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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“Within the next year, there will be more people over 65 than there are under 15, and the number of people over 85 is projected to more than double. The demand, complexity and pressure are growing, yet the workforce is shrinking. It is shrinking, in part, because of the wages that we pay. It is about the real living wage. The Minister has repeatedly stated his support for implementing the real living wage. In fact, he promised it last year and then reneged on that promise. Now he says that he will pay up when the Finance Minister does. He is busy blaming the Brits, and nobody in the Executive is willing to stand up. Nobody will take any damn responsibility for paying those people what they need to be paid in order to do the work that provides the dignity that we spoke about earlier. <BR /> <BR />Right now, the cracks are visible.”
“That is why I support the intention behind the motion and the amendment on the growing crisis in rural areas. <BR /> <BR />For constituencies such as South Down, rurality is not a footnote in this discussion; it is the bulk of the content, because those in places such as Kilkeel, Attical, Ballykinlar and Leitrim have a very different experience from those in urban areas. A missed call in Belfast may mean a delay. A missed call in somewhere such as South Down may mean that a person does not see anyone for the entire day. <BR /> <BR />We know that the pressures will only increase. The Department's figures show that more than 23,000 people receive care every week from domiciliary services. At the same time, our ageing population is growing rapidly.”
“Is dignified care too much to ask for? I urge the Minister to hear those voices, listen to what they are saying and determine whether we can do something about it. <BR /> <BR />As a member of the Health Committee, it is important that I say that this is one of the issues on which there is consensus among Committee members. The Committee agrees that something needs to be done. We recognise the essential role that home care workers, be they employed by HSC or the independent sector, play not just in supporting vulnerable people but in holding together our wider health service. When home care struggles, obstacles emerge in other places in our health service. Hospitals get backed up, and staff then feel the pressure, families become exhausted and frustrated, and patients remain in beds when they should be at home.”
“Domiciliary care workers are frustrated by changes to the system that mean that they can sometimes spend only 15 minutes with somebody for whom they care. They wonder what will happen should they go over time. Will they not get paid? Do they stop the care? Do they jump in their car and move on to the next person? The pay that they get for their mileage does not reflect the cost of the mileage or the number of miles that they cover. One constituent said to me:”
“Tonight, people across South Down and beyond will be worrying about whether they will get their loved one home from hospital. Families will be wondering whether the care package that they have at the moment will still be there in a month's time. Home care workers, who drive on rural roads in all weathers, will be rushing from call to call to try to offer dignity, compassion and humanity from a system that too often feels stretched to breaking point. <BR /> <BR />In the past days, I have been inundated with responses to my post on social media about the debate. It is important that the voices of the domiciliary care workers who have reached out to me be heard in the debate. They referred to being paid per call, rather than per hour. Imagine if that were the case here, with MLAs being paid per contribution rather than being paid a salary.”
“The system that our Executive oversee relies far too heavily on goodwill. Those families need consistency, certainty and services that are built around dignity rather than desperation. <BR /> <BR />We have the motion, as presented to us, and the amendment. The SDLP is happy to support both, but, further to the conversation here today, let us hope that we see action from the Department for those who need it.”
“They are all great, wonderful words, but families do not live inside strategies: they live inside a reality, and the reality is that many still cannot access the timely assessments. Many feel abandoned during transitions, and many still encounter entirely different levels of support, depending on where they live. That postcode lottery is entirely unacceptable. <BR /> <BR />In South Down, we are fortunate to have incredible organisations, schools, community groups and advocates, who are doing remarkable work. People go above and beyond, every day. Parents support other parents. Voluntary groups step in where statutory services fail. Teachers and classroom assistants try to create inclusive environments with limited resources. However, many of those groups spend half their time searching for funding just to be able to survive.”
“I do not believe that Ministers in London would really understand the issues that are relevant to people in South Down or other constituencies here, so it is good that we have a local Minister here and an Executive, whom we can hold to account, to make sure that the delivery of those services is bespoke to the needs that we have in our communities. <BR /> <BR />The Department's autism strategy sets out clear commitments around early intervention, educational inclusion, workplace support, housing support and inclusive communities. The SEN reform agenda talks about providing:”
“The autism strategy itself acknowledges that autism is becoming even more prevalent in our society and that there is no one-size-fits-all approach, yet families are too often forced into a one-size-fits-none system. <BR /> <BR />Whilst I welcome the amendment, and it is not disagreeable, it is a little bit surprising, because its proposer and his TUV colleagues spend more time calling for this place to be collapsed than not, and, if that were successful, it would mean that autism services would be handed over to Ministers in London.”
