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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“That is not a statistic in isolation: it is a person in pain and distress, waiting almost an entire day and night in the back of a vehicle before even getting in the door of an emergency department. In that same month, 40% of ambulance arrivals at the Ulster Hospital waited longer than two hours. The average handover time there was two hours and 28 minutes. The longest wait at the Causeway Hospital exceeded 16 hours, and, at Antrim Area Hospital and Craigavon Area Hospital, it was more than 15 hours. Across Northern Ireland, emergency departments remain under constant pressure. <BR /> <BR />In his winter preparedness plan, the Minister set a target that, by the start of December, handover should not exceed two hours; yet, in several hospitals, a quarter of arrivals or more breached that standard.”
“I rise to raise the issue of ambulance handover times. In January last year, the Minister of Health was called before an urgent meeting of the Health Committee amid sustained pressures on the health service that winter. There, he talked about how his winter preparedness plan for this year would be better. It started with a blank page, and it was to involve big discussions with experts about how we reduce pressure on the health service. That is how we were supposed to move forward. <BR /> <BR />One of the focus areas was about reducing ambulance handover waits to two hours. Yet, here we are, a year later, having seen that an ambulance waited outside the Ulster Hospital for 19 hours and four minutes before the patient was admitted.”
“Thank you, Minister. I want to ask you about that. We were promised that Encompass was going to be data-heavy, with all the bells and whistles available in order to improve services. Are you able to give us a timeline for when that data will be available, when it will be able to be used and when it will be publicly produced?”
“As a fellow Health Committee member, are you concerned about the lack of data that we have been able to interrogate from Encompass so far?”
“As the New Script for Mental Health campaign has highlighted, without transparent data, MLAs cannot scrutinise performance, public funds cannot be assessed for value against outcomes, inequalities cannot be addressed if they are not being measured and strategies cannot succeed without accountability. Until we can properly measure the problem, we cannot credibly claim to be addressing or solving it.”
“If we are serious about improving our outcomes, reducing long-term costs and restoring public confidence, accurate, consistent and transparent data must be treated as essential infrastructure.”
“The Department has previously cited the roll-out of the Encompass system as the reason for the delay, but, as we know, Encompass was completed in May 2025, and the Department of Health's deadline has now passed. The long-overdue progress is welcome, but systems are useful only if they ask the right questions. <BR /> <BR />Today's debate is not a technical one about data; it is about the strategic need to better understand how to reform our failing systems. If we do not collect meaningful data, we cannot demonstrate need; if we cannot demonstrate need, we do not commission services; and, if we do not commission services, we create avoidable costs to the patient and to our health system.”
“The cost does not vanish; it compounds. What appears to be short-term financial restraint becomes long-term financial pressure, and that pattern continues to repeat across the system. <BR /> <BR />The Health Committee has heard evidence that the culture in the Department often appears to be focused on managing the immediate financial pressure, rather than designing services around long-term efficiency and outcomes. When the data is incomplete, services are easier to defer, and, if the data is fragmented, reform is fragmented. Thanks to the New Script for Mental Health charity, it has been pointed out that, while we are almost five years into the mental health strategy, there is still no outcomes framework.”
“<BR /> <BR />Let us take eating disorders as another example. The routine data that we collect reflects those diagnosed in hospital settings with conditions such as anorexia or bulimia. A condition such as binge eating disorder is not considered in the data and does not have clearly defined service pathways, despite being one of the most common eating disorders in the UK. If we are not measuring prevalence properly and there are no clear pathways, we are not intervening early. When we fail to intervene early, we store up greater costs and poorer outcomes down the line. An untreated patient does not disappear; their condition is likely to worsen. They may develop depression, obesity, diabetes or myriad other conditions. They may require more intensive mental health support later, alongside costly physical healthcare.”
“If you cannot measure what works, what does not work, where demand is rising or where gaps exist, reform becomes guesswork. <BR /> <BR />The Minister talks about transformation, prevention and early intervention, but, without reliable, standardised and transparent data, we cannot accurately grasp the need or whether any of it is delivering. The 2023 study by the Simon Community NI and Depaul found that 68% of people experiencing homelessness have a diagnosed mental health condition, compared with 19% of the general population. Crucially, 84% received that diagnosis before becoming homeless, and that tells us something vital: when we fail to intervene effectively in mental health, the consequences spill into housing, justice, education and beyond. Crisis is always more expensive than prevention.”
