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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“It affects all of us, the people whom we love, our friends and our families. It is important that we do what we can to tackle the stigma around mental health, given the fact that it is so prevalent in society. <BR /> <BR />I will talk a little bit about the local issues that are being targeted towards tackling stigma, which are really important to highlight. I am keen to hear from the Minister about the work that he has been doing on the kind of advertising that can take place to highlight the issue. I think back to the campaign that said, "It's OK not to be OK", which many Members have mentioned. At a Health Committee meeting, the Minister said that there was a moratorium on public advertising. However, we should look at whether advertising is effective and whether it has positive outcomes.”
“I thank the Member who proposed the motion. I give credit where credit is due, because, at most Health Committee meetings, she brings up issues to do with mental health and dual diagnosis and how we can tackle those. She is very passionate about those issues, and I am glad that we have the opportunity to highlight them. <BR /> <BR />On overall mental health, when we read background information, research or surveys, one key statistic that always comes out is the fact that one in four people suffers from mental ill health at some point in their lives. I look around the Chamber and see, maybe, 16 people here. It is more than likely that four of us will be affected by a mental health issue, be it an issue that we might have had from a young age or when we are older, such as postpartum depression or anxiety, or any other issue.”
“My understanding is that there was already a consultation and engagement on the strategy and how to move forward. I want to hear a little more about that. Is that consultation going to be the final input? Is there going to be co-production and co-design to make tangible progress? Where we have the framework, it is important that we also have the tools and action to move forward. <BR /> <BR />I am happy to support the motion today. Where we have the framework, we need to see tangible progress that benefits the people who need mental health services in Northern Ireland.”
“As Autism NI put it when reaching out to all of us, we are witnessing NHS England's prioritising autism over the next 10 years, including creating specific guidance for meeting the needs of autistic adults in mental health services. Legislation in England is not quite as robust as what we have here, but we are lagging behind when it comes to policy and action. Although one might be better than the other, a holistic approach is needed. <BR /> <BR />If we are to make progress on the Autism Act, the autism strategy and the delivery plan, we need stable government. That is not up to just the Department of Health. It is very important that that is acknowledged. Many organisations will say the same. <BR /> <BR />There is bureaucracy around a lot of it. There is a consultation on the framework to inform the implementation plan.”
“I absolutely agree: there are many adults who receive a later diagnosis or are yet to receive their diagnosis, and there are some who do not even know where to turn in order to get diagnosed. A lot of them go privately, and if they have other conditions that are exacerbated, it is even more difficult to get prescriptions through the NHS. It is all interlinked and connected. <BR /> <BR />However, we have to acknowledge that work is ongoing on the legislation and policy here in Northern Ireland. The Member who spoke previously mentioned the DUP Bill that passed in the previous mandate. We have some of the most comprehensive legislation on autism support right across these islands, which is significant in and of itself. However, unless we see tangible action and progress, that means very little.”
“We also help constituents to access mental health provision. However, when two of those issues combine or, sometimes, when all three combine, that makes it even harder for the individuals. It is very important that, when we assess need, we do so on an individual basis.”
“It is really important that those of us who sit on the Health Committee acknowledge that we are not always across all the detail of a number of the issues that go through the Committee. I put on record my thanks to the parents and individuals who reached out and shared their lived experiences. <BR /> <BR />According to the 2022 census, over 35,000 people in Northern Ireland identify as autistic. We know that, unfortunately, those who live with autism are very likely to experience mental ill health as well. The Department's mental health strategy notes that seven out of 10 people with autism also have a condition such as anxiety, depression, ADHD or obsessive-compulsive disorder. Many of us assist people in our constituencies who live with autism and want to access education services or the health service.”
“I thank the proposer of the motion today. Before I move to my notes, I want to highlight the fact that, last week, when I spoke on social media about this motion's coming up in the Assembly, a number of people who live with autism or have family members who do contacted me directly to share their experiences. An overwhelming number of the responses were from mothers with children who have autism and also suffer from mental health issues and who are really struggling to access not only services but information about where to go for them. Although it was deeply frustrating to hear their experiences, it was also enriching, because I had never heard about some of the issues that they raised.”
