Danny Donnelly
East Antrim · Alliance Party · Northern Ireland
“I thank the Minister for that answer. It will not satisfy the people of the area. The completion of the 3 km distributor road was planned to be a key part of the development, linking hundreds of houses to the wider road network, but, due to a planning issue by her Department in the 1990s, it never happened.”
“I thank the Minister for his statement. Minister, as you mentioned in your statement, the inquiry was highly critical of what it describes as "an adversarial and oppositional approach" by the Belfast Trust to the inquiry.”
“The Minister mentioned the need to reform the health service. In light of the recent startling figures that show that half a billion pounds was spent on locums over the past three years, does he agree that investment in attracting permanent doctors may be a more prudent use of Department of Health resource?”
“<BR /> <BR />As a nurse, I condemn the attacks in the strongest possible terms and highlight the specific impact that they have had on people who care for us when we are at our most vulnerable.”
“Every day, they treat patients with skill, compassion and professionalism. Let us be absolutely clear: when a nurse is intimidated on her way to work and chased by masked men into the Ulster Hospital, that is an attack on our health service.”
“I will speak today about the attacks on our international healthcare staff. I begin by saying that my thoughts are with the victim of the brutal attack in north Belfast and his family. I hope that he recovers well. <BR /> <BR />Violence has no place in our society.”
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“Minister, is further recruitment being planned for prison officers?”
“I thank the Minister for that answer. It will not satisfy the people of the area. The completion of the 3 km distributor road was planned to be a key part of the development, linking hundreds of houses to the wider road network, but, due to a planning issue by her Department in the 1990s, it never happened. Will she commit to visiting the area, reviewing the issue and working to resolve it for the growing number of people who are impacted on in Larne every day at those key traffic times, noting that the Northern Ireland Public Services Ombudsman's (NIPSO) report said that vesting should not be ruled out?”
“Will the Minister give an update on the hospital reconfiguration plan, to which the Member who asked the substantive question referred? When will that plan be produced?”
“The Minister mentioned the need to reform the health service. In light of the recent startling figures that show that half a billion pounds was spent on locums over the past three years, does he agree that investment in attracting permanent doctors may be a more prudent use of Department of Health resource?”
“I thank the Minister for his statement. Minister, as you mentioned in your statement, the inquiry was highly critical of what it describes as "an adversarial and oppositional approach" by the Belfast Trust to the inquiry. Does the Minister accept that that points to a deeper cultural problem in parts of the organisation, where challenge and scrutiny are resisted rather than embraced? What specific actions will he, as Health Minister, take to change that culture? Furthermore, can the Minister confirm whether the Belfast Trust remains in special measures?”
“I thank the Member for that very powerful example and her recognition of the power of childhood trauma. Does she agree that trauma-informed practice does not excuse harmful behaviour but helps us to understand it and to respond in a way that promotes safety, responsibility and recovery?”
“Our international healthcare staff are needed and valued, but they are worried and fearful for their safety and that of their families, including their children. School principals have told us that some children from ethnic minority backgrounds have stayed away from school over the past week owing to fears about travelling and being out in the community. Beyond making statements of support, what practical action in terms of workplace support is the Minister taking to ensure that international healthcare workers feel that their concerns are being heard and that they can safely continue to work in Northern Ireland?”
“Thanks to the Minister for that answer. What role will event duration monitors (EDMs) and near-real-time reporting play in keeping users of our bathing waters informed about water quality?”
“What impact do reapplications have on slowing down the processing time for the DAERA planning response team?”
“We value those who have chosen to care for our communities, and we recognise that our health service would collapse without them. To every international doctor, nurse, care worker, healthcare assistant, porter and allied health professional working across Northern Ireland today, or anyone else who feels frightened or intimidated by the events of the past week, the Assembly should send a simple message: you are welcome here, you are valued here and you belong here.”
“Every day, they treat patients with skill, compassion and professionalism. Let us be absolutely clear: when a nurse is intimidated on her way to work and chased by masked men into the Ulster Hospital, that is an attack on our health service. When a care worker is made to fear for their family's safety at racial checkpoints that have been set up outside our hospitals, that is an attack on our health service. When talented and dedicated professionals begin to consider leaving Northern Ireland because they no longer feel welcome, that is an attack on our health service. <BR /> <BR />The overwhelming majority of people in Northern Ireland reject racism, hatred and violence. We value those who have chosen to make their lives here.”
“<BR /> <BR />As a nurse, I condemn the attacks in the strongest possible terms and highlight the specific impact that they have had on people who care for us when we are at our most vulnerable. Over recent days, we have heard deeply troubling accounts from international healthcare workers in Northern Ireland: nurses who are afraid to travel to work, healthcare staff who are fearful of being identified in public and people who have dedicated themselves to caring for others who now question whether they have a future here. <BR /> <BR />Without international healthcare workers, our health and social care system would not function. The overwhelming majority of staff have come here from other countries to build a life, contribute to our communities and care for our loved ones.”
