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 often think that it will come to one of their friends losing their life for some of them to think that it is not cool any more, because the scooters are seen as that. It would be really unpopular, but, if we had greater powers — from the responses that the Minister has given to questions for written answer, it appears that that is supported — we could all tell the police which shops to go to or where people hang out with e-scooters, and they could go and see a bunch of them, because e-scooters are becoming more and more popular in certain areas. <BR /> <BR />I will move on to talk about North Belfast in particular and the whole Belfast hills area, which leads on to west Belfast, where scramblers are being used in non-rural settings more and more.”
“Thank you. I agree with the Minister. The e-scooters are targeted at the younger generation, who want to use them, although they are a different form of travel. We see people use them responsibly, for example to get to work, but, for the most part, that is not what we see daily. <BR /> <BR />I am told that some e-scooters can go up to 60 mph. The ones that we generally see can go up to 40 mph. We want to see more 20 mph zones for cars in our neighbourhoods, yet we have scooters that can go up to 40 mph, and there are kids on them without helmets. It is absolute madness. We also see them not just in green spaces but on our roads. In North Belfast, we often see many young people trying to get to the Belfast hills on the main roads. They cut across all the traffic, again not wearing helmets.”
“They are targeted towards an older population, but let us face it: it is families who are buying them for teenagers and children.”
“I will start by paying tribute to the lives that have been lost not just in Northern Ireland but in the Republic. We saw the recent introduction of Grace's law in the Republic, although some of it already applied here. In the past month, that has brought even greater attention to the issue here. <BR /> <BR />I will also speak about the current law on e-scooters. In the previous two mandates, pressure was applied, and there were calls for new legislation on e-scooters before they had picked up the pace to get where we are now. We have not seen that progress yet, so I hope that the Department of Justice and the Department for Infrastructure, which have shown a willingness to work together, will do so. <BR /> <BR />I also want to highlight what we can do about the manufacturing of e-scooters.”
“We had the winter plan, which was, essentially, services that already existed dressed up in different clothes, and it did not deliver for people. You said that you could not implement the real living wage. You had a budget last time and did not implement it. That is what we were talking about last time, so what will change so that we do not see in excess of 1,000 deaths again this year?”
“I thank the Minister for coming to the Chamber. However, so many times you come to the Chamber, Minister, agree with Members, and say, "Yes, it's bad, it's really bad, so it is", but, in case you have forgotten, you are the Minister. Do something about it. We have heard time and again how things are getting so bad and crippling in our health service. Since sitting on the Health Committee, I have come to the realisation that the question has to be asked: if the Health Department had 100% of the Executive's Budget, would things be any better? Since you have been in office — this also applies to your predecessor — we are yet to see a prioritisation of what it is that you want to work efficiently to make savings that will actually make changes.”
“— that might be able to help our constituents more?”
“I thank the Minister for his answer. I think that he, like many others, would agree that the fact that rents have outpaced wages by 16% is just mad. In my constituency of North Belfast, rents are increasing in areas that have never seen the likes of those increases before. People who cannot get onto the property ladder turn to the rented sector, but the rental price is much more than any mortgage would be. It is absolutely infuriating. The Minister outlined some rent control measures, such as the third-generation control measure. Is there anything else on his agenda that he is going to look to, either in this mandate or commencing work in the next mandate —”
“Whilst our thoughts are with the staff at Ulster University, our thoughts and actions should also be about sustaining our higher education system across Northern Ireland so that our people here can benefit.”
“I echo the comments of my colleague regarding the fact that this is happening in universities across the UK, but we have specific issues here in Northern Ireland that have not been addressed. Where is the review of higher education funding? Why have we not seen the Minister be forthcoming with what the Department can do in that respect? We need to deliver for people here who will drive the economy. People who work in academia at Ulster University collect data not only to enrich policy here but to drive legislation, to drive changes that can be made and, ultimately, to drive the economy. We have students here who will be applying for university in the next few years and are now wondering whether that will affect them too. We need clarity on that.”
“Unfortunately, when we hear about the 450 job losses, my thoughts are with the people who are affected, but it will also affect the wider community that is concerned about what it means for the future of the campus. <BR /> <BR />To the particular people from Ulster University who have been in contact: our thoughts are with you. We are concerned for your future. We have to be realistic here. Northern Ireland has only two universities. There are not many opportunities for people in academia or at university management level. We will lose people to across the water again; we will also lose students, because there is no doubt that, as we lose staff, courses will be cut. Therefore our students and people in Northern Ireland will, again, look across the water.”
