Órlaithí Flynn
West Belfast · Sinn Féin · Northern Ireland
“<BR /> <BR />Parliamentary privilege is a complicated issue, but it is a very important one for all Members to understand. It was helpful to get Matthew's intervention on the fact that the repeal changes nothing for Members. It simply takes away the reference to privilege which never fully existed. I thank Matthew for his intervention.”
“My comments will be brief. As Deputy Chairperson of the Committee on Procedures, I welcome the opportunity to conclude today's debate on the motion to repeal Standing Order 70 and make a number of consequential amendments.”
“<BR /> <BR />I thank the Chairperson and members of the Committee on Standards and Privileges for undertaking a comprehensive review of Standing Order 70 and for bringing the outcomes of that work to the Committee on Procedures, with the recommendation to make the changes to Standing Orders.”
“I thank the Minister for that response. As you outlined, Minister, a key part of creating a more resilient road network is having the workforce to deliver it. We know that British austerity has severely impacted on our workforce in DFI, creating an over-reliance on contractors and driving up the cost of works as a result.”
“I support the motion, and I thank its sponsors. <BR /> <BR />For many people, the journey to becoming a parent is not straightforward. Whilst some conceive without difficulty, others face years of heartbreak, uncertainty and loss.”
“<BR /> <BR />I have learned that people often talk about IVF as though it guarantees a baby. Tragically, the reality is that that is not always the case. This is not the first motion calling for three cycles of IVF that we have debated.”
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“The Minister has spoken about his support for the five-trust model working as a single unit, without necessarily putting that formally in place because of constraints in money, time and all the rest. Hopefully, this can be an example of where we can make a bit of progress on that. <BR /> <BR />The motion calls for:”
“There is also a wider picture that cannot be ignored: evidence shows that ADHD is associated with higher risks of substance use and earlier contact with the criminal justice system. When support is delayed or absent, people are more likely to require later interventions by addiction services, policing and the courts at far greater human and financial cost. <BR /> <BR />The motion does not seek to apportion blame; it seeks leadership. We call on the Health Minister to engage with the health and social care trusts to explore any regional solutions that it might be possible to put in place and any services that will encapsulate diagnosis, treatment and mental health support in a coordinated and commissioned way. Hopefully, that can be explored. We are moving towards a regional mental health service and regional crisis services.”
“Where services are not available early, trusts are required to respond through mental health services, addiction services or crisis care to consequences that occur later down the line. That is cost-shifting, not cost-saving, and the impact on people's lives and futures is profound. Without timely assessment and appropriate treatment, many adults will struggle to sustain employment or maintain stability in their lives, and many children and young people will struggle to concentrate in school or to engage in learning and progress to further education or university. Those are not personal failings on the part of those individuals; they are the predictable outcomes of unmet clinical need.”
“At a meeting last week, I discovered that the Belfast Trust is the only trust that has no services for kids over the age of 10. Gaps have developed. That is not to put the blame on the trusts, because they are also in a difficult position and cannot commission new services when they do not have the funding to do so. Nor are GPs commissioned to provide assessments, prescribe or manage people's care on an ongoing basis. Where individual GPs step in to support patients, they do so without a commissioned pathway, and shared care depends on clinical judgement rather than a consistent system. <BR /> <BR />The absence of commissioned ADHD services does not save money.”
“There is a clear irony here. We know that the Minister and the Department already accept most of what the motion calls for — the Minister may say that when he responds — and that it is already contained in the mental health strategy, which has a specific section that calls for early intervention, regional consistency and better support, particularly for neurodivergent people. Leaving aside the Department of Health, we know that the children and young people's emotional health and well-being framework already acknowledges the long waiting times, delayed assessments and fragmented pathways. Despite that recognition over a number of years and in different pieces of work, ADHD services remain largely uncommissioned and underdeveloped. That is not necessarily a failure of individual trusts. I spoke earlier about a postcode lottery.”
“The current system too often treats ADHD and mental illness in silos, leaving people to be passed from service to service, falling between thresholds and receiving no consistent care. That is why the motion specifically calls for ADHD mental health services that will recognise and respond to co-occurring conditions.”