“I will speak today about the attacks on our international healthcare staff. I begin by saying that my thoughts are with the victim of the brutal attack in north Belfast and his family. I hope that he recovers well. <BR /> <BR />Violence has no place in our society. Over the past week, Northern Ireland has made headlines around the world for all the wrong reasons. Images of families fleeing their homes, of homes and businesses being attacked and of buses and our infrastructure burning have travelled far beyond these shores. The United Nations High Commissioner for Human Rights has rightly expressed alarm at the violence, racial hatred and divisive narratives that have fuelled the attacks.”
“I am sure that the deputy First Minister is aware that the extra spending required to run our divided society has been calculated at almost £1 billion a year. Could the case for more funding from the UK Government be improved if the Executive Office took more seriously the issue of the cost of segregation?”
“Does the Member agree that, if the Bill is voted down today, there will be no opportunity to take evidence at Committee, to shape the Bill, to propose amendments or to remove the clause to which there is so much opposition?”
“I thank the Member for giving way. Just to be clear, does the Member agree that clause 3 could be amended after Committee Stage and voted down at Consideration Stage?”
“The question is whether the Minister is prepared to respond with the seriousness and urgency that the current catastrophic situation requires.”
“That focus on accountability is of the utmost importance. Overcrowding is persistent, 12-hour waits are now routine and corridor care continues, so clear responsibility must be taken for improvement. The Minister should set out a clear and public plan to address the concerns in the report. He should deliver a plan for real and sustainable reform. This needs to be treated as the patient safety issue that it plainly is. More than 1,000 deaths a year being associated with prolonged waits in emergency departments cannot be regarded as a routine performance problem but should be taken as a clear warning and an issue that demands urgent action. Patients and families demand better, and staff in our emergency departments, who work under extraordinary pressure, deserve better.”
“When I asked Dr Perry about the barriers facing emergency care and what the solutions were, he was clear that there was a need for a multi-year strategy that looked specifically at social care, not just the front-door solutions that inevitably add to pressures. The report looks at recommendations such as that. Dr Perry and Dr McGurk also told us that, while the Minister's Release to Rescue programme had reduced ambulance waits outside hospitals, it had made overcrowding inside worse. <BR /> <BR />The royal college's recommendations are practical and deserve serious attention. They include ending the corridor care and mortality associated with long waits by the end of the decade, adopting a whole-system approach to overcrowding and ensuring that there is clear accountability for delivery.”
“<BR /> <BR />What is especially important about the report and what Dr Michael Perry and Dr Sara-Jane McGurk reaffirmed for us at Committee is that it makes it clear that it is not simply a demand issue. Attendance numbers at emergency departments have changed little while the long waits and the mortality associated with them have risen sharply. That is exactly what happens to a system that is under sustained strain and in which patient flow is critically blocked. That is exactly what this is about: patient flow, delayed discharge, bed availability, community capacity and social care. It is a whole-system problem that requires a whole-system response.”
“On Thursday, in a briefing to the Health Committee, the Royal College of Emergency Medicine (RCEM) set out the scale of the crisis in emergency care in Northern Ireland and the human cost linked to the failure to address that crisis. Using the standard mortality ratio calculation, the RCEM has estimated that, in 2025 in Northern Ireland, there were 1,032 excess deaths associated with patients waiting 12 hours or more in emergency departments before admission. To put that into perspective, that amounts to around 20 people each week. In 2020, the estimated figure was 461, and, in 2016, it was 60. The royal college described the situation as catastrophic, and I wholeheartedly agree.”
“Does the Member agree that where models of support, such as the Western Trust's family response and the early diversion work elsewhere, are already showing positive outcomes, the question should be how we can learn from those models to make that kind of practical, relationship-based support available to families in North Antrim?”
“On a point of order, Madam Principal Deputy Speaker. It appears that Mr Buckley is extrapolating quite far from the truth of the Bill. Will you please make a ruling on that?”
“On a point of order, Madam Principal Deputy Speaker.”
“Greater understanding and awareness can make a meaningful difference for those living with coeliac disease and those struggling with symptoms who have not yet been diagnosed or received the support that they need.”
“For many people with coeliac disease, eating out can be stressful rather than enjoyable. Even very small amounts of gluten can cause harm, and cross-contamination from shared utensils, fryers, chopping boards or preparation areas can make food unsafe. Research suggests that consuming more than 10 mg of gluten a day may be enough to damage the small intestine of someone with coeliac disease. Gluten can also appear in products that many people would never think of, including medications, supplements, lip balms and even children's play dough. <BR /> <BR />Although awareness has improved over recent years and gluten-free options are now widely available, many people still face daily challenges when shopping, eating out or trying to access reliable information.”
