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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“There is a backlog in and underfunding of our mental health services, people are desperately waiting for ambulances, there are problems for people in accessing GP services and with the funding of community pharmacies, and Fire and Rescue Service funding also comes out of the Department of Health's budget. The list goes on, and, in every element, there is a shortage. When there is a shortage in the Department of Health, it means that people are impacted on or that they will wait longer, or that, as on most occasions, they are impacted on as they wait longer. <BR /> <BR />The second issue is transformation. We have been promised health service transformation for a generation. That transformation will require funding, and I want to address that budgetary element.”
“I do not intend to speak for long. I will just put a particular slant on the issue of the Health budget and our system, which looks back at the Budget over the past year. We often think that Budget debates are about the year ahead, but this one puts in proper order the decisions that have been taken over the past year. <BR /> <BR />It is evident that there are many problems in the health service and that those problems remain as a result of two issues. <BR /> <BR />The first issue is the underfunding of the health service. Even though — this is the anomaly — it gets the largest slice of the Budget here, that does not reflect the massive scale of the need in our community for people to avail themselves of health services for treatment, whether that is because of waiting times in emergency departments or as a result of waiting lists.”
“In Fermanagh and south Tyrone, ambulance response targets are missed more often that they are met. It is worth saying that again: they are missed more often than they are met. Rural families travel 65 miles for surgery. Every delay carries risk. In spite of that, thousands of rural people have endorsed the SOAS road map with one united voice, because they want a health service that delivers for them. This is their moment. They have come up to Parliament Buildings today and asked a question. Let me amplify that question in this place: will the Department and the Executive stand up for the people of Fermanagh, or will they not? The decision is theirs.”
“<BR /> <BR />The problem is that we do not have the workforce model or ministerial or departmental will to return emergency general surgery. Meanwhile, patients endure double emergency department waits, first in Enniskillen and then in Altnagelvin Area Hospital.”
“For three years now, emergency general surgery has been suspended at the SWAH. We were told that that was temporary, but, sadly, that approach from the Department of Health and the Executive is nothing new. Temporary always becomes the new norm. <BR /> <BR />The building is not the problem. With five operating theatres and a modern emergency department, it is a state-of-the-art facility built to serve a deeply rural population. In recent months, I have repeatedly highlighted the growing backlog in estate management across our health service that is not being adequately addressed — hundreds of millions of pounds' worth of work that needs to be done — but let me be clear about this: one place where there is no backlog of maintenance is the South West Acute Hospital.”
“I add my support to the need to restore emergency surgery services at the South West Acute Hospital (SWAH). I recognise the crowds outside the Building today from across Fermanagh and south Tyrone who made their way here to make sure that their voice was heard. What a privilege it is to hear from such a committed, people-led, community-focused campaign and to have those people here with us. They represent farming families, school leaders, trade unions, business owners, sports clubs, church leaders and citizens who believe, simply, that rural lives matter. <BR /> <BR />The briefing paper that Save Our Acute Services (SOAS) provided makes the point starkly that where you live should not determine your health outcome. For those in Fermanagh and south Tyrone, however, it does.”
“There is the potential for better weather predictions to pinpoint where that will happen and then target resources to that area. I know that it will cost money and that money is scarce, but that would be helpful to residents in your constituency as well.”
“The Member will appreciate that we had similar issues in South Down. The Department would like to see the development of better weather predictions, and it would be great to see finance for that. There might be cases in which we get a weather warning that encompasses the whole of the North but the rain falls only in specific places.”
“It is a constructive point. Lots of what has been said is, I fear, about looking back at what we have done in putting together all the information on how we have achieved something. Is somebody interrogating the information to look for patterns to pre-emptively provide interventions that may prevent people's conditions from getting worse, which, if they do so, costs more down the line and causes people more harm?”
“Provided that we can match that with finance, that will help to address the problem, because we will be helping the people who need our help the most. <BR /> <BR />I am delighted to support the motion, and I hope that others will do so as well.”
“<BR /> <BR />Members have referenced the establishment of the mental health strategy, which is a 10-year plan. We know that, many years into it, only about 13% of the outcomes have been funded, yet we are at the halfway mark of that process. It seems a bit strange and as though we are doing things back to front or upside down, because we have not mapped all the data, yet we are trying to come up with a strategy that we are not even funding. It feels like we are approaching the issue of mental health in the wrong way. <BR /> <BR />The spirit of the motion is to say, "There is lots of data. Let's grab that data, put it together and see what story it tells us, and then let's see if we can match that data to the need in our community".”
