Colin McGrath
South Down · Social Democratic and Labour Party · Northern Ireland
“Minister, regardless of where people stand on the exact figure, surely we can all agree that a health service cannot function without the doctors whom it trains.”
“Minister, climate change is happening, and extreme weather events are taking place. We saw that in Downpatrick a number of years ago when the town centre was ravaged by flooding, and it has taken the businesses affected many years to try to get over that flooding.”
“Minister, given that capital funding is, generally, being decimated, the extent of which may increase as a result of the Executive's not agreeing a Budget, what impact will that have on any final road maintenance strategy, and are any contingencies being put in place to manage that?”
“<BR /> <BR />Since March 2025, the parliamentary excellence programme has delivered dedicated sessions with the Executive Office on the strategic framework and its delivery plan, enhancing Members’ understanding of the cross-government approach and their role in scrutiny, legislation and constituency engagement.”
“<BR /> <BR />More broadly, the Assembly Commission supports Members and Committees in carrying out their scrutiny functions, including in relation to the Executive Office’s work on that framework.”
“As the Member mentioned, one example is the Assembly's Women's Caucus, which has a particular focus on supporting women in public life and highlighting the increasing challenges that women face in the digital sphere, including online abuse.”
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“I will not need it, but thank you very much, Mr Deputy Speaker. <BR /> <BR />That is the very point that I was making. Had we had a Minister in place, and had this place been up and running, we could have addressed the matter, but it was instead left to the staff to do so. Thankfully, they did the work that they had to do to turn around the figures. <BR /> <BR />It is really important to note that we can always do better. That much is clear. All of us, regardless of our age or background, want only the best for our children. We want to give them the best start that they can get in life. I spoke to health visitors about the motion, and they detailed to me the work that they do and how they are able to identify certain traits or characteristics in children during those early formative years.”
“<BR /> <BR />The proposer of the motion will undoubtedly agree that a motion could have been tabled much earlier had this place not been collapsed during the two years that we are talking about, in which time matters were at their absolute worst. We can see that it was through the resilience, determination and hard work of staff in the sector that matters were addressed. We politicians are now able to reflect on that.”
“Another point that is just as important needs to be made, however. In 2022-23, the year previous to the year that is dealt with in the motion, the number of children who were not being seen across all trusts for their year 1 health review was 33%, so we improved by 18% in 2023-24. In the Southern Trust in 2022-23, the number of children who were not being seen was a staggering 65%, so, again, we managed to improve by 19% in a year. The overall figure for year 1 health reviews across the North that were completed within the accepted time increased from 46% to 59% during the period. There is therefore improvement in the sector, but, in congratulating ourselves on that improvement, we should not overlook the fact that a massive number of children are not being seen in time.”
“In addressing the motion, it is important that I set it in the context in which we find ourselves. The motion makes the important points that the fact that 15% of children across all health trusts are not being seen by a health visitor is alarming, that the fact that that percentage rose to 46% in the Southern Trust is deeply concerning and that, yes, we:”
“Minister, would the W45 —? No, I will stick to my question. What assurances can the Minister give that resources up to and including inpatient bed facilities will be available to social workers who are undertaking Mental Health Order assessments? Will he intervene urgently to ensure that the action that NIPSA suggests that it will take from Wednesday is averted in the interests of everybody's public health?”
“The Minister previously detailed to me that, as of June 2024, there were 40 whole-time-equivalent dentists employed in hospitals across the North but just over one and a half employed in the Southern Trust. Why is there such a disparity?”
“It is part of a jigsaw puzzle of services right across the North, therefore, it would benefit people in the north-west, but it would also assist the overall network of services that are provided for everybody and would be a great addition to the help that we could provide. There is cross-party support for it here. Everybody who has spoken today has been in support of it, so I hope that that can go some way to getting it on an agenda somewhere to keep the idea alive and see if we can deliver for the people of the north-west and, ultimately, deliver for their families, friends, community and the network of service provision and others that are impacted on right across the North.”
“I appreciate that it is difficult for those who hold the purse strings to get continual asks for extra services and delivery, but it is also deeply frustrating when you think about how much money it will cost to deal with the ramifications of certain actions, illnesses, conditions and instances, whereas if we just invested the money, we would be able to save so much more money down the line. Maybe the Minister could consider the Shared Island Fund or the new transformation fund. Maybe there are ways that a centre in the north-west would save money in the long run over other services and provisions and, therefore, would be a good idea. <BR /> <BR />The Opposition wanted to have the debate for the north-west.”
