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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“Home care should not be a rushed, task-based exercise carried out against the clock. It should be about supporting people to live safely and with dignity in their own homes. The motion calls for meaningful engagement and co-production with providers, workers and service users. That is essential, and I want the Minister to respond, hopefully today, that he intends to engage directly and meaningfully with care providers to find solutions to the issues being identified. <BR /> <BR />I support the Minister as he tries to shift left, and I hope with all hope that that is successful. I hope that the new neighbourhood model will help that and allow for care to be provided in the most appropriate environment. However, on the issue of social care, the Minister needs to do more.”
“We have to ask ourselves whether meaningful, compassionate and person-centred care can realistically be delivered in such a short period, particularly for people with significant physical or cognitive needs.”
“Independent providers deliver the majority of home care hours across the North, yet many warn that the current model is becoming financially unsustainable due to rising fuel costs, operational pressures and workforce challenges. Retention is an increasingly serious issue. Experienced care workers are leaving for sectors that offer similar pay for far less demanding work. To repeat: Minister, that is why you must fulfil the commitment to introduce the real living wage for social care workers. <BR /> <BR />We need to reflect carefully on the quality and dignity of the care provided. We in the Chamber know that many home care visits still last only 15 minutes.”
“In places such as Armoy and surrounding rural areas, constituents who come to my office are regularly told that they live in what has effectively become a home care black spot. That is not sustainable, nor is it fair on patients or their families in North Antrim, including Armoy, or in any other rural part of the North. <BR /> <BR />Last week, we heard reports that providers may withdraw services from some rural areas because continuing to operate there is no longer financially viable. If we lose providers or provision in rural parts, that will make the existing problem much worse. That should concern all of us, because, when those services disappear, vulnerable people are left with few alternatives. Home care providers raise those concerns with me repeatedly.”
“Demand for home care is increasing year-on-year, and the level of need is becoming more complex. We need to get to grips with the situation. We need to plan for a future where more people live longer with frailty, dementia, disability and multiple long-term conditions. That plan needs to take on board the other realities that are happening at the same time. Care providers are dealing with rising costs, workforce shortages and growing difficulties in retaining experienced staff. Those pressures are felt particularly sharply in rural communities. In parts of my constituency of North Antrim, families are told repeatedly that no care package can be sourced because there are simply no carers available in their area.”
“<BR /> <BR />Colleagues will touch in greater detail on the impact that rising fuel prices are having, but the Minister will not be surprised to hear me once again demand that the very least that he does is implement the real living wage for our social care staff, fulfilling a promise that he made to that sector in January 2025. That is the right thing to do to show that we value the vital work that is carried out in that sector — mostly, it needs to be said, by women, which is another inequality. Not only would it send a signal that the work that those workers do is valued, but it would help the independent care sector, which continually tells us about the pressures that it faces in recruitment, retention and sustainability. <BR /> <BR />The North has an ageing population. That will not change; it will continue to be the case.”
“<BR /> <BR />The motion rightly begins by recognising the essential role played by home care workers across the North. More than 30,000 people work across our wider social care sector, all of them carrying out demanding and often deeply personal work every day. They deserve our praise and our gratitude, but, obviously, care workers deserve more than my warm words and thanks: they deserve fair pay, decent conditions and recognition for the vital role that they play in sustaining our health and social care system. Those workers travel long distances in all weather, often under intense time pressure, to provide personal care and support to some of the most vulnerable people in our society. In many cases, they are the only regular social contact that a person has.”
“As my party's health spokesperson, I am continually discussing and debating in the Chamber issues of great importance to the people whom we represent. In health, there are so many such issues that, at times, it feels hard to prioritise them, but I can say without contradiction that the crisis in social care is one of the most important issues that the Health Minister must address, because of its impact on the whole health system and because it affects large number of families in every constituency across the North. It is not an exaggeration to state that for me, as an MLA, one of the most common and distressing issues raised in my office is the struggle that families face in trying to secure appropriate home care packages for their loved ones so that they can remain and live safely and independently in their own homes.”
“The answers should include clear timelines, better accountability, improved workforce planning and details of greater engagement with autistic people and their families and carers when services are being designed and reviewed. <BR /> <BR />It is also important that we recognise the increasing demand on autism services. As diagnosis rates continue to rise, services must be properly resourced and planned for the future. The motion is an opportunity to recognise the challenges that remain and to push for practical improvements that can make a real difference to people's lives. Ultimately, autistic people and their families want the same thing as everyone else: timely support; fair access to services; opportunities to reach their potential; and the ability to live independently and with dignity.”