“People often think that only bread and pasta contain gluten, but it can turn up in all sorts of places. It can be hidden in soups, sauces, processed meats, soy sauce and snack foods. Some alcoholic drinks also contain gluten, particularly beers and ales.”
“May is Coeliac Disease Awareness Month. It is a condition that affects about one in 100 people in the UK, and it is estimated that around 64% of those people remain undiagnosed. It is a serious autoimmune condition in which the body's immune system attacks its own tissues when gluten, which is a protein found in wheat, barley and rye, is eaten. Symptoms can be recurrent, persistent or unexplained. They may include but are not limited to fatigue, stomach pain, nausea, anaemia and neurological issues. The only treatment is a strict, gluten-free diet for life, but that is far easier said than done.”
“If we already know where the gaps are, we have a responsibility to close them. There must be clear pathways, coordinated planning and consistent provision so that young people with SEN can continue to access the support, opportunities and stability that they need to participate fully in society.”
“<BR /> <BR />In other jurisdictions, it has been recognised that transition planning must include education, health, social care, employment and independent living and that that support should continue where it remains necessary for a young person to achieve their outcomes. We cannot continue to accept a situation where Northern Ireland lags behind other jurisdictions on something that is so fundamental. People here should not have to settle for less support or fewer opportunities simply because our system is so fragmented. I support the calls for Ministers to work together to develop proposals that facilitate effective transition planning for young people post 19 and address the loss of statutory support when young people move from children's services into adult provision.”
“When I think about Alma and her tireless work for Caleb's cause or those who have campaigned endlessly to have their voices heard, I see how their advocacy has ensured that those experiences cannot be ignored, yet they are still being left behind by a system that is not working for them. <BR /> <BR />That is representative of a far wider problem in our society and how it supports those in the deaf and disabled community. I have heard that directly from the people who are most impacted. It is an endless fight just to have access to the most basic rights. That should never be accepted. It should not be the norm. No one should have to campaign relentlessly simply to secure the support and stability that they need to live a full life.”
“The issue sits across multiple Departments, weaved inextricably into the fabric of our society. The impacts are monumental and far-reaching for those who rely on SEN support. We have heard again and again about the cliff edge of support post 19, but it is imperative that we grasp what it means for the young people in our society and their families who are left trying to navigate fragmented systems across health, education and everyday life for lifelong conditions. That cannot be acceptable in modern society. We cannot simply abandon people. I share the disappointment that has been expressed here that the Health Minister is not here to hear the debate. We need to do more than just acknowledge their struggle: there has to be a solution.”
“Thank you, Minister, for giving way. I acknowledge what you said about the Release to Rescue protocol. Do you acknowledge that Release to Rescue adds extra pressure on wards? I know of a ward that went from five corridor beds up to six when Release to Rescue started. How many times has Release to Rescue been activated since its commencement?”
“You mentioned rising demand again. The Royal College of Emergency Medicine report states that demand has remained relatively static. To what rising demand are you referring?”
“Yes, let us improve navigation into the system, but, more important, let us fix the reasons why the system is gridlocked in the first place.”
“<BR /> <BR />If you want to acknowledge the shift-left agenda and focus on prevention, early intervention and strengthening community provision and the role that that plays in decreasing pressure on EDs, you should look at increasing capacity in the community and ensuring that crisis points are avoided. That means looking at a renegotiated, fairer contract for community pharmacy, fair pay and conditions for care workers and ensuring that there is proper funding for GP surgeries and a fully funded mental health strategy, because prevention, early intervention and strengthening community provision needs to come at a much earlier stage in order to meaningfully tackle the sustained and growing pressures that face our emergency care settings.”
“It is about social care, investment in community services, nursing home capacity, workforce pressures and whether community care services exist in sufficient capacity to allow patients to leave hospital safely and in a timely manner. Therefore, while anything that can help reduce unnecessary demand on emergency care and help patients access the right care should absolutely be considered, it would be disingenuous and inaccurate to overstate the role that an integrated 111 service could play right now in increasing community capacity or early intervention and prevention and, therefore, the pressures facing emergency departments.”
“That is exactly the issue with confusing better navigation of the system with actual transformation of the system itself. <BR /> <BR />The pressures facing our health service, particularly emergency departments, stem mainly from the lack of capacity in the community and the inability of patients to flow through hospitals to access care in the community. As a nurse and an MLA, I have seen that at first hand. When I visited Antrim A&E in December, there were over 100 medically fit patients who could not be discharged into the community, in comparison with around 50 decisions to admit (DTAs) who were stuck in A&E without being able to get to a ward. It is fundamentally about delayed discharge.”
