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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“It reminded me of the scale of the problem and the fact that, if we can tackle it as a community, we have a chance. <BR /> <BR />It seems to me that, if we really want to make a difference, there are three things that we need to do. First, we need to raise awareness, and, once again, I thank Members for using the debate to raise awareness. Secondly, we need agreement on how to cure the problem or, at least, how to address it and take a bite out of it. Thirdly, we need to devise a policy with a fully funded and resourced action plan that gives meaning to our determination to cure or tackle the problem. If we can do all three things, we will achieve better outcomes, and, if we achieve better outcomes, we will offer hope. Hope, for me, is success.”
“I have also felt that, for a long time, societal interventions, empowering communities to understand the members of that community, to spot when they are not as they should be and to know how to intervene are important. <BR /> <BR />Órlaithí Flynn mentioned Christmas trees. I am a member of the Ards suicide awareness group, which I helped to set up a few years ago, and, last Christmas, we put a tree in Tesco on the Castlebawn Road in Newtownards. On the table, there were a lot of blank cards, and I sat one afternoon and watched individuals and families lift one of the cards, write a note on it and put it on the tree. There was a shockingly high number of people. For them, the importance of that simple gesture was exponential. It was out of kilter.”
“<BR /> <BR />The action plan highlighted a new strategic action area around a whole-of-government-and-society approach. As I bring my remarks towards a close, I want to talk about the need for a societal approach. Mrs Dodds asked me to comment on prescribing rates. They are shocking, and that is a sign — a symptom, perhaps — of the fact that, to some extent, we over-medicalise how we approach mental ill health. Pills and medication have their place, but so do societal interventions. For example, a community psychiatric nurse sitting in somebody's kitchen, offering the human touch and saying, "Let's go on this journey together. I'll walk with you. I know how to get you to a better place", is important.”
“They include Towards Zero Suicide, the multi-agency triage team collaboration between Health and Social Care (HSC) and the police; resilience building; counselling provision; the self-harm intervention programme; the "Flourish" church suicide prevention initiative; and Lifeline, to name but a few. We have undertaken extensive research and engagement to better shape the future of suicide prevention service delivery here. A review of Protect Life 2 has just been completed and is now available on the departmental website. That review has highlighted the need for a more focused and measurable action plan. To achieve that, work is well under way on revising the action plan in line with that report and to develop a new three-year delivery plan. That will set out the detail of how we will deliver actions and the targets that we wish to achieve.”
“I thank the Member for the intervention. I am in favour of Departments offering suicide prevention training. I pause at the idea of making it compulsory for every member of front-line staff, however, given that that person may have had experience in their family or community circles. I think, Principal Deputy Speaker, that the Member is sympathetic to that. I pay tribute to the Member, because, through chairing the all-party group on suicide prevention, her work on understanding and promotion is absolutely exemplary not just on this issue but on cross-party and cross-community cooperation. I commend the Member for that. <BR /> <BR />I go back to Protect Life 2, which contains a number of programmes designed to prevent suicide.”
“I absolutely will give way to the Member.”
“That is aimed at increasing awareness of mental health as a significant public health issue in Northern Ireland and preparing officers to deal with the sometimes challenging incidents that they encounter where no crime has been committed but an individual is experiencing a mental health or emotional crisis. The PSNI already trains all student officers in suicide prevention rather than in just suicide awareness. Some Members will be aware that the Chief Constable, Jon Boutcher, intends to introduce a policy called "Right care, right person" (RCRP) in recognition of the fact that police officers are not fully trained to deal with all mental health issues. I look forward to working with the PSNI to determine the best way to roll out the "Right care, right person" policy.”
“Much excellent work is already being taken forward with other Departments, and I will take the opportunity to highlight some of it. For example, the Department for Communities has rolled out a mental health first aid pilot scheme across the Department. DFC has also ensured that suicide prevention training is mandatory for all front-line staff, and it has a six-point plan for managing suicide and self-harm declarations that are received from claimants, whether that is in person, in a phone call, in writing or via electronic media. The Department of Justice supports suicide prevention efforts through the PSNI's contribution to the multi-agency triage team. The PSNI has also developed an online mental health lesson plan for police officers.”
