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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“I trust that the Minister is able to confirm to the Assembly today that Craigavon Area Hospital redevelopment, described in the correspondence to the Committee as "in design and development", will not form part of that review exercise, nor be at risk of not being progressed. I look forward to hearing that confirmation as we progress with the debate. <BR /> <BR />While tens and, indeed, hundreds of millions of pounds appear to be frittered away on project after project, the bulk of the main hospital at Craigavon stands just as it did in the early 1970s. I urge the Minister to recognise the great need and the potential at Craigavon Area Hospital. It serves almost 250,000 people in that part of Northern Ireland who deserve the facilities that will bring their healthcare experience into a new and modern era.”
“I hope, Minister, that that is not an indication of the priority or focus that will be placed on the redevelopment of Craigavon. The Minister's paper to the Committee last week stated:”
“On Thursday, officials appeared before the Health Committee and spoke to an update from the Minister. The draft budget allocation includes £71 million ring-fenced for flagship projects, city deals and Inclusive Future funding. Some £114 million is being allocated to contractually committed projects and £162 million to maintain the existing estate, including infrastructure, equipment and fleet replacement. Some £47·5 million will go towards progressing projects that are in design and development. <BR /> <BR />The Minister's correspondence confirmed that £500,000 was being earmarked for Craigavon Area Hospital redevelopment programme team, healthcare planning and site master plan. However, that is the last item of more than 50 capital projects listed across four tables.”
“There have been major injections into state-of-the-art hospitals, wards and facilities in other trusts over that period, not least in Antrim, Altnagelvin and the Royal. I have argued very strongly for that development. Northern Ireland needs a new children's hospital and a regional neonatal unit. Those are important additions to the health infrastructure. However, we must remember that other acute hospitals, serving major centres of population, also need investment. <BR /> <BR />The Department of Health's proposed capital allocation, as set out in the draft budget for 2025-26, is £391 million. The Minister has argued that that is less than is required to fund essential expenditure for Executive flagship projects, contractual commitments to progress projects in design and development and the continuation of existing services.”
“It was the panel's view that inadequate isolation facilities and poor ventilation made it difficult to prevent transmission. We hope that we will never experience another COVID-like episode, but we must make appropriate preparations and changes. All our hospitals need to be fit for purpose to meet the challenges of everyday illnesses and the unexpected. <BR /> <BR />We are also all aware of the issues in recent months regarding capital projects that have drawn significant public attention, in the main in the Belfast Health and Social Care Trust. Overruns and additional costs obviously impact on the commencement and delivery of new facilities elsewhere. In the past decade, capital expenditure in the Southern Trust has represented roughly 11% of that across the six trusts, the bulk of which was for preventative maintenance.”
“Members will recall that an independent investigation was required after suspicious clusters of COVID cases were identified in Craigavon Area Hospital and Daisy Hill Hospital and that an independent panel conducted a level 3 serious adverse incident (SAI) review. Deficiencies in the hospital estate were identified as contributing to the likelihood of transmission. The report concluded:”
“No, I want to make progress. <BR /> <BR />It is clear that Craigavon Area Hospital is not appropriate for high-quality modern healthcare. While the master plan was proposed almost a decade ago, we have moved forward very little on it. The Southern Trust submitted a plan for £151 million of work on an initial phase to increase bed capacity, provide additional dementia beds in the Bluestone unit, install new MRI and CT scanners and repurpose a day surgery unit. However, it is clear that we now require a new hospital that matches modern expectations. That will be a challenge, because it will have to be constructed alongside the hospital's work, as it will remain on the site. <BR /> <BR />Recent reports have underscored the argument for redevelopment.”
“It is hindered by a lack of available space, and, with the reconfiguration of hospitals, Minister, we do not want it to miss out on services or on perhaps becoming a specialist regional centre on account of the unsatisfactory site layout. Having said that, I am not blind to the needs of the Daisy Hill Hospital, St Luke's Hospital and many other sites across the Southern Trust area.”
“However, it has served its community for five years, and its layout is now problematic and outdated. I reinforce the point that it is a key hospital in all the Department's strategic documents on reconfiguration and modernisation. It is bracketed with Altnagelvin Area Hospital and major sites in Belfast as being an acute centre for Northern Ireland. I understand that the Southern Health and Social Care Trust has indicated that it has plans for the redevelopment of Craigavon Area Hospital. The situation is made slightly worse by the fact that the Southern Trust had been moving services to Craigavon Area Hospital, meaning that there is more pressure on the site. <BR /> <BR />Craigavon needs to be able to offer as much as possible.”