“When the Ulster University campus was relocated from Jordanstown, where I attended and studied — anyone in the Chamber who studied there will recognise the stark difference between that and what is now at the Belfast campus — we in north Belfast were promised a reinvigoration, a revitalisation and a connection to our communities in that part of the city. For years, we looked on with anxiety and stress at the new build coming on and the stalling of it. However, when it finally happened, we were thankful that it was relocating to the north part of the city, and we were thankful for the opportunities that it could bring for local people, also opening gateways to connect north Belfast with the rest of the city.”
“<BR /> <BR />Can the Minister inform the House when he will publish the cost-of-service review that was commissioned a year ago and give us an update on the £1·6 million of additional funds that will be allocated? Can he provide any more information or help to our constituents in North Belfast who do not qualify for the dental access scheme and are not currently registered with a dentist? Where do they go, and where can they turn? We would be grateful to get answers from the Minister today.”
“They simply cannot turn anywhere else because, when their dentist turns private, they can no longer afford treatment. There is nowhere that they can turn. <BR /> <BR />We also need to see greater emphasis from the Department of Health and Department of Education on educational awareness in schools. I remember, as, I am sure, others do, that, when I was growing up, there was more discussion about dental hygiene in school. You were given a toothbrush and toothpaste, spoke about them and brought them home. That does not happen in all our preschools in North Belfast. In many of them it does, but we have had people reach out to say that it does not. Where it works, it is helpful. It might not seem like a big deal, but, when parents are already stretched enough with purchasing food and the rising cost of living, every little helps.”
“I echo the contributions that have been made about dentists' practices and the dentists themselves who work in them. They are running businesses and, of course, offering a public service. No other business would run at a loss. If you are not getting paid for what you do, how can you sustain yourself? We hear from dentists who are not getting paid what it costs to put a filling in a person's mouth. They are working at a loss to do that. Of course they will turn private, because they are having to pay out of their own pocket, and we will see those waiting lists increase. <BR /> <BR />The Member spoke about 20,000 people in North Belfast — adults and young people — who are no longer registered with a dentist: where have those people gone? They have not all died and no longer need a dentist.”
“Not everyone has the luxury of going to see a dentist for a check-up. When younger people over the age of five come forward to see a dentist, often it is too late. We see increased rates of tooth extraction, which means that the community hospital dentist team has longer waiting lists extended and is under more pressure. We are really talking about swings and roundabouts here: when you take your focus off one area, you put greater pressure on another area. Investing upstream will help the whole service.”
“I have tabled a question for written answer to the Minister about the £1·6 million of additional support payments that were outlined last May, I believe, to dentists that are still providing NHS care. That money was announced, but it has still not been allocated. We also know that only half of the funding to mitigate rising employer National Insurance costs has been allocated, so, even when there is funding, we do not seem to see movement on it. It is really important that we do that. <BR /> <BR />It is also really important that we have a campaign to ensure that parents know that their children should be seen by dentist before their first birthday, but people in North Belfast simply cannot afford to go private.”
“<BR /> <BR />I have asked the Minister many questions, in the Committee and through questions for written answer, specifically about the dental access scheme. When people contact us in our constituency offices, our first priority is: can we get them on to the access scheme? So many of them cannot get on to that scheme because they do not need just one treatment. There needs to be an understanding in the Department that, when we ask people what they need, it is not just that they need one emergency treatment. They need ongoing treatment, and there is nowhere to turn to. <BR /> <BR />My colleague who opened the debate talked about additional funding and resources and the cost of service review.”
“However, in North Belfast, the issue has also been raised with us by preschool teachers who are noticing younger children in our constituency who have never been to a dentist. The first time that I spoke about this in the Assembly, a dentist from North Belfast contacted me to say that most parents are not aware, because there is no campaign, that children should see a dentist before their first birthday. I am a parent of two boys. My seven-year-old is not registered with an NHS dentist, or any dentist, but my nine-year-old and I are. We are very lucky that our dentist will see the seven-year-old and check on him, but we cannot register him with the practice. I am lucky that I can pay fees that are cheaper than private fees, but many people are not so lucky.”
“I thank the Member for bringing the Adjournment debate to the House. As a member of the Health Committee and a North Belfast MLA, I have been working on the issue for some time. Like my colleagues in North Belfast, I see this issue in my constituency office time and again. <BR /> <BR />I hope that the Minister and the Department are aware of the links between poverty and oral hygiene. It is not merely a coincidence. Academic research highlights the fact that, in areas where there is more socio-economic deprivation, there are more people — younger people especially — who are more susceptible to oral health issues and tooth decay. That issue has been raised with us by organisations, as the Members who spoke previously said.”