“The advantage of the wider group that I am talking about would be that the societal determinants of mental health are the same as those for physical health outcomes, including individuals' experiences in early years, education, housing, employment opportunities, the physical environment and exposure to pollutants, and access to a healthy diet. It is essential to address those social determinants in order to improve the physical and mental health outcomes of our population. The group will also ensure that there is greater synchronicity across strategies, given the close linkages between mental health, physical health, substance abuse and suicide prevention. <BR /> <BR />While suicide prevention is not explicitly mentioned in the draft Programme for Government, I always welcome the opportunity to work with other Departments in that area.”
“Some Members mentioned my commitment to tackling public health, including by tackling health inequalities, and I believe that that broader focus will help to address the wider social determinants that are linked with poor mental and physical health. On that basis, I affirm that I am a fan of Professor Michael Marmot, a man who talks about not just the causes of ill health but the causes of the causes. For example, we know that smoking causes cancer, but what causes people to smoke in the first place? That, I think, is how we unlock better outcomes for people.”
“<BR /> <BR />It is widely acknowledged that many factors can impact on suicide — for example, financial difficulties, poor employment or a lack of housing opportunities — and the Executive group affords important opportunities for Ministers to hear at first hand from stakeholders about the impact of suicide and about exactly what is needed to improve outcomes and to prevent suicide and self-harm. The group also provides a forum for Ministers to hear about some of the great work being done in our communities, and I think that working in the communities is the key to better outcomes. <BR /> <BR />I have agreed that the group should be reformed, and we could usefully discuss having a wider remit to focus not just on mental well-being and suicide prevention but on the wider public health aspect.”
“The leader of the Opposition and Members will be aware of the Executive working group on mental well-being, resilience and suicide prevention, which Mr Middleton wanted me to refer to. The group plays an important role in ensuring that all Executive Ministers are informed of and involved in the governance of the Protect Life 2 strategy. The group was established in recognition of the fact that suicide is a societal issue and that it cannot be solved by the Department of Health alone but requires efforts across all sections of society. It requires each Executive Department to recognise and step up to the fact that it has a critical role to play.”
“Again, that shows that, in Ema Cubitt, we have an independent person at work, and I really welcome that. <BR /> <BR />The strategy on suicide prevention has 10 objectives that I hope will achieve better outcomes. The first has great significance to today's motion. It seeks to:”
“Of course, when the strategy was first published, it envisaged much greater investment and Executive-wide buy-in than has actually been the case. I have to say that, when it comes to those who supported the Budget, the irony klaxon has not been silent during this debate. <BR /> <BR />Mrs Dodds referred to the mental health champion expressing her disappointment at the allocation, and I really welcome the fact that Professor Siobhán O'Neill made those comments and made them so explicitly and so publicly, because having a mental health champion — an independent assessor — was my idea. The fact that she can make those remarks proves that she is an independent assessor. Indeed, more recently, I appointed an independent autism reviewer, and Members will recall her remarks from last week.”
“I thank the Member for his intervention. I am on record many, many, many times saying that, if you take a map of Northern Ireland and put on that map the hotspots of the Troubles measured by shootings, bombings and murders and then superimpose a contemporaneous map of mental health issues — completed and attempted suicides, drug and alcohol abuse etc — you will have a match. I mean somewhere like north Belfast, to pick one area, so, yes, the Member's point is well made. <BR /> <BR />The Protect Life 2 strategy was launched on World Suicide Prevention Day, 10 September, back in 2019, and it has now been extended to 2027. At least £12 million is spent annually on suicide prevention in Northern Ireland, and the strategy is also supported by activities in the mental health strategy.”
“<BR /> <BR />I believe, because the experts have told me, that every suicide is preventable right up to the moment when it takes place. As is often said, suicide tends to be a permanent solution to what is often a very temporary problem, emotion, feeling or set of circumstances.”