“They might have records of people who are dealing with mental health issues but who may not be known to the Encompass system. The judicial system might also have information, and, as I mentioned, the preventable deaths tracker goes into the Coroners' Court. <BR /> <BR />There are lots of places where people with mental health problems will present, and it is about trying to bring that information together so that we can start to see patterns. Then, if we can see the patterns, we can start to provide the service response where it is needed most. The problem is that, if we do not look for that information, we will not know about it and will not be able to respond. There are lots of ways of approaching this, and we need to look beyond Encompass, even though that is a good place to get some of that information.”
“<BR /> <BR />After a conversation at The Well, staff put me in contact with people in England who deal with the preventable deaths tracker. I found that to be of interest because it goes into an area on which research and figures are not readily available. Those people were going into the Coroners' Court, extracting patterns in mental health issues from its reports and flagging them up to the system. What I note from that is this: if we rely too much on Encompass, we will go down the route of using a hospital-based health service alone to look for information, but that is not the only place where we need to shine a light. There are lots of other places where we could go, such as to the police, who deal with people who have mental health episodes.”
“We understand that, in the past year, 38% of adults here have reported concerns about their mental health. That means that nearly a third of our population may be in the category of needing some help or assistance from our system. That begs the question: if mental health concerns are so prevalent, why do we not have a standardised approach to mental health support? <BR /> <BR />In my constituency of South Down, I see incredible, remarkable organisations, such as Life Change Changes Lives, Pop Up Art, MYMY and The Well. They support people at the most challenging and difficult moments of their lives, and I am sure that all MLAs will be able to name organisations in their constituencies that provide such support.”
“We are not even near the end of the debate, yet it is amazing that we can already hear a theme being repeated, which is that doing this is simple, basic, fundamental, sensible and reasonable and that we must get it right. I contribute to that view by supporting the motion and saying that it is a simple concept: we need to know what is happening in our mental health system in order to be able to respond effectively. As MLAs, all of us will deal with constituents weekly who are waiting for assessments, therapies, a CAMHS appointment or crisis support. We all know the repetitive queries. They include, "How long will I be waiting?", "Where am I on the list?" and, "What happens to me next?". Too often, however, we cannot answer their questions with any certainty.”
“Minister, you have paused our involvement in the trial, awaiting the outcome of a judicial review. If there is some logic in that, it is at least to get a determination on what the outcome should be. If we were to follow the intent of the original question, it would undoubtedly lead to another judicial review but from the other side. Is it not time to stop using vulnerable people as a political football and allow the scientific and medical experts to complete their trial, so that we will be led by the science?”
“I thank the Minister for giving way. On the topic of money, Minister, is there an opportunity to explore a graduated implementation of the service? Every time you help somebody, you save the health service £50,000, £60,000 or £70,000 that could be reinvested into the service, and that figure could grow as the years progress.”
“<BR /> <BR />The motion is not asking for miracles. It asks for transparent and achievable goals; a clear, time-bound delivery plan; defined milestones; transparency about costs and savings; and serious consideration of a phased or pilot approach that learns directly from the South and, if possible, works in partnership with the South. <BR /> <BR />Even today, in 2026, stroke kills, but it does not always have to. We have a moral obligation to survivors and those who are yet to have a stroke to ensure that they do not lose their future simply because their stroke happened at the wrong time.”
“There is much that we can learn from that, and, given the complexity of our geography and the constraints on the health budget, I wonder whether the Health Minister will consider emulating the current process in Dublin and Cork in the Ulster region to encapsulate places such as Cavan, Donegal and Monaghan. People from those areas have to travel all the way round to access a service that could be provided in Belfast and have to try to get down to Dublin in time. I am sure that, if approaches were made to the Dublin Government to assist with some of the funding for that, that might help us provide the service with some finance. I hope that the Minister can look at that as a positive North/South health arrangement that might deliver services, be there for people when they need it and not put strain purely on our health service budget.”
“Thrombectomy is not just life-changing; it is highly cost-effective and saves around £47,000 per patient over five years by reducing long-term disability, hospital stays and social care costs, and that is exactly the kind of reform that aligns with the Health and Social Care (HSC) reset plan. <BR /> <BR />Crucially, we do not have to guess what works. In the South, a 24/7 thrombectomy service operates in Dublin and Cork. Dublin moved straight to a round-the-clock model. It did not wait for a perfect workforce. It started, it learned and then it scaled. The culture in the South was one that said, "We are going to do this because it is the right thing to do". The South's thrombectomy rate is around 10%, which is far higher than anywhere in the UK.”
