Philip McGuigan
North Antrim · Sinn Féin · Northern Ireland
“I concur with the Minister that patient safety is ultimately the top priority, but patient safety is also important, as the Member said, in terms of assessments. If you cannot get assessments, your safety is compromised.”
“On a point of order, Mr Speaker. Further to my party colleague's point of order about the DUP's internal investigation, what is the point of doing an investigation if you are telling us that you have nothing to answer for? You were the leader of the DUP at a time when accusations were levelled against Jeffrey Donaldson.”
“Minister, in your previous answers you talked about the pressures and the difficulties. You said that you were looking for a fair funding model, and you spoke of the need for taxpayers here to be treated equitably.”
“Minister, the inquiry found systematic abuse, neglect and serious governance failure at Muckamore Abbey Hospital over many years — failures that were not isolated incidents but reflected systematic issues across leadership, staffing, safeguarding and oversight that resulted in decades of physical and psychological abuse.”
“When I engage with health service sectors as my party's health spokesperson, there is not one that does not talk about workforce pressures and problems with staff recruitment and retention. That is clearly the case with doctors.”
“First Minister, you have spoken previously about the opportunities created as a result of our unique economic and trading position and about the increased potential that comes with all-island cooperation.”
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“I concur with the Minister that patient safety is ultimately the top priority, but patient safety is also important, as the Member said, in terms of assessments. If you cannot get assessments, your safety is compromised. <BR /> <BR />Following on from the issue of assessment, Minister, what progress has been made in improving autism services for adults once assessed, particularly in relation to accessing mental health support and supported living to enable autistic adults to live as independently as possible?”
“On a point of order, Mr Speaker. Further to my party colleague's point of order about the DUP's internal investigation, what is the point of doing an investigation if you are telling us that you have nothing to answer for? You were the leader of the DUP at a time when accusations were levelled against Jeffrey Donaldson. In the absence of that inquiry, I think that it would be appropriate for you to recuse yourself.”
“Minister, in your previous answers you talked about the pressures and the difficulties. You said that you were looking for a fair funding model, and you spoke of the need for taxpayers here to be treated equitably. Expanding on the need for taxpayers to be treated in fairness to the level of need, is our current level-of-need estimate a fair estimate?”
“When I engage with health service sectors as my party's health spokesperson, there is not one that does not talk about workforce pressures and problems with staff recruitment and retention. That is clearly the case with doctors. There is clear evidence that doctors in particular have better pay and conditions in the South and that we are losing staff to the South as a result. What is the Minister's assessment of that? What have he and his Department done to try to retain doctors here in the North?”
“Minister, the inquiry found systematic abuse, neglect and serious governance failure at Muckamore Abbey Hospital over many years — failures that were not isolated incidents but reflected systematic issues across leadership, staffing, safeguarding and oversight that resulted in decades of physical and psychological abuse. You have given an abject apology on behalf of the entire health system today: that apology is absolutely necessary, but it is not sufficient. Families now expect three things: accountability for those responsible; full implementation of the inquiry's recommendations; and clear evidence that vulnerable people in our health system are safer today than they were yesterday. Can you tell us that those three asks will be met for those families?”
“First Minister, you have spoken previously about the opportunities created as a result of our unique economic and trading position and about the increased potential that comes with all-island cooperation. Will you outline how the work of InterTradeIreland and Tourism Ireland is supporting further development of the all-island economy and ensuring that workers, families and businesses benefit from economic growth?”
“Last week's acts of racism and the threats against our healthcare workers were an absolute disgrace. The Minister has articulated how much our healthcare service depends on people who come from outside the island to help out. Given that, has the Minister or the Department assessed in the short term or even the medium term the damage that the recent violence has done to staffing levels, attendance rates and healthcare service delivery? Is the Minister concerned that such incidents of racism and threats against our healthcare staff could undermine efforts to recruit international staff to our health service and retain them?”