“That took me back to a meeting that Órlaithí Flynn chaired with the all-party group in Derry/Londonderry at, I think, the Magee campus of Ulster University when Protect Life 2 had just been published. We were debating the policy and the idea that the target was to reduce the number of suicides by 10%. We thought, "Gosh, that's not very ambitious". To be fair to officials, that is internationally based by, I think, the World Health Organization. It is a practical, achievable target, but we all agreed that it was not a target to be celebrated if we achieved it. None of us wants to go to one of the families that continue to lose loved ones through suicide and say, "Haven't we done well by reducing the rate by 10%?", because, for them, the loss is 100%. So, crudely, one suicide is one too many.”
“Madam Principal Deputy Speaker, thank you very much. Thank you, too, to the movers of the motion and the amendment. <BR /> <BR />Mr McGrath, the mover of the motion, began by reminding us that we have lost more of our fellow citizens to suicide than we did during the course of what we euphemistically call our Troubles. I remember making that point a few years ago on a live debate on BBC Radio Ulster, and the host reacted as if he had been given an electric shock. We are talking about a very well-researched journalist. The point about that is that there is a lot more that we have to do in raising awareness, and to the extent to which this debate raises awareness of suicide and poor mental health, so much the better. <BR /> <BR />Mr Carroll asked whether the Protect Life 2 strategy was ambitious enough.”
“I agree with the Member. I am simply acknowledging that that needs to be worked through. <BR /> <BR />I am heartened by the tone of the debate and look forward to working with Members over the next three years to deliver better outcomes.”
“That is how we deliver better outcomes, saving money, saving the health and social care system and saving lives. I will shortly launch a public consultation on the hospital reconfiguration framework: 'Towards a Northern Ireland hospital network'. I understand that, like politics, all healthcare delivery is local. However, healthcare has made magnificent advances. If I need a procedure that my local facility delivers once a day but I could travel a lot further to a facility that does it 10 times a day, five days a week, I know where I would want to go for that procedure. To be honest, we have to acknowledge that there is a tension between community consultation, co-design and co-production; MLAs' natural desire to preserve and promote local services; and clinical advice. We have to acknowledge that tension and work to overcome it.”
“One of my first actions as Minister was to meet the professor on a Zoom call and ask him whether he would travel back to Northern Ireland for one day, not to rewrite his report but to reboot and remind us and share his impression of the positive international initiatives that have occurred in the past eight years. I hope that the whole of the Northern Ireland Executive will again meet the professor and endorse his views when he is here on 9 October. I expect that he will acknowledge what we have done and that the report has not gathered dust on the shelf, and I refer to some of the advances that I mentioned. <BR /> <BR />My key areas of focus for the next three years include delivering reform, tackling waiting lists, improving cancer services, addressing mental health and confronting persistent health inequalities.”
“Work continues across the system to stabilise, expand and develop the workforce and to support the more effective use of staff across different specialities. However, progress in those areas has been hampered not only by the continuing pressure on the service but by the uncertainty about funding. We used to worry about losing staff to Australia; today, we worry about losing staff to Athlone. <BR /> <BR />Turning to transformation, the motion stresses the importance of the need for:”
“Members will recall that my Department submitted a bid for some or all of that £135 million earlier this year. That included a reinstatement of a form of the cross-border reimbursement scheme, which I am regularly urged to do. In the end, not a penny of that bid was met. The irony klaxon sounds daily in departmental headquarters. <BR /> <BR />On staff, the importance of an appropriately qualified, well-equipped and fit for purpose workforce to underpin all aspects of continuity and change in service delivery cannot be overstated. This is not just about numbers. It is about different ways of working to get the best services for patients from all available resources and having the right staff with the right skills in the right place at the right time.”
“<BR /> <BR />We need a long-term collective effort, sustained and substantial investment through multi-year budgets, workforce development and system-wide transformation. Miss McAllister mentioned multi-year Budgets: it is my expectation that, when we get to the financial year 2026-27, we will finally reach the point where we will have a multi-year Budget, which, itself, will be transformational for the delivery of public services. <BR /> <BR />My Department estimates that, in addition to the £76 million that I referred to, there is a further requirement of £80 million per year to support elective care and reduce the demand/capacity gap and of another £135 million per year for up to five years to remove the waiting lists backlog and for investment across diagnostics, imaging and pathology.”
