Mike Nesbitt
Strangford · Ulster Unionist Party · Northern Ireland
“Think public service, wisdom, generosity and courtesy. Think integrity, insight and curiosity, the lack of which is a key criticism of the two public inquiry reports of recent days.”
“I spoke during Members' statements earlier about the untimely passing of the Western Trust's chair, Dr Tom Frawley CBE. I repeat my condolences to his family, his friends and his many admirers.”
“I absolutely share the Member's ambition to see people living in the community. The trusts provide a range of evidence-informed programmes for individuals who are awaiting assessment. For children and young people, early intervention teams deliver proactive needs-led programmes that are neurodiversity-affirming and trauma-informed.”
“Thank you, Mr Speaker. The Western Trust has assured me that it has undertaken a comprehensive early engagement exercise with stakeholders, involving all political parties, local businesses, service users, community groups, the Patient and Client Council (PCC), local media, community planning partners and Departments, including mine and D…”
“The role played by social workers in delivering safeguarding and family support interventions is complex and challenging. The work frequently pivots on multidisciplinary collaboration, with parents and carers positioned as partners in the formulation and delivery of safeguarding and support plans.”
“I fully recognise the impact of the current delays on individuals and families. The situation has arisen due to a combination of factors, including funding that falls short of objectively assessed need and previously missed opportunities to reform health and social care delivery.”
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“I assure Members that I have relayed to my Department the urgency at which progress must be made. <BR /> <BR />We are in only the foothills of what will be a long, uphill trek. It is long past time we began. I am very pleased to be the Minister to make this start, but it will require future Ministers, Executives and Assemblies to maintain the course. I commend the statement to the House.”
“The second phase will see the geographical scope of the scheme extended to all European Union countries. By opening up the scheme to the EU, patients will have a greater range of providers to choose from. I want to ensure that the scheme targets the patients who have been waiting a long time for their treatment. Therefore, in line with the strategic direction to target long waiters, patients will be able to access the reimbursement scheme if they have waited on an HSC treatment waiting list for two years or more. <BR /> <BR />I hope that the Assembly will enthusiastically support my focus on the longest waits and on delayed treatment for our youngest in society. The statement is the first in a series of announcements. As I have said, an implementation plan will follow later this month.”
“Building our workforce and the infrastructure required to sustainably reduce our lists will take a collective effort. <BR /> <BR />I also plan to establish a waiting list reduction reimbursement scheme. I know how important it is to have the scheme up and running as quickly as possible. For that reason, the scheme will be initiated on a phased approach. An initial £10 million will be invested. The scheme will commence in June 2025. It will give patients who are ordinarily resident in Northern Ireland and are on an HSC treatment waiting list the option to seek and pay for treatment in the private sector and have the cost reimbursed up to the cost of the treatment by the HSC in Northern Ireland. The first phase will allow reimbursements for treatment in the Republic of Ireland.”
“<BR /> <BR />While improvements in efficiency and productivity have been made by trusts in recent years, there remains scope to secure further gains by optimising the resource available to trusts. It is imperative that trusts ensure that appropriate focus is given to deliver service improvements, with implementation of good practice across the patient pathway to help to drive improved quality, equity and efficiency. An expansion of pre-operative assessment capacity to ensure that patients are fit and ready for treatment will be another important area for investment. <BR /> <BR />I remind Members that investment at this level will need to be sustained for at least five years to bring hospital waiting times down to acceptable levels.”
“In that context, work is under way by my Department to deliver a £500,000 waiting well programme to support those on waiting lists and a £1 million cancer charities programme to deliver cancer work in the community to reduce pressures on statutory services. <BR /> <BR />Addressing the current waiting times and the associated capacity gap will also require an increased focus on demand management and an expansion of core capacity, coupled with an increase in productivity and efficiency. My Department will work across the primary and secondary care interface to ensure that patients are being managed in the most appropriate setting and that capacity is being expanded on a sustainable basis across the HSC.”
“Funding will also be targeted at specialist procedures where there are long waits impacting particularly on women and children. This will include women waiting on gynaecology mesh removal procedures and children waiting for procedures such as percutaneous endoscopic gastrostomy (PEG) tube fitting, squints and scoliosis procedures. <BR /> <BR />The role of the voluntary sector in healthcare cannot be overstated, and I am pleased that there is already a strong partnership between the sector and my Department. It is something that I am keen to expand and build on further to promote and develop initiatives that provide support to those on waiting lists.”