“I stand in solidarity with all who have been affected by the attacks, and I stand with the health service, with healthcare workers from every background and for the principles of equality, inclusion and respect that must define our society. Racism must be challenged wherever it appears, and we must ensure that all our healthcare staff can live and work free of fear, intimidation and hatred.”
“Without international recruitment, many services would face even greater staffing shortages, and patients would experience longer waiting list waits and reduced access to care; in fact, our health service would collapse without them. <BR /> <BR />No healthcare worker wearing a uniform should have to fear travelling to work or providing care in their community. I hope that no healthcare worker feels that they have to leave their job in the North and move away because of racism. To every international healthcare worker who has chosen to make their home in the North, I send a clear message: you are valued; you are respected; and you are welcome. Your contribution to our Health and Social Care service is recognised and deeply appreciated by us all.”
“Vacancy levels remain high in many professions; recruitment remains difficult; and retaining experienced staff is an ongoing challenge. Against that backdrop, international healthcare workers have become a vital part of our health service. Doctors, nurses, allied health professionals, care workers, support staff and many others come from across the world and make an enormous contribution every day. They care for our loved ones, support our communities and help to sustain services that would otherwise struggle to function. The reality is that our health service depends on their skills, dedication and commitment.”
“I rise as my party's health spokesperson to condemn in the strongest possible terms the racist attacks, threats and intimidation that have been directed at Health and Social Care workers in the past week. The scenes that we have witnessed have been shameful. Healthcare workers who have dedicated themselves to caring for others have been subjected to fear, abuse and intimidation simply because of where they come from or the colour of their skin. Such behaviour is utterly unacceptable and has no place in our society. <BR /> <BR />Our Health and Social Care system faces unprecedented challenges. We continue to experience significant workforce pressures across all our hospitals, community services and primary care.”
“Minister, I will continue in a similar vein. In your response to John, you mentioned the Enterprise project. It gives us a glimpse of what we can achieve across the island with the all-island rail review. For additional information, how do your Department and your counterparts in the South plan to implement the rail review?”
“When services are fragmented, as has been said, families fall through the gaps, so we need early intervention. Every child deserves the opportunity to grow up safe, supported and able to reach their full potential. Every family deserves access to help before they reach crisis point. The evidence is clear: early intervention can change lives, and it should not depend on where a child happens to live, whatever part of North Antrim they live in. That support must be available consistently across North Antrim and the North.”
“<BR /> <BR />Community and voluntary organisations are also doing commendable work in bringing family support directly into local communities, but they cannot be expected to compensate for gaps in statutory provision. Families who are experiencing stress, isolation and financial hardship are finding that services are increasingly overstretched. Children who require additional support are often left behind for prolonged periods, falling further behind in school or struggling with mental health, frequently without fully understanding why they feel the way that they do or how to manage it. <BR /> <BR />The consequences of delayed intervention are entirely predictable. When early intervention is delayed, problems escalate and pressures intensify.”
“I also want to acknowledge the vital role that is played by GPs, health visitors and schools in identifying the early signs that additional support could be required. They are often the first to recognise when a child or a family are beginning to struggle. I share their frustration and the frustration of families when support for those early concerns leads to an uphill battle to access assessments and services. Parents across North Antrim repeatedly raise concerns about delays in accessing autism assessments, speech and language support and child and adolescent mental health services. Those delays can have a profound impact, not only on the child's development but on family well-being and confidence.”
“While I welcome the development of the new, targeted outreach model for families who live outside designated Sure Start areas, its long-term impact remains to be seen.”
“<BR /> <BR />I acknowledge the work carried out by organisations such as Dalriada Rural Sure Start, the local family support hubs and the many community and voluntary organisations that work across North Antrim. Their staff and volunteers make a genuine difference every day, but many of those services continue to operate under significant pressure and uncertainty.”
