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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“If we fail to build a sustainable community care system now, the pressure that we already face will become even more severe in the years ahead. <BR /> <BR />We all have stories of friends and family members who waited for hours in A&E because of a lack of community care on the other side. This year, we have already seen that almost one in four patients attending a major emergency department waits more than 12 hours; 10 years ago, that number was one in 100. That reflects the systemic pressures across the health and social care system, including community capacity failures and delayed discharges. Recently, in one of our major hospitals, there were 70 patients in A&E about whom there had been a decision to admit — they required admission to the wards for treatment — and over 100 medically fit patients in the wards.”
“Strengthening home care provision is a vital part of the solution to the crisis of hospital flow and the need to reduce pressures on our health service. <BR /> <BR />As Members will be aware, the number of patients waiting more than 12 hours in A&E has increased by 14% since March last year. Recent projections from the Northern Ireland Statistics and Research Agency (NISRA) show that Northern Ireland's population is ageing rapidly. The number of people over the age of 65 is projected to rise by almost 45% over the next 25 years, while the number of over-85s is expected to more than double, rising by 126%. Those figures are more than alarming; they are a flashing red light and a blaring siren. This is not a question of affordability; it is a necessity. Demand for care in the community will only continue to grow.”
“<BR /> <BR />I thank the Member for proposing the amendment today. We support it.”
“What is striking about those experiences is that they are not isolated incidents: the same themes continue to emerge across health, education, transport, employment and community life. That needs to be addressed. <BR /> <BR />After discussion with members of the autism community today, I want to be clear: autistic people have always existed in our society. It is about being recognised and understood and having the ability to seek the support that they may previously have been denied or been unable to access. The responsibility now is to ensure that services reflect reality and are capable of providing the support that people need. I reiterate what my colleague Nuala said: if the Department is not clear about what post-diagnosis support should be provided, how can anyone else be expected to understand?”
“<BR /> <BR />Many of the concerns that have been raised in today's debate have been consistently reflected to me during the work that I have been undertaking with the disability community as part of developing my private Member's Bill on the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD). I have heard about systems that are fragmented, inconsistent and too difficult to navigate and about the lived experience of poor accountability, inaccessible services, failures in transition planning, inadequate mental health support and the exhaustion of constantly having to fight for basic rights and adjustments. <BR /> <BR />I commend the work of the Independent Autism Reviewer, Ema Cubitt, who recently highlighted those fragmented services in her powerful first annual report. I encourage all Members to read it.”
“Timothy Gaston made a point about the Barnett consequentials that come here as a result of the services that are delivered in GB. He is right that Barnett consequentials come to Northern Ireland because of services provided there, but we need to look at the ever-growing health service budget and ask where those priorities have been. The Minister responded with some of the things that are being done in the health service, but, as we have seen from the Independent Autism Reviewer's report and have heard time and time again from families who come into our constituency offices, things are not OK. Services are not being delivered reliably, waiting lists for assessment and diagnosis are far too long, and people are being failed.”
“Thank you. I agree absolutely that it is because of a failure to provide early intervention that those families have moved to a point of crisis at which they require that level of care. <BR /> <BR />Another theme that came up time and time again was the long waiting lists for diagnosis for adults and children. Thousands of adults who have realised that they may have autism are now on waiting lists to find out whether they do. Another glaring theme was the need for better mental health services for people with autism. Those issues are connected, and people with autism suffer a lot worse mental health conditions. There needs to be earlier intervention, and services need to be provided. <BR /> <BR />I will respond to a few of the issues that were raised.”
“Thank you, Madam Principal Deputy Speaker. I thank all Members who have contributed to the debate. I will highlight some of the points that resonate with how far-reaching and important the issue is. <BR /> <BR />There has been a lot of agreement, which is good. I think that Robbie Butler suggested that the debate was not so much a debate as a consensus, and some key themes have shone through. Fragmented services came up time and time again, and the Independent Autism Reviewer strongly highlighted that in her report. Quite a few Members mentioned respite services, particularly in the context of the BBC documentary 'I Am Not Okay', which was first broadcast in September 2024. Shockingly, that is now more than 18 months ago. As we have just heard from the Minister, some of the mums now have respite services for their children.”
“It must be about reforming how services are delivered and focusing on creating a sustainable health service, not just cutting costs to meet a budget target until it is the next Minister's problem. That means that all parties need to step up and get behind the genuine transformation of the health service.”
