Debate contribution: Health and Social Care Transformation

Debate contribution by Mr Philip McGuigan on 6 October 2026.

MLA: Mr Philip McGuigan
Party at the time: Sinn Féin
Date: 6 October 2026
Type: Debate contribution
Business: Private Members' Business
Heading: Health and Social Care Transformation
Assembly identifier: Official Report component 5777049

Text

I thank the Members who tabled the motion and the amendment. I take exception to Mr McGrath's narrative of the Health Committee. It may dispel some of the public narrative when I say that I agree with my Health Committee colleague Diane Dodds — I am speaking not as Chair of the Health Committee but as my party's health spokesperson — that what we rightly do on the Committee is challenge the Minister in a constructive way. Indeed, in the short time since the Minister took office, he has asked us to challenge him and his decisions, as is our right. All of us on the Health Committee have done a reasonably good job of doing the right thing, which is to take politics out of the Health Committee. Health is far too important for us not to do so. I have said time and again that I do not care what political party the Health Minister comes from. I want the Health Minister to succeed in everything that he does, because health is far too important for the population that we all serve for him not to do so. As the then Health Minister Michelle O'Neill announced 'Delivering Together' in response to the Bengoa report, she said that "whole system transformation" would be required across primary, hospital and community care, and she warned us of the consequences of not delivering planned and managed change in our health and social care system. Ten years on, we are, unfortunately, living with the consequences of delay and unmanaged change: staff shortages, overcrowded emergency departments, ambulance delays and patients remaining in hospital beds because the number of home care packages is insufficient to support safe and quick discharge. Every week, I meet GPs, community nurses, allied health professionals, hospital clinicians, social care providers and home care teams, and I hear about the challenging environment in which they are trying to deliver services, be that in unsuitable buildings or with staff shortages and demand outstripping capacity. Constituents contact me regularly with their personal stories of long waits for assessments, diagnostics and routine procedures that have become urgent; people losing their independence while they wait for services; and families forced to shoulder care because of the limited availability of home care packages. Those prolonged waits increase clinical complexity, lead to deterioration and cause moral injury to staff who know what good care looks like but cannot deliver it in circumstances where the system is either under-resourced or fragmented. That is especially difficult when it comes to red flag cancer care and time-critical appointments. The focus has to be kept on the priority of getting to grips with our unacceptably long waiting lists. I welcome the Executive's commitment to tackling waiting times and the work that has gone into achieving reductions to date, particularly for those on the longest waiting lists. It has to be acknowledged, however, that we still have a long way to go. There are many challenges to be overcome if what we are doing is to be sustainable in the long term. Investment is needed, but that alone will not solve the problem. When the permanent secretary was before the Committee last week, he talked about the difficulty of changing the engine while driving the car. I agree that we have had decades of underinvestment, but we need to spend money in the right places. I was struck by Danny Donnelly's opening remarks when he detailed the raft of strategies that we have that are not funded and the raft of strategies that we do not have that are needed. Genuine and impactful healthcare transformation is about much more than our hospitals, where they are located and the services that they provide. It begins with timely access to GPs, and it extends through to community and allied health professionals, robust home care services and sufficient staff to ensure safe and timely discharge from hospital. If there are any weak links in that chain, the whole system strains. I was struck by the BMA's warning about social care reform by service collapse, and that should concern us all. We see it, time and again, most recently with the midwifery shortages at Daisy Hill Hospital and in discussions about services at the Causeway Hospital and the South West Acute Hospital. Patients deserve to understand the clinical evidence and the alternatives that have been considered and how the service will be protected. I am rushing through my speech, because I am going to run out of time. We need to take the politics out of it, and I urge the Health Minister to take the politics out of it. His party leader —
— introduced party politics into it, but we need decisions that are made on the clinical evidence and in the best interests —
— of our patients.

805 words. Text as published by the Northern Ireland Assembly.

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