“<BR /> <BR />Children with an unmet ADHD need are more likely to struggle in school and to experience anxiety, exclusion and extremely low self-esteem. Adults with undiagnosed or unsupported ADHD face a higher risk of unemployment and poor mental health, and a lot of them will come into contact with crisis services at some stage. Those outcomes are not inevitable. They are the result of a system failure. I am not putting it directly onto the Minister who is with us here today and holds the portfolio. The system has failed for years, and it is failing at the moment. <BR /> <BR />The situation is even more challenging for people who have ADHD alongside mental ill health or a diagnosable mental illness.”
“At the minute, shared care arrangements are in place, which are discretionary for GPs who can decide whether they want to prescribe for patients, but that leaves many people having to either continue to self-fund for treatment or wait in public pathways: the options are to self-fund or wait. It is not just an inconvenience; it has real and lasting consequences. I am dealing with a case in west Belfast of an adult who paid for and received a private diagnosis of ADHD. The guy is in a terrible state at the minute, as is his family, because there are issues with him continuing to get the medication on which he depends. I am sure that we all see at first hand in our offices how it impacts on children and adults.”
“For children, ADHD assessment has largely been absorbed into an already overstretched child and adolescent mental health services (CAMHS) system. CAHMS is not an ADHD-specific service. Extremely long waiting times mean that children are waiting for years for their assessment and are losing critical opportunities for early intervention. <BR /> <BR />As a result of those gaps, many people will seek private assessment out of desperation; yet, afterwards, they often discover that there is still no automatic route back into health and social care treatment, including in cases where they need prescriptions for medications.”
“There is no single, standardised pathway for diagnosis, treatment and ongoing support; instead, access to assessment, diagnosis and treatment depends largely on where a person lives, their age and their ability to pay privately, which has created another postcode lottery. Provision has developed in a fragmented and inconsistent way across the health and social care trusts. It is not because of a lack of need or evidence but because a regional ADHD service has not yet been commissioned. <BR /> <BR />For adults, the situation is particularly stark. There is no commissioned adult ADHD service, and, in many areas, there is no clear pathway at all. Adults are often diverted into mental health services that are not designed to assess or manage ADHD, and, sometimes, people are left without support altogether.”
“I am pleased to propose the motion on commissioned attention deficit hyperactivity disorder services. <BR /> <BR />ADHD is a lifelong neurodevelopmental condition that affects how people think, learn, work and relate to the world around them. It affects children and adults, families, communities, education, employment and mental health; yet, despite its prevalence and its impact, ADHD services in the North remain fragmented, inconsistent and fundamentally unfit for purpose as they stand. <BR /> <BR />At the outset, it is important to be clear about the current position here. There is currently no commissioned regional ADHD service.”
“Go raibh maith agat, a Phríomh-Leas-Cheann Comhairle.”
“I sincerely hope that we can get that legislation agreed at the Executive table and over the line. The NISRA statistics on alcohol deaths for last year are due out either at the end of this month or next. Does the Minister have any update on the piece of work that was taking place in a border constituency, funded with PEACE PLUS money, on a big community detoxification centre ?”
“The deputy First Minister referred to the inquiry that was launched by the APG, which will look at the potential for cross-departmental funding for suicide prevention from all Departments, because the issue cuts across all Departments. Does the Minister think that the APG's work and recommendations might assist the Executive subgroup in seeing what each Minister can bring to the table to try to save more lives?”
“I thank the Minister for his response. The Minister knows that the Charity Commission is dealing with an extensive backlog in registrations and the administration of accounts. I appreciate that he intends to introduce legislation to try to streamline the process, but has he considered any further reforms in the meantime, such as putting in place a stricter definition of what constitutes a charity?”