“It should go without saying that there is no health service without healthcare workers. Health workers have carried the system through some of its most difficult years. They deserve more than just warm words; they deserve proper support, fair pay and a health service that is sustainable for the future. <BR /> <BR />There are also opportunities for invest to save. One example is the expansion of the thrombectomy service from a nine-to-five service to a 24/7 service, which would end the inequality in the delivery of a treatment that saves lives and prevents disabilities following a stroke at a saving of £47,000 per patient treated. That cost-effective service should be invested in. <BR /> <BR />The Budget must be about more than simply managing crisis after crisis.”
“When we see 12-hour A&E waits increasing by 14% in the past year and when we are repeatedly warned that that has a direct impact on excess deaths, with over 1,000 a year being associated with 12-hour waits in A&Es in Northern Ireland, it is clear that difficult decisions need to be made. Had they not been avoided for so long, we could deliver meaningful change. <BR /> <BR />We cannot continue to ask front-line staff to carry the burden of a system that, everyone knows, is not working. Alliance welcomes the Minister's previous commitments to prioritise healthcare staff pay from the beginning of the financial year, because staff deserve certainty and fairness after years of pressure and instability. However, those commitments need to be delivered on. Carers also deserve the real living wage, as was promised.”
“It was also confirmed at Committee in December that efficiency work was only beginning. Frankly, that should have happened much sooner; it should not have taken the arrival of a new permanent secretary to kick-start serious work on efficiency and sustainability. The Minister should have been driving that agenda long ago, but real change requires action. That is why transformation cannot remain just another slogan. "Shift left" has to mean more than just words; it has to mean real investment that reaches the front line of community care. That means properly supporting GPs, community pharmacy, mental health services, social care and early intervention services. We also need urgency around reform.”
“Mike Farrar, the permanent secretary, has said that another one-year budget would make it almost impossible to deliver the necessary savings and that it would jeopardise the vision to transform Northern Ireland's healthcare system. The Fiscal Council is right to warn that the current position is not sustainable without either new recurring funding or significant reform. If we do not strategically review departmental expenditure and prioritise sustainability, we will simply continue to lurch from one financial crisis to another. <BR /> <BR />Last week at the Health Committee, the permanent secretary said that Northern Ireland could be in a prime position to successfully deliver a neighbourhood care model because of the size of our health system. That should be seen as an opportunity.”
“Thank you, Principal Deputy Speaker. I speak today as Alliance health spokesperson. <BR /> <BR />There is almost broad agreement across the Chamber about the need for a fairer financial settlement from the UK Government. Northern Ireland continues to be underfunded according to objective need, which places enormous pressure on public services, especially health. However, we also need to be honest with ourselves: over many years, we have continued to put increasing amounts of money into health — it now accounts for over half of the Executive's overall Budget — but outcomes have not improved at the pace that patients and staff deserve. We have heard warnings that, unless the service is transformed, that proportion is set to increase to 75% by 2050. Something fundamental needs to change, and we need a three-year Budget.”
“Therefore, I hope that the Minister takes the message of action seriously and is prepared to match the scale of the mental health crisis with the urgency, accountability and action that it demands.”
“Behind every delayed action is an impact on someone's life. It represents longer waits for assessment, inability to access treatment, health deterioration and a greater cost to the health service, digging us deeper into a reactive and crisis-driven service. <BR /> <BR />The Committee has agreed to write to the Department to seek clear information around accountability, because there are now serious questions that need to be answered. Who is responsible when targets are repeatedly missed? What mechanisms are in place to meaningfully monitor delivery? Writing a job description two months after a full team is supposed to be in place is not an achievement to the person in crisis who still cannot access the services that they so desperately need.”
“Workshops and draft actions for digital mental health were highlighted, despite the commitment to have an action plan completed and implementation under way by March. Those are only a few examples of an update that, honestly, was shocking and stark, littered as it was with missed targets and a serious lack of accountability. <BR /> <BR />There is a real danger that we become so used to delay and watered-down ambitions hidden behind budgetary constraints that failure to act becomes the norm. Funding pressures are real — no one is pretending otherwise — but not every failure can be blamed on budgets. When Departments miss their targets and attempt to present missed deadlines as achievements or progress, there is a serious issue. Delivery plans and strategies are not box-ticking exercises; they are supposed to improve people's lives.”
“The theme of this year's Mental Health Awareness Week is action, so let us talk honestly about action. <BR /> <BR />Last week, the Health Committee received a written briefing from the Department of Health on the progress of the mental health strategy. Frankly, it was deeply concerning. The Department presented as achievements things that, going by its own timelines, should have been delivered months ago: for example, writing two job descriptions was listed as progress, despite the commitment to have the full team in place by March this year. An early intervention and prevention plan is still being developed and finalised, despite a commitment to have a full draft completed by December last year.”
