Nuala McAllister
North Belfast · Alliance Party · Northern Ireland
“I have submitted quite a number of questions for written answer on autism services, and the answers, sometimes on the same day from the Department, contradict themselves. The Minister often refers to the emotional health and well-being framework as the idea that will frame all of the uniform services.”
“Absolutely. Everyone is taking my speech; I was going to say that. Of course, it is complex and subjective to the individual person. If we are truly talking about keeping an individual safe and other prisoners safe, we would not do what the amendment proposes; we would carry on in the way that the system already operates, using a risk-bas…”
“I thank the Member for his question. The Assembly Commission is progressing a programme of remedial works to address defects identified in the roof of Parliament Buildings and to protect the long-term integrity of this grade A listed building. The works have been structured in two phases.”
“More often than not, we have conversations in the Chamber or in public about trans women, but that would place a trans man who has been convicted of a violent crime against a woman in a prison with women. It does not make sense, and it is not coming from the perspective of safety; it is coming from ideology.”
“In providing catering services throughout Parliament Buildings, the Assembly Commission strives to meet the differing demands of the special dietary needs of our wide customer base.”
“I support amendment No 96 and oppose amendment No 97. I do not plan to speak to amendment No 96, as there were a number of interventions last night, and I will leave many of the remarks to my party colleague the Minister of Justice. <BR /> <BR />We oppose Timothy Gaston's amendment.”
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“<BR /> <BR />We will all have heard from constituents and organisations, both those in our constituencies and those related to our portfolios, that it affects not just organisations that are primarily healthcare providers but those that offer some services to do with health. Newington Day Centre, in my constituency of North Belfast, was one of the 259 applicants but, unfortunately, not one of the 25 that received the funding. Whilst all the services should be directly assisted with core grant funding, many of the organisations have, in the past, had to rejig their funding to make sure that they could make ends meet and are now having to do the same again. However, unfortunately, many of them will have to cease some of the operations that they run, and other organisations are worried about having to cease altogether.”
“As many of the organisations that reached out to us before we tabled the motion highlighted, the fact that the funding was reduced so drastically in 2023 could have resulted in only one thing: the service collapse that we see in the community and voluntary sector. <BR /> <BR />At the Health Committee, we hear time and again from the Health Minister and his officials about the commitment to "Shift left" to ensure that we fulfil our promises on prevention before we need to spend significant money further down the stream. However, in order to support that "Shift left" agenda, I ask the Minister to reflect on the role that the community and voluntary sector plays.”
“Thank you, Deputy Speaker. <BR /> <BR />I rise to support the Committee motion. At the start, I highlight, not just to the Health Minister but to the public and those who received the core grant this year, the fact that the motion is specifically not aimed at those who got the funding. It is important to highlight that, and I understand that my colleagues on the Health Committee have done the same. <BR /> <BR />We understand the difficult situation that the Health Minister and all our Executive colleagues are in with regard to funding in the upcoming year, but, as the Member who spoke before me stated, there are political choices on priorities that must be made. As the motion points out, only 25 of the 259 community and voluntary groups that applied for core grant funding were successful.”
“I ask this for clarification because I do not sit on the Education Committee and am a bit unsure about the particular process. Were assurances given that, if Committee members decided to sit over the summer recess and were able complete all of the necessary work and hear from all of the people and organisations involved, the law would be implemented by the next academic year? If the process ran until December, would the Bill's provisions have the same start date after receiving Royal Assent?”
“They should be well equipped to ask questions there and should get answers from the Chief Constable.”
“Further to that point of order, Mr Speaker, I thank you for your response to the point of order from the DUP Member, but will you also direct the correspondence to all members of the Executive? In particular, I think of the Minister for Communities, who often responds to questions by directing Members to the Housing Executive. I also think of the Minister of Education, about whom the same can be said regarding the Education Authority. <BR /> <BR />I also highlight the fact that, in your well-prepared response to the Member, Mr Speaker, the information on the Policing Board that you relayed did not mention the PSNI's operational independence. The Policing Board is the authority that holds the police to account. Will you remind the DUP that three of its Members sit on the Policing Board?”
“In my constituency, we sometimes have fires on the Cave Hill that cause damage to a much lesser extent; I cannot imagine the damage that is caused by the fires in the Mournes. When can an assessment of the environmental damage take place? Where the fires have gone out, has that already been done?”
“Minister, during the past five years, the health trusts in Northern Ireland have spent close to £3 billion on care home contracts without going through procurement processes. What is your assessment of how that spending aligns with requirements and best practice, given that there are concerns about the lack of flexibility for those who are availing themselves of places in care homes?”
