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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“I rise to propose our motion calling on the Health Minister to introduce a statutory organisational and individual duty of candour by the end of the mandate. Since the beginning of the hyponatraemia inquiry in 2004, following the deaths of five children in Northern Ireland, there have been consistent calls for a statutory duty of candour for healthcare workers to be enacted. Despite that, I stand here, 20 years later, with little progress to note from the Department of Health and a string of Health Ministers. Unfortunately, in those 20 years, we have also seen scandals that could and should have been prevented, such as the actions of Dr Michael Watt, the infected blood scandal, abuse in Muckamore Abbey Hospital, the urology and cervical smear reviews and the scandal at Dunmurry Manor, to name a few.”
“This particularly welcome announcement will bring positivity and opportunity to North Belfast, which has sought investment for many years and is now getting what it deserves.”
“We can reconnect the city from the Belfast hills right down to the city centre through our green spaces. It is an opportunity for us to work together across the divide and all political parties to bring our communities together and lead from the ground up in order to ensure that we have this integration and reimagining of the North Belfast area and green spaces that are truly transformed. <BR /> <BR />The project will be led in partnership by Belfast City Council and the Department of Justice. The latter has been working for many years to address the peace wall in Alexandra park. I am excited for the opportunities that this will bring. I am also excited to work alongside communities in my constituency to truly transform our parks, which have been neglected for many years.”
“I mark yesterday's announcement by the Special EU Programmes Body (SEUPB) of €13·5 million for the Waterworks and Alexandra Park in my constituency of North Belfast. It is a massive opportunity that is aimed at reimaging communities and bringing them together. <BR /> <BR />In 2024, there is a park in a constituency in Northern Ireland that has a peace wall running down its middle to divide two communities. The funding, which is earmarked for bringing communities together, represents an opportunity not only to truly transform our shared spaces and reconnect the entirety of our constituency but to tackle division at its core. It is a massive opportunity not just for that particular area but for the entirety of North Belfast.”
“Alliance would like to see the report and its findings released without further delay and, most importantly, before the deadline of April 2025, so that Alan Black and his work colleagues can get the truth and justice that they deserve.”
“Do not get me wrong: despite my criticisms of the Office of the Police Ombudsman, I must lay out today that we know that it is a necessary and helpful tool for those who seek truth and justice whilst ensuring that all police action is lawful and necessary and that all investigations are upheld to the highest of standards in order to have a police service that upholds law and order. Securing respect for the rule of law and effective policing is not just important now; it was important in the past. To ensure reconciliation in Northern Ireland, the accountability mechanism provided by the Police Ombudsman is crucial.”
“If this report was completed, can we not just publish it now? We do not need to wait until the deadline of April 2025. <BR /> <BR />Mr Black has gone on record in the media confirming that his health is not great at the minute and that he would like to see the report published as soon as possible. Victims should not be pushed to make such public statements. They should not be treated in such a cruel way. They have put their emotional, physical and mental health on the line for over 50 years. For an eight-year inquest and a complaint initially made in 2013, how do we have a system that is so broken, especially when it can be made available and brought to a conclusion much sooner?”
“I can only imagine just how deeply personal this campaign is for him, and it is a fitting tribute to colleagues who were murdered that day that, in his words, he wakes up every morning and, to this day, they are the first people he thinks about. <BR /> <BR />I welcome the fact that, earlier this year, the Police Ombudsman's office confirmed that it will be reporting on the case, despite the uncertainty of the impact of the now-condemned Legacy Act. However, it is Mr Black's understanding — we have heard it again from the proposer of the motion today — that he was told that the report was written and completed back in 2020. What exactly is the delay? What is going on here? What is the truth behind whether it was finalised? Is it finalised? What is stopping it? Why have Mr Black and the bereaved families had to wait since 1976?”