“I also intend to expand primary care elective services where there are long waiting times for assessment in areas such as dermatology, minor surgery and gynaecology. It is estimated that £2·9 million would allow the service to see and treat approximately 16,500 patients this financial year. <BR /> <BR />In addition, I have decided to allocate £10 million towards mega-clinics to help an estimated 20,000 additional patients. As Members are aware, mega-clinics provide groups of patients with a one-stop shop that can involve, for example, surgical review and anaesthetic preoperative assessment in a single appointment. Other initiatives for the year ahead involve targeting long waits of four years or more, including hip, knee and other orthopaedic treatments, tonsillectomies, hernia treatment, gallbladder removal and colonoscopy.”
“<BR /> <BR />On the waiting-list backlog, our first step on the journey will be a focus on our current waits of over four years for assessment and treatment. Building the workforce and infrastructure required to sustainably reduce the time that patients wait will take time, and, clearly, independent sector capacity will be required to help in that regard. The HSC will need to be sufficiently agile to allow the timely issue of contracts to existing and new independent sector providers. Partnership working with the independent sector will include outsourcing to their facilities and expansion of insourcing contracts across a number of general specialties, including ophthalmology, cataracts, orthopaedics, general surgery, gynaecology and ENT.”
“<BR /> <BR />With so many patients waiting for so long, I have told my Department that I want every single opportunity and inch of capacity to be utilised. Given the current significant levels of waiting-list initiative spend on endoscopy and diagnostic imaging, Health and Social Care core capacity in those areas will be expanded in the first instance, with further investment in other areas including urology, breast surgery, dermatology and cardiac surgery. <BR /> <BR />Other areas where capacity will be expanded include trauma services. Expanding trauma capacity will improve performance against the 48-hour hip fracture target and the seven-day access target for all other fractures. Increasing trauma capacity should have a benefit for orthopaedic capacity, as one is often offset against the other in crisis.”
“<BR /> <BR />In general, we will invest across three areas: red-flag and time-critical services, capacity building and backlog clearance. For red-flag and time-critical treatments, investment will be made to expand core capacity across a number of high-risk specialties. That will help make those services more sustainable and reduce reliance on the independent sector. For capacity building, the initial focus will be on areas where the infrastructure is already in place so that we can utilise all available resources — for example, uncommissioned theatres or unused scanning sessions. Significant reforms and improvements have already been made in recent years on the development of elective care centres right across Northern Ireland, and I expect that this investment will further accelerate that.”
“Let me make this clear: I fully support the Executive's decision to prioritise waiting lists. It provides a sharper focus that is targeted in a way to have an effective impact on waiting lists. It would have been preferable, of course, to do that through additional funding and in a much more strategic and planned manner, but we are where we are. The statement is about setting an outline for the actions that we are proposing. I know that Members will rightly want more details on cost projections, outcomes for patients and timetables. More detail will be provided later this month in an implementation plan for my Department's elective care framework. However, I know that there is significant interest already, among not only MLAs but patients, and that is why I make the statement today ahead of the publication of that implementation plan.”
“To be clear, the vast majority of the £215 million investment is not new or additional investment; instead, there is £50 million of additional allocation to the Health budget, and that £50 million is very welcome. However, the remaining £165 million has had to be found from within the existing allocation, and that will have unavoidable consequences for wider Health and Social Care (HSC) provision and, I must be honest, my ability to fund reform and balance the Department of Health's budget by 31 March next. However, as that was an Executive-wide decision, I hope to get the support of my Executive colleagues in managing the challenge. <BR /> <BR />In the coming weeks, my Department will publish detailed plans and assessments on the financial pressures this year and the measures that will need to be taken in the short and medium terms.”
“<BR /> <BR />It is in that context that today I announce a series of initiatives to reduce waiting times. The central focus of the plans is on reducing the long waits for care and treatment that affect all of us in Northern Ireland. We could devote time and energy today to discussing how we got here, with roots stemming from a series of decisions taken over a decade ago, but, as I have said previously, that will not improve the outcome for a single patient, so let us instead focus on the future. <BR /> <BR />While the budget for this year remains under extreme constraint, today's announcement reflects the Executive's ring-fencing of up to £215 million in this year's Budget for waiting list activities. I welcome the investment, not least because I and my immediate predecessor repeatedly called for it for over a year.”