“In many rural parts of the constituency, such as Ballycastle, Bushmills, Armoy and the glens, families are often required to travel significant distances to access support services, frequently with limited or unreliable public transport options. For parents of young children, particularly those who are already under pressure, that can become a barrier in itself. For early intervention to be effective, support must be accessible at the point at which it is needed. Programmes such as Sure Start have been highly effective at identifying needs at an early stage, as others have indicated. However, those services are available only in certain parts of the constituency, creating what many families describe as a "postcode lottery" in accessing early years support.”
“Importantly, it is also one of the most cost-effective investments that any health and social care system can make, yet families across North Antrim increasingly report that support is becoming more difficult to access and navigate. Waiting lists are growing longer, services are becoming more fragmented, and too many families are at risk of falling through the cracks. <BR /> <BR />There are significant concerns regarding the availability and location of early years services across the constituency. North Antrim includes a large rural population for whom access is already constrained by distance and limited public transport. That exists alongside areas of deprivation where families face multiple and overlapping challenges.”
“I welcome the opportunity to speak on the issue and thank my constituency colleague Sian for securing the debate. Across North Antrim, families, practitioners and community organisations have highlighted the growing difficulties in accessing early intervention and family support services. As other Members have indicated, early intervention is critical. It can be the difference between a family coping and a family reaching a crisis point. It can prevent relatively minor challenges in childhood from escalating into significant difficulties in adolescence and adulthood. Sian and Jon indicated examples of such things. <BR /> <BR />Early intervention strengthens resilience, reduces harm and supports children to thrive.”
“First Minister, given how you have responded, do you believe that the British Government have failed in their responsibility to adequately fund the Executive to protect our public services, support working families and help local businesses? Further to that, can you outline exactly what more, you believe, Westminster should do?”
“— that respond consistently to their needs.”
“It is therefore deeply disappointing that the Health Minister has stated that there is insufficient time in the mandate to bring forward the necessary legislation. Families have waited long enough. At the very least, preparatory work should begin on meaningful legislative change that can be progressed in the next mandate. <BR /> <BR />Parents should not have to lie awake at night wondering what will happen to their son or daughter when they are no longer there to provide care. Families deserve accessible, reliable, specialist support services —”
“Under her leadership, the Department for the Economy undertook a review of post-school provision for SEN learners, engaging with parents, schools, colleges, advocacy organisations and community groups that had been calling for change for years. That work has already helped to bring forward proposals that are aimed at improving access to further and higher education; strengthening support in colleges and training programmes; improving careers advice and transition planning; and exploring how apprenticeships can be made more accessible for young people with additional needs. <BR /> <BR />Importantly, there has been a commitment to developing a dedicated transition support service so that families are not left to navigate the challenges alone. Those are positive changes, but families also need leadership from the Department of Health.”
“It also calls on the Minister of Health to work proactively with the Minister for the Economy and the Minister of Education to develop legislative proposals that facilitate proper transition planning for young people, post 19, and address the issue of the loss of statutory support once a young person leaves children's services. Families should not be left abandoned and frustrated between Departments, and young people should not lose support simply because they reach an arbitrary age threshold. <BR /> <BR />I acknowledge the important work that has been undertaken by my party colleague Caoimhe Archibald, the Minister for the Economy, who is here to respond to the motion.”
“It recognises that the issue cannot sit in one Department. It is not solely an education issue; it is not solely a health issue. It is about health, education, skills, employment, independent living, social care, transport and family support. That requires a genuinely joined-up cross-departmental response. <BR /> <BR />Our amendment therefore calls on the Minister of Health who, I am disappointed to say, will not be responding to the motion, to lead on the issue and to begin the necessary preparatory work, ahead of the next mandate, to develop legislation that supports post-19 adults with special educational needs or additional and complex needs in all aspects of their lives.”
