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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“The Minister may claim that, technically, that is the case, but his previous answers and the lived experience of service users on the ground are clear: the services delivered by the trusts are not fit for purpose. <BR /> <BR />The current model of post-diagnosis provision is not working. Once someone finally makes it through the waiting list to receive a diagnosis, there is no guarantee of what, if any, support they will be offered. There is a lack of clear pathways, and support is inconsistently rolled out across trusts, and there are reports of disagreement across trusts on the best clinical pathways to utilise. All the while, children and young people who have received an autism diagnosis are left waiting for support, too often having to change their way of life to fit neurotypical societal expectations.”
“for anyone, including children, who receive an autism diagnosis. In response, the Minister claimed:”
“However, there is no commitment to ensure that the framework will address the lack of obligated support for children and young people following a diagnosis of autism. Finally, in March, I submitted the most straightforward question that I could formulate and asked the Minister to confirm:”
“and that the emotional health and well-being framework would help to "identify gaps in service" and to:”
“following diagnosis. I then asked the Minister whether the emotional health and well-being framework would address the lack of obligated support. In his answer, the Minister stated that trusts "offer" post-diagnosis support, that:”
“following diagnosis. The Minister responded:”
“for autism spectrum disorder (ASD). Following on from that, in January I submitted another question for written answer, asking the Minister whether there was:”
“That is why I have been trying to get to the bottom of the role of the Department of Health in ensuring that there are accessible, equitable, fit-for-purpose autism services, particularly for young people once they receive a diagnosis and before that. Last November, through a question for written answer, I asked the Minister whether there was a support pathway for families and young people following a diagnosis of autism. The Minister confirmed that:”
“I am sure that we could provide plenty of anecdotal examples in our speeches today — queries from people who have come to our constituency offices about the exorbitant waiting time to receive a diagnosis in the first place or, if you are lucky enough to get through that wait and receive a diagnosis, the insufficiency of the services, the availability of which too often depends on where you live and which trust area you fall under. As Ema Cubitt, the Independent Autism Reviewer, put it in her first annual review, published two weeks ago:”
“Too often, those waits are not short. The National Autistic Society states that assessment and diagnostic waiting times in some trust areas can be as long as four years for children and over five years for adults, despite NICE guidelines stating that it should take no longer than three months. That is over 17,000 children and young people and their families left waiting in uncertainty, often forced to access mental health services due to the anxiety that that has caused. <BR /> <BR />It is becoming more and more clear that our health system does not have the services in place to ensure that, once those children and young people have their autism diagnosis confirmed, they receive the support that they need.”
“In the Chamber last October, I highlighted the fact that over 17,000 children and young people in Northern Ireland are waiting for an autism diagnosis. Despite some scepticism and a query from FactCheckNI, that was confirmed to be the case, with the Minister confirming in response to a question for written answer that 17,205 children were waiting for an autism assessment.”
“I rise to highlight an issue that grows ever larger in our society: the lack of fit-for-purpose autism services. At the outset, I will say what many people have said for years: autistic people always existed, long before they received diagnosis, recognition or inclusion. They existed, often adapting, masking and trying to fit in best to a society that is not made for neurodiverse people and that needs to change. <BR /> <BR />The rates of autism diagnosis are growing, as are the numbers of children and young people waiting on an assessment for autism, because, finally, they have recognition that they can and should receive the support and diagnosis that they need.”
“I want to touch on the women's health action plan. I appreciate how difficult budgets are at the minute, but attitude does not cost money. The way in which women are treated culturally in Northern Ireland can be difficult for many. It comes down to the issue of medical misogyny. Through the women's health action plan, what steps will you commit to taking, Minister, to ensure that there is a mindset and culture shift in our health service, so that women feel that they are validated and listened to and that their concerns are properly taken seriously?”
“Does the Minister agree that the law that allows the investigation and, therefore, the misconduct proceedings to stop must be changed so that any investigation can continue regardless of whether an officer resigns or retires?”
“Minister, I am grateful for your initiating the review. If you do not mind, Mr Deputy Speaker, I pay tribute to Katie's family — her mum and dad — who are in the Public Gallery today. It is a really difficult time for everyone who loved Katie, including her friends and family, and we will continue in the quest to get answers and make change permanent. <BR /> <BR />I have been raising questions about the murder of Katie Simpson for years now, and it is really important that we have those answers. My question today is about the entirety of the police misconduct process. It has been reported that almost all the officers who were under investigation in relation to the Katie Simpson murder investigation have either retired or resigned.”