“Mental health remains one of the greatest health issues affecting Northern Ireland, and it impacts on the most vulnerable in our society. In 2024, its cost was conservatively estimated at £3·4 billion annually by a PAC report. The findings also pointed to the unacceptable state of mental health data in Northern Ireland: data is limited and overwhelmingly focused on activity rather than impact; there is variation across the trusts; and it is disjointed and inconsistent. The report noted that, even where data exists, access to it is extremely challenging. Most concerning of all, the Committee highlighted that the Department developed the 10-year, £1·2 billion mental health strategy despite having little data on outcomes, no strategic data on the workforce needed and limited data on the voluntary and community sector.”
“Just last week, the Minister's party described Hilary Cass as the UK's pre-eminent expert on these matters. The Minister had so much confidence in her that he commissioned her to assess Northern Ireland's gender identity service's compliance against her original review from 2024. One of the key recommendations of the Cass review was a clinical trial of the long-term effects of puberty blockers. Has the Minister now ditched his expert of choice because it was politically expedient to do so?”
“Thank you for giving way, Minister. The Minister has highlighted the cost as being £5 million. Has the Minister any idea of the figure for the savings and the potential for those savings to be reinvested in other areas in the health service?”
“I thank the Member for giving way. Aside from the cost, does she agree that the lack of a 24/7 thrombectomy service results in a moral injury to the staff, who enter their profession in order to save lives, not to see preventable life-changing harm happen to their patients because of the time of day at which they took a stroke?”
“— walking out of a hospital or not being able to or worse.”
“Whilst a stroke can strike at any age, there will clearly be an increased demand for services. Receiving a mechanical thrombectomy could mean the difference between —”
“There are benefits for patients and for the system. Thrombectomy is one of the most cost-effective interventions in the system, saving around £47,000 per patient over five years, as we have heard. It also has an economic benefit, as Linda mentioned, preventing people from having to give up work or allowing them to continue to care for others or to continue to be parents. It is a truly transformative treatment, preventing disability and the impact that that could have on someone's life and on their physical or mental health. Some 150 patients get a thrombectomy every year, but 100 more could benefit. You can have a stroke at any age, and we know that increasing age is a factor. Northern Ireland's ageing population means that we will have doubled the number of people aged over 85 by 2047.”
“Some 3,000 people in Northern Ireland suffer a stroke each year, and there are 39,000 stroke survivors living in our communities. The impacts include death, disability, suffering, inability to work or to care for others and the requirement for long-term care. Those are all real-life consequences. We have a fantastic thrombectomy service that is currently working from 8.00 am to 5.00 pm, seven days a week. Over 100 people a year in Northern Ireland miss access to a thrombectomy because of those restricted hours, resulting in avoidable harm for patients and avoidable pressure on Health and Social Care services. For every 100 patients who miss out, 42 suffer significant disability, 28 need care and some will die. <BR /> <BR />The cost of improving the service to a 24/7 service has been calculated at £5 million a year.”
“We have heard time and again that the main issue in hospitals is the lack of patient flow. That results in ambulances being stacked up outside full and overcrowded A&E departments, leading to longer response times. Unless we fix patient flow in our hospitals, people will continue to suffer and wait too long for an ambulance. <BR /> <BR />Dr Peter Keston, a neuro-radiologist from NHS Lothian in Edinburgh, has said:”
“As Colin mentioned, the Republic of Ireland is already delivering that service. The other priorities in planned prevention, including things such as picking up hypertension and atrial fibrillation (AF) in the community, both of which are major risk factors for stroke, thrombolysis, rehabilitation, hyper-acute stroke treatment and the workforce, are all vital elements of stroke services. <BR /> <BR />There is one other thing that I would like to highlight. It should be noted that a suspected stroke is a category 2 call in the Ambulance Service's triage system. That means that the target response for a suspected stroke is 18 minutes. Just 18·5% of category 2 calls were responded to within that 18-minute target between April 2025 and January 2026. I am sure many of us are very aware of what goes on in our A&Es in our hospitals.”