“Minister, I agree with your remarks: we cannot keep doing the same thing in the health service and keep getting the same negative results. We need to do things differently. Given that the Executive have ring-fenced the money for waiting lists, what engagement have you had with the Health Minister about how things might be done differently? History has taught us that, when it comes to the Department of Health and all the trusts, there is a reluctance to change.”
“Not with particular regard to financial savings that can be made; I assume that that is what you are referring to. I do not doubt, however, that that could be an element of the terms of reference that the new working group will establish. It is not, however, something that we have concrete plans to do on the Assembly Commission, but I can get back to the Member after the terms of reference are finalised at April's working group meeting. The Assembly Commission will get those terms of reference at its meeting thereafter in May or June.”
“<BR /> <BR />To assist the working group, RaISe compiled a research paper entitled 'Artificial Intelligence Guidance in Parliaments: good practice and current examples', which provided an overview of good practice, recommendations for and examples of artificial intelligence guidance for Parliaments. The AI working group intends to establish a baseline of AI use in the Assembly, which will help inform the development of the guidance and raise awareness. The AI working group will agree terms of reference at its next meeting, which is this month, at which it will consider AI projects that align with organisational goals and values. In addition, the group will meet quarterly to monitor emerging trends, technologies and regulations in the AI landscape.”
“I thank the Member for her question. The Assembly Commission recognises that the rapid growth of artificial intelligence is a development that cannot be ignored by any modern organisation, because of the potential that it may provide for innovation. The Assembly Commission has established a working group to consider potential opportunities that AI may offer the Assembly and the Assembly Commission. The AI working group first met on Friday 22 November 2024. The group is being led by the Assembly's Research and Information Service (RaISe) and includes staff from a wide range of business areas in the Assembly Commission. The AI working group is establishing terms of reference and intends to develop guidance on the use of AI.”
“I thank the Member for his question. However, is he talking about automated services outside the cleaning contract? Yes? We have no plans to introduce any further automation. Therefore, we have no services outside the current cleaning services and no further plans to do the same.”
“I thank the Member for his questions. He will appreciate that I cannot answer the final hypothetical question. However, the assurances given to the Assembly Commission, some of which happened before my time, were that the change in contracted hours was voluntary or that there could be redeployment within the service. However, we are keeping the issue on our table so that we can see what takes place, notwithstanding our relationship with the negotiating body. As members of the Assembly Commission, we want to keep on top of the issue. Where we have got to now is that it has been done on a voluntary basis or by redeployment within the service, but we keep a close eye on it.”
“That was recognised by the cleaning industry at the Kimberly-Clark Professional Golden Service Awards 2024 when Parliament Buildings won the best-cleaned premises award for office areas between 10,000 and 30,000 square metres.”
“As such, Aramark's staff sit outside of the joint Assembly Commission management/trade union side negotiating body. Despite that, Aramark carried out a consultation exercise with staff in 2023 in advance of the changes due to the automation. The consultation exercise highlighted the fact that the changes required were a minimal, voluntary reduction of hours or the redeployment of staff within the contract’s other services provided at Parliament Buildings. <BR /> <BR />The cleaning contract has performed well and provided a quality service for the users of Parliament Buildings, with high levels of hygiene and health and safety.”
“With your permission, Madam Principal Deputy Speaker, I will group questions 3 and 8. <BR /> <BR />I thank the Members for their questions. The Commission requires its support services contractor to provide comprehensive cleaning services in Parliament Buildings that ensure that the accommodation is maintained to an excellent standard. The use of a single Co-bot vacuum and scrubber-dryer was introduced in 2023 to support Aramark’s team on-site, in the context of the budgetary constraints set out by the Assembly Commission and the reduction in footfall in office buildings due to the introduction of working-from-home policies. The Co-bot works alongside a member of Aramark’s team. <BR /> <BR />Aramark manages the implementation of its contract in Parliament Buildings and retains all responsibilities for employing its staff.”
“That brings me to the reconfiguration plan. My party welcomed the publication of that plan, but we do not have the detail of the services that are in it or what it actually means. What do we know about the master plan for Craigavon and how it fits in with and suits the needs of any reconfiguration of our health transformation? An holistic approach has to be taken for all of the health estate. <BR /> <BR />I thank the Members again for tabling the motion. I look forward to perhaps following up at the Health Committee at a later date some of the issues that have been raised.”
“I know that those of us who are Belfast MLAs are sometimes in the privileged position of being able to access quite quickly so many hospitals in our area. We have to sense-check the situation in rural constituencies, because they also need hospitals that are fit for purpose and fit for the services that are run in them.”