“On a point of order, Mr Deputy Speaker. I apologise: I should have declared an interest in that my partner works at the Children's Law Centre. We referenced the centre many times, and I neglected to declare an interest in my speech.”
“They will tell you, as they tell us every day when they are in contact, "That is not delivering to the need. That is not being child-centred. Focusing on the bureaucracy and the paperwork is not meeting the needs of all the children who need to have that special additional care in our schools." <BR /> <BR />I am happy to support the motion and to see reform of special educational needs provision in the future. However, it must be a reform that works and delivers and is child-centred and based on the needs of the child now and in the future.”
“Thank you. <BR /> <BR />I can partially agree, but, if you had just listened to what I highlighted afterwards, I said that there are other schools in my constituency where the model of care that they use in the Belfast Boys' Model School does not work. It is based on the individual needs that the SENCO can address, working alongside the parents. I agree that rushed reform that overwhelms the system, overwhelms the very people who provide it and concerns the parents who worry about it — they come to us, and I am sure that they come to you — is not better than having no reform. We need to get it right; that is really important. It is about that individual need. It is really a sad indictment. We have moved to a very paperwork-based system because SENCOs are simply overstretched.”
“I know, Minister, that you have been or are going to Belfast Boys' Model School. I think I heard you speak about it in the past: I am sorry if I am wrong. That school has implemented a different way of working that works for their children and the kids who go to that school. However, just a short way down the road in other schools in North Belfast — I think of Blessed Trinity College — the same system does not work. Therefore, you have to allow teachers to have that individual discretion that meets their pupils' needs, but that just means more work, not that — yes?”
“I come back to the one annual intervention needed by the Education Authority that has been a problem for SENCOs and parents in reviewing the plans. However, it has worked in some circumstances to change the system.”
“I have noticed the difference that it makes for parents and children, yet that teacher is still under extreme pressure and cannot get through her day without using additional hours to speak to parents, ensuring that intervention in children's plans happens where it is needed.”
“Once they recognise that the designated teacher for child safeguarding is usually a different person from the SENCO, they must collaborate and work closely with the SENCOs. We have had circumstances in North Belfast where SENCOs and principals have taken children to their own homes because foster care placement could not be found for them. Every one of those children has complex and additional special educational needs. That is just a snapshot of one story, but it can be replicated across many schools in North Belfast because it is an area of multiple deprivation that sees more complex needs. <BR /> <BR />Primary and secondary schools, even in my constituency, are often different, and we are very lucky that we sent our children to a school that has a full-time SENCO.”
“Those issues are often brought by parents, and I want to focus on that. SENCOs have to have a relationship with parents, too, particularly when advocating for or on behalf of children's individual educational learning pathways. It is that relationship with parents that often brings them to our door to ask for our help because schools are often physically unable to facilitate the entirety of an individualised plan. That is not because SENCOs or teachers are not trying but because they do not have the capacity. <BR /> <BR />In one ward in North Belfast, one child in 20 has a care order. That means that they are under the care of the state in a residential care home, in foster care or in kinship care.”
“I am glad to speak to the motion, and my focus will be primarily on the unique and special circumstances in my constituency of North Belfast. I do not claim that all the issues in North Belfast are unique but there are some circumstances there, and actually good work that I want to highlight. <BR /> <BR />Coming from a family of eight children, seven of whom are teachers or classroom assistants, a week does not go by when I do not get complaints around dinner tables, in phone calls or in texts about needs in their schools — special schools, primary schools and secondary schools across the spectrum. I seem to be the voice that they go to to complain, ask questions or seek signposting for where they should go to next alongside their colleagues, too. So often, we have already seen the issues in our constituency offices.”
“There are workforce issues, but it is about educating the public. <BR /> <BR />We need to stabilise the service. We need to get more dentists registered in the NHS, but, ultimately, we need to be able to pay dentists for the service that they carry out. If you are paying a dentist £10 for a procedure that costs £20, what sort of way is that to do business? If there was any sort of investment in any business here in Northern Ireland, whether it is a coffee shop, hospitality or retail, we would not ask them to pay more just to exist, but that is what we are asking of dentists. It is not supposed to be a business; it is supposed to be free healthcare. <BR /> <BR />If we want to move on and ensure that we keep NHS dentistry, we need to stabilise that service and invest in it for the future.”
