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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“Does that mean that we should sit back and do nothing until we get a new Ireland? Absolutely not. <BR /> <BR />Waiting times in emergency departments here are now among the worst in these islands. Our citizens deserve better. The problems that the motion identifies boil down to patient safety, staff welfare and system failure. It is the responsibility of us who work in this place to address all three of those issues. Patients regularly wait for hours, often into the following day, to be seen. Many are elderly, frail and disorientated. Some are babies and children. They are people of all ages and are injured or sick. Some are under the influence of alcohol or drugs, and some are in the middle of a mental health crisis.”
“It is a worthwhile debate. I thank the Members who tabled the motion: it gives us the opportunity to discuss the reality that patients, families and healthcare workers experience inside our hospital emergency departments. Given that my contribution will focus on patients and staff, I will get the politics out of the way early. Yes, the Minister of Health, like all Executive Ministers, has a constrained budget and could easily spend more money if he had it. Unfortunately, successive British Governments and their austerity policies have pillaged our public services, particularly our health service. I genuinely believe that the only way in which we can fully redress the problems that our health service in the North faces and give our citizens the best possible outcomes is in the context of an agreed all-Ireland health service.”
“Today, I hope that the Minister can provide reassurance that tangible progress is being made in that regard, as discussions alone cannot become a substitute for decisive action. <BR /> <BR />Paediatric and perinatal pathology is an essential service. It plays a vital role in providing answers, supporting learning and offering compassionate care to families who have experienced a profound and life-altering loss. I hope that, by bringing focus to the issue today, we can respectfully acknowledge the depth of grief carried by those families and commit to doing all that we can to lessen the burden placed on them when pathology services are required.”
“Clearly, I welcome those discussions and again ask the Minister to give us an update on those discussions in his response to the debate. A joined-up paediatric pathology service on this island makes perfect sense. All-island cooperation has the real potential to form part of any sustainable, future model. Indeed, in previous health debates in the Chamber, it has been clearly evident that collaboration across the island can bring clear benefits to citizens the length and breadth of Ireland, particularly in areas requiring highly specialised expertise. We have already seen that work effectively in Altnagelvin's North West Cancer Centre and the children's cardiology unit at St Vincent's Hospital in Dublin.”
“During my meeting with the Royal College of Pathologists, I was informed that a number of the people who are carrying out the service in Scotland and Liverpool come from the North, so we have people from here who are doing those jobs elsewhere. We need to get people from here able to practise here and provide the service here. <BR /> <BR />New and emerging post-mortem methods, including digital pathways such as CT imaging, could also be utilised in some circumstances. Are they being explored? If so, to what extent? <BR /> <BR />The Minister has also spoken about the potential for an all-island approach, referencing discussions with his Southern counterparts — the former Minister Stephen Donnelly and, more recently, Minister Jennifer Carroll MacNeill.”
“It would be helpful if the Minister, when responding to today's debate, could update the House on the detail of those recommendations and outline the progress that he has made to date in implementing them and, perhaps, commit to bringing forward an implementation plan that would set out clear time frames on how and when the essential service will be restored. I recognise that there is no quick fix to the issue, but it has been seven years, and there is a need to make progress. <BR /> <BR />It is vital that we get a sense of what is happening in workforce planning and of what proactive recruitment measures are being taken, what training opportunities are available currently and how they can be made accessible to people here in the short term in the absence of the necessary training infrastructure.”
“It was undertaken by Queen's University with support from the Public Health Agency (PHA) and had input from key stakeholders, including Sands and Cruse Bereavement Support. I welcome the involvement of bereavement organisations in the process. It is vital to ensure the centrality of families' experiences, their voices and needs in shaping the delivery of services in the future. The Minister has also stated that all 21 recommendations in the report have been accepted and are being actioned.”
“The Royal College of Pathologists, which I met recently, has highlighted the fact that there are only 52 consultant paediatric and perinatal pathologists in Britain, with up to 25% expected to retire within the next five years. Some regions across the water in England — the south-west and the Midlands — have no consultants in post, so it is clear that there are difficulties across these islands. However, recognising the scale of the challenge does not remove the responsibility to act with urgency, transparency and compassion to find a remedy. <BR /> <BR />The Minister has previously stated that his Department has commissioned an evaluation of paediatric pathology services.”