“I wish to speak about Mental Health Awareness Week. I begin by recognising the charities, community organisations and front-line staff across our mental health services who continue to do extraordinary work in a system that is not fit for purpose. Yesterday, I had the pleasure of joining my local Extern Embrace group at its Darkness into Light event in Ballygally, where I heard about the physical and mental health benefits of cold-water-dipping groups. However, our system is one in which people are left waiting until they reach crisis point before receiving the help and support that they need, and some never get it. We have a mental health strategy for which only 16% of the required funding has been identified, and it increasingly risks being shelved due to a lack of action.”
“The Minister will be aware that the 12-hour target in A&Es is that no patient should ever wait more than 12 hours, but recent statistics show that 12-hour waits have increased by 14% in the past year, from 10,000 to 12,000, whilst the Royal College of Emergency Medicine report referred to by Mr Buchanan showed that excess deaths related to long waits in EDs have more than doubled in the past five years to more than 1,000 a year. Given that stark evidence of the need for reform, what action will the Minister take to advance reconfiguration before the end of the mandate?”
“<BR /> <BR />Closing that gap means prioritising prevention, increasing access to NHS dentistry, integrating oral health into wider health policy and ending any assumption that access to dental care is somehow optional or secondary when it is, in fact, fundamental to health and well-being. Older patients who have attended the same practice for decades are being told that NHS provision is no longer available; some parents are struggling to find care for their children; some adults are putting off treatment until the pain becomes unbearable, because they cannot find a NHS appointment and cannot afford the private fees; and we have heard some of the options that people are trying for themselves. That is not sustainable or acceptable. We need to stop managing decline and to start leading reform.”
“Would anyone here credibly present that as a genuine saving? A reduction in expenditure caused by shrinking services is not a success; it is a false economy. <BR /> <BR />Poor oral health is not a stand-alone issue. When patients cannot access dental care, it affects the whole healthcare system. It increases the risk of heart disease, diabetes and other systemic conditions. It is also an equality issue. When the rates of dental decay among both children and adults are highest in the most deprived areas, as we have heard time and time again today, there is an obvious two-tier system. For a Minister who has often spoken about his commitment to tackling health inequalities, this surely has to be one of the worst.”
“I asked the Minister about the impact of that reduction on NHS dentistry services, and his response stated:”
“As we have heard, the British Dental Association has been clear that NHS dentistry in Northern Ireland has shrunk at a faster rate than in anywhere else in the United Kingdom. It has also warned that the absence of meaningful workforce planning over many years is compounding the crisis. Reforming the payment model is essential, and the Minister suggested in his contribution that he intends to address the contract that has been in place since 1990 and that the cost-of-service review will be with him in a matter of weeks. <BR /> <BR />Funding is an important part of the problem. I want to reflect on the Minister's recent response to a question for written answer that I asked about a £2·1 million reduction in expenditure on NHS dentistry.”
“Yes. The Member is exactly right. Certainly, I hope that the practice does not exist, but, if it does, we need to take urgent action. <BR /> <BR />Órlaithí mentioned the fact that people who are without dental care end up in A&E, and that is another impact on our secondary healthcare system. Mark Durkan mentioned that the loss of services has become normalised, and he is absolutely right that people accept that now as part and parcel of the system. <BR /> <BR />The motion rightly highlights the deterioration in access to NHS dentistry and the consequences for patients across Northern Ireland. Our amendment calls on the Minister not simply to accelerate an action plan but to develop a new oral health strategy.”
“Thank you. The evidence is anecdotal. If dentists see teeth with those impacts or people say that they have done it or that other people have done it, it has to be reported to the political representatives.”
“<BR /> <BR />The horrible idea that people are doing DIY dentistry on themselves is absolutely harrowing, and the issue was raised by Diane and Gerry. I cannot get that idea out of my head. I hope that there is no evidence, but, if there is, we should take urgent action.”
“Thank you, Madam Principal Deputy Speaker. I am pleased to speak in support of the motion and the amendment, and I welcome the opportunity to make a winding-up speech. <BR /> <BR />Members across the Chamber have reflected on the seriousness of the pressures facing NHS dentistry and on the very real consequences for the constituents who can no longer access the care that they need. There has been clear recognition during the debate that it is not a short-term pressure nor a localised difficulty; it is a deep structural problem that now requires a serious and strategic response. Many of the comments made in today's debate were strikingly similar. I will not go into all of them, but a few of them deserve to be highlighted.”
