we have to accept that the technology is available in Northern Ireland but almost via a postcode lottery system, which is not good enough. We should offer the same treatment to people across Northern Ireland. That is not the situation just for diabetes; it really has to change in a range of areas. <BR /> <BR />Many colleagues across the Chamber have talked about the National Diabetes Audit.”
“That figure is expected to rise to approximately £524 million by 2035. Many of my colleagues are protective of the health budget, but surely this is the classic Professor Bengoa issue where we must do something to stop people getting sick in order to be able to spend money on other priority areas in the health budget. Therefore, it is important to look at this element. <BR /> <BR />As of 31 March 2024, there were 114, 673 patients on the diabetes register — that is a significant number. It equates to a raw prevalence rate of 70·3 per 1,000 patients, ranging from 65·3 per 1,000 among practices in the Southern Trust area to 77·4 in the Northern Trust area. There is a variation in the prevalence of diabetes across trust areas.”
“I want to add some words to the areas that have been covered in the debate. I thank the Members who have spoken. The subject has a wide range of issues, but there is also wide consensus across the Chamber that we need to do something about it. <BR /> <BR />As has been mentioned, diabetes is one of the most significant long-term illnesses that our people face. It can have serious consequences, if it is not well treated and controlled. People with type 1 diabetes that is not well controlled are at risk of long-term complications, including sight loss, heart disease and stroke, which are very serious. The debate is worth having because of the number of people whom it can impact on. <BR /> <BR />As others have said in the debate, Diabetes UK has predicted that the cost to Northern Ireland is £291 million per year.”
“I appreciate that. I would appreciate a more detailed follow-up answer on the matter. Minister, do you understand that the issue is of great importance to my constituents? Lives have been lost on that road and will continue to be put in danger as long as the small openings remain, the crossings are not closed and the improvements are not made.”
“I thank the First Minister for her answer. It was a very general answer, however. Should President Trump re-impose the tariffs, Northern Ireland will be hugely disadvantaged as a result of its being in the single market for goods and having to apply the EU customs code. We will therefore be liable to pay duty on US goods coming into Northern Ireland. What specific measures has the First Minister suggested to the UK Government that they might employ in order to protect Northern Ireland?”
“I thank the Member for giving way. She makes a very important point in relation to how children's needs are assessed. One of the issues around the South Eastern Trust, in particular, is the number of families who are still waiting for contact with a social worker. That is a very issue. The South Eastern Trust is completely out of kilter with other trusts in relation to that number of families. Does the Member agree that that leads to an exacerbation of the problem and that things can get out of hand quicker because help is not available or assessed?”
“I will. <BR /> <BR />We make substantial use of the voluntary and community sector. I ask you, Minister, to look at that relationship and perhaps at longer-term contracts and better arrangements.”
“It is difficult, Minister, to see how those ambitions, which are publicly accepted and part of your Department's documents, will be fulfilled if this kind of funding is continued. We make substantial —”
“One of the more advanced descriptions of the voluntary sector's role is contained in our current mental health strategy. Action 17 is:”
“I would like to understand, as would the House, why there was no screening exercise on the new programme and the new design and on the decision to maintain a cut that is obviously so damaging. <BR /> <BR />I will say a few words about the way in which the Department considers the voluntary and community sector. In his report, Professor Bengoa said:”
“We are talking about organisations' need for staff to work through the administration of programmes. Simply allowing those organisations to go under or reduce services certainly will not help the Department to deliver for people. <BR /> <BR />I note, Minister, that, in a written response to my colleague Paul Frew, you indicated that you were committed to increasing the budget for the core grant scheme. I ask you, in your response, to expand on that. I recently got the equality impact assessment (EQIA). When we asked what equality impact assessment had been done, you indicated that you did not do one on the new scheme. However, the previous decision to cut funding was put through an equality impact assessment. Your letter stated that that recognised:”
“They are important, and I wish those organisations every success for the future. I have, however, met organisations that receive no funding at all, and they all talk about their ability to deliver core services. For example, Relate indicated to me that 40% of its referrals come from the statutory sector — GPs and others — yet its exclusion from the core grant scheme will have an impact on staff and the ability to deliver on those core services and the agenda of shifting left. It would be interesting to know, Minister, whether you have any data on that aspect of the issue: what will be the impact of defunding all those core services on that policy intent? <BR /> <BR />I understand that you fund the delivery of programmes through the voluntary and community sector. That is not what we are talking about.”
“, although I do not want to steal your thunder. However, budgets are about political choices and what a Department deems appropriate. The cross-party nature of the motion indicates that you are at odds with others in the House on this issue. <BR /> <BR />The core grant has been cut from £3·6 million to £1·8 million. That maintains the cut that was instigated for the past two years. It is a minuscule amount of money in a budget of £8·5 billion. Not to steal my colleague Peter Martin's thunder, he has calculated that that is 0·02% of the budget, but that cut will have real and serious consequences for the voluntary and community sector's ability to deliver to the most vulnerable across our community. <BR /> <BR />I will be clear: I am not querying the awards that have already been made.”
“I thank the Minister for coming to the House today for this important motion. I have no doubt, Minister, that, during our discourse, we will hear you talk about pressures on your budget. There may be an odd irony klaxon thrown in for good measure”
“Thank you, Minister. All of us in the House recognise that excellence in our schools and throughout the education system for all of our pupils is really important. What do you see as the long-term stages in the process?”
“I thank the Minister. It is good to hear that some of the SEP programmes in mainstream schools are still being progressed. However, progress is slow. I know that he will agree with me that many of those schools become very disheartened. They have extremely challenging accommodation needs. I am keen to for him to explore what additional resources the EA needs to progress cases. For example, Carrick Primary School in Lurgan has waited for almost 10 years for that business case. I am keen to know what more we can do to progress the issue.”
“Thank you, Minister, for your statement. You talk about the Executive doing things differently. Ministers also need to do things differently, however. What interrogation is your Department, along with the Department of Health, conducting of the situation in which the management costs of the Belfast Health and Social Care Trust (BHSCT) of £63 million are more than the management costs of the Southern Health and Social Care Trust (SHSCT) and the Western Health and Social Care Trust (WHSCT) put together? Bureaucracy and administration should surely be managed in such a way as to allow more money to be spent on reducing waiting lists.”
“I thank the Member for answering on behalf of the Commission. It is good to know that we are making plans to mark the 80th anniversary of VE Day. Before I came in, I went into the Senate Chamber and read the inscription of gratitude: the Senate Chamber was used as an operations room by the Royal Air Force during the Second World War. Does the Member have any sense of when there will be a public announcement about the commemorations? They are very dear.”
“I thank the Member for giving way. He has made really important points about the vast area that Craigavon Area Hospital covers. It services a huge part of Northern Ireland. The motion today contains a relatively modest demand for the Health Minister; it is just to get the programme of development started. It is important that we acknowledge that that can be done in small steps. The motion is about that first small step.”