“For many families, travelling to Liverpool is not just distressing but overwhelming. It creates delays in funeral arrangements and places an emotional and financial burden on people who are already broken by loss. Parents have spoken of feeling powerless, excluded and retraumatised by a process over which they have no control. <BR /> <BR />I recognise that the situation is driven in large part by a global shortage of the highly specialised skills required in paediatric and perinatal pathology, and I acknowledge that restoring a service here is made more challenging by the need to recruit three specialists simultaneously in order to establish a safe, sustainable and resilient service. There is no doubt that workforce pressures in the sector are significant.”
“No parent should have to watch on as their child is transported away because our health system cannot provide what should be a basic compassionate service here. <BR /> <BR />Following the resignation of the last specialist consultant in the field here, post-mortem examinations for babies and young children from the North have been carried out at Alder Hey Children's Hospital in Liverpool. I acknowledge the professionalism, expertise and compassion of the staff at Alder Hey, as well as the dedication of our Health and Social Care (HSC) professionals here who support the families through the process, but the reality remains that the arrangement places an additional emotional and logistical burden on grieving families at an already unimaginably difficult time.”
“The North does not have a paediatric pathology service. That has been the case since 2019, and it is a glaring, important deficit in the health service here. I will ask questions and make suggestions to the Minister later in my speech. At the heart of the debate, however, are not structures and strategies but families facing the unimaginable loss of a child. Since 2019, bereaved parents in the North have been forced to endure not only their grief but the added trauma of knowing that their child must be taken across the Irish Sea for a post-mortem examination, should one be required. At that time of unbearable loss, families are confronted with distance, delay, unfamiliar systems and the pain of separation.”
“Go raibh maith agat, a Leas-Cheann Comhairle.”
“In your response, Minister, you mentioned the importance of GPs, pharmacies, the independent sector, domiciliary carers etc, and I wholeheartedly agree with that. It will be no surprise to the Minister that, when some of those groups come to the Health Committee, they express their unhappiness and dissatisfaction with the current levels of core funding, which have caused issues. In your engagement with those groups, have you found that current issues are creating obstacles? What is the level of engagement to ensure that your proposed model will be a success?”
“I thank the deputy First Minister for the statement and the update. In her answers, she mentioned collaboration a number of times: does she agree that all our people here are best served by working together on a North/South, east-west basis consistent with the Good Friday Agreement?”
“I welcome the prioritisation of Health by the Minister and the Executive. Given that the health service relies heavily on staff, can the Minister give a commitment that health workers will get their pay rises in a timely fashion?”
“<BR /> <BR />While I welcome the priorities and the associated recommendations outlined in the report on the review, particularly on person-centred care, expanding the neurology workforce, addressing gaps in existing services and making better use of current resources, I fully concur with the Members who moved the motion and the amendment. I ask for implementation without further delay of the recommendations in the report as well as any additional actions arising from the consultation process. That action is needed to restore trust and public confidence in our neurology services.”
“<BR /> <BR />I acknowledge the important work of the Neurological Charities Alliance in the North, and I voice my support for its FightForNeuro campaign. Charitable organisations too often have to step in to fill gaps in statutory services, providing a lifeline for patients, carers and families. I thank Treasa and Bill, whom I met along with the Neurological Charities Alliance last week, for sharing their lived experience with me. Their personal accounts were deeply impactful, and I am grateful to them for sharing how they were diagnosed, the problems that come with their conditions and in accessing services in the health service and the impact that that has on their condition, their physical and mental health and their families.”
“<BR /> <BR />We are all aware that lengthy delays can lead to deterioration in physical and mental health, placing unnecessary strain on carers and limiting the ability of individuals and families to remain in employment or to participate in the activities that give their lives meaning. I have heard first-hand how living with a neurological condition can be life-altering, complex and unpredictable. Those conditions, which include MS, Parkinson's, epilepsy and migraines, to mention a few, can affect mobility, cognition, communication and emotional well-being not only for the individual but for their families and those who care for them. That is why it is vital that patients feel listened to and supported from the moment that symptoms emerge, regardless of which trust area they live in. It is clear that that is not currently the case.”
