Debate contribution: Health and Social Care Transformation

Debate contribution by Mr Colm Gildernew on 6 October 2026.

MLA: Mr Colm Gildernew
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 5777082

Text

I am delighted to speak in the debate, because, if we are serious about making difficult and lasting changes, we absolutely need a shared programme of reform that can survive beyond an individual Minister or electoral cycle. As a former Chair of the Health Committee, I had the privilege of meeting Professor Bengoa several times. Two of the really important things that Bengoa said, which are neglected at times, were about setting out a vision and about the whole issue of double running. Budgets for double running is a real issue, but there is a huge need to set out a vision. It is also important that I call out those who revert to the allegation of parish-pump politics the minute that communities raise very valid concerns. It is an insult. Many who engage in that slur, and it is a slur, do so from a position of living beside multiple hospitals and the motorways to get them there. It is an insult that is designed to portray our rural communities as insular, naive and unwilling to move with the times. Nothing could be further from the truth. The south Tyrone area, for example, far from being parish-pump, is the beating heart of our engineering and manufacturing sector, generating significant revenue for the economy and employing skilled workers who contribute taxes on the same basis as everyone else. We are therefore entitled to safe and effective healthcare on the same basis as everyone else. Are we prepared to travel? Absolutely. Are we prepared to look at positive change? Absolutely. There needs to be engagement with us, however, so that that can be the case. It is also important to state that we cannot simply lift non-relevant models, such as the so-called London and Manchester models, because they do not recognise the unique rural demographics that need to be served here. As we move forward, we need to be clear about what transformation looks like for people in their everyday lives. For women, it means finally delivering the long-promised improvements in women's health. For people who live in rural communities, transformation has to mean proper access to key services. It means provision of timely and accessible mental health services right across the North, properly resourced and supported social care services, and effective and available primary care services from our GP network. I represent Fermanagh and South Tyrone. I know that moving a service on a map can look very different when someone is being asked to consider a change that will involve their travelling significant distances for treatment when public transport is limited and ambulance cover insufficient. It can look very different when an older person depends on family members even to get to an appointment. Reform, therefore, must be designed with our rural communities, not simply imposed on them. If we are serious about reform, we will also have to look genuinely at how we do that on an all-island basis. Our hospital in Enniskillen — the South West Acute Hospital — currently cannot serve any of its natural hinterland to its south, nor, indeed, an awful lot of the hinterland to its east and west, due to the unique geography of its location. That has to change. We have to look at how we do things better on an all-island basis. There will inevitably be difficult decisions ahead. I believe that they will only command public confidence if people can see the evidence behind them, and therefore the Minister has to set out that vision. What are the changes? What are the improvements? There must be evidence, and we must engage with communities. If communities are genuinely involved and there is a clear alternative in place before existing services are removed, I believe that transformation can then become something other than a word that is associated with withdrawal or collapse and can genuinely become about improvement and opportunity. That is where we need to move to. It has to mean genuine improvement in how we deliver healthcare for all our people, and that is the job for all of us to engage in.

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

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