“She has supported the ongoing work by many in the voluntary and community sector who have worked diligently for years, including those who support the all-party group on autism. The findings that are there and that are being discovered should worry us, because autism is not a niche issue. As the reviewer would say:”
“Parents are absolutely fighting for assessments, children are waiting years and years for support, young people are reaching adulthood only to discover that the structures around them simply melt away, and carers, siblings and families are carrying pressures that government often fails to see. <BR /> <BR />One area where this place has found consensus in recent years is on the need to see better autism services. That has involved the establishment of the office of the Independent Autism Reviewer. The appointment of Ema Cubitt, who is here today, has been incredibly positive. In her work, the Independent Autism Reviewer has highlighted the major pressures in respite provision, long waiting times, postcode inequality and the absence of proper transition pathways for young autistic people.”
“Of course, there are debates in the Chamber where statistics are the things that matter. Then there are debates like this one, where what we are talking about is a matter of exhaustion for families. In our communities there are people who are living with, or caring for family members with, autism and are trying to hold things together whilst waiting lists grow longer, support becomes harder to access, responsibility is pushed from Department to Department and, at times, it really feels as though nobody is actually being held accountable. The motion talks about "fit-for-purpose services". For far too many families across Northern Ireland, the services are nowhere near being fit for purpose.”
“It means making sure that the young people who are looking at nursing as a career today will still believe that it is a career worth pursuing tomorrow. We rightly say, "Thank you" to our nurses today, but, if that is all that we do, we have missed the point. The greatest tribute that we can pay to nurses is action, because, if we continue to lose nurses faster than we support them, we fail not only those workers but every patient who relies on them. Yes, today, we say, "Thank you" to our nurses, but tomorrow and the day after that and the day after that, our Executive must prove that the words mean something with delivered, measurable actions for our nurses.”
“<BR /> <BR />No health service can survive if its staff are exhausted, undervalued and pushed to breaking point. The basic truth is that, at some point in all of our lives, a nurse has been there for us or for somebody we love. A nurse has been there in moments of fear, in moments of grief, in moments when everything has changed in a heartbeat. Long after we forget that building, the waiting room and the treatment, we remember the nurse — the person who spoke calmly, the person who cared, the person who stayed with us — and the care that we received. <BR /> <BR />If we truly value nurses, it has to mean more than just warm words. It has to mean proper staffing, fair pay and safe working conditions.”
“Members may be aware that today is International Nurses' Day. We should think of the nurses who have possibly just finished a 12-hour shift and are probably exhausted and emotionally drained from doing all that they have had to do overnight in what was probably a short-staffed environment. The daytime staff will be doing that today. We must remember the nurses who miss birthdays, family events and weekends and go above and beyond the call of duty to care for people in the most difficult times in their life. Today is about the fact that, despite everything that we ask of them and despite the pressures, the staff shortages and the burnout that they face, those nurses still turn up at every shift to provide care for people in our community. That is extraordinary.”
“The first step towards identifying the solution to a problem is to acknowledge that there is a problem and then to determine who is causing it. I have asked you time and time again who is causing health service problems — you, through a lack of decision-making, or the Executive, through lacking the finance to deal with the problems — yet you have always ducked the question. I will go again: is it your lack of decision-making or the Executive's lack of funding that is causing the problem in domiciliary care?”
“I thank the Minister for the statement on this most important issue. Of course, our thoughts are with Katie's family. Katie was let down by the system, but the system is made up of individuals who operate within it. We have a complicated tapestry of justice agencies. Some of those agencies are the responsibility of the Minister, some are not, and some are the responsibility of other Ministers who need to step up to the mark. What assurance can the Minister give that all those agencies will be required to carry out the recommendations that are contained in the report, so that we can have confidence that all the agencies and individuals will do everything that they can so that this does not happen again?”
“Those responsible have nothing to offer society: no mandate, no support and no future. They have shown a willingness to endanger the lives of police officers, civilians and families without consequence in their own minds. In response, we must show unity in backing the police, rejecting violence and defending the peace that the vast majority of people across this island value and want to protect. <BR /> <BR />I will end by saying that I am not so sure that we have seen that unity in the Chamber today. That is disappointing. Was some of what has been said amplifying political disdain or being used for political gain? I hope that it was not the latter.”
“<BR /> <BR />As a member of the Policing Board, I record my admiration for the officers on the ground. Their actions were decisive and brave. They prevented what could have been a catastrophic loss of life. While others chose to spread fear, those officers chose to protect the public, evacuating residents, managing a live threat and putting themselves directly in harm's way. That is policing at its best. <BR /> <BR />I also recognise the human cost involved. A delivery driver's vehicle was hijacked, and that delivery driver — an ordinary worker — was forced into a situation that must have been utterly terrifying. That is the reality. Those responsible prey on civilians, exploit fear and drag innocent people into violence in which they wish to play no part.”