“Thank you, Deputy Speaker. <BR /> <BR />Minister, I welcome your taking the initiative by coming here today to keep the House up to date on the progress that you will be making on this new level of scrutiny. Will you keep MLAs up to date on the oversight in future both in Committee and in the Chamber?”
“Rather than trying to frame those statistics as an improvement, we need long-term ambitions for breast cancer diagnosis so that women in all of our constituencies can be seen in good time, rather than having the overwhelming stress and anxiety of that wait.”
“How long do we expect those clinicians to run themselves into the ground for? How many extra shifts, including weekend shifts, can they do to see all the women who are waiting for that life-changing diagnosis? <BR /> <BR />We urgently need a workforce strategy and a service strategy from the Department because the situation is not the fault of clinicians on the ground; it is a systemic issue. There are fundamental problems that need to be structurally addressed. We want to tell women that they can receive their life-changing diagnosis and treatment in good time, but, unfortunately, over the past year, many people have waited for up to 10 weeks to begin that treatment, and that has often made things worse.”
“The Minister's response was to welcome the improvement, yet the statistics showed that just 6% of women who were waiting for a red-flag appointment were seen in that two-week window. We also had women coming forward in the media during that time, highlighting that they had waited up to 10 weeks for their appointment and, indeed, had unfortunately been diagnosed with cancer after that time. We all know the importance of early detection and treatment for the likelihood of success in battling a cancer diagnosis. Seeing such a small proportion of women being seen in that two-week window is nothing short of a disgrace. <BR /> <BR />I pay tribute to the many clinicians who work overtime on the ground. They are trying to see improvements in that area. Unfortunately, that will not be sustainable.”
“I also welcome Julie to the Chamber today and wish Gary all the best. He was always a pleasure to work with. <BR /> <BR />I will speak today about breast cancer referral times. I have spoken about that in the Chamber many times over the past year and, indeed, since being elected as an MLA for North Belfast. Over the past two weeks, we have had Easter recess, when many people took a break to recuperate and perhaps took some time to spend with their family. During that time, however, many women in Northern Ireland were having to wait anxiously for an urgent, red-flag breast cancer diagnosis appointment. <BR /> <BR />Over the past 14 days, we saw statistics come out from the Department of Health that showed the Department patting itself on the back.”
“I hope that the strength of the public reaction has shown the Minister of Health and the Minister of Education how important the services are. <BR /> <BR />I will end with this: why is it that children with additional needs — complex needs — and their parents constantly have to fight for their basic rights? They constantly have to fight to be heard and for their children to be assessed and diagnosed, for respite and for SEN school provision. That has to change.”
“I absolutely agree with the Member. <BR /> <BR />Yesterday, I spoke on the phone to another mother, who was in a dire state, about the lack of summer scheme provision. When I told her that there had been a U-turn — she had not realised that — she asked, "What was the point of it?". What was the point of it? <BR /> <BR />Parents have spoken about why they are at crisis point. Today's debate is not just about summer scheme provision; we are here because parents are at breaking point and in crisis. Parents are having to relinquish the care of their child to the state, because they simply cannot go on. It was so distressing that the announcement was made at the start of the Easter break, not just for government but for families, who will have to cope over the next two weeks.”
“They were quoted £52 an hour for such help and provided me with proof of that quote. If a trust cannot provide respite, how can we expect parents to do so? I understand that some children require four-to-one, three-to-one or even two-to-one support, but many of the mothers who look after their children at home do so on a one-to-one basis, and we expect them to cope. However, they cannot do it any more, and many of these —.”
“However, no matter how many times I have asked the Minister, his officials or officials from the various trusts about that, they have maintained that the additional £13·1 million investment was not just about increasing beds. We have seen progress, but that has been minimal, and the fact remains that overnight respite has not been restored to pre-COVID levels, which were not good enough even then. <BR /> <BR />Last week, we were informed that a trust had sent money — £200 or £500 — to families who, whether or not they were in receipt of direct payments, had been approved for respite care. The trust could not provide respite for them, so it thought, "We'll leave it to you". One of the families contacted me by phone, saying that they had looked for private help.”
“However, from my ongoing contact with the families involved and numerous others trying to access respite services that they have been approved to receive, I know that they have not been able to do so. <BR /> <BR />The Health Committee was told just two weeks ago that things were OK and that many of the families were happy. However, following the Committee's briefing from the South Eastern Health and Social Care Trust and the briefing from the Health Minister last Thursday, I was again contacted by the families, along with the National Autistic Society, who said, "I am not OK". MLAs were reminded that the aim of the campaign was to ensure that respite facilities for families in crisis were introduced and that additional residential and overnight respite beds were added to the system.”