“Therefore, should the Government in London decide to invest in tackling that issue here, there will be no repercussive effect for England, Scotland or Wales. It is a population health issue only in Northern Ireland, so please be assured that I am fully committed to making the case for additional funding. <BR /> <BR />Some £76 million has been referenced as being invested this year to address waiting lists. It matches the additional investment of last year, but it is significantly less than what is required. It will be used for those with red-flag or time-critical waits: those with cancer or with life-, limb- or sight-threatening issues. The bottom line, however, is that £76 million is not sufficient to do any additional work on those waiting for long periods. It will simply help us to stand still.”
“I thank the Member for his comment and can certainly assure him that that will happen. <BR /> <BR />Miss McAllister talked about the plan for hospital reconfiguration. It is at pre-consultation stage. I have asked officials whether it would be possible to bring that plan to the House as early as Monday week, and I await their response. I am keen to do it as soon as possible, and I assure the Member that the assessment of the reconfiguration will be clinically led. <BR /> <BR />In tabling the motion, Members asked that I work with Executive colleagues to make the case for additional funding to Treasury. I have made the point to the Secretary of State for Northern Ireland, the Secretary of State for Health and Social Care in London and the Prime Minister that poor mental health and well-being is a legacy issue of our conflict.”
“We need immediate and sustained investment to secure additional capacity in the short to medium term. <BR /> <BR />The reality is that improved outcomes will be achieved only with significant recurrent investment to transform the delivery of elective care on a sustainable basis and address that gap between demand and capacity. Although the current financial position is extremely challenging, we must continue to do whatever we can with the budget available to improve the waiting list position.”
“<BR /> <BR />Notable achievements include two dedicated day procedure centres at Lagan Valley Hospital and Omagh hospital; elective overnight stay centres at Daisy Hill Hospital, the Mater Hospital and the South West Acute Hospital; the introduction of medical clinics to maximise patient throughput; the expansion of post-anaesthetic care unit beds across the region; an orthopaedic hub at Musgrave Park Hospital; two rapid diagnostic centres; and a programme of outpatient modernisation. It is important that we acknowledge and build on those improvements to ensure that that momentum is not just maintained but increased. It will only be through a continuous and sustained focus on ensuring effective implementation of all those arrangements that improvements will be secured. However, those alone will not address the backlog.”
“It is important that I make it clear, however, that delivering on that plan will require sustained investment. The scope to do that is being severely hampered by the belt-tightening constraint of the current financial environment. As always, we strive to do what we can with the limited resources that we have, and, since publication of the initial framework in June 2022, we have seen the successful implementation of initiatives that have led to benefits for patients and, as I mentioned, a small but tangible start to improvements in waiting lists.”
“It is understandable that there is a sense of urgency about the issue, but there is also a sense of frustration: deep frustration. The reality, however, is that the health and social care system is hugely complex, consisting of a wide range of varied and interdependent elements. <BR /> <BR />Members will be aware that, in May, my Department published an updated elective care framework plan. The framework built on the lessons learned from the first framework published in 2022. It sets out a clear plan to address waiting times, with a focus on areas where the impact would be the greatest: for example, areas where high volumes of patients are waiting for non-complex treatments. I am fully committed to delivering that plan and building on the good work that is already being done across Health and Social Care.”
“While I fully recognise the severity of the situation and do not want to understate it in any way, I am encouraged to note that, in overall terms, we are beginning to see small but tangible improvements to the waiting list position. At the end of March, there was a reduction in the numbers waiting for inpatient or day-case treatment for the seventh consecutive quarter, with a 14·3% decrease in the numbers waiting since the same month last year. While that is good news, it only begins to scratch the surface of the problem. Those figures are, of course, not just numbers on a page; they represent individuals, family members and friends who are often waiting in pain for life-enhancing, life-changing or life-liberating treatments.”
“At the end of March 2024, 356,000 patients were waiting for a first consultant-led outpatient appointment, 95,000 patients waiting for inpatient or day-case treatment and just under 165,000 patients waiting for a diagnostic test. Of the total number of patients waiting, almost 50,000 were waiting longer than 52 weeks for treatment. Those are eye-watering and, frankly, wholly unacceptable figures for a population of our size. <BR /> <BR />In addition to the growing backlog of patients waiting, new patients continue to be added, and, inevitably, the gap between demand and capacity exacerbates the problem and waiting lists continue to grow.”