“Will the Member recognise that legislation that was introduced in the previous mandate has brought about significant change as a result of the offences with which we can now charge perpetrators? Non-fatal strangulation is just one example. Although I recognise that he is passionate about the issue, as we all are, we must give credit where credit is due to members of the Executive. I am talking not just about the Minister of Justice —”
“We will get to the root causes of the problem — the perpetrators — so that every woman in Northern Ireland is safe and never again is any woman failed as Katie was.”
“It is unfortunate that it has come to such circumstances in which we have seen the death of a woman in 2020 still being talked about in 2025 without justice having been done. <BR /> <BR />Long before the death of Katie Simpson, Jonathan Creswell was convicted of the gruesome assault of a partner. I commend Abigail Lyle for speaking publicly about the abuse and violence that she suffered at his hands. That conviction should have triggered public protection arrangements, but it did not. We will, hopefully, have learnings from the review, and we will see what we can change, not just for Katie but for all women across Northern Ireland. Tackling violence against women and girls is something that we will not speak in platitudes about but take action on.”
“I welcome the announcement by the Justice Minister of the review of the case of Jonathan Creswell. I submitted a question for priority written answer to the Minister regarding Jonathan Creswell and the operation of public protection arrangements. I am glad to see two aspects under review: his case specifically and the wider issue of referrals into public protection arrangements. <BR /> <BR />As more continues to emerge about failings in relation to the death of Katie Simpson, I am glad that the Justice Minister is taking the matter seriously, and I welcome her commitment to shed light and identify learnings. I have been working on uncovering the failings surrounding Katie Simpson's death for a number of years — across the community in Armagh, in Tynan and in the Police Service, social services and many agencies in Northern Ireland.”
“They will ensure that we make progress in implementing the changes that we need here in Northern Ireland.”
“That list is not unique to us here in Northern Ireland — it is across the globe — but it is incumbent on us, in the society that we live in, where we have the democratic methods by which to deal with climate change, to do so in order to play our part in the global fight against climate change and take the required action. <BR /> <BR />When the Assembly was down, I stood with many young people across Northern Ireland who were protesting then, before and since about climate change. I made a commitment to them that, if elected to the Assembly, I would do everything that I could to ensure that we tackle the issue. It is incumbent on every single one of us today, by supporting and voting for the regulations, to make that commitment in full today. I am proud to support my colleague's introduction of these regulations.”
“My colleague the Minister has already agreed to ensure that mitigations that can be made should be made. However, it is incumbent on every sector across Northern Ireland to get on board and maximise the potential to ensure that we deal with climate change. If we do not, we add to the risks across our community. We add to risks to our habitats; to the changing of our soil diversity and climatic conditions; to our natural carbon stores; to agricultural and forestry productivity; to agriculture and forestry from pests; to freshwater species; to habitats changing; to marine species; and to our infrastructure networks. The list goes on.”
“I had not intended to speak in the debate, but I want to highlight some points, particularly as I am part of a younger generation that was attuned to the issue of climate change when growing up. We knew that some issues that affected our local communities were man-made and that they had a greater effect on people from more working-class areas but that climate change affected all of us across the region and whether we lived in Northern Ireland, the UK or anywhere on the globe. It is an issue that we cannot escape from. <BR /> <BR />The risks of not dealing with climate change will continue for all generations, including my children and their children, if we do not grasp the reality of it today. We need to stop burying our heads in the sand when dealing with the mitigations around carbon budgets.”
“Will the Minister outline his current priorities and what he can do to give a bit of hope that health inequalities will be tackled by way of preventative measures?”