“Many people living with neurological conditions and their carers reported feeling unsupported by the healthcare system physically and mentally. Access to specialist services remains a major challenge. As has been pointed out, 82% of those who responded to the survey reported difficulty accessing inpatient neuro-rehabilitation; 80% reported difficulty accessing neuropsychiatry; and 71% reported difficulty accessing neuropsychology. Respondents raised concerns about insufficient time during appointments, a lack of continuity in the professionals whom they see, difficulty in accessing follow-up care and the additional financial burden of managing their condition, including the cost of transport, therapies, equipment and, in some cases, having to seek private healthcare.”
“People living with neurological conditions and those presenting with symptoms deserve better; they deserve far better. <BR /> <BR />The report identifies significant capacity constraints across the system that are compounded by fragmentation between primary, secondary and community care. That fragmentation creates gaps in services and inequitable access to timely neurological care across trust areas. The report also highlights the acute workforce shortages, including in consultant neurologist, specialist nurse, allied health professional and psychology roles. The findings echo the concerns that have been raised by patients, carers and advocacy groups. <BR /> <BR />The 'My Neuro Survey 2024-25' provides stark evidence of the reality.”
“I begin by thanking the Members who tabled the motion and the amendment. We will support both. <BR /> <BR />The regional review of neurology services was first launched in 2018 in response to serious concerns about service pressures, clinical governance and patient safety, following, as has been pointed out, the largest patient recall in the history of the NHS. Now, in 2025, with the publication of the final report, it is clear that neurology services remain under-resourced, understaffed and under substantial pressure. Waiting lists, both in numbers and length of wait, have reached unacceptable levels. That has led to inevitable delays in diagnosis, treatment, follow-up care and, potentially, missed opportunities for early intervention that, in some cases, have resulted in patients presenting to emergency departments in crisis.”
“Minister, you mentioned that there would be a number of groups and organisations in the forum to hold you to account. Can I have some more detail on that?”
“Deputy First Minister, how will Executive Office structures apply the lessons from what was an unprecedented global health emergency?”
“— more importantly, can be a blueprint or a road map for doing things better.”
“I thank the Minister, permanent secretary and departmental officials for engaging with the Committee over the past year. <BR /> <BR />Lastly, I pay tribute to those who shared their lived experience with the Committee, including individuals receiving palliative care and families who have lost loved ones. That cannot have been easy for them, but I want them to know how important their contribution and testimony was to the Committee: your experiences have, hopefully, shaped our inquiry report for the better. A report that hopefully, but —”
“<BR /> <BR />As I conclude, I place on record my thanks to those in the sector who so willingly engaged with the Committee, including the hospices in the North, Hospice UK and the All Ireland Institute of Hospice and Palliative Care. I thank all the organisations, health professionals and individuals who provided valuable evidence to the Committee as it considered this important issue. <BR /> <BR />I thank the Committee Clerk and his staff for their valuable assistance and contribution throughout the inquiry process in organising and managing the sessions and, in particular, for collating the evidence and drafting and redrafting the report. I also thank my fellow Committee MLAs for their considerable and considerate consideration of the issue.”
“<BR /> <BR />General palliative care is provided predominantly by GPs and district nurses. That service is undervalued and under-resourced, and it is not meeting the public's expectations. Specialist palliative care by multidisciplinary teams is an essential healthcare service that should be fully funded through Health and Social Care. It has been underfunded for a prolonged period. There is a critical need for investment in the community specialist palliative care workforce. As more individuals choose to receive care at home, there is an urgent demand for a sustainable, multidisciplinary, community-based workforce. The current strategy for paediatric palliative care is not adequately funded.”
“However, such community care exists only in certain areas of the North, which results in inequity of access for patients and families. That inequity exists in rural areas in particular. <BR /> <BR />The Committee believes that immediate investment in palliative and end-of-life care is necessary. There is a significant gap in out-of-hours palliative care services, particularly for symptom management. That lack of service can be a barrier to patients returning home, and the absence of 24-hour care makes it difficult for patients to receive timely support. Community and palliative pharmacy play a critical role in keeping the patient stabilised in their home and in the hospital setting, especially at the point of discharge. It is important that those functions are adequately resourced to support patients.”