“In 2022, the stroke action plan committed to delivering a 24/7 thrombectomy service by the end of 2024. It is 2026: that commitment was not delivered, and no replacement timeline has been put in place. Every day that passes means that people continue to lose chances that they will never get back. <BR /> <BR />The motivation behind our motion today is not blame. It is not about blaming the Minister or clinicians, because I genuinely believe that the Minister wants to do all that he can for stroke victims and survivors. Stroke teams based in our hospitals have gone above and beyond. They have expanded access, embraced innovation and improved outcomes when they have been given the tools to do so, but goodwill cannot carry a system for ever.”
“When he had his stroke, his wife, Suzanne, recognised the signs immediately and called for help. The ambulance crew made a critical decision to bypass the local hospital and take him straight to the Royal Victoria Hospital (RVH), and Paul received a thrombectomy. Doctors had warned Suzanne that he had only a 10% chance of surviving the procedure, but the clot was removed on the first attempt. Paul lived, is with us today and, while he still lives with the impact of the stroke, the thrombectomy saved his life. Since then, he has achieved one of his life's ambitions and walked the Camino de Santiago to Santiago de Compostela. That is what access can do. <BR /> <BR />Paul was lucky, but luck should never be the organising principle of a health service.”
“When it is delivered quickly, it can prevent severe disability and allow people to walk, talk, work, parent and live independently again. It can mean the difference between coming home and never truly coming back. Despite that, access in Northern Ireland is still limited to 8.00 am until 5.00 pm. That means that, in reality, over 100 people every year are denied a thrombectomy simply because their stroke happened at the wrong time of day: not because the treatment does not exist or would not work but because the service is not there when they need it. That seems wrong. <BR /> <BR />I will put a human face on the debate and talk about Paul. Paul was 41 years old. He was an English and drama teacher who was working, active and planning a future, as the rest of us do, without imagining that one ordinary day would split his life in two.”
“One moment, you are yourself, and, in the next, words will not come, your arm will not move, the room tilts and fear takes over. From that moment, time becomes everything. Every minute, brain cells die. Every delay steals a part of you that may never come back. Yet, in Northern Ireland, whether you get the most effective stroke treatment available can still depend on what time of day you collapse. <BR /> <BR />In framing today's debate, there is a strong moral argument to be made for a 24/7 thrombectomy service. We already have the clinical evidence: thrombectomy is one of the most effective medical interventions to be developed. A doctor physically removes the clot that is killing the brain, restores the blood flow and, in many cases, restores a future.”
“Thank you, Mr Deputy Speaker. I begin my contribution by acknowledging the stroke survivors and families and representatives of the Stroke Association who are in the Public Gallery, watching the debate. You are not statistics, and you are not case studies. You are people who know, in your bodies and lives, how suddenly everything can change, and you know the importance of having a 24/7 thrombectomy service. Today, we are here for you. <BR /> <BR />A stroke is something that will, undoubtedly, touch all of our lives, be that through experiencing one or through family or friendship circles. A stroke does not announce itself politely or time itself around service provision. It is devastating and incredibly frightening.”
“Does the Member agree that the community and voluntary sector is left to pick up the pieces, and the fact that the amount of money that it has available is shrinking means that we get a double whammy: fewer services available alongside fewer statutory services?”
“It is an issue for every Minister around the Executive table. I hope that Ministers listen, because the community is having to pick up the slack. It is left struggling year-on-year, trying to find the funding to deliver essential services. Given that almost half of ADHD PIP claims are being disallowed, numbers are rising year-on-year and families are forced to go private or give up trying entirely, that is not individual failure; it is a systemic failure. We are letting people down when they need help most.”
“Those numbers reflect real people and families who are struggling, often without diagnosis, treatment and consistent support. <BR /> <BR />The publishing of the Department's report on commissioning ADHD services is overdue. Families, clinicians and community organisations need to see the evidence, the scale of the need and the options that are being considered. Transparency builds trust, and trust is badly lacking when people wait for years for assessment or have to pay privately out of absolute desperation. Shared care arrangements matter. If GPs are not properly supported and involved, treatment pathways collapse before they even begin. <BR /> <BR />I want to be clear with the Executive today: ADHD is not just a health issue; it affects education, employment, social security and mental health.”