“Thank you, Mr Deputy Speaker. The motion highlights the importance of progressing the major rebuild at Craigavon Area Hospital. I remind the House that Craigavon Area Hospital serves the whole of the south of Northern Ireland. It has approximately 240,000 people in its catchment area, and it covers five constituencies represented in the House and three large council areas. It is a regionally significant acute hospital with an extensive range of departments and services, including acute and intensive care, chronic disease management and ambulatory care.”
“— and I continue to urge people to urge their MPs to vote against the Bill.”
“— and coercion remains a significant risk. That is a significant change to the way that we view life in the United Kingdom, — <BR /> ,”
“The protection for vulnerable groups, such as people with learning disabilities or Down's syndrome, has been rejected. Doctors, including doctors in hospices, would be expected to include voluntary assisted dying when outlining treatment options. Hospices would be tied to operating the legislation and could not opt out on conscience grounds. Those are all the changes that have been made to the Bill. <BR /> <BR />Concerns that feeling a burden on others could be a motivation for assisted suicide were ignored —”
“Bradford West Labour MP, Naz Shah, who was originally supportive of the Bill and served on the Committee scrutinising the Bill, stated this week that the legislation was "fundamentally flawed". The witness list at Committee was 4:1 in favour of the Bill's supporters. Nine lawyers were invited, none of whom opposed the Bill, and eight witnesses from other jurisdictions were all supportive. <BR /> <BR />The changes proposed at Committee to what MPs voted on are highly significant. They include the removal of the High Court judge safeguard; meeting a palliative care specialist in the decision-making process was simply dismissed from the Bill; and there is a potential for change to the National Health Service Act 1946, which would change the life-affirming duties to the commissioning of death services within the NHS.”
“I want to comment on the latest developments in the legislative process for the assisted suicide Bill at Westminster. Before I do so, I want to make it absolutely clear that the DUP is a pro-life party and finds the Bill abhorrent in all its proposals. <BR /> <BR />Kim Leadbeater, the sponsor of the Bill, has been forced, against her wishes, to table an amendment to extend the implementation period for the Bill to four years, and that could extend the period until after the next general election. The BBC has reported that the Government have concerns about the timelines for the implementation of the Bill. I trust that people will grasp that that demonstrates not only the chaos around the Bill but the magnitude of the issues that are at stake and the changes proposed at Committee Stage. <BR /> <BR />The Labour MP Jess Asato said:”
“I thank the Member for giving way and for building up a really good picture of the road network around Craigavon Area Hospital. It is indeed a fairly congested and very busy place. Do you agree that, before there are any moves to open up roads that would impact on private developments, residents should be consulted and there should be a fairly major exercise to reassure residents that their roads will not be used as rat runs to the hospital?”
“I thank the Member for giving way. She makes an important point about schools. In a briefing paper that I have seen, the controlled sector made the point that the 2016 report to which the Member who opened the debate referred addresses the cost of unoccupied places at schools but does not address the fact that schools are funded only for the pupils who are there. Some of the costs of division in the report are imaginary.”
“Minister, I do not know whether that means that you intend to raise the issues or that you are not aware of them. There are significant changes coming for businesses and consumers in Northern Ireland, which may limit choice and bring greater disruption. I would be grateful for your assessment of what those difficulties might be.”
“Minister, my constituents in Lurgan will be gravely disappointed by your answer: no plans to do anything. I highlighted the issue to your officials during the consultation period, and numerous constituents have complained about the traffic disruption. Do you at least have plans to look at car parking facilities in the vicinity of Lurgan train station, so that we can at least enhance the number of people who can park their car and travel to Belfast or onwards?”
“— in favour of any of this, but I urge you to take urgent action.”
“Any winter health plan to improve the situation will have to demonstrate that that is at its core. That is what will fix ambulance handovers and the harm that is being done to patients and patient safety. <BR /> <BR />I also refer in passing to our session last week — this was brought up by Nuala McAllister — on the issue of palliative care. There are people whom ambulance crews clearly have to take to hospital because there is nowhere else for them to go. At Christmas, at the Southern Area Hospice Services ceremony of remembrance, a lady spoke to me about her sister-in-law, who died in an ED in Craigavon with, as she described it, not even a pillow —”
“I hope that we will be able to make improvements, so that our community across Northern Ireland is not left at risk of those things happening again. <BR /> <BR />We have discussed across the House many of the issues that are really important when it comes to trying to fix the system, but the one that we keep coming back to is that of the flow of patients through our hospitals. We are in the almost absurd — I use that word advisedly — position in Northern Ireland in which we have sick patients who cannot get into hospital because we have well patients who cannot leave hospital. I do not think that anybody can stand over that kind of situation. No matter what we do, it will come down to fixing the flow of patients through hospitals, including getting them into hospital, onto the ward for treatment and discharged in a timely manner.”
