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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“On behalf of the Alliance Party, I support the Bill at its Second Stage. I thank the Minister for bringing it forward and for the previous engagement of his officials with us at the Health Committee, which was very helpful. Like Members who have spoken previously, I share the disappointment that the Bill has been required. <BR /> <BR />We supported the Hospital Parking Charges Act and welcomed its passage through the Assembly in the previous mandate. It was one of many private Member's Bills that passed in the final stages of the mandate, just before I joined this House, and it highlights how important private Members' legislation is to ensuring positive change.”
“I thank the Minister for his answer. The Minister will also be aware of the 'Worried and Waiting' report, which was launched in the Building earlier. The report shows that paediatric waiting lists in Northern Ireland have increased by 173% in the past seven years, which is wholly unacceptable. With far too many children and their families waiting for outpatient appointments, what is the Minister doing to communicate with and support people who are on those waiting lists, who often feel isolated and forgotten?”
“<BR /> <BR />While those pressures are significant and further investment is clearly needed, we must also assess the effectiveness of what we spend on the health service in relation to outcomes. We will continue to push for transparency on health spending to ensure that we get as much as we can for the money that is spent. The Minister must be clear on how investment is addressing the pressures and improving outcomes for the huge number of people who continue to suffer ill health, be that on waiting lists or in crowded wards or dangerously overcrowded A&E departments.”
“<BR /> <BR />The importance of having an Executive and a Health Minister in place has been reinforced by the positive steps towards a pay settlement for the health and social care service in Northern Ireland through the proposed consolidated pay uplift and the non-consolidated payment. Minister Swann rightly identified pay as a priority. It is clear from the previous restoration in 2020 that progress can be made on such essential workforce issues only with a Minister and a full Executive in place. We must never again allow our valued healthcare staff to go without the fair pay that they deserve. Without the workforce, there is no health service and there can be no transformation.”
“It was envisaged as a 10-year programme, but we are now more than three quarters of the way through that 10-year period with almost no progress. The main reason for that has been wider political instability. The absence of a functioning Executive and Assembly for five out of the last seven years has resulted in the absence of financial decisions and scrutiny. With last year's Budget, we saw the devastating impact of that stalemate, with an unaccountable Secretary of State making decisions over which we, as MLAs, had no say. Until we see genuine reform of our political institutions to ensure that never again can one party prevent the Assembly and Executive from functioning, we will not be able to commit to the transformation that is required to fix our health service and ensure the best outcomes for our people.”
“The year 2023 was the worst to date for GP surgeries having to hand back contracts. We must take steps to address the challenges facing general practice in Northern Ireland. That should include an indemnity solution for GPs in Northern Ireland, who are disadvantaged in comparison with the rest of the UK due to the higher personal cost of indemnity. We must also urgently recommence the roll-out of multidisciplinary teams that began in 2018 but has effectively stalled since then. As with so many of these issues, funding will be key. <BR /> <BR />The wider transformation of our health and social care service must be an overarching priority for the Department. The Bengoa report has been sitting on a shelf since 2016, and we have missed opportunities for genuine reform through the lack of progress on that.”
“The conditions simply are not there in the practices to meet demand. Chronic underfunding, a lack of proper workforce planning and the impact of the COVID pandemic have provided a perfect storm of conditions to lead the service to this breaking point. The findings of a recent Audit Office report include that almost one in three GP practices have sought crisis support services in the last four years; 13 practices handed back their contracts or gave notice of doing so between March 2022 and March 2023; and 39 practices were assessed as being at risk as of March 2023. That speaks to a full-blown crisis. <BR /> <BR />Primary care has become more difficult and challenging, particularly in rural areas, and I have seen that at first hand in my constituency of East Antrim.”