“That matters because many young people with ADHD thrive in practical skills-based environments, but, without a diagnosis, support and workplace understanding, those opportunities are lost and so is the potential of those young people. <BR /> <BR />I recently asked the Communities Minister how many people with ADHD have been awarded personal independence payment (PIP) in the past five years. In just five years, the number of people with ADHD who have been awarded PIP has more than tripled, rising from around 300 claims in 2020 to well over 800 in 2024. Despite that, almost half of ADHD applications were disallowed at initial assessment last year, with many being later overturned after reconsideration. That shows just how poorly the system understands and responds to ADHD in practice across the spectrum of services.”
“<BR /> <BR />Those organisations reflect to me a number of the key issues, including that people wait years for an ADHD or autism assessment; that many of the individuals have overlapping ADHD, autism, anxiety, depression or learning disabilities; and that service provision does not reflect need. Grassroots organisations such as those fill the enormous gap where there is no funding. I hope that the Minister will provide details of any support that will be made available, given the UK Government's disgraceful cut to the local growth fund, which will impact on even more of the organisations that reach out across our constituencies and help people where the system is not able to catch up. One group recently contacted me during Apprenticeship Week to raise concerns about barriers to small employers in taking on apprentices.”
“The debate matters, because ADHD is not a marginal condition that affects a small cohort of people but a growing, life-shaping reality for thousands of people across the North. The evidence shows that the system is struggling to keep up. At the outset, I acknowledge the work of those across South Down who are stepping in where that system falls short. I am sure that other MLAs have such organisations in their constituencies that support families, advocate for children and help adults to navigate services that are not designed with them in mind. I think specifically of Autism Support Kilkeel, the Downpatrick Autism Family Support Group and the ADHD hub in Newcastle, although I know that there are other organisations in South Down that help.”
“Indeed, Minister. It is 50% in urban areas and 29% in rural areas, and, frighteningly, it is just 14% in my South Down constituency. That is an inequality, and it is an injustice that needs to be made right. Minister, are you up to that task, or are you asleep at the wheel? If you are, what will it take to wake you up?”
“I wish the Minister well as he stands down from his role as party leader and can focus on his work as Health Minister.”
“Many tourists who visit our area go to visitors' centres, such as the Saint Patrick Centre in Downpatrick. Unfortunately, however, funding is often short to maintain those buildings, which can impact the product that we have to offer. Was any consideration given at the meeting to developing a capital grants scheme for such buildings to help with their upkeep?”
“I thank the Minister for his answer. I asked the question on the basis that those schools come together and amalgamate and take the leap as we try to reduce the capital footprint of schools across the North in order to save money and redirect it to the classroom. Many of those schools, including Lecale Trinity Grammar School in Downpatrick, need a small amount of capital investment in order to make them more sustainable. In this instance, there are two buildings where a small connecting corridor would link them together as one building, which would save children having to walk in the rain, snow, across ice or whatever from one class to the next. I ask the Minister to revisit that decision in order to determine whether there is some way of helping that school.”
“Business rates can cripple a business. Businesses in Downpatrick are aware of that, as their high rates have not been matched by footfall due to the hangover from the floods in 2023. Will those businesses be protected and assisted as part of the paused process?”
“<BR /> <BR />I recognise the work of the people on the ground, assisted by the County Down Rural Community Network, to try to take the 25-year-old peace maze to the next stage so that it can be there for future generations — children, young people and communities — to learn about the importance of peace and to maintain the tourism speciality in Castlewellan that puts it on the map.”
“Part of that work will involve an art competition for schools in the district about what peace means to them, followed by an art exhibition, so Newry, Mourne and Down schools, and maybe even those further afield, need to be ready. <BR /> <BR />At a time when politics too often feels defined by constant fighting for fighting's sake and point-scoring, as we have seen even today, such projects remind us of our responsibility as a political institution. People need something to hope for, as they did in 1998. They need to see that cooperation is possible, that progress can be made and that peace is something that we tend, not something that we take for granted.”
“It was planted by children and families from Castlewellan and the surrounding area, was funded by the EU and was shaped by hope rather than certainty in those days. It has become a quiet but powerful symbol of what many people believe peace is: something that grows slowly, is rooted in the community and is shaped over time. <BR /> <BR />What strikes me most today is that those who planted the trees still talk about their involvement in the process. They remember where they stood and what it meant, and they feel connected to it. That tells us something important: peace is not an agreement or an institution; it is all about people. The current project matters because it recognises that truth. It preserves the original artwork, captures oral histories and invites a new generation to reflect on what peace means to them today.”