“During December and the first half of January, we had ambulance handover delays of 16 hours and nine minutes at the Mater Hospital; 19 hours at Causeway Hospital; 23 hours and 36 minutes at the Ulster Hospital; and 25 hours and 15 minutes at Antrim Area Hospital. Those figures in the system really are unacceptable. <BR /> <BR />Debates such as this are important, but it is also important that we have a plan of action to understand exactly what we can do to make things better. Sadly, harm comes to patients. Mr Gaston demonstrated that very well when he talked about the shocking and untimely death of his constituent. I do not think that any one of us can feel anything but shame about the system over which we preside. I know that you, Minister, feel the same.”
“I thank my colleague Alan Robinson for proposing the amendment and highlighting the difficulties in the health system. At the end of the debate, I put it on record once again that the Audit Office report said that delayed ambulance handovers cost us £50 million over five years, including £13·2 million in the most recent year. They caused a 25% reduction in operational capacity and placed close to 4,000 patients at risk of serious harm. They also contributed £37·8 million to an overtime bill for Northern Ireland Ambulance Service staff. At a time when the health service is under pressure in all directions, those are issues that we cannot ignore.”
“Thank you, Madam Principal Deputy Speaker. <BR /> <BR />First of all, I will say, "Thank you", because the tone of the debate has been helpful, and there is consensus across the House on some of the themes. We are happy to support the motion, but we thought that we should maybe recognise that, although this is a potential solution, there are other issues that need to be addressed. They are ours to address, and we need to get on with doing that.”
“Yes, of course, Mr Deputy Speaker. <BR /> <BR />Minister, it is a really important debate. It attacks the most fundamental part of a child's development and progress. I hope that you will have some positive things to tell us.”
“I want children, no matter where they are born in Northern Ireland, to have access to services and to be able to grow up, develop and thrive in the best way possible. <BR /> <BR />In Northern Ireland, unlike some parts of the United Kingdom, there has been some rise in the birth —.”
“In a recent conversation with the Southern Trust — I digress a little because this annoyed me so much — I felt as though the officials were simply going through the motions: "I have to deal with this difficult MLA, and I'll have to have the call and the meeting". Behind that call was a family in real distress. Everybody is under pressure, but it is really important that we look at how we help children to access services at the earliest stage but also as they progress through their lifetime. <BR /> <BR />Help for mothers who may have difficulties with the birth or development of their children is another issue. I know that you have been doing some work, Minister, on exclusion in areas of social and economic deprivation. This issue neatly fits into that programme.”
“Again in the Southern Trust, I have had conversations recently with families who have real concerns about the development of their children but have not been able to access appropriate social work help. We need to look not only at the health visiting needs but at continuing that work by having a coherent service for children and young people.”
“Practitioners said that work was more dominated by social concerns, with more families impacted on by poverty and safeguarding concerns. That goes back to the coherent service that children and young people should expect from the Department and the lack of social work access experienced by many families, which is particularly acute for families of children with disabilities.”
“<BR /> <BR />The findings of an Institute of Health Visiting survey of health visitors across the UK, which was unveiled in January, showed a rising need among families that face increasingly complex health and developmental challenges, with support becoming harder to access. Service gaps were also flagged, with massive differences in the availability of services across the United Kingdom. Health visitors spoke of being under immense pressure with challenging workloads, and that is no different in our part of the United Kingdom. Mental health problems were considered to be the main reason for increased demand, with the behavioural problems of the child, including growing concerns about neurodevelopmental issues such as autism or ADHD, being the second most common reason for families needing extra help.”
“<BR /> <BR />I was contacted recently by parents, and have been looking into the issue of skeletal dysplasia and the support that children with the condition receive so that they can engage in daily activities in as similar a way as possible to their peers, thrive and realise their full abilities. I tabled a number of important questions on the issue, and, so far, have been discouraged by some of the answers. That is an area where health visitors, through developmental reviews, will help ensure that children are referred to the appropriate services for assessment and receive the appropriate additional support.”