“In reality, the options available to many young people post 19 are non-existent or far too limited. Many young people move into university, further education and employment, while those with profound or complex needs often face a future in which little meaningful provision is available to them. Families are left to battle for support services and appropriate placements, often reaching crisis point before help arrives. <BR /> <BR />Unlike in England, where, as we have heard, education, health and care plans will continue until the age of 25, there is no equivalent statutory protection in the North once a young person turns 19. Whilst other parts of these islands have developed varying levels of post-19 support, families here continue to face uncertainty and inconsistency. That is why our amendment is important and adds to the motion.”
“One day, there is structure, therapy, transport, educational provision, respite and coordinated support; the next day, families are left to navigate fragmented adult services, between Departments and on inconsistent pathways, often without guidance or protection. I have listened to parents tell me about the years that they spent preparing their child for adulthood only to watch statutory support disappear overnight when school ended. That, surely, is not fair; it is certainly not what families deserve. <BR /> <BR />Young people with special educational needs have the same aspirations as everyone else. They want opportunities to learn, to contribute, to build relationships, to participate in their communities and to live with dignity and purpose.”
“I will speak in favour of the motion and, in particular, to our amendment. As Cara did, I acknowledge at the outset the work of Alma White and the other Caleb's cause campaigners in raising the issue and setting the political agenda. I welcome all who are in the Public Gallery. Alma's determination, courage and persistence have, along with the rest of the campaign group, ensured that the voices of families caring for young people with special educational needs, additional needs and complex needs can no longer be ignored. <BR /> <BR />For too many families across the North, the transition out of school and children's services at the age of 19 is not a transition but, as Cara said, a cliff edge.”
“Go raibh maith agat, a Leas-Cheann Comhairle.”
“That timeline appears to be somewhat ambitious, given the scale of workforce planning considerations, digital integration and service coordination that would be required, but I will leave the Minister or the motion's sponsors to comment on how realistic that time frame is. What matters most is that any future model is properly designed, properly resourced and genuinely capable of improving patient care and system flow — we all agree on that. It is about creating a more joined-up health system that helps patients access appropriate care more quickly, reduces avoidable pressures in hospitals and supports the wider transformation of our health service. That is required urgently.”
“Rural communities have more difficulty than urban communities in accessing community provision and urgent care alternatives. If those services are not strengthened first, there is real risk that a 111 system could create additional demand without delivering meaningful improvements for patients or front-line staff. <BR /> <BR />Ultimately, though, the principle underpinning the motion is about ensuring that patients receive the right care in the right place at the right time. There is undoubtable merit in examining coordinated, clinically supported urgent care access. That could complement the shift-left agenda — the neighbourhood model — which is focused on prevention, early intervention and strengthening care within the community. The motion calls for proposals to be brought forward by 2026.”
“<BR /> <BR />It is equally important to acknowledge that elements of the approach are already being delivered here by the Ambulance Service’s Hear and Treat service and integrated clinical hub services. A number of weeks ago, I had the opportunity to meet with representatives of the Ambulance Service and hear directly about their increased use of clinician-led telephone assessments in how they triage patients' needs for ambulance dispatch or hospital attendance. <BR /> <BR />I am always cautious about proposals that simply seek to replicate systems that have been developed elsewhere. Whilst we remain partitioned, we are a small health system. We also have different service structures and significant workforce challenges in many areas, as we have discussed in the Chamber on numerous occasions.”
“If we are serious about reforming urgent and emergency care, we must think about the entire patient pathway and how services connect. <BR /> <BR />A 111 service would not solve all the pressures facing health and social care: no single reform can. It is important that we approach the proposal realistically. The experience elsewhere has shown that 111 systems are not without challenges. In England, concerns have been raised about overly risk-averse triage systems, which can lead to unnecessary referrals to emergency departments or ambulance dispatches. Questions have also been raised about staffing pressures, public confidence and whether sufficient community services are available to provide meaningful alternatives to hospital attendance.”