“That is very disempowering, and it can be very frustrating. <BR /> <BR />We also talked about mental health and the connectivity, the dual diagnosis, between the two strands of addiction and mental health. That is a point that we continually make. I worry that, for as long as I have been here, we have been making that point, but it seems that nothing is being done about it. Maybe a nice, big, new centre in the north-west, in the Causeway Coast and Glens area, might be able to take on the dual diagnosis and become the cheerleaders and say, "What can we do to try to provide services for matters such as that?". <BR /> <BR />Another striking remark by a number of Members was that the cost of inaction is just huge.”
“That is why we want to see the development of a centre for the north-west. <BR /> <BR />It was well highlighted that the Programme for Government had no mention of addiction. It contained a list of some of the things that need to be prioritised, but it is worth noting that, while we are having a debate about addiction, there was no reference in it to that. <BR /> <BR />We also had a discussion about the ripple effect of addiction and how family, friends and people who are closest to those affected are also impacted on. Sometimes, it is the family members who feel the most helpless. They can see the person, they have love and concern for the individual, and they can see the harm that is being done, but when they try to find support, they just do not know where to go or where to start.”
“The level of deprivation that is there speaks to the reason why areas such as the north-west will have higher rates of addiction. There should be a good opportunity there to find the right support services to help people. A number of Members spoke about the various groups that are in the community, such as the Northlands centre. Nobody wants to see a replication of work that is already being done, and nobody wants to take work away from organisations in the voluntary and community sector. It is about how we can try to connect them via a hub to which we can bring people and groups together and say, "If you're going to go out and do that, here's another group that is going to go out and do something different. If nobody is going to do this, we will do it here in this centre".”
“That is why we have considered that today for the north-west and, as I will repeat for Maurice Bradley, for the Causeway Coast and Glens area. We heard that as well. <BR /> <BR />I am never a fan of picking out what individuals said, so I will reflect back what Members said, because there have been excellent contributions. We need to note them. Reference was made in the debate to the high rate of alcohol deaths. When we think of addiction, we think about drugs and often overlook the fact that alcohol causes one of the biggest addictions in our community. The fact that drug deaths are going up speaks to the sense that we need to do something about it. <BR /> <BR />As many Members referenced, deprivation is closely very connected and related to addiction.”
“Since its foundation in 1984, many thousands of people have benefited from Cuan Mhuire's services. The Friends of Ward 15 provides help and support through a community response. That centre is there and is the hub of the support. The community, including family and friends, if they are there, can come in and provide help. That is an example of how such services can ensure that the stigma that is felt by those who are suffering from addiction is removed. No more stigma should be attached to those who are seeking help. We should try to support people who need help, and we should congratulate people who seek help by saying, "Well done. You've stepped up. Here's the support services that will get you further in your journey". Such support should be available across the North.”
“Again, that speaks to the scale of the problem. We have come to work — we have been here for two days already — and we will be back to our constituencies and doing Committee work by the end of the week. Five days will have passed. Half the people on that list are living, every day, with the impact of what is happening as a result of their illness. <BR /> <BR />The database gives an indication of where some of the issues are presenting, but it also provides the evidence that is necessary to allow us to respond. Cuan Mhuire sits just outside my South Down constituency. We also have Ward 15 in Downpatrick, which I can see from my living room. Those places have a person-centred approach to care, and their focus is on helping those who suffer from addiction to see the goodness in themselves and to discover a sense of purpose in their life.”
“If we can take that as a starting point, we can take the next step collectively to address the level of care that such a person requires. I will say that again, because I think that it is a powerful thing: care is needed for that individual. <BR /> <BR />According to the Northern Ireland substance misuse database, almost 4,000 people suffer from an addiction and have presented to services for support. We know that we can probably multiply that — we could double it, treble it or quadruple it — and get the number of people who are actually living in our community with problems. The majority of those people are men, and around half are in the 26-to-39 age bracket with an addiction to drugs. Some have an addiction to drugs and alcohol. Cocaine was reported as the most commonly used drug, and more than half reported the daily use of drugs.”