“<BR /> <BR />While we need to consolidate and build inpatient services, the Committee has significant concerns about community services that are provided through hospices and trusts. The Committee held an event in June with the Voices4Care group and other family members who had lost loved ones who had received palliative care. The Committee was concerned to hear the lived experience of families, who, at times, struggled to get support and were told to take their loved ones to emergency departments to wait for treatment. Those families had to drive for hours in their loved ones' last days to find urgent medication. We must do better. <BR /> <BR />The sector is innovating, and the Committee saw some really good examples of community care, including out-of-hours nursing support, just-in-case boxes and 24/7 telephone support.”
“For inpatient services, we need an immediate move away from the long-standing practice of providing 50% funding on the basis of the cost of a general medical bed in a hospital. What hospices provide, in their inpatient services, is specialist multidisciplinary care, and we are doing staff and patients a disservice by continuing the current practice. In their evidence, departmental officials highlighted the fact that it is difficult to assess the cost of providing specialist care. However, the Committee did receive correspondence from the Department that provided information on the cost of providing specialist care in a fully funded trust service, which was significantly greater than the amounts that are provided for hospices and inpatient services.”
“<BR /> <BR />I want to touch briefly on the key themes of the evidence that we heard and some of our recommendations. Universal access to palliative and end-of-life care is a recurring theme as is our call for a legal right to palliative care. It was acknowledged that legislation alone would not solve all challenges but would raise the profile of palliative care, ensure consistent commissioning across trusts and help to secure equitable access. <BR /> <BR />Another constant theme was hospice funding. Our hospices face constant financial instability and risk, which prevents meaningful development and growth. Without multi-year budgets and long-term planning, meaningful service development is impossible, leaving clinical needs unmet and communities underserved.”
“Palliative care is key to bringing about a more efficient and effective system for healthcare, and the Committee hopes that the Minister will today acknowledge the importance of prioritising palliative care services. <BR /> <BR />We are already working to an underestimated need for palliative care. The Office for National Statistics projects that we will experience the largest proportional increase on these islands in the number of deaths that require palliative care, with a 32% rise expected between 2023 and 2048. That outlines the need to increase the focus that has been placed on palliative care and put the correct structures in place that will ensure that, as demand for palliative care increases, the systems are in place to be able to provide patients and families with the holistic care that is needed.”
“Good palliative care allows the bereaved to recover sooner and continue living their lives without crippling memories of unnecessary suffering. That is an important statement because, when there has been a gap in the patient's care or a barrier to accessing proper and timely palliative and end-of-life care, the effects are disastrous for the patient as well as for the families and the carers and key workers who were involved with the patient. <BR /> <BR />Palliative care is unique. We have only one chance to get it right for a patient and their loved ones at a time in their life when they are at their most vulnerable. The Committee's 27 recommendations provide the overall steps that are required for us to get this vital service in our health service right.”
“It is important to note that palliative care is not just for older people. Many of those who are terminally ill leave behind young families. Paediatric palliative care services see families from before the child's birth right up until they are 18 years of age. When a child and family receive that diagnosis, palliative care aims to improve quality of life, to support families emotionally and practically and to help children to live as well and for as long as possible. It is a long-term, holistic approach that is not just about the final stage. <BR /> <BR />Nothing sums that up better than a quote from the evidence that the Committee heard when members were told:”
“It states that palliative and end-of-life care:”
“It is, however, facing barriers to effecting the change that is needed and required. The Committee intends that its report will shine a spotlight on that area of the healthcare system and that it will, hopefully, greatly assist the Minister, the Department and the relevant arm's-length bodies in meeting our shared goals of high-quality care and outcomes for patients and their families and carers. <BR /> <BR />The World Health Organization states:”
“I hope that the event will be well attended. Those who attend the event will watch a video in which a family member of a patient describes the care that is given by the hospice as "beyond special". That was the experience of Committee members when we visited each of the hospices. The quality of care and the services that are provided by the sector, through patient and community services, is something that we should all be proud of. <BR /> <BR />Early in the inquiry, the Committee learned that the sector has an exceptionally skilled workforce, in statutory and community settings across the North, who have a passion to keep improving access to high-quality care services for patients and families. Not only does the sector understand the challenges facing services, but it has many of the solutions to those challenges.”