“A genuine desire to improve that situation was one of the motivating factors for the MLAs whom I represent as a party to take up the challenge of coming back into the Department. <BR /> <BR />When I took up the office of Minister of Health just over 11 months ago, I stated that tackling the waiting lists would be one of my main areas of focus. I have been clear to Executive colleagues that dealing with the backlog will take unprecedented levels of intervention, action, support, investment and time. The plan to tackle our elective care waiting lists is the elective care framework that was updated and published again in May last year. It outlines how we need to invest in capacity building and take action to clear the backlog of patients.”
“Members may be aware that I have already put on record my analysis of my Department's budget, which is that it represents a quadruple challenge. Those are, first, to spend the money wisely on waiting lists; secondly, to mitigate the damage to other services from the Executive's decision to ring-fence £165 million of the existing budget for waiting lists; thirdly, to press on with the reform of healthcare delivery; and fourthly, to balance the books. <BR /> <BR />Today, I will put a primary focus is on the first challenge. I am sure that every Member agrees that we need to bring a sense of urgency to tackling the unacceptable waiting lists across a number of specialities. Far too many patients are waiting far too long for assessment and treatment right across Northern Ireland. Our waiting lists are truly appalling.”
“The plan should provide equitable, sustainable and affordable access to the technology, targeted to optimise outcomes for those who are most likely to benefit from it. I have to put in the proviso, as always, that additional investment will be required for the devices and for the workforce. England has outlined a five-year implementation plan; in Northern Ireland, I am keen to emulate that in terms of the priority groups and the roll-out schedule, and I hope that that will be published in the near future. I hope that that gives some assurance to Members on this important issue, about which they are rightly passionate.”
“That is being finalised, and it outlines an appropriate timescale for roll-out. I hope to have that as soon as possible.”
“As Órlaithí Flynn pointed out, I am not particularly drawn to high-input plans but rather action plans for how we are going to deliver. She is quite right, but I assure Mr McGuigan that I am not envisaging any sort of cliff edge come 2026. I want us to focus particularly on two key developments: one is joining the national audit — I addressed that in my remarks already — and the other is a focus on that hybrid closed-loop system. Similar to the other UK nations, work has been taking place to develop an implementation plan in Northern Ireland. I hope that Members will understand that the establishment of any new clinical service to the required standards takes time. I have, however, recently supported the establishment of a clinical working group that will work with stakeholders across the trusts to develop that implementation plan.”
“That will support the integration of continuous glucose monitoring technologies into diabetes care, and updated information will be communicated to all stakeholders. <BR /> <BR />The critical role of our diabetes specialist healthcare professionals was recognised in the diabetes programme of care strategic workforce review, which was led by the Public Health Agency (PHA) and commissioned by my Department. That review was the first multidisciplinary workforce review to be undertaken and was a recommendation in the framework. Now in the final stages of completion, it will inform our workforce planning needs, ensuring equitable access to specialist diabetes professionals right across the region. <BR /> <BR />The Chair of the Health Committee mentioned the fact that the strategy expires in 2026.”
“The NICE hybrid closed-loop systems guidance states that the support of a trained multidisciplinary team that is experienced in insulin pumps and continuous glucose monitoring is required. <BR /> <BR />In addition, the role of peer support is also to be considered. The importance of peer support has been a recurring theme throughout the conversations that have taken place on the different aspects of diabetes treatment and care. Sharing a lived experience, providing or receiving support from like-minded people or being able to talk with somebody who is going through a similar situation or has lived through it are empowering tools. The trained multidisciplinary team in the regional insulin pump service will enable the implementation plan, once approved, to be taken forward, although additional capacity will be required.”
“Following the endorsement of the National Institute for Health and Care Excellence's TA943, which is the provision that relates to hybrid closed-loop systems for managing blood glucose levels in type 1 diabetes, my Department has requested that work be undertaken to understand the implications, and an implementation plan is being drafted. <BR /> <BR />Funding is, of course, required for devices in addition to recruiting and upskilling the workforce that is needed to offer hybrid closed-loop systems safely, effectively, equitably and sustainably across the region. Therefore, given the scale of investment that is needed, financial requirements are also being considered.”
“A regional multidisciplinary team delivers the insulin pump pathway, connecting with local trusts and providing a high-quality service. In year 1, the service began a rebalancing exercise across the region, directly supporting the ambition of equity as the chief priority. <BR /> <BR />People who are living with diabetes and who were involved in the co-design of the regional insulin pump service reflected the need for quality of life to be a key indicator. Centrally, quality of life is a key consideration in pump decision-making; that is, clinical consideration of where provision would significantly improve quality of life for the person who is living with diabetes. The acceptance of that recommendation made Northern Ireland the first region among the four nations to use quality of life as a criterion.”