“Thank you, Mr Speaker. Apologies for the confusion before. <BR /> <BR />Alliance will support the DUP motion. The Kingsmills massacre was a reprehensible act of savagery, and, as the coroner's inquest finally confirmed earlier this year, an overtly sectarian attack. It is representative of an extremely dark period in our history — one that it is incumbent on everyone in this Chamber to avoid going back to. In order to move forward as a society, we must ensure that victims are properly supported and that the pursuit of justice is facilitated. I take the opportunity to pay particular tribute to Alan Black for his continued campaign for truth and justice. He has been campaigning for truth and justice for his colleagues and friends for longer than I, and many in this Chamber, have been alive.”
“Will the Minister outline the expected impact of the strike action today, particularly the late notice of the Solicitors Criminal Bar Association's action?”
“— and many reviews. What can the Minister —?”
“I thank the Minister for coming to the House and making the statement. I noted that he said that the report was actually published. Hopefully, the Health Committee will get a chance to go through it in detail. It was bad form not to give Committee members sight of the report. <BR /> <BR />Given that the RQIA's governance report made 23 recommendations, the maternity and neonatal safety oversight board will, no doubt, make separate recommendations to those of the Renfrew report and RQIA report, and you have spoken now about a consolidated regional action plan, what accountability will you provide to the House and the Committee to ensure that recommendations are actually implemented, without our having to ask for those updates every quarter or six months? How can we ensure that the action plan will actually be implemented?”
“The Member is referring to adult services. She will be aware that the BBC documentary highlighted the fact that social workers are not allowed to go into the person's home. They are told that the risk is too high and that it is unsafe to do so, yet we expect families to be there all the time with no help. What is the risk to them?”
“As I said, we are happy to support both amendments and the motion.”
“<BR /> <BR />I have raised many times the issue of respite services for children, and I will continue to do so in the Chamber and in Committee. We need to get answers. The Minister mentioned last week that plans might be in place. Perhaps he could update us on those today.”
“The British Association of Social Workers (BASW) has said consistently that we need to plan not just for services but for the workforce. <BR /> <BR />I have spoken in the Chamber many times — in March, April and just last week — on the provision of respite services for children. Multiple judicial reviews (JRs) have taken place and ruled in parents' favour on the need for trusts to provide respite services for children with complex needs. I understand the position that the Department may be in when it comes to tackling the workforce issue, given that the staff may not be there. The Minister said that again last week. We need the safe staffing legislation to move forward. We also need to add the likes of the British Association of Social Workers to the social care collaborative forum so that it can feed into that.”
“<BR /> <BR />At the same Committee briefing, we were told that there will be a public consultation on the adult learning disability model. That consultation has not happened yet. I hope that the Minister can give us an update on where it is. We were under the impression from the briefing that that would form part of the social care collaborative forum's framework. There are a number of work streams in that. This is another one that, I understand, already has or could have a costed implementation plan that was due in the summer. I would like an update, if the Minister is able to provide that. <BR /> <BR />I will move on to transition. One of the areas that we focused on was the fact that 300 children are due to transition in the next two years. Therefore, there must be planning.”
“<BR /> <BR />Aside from respite provision for families, one of the other issues that come up time and again in the Committee for Health, of which I am a member, is the difference in provision between trusts and the difference in provision if you move to another trust area, which is why I support the DUP amendment today. A report that was given to the Committee highlighted the fact that 47 separate services are run across all the trusts in Northern Ireland. There are different types of services, some of which are voluntary, and some of which are specifically trust-run. However, only 10 of the 47 are available on a regionally consistent basis, which is a poor reflection of where we stand when it comes to services for adults with complex needs. We need to have consistency across all provisions in Northern Ireland.”