“There is a clear need for better planning across Departments dealing with health, education, further education, employment and communities to ensure that autistic young people are properly supported as they move into adult life. <BR /> <BR />The autism strategy and the Autism Act already provide an important framework for improving services, but we need to move beyond frameworks. The key issue now has to be delivery. The motion asks the Minister to outline how the commitments within the strategy and Autism Act will be implemented during the remainder of the Assembly mandate, and how services will continue to improve in the years ahead. We need to hear answers to those questions from the Minister.”
“In some areas, families can access therapies, family support and early intervention programmes, relatively quickly, but in other areas, those same supports are extremely limited or, in some cases, unavailable. There needs to be greater consistency so that autistic people and their families can expect a fair standard of support, regardless of where they live. <BR /> <BR />The report also draws attention to the difficulties that many autistic young people face when moving from children's services into adulthood. We will be supporting the amendment, which reflects that. Too often, support reduces significantly when a young person leaves school or reaches adulthood. Families frequently describe that transition as being confusing and stressful, with little coordination between services.”
“<BR /> <BR />The report also highlights the impact that long waiting times for autism assessments have on children, young people and adults. Many families wait years for an assessment, and, during that time, children can struggle in school, while parents can struggle to access support. As a result, their mental health can worsen. Early identification and intervention are important, and delays not only affect outcomes for autistic people but can place additional pressure on schools, health services and families. <BR /> <BR />Another issue raised in the report is the lack of consistency in the services that are available across the North.”
“It shows that services are inconsistent across different areas, that waiting times are too long and that many families are finding it difficult to access the support that they need at the right time. <BR /> <BR />One of the clearest concerns that the report raises is the pressure on respite and short-break services. For many families, respite care is essential, as it provides support for parents and carers, gives children and young people opportunities to engage in activities and helps prevent families from reaching crisis point. Access to those services varies significantly, however, and depends on where people live. Families should not receive different levels of support simply because they live in a different health trust.”
“I thank the Members who tabled the motion and the amendment. The motion is important, because it reflects the experiences of, and gives a voice to, the many autistic people and their families across the North who are struggling to access support and the services that they need. The recent findings of the Independent Autism Reviewer's first annual report highlight a number of serious and ongoing issues with autism services, and those issues are deeply concerning. I record my thanks to Ema Cubitt and her team for producing the report and for shining an important light on the conversation that we are having today. The report confirms what families, carers and autistic people have been telling us for many years.”
“Economic growth and environmental responsibility cannot be treated as separate issues; they have to go hand in hand. <BR /> <BR />There is also a need for genuine collaboration across Departments, agencies and local government to ensure that infrastructure, tourism, transport and environmental planning are all aligned. If that is delivered as it could and should be, there will be a massive opportunity to grow our economy, support our hospitality sector and improve North/South and east-west connectivity, while ensuring that the environmental concerns that have been raised remain central to the development.”
“We have a responsibility to engage openly and honestly with local communities about any future growth and expansion, and the residents who live around the airport must be part of that conversation. The Economy Minister has launched a consultation on aviation policy that looks at the impact of environmental issues and sustainable travel. That consultation is important because it gives us the opportunity to shape for the future a strategic approach to aviation that balances economic growth with environmental responsibility and community well-being. Sustainability has to be at the heart of future aviation planning. That means investment in greener technologies, better public transport, stronger rail infrastructure and supporting efforts to reduce emissions across the sector.”
“Better transport links between our towns, cities and airports can support regional balance, and economic development will make travel more accessible for workers, businesses and tourists alike. I particularly welcome the ambition to develop a direct rail connection to the airport. As others have said, that would be a first on the island, and it represents the type of long-term infrastructure planning that we need more of. Expanding rail connectivity is critical not only to improving accessibility but to supporting more sustainable travel choices into the future. <BR /> <BR />While there are clear economic opportunities, we also need to recognise the concerns that have been raised by residents and environmental groups.”
“The potential to accommodate 7 million passengers, double the workforce and contribute £1·7 billion to the economy by 2040 represents a major opportunity for job creation, investment and long-term economic growth. We know the importance of tourism to our local economy. Tourism supports thousands of jobs across hospitality, retail and arts and culture. Belfast continues to grow as an international destination, and strengthening our connectivity is key if we are serious about continuing that growth and attracting visitors from across Europe and further afield. <BR /> <BR />Importantly, however, this cannot be viewed through the lens of Belfast alone. There is real potential here to strengthen connectivity across the island of Ireland.”