“The fact that the Question will be put on them in order means that they will not both be supported, but we would be happy to support both, because we are all pushing in the same direction and coming from the same place in trying to deal with the issue. <BR /> <BR />For many of us, including me, it is not an easy conversation to have. We all have family members who have to deal with addictions and their ramifications, and some of us may have to do that ourselves. As with everybody in our community, if you put 40 Members in a room, quite a number will have had to deal with the issue at first hand. It is important that, when discussing the matter, we do so with compassion and sensitivity, because addiction is not a choice. It is not a weakness. It is an illness, and many people suffer from that illness.”
“Thank you very much, Principal Deputy Speaker. I feared that people would run to the door before I could speak. <BR /> <BR />One of the first things that I will comment on, forbye the seriousness of the issue, is that I was straining a bit to hear what Members were saying. That is a reflection of the fact that we were a little quieter, and that showed agreement. When we are in agreement in the Chamber, the decibel levels go down, not least from me. That is a good indication that Members across the Chamber are of the same opinion. <BR /> <BR />We have in front of us two amendments that are mutually exclusive. Our party has no problem with either.”
“What has Mary Lou done? What are Mary Lou's proposals?”
“This proposal will see over half of the population of Northern Ireland not having access to an MDT model. It means that you, Finance Minister, are presiding over a postcode lottery for access to MDTs. According to the sector, the GP federations that are yet to become MDTs struggle to attract staff, face longer waiting lists and are more at risk of collapse. In fact, at an event last week, one GP suggested that it may be time to move on from MDTs because it is taking so long for them to be rolled out. Minister, do you agree with the Executive's two-tier health system and postcode lottery? Do you think that it is acceptable?”
“On a point of order, Mr Speaker. I concur with the remarks that have just been made. It is only appropriate that we have a half-hour suspension to allow Members to fully read the document. There may be the method of putting it in the Library, but that is not the traditional method. It is emailed to Members or made available outside the door, and we received it at 10:58 am, which does not give us enough time to discuss such a major announcement on an Opposition day.”
“You mentioned the trusts and what they do. Does the Member agree — his Minister has said this at different times — that it will be incredibly difficult within the current financial envelope when they are asked next year to make £200 million worth of savings? I am at a loss as to how they will be able to do more when they are saying that they do not have enough to do it at present, and, next year, they will be asked to do it with £200 million less.”
“If that is truly doing what matters most, I cannot imagine what the Executive, with no ambition, no accountability and no regard for the public, would consider to be doing what matters least. This is a Government who have set the bar for health so low that they are already guaranteed to miss their targets. If this is the best that the Executive can offer, I fear that the only thing that is more broken than our health service is the Executive's ambition and that the only thing that is growing more than our waiting lists is the Executive's complete disregard for the people whom they are meant to serve.”
“You have just slashed the core funding, and the groups that are hardest hit are those that support people with acute mental health needs. <BR /> <BR />The Health Minister has repeatedly told us that he does not have enough money to achieve health outcomes or to resolve pay disputes with staff. He even voted against his own Budget, yet here we are with an agreed Programme for Government that offers no substantial financial commitments or arrangements, no plan for the staffing of the service and no vision for transforming our health service. The document, insultingly subtitled, "Doing what matters most", even has the audacity to say:”
“What we are saying is that, this year, we did less than last year and will probably do less next year. Is that really the plan? Is that the ambition with which you are happy to go to your constituents and say that it is how you will sort out our health service? Is that the most exciting thing that you can go out with as you tell people here that you will address the issues for them? <BR /> <BR />What about mental health? We have a mental health strategy that was costed at £1·2 billion over 10 years. This year, the Department was meant to allocate £62 million. Guess what? It has not been allocated. The agreed Programme for Government says that the Executive will work with the community and voluntary sector to address mental health. Again, are you serious?”
“It lays out a target for 2027, with the hope — the hope — of investing £135 million a year, treating an additional 70,000 patients a year and spending an extra £80 million annually on elective care. Seriously, is that the best that can be done? That is not a plan but a collection of empty promises and fluffy language designed to pacify the public, who are dying on waiting lists and dying while ambulances remain stuck outside emergency departments. <BR /> <BR />Last year, £76 million funded 263,000 assessments, treatments and diagnostics. The document states that, this year, the Executive will invest the same money and deliver 250,000 assessments, treatments and diagnostics. With a flat-cash Budget for next year, there is no prospect of those fortunes being reversed. The £135 million target has already been significantly missed.”