“Earlier this year and last year, I was contacted by two families in the North Belfast constituency. They had similar circumstances but different backgrounds. One family was an elderly couple who were having difficulties with respite provision for their adult son. They needed that respite provision to look after their own health. At the Committee meeting of 23 May, the adult learning disability team from the Department gave us an update, and we touched a little on the demographic of people who are getting older and are looking after their older children. Again, the urgency of the issue rings true. There is a vast number of vulnerable people out there who require the service, but every one of those individuals has a family that we need to think about and provide with the respite that they need.”
“I thank Sinn Féin, the SDLP and the DUP for tabling the motion and the amendments. We support all of them and hope that the SDLP amendment will be passed to include children's services. <BR /> <BR />In my first Committee for Health session, I raised the issue of respite services and services for adults with learning difficulties, particularly to ensure that people can remain in their communities. Unfortunately, the consistency of the services — not the services that are offered, although we need to be realistic that the budget for them is not infinite — continues to go downhill. It must be put on record that the staff who work in trust-run and voluntary services do a fantastic job every day and are put under immense pressure. <BR /> <BR />I want to speak a bit about the individuals and their families.”
“I thank the Minister for his answer. I appreciate that work is ongoing. However, in the debate last week, the Minister acknowledged the documentary 'I Am Not Okay'. Those families and many others will want to know the answer to this question: when will we see increases in respite provision and long-term residential provision? Unfortunately, we are now arriving at that situation.”
“It is often those people who go on to do the fundraising. People who have had the experience of the hospice providing for their families then feel that the onus is on them to give back. That should not be the case, even though it is a worthy cause that each individual does that for. <BR /> <BR />I look forward to the Committee's inquiry, when we will be able to hear more from the palliative care network that the Minister outlined and will have an opportunity to ask questions. We look forward to hearing more about the implementation of the recommendations that are in the palliative care strategy so that we can have more of a network. <BR /> <BR />I am hopeful that the House will not divide on the issue. I am glad that we have had the opportunity to speak about this worthy cause, and I commend the amendment to the House.”
“We all know that there are statutory services, and, on paper, hospices may be a core part of the health and social care trusts' palliative care services. However, from speaking to the families of children and adults with a terminal illness, we know that admission to a hospice takes a referral, whether it is to the Marie Curie Hospice or the Northern Ireland Children's Hospice, for end-of-life care. Whilst we recognise that there is community care and hospital care, more often than not, there is a referral to the likes of the Northern Ireland Children's Hospice or the Marie Curie Hospice, and that is why we want to draw particular attention to the amendment. <BR /> <BR />The issue matters to the 350 families that the Northern Ireland Children's Hospice services not just during their time with the hospice but long after it.”
“For anyone who has not visited the adult hospice, you can contribute to its efforts by using the on-site cafe. There is an opportunity for the Minister also to visit the adult hospice if he visits the Children's Hospice. <BR /> <BR />I will turn to some of the comments that were made. Many contributions mentioned the Budget. We understand the Budget situation that we are experiencing. Looking to the wording of the motion, I note that it does not say that the Minister or the Department had reduced funding to the Children's Hospice. There is a recognition that it had funding. Unfortunately, however, costs have risen, meaning that the service is no longer sustainable. That is not to say that the Department is at fault, but the hospice provides statutory services that must be provided.”
“The whole family unit is looked after in the Northern Ireland Children's Hospice, and nothing is spared when it comes to taking care of them. I put on record our support for every person employed by the Northern Ireland Children's Hospice as they do that particularly important work. <BR /> <BR />While at the hospice, we looked at the bereavement room and the remembrance garden. It was a poignant experience to think about the families going through some of the darkest days and hours of their lives, but they are supported by a fabulous, wonderful team of staff. I agree with many of the comments: it is a cause worthy of discussion and of being highlighted to the Minister and the Department. I also want to acknowledge that not only the Children's Hospice but the adult hospice are located in North Belfast.”