“The Department of Health has taken a number of measures in recent months, such as the authorisation of £4·8 million by the permanent secretary in November 2023 and £10·1 million authorised to help stabilise the service by the Minister in February 2024. Those were helpful but cannot resolve the long-standing funding deficit that has been building for over 15 years. In addition to resolving the £15 million shortfall, immediate policy changes are required, such as a reviewed community pharmacy contract and a drug tariff specific to Northern Ireland that recognises our unique factors. <BR /> <BR />The challenges facing our GP surgeries are also evident. We will all be very aware of the impact they have had on GP appointments. Every day, we hear from constituents about how difficult it is to access their GPs.”
“<BR /> <BR />As mentioned in that debate, the timely provision of domiciliary care packages lessens the pressure on hospitals and therefore on waiting times by allowing people to be supported in their own home. Being able to safely discharge patients when they become medically fit makes more beds available in the wards for patients who need to be admitted for care and improves patient flow throughout our hospitals. People are arriving at A&E departments in ambulances, waiting outside in an ambulance and then waiting in crowded A&Es for a bed for further treatment. Further investment is required to continue to alleviate the pressures on the domiciliary care sector. <BR /> <BR />Another crisis in our community is our community pharmacy sector.”
“<BR /> <BR />Domiciliary care is another area that urgently needs to be addressed. Many people cannot access domiciliary care packages to ensure that they can be cared for in their home. In November 2021, Minister Swann invested £23 million to improve the terms and conditions of domiciliary care workers in the independent sector. That was welcome at the time, but we need further protection and support for our domiciliary care workers. It was also welcome that the first Adjournment debate of this Assembly mandate was about domiciliary care packages. It affects many families in East Antrim, and I am sure that that is the same for all MLAs across the Chamber.”
“Too many people across Northern Ireland are suffering as they languish on waiting lists, getting sicker, losing mobility, having mental health issues and, sometimes, not even getting the surgery they have waited for. <BR /> <BR />We will all have heard the shocking statistics over the last few months and years, but a recent report on the performance of Northern Ireland's healthcare highlighted that 60% of patients had waited for more than a year for in-patient treatment at June 2023, compared with just 5% of patients waiting more than a year to complete the entire pathway from referral to treatment in England. The report starkly describes a system operating at the very edge of its capacity and capability, highlighting that it is not fit for purpose and needs to evolve considerably in the coming years.”
“I speak today as the Alliance spokesperson for health, and I will highlight some of the priorities facing the Department of Health. <BR /> <BR />As my colleagues have indicated, we will support the motion, and I thank the Finance Minister for tabling it. As we have heard many times today, there is no question that every Minister and Department are facing severe financial pressures, and Health is no different. <BR /> <BR />In the Health Committee on 14 March, the Minister indicated that additional significant investment would be required to deal with some of the key issues facing the Department. We can see some of those pressures throughout our health service. We have previously discussed waiting lists in the Assembly, and it must be an urgent priority of the Department to tackle our unacceptable waiting lists.”
“I thank the Minister for her answer. There have been concerns about the way that the funding has been provided. For example, the money is released every three months in arrears, which creates instability for many organisations. What assurance can the Minister give that, beyond March 2025, the system in place will be more efficient and effective?”
“The Minister has just answered my supplementary. Thank you, Minister; I appreciate it.”
“We have heard a lot of these things. Vaccine misinformation on social media has already been mentioned today. One thing that concerns me is that talk like that might put people off taking the vaccine when it is offered. Does the Member agree with me that people who are offered the COVID vaccination in the ongoing roll-out should take it, and does he support the roll-out of the COVID vaccination?”
“I will raise a point about the danger of vaccine misinformation, which, sadly, remains prevalent, particularly on social media. I hope that all Members agree that such misinformation should be challenged. Vaccines save lives, and the COVID vaccine has saved many lives across the UK, including here in Northern Ireland. It has also allowed us to move away from lockdowns and other public health measures. It is important that we support the continued roll-out of the vaccination programmes.”
“As with other COVID-related extensions, it is important that the Department of Health works towards a more long-term solution — a permanent solution. I hope that the Minister intends to work with relevant partners to take full consideration of the operation of vaccine programmes over the next two years.”
“We should do all that we can to support the roll-out of those vaccination programmes.”