“What we saw in Dunmurry was not just reckless but utterly indefensible. A vehicle was hijacked, and a terrified civilian was forced to drive what was effectively a bomb. That device was planted in the middle of a residential community. By any measure, it was an attempt to kill. It was not some abstract act against the system; it was carried out in a built-up area, beside homes in which families, including those with young children, were present. It placed ordinary people in immediate danger and risked lives on a scale that is hard to comprehend. What makes what happened even more disturbing was the sheer recklessness of using such a device, which senior police have described as unpredictable, dangerous and a crude weapon that could have caused devastation well beyond its intended target.”
“We will continue to provide help and support where we can, especially for North Belfast, which is my second home.”
“While today's debate is important, we must not lose sight of areas that need to have that MDT service introduced. If we are serious about reforming our health service, about that shift left and about getting treatment for people as close as possible to their homes so that they do not have to travel, the MDT model provides an excellent opportunity to do those things, but that will mean full roll-out, sustainable funding and additional resources. That is probably where there will be some problems. I am happy to support that for North Belfast. <BR /> <BR />I offer a slight apology, like Carál did last week. I have to go and chair the all-party group (APG) on youth participation in the Senate Chamber, so I will not get to hear the Minister's remarks, but I have a fair idea of what he will say.”
“I appreciate that the Minister does not have a storeroom of social workers, practice nurses and physios down in the Department that he can just hand out. That is the aspiration. It is about how quickly we can make that a reality and how quickly we can move on. <BR /> <BR />If there is full roll-out and partial roll-out, that does not represent fairness or equality of service provision. We do not want to see that two-tier system, as has been referenced, where some can get access to services and others cannot. Somewhere in the region of half a million people across the North are not part of areas that have MDTs. Those people are being left behind, unable to access the full range of services without having to go through extra hoops and going to other secondary care locations.”
“I spoke at the South Belfast GP Federation's annual meeting last year, and GPs from one surgery in South Belfast talked about how difficult they found it when one GP practice, which was basically a couple of hundred yards away, was able to offer a raft of additional services, yet theirs was not because it was on the border with an area that had MDT services. That inequality in its own right was felt very sorely by those practitioners who were not able to offer that range of services. The jealousy tipped towards those GPs who were able to offer those services, so it is something that is absolutely seen as being valued in the medical fraternity. Therefore, it is something that I would like to see pushed, rolled out and offered as far as possible. I know that that is an aspiration.”
“That is why we have a physio. If somebody needs to get those issues seen to, it is better to get them directly to the physio rather than have them come to me and for me to then refer them to the physio, which adds an extra layer". Having that ability in-house to make referrals quickly helps people to get treatment much quicker and more locally, and it helps to address health inequalities. The vast need to address the health inequalities in North Belfast has been eloquently put by others here today. <BR /> <BR />Of course, the system has not been fully realised; it has only been partially implemented.”
“I am delighted to speak on behalf of the SDLP in my second North Belfast Adjournment debate. I am the son of an Ardoyne man, and I am a former resident of Ashley Gardens on the Antrim Road, off Somerton Road and Lansdowne Road, so I feel like I am almost a local. I have been so impressed by these Adjournment debates that I have managed to secure one next week for South Down, so any North Belfast Members who would like to come along will be more than welcome. <BR /> <BR />We know that MDTs have the capacity to transform primary care. They ease the pressures on GPs by offering a range of services in health centres. It is also about quicker access to those services. I remember visiting one of the GP practices in my area, and the GP was really clear about MDTs. He said, "Do you know what? I am not an expert in knees, joints and moving legs.”
“<BR /> <BR />I thank everyone for participating in the debate, supporting the motion and sending a unified message from the House. As Robbie said, eloquently as always, if you are dealing drugs in our community, it is only a matter of time: we will get you.”
“<BR /> <BR />I will finish where I began, which was with an email from a man in Downpatrick asking me when we would address the elephant in the room. Let the message from today be that we are going to address the elephant in the room: to challenge those people in our community, to try to rid ourselves of those dealers and to make sure that, if they try to deal and pass those drugs on, they will feel the full force of the law as a result. Again, I am delighted that there is support from around the House on the issue. There is a slight difference on timescale, but we will not divide the House on that, because we are here today to be united in the message that we send out. We just want it to be done as quickly as possible; we know that it sometimes takes a little bit longer.”