“It is a privilege to speak to the motion today to highlight how much each of us, as MLAs, care about the issues that affect vulnerable families across our constituencies. <BR /> <BR />I also want to talk about a visit with party colleagues to the Children's Hospice a while ago. It was a beautiful visit, and it was an opportunity to talk to families, children and young people about what the hospice means to them. We talked to families who had been offered the respite care that they needed for their children with life-limiting conditions. We had a tour of the building and spoke to nurses and some of the other health practitioners. We also spoke to the holistic care providers: the hospice does not provide just health services, and it is about not just the individual but the entire family.”
“Thank you, Madam Principal Deputy Speaker. I thank the Minister for the comments that he has just made, and I thank the DUP for tabling the motion. We hope that, after listening to all the comments, all Members will support the amendment and the motion. <BR /> <BR />From the outset, I want to highlight the fact that I agree with a lot of the points that have been made across the Chamber. This issue absolutely deserves attention and deserves to be spoken about on the Floor of the Northern Ireland Assembly. It deserves the attention of every legislator, whether in or outside the Executive, because it is a fundamental issue for families across Northern Ireland who have to work with the Northern Ireland Children's Hospice and every hospice that we have in Northern Ireland.”
“On a point of clarification, I do not know whether I misheard you. Did you say that there was 50% funding already for the hospice. I thought that I heard you say that.”
“<BR /> <BR />More burdens are placed on the educational system as well. I hear from teachers who have to ensure that those kids are, for example, not given homework because they do not want to cause tensions in the home. They are also bringing in extra food for those kids. They are aware that even some of those children do not have allocated social workers. Again, that is not the fault of individuals, but it brings further weight to the idea that North Belfast and West Belfast need a specific priority and focus. It has been the focus in the past few weeks when it comes to social care, and I look forward to hearing from the Minister about that area of prioritisation and what plans could be put in place.”
“That is not their fault; it is simply because they have no choice and cannot simply walk away. Some social workers now choose to work in the private sector, because doing so is more appealing and family-friendly. I do not doubt that a massive amount of effort and work is put in by individual social workers, but they are beyond capacity. <BR /> <BR />I will touch on Operation Encompass, which was rolled out by police. When a child has been present at a domestic violence incident, the police contact the school to let it know, so that it can put wrap-around care in place. Some contact that we have had with schools in North Belfast, particularly in working-class areas, suggests that, in many of those cases, the school does not know what happens beyond school because, again, there are unallocated places for social workers.”
“I highlight that because it is really important that we are explicit about the differences across Northern Ireland due to the links to poverty. Although I recognise that the Health Minister is here, it is not just his responsibility; it is the Communities Minister's responsibility as well. A number of weeks ago, we had an Adjournment debate on tackling poverty in North Belfast. It gives further weight to the argument that North and West Belfast need to be prioritised. <BR /> <BR />In the previous debate, the Minister recognised and highlighted the increase in training places. Unfortunately, that does not seem to be enough. Through engagement in our constituency offices, we hear that social workers who have had just one or two years' experience are now leading teams, particularly in certain divisions.”
“<BR /> <BR />Ahead of the debate today and as part of ongoing engagement, we have had correspondence from the British Association of Social Workers. It provided a briefing. I will read out something that it said:”
“I thank the Member for securing the Adjournment debate. I read the two questions that the Member submitted, and I was in contact with the Belfast Trust, like many of the North Belfast and, no doubt, West Belfast MLAs who are here. <BR /> <BR />Today has been a day of discussions about health and social care, but we need to be particular in this debate about the reasons for vacancies in North and West Belfast. Members have discussed the poverty rates, and it is obvious that, where poverty rates increase, we will have more complex needs. That also makes us think that increasing the workforce in those areas should be a focused priority. Yes, those areas may require more social workers than other areas, but they also require greater focus on fixing the problems.”
“That is because it is crucial that everyone has confidence and faith in the social care system. <BR /> <BR />I recognise that some of the work that I mentioned is cross-departmental. It is a massive task, and I do not underestimate that. However, the first consultation on adult social care reform was in 2012. It is now 12 years later. We need to see action and progress and to ensure that adults in the social care system, and the families who support them, get the right help.”