“I thank the Minister for his statement. Minister, you mentioned industrial relations. Will your announcement do anything to address the ongoing industrial dispute with the National Association of Head Teachers (NAHT)?”
“When response times worsen for category 1 calls, the consequences can be catastrophic. We are talking about people's lives. <BR /> <BR />When we discuss excess deaths in A&E, winter pressures, ambulance handover delays and category 1 targets, those are not separate conversations; they are part of the same patient safety crisis. Every delay has a consequence, and every missed target has a human cost. When only one in seven rural category 1 calls is being reached on time, the Department must treat that with the urgency that the risk to people's lives demands.”
“<BR /> <BR />I want to be clear: this is an issue for the Department of Health and the Minister. No blame should be directed at the dedicated and hard-working staff of the Northern Ireland Ambulance Service, who work under immense pressure and are not the cause of the crisis. They are the victims of pressures and inefficiencies in the wider health system. This is not just about ambulances but about delays in handing patients over to emergency departments, poor hospital flow and the lack of capacity in our communities. It is a perfect example of what happens when pressures upstream are ignored for too long. When patients cannot move through hospitals, ambulances cannot get back on the road. When ambulances cannot get back on the road, response times worsen.”
“Those are moments when every minute lost can worsen outcomes and reduce the chance of survival. In urban areas, that target is missed in more than half of category 1 calls: 52% are missed. That, in itself, is unacceptable. In rural communities, there is an 85% chance that the eight-minute target will not be met for the most serious, urgent and life-threatening emergencies. We already know that people living in rural areas are often disadvantaged by poor transport infrastructure, longer travel times and wider health inequalities. That means that timely access to emergency care is absolutely essential. When only one in seven of those calls is being reached within the target, rural communities are not just being let down; they are being disregarded.”
“I rise to talk about ambulance response times in rural areas. Recent figures have confirmed that just one in seven category 1 calls in rural areas are responded to by the Northern Ireland Ambulance Service (NIAS) within the targeted response time of eight minutes. At first glance, eight minutes may not sound like much, but, in reality, it can be the difference between life and death. Imagine if you or someone you love goes into cardiac arrest or begins to choke or is involved in a serious incident and is bleeding heavily. Suddenly, eight minutes is not just a target on paper. It is not a statistic, nor is it a performance indicator. <BR /> <BR />Category 1 calls are the most urgent emergencies. They are described by NIAS as "immediately life-threatening".”
“If we want safer communities, let us not only punish those who profit from addiction but build a system that reduces harm and prevents more families from ever having to bury a loved one in the first place.”
“The recent Drug Deaths Taskforce report's recommendations included increased funding for the staffing of drug outreach services, especially for young people and young adults; introducing real-time drug testing and faster public alerts on dangerous substances; monitoring the emergence of synthetic opioids as an urgent public health priority; strengthening the drug and alcohol monitoring and information system (DAMIS) through the rapid testing of drug samples submitted by community and voluntary organisations; and standardising the emergency department recording of non-fatal overdoses to improve trend analysis, treatment and service planning.”
“In March 2024, 60 United Nations countries collectively called for an end to the so-called war on drugs, which, in reality, has been a war on people. The policy that continues to constrain a health-led response in Northern Ireland is Westminster's Misuse of Drugs Act 1971. That legislation is not devolved. <BR /> <BR />There should be no ambiguity: the issue in Northern Ireland is profound. Campaigns such as Jasmin's law are at the very heart of ensuring that there is accountability, but we must start earlier and be prepared to act before more lives are lost.”
“Globally, the tide is turning. In 2022, the UN High Commissioner for Human Rights, speaking at the UN Commission on Narcotic Drugs, declared:”
“Drug policy reform activist Dr Órfhlaith Campbell highlighted Lyra's work as a stark reminder of the turmoil and mental health challenges faced by that generation. She also highlighted the connection between mental health issues, poverty, deprivation and substance use disorders and acknowledged that, alongside the harrowing rates of suicide, Northern Ireland has suffered significantly from drug-related deaths. Dr Campbell stated:”
“The rate of drug deaths for under-35s in Northern Ireland is alarmingly high. <BR /> <BR />The closing lines of Lyra McKee's final article before her murder in 2018, which was about "ceasefire babies", are poignant:”
“I absolutely agree. We need to step in early to save lives. Tackling drug-related harm and prevention is predominantly a health-related issue. <BR /> <BR />Research from Queen's University has highlighted the fact that young adults aged 25 to 34 account for the highest number of drug-related deaths in Northern Ireland, rising significantly over a decade from 13·4 per 100,000 in 2011 to 27 per 100,000 in 2021. The same research showed that the highest number of ambulance call-outs for drug-related overdose incidents for females was in the 15-19 age category while, for males, it was in the 25-29 age category. Moreover, emergency admissions data indicates that the highest number of hospital admissions for overdose incidents occurred in the 10-19 age group between 2021 and 2023.”