“The deepening problems in our system have brought us to this point. What a claim we have to make that we have the worst waiting times in all of Europe. Given that, one would have thought that health would be the defining priority for the Executive in implementing their first Programme for Government since 2011. It was certainly a strong election promise. Does anyone remember the extra £1 billion that was being promised? <BR /> <BR />What does the document tell us? It gives us a vague overview of the problem. It is sprinkled with buzzwords such as "close the gap" and "reconfiguration". It has taken over three years for us to be given an overview of what is already being done. It mentions investing in primary, community and social care but with no finance, no action and no plan to help those sectors.”
“The Executive constantly accuse the Opposition of lacking positivity, so, in the spirit of kindness, let me offer them a "Well done": well done for doing just about enough to fulfil the absolute minimum expectation of any Government by finally agreeing a Programme for Government. Let us be clear, however, that it has not been implemented. It is not fully funded. It does not even contain clear accountability mechanisms or targets, but, yes, the Executive have agreed a document. <BR /> <BR />I will focus my remarks on the details or lack thereof of the health commitments in the Programme for Government. As we all know, Northern Ireland's health service is in a state of crisis. There have been years of neglect, inadequate transformation of public services and a failure to address growing waiting lists.”
“I would love to say that as somebody who has never had a tooth extracted or a filling in my life, but I am afraid that I am guilty of all those things. I will sit down quite worried about what Nuala McAllister listed as all the foods that you are not supposed to eat, because that has just cut out my dinner and supper this evening. I will have to find something else.”
“I do not know whether that has happened in the intervening period, because it has been a few years, but it certainly looked at things like service delivery for children and young people so that they do not lose their teeth or have bad oral hygiene from a young age. <BR /> <BR />Another issue raised with me was about older people living in care homes and residential homes. There used to be dentists who went into such places to help out where they could, but it was felt that that had to go on the back-burner because of the lack of funding. Is there an update on that? We need to help those who do not ordinarily reach out for help. It is one of those things: you speculate to accumulate. If you spend money and try to assist people with their oral hygiene, it will not cost money to fix the problems afterwards.”
“If the budget that he is given is not enough to deliver services, it is unlikely that he will be able to provide a resolution. A conversation needs to take place between the Executive parties on where the budget goes or what transformation will be prioritised to free up money in the future. <BR /> <BR />I know that there was an oral health strategy. It was one of those 10-year strategies. I am not sure where that is. I remember talking to some practising dentists who said that they were looking for updates on it. They were looking to see whether it could be tightened up, funded out and action planned.”
“That will impact massively, because the system of our health service is based on providers almost being independent of the Department and government but contracted to deliver the services. That means that they are seen as private businesses. They will have to find the money for the National Insurance lift, which will push so many practices over the edge, especially if they are reliant on NHS dentistry. <BR /> <BR />People tell me all the time that they hate going to the dentist, but I never get complaints about the service. A good service is being provided. If people have pain and can access the service, they get treatment. That tells me that there is a good system with good practitioners. However, all roads lead back to money. The Minister's hands are pretty much tied. He has made that point over and over again.”
“Underpinning most of it, of course, is finance. Regrettably, we are almost sleepwalking towards a two-tier system in which those who have money can afford to go private and those who do not cannot afford to go private and so rely on National Health Service providers. However, most dentists say that they cannot exist by simply providing National Health Service dentistry, because the money just does not come back. It costs them money to provide that service. More and more dentists are opting out, which means that it is more difficult to get access. <BR /> <BR />Of course, there are then overall financial issues, such as the National Insurance rise that is coming in.”
“I thank the Member for raising the issue, another health issue to do with Fermanagh and South Tyrone. I am delighted, as the SDLP and Opposition health spokesperson, to support the Member, because there are unique attributes to a large rural constituency and access issues are much more difficult. It is a good and proper that the Member highlights those. <BR /> <BR />Needless to say, the principles that the Member talks about for Fermanagh and South Tyrone are pretty much the same across the board. As health spokespersons and members of the Health Committee, we regularly meet the British Dental Association and our local providers. One of the senior practising members of the British Dental Association has a practice in my town. Through conversations over the years with her, I get updates about what dentists face.”