“There are many contributing factors, not least the overall financially constrained environment but also the scale of the gap between funded health service capacity and patient demand and the residual effects of the impact of COVID-19, which had a devastatingly disruptive impact on our health and social care system. In that context, I am mindful of the fact that there was a rise in the number of people waiting for a first consultant-led outpatient appointment in the Northern, Western and Southern Trusts at the end of June. While I do not want to bombard Members with figures, it is important that I be clear about the full extent of the problem. I will therefore draw on the March 2024 statistics, which include four out of our five geographical trusts.”
“I welcome that candour and the de facto acknowledgement that the health budget passed by the Assembly is entirely inadequate. My immediate predecessor as Health Minister remarked previously on the irony of Members repeatedly demanding more investment in health, having voted for that Budget. I will not labour the point, but the irony klaxon has been sounding quite a bit in the debate. Can Members really demand more health spending when they endorsed a Budget that gave the Department of Health less than it spent last year? <BR /> <BR />We are all aware that elective care waiting times in Northern Ireland have significantly increased in recent years, and I have been clear that that is entirely unacceptable.”
“It is simply unacceptable that our waiting times lag so far behind those in the rest of the United Kingdom, and it is incumbent on me and on all of us collectively to ensure that we are doing everything in our power to address waiting times. <BR /> <BR />I do not intend to rehearse at length my position on the Budget, but suffice it to say that the Budget has imposed severe pressures on all parts of Health and Social Care. You do not have to take my word for it. The draft Programme for Government, approved by all Executive parties, explicitly states:”
“I welcome the opportunity to respond to the debate. I will outline for Members the current position on waiting times; the actions that have been taken and the ongoing actions to address the issues, including, of course, service transformation; the importance of having an appropriately qualified and structured workforce; the complexities of working in a highly financially constrained and challenging environment; and, critically, what we need to do to ensure that we can deliver effective and sustainable health and social care services for all. <BR /> <BR />At the outset, I fully acknowledge that the people of Northern Ireland are not receiving the timely and effective care that they deserve. Far too many people wait for far too long.”
“Perfect. Thank you very much, Madam Principal Deputy Speaker, and I thank the Members who tabled the motion and the amendment and everyone who contributed. It is not just an important issue; we should be really passionate about it.”
“We did not vote for the Budget in this party, and one of the reasons was that we were not going to be able to roll out the MDTs as we would wish. <BR /> <BR />Let us speak again after the debate about south Fermanagh.”
“We have daycare procedures in places such as Lagan Valley. We have elective overnight centres, such as the South West Acute Hospital, and I hope that we will develop the Causeway Hospital in the fullness of time. Things are happening. The professor is coming back — he is scheduled to be here on 9 October — to reboot that report. That is when I am going to say, "We need to finish this deal". Multidisciplinary teams clearly work. They are probably the biggest success story of recent years in transforming our health service. Seven of the 17 GP federations have MDTs. Fermanagh and South Tyrone is down to be one of the three in the next tranche, but I gently say this to the Members opposite and Mrs Erskine: you voted for the Budget.”
“To shift the budget left will require health inequalities and health literacy to be tackled, and people to be more conscious about staying healthy and not getting sick. <BR /> <BR />Deborah Erskine talked about promoting the beautiful constituency of Fermanagh and South Tyrone. Áine Murphy asked whether I would meet her to talk about problems in south Fermanagh. I most certainly will, but maybe we should do it in the beautiful constituency of Strangford. Maybe we should go down to Harrisons on Strangford lough and have a little meeting there. Other restaurants are available. <BR /> <BR />What else can I say in response? I want to talk about multidisciplinary teams. Professor Bengoa reported eight years ago. Some people think that that report went on to a shelf. It did not; we have started actioning it and shifting left.”
“<BR /> <BR />Jemma Dolan made the point that 95% of first contact is at a primary level. That is true, but it is also true that primary gets 5·4% of the total budget. I would like to see that go up really significantly. That is why I am promoting what Professor Bengoa called the "shift left". In an ideal world, if you need access to healthcare, you get it in your home, and if you cannot get it in your home, you get it as close to your home as possible in a GP surgery, a community centre or whatever. The second-worst outcome is having to go to an acute hospital. The worst outcome is having to go to an acute hospital and stay overnight. The problem with the budget is that, if you are in an acute hospital, that is where the big problems and the expensive processes to fix are.”