“I support the motion and our amendment. <BR /> <BR />The potential that the Belfast City Airport master plan 2040 brings not only for Belfast but for communities across the North and, in fact, the island is absolutely huge, and we need to make sure that it is achieved. First, connectivity matters: air travel plays a vital role in supporting our economy, our tourism sector, our businesses and our communities. It connects families, supports inward investment and helps to ensure that people can travel easily for work, education and leisure. The master plan will allow greater travel opportunities for people across our island. <BR /> <BR />The ambitions set out in the master plan are significant.”
“Go raibh maith agat, a LeasCheann Comhairle.”
“Therefore, we believe that he must play his part and prioritise certain areas, particularly palliative care, in the incoming budgetary period.”
“The Committee produced 27 recommendations, which would not only improve outcomes for those with terminal illnesses who require end-of-life care but would also move care from expensive hospital settings to much more efficient community settings and free up resources in our hospitals and patient flow. The Committee's view was that not only would we get better outcomes but much more efficient spending of the Department of Health's budget. Despite the Department accepting all but one of our recommendations, we were told last week that there are no resources or timelines for introducing some of the <BR />Committee's recommendations that would undoubtedly improve care for those who are most in need. <BR /> <BR />The Health Minister has asked the Committee to advise and assist, and we have played our part.”
“However, the Committee is clear that we have a very committed, highly-skilled workforce, and we thank them all for the work that they do. They go above and beyond in caring for patients and their families. The workforce will be key in driving change in the system. <BR /> <BR />The Committee's role is to scrutinise the budget and the Department's work, and the Minister likes to tell the Committee that it should advise and assist him in his role. Yet, when it does that, the Minister’s standard answer is that there is not enough money. The Committee does assist and advise him. For example, the Committee spent a considerable amount of time over a number of months doing an inquiry into access to palliative care.”
“That is part of the Health Committee's problem with scrutinising the Department of Health's budget: the numbers are always changing. In the last couple of weeks, the Minister has mentioned a shortfall of anywhere between £600 million and £800 million, and it is difficult for the Committee to take a position on a constantly changing shortfall figure. <BR /> <BR />The Committee is, of course, concerned about the budget that has been provided to the Minister. Every week, we hear about the problems that all areas of our health service face, such as a lack of community services, ambulance waits, waiting lists and the delivery of mental health services, and I could go on for the rest of the debate on some of the deficits faced by our health service.”
“I welcome the opportunity to speak on behalf of the Health Committee on the Finance Committee's report on the draft Budget. I thank the Committee for Finance for undertaking the work to provide a collective view of the Committees' positions on the draft Budget. <BR /> <BR />The Health Committee did not come to a position on the draft Budget. The Committee was briefed by the Department's interim director of finance and senior officials on 19 February on the 2026-29 multi-year Budget, and they advised that the proposed Budget represents a disappointing outcome for Health. The briefing paper provided by the Department outlined that the projected funding shortfall for 2026-27 was £1·08 billion, rising to £1·844 billion in 2028-29.”
“As you have indicated, Minister, the closure of the Bann bridge at Kilrea has had a serious impact on the businesses and residents of Kilrea. Whilst, as you have said, the closure was absolutely necessary for safety reasons, it has flagged up the very real need for a new bridge at Kilrea in order to meet transport needs in the area. Have you had any engagement with Causeway Coast and Glens Borough Council on its work to include a new bridge in its development plan, and will you support that?”
“One of the key challenges across the totality of our health service is staff shortages. With the Department of Health no longer funding physician associate degrees, can you outline whether the Department will repurpose that funding? Will it be used for other training places?”
“It is a wonderful opportunity for midwives, their families, colleagues and supporters to come together to get active and show appreciation for the profession. I hope to be kitted out and show my support to our midwives and the incredible work that they do. On International Day of the Midwife, let us celebrate their dedication, acknowledge the challenges that they face and commit to delivering the change that women, babies, families and midwives themselves deserve.”
“They do so while managing increasing pressures, staffing shortages and rising complexity in the needs of women and babies. Their commitment ensures that families receive the support that they need, even when the system around them is under strain. Recognising the work of midwives today is also a reminder of the need to strengthen the services that they rely on by improving working conditions, investing in safe staffing and ensuring that every woman and baby receives the standard of care that they deserve. <BR /> <BR />As part of recognising midwives, I want to highlight an event that is taking place this weekend. On Saturday 9 May, there will be a special Stormont parkrun, here on the grounds.”
“<BR /> <BR />The North remains the only part of these islands without a maternity strategy. The Renfrew report, commissioned by the Department of Health and published in 2024, sets out clear evidence that maternity and midwifery services require a regional, coordinated five-year plan. It highlights the difficult experiences faced by many women throughout pregnancy, labour, birth and the postnatal period; experiences that have affected their physical and mental health, their well-being and their early relationship with their baby. Despite the strength of those findings, progress on implementing the report's core recommendations has not yet begun. Yet, in the face of those challenges, our midwives continue to deliver safe, compassionate care every day.”