“Yes, I agree absolutely that there is an economic argument for that as well. I commend those people for being so active in sharing their experiences. That has helped me and other Members to understand the impact on their life. <BR /> <BR />I know that the Minister is keen to address health inequalities. It does not get more unequal than not having access to a potentially life-saving procedure because you fall ill at a certain time of the day. Strokes do not occur conveniently during office hours. <BR /> <BR />The 2022 stroke action plan highlighted thrombectomy as its third priority and committed to moving to a 24/7 thrombectomy service by the end of 2024. That has not been delivered, and no new time frame has been established. The motion asks for a time-bound plan, noting that England aims to deliver 24/7 thrombectomy by April 2026.”
“<BR /> <BR />It has been my privilege to meet stroke survivors and to hear about their experience and what the procedure and care have meant to them. I spoke to two of them again today. Clodagh Dunlop is a police officer who suffered a huge stroke in April 2015, leaving her unable to move or speak for nearly three months. Clodagh had a mechanical thrombectomy, and she is clear about the fact that it saved her life. Paul McLean, who has been mentioned, is also clear about the fact that getting a thrombectomy enabled his recovery and has highlighted the importance of the speed of intervention to being able to regain functions. I am glad to hear that Paul is now a proud parent.”
“I thank the Opposition for tabling the motion. It is incredibly important, and I suspect that we will hear the same arguments from parties across the Floor. During my career as a nurse in the health service, I have been aware of the horrendous impact that stroke can cause: death, disability, suffering, inability to work, inability to communicate and requirements for long-term care. Since becoming an MLA in 2022, I have been keen to see the extension of the thrombectomy service to operate 24/7. We have heard the benefits of that relayed time and time again in the Chamber, in the Health Committee, at the all-party group on stroke or at events put on by the Stroke Association or Northern Ireland Chest Heart and Stroke.”
“Businesses in my constituency have told me about the importance of dual market access in enabling them to sell goods into the wider EU market, the South and GB. They can certainly quantify how good dual market access is for them. Maybe the Member has not had that experience with businesses in her constituency: could she confirm that?”
“Diane Dodds said that 40% to 80% of young people not in education, training or employment have ADHD and that 40% of those in young offender centres have it. Those are shocking statistics and show where the unmet need shows up in other areas of the system. Alan Chambers highlighted the fact that delays for children and young people carry long-term risks that they will take on into their lives. Colin McGrath pointed out the impact of cuts to the local growth fund, which funds many of the support groups that people rely on. <BR /> <BR />There was quite a lot to get through there, Principal Deputy Speaker.”
“People deserve to know what work has been done and what options have been considered. <BR /> <BR />The motion is not about grand promises but about clear actions: published work, proper commissioning and joined-up pathways. It is also about recognising that the current approach is failing and committing to do better. We urge the Minister to treat this not as a future aspiration but as an urgent responsibility. <BR /> <BR />I will quickly go through a couple of the comments. The proposer, Órlaithí, highlighted the fragmented nature of care for ADHD and said that those co-occur a lot with other mental health conditions. That is important. She talked about the serious impacts of unmet clinical need. My colleague Nuala pointed to the economic argument for commissioning an adult service. Again, the Minister referred to that in his response.”
“That is a choice not made lightly, but it is the only choice often available, yet, even when they do that, people find themselves unable to re-enter the public system easily, facing barriers to shared care arrangements and post-diagnostic support. It is important to say clearly that it is not about blaming GPs. Shared care requires clear clinical governance and guidelines for patient safety. Without that, GPs are being placed in an impossible situation, and parents and patients are left frustrated in a system that few can afford. That is an impossible choice between affordability and treatment of their condition. <BR /> <BR />Our amendment asks the Minister to publish the Department's report, and he has confirmed today that he will do that within days. That is positive and good to hear.”
“The result is a system that is fragmented and inconsistent and where access depends on geography or on age rather than on need, and we have heard that again and again from across the House. Individuals are left to navigate complex pathways without being equipped to do so. <BR /> <BR />We also know that there is the emergence of the two-tier system that has been referred to quite a bit, including by Mr Carroll, Cheryl Brownlee and other Members. People are being driven into private healthcare because of the need to get medication and because of what the Minister referred to as love for their children and family members. Many people, out of desperation, seek private diagnosis at significant personal cost.”
“The answer pointed out that there is no commissioned service for ADHD and that, therefore, the trusts do not regularly provide information on their waiting times. The information provided is management information sourced by local trusts' manual returns, not official statistics, and the implementation of Encompass from 2024 has impacted on both the returning of data and confidence in its accuracy. The numbers that we got back were from only two trusts, with around 4,000 adults in those trusts awaiting diagnosis and 6,409 children across Northern Ireland waiting for diagnosis. Those are huge numbers. That is not a sustainable position, and it is not defensible.”