“When the troubling announcement was made last week, we all heard straight away from parents whose children, at the time, were still in school and were just about to enter their Easter break. Those parents were already stressed about the lack of respite that they had. Their common theme was that the summer schemes were a form of respite not just for the families but for the children. <BR /> <BR />The fact that families have to rely on education settings to provide much-needed respite services is a dire indictment of the actions of the Department of Health. I have spoken so many times in the Chamber about the 'Spotlight' documentary 'I Am Not Okay', which aired 18 months ago. Following that documentary, the Health Minister committed to investing £13·1 million in respite services.”
“Our motion describes the summer schemes as "vital" and "a lifeline" for children and their families. That reality cannot be overstated. I recognise that the comments being made across the Chamber are trying to touch on the reality of the day-to-day lives of parents and their children. I also recognise and respect the fact that the debate is not about political point-scoring and must be about those families. However, without accountability, there will never be change. That is important. <BR /> <BR />Much of the focus today has been on the Department of Education, and rightly so, but Departments must work together. I will spend a lot of my time today on the Department of Health and the Health Minister's responsibility in the area.”
“Minister, you anticipated part of my question. We have heard from some concerned nurses. The Royal College of Nursing (RCN) also has concerns about the protocol, but we have to do some things differently. What has the engagement been like to ensure that we have buy-in from not only the RCN but emergency departments and clinicians who will run it on the ground? Ultimately, they will look after the patients who are released to the hospitals so that the ambulances can go back into the community.”
“I thank the Minister for his statement. I was going to say that the DUP follows evidence when it suits it, but we and the public are well aware that the DUP does not follow evidence to inform policy. <BR /> <BR />It is really important to listen to the voices of people affected. As someone whose grandfather had an alcohol addiction and eventually succumbed to the disease in hospital, I saw at first hand what alcohol can do to a person's mind, body and family. In all likelihood, more than the estimated £117·4 million could be saved. How many lives could be saved by using that money for other preventative measures or to tackle other diseases, such as cancer?”
“Minister, as a member of the Health Committee looking at the Bill on hospital car parking charges, I agree completely with what you said. Would you also agree that doing this at this stage, close to the end of an Assembly mandate, is similar to what happened with the Hospital Parking Charges Act 2022, and it might be seen as disingenuous in terms of such a payment coming into existence?”
“I thank the Minister for his answer, although I point out that bullying that commences in school often takes place outside school hours. There is such a thing as a cardboard box that does not cost £20,000 a pop that can be used to hold phones. <BR /> <BR />The Minister talked about data gaps and where we might be able to see those. Has he considered collating anonymous data? If not, might he reconsider that, so that the Department can see the trends more thoroughly?”
“We ask those questions because we are talking about a condition that affects real life and has devastating consequences for the women and girls who live with it. <BR /> <BR />This month, women have been bravely sharing their stories online and in the media. They have been sharing how they have been stuck at home, unable to move due to the pain; how they have been unable to go to work; how they have crowdfunded for private treatment; and how they have waited for 14 years and had four surgeries just to get a diagnosis. We have even had clinical professionals say that, in Northern Ireland, women get a raw deal. I hope that many Members will join me in dropping into the event this afternoon and that they will continue to apply pressure and speak up for the women affected.”
“Last week, the Chamber agreed on the urgent need for a women's health strategy and the action plan that was promised over two years ago this month. The Health Minister has committed to commencing investment in specialist endometriosis care in 2026, but what does that mean, and what will the service entail? <BR /> <BR />The issue unites us all in the Chamber. We have all called for more acceptable waiting times, quicker diagnosis and treatment and, most importantly, for women to be listened to. However, we still have too many questions. How do the Minister and the trusts plan to reduce the unacceptable waiting times? Where are we with the pilot to transfer patients from secondary to primary care? Where are we with the ongoing work on the endometriosis clinical pathway? How will the plans for gynaecology ambulatory hubs work in practice?”
“Yet women still wait for years. In 2025, the average waiting time for women in Northern Ireland to receive a diagnosis following their first GP visit was a shocking nine years and 10 months. In addition, research shows that it took, on average, three and a half years following symptoms beginning to show for women to take that first step of reaching out to their GP. That means women are experiencing over 12 years of ever-worsening symptoms, including severe pain, chronic fatigue and heavy periods, before finally having their experience formally acknowledged with a diagnosis. That is simply not acceptable.”