“The number of people attending emergency departments has changed relatively little, while the number of long waits and the mortality associated with them has risen dramatically. The number of 12-hour waits has increased by more than 14% from March last year to March this year — 14%. The winter preparedness plan has clearly failed. Almost a quarter of emergency department attendees waited for more than 12 hours before being discharged, admitted or transferred. A decade ago, only 1% of patients waited that long. The report also estimated that 1,032 excess deaths last year could be attributed to long waits for admission, and there have been over 1,000 excess deaths a year for the last three years. Importantly, the Royal College of Emergency Medicine vice chair in Northern Ireland stated:”
“I welcome the intention behind today's motion to explore a more integrated approach to urgent care in Northern Ireland and help patients access the right care. An integrated 111 service could effectively represent a tidying-up of the existing Phone First and out-of-hours systems. However, without clear evidence of significant unmet need, specifically around system navigation as opposed to the need for wider structural transformation, there is a risk that we are putting the horse before the cart in meaningfully addressing the pressures in our emergency departments. <BR /> <BR />The Royal College of Emergency Medicine report published earlier this year makes for deeply concerning reading. It clearly outlines the fact that overcrowding and long waits in emergency departments are not primarily the result of increased demand.”
“At a time when your Department is supposed to be championing openness, transparency and accountability through the Hillsborough law and the Being Open framework, can you see how your response to the report could damage public trust in the process and, indeed, in the health service?”
“Members of the Ladies with Letters group who have been impacted by the scandal described it as:”
“Thank you, Minister. Will the Minister acknowledge that there may be legislative gaps in safeguarding? Will he commit to working with the Minister of Health to strengthen protections for children who engage in sport?”
“Without that, we will see increasing disease progression and comorbidities, such as poor mental health, so please join me in supporting Arthritis Awareness Month by following the campaign on social media and highlighting the information and support from Arthritis UK, which can help our constituents open the door to a better way forward.”
“The awareness month will lead up to the launch of an Arthritis UK report, 'The Silent Treatment: Why an Arthritis Diagnosis Matters'. That report will highlight the barriers faced in achieving a timely and personalised arthritis diagnosis and why a diagnosis matters. <BR /> <BR />As well as facing diagnostic challenges, people with arthritis in Northern Ireland experience some of the longest healthcare waits, with years spent in severe pain, waiting for such vital care as orthopaedic surgery. We must treat that as an urgent healthcare priority and take a relentless approach to driving down orthopaedic and rheumatology waiting times. People with arthritis deserve timely access to surgery and treatment, with support before and after treatment to secure the best possible outcomes.”
“I rise to highlight Arthritis UK's first Arthritis Awareness Month. An arthritis diagnosis can open the door to life-changing support: that is the message from the health charity Arthritis UK during its first Arthritis Awareness Month, which is shining a light on the diagnosis of arthritis and other musculoskeletal conditions, which affect over half a million people in Northern Ireland. Those conditions are a leading cause of persistent pain, disability and lost working days, yet they are often dismissed as just a bit of pain or a natural part of the ageing process rather than as life-limiting and life-changing. A diagnosis can open the door to treatment, community and better symptom management, yet people with arthritis often struggle to get a timely diagnosis.”
“I am interested in the Member's example of the lady who was unable to leave that care provision. Does the Member agree that it makes no economic sense to deliver that more expensive care in a nursing home, when what that lady obviously needs is a less expensive care package at home?”
“I thank the Minister for giving way. We have seen a 14% rise in 12-hour waits in A&Es, primarily because of overcrowding in emergency departments and on wards and the inability to discharge medically fit patients. The numbers do not add up. There are twice as many medically fit patients on wards as there are patients in A&E who need to be admitted. If we cannot discharge those patients in a timely and safe manner, that is a crisis. Does the Minister accept that the lack of capacity in the community is driving that overcrowding in A&Es and on wards?”
“Workforce stability depends on fair pay and proper recognition of the value of care work. Unfortunately, the real living wage was not delivered last year as promised, but we welcome the Minister's intention to look at that and at pay uplifts early in the budget process. <BR /> <BR />Pay alone will not solve every challenge. We also need workforce planning; support with travel and mileage costs, particularly in our rural communities; improved recruitment and retention; and genuine engagement with staff, providers, carers and service users. Strengthening home care provision is about creating a sustainable healthcare service for the future. For those reasons, Alliance will support the motion and the amendment.”
“If the medically fit patients could have been safely discharged in a timely manner, the patients in A&E could have been admitted to the wards for the care that they needed. That is why home care should not be treated as a secondary service: it is essential healthcare infrastructure. <BR /> <BR />We need to take seriously providers' warnings regarding the sustainability of domiciliary care in our rural communities. If services are withdrawn from rural areas because providers can no longer afford to deliver them, vulnerable people and their families will be left without access to care. No one should face reduced access to care because they live in a rural area. Care workers too often feel overstretched and underpaid, which is why Alliance has consistently supported the introduction of the real living wage for social care workers.”