“I know that notification was sent out, but I inform Members that, immediately following the meeting in room 342, we will meet at 1.45 pm, when Members can gather outside Parliament Buildings for a moment of reflection to remember each of the 290 lives that have been lost to suicide. Family members and community and voluntary groups will be there, and the Minister of Health will be in attendance. Members are all more than welcome and, hopefully, can come along. The moment of reflection will be quiet, dignified and deeply human. It is an opportunity for us all not just to remember but to recommit to doing better and acting earlier to ensure that no family feels abandoned in its darkest hour. If colleagues are available, I encourage them to attend and join some of the families at 1.45 pm tomorrow.”
“<BR /> <BR />Tomorrow, the all-party group on suicide prevention will mark an important and solemn moment here at Parliament Buildings. At 1.00 pm in room 342, we will come together for the official launch of an inquiry into cross-departmental funding for suicide prevention. I welcome the confirmation that the Health Minister will formally launch the inquiry, which underlines the seriousness and urgency of the work. With 290 suicides registered in the North in 2024, the inquiry could not be more timely. Suicide does not sit with one Department; it genuinely needs a whole-of-government approach.”
“Today, on what is often referred to as Blue Monday, I want to pause and speak directly to the reality behind that phrase. While Blue Monday is sometimes described as the most difficult day of the year for many people in our constituencies, emotional distress, loneliness and despair are not confined to one Monday in January; they are daily realities shaped by social isolation, poverty, trauma, poor mental health services and ongoing pressures facing individuals and families. As a society, we must be careful not to trivialise those experiences, but instead use moments like this to recommit ourselves to meaningful action, compassion and prevention. In my community in West Belfast, we can see at first hand the impact that poor mental health and suicide have had on families and communities, which highlights the urgent need for more support.”
“<BR /> <BR />My colleague Philip McGuigan, who is Chair of the Health Committee, mentioned the other good examples of children's heart surgery and the North West Cancer Centre at Altnagelvin. It is important for the public to realise that we really care, and, if we find a solution, even around the digital stuff, let us look at it. We need to stop what is happening at the minute, because no one wants to be in that position.”
“It is really important to make the point that we need to have any conversations or explore any options that we can with the South for the sake of every citizen living across the island. I do not know how achievable that is, but no one wants to be in the position of putting a baby or child on a boat or a plane for a post-mortem. Therefore, trying to find an all-island, localised solution would benefit the South as much as us. That might not happen in the short term or even in the medium term. Looking at such specialities will probably require a broader discussion about workforce and training on the island. That is probably being done, but, if it is not, it needs to be, so that, at least, we can give reassurance and comfort to families who have already gone through that terrible situation that we are trying to change it.”
“His latest update to the Assembly Chamber was that, regrettably, the South is now facing its own capacity issues, with two out of three of its paediatric pathologists due to retire soon. We do not have any paediatric pathologists. The South is facing its own shortage and difficulties, and we have heard about how widespread that situation is in Britain and possibly globally.”
“On top of that loss, families are having to make a decision about putting their child on a boat or an aeroplane to go across the water for a post-mortem. It is hard to put yourself into the shoes of the families who have had to go through that process. <BR /> <BR />I acknowledge that the Health Minister referenced the issue in the Chamber a number of months ago. As the Minister and his predecessor will know, we have raised the issue at the Health Committee over the past number of years. We welcome the ongoing discussions to try to find a solution that will keep the service on the island. It is my understanding — the Minister can correct me if I am wrong — that we had moved closer to a position where he could make a decision and movement was imminent but that that has changed.”
“Members have touched on all the key points and the motivation for bringing the motion to the House. Diane Dodds made a point that I want to repeat. When we talk about all-island cooperation and collaboration, at times, people make assessments and judgements that the discussions are political, but that is not what this is about. I hope that everyone recognises that, regardless of which party tabled the motion, the motivation at its heart is to try to take away the absolutely dreadful decision-making process that families have had to go through for the past seven years. Alan and Colin very eloquently said that we are talking about the most unimaginable pain. Families are going through this situation daily. As a mother, I cannot even imagine the grief of losing a child.”
“Minister, I welcome those savings through the important initiative that your Department has undertaken. You are aware, of course, that local prescribing levels for anti-depressants are the highest across the islands. Are any conversations under way with GPs and clinicians on how we can reduce those prescribing levels and replace those anti-depressants with cost-effective treatments that are not necessarily medication?”