“I welcome today's motion and the opportunity to discuss the urgent need for a joined-up and proactive response to drug-related harm in Northern Ireland. <BR /> <BR />I support the principle of stronger accountability for those who profit from the supply of illegal drugs. The devastation caused by drug dealing is real, and the impact on families and communities is tragic and undeniable. Campaigns such as Jasmin's law come from unimaginable pain. That pain deserves to be heard and recognised. I understand that the Justice Minister has recently met Pauline Duddy. <BR /> <BR />While sentencing has a role to play, it cannot be the whole answer. This has to be about prevention, not just crisis intervention. The issue crosses many areas of public life, and tackling drug-related harm —.”
“Thanks to the Minister for that answer. The Department's consultation on low-carbon heating support closed in January 2025, which was over 15 months ago. The response that the Minister referred to was published in January this year, and it commits not to a scheme but to further consultation. Can she explain why it will take until at least 2027 to legislate for that? Does she accept that, for families who are still relying on heating oil, the pace of progress is not good enough?”
“I just want to pick up on that point about the thrombectomy unit. I think that the cost would be £5 million a year, but, as a result of that investment, a lot of suffering would be alleviated and lives would be saved, and a lot of disability could be avoided, which would result in money not having to be spent on care. Therefore, it would make financial sense, as well as alleviate death and suffering.”
“Although there are other issues to raise around how sustainable and fit for purpose the budgeting models of the current system are, I understand that difficult decisions have to be made, of which this, clearly, is one. It is not lost on me that, earlier today, we were discussing the pressures on our A&Es and the harm that results from that because of the inability to build capacity in our community. We need to focus on ensuring that we are in a position to implement this at the right time and work towards it in a meaningful way, rather than treating May 2029 as a default. In the longer term, we need a system of action, not reaction. Otherwise, we will continually end up in this position, and we cannot let this happen again.”
“That said, the financial reality is that the removal of parking charges would cost around £7 million a year. In the current circumstances, that is not an insignificant sum.”
“I speak as the Alliance health spokesperson. At the outset, I acknowledge plainly that this issue has caused real frustration and distress for healthcare workers and for patients and their families across Northern Ireland. The initiative was, in theory, a positive one. It sought to bring greater fairness and consistency to hospital car parking. It reflected a legitimate concern about how parking operates in certain trusts. We are not where we want to be. <BR /> <BR />It is important to note the impact of the issues that have come to light, such as parking capacity, transport infrastructure and how staff, patients and families are, practically and realistically, expected to access hospital sites. Those issues need to be addressed so that this does not become a permanent deferral process.”
“I thank the Minister for that answer. Over 1,000 excess deaths a year being associated with overcrowding and long waits in A&E is a catastrophe. In previous responses to questions for written answer about excess deaths in A&E, the Minister pointed to urgent care centres, Phone First, minor injury units and additional emergency medicine consultants. Those steps are welcome, but the Royal College of Emergency Medicine is clear that attendances at EDs have barely changed, while long waits and associated deaths have risen sharply. Does the Minister accept that, unless patient flow improves across the wider system, particularly through tackling delayed discharge and strengthening capacity in our communities, those measures will not be enough to reduce dangerous waits and the harm associated with them, and what will he do about that?”
“Does the Member agree that higher spending on active travel benefits all our communities?”
“I thank the Minister for taking the intervention. The Minister will be aware that SEN and Youth Service sit under the same area in the EA. While it is welcome that SEN summer schemes are going ahead, the EA Youth Service cannot plan past June. How can one confirm for July and August when the other cannot? Will the Minister confirm when the EA's Youth Service budget for 2026-27 will be available and announced?”
“Does the Member agree that all forms of respite are a lifeline to the families of children with additional needs, some of whom are at the edge of crisis, and that this issue is too important for another U-turn such as that on the real living wage? Ministers must guarantee that all forms of respite, including these schemes, will be delivered.”