“Today, on the International Day of the Midwife, I recognise the extraordinary contribution that midwives here in the North make for women, babies and families. Our midwives are there at some of the most significant and vulnerable moments in people's lives. Their compassion, expertise and calm presence provide reassurance and care to expectant mothers when it matters most. <BR /> <BR />This year's global theme, "One million more midwives", is both a celebration and a call to action. It reflects a clear and urgent reality. Across the world, there are not enough midwives to meet the needs of women and babies, and that global message resonates strongly here in the North. While we are fortunate to have highly skilled and dedicated midwives, they are working in a system that is under significant pressure.”
“I urge the Minister to work closely with dentistry representatives to address the issues, which include access, workforce challenges and the growing crisis in NHS dentistry, and to restore public confidence in that vital part of our health service.”
“He must publish the findings of the general dental services (GDS) cost-of-service review without any further delay. It is essential that the NHS dental contract be revised to reflect the true cost of delivering modern dental care, ensuring that practices are not pushed towards privatisation out of financial necessity. Everyone deserves to be fairly paid for the work that they do. <BR /> <BR />In his three-year plan for Health and Social Care, the Minister has committed to developing an action plan for the reform of general dental services by April 2027, but we are now almost halfway through 2026, and time is running out. I am increasingly concerned that, by April 2027, we may not have any health service dentists left.”
“Our public health service was created to reduce health inequalities, yet we are witnessing a widening of those inequalities across the board. With private health care becoming increasingly evident, nowhere is that shift more visible than in dentistry. Access to dental care cannot be based on someone's ability to pay, so we must speak with one voice to ensure that it does not. <BR /> <BR />The Minister of Health's announcement last week of an £8 million investment is welcome, but, like the funding that was announced last year, it focuses predominantly on short-term stabilising measures that only highlight the urgent need for sustained action and long-term reform. The Minister must bring forward a plan to stabilise NHS dentistry in order to prevent a complete collapse of the service.”
“<BR /> <BR />The importance of dental care cannot be overstated. Oral health is closely linked to wider general health, with well-documented associations with heart disease, diabetes, respiratory illnesses and complications in pregnancy. When people cannot access routine check-ups or preventative treatment, minor issues escalate to serious conditions that place additional pressure on the wider health service. <BR /> <BR />We know that further losses of NHS dental practices will have a disproportionate impact on those on lower incomes and on children. They may then go without regular check-ups and preventative care for many years. An entitlement to free dental treatment is meaningless if people cannot find an NHS dentist with the capacity to treat them.”
“Those barriers include transport difficulties in rural constituencies, the cost of travelling to the nearest NHS dentist, ill health or caring responsibilities on the day of an appointment and the reduced availability of NHS appointments as more practices scale back or withdraw from the system, resulting in patients being unable to attend within the required time frame. When tens of thousands of patients' registrations lapse, however, we must be honest and say that it is not a failure of patients to attend but, rather, a failure of a system that cannot provide appointments within the time required in order for them to remain registered. We must also recognise the growing number of people who have never been able to secure NHS dental registration. For them, the barriers to accessing care are even more pronounced.”
“In my North Antrim constituency, the scale of the issue is stark. During 2024-25, 23,865 registrations lapsed. There were also 2,500 deregistrations. Those figures represent individuals who have effectively fallen out of the system. The fact that we are seeing such numbers in a single constituency, with people losing their NHS dental registration within one year, suggests that it is a matter not simply of missed appointments but of significant and persistent barriers to care.”
“I thank the Members who tabled the motion. We will support the motion and the amendment. The motion highlights the fact that "only 50%" of the population of the North is now registered to receive NHS dental care. That statistic should cause us great concern. The motion also draws attention to the growing problem:”
“There is absolutely no doubt that, in recent years, an increasing number of patients have struggled to access NHS dentistry services here in the North, as more dental practices are moving towards privatisation due to a lack of investment and rising costs across the sector. Constituents contact my office and me about that issue regularly, as do representatives of the dental profession, who have been very clear that, unless meaningful action is taken soon, more dentists will inevitably leave the NHS. The crisis in NHS dentistry will then deepen further and have more of an impact on citizens in the North.”
“I thank the First Minister for her answer. Following on from that answer, First Minister, do you believe that it is time for the Justice Ministry portfolio to be selected in the normal way, just as all other Ministries are?”