“I thank the Minister for the statement. We respect the fact that there is a difficult budgetary environment, but we also recognise that, since 2003, our spending in health per head has risen faster than it has in any other nation in the UK, so, clearly, something is going wrong, because we are not having better outcomes. Unfortunately, the statement reads full of contradictions. The Minister says that he wants to implement greater lung and bowel screening, subject to funding, but, later in the statement, he says that he wants to move more towards preventative measures. What is the priority? It costs us more to do nothing or stand still; it costs us more when we do not put the money into prevention.”
“During the pandemic, a lot of the public health priorities were shifted from one body to another so that certain bodies, whether hospitals or the community and voluntary sector, could help those who were overwhelmed with the adults who were suffering from COVID. However, that balance has not been struck again as regards shifting the responsibilities back. Can the Minister commit himself to assessing that situation, particularly when it comes to the resources that were never shifted at any period? There are some organisations that still carry the burden. Despite reaching out a hand to help during COVID, they are still burdened with the responsibility and resources from the time.”
“I thank the First Minister for her answer. You will be aware, of course, that the preservation of documents will be very important for many mothers and the babies who were adopted out of the mother-and-baby homes. There are other documents that need to be preserved and maintained, particularly those held by the Catholic Church, which I mentioned previously in the House. Can the First Minister confirm whether her Department has issued any correspondence to the relevant bodies to make them aware of the law that was passed in the previous mandate regarding the protection of those documents and whether there has been positive correspondence in response to that?”
“They are young people, and we need to ensure that there are smiles on their faces while they undergo some of the most intensive treatment in their hospital experiences. <BR /> <BR />Yesterday, I attended the NI HealthTech Leaders' Forum event. One thing that came out of it that is relevant to the motion was investment in health. We need to invest in health and look at it not as a cost but as an investment. The more we invest in health, the more we can transform the lives of everyone who does not need to reach that hospital stage. When, however, patients reach that hospital stage, we need to have the service —”
“We support the Department in everything that it is doing to tackle that in the first instance. <BR /> <BR />My colleague and I visited the children's hospital, primarily the emergency department team. We noted some aspects that struck us. It relies on charitable funds, which get consumed by the Belfast Trust. One charitable fund relates to the use of a facility that includes a room into which parents can be brought to receive the most devastating news that their child did not make it. Having to rely on charitable funds for that is a disgrace. Also, I have stayed in hospital with my child a number of times over the past few years, and it is often pot luck whether relatives are able to stay with their loved ones. We expect children who stay in hospital for quite some time to live there, but the facilities are just not up to scratch.”
“Too often, when we have reviews in the health service, inevitably, the groups or even the individuals who were responsible for some element along the line sit on those reviews. We keep coming back to that issue, and there needs to be accountability, especially around structures and working with the boards of the individual trusts. We support calling those witnesses back to the Committee. <BR /> <BR />I move to the maternity hospital. I have engaged with midwives, who have been excited about the hospital being handed over and are very much looking forward to the new building. Having the new building will boost staff morale. They are also disappointed, and, hopefully, we can see movement on that. We absolutely cannot, however, support the handover of any building where there is still pseudomonas.”
“I recommend and ask that the Minister engage with those on the ground and in the hospitals, with allied health professionals (AHPs) and with representative bodies to put a bit more meat on the bones. <BR /> <BR />I turn to the maternity hospital. I looked at the response to my Health Committee colleague's question for written answer on the water safety group. I was shocked and surprised to hear that conflicting evidence was given at the Health Committee. My party colleague and I support recalling the group to the Committee to hear the true facts of the matter. <BR /> <BR />I share the concern reflected in the remarks about the review and who co-leads it, but I am not surprised, to be honest.”
“It is important to take that issue into account, because, regardless of who holds the health portfolio, if we have stop-start government, we will not have true transformation of our health service. <BR /> <BR />As my party's spokesperson on the Health Committee, I am willing to work with the Health Minister on transformation. I recognise that the reconfiguration framework is being consulted on, and we will respond to that. I understand the Minister's desire to avoid over-politicisation by not including a lot of detail on the reconfiguration. Unfortunately, however, when you do not include the detail, it is harder to bring people along with you, because they do not know what is happening.”