“We have to take into account the fact that, because you cannot access a dentist, especially as a young child, it does not mean that you will never go to a hospital, because we are seeing more children who have poor oral health ending up needing inpatient care to receive treatment. Therefore, it has an impact on inpatient care, too. <BR /> <BR />It is important to ensure that education plays a key role in dentistry care. I was glad to hear the Minister in the Adjournment debate outline the additional practices that are taking place in primary schools, but we need to get that information into the home as well so that parents and those who look after our young people, and the young people themselves, understand what it means to have good oral hygiene. That should be part of an oral health strategy, and the profession could feed into that.”
“<BR /> <BR />As I said, I have submitted many questions for written answer, and I hope that we will get answers here today. That lack of clarity, combined with the fact that half the funding allocated to mitigate rising health-related National Insurance contributions is yet to be allocated, raises questions and a complete understanding of why the BDA cannot commend any additional investment when there are questions around whether it will be spent. <BR /> <BR />I appreciate that the Minister faces many challenges, given the proposed Executive Budget, but, with regard to the two points that I previously raised, where money has been allocated, we are not seeing it being spent in a way that will tackle the barriers to accessing an NHS dentist. We hear a lot about shifting left, reducing inequalities and reducing pressure.”
“We are in a lucky position where we can pay higher fees to someone who is not an NHS dentist, but all children should have access to an NHS dentist free of charge. <BR /> <BR />The continuation of the 30% enhancement to fees for priority treatments was part of the reason why the BDA could not commend the investment to its profession last year, so continuing that without change is questionable at best. <BR /> <BR />The Minister will know that I keep coming back to the activity enhancement payment. I raised it in an Adjournment debate, in correspondence and in questions for written answer. Although the rise from £1·6 million in the last financial year to £2 million for the current year is positive, we need to get clarity on whether it has been distributed.”
“It is important that we see the outcome of that targeted intervention and build on it, especially in our rural communities. It is easier for me living in an urban constituency, but many Members from rural areas have spoken of particular delays and issues. <BR /> <BR />The continuation of the enhanced child examination scheme is another example, which I welcome. However, the reality is that it does not address the issue of registrations. It registers children with a dentist, but they are not registered with a practice. I do not know whether the Minister will remember, but during the Adjournment debate a couple of weeks ago, I raised the issue of how I have registered me and my nine-year-old with a dentist but I cannot register my seven-year-old, and that is in an urban area in Northern Ireland.”
“Perhaps the Minister could take on that issue before the end of this mandate as well and resume negotiations or correspondence with the GMC — I believe that it is the GMC, but I might be wrong on that — to see whether we can fast-track registrations or even halve the time or take a year off. Five years is a very long time for someone, given that they have undertaken all the professional development in their own country. I will leave that one with the Minister. I do not expect an answer today, as I appreciate that I have just raised it. <BR /> <BR />I also welcome the targeted intervention in the Western Health and Social Care Trust. It is a show of good faith regarding the need to address specific challenges in rural areas and certain geographical barriers to access.”
“However, I would welcome clarity from the Minister on whether that was done with the intention of those places continuing in the coming years and whether we can possibly build on that. <BR /> <BR />One of the issues that the Member who spoke previously also touched on was the fast-tracking of overseas dentists in England and Wales. Here, in Northern Ireland, those who trained overseas are finding it really difficult, waiting five years plus. I assumed that there was a system right across the UK to get registered as a dentist to practise in Northern Ireland, given that we have such difficulties in getting dentists to register with the NHS.”
“<BR /> <BR />Members will be aware that we had a similar discussion, a couple of weeks ago, specifically regarding NHS dentistry in North Belfast. Following that Adjournment debate, the Minister announced £8 million in funding for dental services in this financial year. Importantly, the Member who spoke previously, asked for a breakdown of that money to see where it is going and how it will be spent, if it is spent. I will do so again. Whilst any additional funding must absolutely be welcomed, I share the concerns of the BDA that that alone is not enough. Many of those measures must be caveated, given the sector's previous experiences of the delivery of funding. The six additional dental foundation training places are a positive development. It may not be enough to meet our needs, but we must welcome the addition.”