“First Minister, I thank you for that answer and the work that you and your Executive colleagues are doing to impress on the British Government the need for help for citizens here with the rising fuel and energy costs. Further to that, last week, we saw the British Government seeking to deflect from the Executive's effort to secure a fair and adequate Budget for the North, when they challenged your assertion that funding here would be significantly higher if we were treated on the same basis as Scotland and Wales. Will you set out broadly and put on record how you came to those figures?”
“I know that the SDLP has a mad obsession with Sinn Féin, but the subject of your angst, today, should be those who are supporting the Bill that is delaying what Sinn Féin proposed — the ending of car parking charges — not Sinn Féin that, today, put on record, that we are voting against the Minister's Bill. We want to see the end to car parking charges, which we brought to the Chamber, implemented.”
“Sinn Féin is taking responsibility for its part in the hospital car parking charges issues. This was a Sinn Féin Bill. Sinn Féin proposed that we ended car parking charges for patients and staff across the North. That was our responsibility, and it was supported by everybody in the Chamber. The Member talks about taking responsibility for where we are today. We are opposed to the delay. We did not need the SDLP to tell us that we were opposed to it at the Second Stage debate, and we do not need the SDLP to tell us that we are opposed to it at this stage.”
“I do not think that that is credible, and I do not think that it is acceptable that patients, staff and families are being asked to plug gaps created elsewhere in our health system. <BR /> <BR />Being honest about what is in front of us today, the Bill does not stop charges but prolongs them. It asks people to keep paying for longer despite the Assembly's already having agreed that those charges should go. Sinn Féin will not support that, because, if we believe that the policy of charging at hospital car parks is wrong — the Assembly has already made that decision — the answer is not to delay action.”
“I agree about the budget, but the health service can, at times, be inefficient, and we can see wastage. Just last week, for example, at the Health Committee, we heard from the Belfast Trust about major capital projects, including the maternity and children's hospital developments, running significantly over budget to the tune of tens of millions of pounds. There is no clear end point and no certainty on final costs. Those are capital projects that, as I said, are costing the public purse substantial amounts of money. I think that, if the Health Minister were to look deeply into the budget, he would find other examples of where costs can be cut. Millions can be lost to delay, overruns and mismanagement, yet the solution offered today through the Bill is to keep charging families to park at our hospitals.”
“<BR /> <BR />Our current system of parking charges is a patchwork of concessions that look good on paper but not in reality. It is inconsistent, at times it is unclear, and it leaves out far too many people, creating yet more health inequalities. The Minister has suggested that the trusts will review those, but I do not think that we need other reviews, and we do not need more variation between trusts. What we need is a clear, fair, North-wide decision to abolish the charges and to implement the original legislation. <BR /> <BR />We also come to the argument of revenue, and the Minister has outlined clearly that the rationale for introducing the legislation to delay the original Act is the precarious situation that our health service is in.”
“The Member must have been reading my speech because I am going to make that point next. I welcome that intervention, and it is a point well made. <BR /> <BR />In the previous debate, I spoke about a similar scenario of the real-life impact on families of children and young people with cancer. Despite repeated references to exemptions, research from Young Lives vs Cancer shows that 62% of those families are still paying to park at our hospitals. The Minister has since stated and has said again today that the Department has written to the trusts and expects them to review their existing car parking concession policies in light of the proposed legislation. Concerns have been raised, which I share, that a trust-led review alone will not be sufficient.”
“The reason is simple: the Assembly has already made its decision. We cannot have a scenario where we refuse to implement agreed legislation by supporting delay after delay. As I said previously, the Health Minister himself supports the intent of the abolition of car parking charges, and he said that again today. However, supporting the principle means very little if, when the moment comes to act, we are told that it must be postponed yet again. <BR /> <BR />There will also be talk of cost if we do not support the Bill today, but delay is not neutral. Delay also has a cost: a cost felt by patients attending appointments; a cost felt by families sitting at bedsides; and a cost felt by staff turning up day after day to keep our health service going.”
“Today, I speak as my party's spokesperson on health. At the beginning of my contribution, it is important to correct, once again, the narrative that is being portrayed by some Members, who are trying to misinterpret the Bill that is before us today and trying to change the narrative around the original private Member's Bill to end hospital car parking charges that was brought forward by my party colleague almost four years ago. That private Member's Bill passed with the support of all the main parties. There were no ambiguities then. There was a clear, united position that charging patients, families and staff to access health care was wrong. That is why we in Sinn Féin voted against the current Bill at the previous stage and will do so again today. We are opposed to any further delay to abolishing hospital car parking charges.”
“More importantly, on the actions that you have outlined, when will our population in the North see measurable changes?”