“Those issues are important. We are not disputing the fact that flagship projects should happen or that money should be spent, but we should get the costs under control before they spiral. <BR /> <BR />I want to have a bit more clarity on what is part of the plan for Craigavon. Perhaps the Minister will stand up and say that that is part of the business case. If so, that would be much welcomed. If, however, we have to spend money to fix all the problems that have occurred over the past decade, how many years after the business case is produced by the trust will the project happen? <BR /> <BR />As I said, I am happy to support the motion. Many points have been raised by MLAs who are local to Craigavon.”
“Absolutely. If they benefit the patient and lead to better health outcomes, of course, but we are not seeing that. We are seeing things going wrong too often. We understand that the issue of pseudomonas at the maternity hospital is complex, but at what point do we ask, "When are we going to learn and make sure that it does not happen again?". <BR /> <BR />The acute mental health inpatient centre is another issue that beggars belief. It occurred just five years, which is not long, after it opened. We had promises that finance would be created for four beds for learning disability patients. Those were patients who, specifically, were coming from Muckamore Abbey Hospital and who have been failed again. Again, all that adds to the costs. Some costs have been running up for decades, as we have seen with the children's hospital.”
“In any construction project, whether in the private sector or the public sector, there are always bumps in the road and costs that are incurred.”
“When budgets are so strict — we understand the position that the Minister is in — we need to delve a bit deeper into what the figures actually mean and where the money is going. <BR /> <BR />One of the other key things to highlight from our perspective, not only as area-based MLAs but as Health Committee members, is that someone needs to get a grasp of how costs are really out of control. Yes, we recognise and respect the fact that construction costs have been spiralling, but, when we have delay after delay and also have to fix the many problems that are arising, we will simply continue to waste money time and again. We need to get control of the reason why so many things are going wrong.”
“Thanks to my colleague from the Health Committee for proposing the motion. I echo a lot of what has been said by Members across the Chamber. There is not much that I can say that would be additional to or different from what everyone else has said. I agree with the Members who have spoken, but I have some questions that we could put to the Health Minister and that he could perhaps shine a bit of light on. <BR /> <BR />The Member who proposed the motion spoke about the £500,000 that was committed to the redevelopment programme, but I do not really know what that means or what or whom that money is for. I understand that it is for healthcare planning and the site master plan. Beyond that, we are not sure.”
“You could look at decisions by Alliance Party Belfast city councillors when the issue came up and the majority of people or even just 50% voted in favour of or against it. Look at your facts.”
“As a former Belfast city councillor and someone who sat around the table when that decision was made, I point out that you are factually incorrect.”
“<BR /> <BR />Health is the number-one priority for our constituents, and I understand that there are financial implications for the Minister, like all Ministers in the Executive. However, we need to tackle the cost of division so that we can stop just talking about waste and prove that we are doing something about it. That takes political leadership. It takes leadership to make decisions on issues that are difficult but that can be solved. Whether it is leadership on health transformation in our communities or in decisions on peace walls or services in our local areas, we need to ensure that we do not scantily reward people across Northern Ireland but that we deliver the best for all our community. I ask all parties this question: if we do not tackle the cost of division, who exactly does that benefit?”
“The Minister of Health has said that that issue is a priority. Our plan puts the cost at £61·72 million. Conservative estimates suggest that poor mental health has an economic cost of £3·4 billion every year, mostly due to lost productivity but also due to the increased demand that it causes elsewhere in the health service. Every penny and every million spent on mental health matters. That is a way in which we can tackle that situation. <BR /> <BR />The priorities that are highlighted and costed in our paper are not an exhaustive list, but there is a reason that we included both those issues. We recognise their significance to the community in Northern Ireland, not only as a post-conflict society but as a society that has been held to ransom by multiple Government collapses and stagnant progress on those key issues.”
“Although that type of economic modelling has not been conducted in Northern Ireland, there is no reason to believe that slashing our hospital waiting lists would not make a similar contribution to the labour market and Health budget here. <BR /> <BR />In the paper, we also highlight the opportunity for savings to:”
“Last December, the Department confirmed that investment of £135 million per year for five years would be needed to eliminate hospital waiting lists. Reducing wastage through addressing the cost of division could free up enough to allocate that £135 million in the first year and kick-start the work that is needed to tackle the waiting list backlog. That is significant. <BR /> <BR />The benefits do not end there. Analysis that was carried out in England by the Institute for Public Policy Research in 2023 suggests that tackling elective care waiting lists could generate billions of pounds in economic output through people returning to work or increasing their hours, with billions more being saved as a result of reduced demand for health and social care services.”