“As many Members will be aware, Endometriosis Awareness Month takes place in March. Today, Endometriosis UK is hosting a drop-in event in the Long Gallery to provide education on the realities of living with the condition. <BR /> <BR />The theme of this year's awareness month is "Endometriosis Doesn't Wait". As Endometriosis UK puts it:”
“<BR /> <BR />I also welcome the fact that the motion references primary care arrangements. I would appreciate an update on that, specifically on the pilot programme to transfer eligible endometriosis patients from secondary to primary care. <BR /> <BR />We could all speak about women's healthcare all day long and raise issues in the Chamber. We will continue to do so, because, until we eradicate gender bias, it will continue year after year.”
“I had hoped to ask the Minister for an update on that. <BR /> <BR />The Minister announced the women's health survey. I pay tribute to Derry Well Women, which has undertaken a listening exercise on that survey. I appreciate all the work that it and Queen's University have been doing, but we are two years on from the announcement of the women's action plan and are still just talking about it. We need to implement it. There needs to be an entire-system approach to dealing with women's healthcare. What is the time frame for its implementation? When are we likely to see it? Perhaps we can follow up on that with the Minister and his Department in Committee. We all know that action plans are never perfect on first publication, so we will have to keep going back to the drawing board.”
“That is one example of healthcare that is not attributable to puberty, pregnancy or menopause symptoms. <BR /> <BR />Another example, which I have brought to light continually, with the help of members of the gynae workforce in Belfast, is the issue of robotic-assisted surgery in treating gynaecological conditions. The da Vinci robot offers a relatively new way of performing surgery. In January of last year, however, we were informed that 518 male patients and just 86 female patients, which the Minister confirmed, had been treated by way of that innovative surgery. We have pushed the issue consistently through questions for written answer, letters and questions at Committee, and I was delighted to hear that the Belfast Trust should, hopefully, receive its new commissioned robot in the upcoming months.”
“Much research from across the world shows that it takes years for women's bodies and brains to return to pre-pregnancy levels and recover properly, yet we are expected to go home and perform a new role in life. I honestly believe that that is because of gender bias in the healthcare system. It is, however, something that many people in healthcare are starting to tackle. <BR /> <BR />Members have already spoken about the British Health Foundation's 'Bias and Biology' report. Following its research, the British Heart Foundation said that gender inequalities in care following heart attacks show that, compared with men, women are much more likely to receive a delayed diagnosis following a heart attack; less likely to receive timely guideline-indicated treatment; and ultimately more likely to die from a heart attack.”
“Instead, although a lot of them would like to remain at hospital, they are often sent home mere hours after giving birth to take care of a new life while still recovering physically and mentally.”
“It is about having a whole-system approach to how we treat women and an interconnected lifespan of healthcare. No offence to anyone working in healthcare who helped to develop the system, but we are talking about a system that was developed by men for men, because, had the system been developed in conjunction with women, we would not be having the debate today. <BR /> <BR />Today, I looked up the advice that is given in different areas of healthcare. The advice given to those who use vasectomy services includes having 48 hours of heavy rest, no lifting and ensuring that you relax and do not do anything remotely strenuous, yet women do not get the same advice after childbirth, which is often very traumatic.”
“I thank the Member for moving the motion. Two years ago, my maiden speech was on an Alliance motion specifically about women's health. On that date, the then Minister confirmed that there would be a women's health action plan, not a strategy, which everyone in the Chamber united behind and agreed was what we needed. Many in the Chamber were willing to give the Department the benefit of the doubt on the action plan if it was developed and implemented, but we are no further forward today. <BR /> <BR />I start by discussing why we have to keep coming back to the issue of women's health. I agree with the proposer and the two Members who spoke before me that women's health is not about isolated incidents throughout their life, whether it is puberty, pregnancy, childbirth or menopause.”
“Minister, constituents have already been in touch with many MLAs, both childminders and parents, who are concerned that the change will result in the sector increasing its fees so that it feels more sustainable. Have you discussed with HMRC the number of those who might be affected in Northern Ireland? If not, will you undertake to have that discussion with HMRC so that we have a true assessment of the number of people that it will affect?”
“Of course, Alliance supports diversity, as it is an important priority in ensuring the representativeness of the PSNI, but 50:50 recruitment did not work for the long-term sustainability of diversity. Does the Minister agree that, if it did not work in the past, it surely will not work in the future and that, instead, our priority should be on the root causes of why Catholics are not coming forward to join the PSNI? Does the Minister also agree that, whilst the Justice Ministry is not in the d'Hondt process, it still counts towards the party's allocation in that process?”
“Yes, absolutely. The Commission was clear that it wanted to proceed with the memorial only on the basis of the widest possible agreement with victims and survivors. Whilst there is not one view on the issues among the victims and survivors, the engagement that took place with them to get to this point has been extremely important. Their views and feelings were an absolute priority.”