“First, I pay tribute to all who have worked over the past four years to ensure the efficient and effective roll-out of the COVID-19 vaccination programme. It was a remarkable achievement by Health and Social Care staff in particular but also by the scientists who made a life-saving vaccine possible. I also thank Minister Swann for his leadership throughout the pandemic. <BR /> <BR />The Alliance Party will support the draft regulation and the decision to extend regulations 3A, 19 and 247A of the Human Medicines Regulations to maintain the existing clauses until 2026 and to prevent their expiration later this year. Extending the clauses will permit the continued operation of COVID-19 and influenza vaccine programmes under an expanded workforce on a scale required to keep the population safe. That is what is important.”
“I thank the Minister for giving way. For clarity — we discussed this at length in the Committee — is it fair to say that you could bring legislation to the Chamber very quickly, should an emergency situation arise?”
“What role should climate change have in a future Programme for Government? Is the Minister happy to accept an invite to a future meeting of the all-party group (APG) on climate action?”
“Can the Minister clarify what the Bill will seek to do?”
“Sadly, in recent years, we have seen a sharp increase in drug deaths across Northern Ireland. What is the Minister doing to increase accessibility to naloxone and to progress an overdose prevention centre?”
“I thank the deputy First Minister for her answer. Will she agree with me that moves to resell plots of land throughout cemeteries in Northern Ireland where the babies are buried should not happen? Will she commit to working with residents who are opposed to that?”
“We have already heard about holiday hunger from the Member for West Belfast. What other steps will the Department take to try to alleviate holiday hunger?”
“I thank the Minister for his answer. He mentioned a couple of options that he is looking at. Is he considering implementing a cap on school uniform cost?”
“I thank the Minister for his answer. What else does the Minister intend to do, working with the Health Department, to support workforce development?”
“<BR /> <BR />To conclude, I welcome the passing of the Bill, but I recognise that this is only a very early stage in the hard work ahead of us to deliver more sustainable politics and more effective public services. I look forward to working with all Members of the House, particularly with members of the Health Committee.”
“The junior doctor strike was announced yesterday, and it is important that we do not simply wait for the conclusion of Westminster pay negotiations with the doctors in England. Pay here is a devolved issue, and we, rightly, should seek to resolve the issue here in Northern Ireland without waiting to see what happens elsewhere. As I mentioned in the debate on waiting lists, different circumstances exist here compared to the rest of the UK, not least the alternative option of working in the Republic, which is often better paid than jobs here. If we want to attract more people to work in our health service, it is essential that those issues are resolved.”
“<BR /> <BR />Last year, we saw the particular difficulties faced by Departments, not least by the Department of Health, when a punitive Budget was set by the Secretary of State in the absence of local accountability or scrutiny. Political instability also prevents us from having long-term planning, which is how we will be able to deliver on the urgent transformation of our health and social care system and reduce our waiting lists, as we discussed in previous debates. A multi-year Budget is needed to enable the Department and the health service to plan ahead and to deliver that urgent transformation. That cannot be done through comparative annual Budgets. <BR /> <BR />Public-sector pay must be a priority for the Department and the Executive, and I welcome that Minister Swann has indicated that that will be one of his priorities.”
“I will keep my comments brief, as many of the critical points about health have already been made by my party colleague Nuala McAllister and other members of the Health Committee. <BR /> <BR />The Alliance Party supports the Bill since, without it, our Departments and public bodies will struggle to maintain basic public services. The difficult financial situation that we face today is primarily a consequence of the instability of the Assembly, and, like my colleague Eóin Tennyson did, and for the second time today, I must stress the need for reform to ensure political stability and to prevent one party from walking away and pulling down these institutions for several years.”
“Research has indicated that 45% of young people who are referred for mental health services also have communication difficulties, while 81% of children with emotional and behavioural disorders have significant language deficits that are often undefined. Proper investment in speech and language therapy can reduce many of those difficulties and therefore avoid the problems in the justice system that are often seen in later life.”