“Thousands of people access substance misuse services every year, and almost 40% of people know that drug-related intimidation is happening in their community. That should stop us in our tracks. We must call out those who are driving that. It is about organised criminal gangs, many of them with paramilitary links, that exploit vulnerability, enforce debt through fear and profit from the destruction of lives. They are predators in our communities. Sentencing absolutely matters. If you profit from addiction, misery and death, your punishment must reflect that harm. That is why we support Jasmin's law and thank Pauline for her work in Jasmin's memory. It is essential that we, as legislators, deliver on that work.”
“When people pass information to the police, and even to politicians to pass on to the police, it may not lead to an immediate arrest on their street, but it could be the intelligence that leads to major seizures elsewhere, so that local action does feed regional disruption. <BR /> <BR />However, that reassurance goes only so far, because when people see drugs still flowing, intimidation continuing and dealers operating with impunity, they begin to lose faith. When those same dealers appear in court and walk away with what looks like a slap on the wrist, people just lose hope. Perception matters absolutely in those instances, and facts matter. The fact is that drug-related deaths have risen by 47% over the past decade.”
“Thank you very much, Mr Deputy Speaker, and thank you to everybody who contributed to the debate. It is always good towards the end of a couple of days of debate that we get everybody agreeing and on the same page, more or less, on issues, especially when they are so relevant to people's lives. <BR /> <BR />Over the weekend, I received an email from a constituent in Downpatrick who asked me this simple question: "When are politicians going to address the elephant in the room?". He said that the elephant was drug consumption, not potholes or housing, not the usual issues that dominate our feed and the emails that we get. He said that there was a sense that not enough was being done about drugs. I updated him by saying that often the work that is done to challenge those issues is not very visible.”
“We should stop messing about with the public, because they really know when people are talking out of both sides of their mouth, because it is blindingly obvious when you do that.”
“That is not just a policy; that is the practice. I do not want to hear that trusts "should" or trusts "might". What measurable items will be put in place to ensure that those protections are there so that we can protect them? If we cannot protect them, all we are doing is prolonging a situation where families already under immense strain are asked to shoulder costs that they should never have had to face in the first place. That is not something that we should be comfortable with. That is why we in the SDLP have acted to try to bring some transparency to the Bill. We have made our thoughts known. It should have been brought in and implemented at the start of the mandate as per the agreement of the Assembly in its previous mandate.”
“We are told that there are 135 such children and young people every year. Part of the quid pro quo was that those people would be sorted out. When it came down to trust level, they would be able to get assistance and not have to face those charges. What we are being told by the charity that represents them, however, is that they are still facing those charges. That is now. So there is no guarantee that children with cancer can be protected from the charges, yet we are being asked to support the delay on the basis that people such as those children will be helped, but the evidence at this stage is to the contrary. <BR /> <BR />I ask the Executive, through the Minister of Health, what specific, measurable protections will be in place during the delay to ensure that every child with cancer and their family can access free car parking.”
“That does not mean that it is not going to pass. When it comes to the transparency that is needed with Bills, the SDLP was the only party to ensure that there was openness and transparency. The amendment that we tabled at the previous stage, which was supported, because it passed and is in the Bill, ensures that where money is going to be spent through the Bill, the public will be told. If there is one thing that the Executive do not like, it is scrutiny. If the delay is going to cost money, we want to make sure that people know that. <BR /> <BR />I will follow up on some of the correct remarks that the Chair of the Committee made. It is good to see that we are having the discussion, because we have all been lobbied about children who have been diagnosed with cancer.”
“I will just go back to my earlier sentence: a Bill that promised so much and delivered only confusion, frustration and then anger. The confusion bit comes because we were all promised stuff in a private Member's Bill at the end of the previous mandate. We all supported it, and then, as soon as we came back into this place, the first thing that happened was that it was undone. Now we are here, and it will be undone once again. <BR /> <BR />We have said that we voted for it. We supported it at the end of the previous mandate, and all that we have had in front of us since have been Bills to delay that, and we voted against the delaying in this Bill. That is truly the definition of speaking out of both sides of your mouth: "We are happy for this to go down on to the Floor but we are not going to support it".”
“Sinn Féin can say many things about opposing delaying the removal of hospital car parking charges, but the Bill will end up being passed today because it has been able to get here today. It has been able to get to the Assembly as an Executive Bill.”
“Well, well, well. Here we are again. We are at the Final Stage of the Executive undoing the last piece of legislation that was passed in the previous mandate. I will say that again. It is the Executive's Bill that is going to be passed. The original Bill promised so much and delivered only confusion, frustration and anger. Free car parking for everyone at all our hospitals — staff, patients or visitors — and here we stand today to hit a further pause button on that process. <BR /> <BR />We know that the Bill is likely to have the numbers to pass today. With it, the promise made to patients in 2022 will be delayed yet again. While it is true that every party supported the Act in 2022, it is also true that every Executive party supported this Bill's getting to the Floor of the Assembly to be debated.”