“In a standard week, our general medical services clinical teams carry out over 200,000 consultations, over half of which are face-to-face. I think that that maybe explains part of the pressure on access to services. I also share this with Members: according to our Business Services Organisation, we currently have 1,448 GPs, excluding locums. That is an increase over the past 10 years of just about a quarter: 22·7%. Per 100,000 registered population, we are just behind Scotland in the headcount of GPs. Scotland has 77·1 GPs per 100,000 registered population; we have 70·9 GPs, which compares really favourably, particularly with England, which has the lowest ratio at 56·4. That suggests that we should not have the problems that we are having to endure at the moment, so I am determined to work at that.”
“That will help to strengthen the service in those practices and reduce reliance on locums, which is a very expensive way of doing business. <BR /> <BR />We cannot continue with a situation where, in some instances, GPs face such sustained levels of pressure that they feel that the only course of action left open is to hand back their contact. I want to build resilience and capacity in that service. However, I am under no illusion that the new 2024-25 contract will resolve all the challenges that face GPs. The issues that are impacting general practice are complex and will require a sustained and long-term response.”
“<BR /> <BR />Officials in my Department have worked hard to ensure that, where contracts have been handed back, no practice has closed — I commend them for that — and patients have continued to access GP services in their area. Stability of services across Northern Ireland will require new ways of thinking about how our services are organised. In Fermanagh, the Western Trust is playing a leading role in promoting stability through holding the contracts for GP practices that have got into difficulty. There are three such practices in Fermanagh, and my Department is supporting the Western Trust to move towards a more sustainable model for service provision in those practices through the appointment of salaried GPs.”
“There have been too many broken promises to make a promise in the Chamber. I want to get the time frames absolutely nailed down. I promise that, when I say "imminent", I do not mean weeks and months. <BR /> <BR />I acknowledge and appreciate the need to further stabilise and bolster capacity for services in primary care more generally. I fully understand the ongoing challenges that patients and GPs along with their teams face, not least the increasing demand and resultant increasing workloads. Colm Gildernew's point about the workforce was extremely well made. When we think about health and social care, we think about buildings, equipment and medicines, but they do not matter, or they do not count, because they cannot deliver without the workforce and the people.”
“Of course I will give way to the very frustrated Member.”
“Boom. I am sorry. There is no issue that I am aware of that will delay it. It will happen. It is tied in with a couple of other announcements. They need to be tied down — the i's need to be dotted and the t's crossed — and then I will be ready to go. Imminent means imminent.”
“<BR /> <BR />You asked about the new health and care centre in Lisnaskea. That facility will support the delivery of integrated primary and community care services for the population of Lisnaskea and the surrounding area of east Fermanagh. I hope that I will not frustrate you too much when I say that the announcement is imminent.”
“I reassure you that my Department has worked and will continue to work very closely with GP representatives on how best to respond to those challenges. <BR /> <BR />As some of you will be aware, I want to make it my mission to tackle health inequalities in Northern Ireland. I have announced plans for a pilot scheme under the banner "Live Better" that is aimed at taking services right into the heart of the community and making a positive difference to people's life. I am very aware of the recent issues that were raised in the media about escalating tensions at the GP premises in Lisnaskea. Let me make this clear: that behaviour is absolutely unacceptable, and I condemn it utterly. I fully support our primary care staff and value the dedication that they show daily to those who need them.”
“Over the past three and a half months, I have had the opportunity to meet many staff working across primary care, including a number of representatives from the South West GP Federation. We are very fortunate to have such a dedicated workforce. I am very aware of the challenges that face general practice. Those are particularly felt in rural communities, because there is a feeling there of being left out of public services and investment more generally. I appreciate that some people in Fermanagh have concerns about whether they will continue to be able to access high-quality primary care in their area. Those concerns are, of course, not unique to Fermanagh, but they carry a particular weight in rural areas.”