“That investment made provision for pump devices and the specialist workforce that is required to support people who are living with type 1 diabetes to receive insulin pump therapy. <BR /> <BR />The aim of the regional service is to improve the lives of people who are living with type 1 diabetes. The regional pump service was co-produced by people who are living with diabetes alongside clinicians and healthcare professionals across all trusts and Diabetes UK. The goal is to provide equity, reduce variability and enhance outcomes for people who are living with diabetes. The service has established clear regional guidance and protocols in line with NICE and the Association of British Clinical Diabetologists (ABCD). Following a formal commissioning process, the Belfast Trust was selected to deliver the service.”
“<BR /> <BR />All currently available data on diabetes prevalence, treatment and care has been collated and reviewed in the development of the regional integrated pathway for diabetes. That was co-produced with stakeholders, including people with lived experience. Another key service development that has taken place in the last few years under that network and in line with the framework is the regional insulin pump service. In January 2022, former Health Minister Swann formally announced the setting up of the regional insulin pump service to mark the 100th anniversary of the use of insulin to treat diabetes. That announcement, which was supported by £2 million of funding from my Department, enabled that life-changing service to be established.”
“That will support participation in the National Diabetes Audit in the future. <BR /> <BR />Mr Dickson asked for a timeline. I can tell him that the two trusts that are currently not on Encompass will be on it on 8 May. Therefore, in just 10 days' time, all five trusts will be on it. There will need to be a period of embedding and validation. I am not entirely convinced that that will be done as quickly as it might be, but I certainly think that, within this calendar year, at the very outside, we should be harvesting the data that allows us to join that National Diabetes Audit. I make a commitment to the House to come back if there is any hint of a delay on that front.”
“However, I have outlined examples of ongoing work in the nine years since the implementation of the framework that is directly improving treatment and care for people living with diabetes, improving their quality of life and their future health outcomes. <BR /> <BR />The Department of Health remains committed to working towards participation in the National Diabetes Audit, as stated in that framework. However, there have been significant challenges in progressing that recommendation: the infrastructure required to participate fully in the audit is not currently in place. However, with the full implementation of Encompass, which is being rolled out across all the health and social care trusts, the provision of data that is available and extractable for the region will become apparent.”
“<BR /> <BR />The commissioning of young adult transition coordinator posts in each trust supports young people living with diabetes, ensuring that they have a clearly defined pathway of transition and providing a supportive, smooth and seamless transition to adult services. <BR /> <BR />I assume that everybody here acknowledges the fragile health ecosystem in which we find ourselves. Today, however, we recognise what can be achieved when the parts of the system work together to support a common vision. I recognise that diabetes prevalence is rising in Northern Ireland, as it is in other nations.”
“In response, working with key stakeholders, a regionally agreed young adults transition pathway for type 1 diabetes has been developed. Consisting of three stages, it facilitates the smooth movement of children and young adults from paediatric services to adult services for their treatment and care. The paediatric preparation element is the first stage of the pathway, followed by the active progression stage, with stage 3 focusing on the provision of young adult services. The pathway supports and enables Health and Social Care trust clinical teams to identify young adults who should attend and the right time for them to attend. That identification is based on the young person's need as well on as their physical development, emotional maturity, local circumstances and all other relevant factors, so it is not based solely on age.”
“One of the specific priorities identified within this theme is the:”
“The CHOICE programme is specifically for children, young people and their families or carers. It aims to provide the skills and knowledge that they need to manage their diabetes and reduce the impact of the condition on daily activities and lifestyle. The delivery of those programmes across Northern Ireland is crucial in providing people living with diabetes and their carers with the knowledge and skills needed to manage the condition effectively, supporting self-management and empowering individuals. <BR /> <BR />Key theme 5 of the diabetes strategic framework is:”
“<BR /> <BR />There are three agreed and quality-assured structured education programmes for Northern Ireland that are consistent with NICE criteria: the dose adjustment for normal eating (DAFNE) programme, the diabetes education and self-management for ongoing and newly diagnosed (DESMOND) programme and the CHOICE programme. I am sure that Health Committee members in particular are aware that the HSC loves a good acronym. DAFNE is a way of managing type 1 diabetes. Specifically for adults, it provides the skills necessary to estimate the carbohydrates in each meal and inject, therefore, the right dose of insulin. DESMOND is an NHS organisation that helps to deliver high-quality patient education to people with type 2 diabetes and those who are at risk of the condition.”