“I encourage Minister Givan to consider the importance of early intervention in speech and language therapy to the early learning childcare strategy that he intends to bring to the Executive. <BR /> <BR />I also want to highlight the links between communication difficulties and mental health challenges, as Órlaithí Flynn highlighted. That concern is rightly mentioned in the motion. Its timing is appropriate, given that we marked Children's Mental Health Week earlier in February. For many children, speech, language and communication needs can impact on their ability to learn in school, make friends and join in the more sociable parts of the school day. That is exacerbated when children get older and move through the school system.”
“In the debate on the development of a childcare strategy, my colleagues Kate Nicholl and Nick Mathison highlighted the work that we have done as a party through our policy document on childcare, 'Children First'. In that document is a commitment for child-centred care, particularly that providers should work with speech and language therapists and other education and health professionals to provide an integrated support system for children who need such additional support to ensure that every child has the same standard of life, health and education. I welcome the proposal in the motion for a cross-departmental approach to the issue, given the overlap between Health, Education and Justice, in particular.”
“It highlighted that the commissioning of speech and language therapy services has not maintained pace with need and that, therefore, not all children are receiving the services that they need. It is essential that vacancy rates in each trust's service are addressed urgently. As we heard earlier, we have substantial vacancies across the health and social care system. As other Members pointed out, speech and language therapy appears to be quite a sought-after career, although the number of university places seems to limit that option. <BR /> <BR />Childcare is another important part of the debate that should not be underestimated. More needs to be done to connect the importance of speech and language therapy to the development of a childcare strategy, which we discussed last week.”
“Up to 60% of young people in the youth justice estate were found to have communication difficulties, and 46% of those were in the "poor" or "very poor" range. We have discussed a lot of figures on this and seem to be centring on the same shocking figures. Eighty per cent of young unemployed men have an unidentified speech, language or communication need. Investment in speech and language therapy as an urgent early intervention would save money on other services by assisting rehabilitation in prisons and therefore reducing reoffending. As my colleague Stewart Dickson pointed out, that is already ongoing. <BR /> <BR />Recently, the independent review of education emphasised the importance of speech and language therapy.”
“I thank the UUP Members for tabling the motion. For many years, I worked with speech and language professionals in the healthcare system, and it is right that we begin by applauding the hard work of the speech and language therapists in the vital role that they play, particularly in relation to children and young people. <BR /> <BR />Speech and language therapy should be seen as an early intervention that is intended to save money and resources in relation to other services. Early detection of need and early intervention is essential in ensuring that our children and young people receive the support that is necessary for them to be able to communicate their feelings. The risks from lack of intervention are clear.”
“Minister, I am very aware of the vital role that junior doctors play in the health service. Pay decline has been a long-standing issue, but it is not the only issue that affects them and not the only one that informs their industrial dispute. Since the announcement yesterday, has there been contact with the BMA in order to have ongoing negotiations to resolve the situation? A strike would have a huge effect on the delivery of care right across the system and would be felt for quite a long time afterwards.”
“I agree with the Member. It should be noted that Northern Ireland households have the lowest disposable income in the UK as a whole. We have lower capacity to access private medical healthcare. I am aware of people who have used large chunks of their savings or have even borrowed money to access medical care. Does the Member agree that that has created a two-tier health system?”
“— for beginning to address and progress transformation.”
“A major issue remains the lack of legislation on safe staffing and adequate pay. Those are two very important issues, and I encourage the Minister to legislate on them before the end of the mandate. <BR /> <BR />There are other issues that are specific to Northern Ireland. For example, the higher wages available in the Republic of Ireland have led many consultants to work there while continuing to live in Northern Ireland. That has exacerbated consultant vacancies. On top of those factors is the intensity of the COVID-19 pandemic, which our health service has not fully recovered from. I know that those issues are well known to the Health Minister, and I look forward to his plan —”
“As highlighted in the Bengoa report, the majority of HSC resources are invested in delivering acute care, and, as a result, some services have been delivered suboptimally. The evidence is clear: specialised procedures concentrated on a smaller number of sites and dealing with a higher volume of patients will improve outcomes. We support such reforms, focusing on providing diagnostics and treatments far more quickly, especially in primary care. That will assist in bringing down waiting lists. <BR /> <BR />Another issue that remains is the difficulties in recruiting to the workforce and, in particular, vacancy levels. On 30 September 2023, there were 6,920 HSC vacancies across Northern Ireland, which is a vacancy rate of 8·2%. That represents a 14% increase when compared with September 2018.”