“We recognise that this is a long-term process and cannot simply be done tomorrow. One of the first steps will be to assess where we are currently, which is why we tabled the motion as a first step. We hope that the Finance Minister can get behind us on the issue. We need to ensure that all our data is correct and that data on problems that are arising now are compared with data from 2016, because I do not believe that the situation has got any better. <BR /> <BR />The 'Money Well Spent' paper that Alliance published today spells out the priority areas in which, should action be taken, we could see improved funding of almost £1 billion, based on the cost of division. I will expand on two areas that relate to Health. First, we highlight the opportunity to:”
“I want to focus mainly on some of the areas to which we can direct tackling the cost of division. First, however, before I go into that detail, I want to set out that the Alliance Party does not believe that the cost of division is the only reason why Northern Ireland's finances are in such a bad state. It is, however, one of the reasons, and we must tackle it. <BR /> <BR />As a member of the Health Committee, I am used to receiving responses to almost any question that I pose to the Health Minister that set out the difficult financial situation that faces the Department of Health, just as, I am sure, many other Members do with other Departments. We are, however, often challenged in the Committee and in the Chamber to come up with solutions. Today, therefore, I stand here as an Alliance Party MLA to put forward one such solution.”
“I thank the Minister for his answer. Not far from Divis and Black Mountain is Ligoniel dam. Minister, will you commit to meet me on-site to explore the ways in which we can promote nature recovery and what the community is doing there already?”
“Not everything requires money. Some things require policy direction and policy decisions, so it is important that we hear about any movement on that. <BR /> <BR />I support both amendments. Either one or both of them represent something that is more like our position at the moment than the original motion does. However, as I said, it is not a case of outright opposition but of finding out how the proposals work in practice.”
“I want to take a moment to touch on something different. Last week, at the Health Committee, palliative care and the role of the Ambulance Service came up. We have a Northern Ireland-wide Ambulance Service that generally has a regional policy around taking patients, but there is no regional policy when it comes to palliative care. People who should not be in hospital are taken to hospitals, despite it being known that they need hospice care. That requires a significant, isolated focus from the Department. What is happening with those particular patients with regard to social care? We also need an update on the work of the social care collaborative forum. I do not doubt that the Minister will reference that in his winding-up speech, but we need to know where we are with policy decisions by the social care collaborative forum.”
“Some of those policies relate to using St John Ambulance paramedics on rotation and on a voluntary basis. The care of those who are, perhaps, being put into the corridors or wherever space has been found for them could be overseen by the ambulance and paramedicine team rather than the clinicians in the hospital. However, that cannot be done in isolation. It has to be done in conjunction with the emergency medicine staff team at all hospitals that have an emergency department. Following the debate on the motion that we tabled in January, I asked the Minister whether he had engaged with the Northern Ireland Ambulance Service as to whether that could be implemented. I look forward to hearing whether that was explored at all. <BR /> <BR />Social care is really important, and many Members have focused on it.”
“As regards the specific proposal on the W45 policy, I appreciate and understand where the Opposition are coming from. Whilst I do not necessarily oppose outright the implementation of such a policy, it is important to think about how it would work in practice. When my colleagues and I have been on tours of hospitals, particularly emergency departments, we have seen that the clinicians are very concerned about the fact that they cannot stack up more patients in corridors, because there is, physically, no space for people there. There are no rooms. Some hospitals do not have bereavement rooms, because they are using them for patients. We do not have any space for them. <BR /> <BR />Northern Ireland Ambulance Service has specific ideas on how to manage that.”
“As many in the Chamber have referenced, those people are not just a figure; they are individuals with individual circumstances, and we should focus on them.”
“I support both amendments and thank the Opposition for tabling the motion. It is timely because, unfortunately, the problem has not been fixed, particularly since the Christmas period, when my party tabled a motion on ambulance waiting times. Nothing has changed since then, so it is important that, as we move from spring and summer into the winter months, we have the massive change that is needed. The Audit Office report illustrated how dire the situation is, so it is even more incumbent on us to shine a light on the fact that 3,800 patients were potentially subjected to severe harm in the past year.”
“On a point of order Mr Speaker. I wish to apologise for not being in my place last Tuesday for Question Time. Unfortunately, I was ill on the day and did not get my withdrawal in on time. I want to put on record my apologies for missing my question.”
“I look forward to working with the Minister and hearing about progress on the review and the reform of services across the region. Hopefully, some of the questions can be answered later.”