“That structured education has been developed for people who are living with diabetes and meets nationally agreed criteria as defined by NICE, the National Institute for Health and Care Excellence. It has an evidence-based curriculum, which has quality-assured teaching standards and a regular audit. The aim of structured education is to improve the knowledge, skills and confidence of those who are living with diabetes. That, in turn, enables people with diabetes to take increasing control of their own condition and develop effective self-management in their daily lives.”
“The number of people who are living with diabetes continues to grow, and, as Members have noted, almost 115,000 people here live with diabetes. Through the valuable contribution of lived experience and the clinical insights and commitment of healthcare professionals in the context of local and national best practice, the network has delivered a service model that will enable people who are living with diabetes to receive the right support in the right place at the right time under the right healthcare professional. <BR /> <BR />Another key driver for change that is set out in the strategic framework is supporting self-management — empowering people through structured diabetes education.”
“When I say "integrated", I mean regionally standardised services, and I acknowledge that, as raised by the proposer of the motion, that is not always the case with diabetes care. The role of people who are living with diabetes as service users, sharing lived experience, has set the direction of the network's efforts to improve treatment and care. Indeed, in the setting up of the network, provision was made for a collective leadership platform to support real change in improving outcomes for people who are living with diabetes. <BR /> <BR />That is the ethos under which the network has been working over recent years in the development of a regional integrated pathway. That pathway aligns primary and secondary care through the creation of a community care model for type 2 diabetes. The process has not been easy.”
“Deputy Speaker, thank you. I acknowledge some of the points and questions that have been raised by Members, including Mr Dickson, and will attempt to get as close as I can to providing a definitive answer to them over the next few minutes. <BR /> <BR />I start by taking you back to 2016, when the Department launched the diabetes strategic framework. The Diabetes Network was established under the 'Health and Wellbeing 2026: Delivering Together' plan to deliver against the framework, with the aim of transforming diabetes treatment and care across Northern Ireland. The network has been working alongside partners, locally and nationally, including Diabetes UK, and with people who are living with diabetes to achieve that goal. One of the key drivers for change is a partnership approach to service transformation. It states:”
“Equally, I note the words of Mags McGuckin, that tireless and fearless campaigner with Survivors and Victims of Institutional Abuse (SAVIA), who clearly focused more on the institution of the Church than on the individual. <BR /> <BR />It has been said many times in the past week or so that Pope Francis was a disruptor. His life, funeral and burial as the Pope are a clear demonstration of that. As we wait to see what follows, I wish the conclave wisdom when it meets.”
“It would be wrong not to touch on historical institutional and clerical abuse. I acknowledge Pope Francis's personal engagement on the issue. He met victims and survivors on his visit to this island in 2018. Father Timothy Bartlett, who had a key role in planning that visit, spoke last week about a flight from the shrine at Knock to the Mass at Phoenix Park, during which Pope Francis asked for some paper to write notes. I can do no better than quote Father Bartlett, who said that that "penitential act" was:”
“He arrived at the White House in the smallest of small black cars. There was no motorcade. There were no trappings of an international leader, and he eschewed the trappings that are so embraced by just national leaders. At the White House, he met President Obama, who praised his humility, simplicity, gentleness and generosity of spirit. The president told the Pope that he saw a leader whose moral authority came through not just words but deeds. I do not know about you, Mr Speaker, but that is a lesson for me. Pope Francis set the bar very high.”
“Members will be aware that I am not a member of the Catholic Church, but I do not think that that is any barrier to recognising that, for so many in this country, on this island and, indeed, around the world, Pope Francis was both a cherished leader and an inspiration. For the avoidance of doubt, I should not in any way be considered any sort of expert on religion, so I will refrain from commenting on Pope Francis's theology and, rather, focus on the man. <BR /> <BR />It goes without saying that every Pope is consequential globally, but few, if any, have been as universally appealing as Pope Francis — John Paul II, perhaps, but, to me, Francis was different again because of his values. He first struck me as somebody different and somebody special on his visit to the United States in 2015.”
“There is no doubt that progress has been made, in the trusts and regionally, but I want to be the first to acknowledge that the pace of change is not fast enough. We are constrained by workforce availability, infrastructure limitations and funding pressures: that is not an excuse, but it is the situation that we are in. I repeat my determination to the House and the families that I will do all that I can to make things better.”
“Progress on a refreshed service model for adult learning disability has been slower than anticipated due to the impact of other priorities. Officials have now, however, commissioned additional support from the HSC Leadership Centre that will accelerate that work. Our goal is to move towards public consultation as quickly as possible, with a view to implementing a service model that better meets the needs of adults and their families.”