“I thank the proposer for that. It is important that, when we all agree on issues, we work together to progress them. I agree with the Member that we need to see progress before the end of the mandate. <BR /> <BR />I am sure that many Members, like the many constituents who come to my door and the door of others, do not believe that an NHS dental service exists any more, because they do not see it. They do not see it in the working-class communities, and they do not see it outside working-class communities, because it is so hard to get those who are not registered registered. When those who are registered need an appointment to see a dentist, they cannot always get one in good time because dentists are under so much pressure and are overwhelmed.”
“Thank you, Madam Principal Deputy Speaker. First, I thank the Members who tabled the motion. Our amendment is intended to add to the calls — not to take anything away — for urgent dental payment reform and to address barriers to access through an oral health strategy, including a plan needed to address the workforce challenges.”
“I thank the Minister for his answer. I am glad that the Education Authority got involved last week. It is deeply frustrating that it was not until elected representatives got involved that we saw movement. I commend the vice principal, Ms Jackson, on really pushing this issue. She has been working hard to facilitate all the students. Will the Minister ensure that, in the future, Translink tries to accommodate, alongside the Education Authority, any changes that are made, especially if principals are going out of their way to facilitate what is best for Translink?”
“I pay tribute not only to the local police team but to the entire leadership of the PSNI in showing resilience over the past few days — resilience that the police have had to show over the past 50 years in Northern Ireland when it comes to protecting our community. <BR /> <BR />To those behind the attack, I want to be clear: your success has been only in unifying voices against the violence and unifying wider political opinion and the community as a whole in condemning your actions. Such attempts to drag Northern Ireland back to the days of using violence will not succeed.”
“It is not OK in 2026; it was not OK in 1969 and 1980; and it will never be OK. <BR /> <BR />My thoughts are with that delivery driver, who was put in the horrendous position of being hijacked and was very brave in his actions. That bravery meant that the PSNI officers could step in to protect lives. My thoughts are with those brave officers. All of us run with our families when there is danger, but they run towards the danger. For that, I thank them for their service. To the residents in the Kingsway area — in particular, we have heard this morning from the very young family who witnessed the scenes on Saturday evening — I say that my thoughts are also with them, and I hope that all of the victims receive the care that they need.”
“Waking up to the news on Sunday morning of the disgraceful attack in Dunmurry was not just shocking but so disheartening as to how far we have come in Northern Ireland. The overwhelming majority of us here do not condone such violence, and it must be said that the majority of us never condoned it. The action of the thugs who believe that threatening the life of someone who was just going about their job and providing a service to the local community, forcing them to bring a life-threatening device into a residential area to threaten not only their life but the lives of many in that community and of police officers is simply unacceptable. Furthering any political cause by using violence is unacceptable. Alliance has never equivocated on the issue of political violence, not now and not then.”
“<BR /> <BR />In short, I support the roll-out of MDTs in North Belfast. It is disappointing that it has not yet happened and the timeline is moving on. We need the support. If the Minister can touch on that GP improvement scheme and whether we can support practices, that would be helpful.”
“We need to ensure that we have the social workers, pharmacists, physiotherapists, occupational therapists and whoever is needed in practices and that they are not simply shifting from other areas to cause pressure elsewhere in the system and are there to properly service the community. <BR /> <BR />Before I finish, another thing that I want to highlight is that I share my two colleagues' concerns about mental health issues. We cannot overemphasise how important it is that we have mental health practitioners in GP practices in North Belfast, so that we ensure that GPs are not the only people who are able to help those in distress and need. That is seriously impacting on suicide rates in North Belfast and putting stress and pressure on the community and voluntary sector.”
“<BR /> <BR />Minister, we have spoken about access to GPs so many times in the Chamber. This debate is not about that, but it is important: we cannot emphasise enough how many of us, in all our constituency offices, are contacted about access to GPs. The simple fact is that there are not enough of them. There are not enough GPs to serve the number of patients who need to be seen, with the increase in ailments that people have. <BR /> <BR />Therefore, while I support the roll-out of multidisciplinary teams and think that it is the right thing to do, we need to see it done right.”
“However, we know that they will just move from the family and children support services to GP services, and that will just create gaps. It will not fill posts and create additional jobs, because people will just shift and shuffle around. That is why the workforce aspect is so important, particularly when it comes to social work and GPs. <BR /> <BR />More and more GPs want to move to part-time practice because they simply cannot facilitate the current hours that are expected of them. Even those who are part-time are doing hours that would be considered full-time in other jobs. All that places an extra burden on GPs. They are managers and are trying to navigate the whole process of incorporating the multidisciplinary teams as well as trying to service their patients every day.”