“When it goes unrecognised or unsupported, the consequences do not disappear but simply reappear elsewhere in the system, be it the mental health services, crisis care, schools, workplaces or the criminal justice system, and in people's lives. <BR /> <BR />We are seeing children wait for up to five years for an assessment, and we are seeing adults wait for up to eight years, often with no clear pathway at all. I submitted one of the 262 questions that Alan Robinson pointed to. Recently, I asked the Minister:”
“Thank you, Madam Principal Deputy Speaker. This has been a good debate, and I thank those who tabled the motion for bringing this important issue to the Assembly. It is clear that the same issues are being raised in all our constituency offices and that there is a consistent inability across Northern Ireland to get diagnosis or treatment for the condition. <BR /> <BR />The motion speaks to a reality that far too many individuals and families across Northern Ireland live with every day: services are not working or are barely existing and those with ADHD are being left unsupported to face their condition alone. ADHD is not a niche issue; it is a lifelong neurodevelopmental condition that affects education, employment, mental well-being and a person's ability to participate fully in society.”
“Minister, the Chief Medical Officer recently told the Health Committee that the evidence for the minimum unit pricing of alcohol is "irrefutable". We have also heard that from many health organisations and charities that work in the area. What is the Minister's understanding of the barriers to it being legislated for in this mandate and not becoming a missed opportunity to save lives and reduce the pressure on the health service?”
“With the right actions, the region could move from crisis to recovery and ensure that people with MSK conditions receive the timely, compassionate care that they deserve.”
“<BR /> <BR />Despite the seriousness of the situation, the report offers a pathway to recovery. Arthritis UK Northern Ireland is calling for four major reforms over the next five years: establishing a strategic, region-wide approach to MSK care; improving diagnosis and care pathways; addressing extreme waiting times with expanded capacity; and increasing public awareness and patient education. Key recommendations include appointing a clinical lead for MSK health, enhancing GP training, improving transitions for young people, integrating mental health support and accelerating the Department of Health's Support While Waiting policy. <BR /> <BR />Arthritis UK emphasises that, while short-term fixes are insufficient, meaningful change is achievable with coordinated leadership and smarter service design.”
“Most people live with persistent pain, with 79% reporting pain most or all of the time. The impact on work and daily life is profound, with 67% of respondents saying that their condition affects their ability to work. Long waiting lists for rheumatology appointments, which stretch for up to eight years, contribute to worsening physical and mental health. Some 76% say that delays have harmed their mental well-being. Clinicians who contributed to the report described the deep frustration, burnout and what some call "vicarious trauma" as they watch patients deteriorate while they await treatment. The charity also highlights the serious impacts that MSK conditions can have on the economy, as 43% of people with an MSK condition are economically inactive.”
“Arthritis UK has issued a landmark warning that Northern Ireland's musculoskeletal (MSK) health system has moved beyond breaking point, with more than 550,000 people — nearly a third of the population — now living with arthritis or another MSK condition. Its new report, 'From Breaking Point to Recovery: Prioritising Musculoskeletal Healthcare in Northern Ireland' brings together insights from over 200 clinicians, patients and policymakers to paint a picture of a system that is struggling to meet demand. <BR /> <BR />The report outlines a series of stark findings, including that 37% of adults and 5% of children and young people are now affected by MSK conditions.”
“You have noted the apology that was given: was that apology given in public?”
“Given the urgency of the need to improve mental health and suicide prevention, how is the Minister ensuring that the Executive working group drives coordinated action across Departments rather than just functioning as an advisory group?”
“What specific commitments have been agreed, and what practical changes will people with disabilities see as a result of that cooperation?”
“Thanks to the Minister for his statement today. We have heard many times about the potential for cross-border cooperation on health, so the statement is positive. <BR /> <BR />You said:”
“Like Steve Aiken, I declare an interest: I was present at Larne Leisure Centre with members of the swimming club, local families and staff on the night that it was attacked and burned. It is a miracle that nobody was injured or killed. It was an incredibly serious incident, and, regardless of his intention, the Minister's Facebook post formed part of the wider public rhetoric in the period leading up to what occurred. <BR /> <BR />Following the attack on the leisure centre, what steps has the Minister taken to ensure that his future public communications are unambiguous, responsible and fully compliant with the ministerial code and actively support de-escalation for everyone in our community? Why did he not ask people not to go to the protest?”