“I support the motion that my DUP colleague on the Health Committee has proposed. I will speak to a number of aspects of it. I will give most of my attention to the maternity and children's hospital, as the proposer did. <BR /> <BR />First, I will highlight a few points. I do not want to politicise the motion. I am often critical of the Minister and decisions that he may or may not take in the Chamber or outside it, but, to be fair to him, I am a little frustrated by the wording of the motion, particularly because, when the children's hospital was announced, the DUP held the Health and Finance Ministries. We have had a lack of progress on a number of projects because of the merry-go-round of collapse and return of the Assembly and Stormont overall.”
“Advances in medicine and technology mean that HIV can be effectively treated and managed, and we are closer than ever to ending new transmissions. On 1 December, we will shine a light on the real experiences of people living with HIV. Let us take the opportunity to celebrate their strength and resilience and reaffirm our commitment to a future where HIV does not stand in the way of anyone's life.”
“That is one of the many reasons why Alliance is so passionate about high-quality relationships and sexuality education. <BR /> <BR />Positive Life has been leading the way in promoting the Fast-Track Cities initiative, which aims for zero new HIV transmissions by 2030. Recently, Lisburn and Castlereagh City Council joined Belfast City Council and Derry City and Strabane District Council in committing to the initiative, and it is encouraging other councils across Northern Ireland to follow suit. To mark World AIDS Day, many councils across Northern Ireland will light up public buildings on Friday 29 November as a show of support. That is a powerful reminder of the importance of breaking stigma and knowing your status. <BR /> <BR />HIV and AIDS are no longer the devastating diseases that they once were.”
“I rise to mark World AIDS Day, which is on 1 December. I hope that all Members received their red ribbon in their pigeonhole, and I look forward to seeing them wear it throughout the week. Since 1988, people around the world have come together on World AIDS Day to show strength, solidarity and determination in the fight against HIV stigma and to remember those whom we have lost. <BR /> <BR />Globally, 38 million people live with HIV. Over the past 40 years, more than 35 million lives have been lost to HIV and AIDS-related illnesses, making it one of the most destructive pandemics in history. Today, however, thanks to medical advances, people with HIV in the UK can live long, healthy lives. We also now have the tools to stop HIV transmission entirely, yet stigma remains and discrimination persists.”
“The coming days and weeks will be very difficult for Gary's family and everyone who has been touched by the tragic accident. We need to ensure that the momentum that has been built leads to action. I will ensure, through everything that I do as an elected representative for North Belfast, that we see action.”
“Perhaps, in the coming weeks and months, Gary's legacy could be that the Department for Infrastructure turns away from its car-centric attitude and implements the changes that we need to see. Those changes are happening across Europe and the world, and Northern Ireland is, yet again, being left behind.”
“However, people still cycle in North Belfast and into the city centre. They still use the route through Carlisle Circus because they have no other option, despite there being plans and commitments over the years. Over the past few days, I have had contact from many people in the cycling community of North Belfast and wider afield, and there is a lot of anger because of the years of commitments. <BR /> <BR />The Department for Infrastructure needs to urgently prioritise North Belfast and, in particular, the Crumlin Road/Ballysillan/Oldpark scheme and the connection between the city and the Cavehill area. That is a dangerous route that is used by many cyclists every day. Those are not massive requests. We are not asking the Department to go to the ends of the earth; we are asking it to implement what has been on the table for many years.”
“I rise to speak about the tragic death of Gary McMahon in North Belfast. On Thursday 21 November, he was cycling to work when his life was so tragically cut short. First, and most importantly, I express my condolences to Gary's family and friends and all who knew him. I, and many others, are very sorry for their loss. <BR /> <BR />North Belfast is one of the least-serviced constituencies when it comes to safe cycling infrastructure. We have plans, we have plans within plans and we have commitments, but we do not have action. My partner and I cycle the same route that Gary took, and, for the past two years, we have done so with our children on the back of my partner's bike. Anyone who cycles in North Belfast will see what has happened as not just a dreadful and tragic accident but something that, perhaps, could have been avoided.”