“It is important progress, and I am happy to support it as part of the Minister's shift-left agenda, to get more support to our GPs so that it is not just the doctors and nurses who service the patients there. <BR /> <BR />I have concerns, however, that, in one North Belfast ward in particular, Water Works, one in 20 children are in care or have had a care order placed on them. I am sure that there are others on the at-risk register across other wards in North Belfast. The figure is quite high, particularly in the areas of multiple deprivation. That means that there is a greater need for social workers in North Belfast than in other constituencies across Northern Ireland. One thing that, we hope, will happen with the MDTs is that we will have social workers in some practices.”
“We have raised the point many times in the Health Committee that, if we are to see it successfully rolled out across all areas, we need GP practices to get the support to do that. <BR /> <BR />As well as Clifton Street surgery, I have been to other surgeries in that vicinity, such as North Queen Street surgery and Carrick Hill medical centre, and they all have the same thing in common; they all have patients from areas of multiple deprivation. They all see patients who have comorbidities and therefore cannot just go and see a doctor about one issue. Often, those patients have many issues. Many of them are also on waiting lists for other services that they could avail themselves of in-house if those services were available.”
“<BR /> <BR />Following that visit, I asked a question of the Minister in the Chamber about capital infrastructure support for MDTs, and we later spoke at the Committee about how GP practices would be getting such support. I believe that it was the GP improvement scheme that was supposed to help facilitate the roll-out of multidisciplinary teams, but it seems as though something has gone wrong, because a number of practices are physically unable to fit all the teams and the people who are needed on-site into their practice. We can hopefully get an update on that from the Minister. I understand that, at the time, there was a little bit of a wait for transformation funding. Following the announcement that it had been successful the second time, I had hoped that there would be an update on the GP infrastructure support scheme.”
“I thank my colleague from North Belfast for securing today's Adjournment debate. <BR /> <BR />When the Assembly got back up and running after the 2022 election — two years later, in February 2024 — one of the first announcements from the Minister was on the expansion and further roll-out of MDTs, subject to resources being available. We were glad to hear that North Belfast would be part of the next roll-out, so it is disappointing that there has been delay. We are, however, hopeful that the roll-out will happen in North Belfast soon. The GP federation in North Belfast has over 110,000 patients to see across 20 or 21 practices. Because I sit on the Health Committee and from a constituency perspective, I have been making my way around a lot of the practices. My colleague mentioned the Clifton Street surgery, which I visited back in April.”
“I thank the Minister for taking an intervention. Minister, I appreciate that the matter is not normally in your portfolio, but, having listened to what you just said, may I confirm that there are powers under articles 65 and 66 of the Criminal Justice Order and that the police have had drone powers since 2013? Whilst there will be no changes in this mandate, we perhaps need to look at how the police use the seizure powers that they have and their use of drones.”
“I appreciate what the Member is trying to get at, but I sit on the Policing Board with three of your colleagues, and I do not believe that the issue has ever been brought up there. Have you tried to go down that route? We would be more than happy to work with you and your colleagues on the Policing Board to hold the police to account on whether they will initiate that kind of campaign.”
“It seems that it is something that we all agree on in the Chamber. We know that it is a problem that should be fixed. There is an education piece not just for young people but for parents, because they are buying them. It is not actually the young people who are buying them. Hopefully, by all working together, we can progress this. The neighbourhood policing teams need the help and resources. The policing infrastructure can enhance those teams, which will enable them to do that.”
“There should be targeted campaigning towards using them on proper land that is built for that purpose. They are totally destroying green spaces. I remember having meetings with the Belfast Hills Partnership and the National Trust about the use of bikes — not e-bikes — by mountain bikers on Cave Hill and in the Belfast hills and trying to remove them from there. They had to jump through hoops to be able to use those spaces safely, yet people are able to wreak havoc on e-scooters and scramblers. I know that the police want to be able to do something more about the issue. Colleagues in the Chamber from North Belfast often hear about the police seizing boom boxes and drink up on Cave Hill, but e-scooters and scramblers are more dangerous. <BR /> <BR />Hopefully, if all of us work together, we can progress this.”