“<BR /> <BR />For anyone who is listening and might be finding it hard, please know that you can reach out to the Samaritans and to Lifeline. We cannot undo the loss that so many families have already experienced, but we can listen to them, learn from what they are telling us and try to do more to stop others going through that pain.”
“The cost of heating your home, the pressure to spend money that you do not have, empty chairs at a table that cannot be filled and anniversaries of loved ones who we have lost all sit in stark contrast to the positivity that we see on our screens and on our streets. <BR /> <BR />At a time when everywhere seems bright, many people feel completely in the dark. So, I ask Members and the wider public for something very simple over the weeks ahead: please be kind in the Chamber, online and in our communities. We rarely know what the person in front of us is dealing with or what they are carrying, and a harsh word can push someone further down. A small act of kindness can make it easier for them to hold on.”
“While that explanation is important, it does not take away from the reality that too many lives are being lost in that way year after year. <BR /> <BR />Men remain much more likely to die by suicide, especially younger and middle-aged men. People living in our most deprived communities also face higher risk. Older people, often living alone, are particularly vulnerable, and we have seen that the rise in the latest NISRA statistics for 2024 has impacted more on our older population. <BR /> <BR />We are now moving into winter and towards Christmas. On the surface, it is a time of joy, lights and music, but, for many people, it is the darkest, loneliest, most pressurised time of the year.”
“Today, I rise with a very heavy heart. This morning, my thoughts are with families across the island who are grieving someone who they have lost to suicide. <BR /> <BR />The latest NISRA figures on suicide are deeply troubling. They show that 290 deaths by suicide were registered in 2024. That figure is up from 221 in the previous year. To those who have lost someone to suicide, I express how sorry I am for what you have been through and for what you are still going through. I know that no statistic can ever capture the person whom you miss and you have lost. <BR /> <BR />The figures are based on the year that the deaths are registered, and delays in inquests can sometimes mean that some of the deaths that have been recorded happened in earlier years.”
“That ward has been set up to take them out of the emergency department ward to a place where they are safe and have one-to-one care and treatment, and that frees up the police officers and the social workers, who do not need to stay with them. However, the path project is not being funded by the Department; the trust is managing that itself at the minute. If we can look at the good models and good examples that we can build on, that might ease a wee bit of pressure on both Health and Justice.”
“If we could expand those on a regional basis and if Health and Justice worked in tandem to do those things, that would have an impact on the person or patient in mental health distress. We can talk all night about things that might be holding the Minister back in moving forward with some of this stuff — funding is a problem — but how do we build on the good pilots that have already been in place? <BR /> <BR />Just last week, the Health Committee visited the Mater Hospital and the path project. I know that we will write to the Minister about that anyway, but, again, that is another wonderful example of what is happening in the Mater Hospital when people have been assessed and are suffering with really poor mental health.”
“I thank the Member for that intervention. I spent a bit of time with them when they were introducing the multi-agency triage teams, which have been fantastic, with police working alongside mental health practitioners and the Ambulance Service. I am also conscious of the successful custody suites pilot where a mental health practitioner assessed the prisoners coming in, as opposed to a forensic medical officer doing it. I was going to make that point. I am not sure if the custody suite pilot has since fallen because we could not get match funding. I am not sure that it was match funding, but Health and Justice were funding that together at one stage, so there are good examples and models of practice that we can look to.”
“The Minister can fully implement the mental health strategy, Protect Life 2, only if his budget will allow him to do that. However, it still needs to be —.”
“What needs to come from the debate, however, is what can be done at whatever level, whether it is Executive level or different parties or Ministers coming together to see how we can make it work better and maybe speed up the Right Care, Right Person approach so that we are not losing lives in the meantime, as Linda pointed out. <BR /> <BR />Colin said that the PSNI responded to over 100 "concern for safety" calls per day. Think about it: that is per day, so it is obviously taking up a massive amount of police time. Again, it comes back to whether the person who needs the help and support is receiving it regardless of how much police time is taken up. Probably not. <BR /> <BR />Points were made about the strategy, and, again, it comes back to the funding.”