“There was also a commitment to a complete review of the 2006 carers' strategy? Where are we with that? I commend the work of those in the sector who participate in the work streams, because they are dedicating their time and resources and are acting in good faith, hoping to see tangible outcomes for the sector and for people on the ground. <BR /> <BR />Carers NI published its policy document, 'A New Deal for unpaid carers in Northern Ireland', over a year ago. It contains a number of recommendations. I look forward to hearing the Minister's response. <BR /> <BR />Another aspect that I would like to touch on is the adult safeguarding Bill. We, as members of the Health Committee, are well aware that that is in transit through the Health Department, but we would welcome it coming to the Assembly in as reasonably timely a fashion as possible.”
“Can the Minister give some comfort today to those workers in the social care sector, who far too often do not receive the recognition that they deserve, by confirming that that will be the case? <BR /> <BR />Another recommendation that the report states is crucial to all aspects of the reform and that will improve consistency and standardisation of services is a regional approach to data collection for all social care services. That will ensure consistency right across the sector. I know that there is a dedicated work stream in the collaborative forum for supporting unpaid carers. The most recent delivery plan commits to recommendations on the development of an expanded carers' register by September this year. However, we are already in October, so where are we with those recommendations?”
“Indeed, that was made clear in the review of adult social care and the consultations that followed it. While they highlight the crucial role that improved pay and conditions will play in improving recruitment, capacity and quality of service, there are other recommendations on improving the workforce that may not need major funding in order to be progressed, such as improving the requirements for the induction, support, development and supervision of the workforce, values-based recruitment and, crucially, ensuring that the workforce feels valued. Has the collaborative forum made any progress on improving staff inductions and the opportunities for staff development, and will that be implemented? I note that the forum also committed to publishing the finalised social care workforce strategy by December this year.”
“<BR /> <BR />I note that the social care collaborative forum has committed to reviewing, updating and issuing revised nursing home and residential care home minimum standards by March next year. I am keen to receive from the Minister an update on that work and a commitment that those new minimum standards are on track to be issued, with care homes notified of the updates by the end of the financial year, in line with the commitment in the delivery plan. As I have said before, this is a plan, but we do not need more plans. We need action. We need to see change. <BR /> <BR />We all know, as it has been debated in the Chamber before, that there is no service without a sustainable workforce that has clear opportunities for career progression and fair pay and working conditions.”
“Absolutely, I agree. I am sure that the Member has been in touch with constituents who have had responses such as, "Oh, you do have options". However, in reality, because of the cost, they do not have those options. <BR /> <BR />We must get the guidance updated to include proximity. That would not require upfront investment — we look forward to hearing whether that is the case — but would have a massive impact on ensuring that individuals feel more secure in the care home accommodation that is provided while reducing the burden of third-party contributions on families. It is for that reason that we welcome the DUP's amendment. The current charging arrangements are highly unfair and inconsistent. I look forward to seeing urgent progress on the review of those.”
“<BR /> <BR />The Assembly has debated the issue of tackling loneliness countless times, yet we are embedding the threat of loneliness in this way by placing people in care homes that are far too far away from their loved ones.”
“The issue of third-party contributions from family members of those in care homes has been raised by a number of constituents right across Northern Ireland, and I was shocked to discover that the Department's guidance dictating the charging of third-party contributions has not been updated since 2010. In addition, when I submitted questions to the Minister to dig deeper into the criteria of that guidance, I was told that the proximity to the individual's family, loved ones and support system is not taken into account when deciding which care home accommodation is appropriate. How can a care home be classed as appropriate if family members and loved ones live unreasonable distances away when the individual can no longer rely on their support system in times of need or has to pay extra money to stay close to that support system?”