“We should have a situation in which staff can work across boundaries. There is no magic wall between the Southern Trust and the South Eastern Health and Social Care Trust or the Western Health and Social Care Trust: staff should be able to work across boundaries and they should do so. That is very important. Minister, you have looked at a regional approach to breast cancer referrals, so maybe that is something that we should be looking at in this case. In September, there were 23 vacancies across our trusts and recruitment was actively under way to fill them, including six vacancies in the Southern Trust and six in the South Eastern Trust.”
“At one point, as I understand it, as a result of workforce pressures, the Public Health Agency (PHA) issued interim guidance to trusts that the one-year contact would be omitted in specific circumstances. I understand that those interim measures have been stood down, with a marked rise in the number of contacts taking place on time. <BR /> <BR />Where one trust is trailing far behind the others, consideration needs to be given at a Northern Ireland-wide level as to how we do more to ensure an equivalent level of service. That goes back to what I continually reference in the House: there are social and economic inequalities in health, but there are also deep structural inequalities, which are perpetuated by trusts not having the same level of service across various parts of the health service.”
“In the Southern Trust, an area that I represent that includes large areas from Dungannon through to Banbridge, Lurgan, Portadown, Newry, Armagh, Kilkeel and Annalong, the percentage of cases in which no contact was made rose to an alarming 46%. That is deeply regrettable and detrimental. A missed year 1 review is a lost opportunity to monitor, among other things, growth, feeding status and speech and language development. The Southern Trust had been struggling with unfilled vacancies, and full provision of all interventions appears to have resumed. <BR /> <BR />There were commitments that everyone would get their yearly review. I would appreciate the Minister's confirmation that that continues to be the case.”
“That can also be a huge safety net, however, and it is essential for prevention of and early interventions in ill health. <BR /> <BR />Health visitors are valuable in helping parents to understand cognitive development, nutrition and the importance of immunisation. The Healthy Child, Healthy Future (HCHF) programme offers a series of reviews to support parents to make choices to give children the best chance of being healthy. The year 1 review includes a family health assessment as well as topics such as growth, language development, oral health and dental registration, parenting support and health promotion. <BR /> <BR />In 2023-24, 15% of children did not receive a year 1 review.”
“We cannot throw our hands up in horror in the Chamber and pretend that we did not know that the children concerned had all those difficulties or that they require statements when they arrive aged 3 or 4 into nursery school or P1 if we do not document those difficulties in the year 1 review. <BR /> <BR />It is really important to recognise that our children are not only our most vulnerable but our most precious of citizens, and we want to make sure that they are properly looked after and given the best start in life that we can possibly provide. This is about the importance of the role of the health visitor and their relationship with families. We want that to be valued and resourced, because we know the difference that they can make to young lives by maintaining children's good health and well-being.”
“I am sorry, Minister; thank you. It is good to see you. <BR /> <BR />I tabled the motion because I believe that the debate is hugely important not just for the Department of Health but for other Departments. Health visitors have a hugely important role in recognising when things are not quite right with children or when they are not reaching their milestones. That will have an impact on every Department. It will have an impact on the Department for Communities through poverty and social cohesion and so on, but it will also have an impact on the Department of Education.”
“Thank you, Mr Deputy Speaker. I am going to make some important points at the start of my speech, so it is to be regretted that the Minister is not here to hear them.”
“I am told that that strategy may appear in 2025 or possibly 2026, which is when we can look forward to having optimum numbers in the workforce. However, delivering on a workforce strategy will be core to delivering on waiting lists. <BR /> <BR />The commitments in the Programme for Government are good, and the House should welcome them. We want to see waiting lists reduced. That is not a simple problem, however, and we must address the plethora of other issues that surround the issue in order to successfully deliver on it. As the DUP's health spokesperson, I will support a reasonable plan to do all those things, but we need to see that plan from the Health Minister.”
“It will be impossible to sort that out if we do not sort out the issues of investment in our health estate. It means that those who live in the north-west will still be without a new ED in Altnagelvin; my constituents in Upper Bann will see no required investment in the Craigavon site; and we will still have no mother-and-baby unit, despite that being an Executive priority. <BR /> <BR />The health service's greatest asset is its staff. That means those who work in a broken system trying to deliver the best that they can for patients. We have now spent about 10 years trying to get a workforce strategy together for the health service. I do not know what that says about the workforce in the Department.”