“<BR /> <BR />It is welcome that we are back in the Chamber debating this and other vital issues, but, until we have a truly sustainable political system, we will not be able to deliver the transformation that is urgently needed. With that in mind, we must reform the institutions to ensure that one party can never again hold down the entire political process. It will not be lost on anyone that waiting lists got much worse during the period when the Assembly was not functioning. <BR /> <BR />There are key issues specific to the health system that I encourage Minister Swann and the Department of Health to consider. One of the reasons why our waiting lists are so long is that too many people are referred on to them in the first place rather than being diagnosed or treated quickly along a more appropriate pathway.”
“<BR /> <BR />We need to ask why waiting lists are so long in Northern Ireland, especially when compared with the rest of the UK and Ireland. Many of the issues facing Northern Ireland and our health system have been national or international in nature, such as the impact of austerity, Brexit and, especially, the COVID pandemic. However, we do not see such devastating numbers in England. We cannot ignore or forget the damage done by political instability in this place, particularly the fact that we have not had an Executive, a Health Minister or a Health Committee for five of the past seven years. In the two years when those positions were filled, the people in them, understandably, had to prioritise managing the pandemic, which made meaningful reform impossible.”
“Those are huge numbers, but it should not be lost on any of us that they are our families, our friends, our neighbours and people in our communities. People are living in pain, losing their mobility and suffering from mental health issues and loss of well-being while they wait for tests to see whether they have a serious illness. <BR /> <BR />Previous attempts to reduce waiting times have not been successful. A previous departmental initiative, the elective care plan in 2017, had a target of ensuring that all patients would be seen within one year but did not meet its prescribed targets. On the basis of the aforementioned 2026 projections, the Department will not meet its targets as set out in the elective care framework from 2021.”
“The Northern Ireland Audit Office report has highlighted just how rapidly the number of people on waiting lists has risen. For example, from March 2014 to March 2023, the number of people waiting for an initial outpatient appointment rose by 216%; the number of people waiting for hospital admission rose by 147%; and the number of people waiting for diagnostic tests rose by 151%. <BR /> <BR />The same report highlights how, without imminent action, those numbers will only get worse. For example, the Department of Health's elective care framework has projected that outpatient waiting numbers could grow by 91%, from 335,000 in 2021 to 640,000 by 2026, and the inpatient waiting list could grow by 206%, from around 100,000 in 2021 to 306,000 in 2026. Those numbers are surely not sustainable in a population of approximately two million.”
“I thank Mrs Dodds and Mr Robinson for tabling the motion. I look forward to working with both of them as fellow members of the Health Committee. My party will support the motion. <BR /> <BR />The current waiting times in Northern Ireland are deplorable and unacceptable. As stated in the motion, none of the formal waiting targets for health and social care services in Northern Ireland have been met since 2014. Some of the more specific statistics are truly shocking.”
“Ministers will be aware that many of these frameworks are subject to budgets. Is the Minister satisfied that an adequate budget exists for this work over the period that it is required?”
“The vaccine is proven to be safe and has been used since the early 1980s. The times and locations of the clinics can be found on the trust websites. <BR /> <BR />Vaccination saves lives, and I hope that all Members across the Chamber will join me in encouraging people across Northern Ireland to make sure that they and their children are fully protected against this dangerous disease.”
“The Public Health Agency vaccination catch-up campaign is under way across Northern Ireland. First and second doses of the MMR vaccine will now be offered to anyone between the ages of 12 months and 25 years old who missed getting the vaccinations the first time round.”