“I ask the Executive to tell us what it is that they want to do for older people, how much they are prepared to invest and how long it will take them to do it. The Opposition and the public will then be able to hold them to account by checking that the targets are being delivered against. Anything else, frankly, is just waffle.”
“When I was reflecting on the possibility of there being some form of older people's service that is almost like a youth service, I felt that the Older People's Commissioner, perhaps working alongside councils, would strategically be the ideal office through which to deliver such a service in order to make sure that there are services for people across the board. <BR /> <BR />Before I conclude, I ask that the Member who proposed the motion include something in her closing remarks. The motion calls for a strategy. I hate strategies. They are all that we ever get from Ministers. They are bits of paper that are pulled together that then go on a shelf, after which very little else happens. If we call for a costed action plan with delivery timescales, we can hold people to account. That is how a Government are held to account.”
“Those tireless bands of volunteers get together to try to provide some services for one another in their local communities, and they are almost peer-led. As a former youth worker, I can see what has happened since we said, many years ago, that we had to invest in young people and provide a service right across the board that they could access regardless of where they live. Given our changing demographics for age, we need to see an older people's service across the board that provides the structures and services that enable our communities to have activities to do.”
“To have more than half of households relying on grandparents for childcare is a startling statistic and yet another example of our Executive's placing undue responsibility on unpaid carers. Taking cognisance of the fact that we are an ageing society, I say that what is needed right now, more than ever, is for the Executive to invest in our older people and in the various initiatives that are already in place to reduce older people's isolation and enhance their dignity. Remember that one in five people in the North currently experiences loneliness regularly. That is another startling statistic. <BR /> <BR />When I look at my constituency, I am in admiration of organisations such as the u3a and Men's Sheds.”
“Although the Executive Office is responding today, the issue needs to be addressed by the whole Executive. The message that I send to the Executive today is quite simply this: if we do not invest in our older people, we are endangering our present and our future. If we do not invest in our older people and plan for the future, it will impact on our older people's quality of life and their access to healthcare and will heighten their experience of social isolation and perhaps loneliness, but it will also have an indirect impact on those who rely so heavily on them, particularly, as has been referenced many times today, for childcare. <BR /> <BR />A recent survey highlighted how more than half of households require the help of grandparents to provide some childcare.”
“I thank the Member for proposing the motion, which the SDLP will support. Given how important, critical, essential and relevant the motion is, please let it not be a decade before you get to make your next choice. <BR /> <BR />It is an important motion and a reality that we all need to be aware of and prepare for. How often do we hear from various leaders that the measure of a society is found in how it treats its vulnerable, including its elderly? The reality is that we are an ageing population, as has been highlighted today. At present, the proportion of those aged 65-plus is one in six; that is simply going to rise in the future, and it is anticipated that, very soon, it will become one in five. <BR /> <BR />As the Member rightly notes in the motion, that presents challenges and opportunities for public services.”
“Residents of Downpatrick, Ballynahinch and Newcastle are used to being let down by the Executive, so the statement is, if anything, consistent. Given that the statement provides no dates for the work to commence on the Cairnshill stop, states that the route will not be extended to Carryduff and indicates that there is not sufficient funding, does the Minister agree that, for my constituents, it is disappointing, underwhelming and, basically, a let-down?”
“The removal of it felt somewhat as though a state institution was trying to hide the fact that some people rely on it for the news. It was a mere 90 seconds of sign language, and keeping it would have been so beneficial for those who depend on it. <BR /> <BR />I hope that the Bill progresses and will be perfected as it goes through its legislative journey. In the nine years that I have been here, there have not been many occasions when you sense something palpably different about something that passes through the House because there is support for it everywhere. We know that it is the right thing to do. Not many good news stories come out of this Building, so let us hope that the Bill will be one of those.”