“Most of all, we need to address the causes of addiction, one of which is poverty. I absolutely agree with the Minister that a whole-Executive approach is needed to address poverty. It needs a Health approach, a Communities approach and a Justice approach. With addiction to drugs in particular, we cannot police our way out of it or leave it up to the justice system. When the police try to take a different approach, they are often criticised by the public, but we cannot arrest our way out of addiction to drugs. The people who sell to addicts and prey on vulnerable people must be targeted as well; we cannot forget them. We must, however, target the reasons why people become addicted in the first place. <BR /> <BR />As I said, I am grateful to the Member who proposed the motion. It is important that we have an opportunity to explore it.”
“Who will help those people to access services, whether they are in Belfast or not? We need to look at that seriously. A lot of people who get help from the community and voluntary sector are alone, so we need to make sure that any barrier to their accessing treatment is removed. When it comes to collaboration and the commissioning of services, I want to hear more about what is being done with the community and voluntary sector and the impact of that work. Will there be an increase in the workforce in community mental health and community rehabilitation teams? Will there be an increase in the number of beds? <BR /> <BR />I disagree with nothing that Members across the Chamber have said. We can all agree that we need dedicated treatment for every individual in Northern Ireland and that the treatment should depend on their circumstances.”
“In the north-west, there are particular situations in which people cannot access services. It is not because transport is difficult to access physically; the services do not exist. One question to the Minister, therefore, is on the regionalisation of our services: will all the barriers be knocked down to ensure that anyone, no matter where they live in Northern Ireland, whether it is in the north-west or in Belfast, will have access to a regional rehabilitation service, particularly a residential one? Will they have community transport? <BR /> <BR />Many Members spoke about family support and how addiction impacts on the whole family. Some people do not have a family support network around them when crisis point is reached and they are no longer able to help themselves.”
“I highlight the prevalence of the data that has been used across the Chamber. Data is very important in taking an evidence-based approach to any services, particularly health services. Economic prosperity was mentioned last week and again earlier today. We highlighted the need to focus on areas of multiple deprivation. If it is true in that respect, it is also true for our health services. The fact that a drug death is three times more likely to occur in a deprived area speaks volumes about where those services should be prioritised.”
“Thank you, Principal Deputy Speaker. I support both amendments and the motion. I thank the proposer of the motion for bringing it forward. <BR /> <BR />I agree with my colleague Danny Donnelly about trauma-informed practice, not just in treating addiction but across all services in Northern Ireland. It is very important. If we took a more trauma-informed approach to the way in which we run our services, a lot of people could be saved from the extreme consequences of poverty, such as addiction, and we could help people earlier in their life. <BR /> <BR />It is really important that we speak to the motion today, given the update from the Minister about the consultation. As I move through my winding-up speech, I will have a few questions for the Minister, which can be answered at a later date.”
“I thank the Minister for the statement; in particular, I welcome the £61 million for the multidisciplinary teams. It is known that GP practices that have MDTs are less likely to have contract hand-backs. Will the transformation board look at the knock-on effect of that funding, in particular on workforce planning? Where there are going to be more MDTs, there will be a shuffle in the whole system of physios and social workers, and we need to ensure that we have the workforce.”
“Most importantly, we want to see positive outcomes for our constituents.”
“If it is difficult in urban areas for GP practices, it will be even more so in rural areas. Last week, the British Medical Association's general practitioners committee (GPC) for England, following negotiations with the Government, announced a package of an extra £889 million a year. That is a 7·2% increase in contract value, yet the negotiations here between the BMA NI and the Department of Health have been described by our Minister as "toxic". The debate is not toxic. We need to go back to the drawing board to ensure that our GPs and their staff are valued by the Department, the strategic planning and performance group (SPPG) and all stakeholders across Northern Ireland. Coming into the new financial year, we do not want to see more contracts being handed back. We want to see leadership. We want to see our GP services be made secure.”
“At Grove Medical Practice, they have a system through which you can pre-book, and you can also phone up in the morning. I saw first-hand how the GPs' receptionists are straight onto the phones, as they are every day, yet the queues are still there. They simply cannot make their way through all of that. Despite that, GPs stay on after hours every day to make sure that they see as many patients as they can. <BR /> <BR />That is not unique to my constituency. As I said, it is across all our constituencies. The Public Accounts Committee is undertaking an inquiry into GP access to which the Royal College of General Practitioners has said that the National Insurance hike could be catastrophic and that we could see even more contract hand-backs among GPs across Northern Ireland.”