“Currently, it has about 52%. That is just not sustainable, and we have the worst waiting lists in the United Kingdom, with the most expensive per capita costs. Therefore, I also put on record that the Department needs to take more control of its spending. Over the past year, I have been dragging information out of the Department and the Belfast Trust about the new maternity hospital and the proposed new build for a children's hospital. Just last week, I heard further disturbing commentary about the new acute mental health building and the number of repairs that are needed to deal with the structural damage that has been done to it. More money for remedial repairs means less ability to deliver on waiting lists and for our constituents.”
“The ambition to invest a further £135 million to reduce waiting lists and a further £80 million in elective care capacity is welcome, but it will require the Department to step forward with coherent plans in order to do that. Otherwise, those waiting lists will continue in the same vicious circle. <BR /> <BR />We cannot tackle waiting lists without sorting out social care. We have just experienced January and the furore about people waiting in hospital beds who are able to go home but cannot because of a lack of care packages or appropriate placements. If we do not sort out social care, we cannot sort out waiting lists, because we will not have the capacity in our hospitals. <BR /> <BR />Last October, Professor Bengoa told us that, without reform, the Health budget would soon take up 100% of the block grant that comes to Northern Ireland.”
“Those are the real-life problems that our constituents face: waits for life-improving issues such as hip and knee replacements; and waits for life-saving cancer care. There are also waits for elective care and emergency interventions. <BR /> <BR />As we all know, around half a million people in Northern Ireland are waiting for a first consultation. The Department must be honest with us and say that it has never met a cancer target in Northern Ireland since it put cancer targets in place. That is not something that any of us in the Chamber should be proud of. Therefore, I welcome the priority and targets in the Programme for Government on this very, very important issue.”
“<BR /> <BR />Just recently, I received a letter from the chief executive of the Western Trust that confirmed that the average waiting time for a routine hip replacement was in the region of nine years. That is nine years of deterioration and pain. In the same week, I was speaking to a GP who spoke of a patient with a potential cancer diagnosis. That patient was referred by their GP at the start of February and was told that it would be April before they could be called for an appointment with a consultant. I ask the House to imagine the fear and anxiety for that person, who has to wait that length of time for a consultation. Ultimately, that patient had to gather together some money and make a private appointment, and therein lie the two particular problems with waiting lists.”
“I will focus my remarks on the health section of the Programme for Government. As a DUP MLA who campaigned in the election on reducing waiting lists, I am glad to see that as a tenet of the Programme for Government. <BR /> <BR />The Health Minister often describes health as a personal issue, and he is right. It is the most real and personal issue that our constituents experience, and waiting lists and the length of them are a terrible burden on so many of them. We must acknowledge that, while we complain about waiting lists, there are amazing people in the health service who do amazing work, but they are frustrated by the limitations of their position and in what they can deliver. Most importantly, they are really frustrated by the detrimental impact on their patients.”
“Thank you, Minister. It is good to hear about the amount of money that is being invested in that way, because it is being invested on behalf of the most vulnerable people in our community. I hope that you will have a reasonable budget for that. <BR /> <BR />I also hope that you understand the issues with the disabled facilities grant, including the number of reports that have to be made in order to gain it. Minister, will you commit to looking at the case of a young constituent of mine who is disabled and living in a downstairs bedroom and who urgently needs a disabled facilities grant in order to live her best life?”
“yet the world remains silent. <BR /> <BR />While I am an elected Member of the House, I will continue to raise such issues in order to highlight the ongoing persecution of Christians in so many parts of the world. We simply cannot remain silent.”
“<BR /> <BR />They were taken hostage and moved to a small Christian church in the village of Kasanga. Inside the building, which, until then, had been considered a sanctuary, they were first tied up, before all 70 of them were beheaded — 70 men, women and children were beheaded — yet the world remains silent. A coordinator of a local community protection committee is quoted by the global fight against terrorism funding organisation as saying:”
“On 22 February, news reports came through that over 70 Christians had been murdered — beheaded — in the Democratic Republic of the Congo. According to reports from multiple groups that monitor terrorism and persecution, the 70 Christians were beheaded with machetes or other large knives by Islamic militants in the DRC, yet the world remains silent on the slaughter. The 70 Christians were rounded up by Allied Democratic Forces, a group that is said to be affiliated with the terror group Islamic State, or ISIS, according to Open Doors, which monitors Christian persecution around the world. All were reportedly from Mayba in the territory of Lubero and were forced out of their homes on the morning of 13 February, with the rebels telling them to get out, yet the world remains silent.”