“<BR /> <BR />My second point is about a small issue, but it signifies a slightly bigger one. It is about the availability of access to the news for those who are deaf or hearing-impaired. Recently, BBC NI ended its long-standing practice of having a signed news round-up at the end of its lunchtime broadcast. The service was resigned to somewhere deep down in its website for digital access. The impact has been that those who are deaf or hearing-impaired continue to pay their licence fee, but they no longer have the same equality of opportunity to access the news as those who do not rely on sign language. It was a small thing, but it was quite figurative. Lots of us were able to see it in our daily lives — you switched on the news and saw the signing taking place.”
“If we balance the cost of those interventions against what it costs afterwards, if we do not provide that early support, it just becomes one of the issues that we regularly mention in this place. If we put the support in at the beginning, it makes all the difference for the young person or, in this case, the young deaf person. It is important that they get the best opportunity that they can for their life journey. It also makes absolute sense considering the interventions that will be required. I ask the Minister to consider working alongside the Education Minister and the Health Minister to see whether, given the fact that it would cost just £80,000 for the whole of Northern Ireland, that support might be forthcoming across a couple of Departments and whether that might help to add to it.”
“I recently met Auditory Verbal UK, which detailed to me that, if children who are deaf or have hearing impairments avail themselves of the available early interventions, 80% will have educational outcomes that are similar to those of their peers. That is remarkable, because, if they do not get that support, they end up lagging behind and do not get the same opportunities as others in their peer group. With a small investment — I think that it is around £80,000 — staff could be trained in delivering auditory-verbal intervention, which would address that imbalance. <BR /> <BR />I have written to the Education Minister and the Health Minister on that point.”
“Those who are deaf or hearing-impaired who may be following the debate today can take heart from knowing that, at long last, Northern Ireland and the Northern Ireland Assembly recognise their language. <BR /> <BR />I will focus on two areas. The first is support for families. If and when the Bill passes, it will be essential that families who use sign language as their first language have equitable access through publicly funded services to the early support that they need to develop language and communication skills for their children. That is crucial to reducing the lifetime of disadvantages that deaf children face, and it will transform outcomes for the better.”
“Essentially, it is the right thing to do. That makes it easy to support. <BR /> <BR />In recognition of many of the points that have been made, I will say that the legislation recognises and promotes British Sign Language and Irish Sign Language. It places duties on organisations to ensure that their services and information about them are accessible to those who use either. That is very important. To put it in context, over 3,500 people here use British Sign Language as their first language and 1,500 use Irish Sign Language as their first language. That underscores the critical need for the Bill. <BR /> <BR />Language is essential to all of us. It is part of how we communicate with others. It is how we express ourselves, and it is an integral part of our identity.”
“Minister, while many people might say that you are not a class act to follow, I disagree. Your opening of the debate can send a real message of hope to people about how this place counts. You said that you thought that your understanding of sign language was basic, but I think that we could have a conversation later about who has the most basic understanding of it, for I have no understanding of it at all. I am delighted, on behalf of the Opposition, to support the Bill. It is what we in the Building should be doing and what we are employed to do. Regrettably, however, it is something that we do not often do, so, when we get an opportunity to legislate, it is critical that we do so. The Bill is a really exciting thing to support. We just know how much good it will bring to people and how much it will help them.”
“I reiterate the point about moving "at pace", because timing is critical. If the people involved do not get access to the drug before the start of muscle wastage, the drug is of no use to them. The word that Alfie used today about not getting access to the drug was "cruel". That is the word of a 12-year-old to Members of this Assembly. It is cruel, and I hope that we can overcome and ensure that he, along with others, is able to get access to those drugs.”
“Again I remind anybody who has not heard about it that the transformation of health services does not have to mean the centralisation of health services. Transformation means simply working smarter. <BR /> <BR />It is time to knuckle down. It is time to do the hard work of government, address the financial needs of our public sector and deliver transformation, including a three-year finance cycle to improve the lives of people here.”
“Our Budgets and Supplementary Estimates are not helping to address that gap. Where else in the world would you have a Department of Health that comes with a health warning? The unassailable fact is that the Executive expect our public services to, once again, do more with less and with no vision of when things will get better. That is not normal government. <BR /> <BR />If we want to see improvements in our broken health system, if we want to avoid pay disputes and strike action, if we want to avoid devastating and cruel cuts to the service, we need the Executive to work smarter. If we want to see transformation across our health service and other public services, we need to see the Executive work smarter.”