“I thank the Minister for his answer. Although I appreciate that there are budget constraints, North Belfast is often left behind when it comes to work done to encourage sustainable travel, such as cycling infrastructure and greenways. What can the Minister do in the immediate term to assure people in my constituency that this is not yet another area on which they will have to wait years for work to get started?”
“It is positive news that four additional consultants have been placed at the SWAH. Has the Minister met any of the representative bodies on the efficiency of the elective care, not just particular to the SWAH but to all the elective care overnight and day procedure hubs across Northern Ireland?”
“Does the Member acknowledge that, in some of those instances, the individuals involved in dealing with the families afterwards are the same individuals who now sit on the boards that are implementing the very recommendations from the public inquires through which the truth eventually came out?”
“The Minister needs to be honest and genuine today in saying to healthcare workers that a duty of candour will come into force only where there is cover-up. All that people like Alan and Jennifer Roberts want from today is to ensure that there is no cover-up.”
“I am giving you the opportunity of a minute being added on. Does the Member acknowledge that two pathologists and a number of other consultants were also involved in what was potentially a cover-up from the start?”
“We purposely left criminal sanctions out of the motion because we understand that a conversation needs to be had about that. You might want to actually engage on the issue in the first instance, for example, in the Committee, where we have discussed it time and time again. You do not even sit there: you walk out early. You are being really disingenuous here as to why we have tabled the motion.”
“We owe it to every person who was, and continues to be, unable to speak up for themselves. <BR /> <BR />Before I finish, I pay tribute to the parents of Claire Roberts and the many victims of the plethora of scandals in Northern Ireland, some of whom are sitting in the Gallery today. We thank you for your ongoing campaign. We particularly thank Alan and Jennifer, who have fought for almost 30 years and who, as recently as last week, found themselves fighting these issues in court. It is for people like Alan and Jennifer that we need to ensure that the issue does not go unheard. We need to ensure that we instil a legislative basis upon which we can receive honesty and truth for any mistakes that have been made. I commend the motion to the House.”
“Clearly, something needs to change. The reports that have called for an individual duty to be implemented must not be in vain. I recognise that people have concerns about there being a fear factor as a result. To anyone who is worried, I say that we are not blind to the difficult decisions involved in practising medicine. We understand that risks sometimes have to be taken and that decisions may only become clear in hindsight, but truthfulness and honesty must be prevalent. Patient safety is paramount. <BR /> <BR />I hope that we can get support on the matter. Most importantly, I hope that the Minister will commit today to introducing legislation and, perhaps, to exploring the Hillsborough law proposals as an opportunity to do legislative work here on organisational and individual duty of candour.”
“Alan and Jennifer have fought for almost 30 years for the truth about what happened to their daughter, Claire. We all recognise the smiling photo of Claire that we see in news articles to this day. When we talk about duty of candour and cover-ups, it is about ensuring that we get honesty. If we honestly believe that people can hold themselves to account and mark their own homework, we must speak not only to Alan and Jennifer but to every family member who has lost a loved one and still does not have the truth and accountability that they so deserve. <BR /> <BR />The cervical smear review was launched by the Southern Trust in October last year, long after the scandals around hyponatraemia and the actions of Dr Michael Watt became clear and were headline news in Northern Ireland, yet cover-ups continue to occur.”
“We have been told by the sector that the notion of criminalisation is a misunderstanding that was spread carelessly by the Department. To make a mistake is to be human. Doctors and healthcare staff are not immune to making mistakes. That is not the issue at hand. The issue that having a statutory duty of candour would address is where an effort is made to cover up mistakes when they are made. We recognise that the threshold must be high. Where there is an intentional cover-up, however, we recognise that there must be accountability. <BR /> <BR />I have heard some argue that legislative backing for an individual duty is not required, as healthcare professionals can already be held accountable through the GMC. To that I say that they should speak to the parents of Claire Roberts.”