“Last week, the Committee discussed the home care sector and the challenges facing home care providers, such as the difficulty in recruiting and retaining staff and the impact that it has on patients who are willing to leave the hospital. The delayed discharges have direct consequences right across the entire system. When patients cannot be discharged safely because care packages are unavailable, hospital beds remain unnecessarily occupied, which reduces hospital flow and increases the pressure on EDs, delays ambulance handovers, contributes to cancelled procedures and places even greater strain on staff. The crisis in home care is directly contributing to the crisis in our hospitals and emergency departments.”
“There will be little disagreement that our urgent and emergency care system is under sustained and growing pressure. The long waiting times in EDs, ambulance delays, overcrowded hospitals and the increasing difficulty in accessing a GP appointment have, unfortunately and regrettably, become almost normalised in our health service. Despite those pressures, healthcare workers across our system continue to provide extraordinary care with professionalism, compassion and commitment, and they deserve recognition and thanks for their dedication. <BR /> <BR />However, it is also important that we recognise that the pressures facing emergency care do not exist in isolation; they are connected to the wider pressures right across the health and social care system.”
“Minister, your decision has denied those families the transparency and accountability that a statutory public inquiry would bring. Given your decision to withhold a public inquiry and given the details that you know, who has been held accountable in this public scandal?”
“Thousands of women have had misread smear tests, including eight who developed cancer and two who, unfortunately, passed away.”
“That means missed opportunities for early intervention, treatment and support for patients and their families. Without decisive action, the human and financial cost of dementia will continue to rise. We urgently need a bold, new dementia strategy, one that is focused on early diagnosis, better support for carers, a properly trained workforce and long-term investment in services. This Dementia Action Week, the message must be clear: we cannot afford to wait any longer for action.”
“<BR /> <BR />Today also marks the beginning of Dementia Action Week, which is an important opportunity to recognise the growing impact that dementia has on thousands of families in the North. Nearly 25,000 people here are living with dementia, and that number is expected to rise by more than 50% by 2040. Behind those figures are mothers, fathers, husbands, wives, sons, daughters, carers and loved ones, many of whom face daily emotional, physical and financial challenges. <BR /> <BR />New findings from the Alzheimer's Society show that many dementia patients here continue to face long delays to diagnosis, alongside major gaps in treatment and support. Dementia is the leading cause of death across these islands, but one in three people with dementia still do not have a diagnosis.”
“One of my constituents suffered a stroke at just 39 years of age. Thankfully, she received a thrombectomy in time. Her family arrived at the hospital expecting the worst, only to find her sitting up and speaking. Hours earlier, she had been unable to communicate. That is the difference that a thrombectomy can make. <BR /> <BR />Every eligible patient deserves access to that treatment, regardless of when their stroke occurs. Tomorrow at 10.00 am, I will join stroke survivors, clinicians, campaigners and the Stroke Association outside to mark 500 days since the service should have been delivered. I encourage all Members to join us to send a clear message that we can no longer wait for a fully operational, 24/7 thrombectomy service.”
“May is Stroke Awareness Month. It is an important reminder of the need to recognise the signs of stroke and act FAST. The FAST test helps people recognise the most common symptoms of a stroke: face — has one side dropped; arms — can both be lifted; speech — is it slurred or confused; time — is it time to seek urgent medical help? That urgency is exactly why a life-saving procedure such as a thrombectomy is so vital, yet, in the North, it is available only between 8.00 am and 5.00 pm. <BR /> <BR />Last Friday was World Thrombectomy Day, and it was also 500 days since the stroke action plan committed to delivering a 24-hour service by the end of 2024. In that time, hundreds of patients may have missed treatment that could have helped them walk, speak, swallow or live independently.”
“Minister, it is not for me to do your job. That is why you are appointed as Minister. I understand that your party colleague wants the Executive to share the blame. Maybe we do not need a Health Minister if your party wants the Executive to share all the blame without your taking any of the responsibility. <BR /> <BR />My point is that you made financial decisions this year and last year when you were given your budget. You made a promise, and you made the decision to renege on it.”