“Castlewellan peace maze is a jewel in our tourism offering. It was the brainchild of Michael and Beverley Lear, who approached Eamonn ONeill, formerly of this place, in Castlewellan Regeneration Ltd to make it a reality. I am delighted that they have secured a small pot of funding from the Pathways to Peace project to celebrate the peace maze 25 years on and place on record just how important it is not only for Castlewellan but for our peace process. In the early days after the Good Friday Agreement, people were searching for something tangible to hold on to that said, "Things can be different" and, quite literally, "We can choose a better way", and the peace maze was one of those things.”
“There are elements of this news, whether 10 years old or 10 minutes old, that are good because they will make our roads safer. Has the Minister done any work with the PSNI, which will have to do a substantial amount of enforcement in this regard, to see whether we can get more resources for it? It will be required to do extra work, and we know that it is already under substantial pressure.”
“We are aware that there is a crisis in our Ambulance Service. Response times are deteriorating, not improving, under the Minister's watch. Was any opportunity taken to discuss mutual support between the two ambulance services, especially for 999 emergency calls, which have better response times in the South than in the North, that could help people in border communities such as Fermanagh, south Armagh and south Down?”
“For Members interested in the evidence base for that, the all-party group on stroke will hear from Professor Colin Angus of the University of Sheffield this Thursday. He is one of the UK's leading experts on modelling the effectiveness of minimum unit pricing in Scotland, where it has been in place since 2018. <BR /> <BR />We must also be clear about the wider implications. The societal cost of stroke is expected to rise sharply as incidences increase. That reflects not only the need for intensive rehabilitation and long-term support but the economic impact on survivors who are unable to work and the families who care for them. As we approach Stroke Prevention Day on Thursday, let us commit to taking the necessary action to reduce the devastating impacts of a stroke.”
“We know that stroke can destroy a life in an instant. Across the North, at least two people every hour are at risk of losing the ability to see, speak, move or even swallow as an impact of a stroke. It remains the fourth leading cause of death across the UK. The question that is always asked is whether it has to be like that. The Stroke Association is urging the public to protect themselves by regularly monitoring blood pressure and taking steps to maintain a healthy level and a healthy life. Of course, prevention is always much better than cure. That means eating well, avoiding smoking and vaping, staying active and limiting alcohol consumption. <BR /> <BR />One practical action that the Assembly could take is the introduction of minimum unit pricing for alcohol.”
“In my constituency of South Down, over 2,000 people are rebuilding their lives after a stroke; more than 2,500 people live with atrial fibrillation; and over 16,000 constituents have high blood pressure. That could be 16,001 after some of the debates that we have in here of a day. High blood pressure is one of the leading causes of stroke and is responsible for around half of cases. <BR /> <BR />Figures for the whole of the UK show that, every five minutes, someone will experience a stroke. The Stroke Association is concerned because, without urgent intervention and attention, it looks like that figure will move quickly to one stroke every three and a half minutes by 2035. That means that we will see a substantial increase in the number of people who are affected.”
“This Thursday, 29 January, is Stroke Prevention Day. It is important to raise that matter here today, because there are more than 42,000 stroke survivors living across Northern Ireland.”
“We had high hopes last year because there were lots of promises about blank pages and sitting down and getting early resolutions to be prepared, and it did not take us until November before all that was obliterated, and that was shocking.”
“It offers no reassurance to the family sitting beside a loved one who is on a trolley, and it offers no incentive to the paramedic or nurse who is wondering whether staying in the system is sustainable. Unless you are willing to pay social care staff properly or, worse still, promise them a living wage and then renege on that, what is keeping them here? Unless you are willing to introduce safe staffing legislation, what confidence can we have that staff conditions will improve rather than deteriorate? <BR /> <BR />The frustration for many of us is due to the fact that we knew that the problems were coming.”
“The obvious outworking is that patients who are ready to leave hospital but cannot secure a domiciliary care package are left in hospital waiting, causing the person in the ED to wait, causing the person in the ambulance to wait and causing the person dialling 999 to wait. As the SDLP said in its document last year, 'Help Can't Wait'. <BR /> <BR />Having heard all that, I now want to ask this serious question of the Minister, and I do so in a constructive spirit: what is it going to take for you to act with the urgency that patients and staff deserve? Telling people that the system will take five years to fix offers no comfort to the person who dials 999 tonight.”
“I know that I am an opposition MLA, and my words will be treated as, "Here go the Opposition again, giving off about bad things". However, do not take my word for it; hear the voices of the people who have been left behind. Healthcare staff and patients have reached out to me directly, and I will read out some of their quotes. One says:”