“How can we trust that a more open framework will be embedded when it has taken the Department so long to get to here in the first place? <BR /> <BR />Two weeks ago, I learned at Committee that the Being Open framework should launch early next year. Is that acceptable? Is that the grand total of the efforts made since the launch of the hyponatraemia inquiry and the publication of its findings in 2018? I want to make it very clear to all healthcare workers that we appreciate and value their work. The overwhelming majority of healthcare workers carry out their work every day with the utmost integrity, and for that we are grateful. It is important to emphasise that we are not calling for mistakes to be criminalised.”
“I acknowledge that, if the duty were to introduced in a vacuum, it would not be successful or effective. The duty must be implemented alongside efforts to implement an open and transparent environment in the health and social care sector. <BR /> <BR />Staff must feel safe raising concerns at every level. I highlight the fact that the Belfast Trust has done some work on implementation by placing an emphasis on the psychological safety of staff. The trust aims to change behaviours from the macro level to the atomic level as a tangible example of supporting a cultural change, such as having weekly one-to-ones at which people can raise concerns, in order to ensure that it can meet the goal of being more open. Let us be honest, however: we cannot rely solely on the Department of Health to take the lead on changing the culture.”
“That is an extremely important point. We welcome the amendment and will support it. <BR /> <BR />From discussions with the sector, I am clear that it is in full agreement with the need for an organisational duty of candour with legislative backing. I will therefore focus instead on our call for an individual duty. An important discussion on the duty took place at the Northern Ireland Confederation for Health and Social Care (NICON) conference just a few weeks ago, at which an emphasis was placed on the need for any statutory framework to be introduced in tandem with support for cultural changes in an organisation. That is an important point to make. We are not arguing that the legislative approach proposed in the motion should happen alone.”
“The Alliance Party tabled the motion on their behalf, and I want them to know that, if there is anything that any of us can do for them, we will always be here to listen. <BR /> <BR />I thank Sinn Féin for tabling the amendment, which calls for a:”
“They made it clear to me that an individual statutory duty of candour, with legal backing, is essential in order to make sure that lessons are learned from the plethora of health scandals in Northern Ireland. Those are not my words but the words of Glynn Brown, whose son experienced horrendous abuse during his two years in Muckamore Abbey and who speaks on behalf of the majority of families involved in the scandal. <BR /> <BR />My colleague Danny Donnelly and our wider Alliance Party reps have had ongoing engagement with relatives of deceased patients of Dr Michael Watt. Their fight for justice has been made all the more difficult as a result of delays with the deceased patients review process. <BR /> <BR />I have given just a snapshot of the human impact that such scandals have had on families across Northern Ireland.”
“Although a statutory duty of candour, applicable to both the organisation and the individuals in the organisation, with legal backing, would not have saved every life, it would, in all likelihood, have significantly decreased the time for which such actions were able to continue and the number of lives impacted on as a result. <BR /> <BR />Since joining the Health Committee, I have taken every opportunity to speak up on behalf of families who have been impacted on by the abuse and neglect at Muckamore Abbey Hospital. Just last week, I met relatives of Muckamore residents who had experienced severe abuse during their time in the hospital, including the relatives of one young man who was in the hospital for 21 years.”
“<BR /> <BR />I have engaged extensively with families of those who lost their lives and those whose lives were changed as a result of those scandals, and I have heard their pain first-hand. Some of those families are in the Public Gallery today, while others are watching online, and I pay tribute to each and every one of them. <BR /> <BR />We should never underestimate the power of a person who has lost a loved one, who has watched a loved one suffer as a result of mistakes, deliberate or otherwise, or who has witnessed a cover-up instead of transparency to pursue justice, truth and accountability.”