“I thank the Minister for allowing me to come in, because I was going to make an intervention. He talks about the need for the Executive to agree a Budget to provide financial stability. I agree with that, but that is looking into the future. It was not me, as Chair of the Health Committee, who made the promise in January 2025 to introduce the real living wage to home care workers by September 2025; it was you, Minister. I accept that he is inviting me to comment, but I am not the Minister. It was the Minister who disappointed the home care sector. When he had his budget for 2024 and 2025, he made the promise to home care workers that he would introduce the real living wage; it was you, Minister, who reneged on that promise even though you had your budget for those proceeding years.”
“I accept what the Member has said, but I do not agree with him. The current and previous Sinn Féin Finance Ministers have prioritised Departments outside of their own, particularly Health, and have given the Health Minister over 52% of the available Budget. It is unfair to say that other Ministers have not prioritised Health. We all recognise that Health has to be a priority, but it is up to the Minister to deal with the £8·6 billion that is at his disposal and make decisions.”
“Similar situations arise repeatedly across constituencies. Families are exhausted. Many are trying to balance employment, childcare and other caring responsibilities with little or no support. Home care has to be one of the foundations on which the entire system depends, so I hope that the Minister will respond positively to the motion and bring forward a comprehensive action plan that delivers long-term stability for the sector, better support for workers and, most importantly, better outcomes for patients and families across the North.”
“<BR /> <BR />I am conscious that when talking about problems and crisis solutions, it is vital that we do not lose focus on the real issues, which are patient outcomes and supporting families. That means people such as the elderly lady from Ballymena who, after spending time in hospital, wanted to return home. Three weeks later, she is still waiting for a care package. Her daughter has to decide whether she will give up her full-time work to provide the care that is needed: to manage medication, as well as moving, handling and nutrition, without the necessary training, respite or adequate support. These issues are impacting on that mother and daughter, and on families like that across the North. Families are being pushed to breaking point because the support that they need is simply not there. <BR /> <BR />Those are not isolated cases.”
“They pointed out that even small improvements in social care provision and discharge capacity could have a significant impact on pressures in emergency departments. That is something that I hear in my many engagements with those who work across the healthcare sector. <BR /> <BR />If we all recognise that dealing with social care is a major problem, why can we not do more to solve it? Too often, the focus is placed solely on ambulance handovers or emergency department processes. While those issues obviously matter, they are symptoms rather than the problem. If there are no available hospital beds because patients cannot be discharged safely into the community, pressure builds throughout the system. That is why home care cannot continue to be treated as separate from healthcare planning. It is a central part of how our hospitals function.”
“Figures continually show that, at any given time, around 600 patients across the North are fit for discharge but remain in hospital because appropriate care arrangements are not in place. That has a direct impact across the entire health system, on hospital flow, emergency departments, ambulance waiting times and cancelled procedures. The crisis in home care is contributing directly to the wider crisis in hospitals and emergency departments. Today, I met by chance representatives of the Royal College of Emergency Medicine (RCEM) to talk about its recent report on excess deaths caused by long delays at emergency departments. They were clear about the connection between pressures in social care and the dangerous conditions developing across our emergency departments. The major issues are hospital bed capacity and delayed discharge.”
“He told me at the Health Committee that he knows not paying the real living wage and not resourcing social care are counter-strategic. Given the creaks in the health service and the importance of social care as a solution to those creaks, we can no longer make counter-strategic decisions. If we are serious about shifting care into the community, improving hospital flow and helping people to live independently for longer, we must be serious about building a sustainable and properly supported home care sector. <BR /> <BR />We know the wider consequences when suitable home care cannot be accessed. Patients who are medically fit for discharge remain stuck in hospital beds because no care package is available to support them at home.”