“I am sure that the Minister will not be surprised to hear me say that, while, of course, I understand the difficult financial constraints that he and every Executive Minister currently face, I am keen to focus on how the current available budget can be used in a more strategic way by, in this case, looking at investing in measures that will have more impact in the long term: workforce, domiciliary care and early discharge, among others. <BR /> <BR />I am also keen to highlight that there are policy changes that can be made at little to no cost that would begin to have an impact on the ground in the social care sector.”
“It is disappointing that I am able to say the same thing that I said in today's earlier debate about children's social care services, and we have heard that from stakeholders involved in children's social care and adult social care. <BR /> <BR />I appreciate, though, that there are annual updates on the work of the collaborative forum through the end-of-year reports and delivery plans. However, the reality is that many queries and issues raised around social care reform receive the stock answer of, "The forum is looking at this". These key questions remain: when we will reach the point of action? When will service users benefit from outcomes on the ground?”
“We are stuck in a labyrinth of bureaucracy, where change will be a never-ending discussion, while services on the ground continue to deteriorate in the face of growing demand and an ageing and sicker population. That has all been exacerbated by COVID and the instability in this place. <BR /> <BR />In recent months, many questions for written answer to the Minister about social care have been answered with reference to the ongoing work of the collaborative forum, which is due to continue into next year. My frustration is not with the people and organisations involved — they are doing valuable work — but with the fact that so little progress has been made on the recommendations from the consultation.”
“The Minister has since confirmed to me and many others through answers to questions for written answer that any specific changes recommended by the collaborative forum shall be subject to public consultation. <BR /> <BR />I want to focus on that for a moment. As many others do, I acknowledge the fact that consultation is important, as is co-production, but the Department of Health will be consulting on an issue that it has already consulted on again and again. Do not get me wrong: that collaboration is key, and we need to hear again from people in the sector, but I fear that we will now use this as a mechanism of delay rather than one of positive action.”
“It is crucial that social care is properly supported and that the workforce is valued for the care that it provides. <BR /> <BR />Unfortunately, however, adult social care is a perfect example of how slow we can be in Northern Ireland to make progress — something that I have been highlighting as an issue impacting on a range of areas across Health. I understand that the 'Power to People' report in 2017 led to the Department consulting on reform of adult social care in Northern Ireland, which then led to the creation of the social care collaborative forum to implement the outcome of the consultation through a number of separate work streams.”
“Adult social care is a perfect example of how to relieve pressure on hospitals and secondary care. Investing in domiciliary and community care is an early intervention and prevention mechanism that reduces the need for people to go to A&E, use the Ambulance Service or stay in hospital beds that they no longer need. However, social care is about more than just easing pressure elsewhere in the healthcare system. Most importantly, it is a vital sector that, I am sure, everyone will have interactions with at some point in their life, either for themselves or a loved one. Such services give people independence and ensure that they can live their life where they want and on their own terms surrounded by loved ones in the place that they can call home.”
“I thank the Minister for taking an intervention. I completely understand that it is not just his responsibility. Has he prioritised bringing the issues of a Minister for children and families and an arm's-length body to the Executive for discussion with his colleagues?”
“I thank the Member for giving way. I met some of the mums who participated in the recent documentary. They disclosed to us that they — parents who are not able to get respite care — have been sent emails asking whether they could be foster carers. It goes back to your previous point about needing to ensure that there are more services. Do you agree that asking those who are already stretched to the limit is not the right way to go about getting more foster carers?”
“I am looking forward to the annual conference this year, which is something that Ray Jones proposed, to hear further about the progress made on the recommendations. There is, however, a review. It is here, it is being conducted in good faith, it has been consulted on, and decisions must now be taken. We need to ensure that the big policy areas, such as the policies on an arm's-length body and a single children and families social care division, are pushed forward. That responsibility is on all of us. Of course the entire Executive must work together, but the Minister of Health must lead. We must show leadership on the issue and work at pace to ensure that the life of every young person is a priority.”