“I thank the Member for her intervention. Sadly, that is the reality. Too many people are not receiving the appropriate care in time and are losing their lives as a result. Again, that is not to pin it all on whether they have been handled appropriately by the PSNI if officers had been dealing with them. It is not to pin it on emergency department waits or mental health waiting lists. This is a problem that we all need to take responsibility for. You cannot pin it on Health or Justice. <BR /> <BR />Alan spoke passionately on behalf of his party. I am conscious that it is his colleague who holds the Health portfolio. We all understand where the Minister is coming from. He simply does not have enough money to put into crisis services or to put some of those models in place.”
“It is not appropriate that that is being dealt with by a police officer as opposed to a healthcare clinician.”
“As Sinn Féin spokesperson on mental health and as chairperson of the all-party group on suicide prevention, I start by saying plainly that it is not sustainable or acceptable that the police have become the default response to mental health crises in our society. That is not to pin blame specifically on the Minister of Health. We all understand that the issues cut across every Department and are the responsibility of every Department at some level, so we all have a role to play. <BR /> <BR />The motion is fair in respect of what the police have to deal with and cope with at present. It is not fair on them as an organisation in terms of what duties they should be freed up to carry out. It is also not fair on the individual who is in that state of mental health crisis, psychosis or whatever the situation may be.”
“My party's amendment speaks about an all-island approach. There was discussion about that at last week's meeting of the North/South Inter-Parliamentary Association here in Stormont; Linda might give us a bit of an update on that. The all-island stuff speaks for itself: if it is the right thing to do, let us do it. If it will save a life, let us do it. Philip mentioned some of the good practice in the North West Cancer Centre at Altnagelvin. If we can build on any of that, please let us do that. I know that it is not just as simple as that and that it all takes funding, collaboration and hard work, but, hopefully, following the debate on today's motion, we can move closer to that point.”
“Then, hopefully, you will not be in that situation at the other end of the health service where you are requiring treatment to treat your cancer. <BR /> <BR />In the Belfast Health and Social Care Trust, the HPV uptake for girls sits at only 72%. The World Health Organization (WHO) recommends that 90% of 15-year-olds should have received that vaccination. There are ways in which we are falling behind. We could be getting more people vaccinated and screened at an earlier point, and that would mean that they were not coming into the system with the diagnosis of cancer further down the line. I will push that vaccine and promote it in West Belfast to try to get an increase in uptake. <BR /> <BR />We know that the prevention stuff alone will not fix the problem. We need to put in place a series of measures.”
“<BR /> <BR />The international evidence has been mentioned. Even a four-week delay in treatment can increase the risk of death by between 6% and 8%. In the breakdown of the numbers that Diane provided, every one of those figures represents someone who has lost their life who potentially might not have been in that situation. It was powerful just to listen to that breakdown. That is what we are dealing with. <BR /> <BR />I will bring us back to my constituency, West Belfast. We have held meetings on something more specific: the screening for human papillomavirus (HPV) in particular and the vaccinations. All of us try to give that plug to every one of our constituents. Where vaccines are available that can help prevent cancers or pick them up earlier, please get them. It is the right thing to do.”
“It also is for all the families and individuals whom we represent. It is a very current, raw and difficult issue to deal with and even to talk about. <BR /> <BR />Thanks to the DUP for tabling the motion in the first instance. Hopefully, the amendment will get some cross-party support as well, to make some improvements. Across the North, we are simply not seeing people quickly enough, although many families are lucky enough to receive the gold-standard, life-saving care and make it through to the other side. People are grateful for that. However, Diane spoke about one of her constituents, and, sadly, we are not catching everyone. There are still people waiting outside those timelines, where their diagnosis and treatment should have started much more quickly. That might have saved their lives.”
