Debate contribution: Health and Social Care Transformation

Debate contribution by Miss Nuala McAllister on 6 October 2026.

MLA: Miss Nuala McAllister
Party at the time: Alliance Party
Date: 6 October 2026
Type: Debate contribution
Business: Private Members' Business
Heading: Health and Social Care Transformation
Assembly identifier: Official Report component 5777124

Text

Thank you, Madam Principal Deputy Speaker. Before I begin, I put on record that I also welcome the announcement of the 24/7 thrombectomy service. It represents a significant milestone for us in Northern Ireland. We hope that those who can benefit from it will do so in the time ahead. Minister, it is so very welcome. Ten years on from the Bengoa report, we are still talking about health transformation, because it is important and affects people's everyday lives. Unfortunately, we stand in the Chamber week in, week out discussing the slow and steady collapse of our health service. Everyone inside and outside the Chamber knows that, despite the amazing efforts of staff, the health service is not in a good place right now.
We know that people wait for years for treatment, diagnosis or even a first appointment. Whether that is for a cancer diagnosis or access to drugs for a degenerative disease, it is difficult for people and affects their everyday lives. People tell us, on the doors, by email and in our constituency offices, that that is what they want us to talk about in the Chamber. They say, "We want you to talk about health and the things that affect us every day". That is why we are talking about it; we need to look at the real-life consequences. Forgive me, I will not touch on everyone's contributions. Minister, in your response, you said that the reference in the motion to your failures and the failures of your predecessors harming people does not stack up. I will bring a bit of reality. The Department of Health and the trusts have been working on waiting-list validation. That is, I might say, a long-overdue exercise, and it has actually provided some insights through documentation that has been provided to the Health Committee. Specifically, the Belfast Trust confirmed that, in the period between April 2025 and January 2026, 2,116 patients were removed from a waiting list because they had died. During that same period, 1,301 patients were removed from waiting lists in the South Eastern Trust after they passed away. That is not to say that they all died because they were waiting; we cannot say exactly why or how they passed away, but I do not doubt that many people on that list died because they were waiting, and that is just a small snapshot. That situation cannot go on. I will move on to some of the themes that were raised in the debate. I agree with the proposer on the cost of COVID and Assembly collapse. I also agree with the Minister that we cannot have the merry-go-round of constant collapse. That is why we need to reform the institutions. We cannot use COVID as an excuse for delays, however, because some of the things that are bad now were bad before COVID. Therefore, although I appreciate that it led to delays, we cannot constantly go on about COVID. We will support the amendment, but I agree and disagree with different parts of the proposer of the amendment's contribution. I recognise that the whole Executive must take on the challenge of health, particularly in tackling health inequalities and the socio-economic reasons why some people suffer more than others and taking preventative measures to do so. As one of the key architects of power-sharing, however, the SDLP will recognise that one party holds the Health Ministry and that, realistically speaking, the Health Minister must make decisions. There have been lots of discussions on tackling waiting lists. I will say this, Minister: the elective hubs are excellent. Unfortunately, clinicians and those working in the hubs have come to the trusts and the Department to say, "This is how we can do better. If you do this, the elective hubs can be even better". Why are the very people who are carrying out the work not being listened to? There was discussion of the reconfiguration framework, which is two years old. The response that we hear on that in the Health Committee is, "That's just one piece of it; it doesn't mean everything". That is the exact problem: we are not transforming the service holistically but taking tiny steps and looking at it in silos. We need to transform the health service in its entirety in a way that can bring everyone together, because, let us face it, it is easy for me because I am a Belfast MLA who has access to so many hospitals. I must be willing to travel, however. If we expect people from rural communities to travel, then those in Belfast communities must also travel. There was a discussion about parish-pump politics. That is an argument that we often come up against, but we have not stood on picket lines with every party in the Chamber when it comes to changes to services. When it comes to changes that are needed, we believe in following the evidence. However, I say to Colm Gildernew that one of his Ministers — the Minister for Infrastructure — must work with the Minister of Health on community transport, road infrastructure and public transport. The Minister for Infrastructure has responsibility for those things too. Alan Chambers, fair play to you for coming in and delivering that speech. You have a brass neck on you, given that the UUP stood on picket lines, particularly when it came to changes to the minor injuries units. Your Minister endorsed those changes, Mr Chambers, and then you stood on the picket lines. To be honest, Minister, I would be embarrassed for you if that happened again. We do have ideas, actually. We have many ideas, and not just the ideas contained in the Bengoa report.
We have proposed workforce planning. For years, workforce planning has not been going on in the Department of Health despite the fact that, before Danny and I sat on the Health Committee, Paula Bradshaw had been advocating for it. Our ideas also include enhanced theatre protection. How many times have we asked for theatre protection in the Belfast Trust for specialties that can happen only in the Belfast Trust? We need to ensure that the children's hospital has a unique ability to commission services, because it is a regional hospital, not just a Belfast hospital. We must ensure that we can remove waste in trusts, which is something that the Department is not getting a grapple on. Everyone in the Health Committee will agree that there is massive waste when it comes to trust spending, not just on resources but on capital as well. We had the pretend argument from the Department of Health and the trusts that they were going to enhance GP times in nursing homes, but they just copied what GPs were already doing. As for preventative health and the neighbourhood model, we all agree with that. The neighbourhood model should work. I hope that it goes well — it must go well — but how do you expect to deliver a neighbourhood model when the GPs are not even on board? You need to ensure that primary care gets the investment that it needs and that there are proper negotiations with GPs to get them on board.
I will agree to disagree with Maurice Bradley about Bengoa being out of date and there not being any money for it. I agree that money will be needed to invest in transformation but, in all honesty, it will cost us more if we do not invest in it. Minister, you do not have very much time left. Perhaps, you will take up the portfolio again after the election. I want to work with the Minister to ensure that the best decisions follow the best evidence. That is really important. Together for Families and the changes to stroke services and elective care are examples of excellent changes that are being made in the health service, but we also have to be honest with ourselves. It was very brave of the leader of the Opposition to say that local does not always mean best. We have to have an honest conversation. What if best evidence and community agreement will always be at odds? Does that mean that we will never get change? We have to be honest about where we go from here.
Yes.

1,386 words. Text as published by the Northern Ireland Assembly.

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