“Without closing the gap in residential care placements, however, short-break services will continue to be diverted during periods of crisis; that, I am afraid, is inevitable. To deliver sustainable, meaningful change, we must invest in modern, fit-for-purpose buildings, a well-trained, supported and motivated workforce and long-term funding solutions that give trusts the stability that they need to plan and deliver services effectively. Those things cannot be done quickly. <BR /> <BR />I will speak briefly about adults with learning difficulties. While I am assured that most services function as intended, we know that there is room for improvement. Many families continue to rely on that support to manage the demands of caring for adult relatives who have complex needs.”
“That is why we are progressing a new regional framework for children with disabilities that aligns with the findings of the Ray Jones review and reflects the evolving and increasingly complex needs of children with autism, learning disabilities and additional needs. The aim of the framework is to improve the current offer of early help and community-based support; develop additional effective residential short breaks and short-break fostering; rethink our approach to residential provision and out-of-home placements; and improve transition pathways into adulthood. <BR /> <BR />The £13·1 million of additional funding is helping to stabilise services by creating new beds, restoring lost provision and expanding community supports.”
“Mr Mathison and Mr McMurray raised the issue of what some people have said and the tone in which they have addressed some of the families. That was discussed and acknowledged by senior figures in the South Eastern Trust, so I expect to see significant positive change in future engagements. Further work, particularly on the pace of change, is needed, however. I am pleased to say that there will be an oversight panel that will be tasked with supporting, monitoring and challenging — the challenge factor will be important — the remobilisation of short-break services. <BR /> <BR />As I said, the issues are not unique to the South Eastern Trust. Across the country, families feel the strain and the pain of inadequate provision.”
“That is the issue, but I take exception to your use of the term "blocking". That person is a service user who needs help. <BR /> <BR />Last week, I again met the families featured in the 'Spotlight' programme. Also at the meeting were senior officials from the Belfast Trust and the South Eastern Trust. The families have shown immense courage and persistence in advocating change not just for themselves but for other families. I have met them on several occasions, but, in a way, I am meeting them too often: it would be better if we did not need to meet, because that would mean that their needs had been met. <BR /> <BR />The discussion was honest and constructive, because it was about culture and communication.”
“That provides community-based support during evenings and weekends. Once it is fully implemented, the service will provide day breaks for 80 to 85 children who are on the waiting list. Learning disability nurses will be key to supporting the complex healthcare needs of those children during outreach. I give way briefly.”
“Alongside its residential provision, the trust is scaling up the LynC Outreach service.”
“The target date for this is September, though it depends on the successful completion of key interdependent actions. Minor capital works are in progress at Redwood to ensure that it can safely and appropriately accommodate children, and I am encouraged that all posts at Redwood were filled in one day at a recruitment event in March, which reflects a strong commitment from staff. Plans are in place to expand Greenhill's operation from three to five nights a week. That will require further recruitment, and that is scheduled to take place next month. <BR /> <BR />Mr Honeyford asked for a guarantee on the Woodlawn facility: I cannot give a guarantee. The system is so fragile that, if one new child presents, the plans need to be redrawn. Miss McAllister talked about bureaucracy, but it is about safety.”
“As of now, 85 children are on the waiting list for short breaks, and families, I understand, are under immense and sustained pressure. Much of the reduction in provision stems from the repurposing of Lindsay House, a dedicated seven-day short-break facility, which has been redirected to care for children entering the care system. That was a decision made out of necessity, but it impacts profoundly on children with disabilities and their families. <BR /> <BR />To address that, £2·4 million in annual recurrent funding has been allocated specifically to the South Eastern Trust to restore and expand respite services for children with disabilities. Several important actions are already under way. Re-mobilising Lindsay House by relocating children currently in care to Redwood Children's Home will free up much-needed short-break capacity.”
“In October, as Members have said, I committed an additional £13·1 million of recurrent funding to help address the challenges. That has allowed us to start that acceleration work in the Department and across trusts, expanding capacity and trying to reform our delivery models. <BR /> <BR />I take the opportunity to provide an update on the South Eastern Trust and to outline our regional response and share how we are working with the families highlighted in that programme. I will also briefly touch on adult respite services, which remain a key part of the overall strategy. <BR /> <BR />The current position in the South Eastern Trust is deeply concerning. There are just two operational respite beds at Greenhill, and they are available only three nights a week. It is not enough.”