“I also welcome the chance to speak on this important issue. As has been said, cancer impacts on every one of us, those in the Chamber and the families that we represent in our constituencies. I reiterate that cancer waiting times are not an abstract policy issue; they are sleepless nights and anxious weeks, while patients and their loved ones are left wondering whether they will live or die. <BR /> <BR />Nuala talked about the silence when people are waiting and the unknown future. I am sorry to see Sinéad get upset from whatever she is going through at the moment. When we last debated the issue of cancer in the Assembly, in late May or early June, I was unable to take part in the debate because my mother was just going through a breast cancer diagnosis and treatment. I get that it is personal to every one of us in one way or another.”
“Minister, you will remember our conversation at Bunscoil Phobal Feirste about the lack of outdoor space and, in particular, the high number of special educational needs (SEN) pupils at that school, which is the case at many of our schools. Feedback from the EA suggests that Health does not seem to be at the table when it comes more broadly to special educational needs support and specialised services in our schools. Are you aware of those issues? What is being done to support our SEN pupils?”
“I thank the Minister for his response. I am conscious that the strategy has not been fully launched or implemented yet, but will any immediate actions flow from the strategy that might help to offset some of the real, harsh impacts of the cost-of-living crisis that people are feeling at the minute? Can any immediate, short-term actions be delivered on that issue?”
“<BR /> <BR />I would like to hear from the Minister how his Department will address some of those issues, what interventions can be put in place to keep people out of hospital and away from emergency departments, first and foremost, and whether there will be any additional investment in GP practices on top of what was already announced at the Health Committee. I would like to hear about the specific steps that are being taken to prevent avoidable admissions to hospital. Hopefully, that will take the pressure off emergency departments.”
“Our health service, schools and communities are all living with the consequences of decisions made in London and not made directly in this Chamber. However, the question for us now is this: how are we spending what we have? Are we doing things differently? Are we learning from last year and the year before that? None of us wants to see a repeat of last winter. I think back to the long lines of ambulances outside emergency departments, with patients waiting for hours to be admitted or discharged and staff being exhausted and working flat out. That cannot happen again. Sadly, it dragged on beyond the winter, and staff say that it is all year round.”
“They are the backbone of the service. They deserve respect, recognition and fair pay. Thankfully, that is exactly what we have been able to achieve. While no one is pretending that all the challenges in health are fixed, the Executive have stepped forward to prioritise health and deliver on pay when it mattered most and to support our Health Minister. The Department of Health now has a record budget of over £8·4 billion and additional allocations through each of the monitoring rounds, but with all that support comes responsibility. <BR /> <BR />It is not enough to simply ask for more money each time that you find yourself stuck financially. That goes for every Department that finds itself under pressure. That pressure comes from years of underfunding imposed by the British Government.”
“The Finance Minister encouraged all Departments to prioritise their pay awards, especially for our Health and Social Care workers, at the start of the financial year, if that is doable and achievable, as opposed to trying to scramble and being genuinely stuck to meet the need at the end of the financial year. I am really pleased that the Minister promised in his statement that that situation will not happen again. I welcome his commitment to taking responsibility for those allocations going forward. I sincerely believe that that is what true accountability looks like across all our Departments, and it is what staff and the public expect. <BR /> <BR />We all recognise the immense pressure that staff across the system are under. That is all staff: nurses, doctors, porters, care workers, the whole team who basically keep the system running.”
“Thank you, Diane. I am not sure. My understanding was that the amendment was possibly submitted after the original £100 million was set aside by the Executive, as opposed to the additional £100 million. I am not sure whether that answers your question, but I can get that clarified for you. It is my understanding that the original £100 million was the basis of the amendment, but I am happy to have a chat with you following today's debate. <BR /> <BR />I welcome the Minister's confirmation. At Question Time, the Minister of Finance spoke about the Health Minister's confirmation that future pay awards will be prioritised at the start of each financial year.”
“I welcome the opportunity to contribute to tonight's debate on the winter preparedness plan and pay, albeit that it is slightly outdated, thankfully, with the progress that we have seen in the past couple of days. Everyone in the Chamber will be thankful that, together, the Minister and the Executive were able to deliver a pay settlement for our Health and Social Care (HSC) staff. That is the most important thing to come out —.”
“Go raibh maith agat, a Leas-Cheann Comhairle.”