“Thank you, Minister, for your answer. How will the fisheries and water environment Bill strengthen penalties for water pollution?”
“Thanks to the Minister for his answer. What funding has his Department allocated to nature recovery projects? Will he provide some examples of the benefits of that financial support?”
“Thanks to the Member for giving way. Does she agree that the most important part of addressing winter pressures is building capacity in our community so that we can discharge people safely and in a timely way when their treatment is finished?”
“I hope that the Minister will implement the recommendations in the report to improve that vital service. <BR /> <BR />The winter preparedness plan was a rushed and uncoordinated paper, containing little that was genuinely new, and it was even released on social media before it was provided to members of the Health Committee. These may have been things that the Minister wanted to fix, but patients and staff are still suffering harm from severe consequences of winter pressures and a lack of planning and transformation. I call on the Minister to deliver detailed plans for winter 2026-27 no later than the summer of 2026. <BR /> <BR />Warm words and good intentions are not enough. The impact of the Minister's winter preparedness plan was not significant, measurable or noticeable, and the staff are now more burned out than ever.”
“He talked about supporting social care delivery in the community and improving the system flow in hospitals, yet independent domiciliary care workers, one of the most essential parts of our social care system, did not receive the promised pay uplift to the real living wage. <BR /> <BR />Last week, the RCN released a report on the crisis in corridor beds. As previously highlighted, the Royal College of Emergency Medicine released an alarming report with testimonies from clinicians exposing the harrowing reality inside Northern Ireland's EDs. <BR /> <BR />The Minister has spoken about avoiding ED attendance and admission for end-of-life care for people who have a preference to be at home; yet we recently had an inquiry into palliative care in Northern Ireland that concluded that palliative care is fragmented and under-resourced.”
“You cannot credibly claim that progress is measurable if you are not measuring the harm that you are trying to prevent. <BR /> <BR />When the plan was published, I submitted a question for urgent oral answer, specifically to ask how the plan would reduce winter pressures. The Minister talked about vaccination uptake programmes, yet vaccination uptake by staff was not above 40% in any trust in Northern Ireland this winter. He discussed improving mental health and learning disability bed pressures to reduce demand on EDs by ensuring that the right care is available in the right place, yet the mental health strategy has been 80% shelved, with only 16% funded overall. We know that the PSNI is taking more than 100 concern-for-safety calls every day, almost none of which involves crime but people who need mental health care.”
“In 2022, the Royal College of Emergency Medicine, using the standard mortality ratio, worked out that there were approximately 1,400 deaths associated with long waits in EDs in Northern Ireland. In Scotland, in 2024, there were around 800 deaths. We have almost double the number of excess deaths here in Northern Ireland, where the population is three times smaller. <BR /> <BR />The Minister wanted measurable differences, yet, when I have asked repeatedly about the standard mortality ratio, the response has been to say:”
“Staff told us that flu was placing significant additional pressure this winter, with several patients requiring admission but no beds available. Wards were running with three extra patients each without additional staff. We were told that flow had stopped. When it becomes that blocked up, it becomes very dangerous for patients if emergency care is needed. <BR /> <BR />While winter pressures are not new, ambulance delays and corridor care are no longer seasonal issues but are now year-round features of our system. On the night that we visited, around 100 patients in the hospital were medically fit for discharge but were waiting for care in the community. The figures speak for themselves. Patients are waiting far too long in inappropriate settings, and it is clear that harm will occur as a result of those delays.”
“What we saw made one thing very clear: the winter preparedness plan had not delivered a significant reduction in pressure. It was a Sunday at around 9.00 pm, and during our visit there, up to nine ambulances were queued outside the department. At that point, the longest wait in the back of an ambulance was six hours and 21 minutes, and we were told that it had been seven hours the night before. Inside the department, there were 114 patients. Thirty of those patients had infectious conditions requiring side rooms, and 52 patients were waiting on trolleys. The longest wait for a bed in a ward in the department was four days and 16 hours. There were between 14 and 16 corridor beds in use, and there was no spare cardiac capacity. Only one respiratory bed was available for any patients who might require specialist non-invasive ventilation.”