“It is really difficult to find a solution when nobody is prepared to accept responsibility for the problem. Is it you who is not fixing the problem or is it the Executive not giving you money to fix the problem that is the actual problem? Until we know what it is, we are never going to find a solution and are just going to continue to go round and round.”
“Minister, the RCEM report recommends ensuring that:”
“I represent the Downpatrick area — the resting place of three patron saints but particularly St Patrick. Will there be an opportunity next year for a Minister to visit Downpatrick on St Patrick's Day and help sell that wonderful area, which is the true home to St Patrick, and make sure that as many people as possible know about that?”
“As well as looking to the future, is there any way in which finance could be made available where something of that nature is perilously close to happening to help people with the imminent issues?”
“Whilst the Minister mentioned lots of investment in preventative work and the mapping exercise, there are still examples in constituencies such as mine of South Down where people fear that they will lose their gardens, their homes and roads.”
“The BDA has been lobbying many of us for many years now, and I think that we have accepted the point that, if it is not financially viable to deliver the service, the service will not be delivered, and we will see the problems stacking up for the future. Hopefully, we can get some light from the Minister this evening as to what will take place next, and, hopefully, services in North Belfast and beyond will improve.”
“Then, we can see where it falls short, and we can work to try to move forward. <BR /> <BR />Crucially, what is the estimated gap between what dentists are currently being paid and the real costs of delivering care? If that margin is too wide, there will be no provision of services. If that can be reduced to the point where they can deliver the service and get money back for doing it, I think that we will see an uptake in people accessing the services. <BR /> <BR />Will the Minister agree to seeking a reformed dental payment model with the BDA before the end of the mandate that will make health service dentistry sustainable in North Belfast and right across the North?”
“If we take the decision that we value everybody receiving basic care for their teeth, we have to be able to provide that service. <BR /> <BR />I will ask the Minister a series of questions to get some feedback. Does the Minister accept that, without urgent reform, we will lose what remains of health service dentistry in this mandate? That is the sort of crisis point that we have reached. We are not talking about the next 20 years or the next 50 years; we are talking about the next number of years. That statistic of less than half the population being registered with a dentist will decline. <BR /> <BR />Other Members referenced the full cost of service review. When will it be published? Hopefully, there will at least be an analysis of where we are in that review.”
“Who would go into business and say, "I will provide a service that is free, but beyond its being free, I will have to put my hand in my pocket and take from my business to provide that service"? <BR /> <BR />The alternative is that there is an industry around dental treatment. People like to have good-looking teeth. They like the sense of self-confidence and self-worth that comes with having a good set of teeth, and people are prepared to pay for that. We have taken something that should be a health service matter, and we have moved it into the private economic market. Unfortunately, it will always be the case that those who have the money will win in that scenario. We have to take a fundamental decision that we do not want that to be the future landscape.”
“Less than half the population is registered with a health service dentist. That statistic tells us that access is absolutely collapsing. The system is broken, but it is not because dentists do not want to deliver the service; they absolutely do. If there is one thing that is clear, time and time again, when we meet dentists and the BDA, they say that they would absolutely love to be able to deliver a service. However, when you sit down with them and they go through the costs that are associated with some of the care that they provide, you realise that, from a business perspective, it costs them money to provide the service. We have to let that one land for a moment. It costs them to deliver a service. Who would do that?”
“We have to decide whether that is what we want to see. Do we want to see dentistry being purely privatised? Many Members have put forward eloquently why that is not really an option. When we look at areas of deprivation such as those in North Belfast and others across Northern Ireland, we see that the people who cannot afford the services will be impacted on most. They will be left with declining oral health, and that will lead to other complications that, ultimately, we will have to deal with.”
“I thank Mr Brett for securing this important Adjournment debate. The key fact is that, while this debate is relevant to North Belfast, it could relate to anywhere, because such issues are faced in every constituency. Members have referenced the fact that they have had to deal with their constituents' inability to get services, and, likewise, I have had to deal with that in South Down. I should place it on the record that, like Miss McAllister, I am registered with an NHS dentist. I have been lucky to have maintained that for many years, but I know that that practice is one of the last such practices in my area and that people struggle to get access. <BR /> <BR />The message that has occurred over and over this evening is that we have got to the point of saying that we are at the end. We cannot continue the decline in dentistry any more.”