“As Chairperson of the Committee for Health, I welcome the opportunity to speak to the Committee's report on its inquiry into access to palliative care services in the North. I look forward to hearing the contributions to the debate. We also look forward to hearing from the Minister, and we will listen carefully to how he engages today on the report's findings and recommendations. <BR /> <BR />I begin by acknowledging the presence in the Public Gallery of professionals from the palliative and end-of-life care sector, as well as those with experience of being a patient requiring palliative care and families and carers who have provided palliative care to loved ones. Later this afternoon, the Committee will host an event to thank the sector and those with lived experience who have contributed to the inquiry's findings.”
“I welcome the work that the Minister is doing to enhance and capitalise on the North's tourism potential. Minister, will you provide an update on the extension of Fáilte Ireland's experience brands into the North?”
“As we mark International Day of Persons with Disabilities, let us recommit to meaningful, practical action North and South, across all sectors and all communities, to remove the barriers that hold people back and to build a truly inclusive society.”
“That includes delivering properly resourced public services; ensuring timely access to therapies, aids and community-based supports; strengthening our disability and autism strategies; tackling the disability employment gap; and ensuring accessible, safe and reliable transport and public spaces. That work and any solutions must be designed in partnership with disabled people and their advocacy groups. <BR /> <BR />Sinn Féin has consistently advocated a rights-based approach to public policy that is based on equality. Supporting disabled people properly is fundamental to building a fair, prosperous and equal society where everyone is valued and can participate fully.”
“We also know that people with disabilities are more likely to encounter obstacles when entering, remaining in or progressing in their school or workplace. The obstacles and barriers faced by disabled people are not and should not be inevitable. <BR /> <BR />We must continue to highlight the fact that having a disability does not limit a person's talent, ambition, creativity or desire to contribute meaningfully to society. The United Nations Convention on the Rights of Persons with Disabilities places a clear responsibility on public authorities to remove those barriers and to uphold the rights, independence and participation of disabled people in every aspect of life. This year's theme, "Fostering disability inclusive societies for advancing social progress", speaks directly to the work that still needs to be done.”
“I speak today in advance of the International Day of Persons with Disabilities on Wednesday 3 December, which is an important moment each year to recognise the rights, leadership and contribution of disabled people across our society. The day, which was established by the United Nations in 1992, asks us all to recommit ourselves to building a community rooted in equality, dignity and inclusion. <BR /> <BR />Across the island, many people with disabilities unfortunately continue to face barriers. In the North, we have some of the highest levels of disability. We know that those living with disabilities experience poverty at disproportionate levels and face long waiting lists for assessments and support, and we are acutely aware of the challenges that they face when navigating the social security system.”
“Minister, you said that the Back in Business scheme was introduced in 2024: are there plans to continue it next year? Over and above your proposals, what is currently being done under the current rating system to support our high-street businesses?”
“— and collaborative health interventions.”
“Evidence-based policymaking is clearly what we should all be looking to do, and the joint health data equips policymakers and politicians with the evidence that is needed to design better, targeted —”
“Our Executive could have had a much better response to COVID if we on this island had worked on an island-wide basis. That would be the case with any global pandemic. Working as such would certainly strengthen the island's ability to respond to future public health scenarios. <BR /> <BR />There was a lot of talk in the debate about the workforce and about the transient nature of people crossing the border in either direction. The data is extremely useful for giving us a clearer insight into workforce planning and how we can use it when making future policy decisions. On healthcare, for example, the data gives crucial insights into how to plan staffing needs for primary care in hospitals, mental health services and community care. <BR /> <BR />I am a politician who wants to make decisions that improve people's lives.”
“I absolutely agree with those comments. Both health systems need to be improved, but it is clear, as was pointed out, that the South is currently ahead of us. It is ahead of us in life expectancy. Who does not want to live longer? It is ahead of us in addressing health inequalities and tackling waiting lists. Who does not want those particular problems to be solved? We know that we have particular challenges here. As my colleague said, the issues are not confined to one jurisdiction. The data that we have in front of us reflects the lived experience of people across this island, so it is not just about joining two systems together but about creating a better system. <BR /> <BR />We had a Matter of the Day earlier about the Executive's response to COVID.”
“The publication identifies challenges. My colleague Emma Sheerin said that we are talking not just about pinning the North's health service on to the Twenty-six Counties but about creating a genuinely improved all-island health service, just as we are talking about improving education, the economy, the environment and all other aspects.”
“It allows us to understand patterns of illness, disability, chronic conditions, caring responsibilities and age-related health pressures in a way that transcends any border.”