Debate contribution: Waiting Lists: Action Plan

Debate contribution by Mr Colin McGrath on 20 February 2024.

MLA

Mr Colin McGrath

Party at the time

Social Democratic and Labour Party

Date

20 February 2024

Type

Debate contribution

Business

Private Members' Business

Heading

Waiting Lists: Action Plan

Assembly identifier

Official Report component 4380570

Read the official Assembly record

Text

No greater issue has highlighted how sick our health service more than that of the waiting list debacle. The fact that we are raising this issue and discussing it so early after the Assembly's return is therefore welcome. People have been languishing on waiting lists for too long. It is probably too simple to point to COVID and say that that was the cause of any of those lengthy lists; it certainly did not help, but the genesis of the problem goes back much further than that. To find the real answer, we need to delve into the strategy storage room in Castle Buildings, for it is there that we will find the real cause of the problem. It is in that room that we will find many undelivered strategies. Many of those strategies would have helped the waiting lists, had they been implemented. It is in that room that we would find many announcements about reorganising our health service, and it is in that room that we would find plans that would have reorganised and helped, had they been enacted. It is the inactivity of Health Minister after Health Minister and Executive after Executive that has led us to where we are today, with some of the longest waiting lists in Europe.

I will not, because you will have your chance, and I will not get any extra time. How bad is the problem? Last September, 116,000 people were waiting for an in-patient or day-case appointment and 429,000 were waiting for a first consultant appointment. That is 545,000 people out of a population of 1·8 million — nearly one in three — who were waiting to see a doctor. The Sinn Féin-DUP duopoly of power-sharing, with stop-start government, began when they took over in 2007; since then, waiting lists have become five times longer. That is not a success but an abject failure in government. It is an embarrassment. In Scotland, the figure is 627,000; Scotland's population is three times that of here. In Wales, the figure is 734,000; there are a million and a half more people there. Before we hear any excuses, the Tories fund them as much as they fund us. Let us therefore not trot out the old lines so quickly but, rather, have a look at our own actions. More than anything else, it is political inability to solve the problem that is causing and feeding the waiting lists. Stop-go politics is the major harm of our health service. Having a health service that is crippled and unable to take decisions because there is no Minister is causing the real problem. Solving the waiting list crisis will require a two-pronged approach. One side will deal with those who are on a waiting list now, who need to be seen and sorted. The other will make sure that we never again end up with lists as long as they are and have been. I will come back to that shortly. On the issue of political inactivity and having no Assembly, no Executive and no Minister of Health, I am somewhat surprised that the party opposite is raising the issue of waiting lists, given that it collapsed the Government in this place for the past two years. An Executive partner collapsed it three years prior to that. I am in no doubt that that hiatus, or double hiatus, saw many people die while they were on a waiting list. They will have died with their health issues unaddressed, left in pain, suffering and a burden on their family, because their health issues could not be addressed in a timely manner. It is a bit of an embarrassment that, of all the parties that could have tabled a motion on the state of our health service, the party opposite — it collapsed the Government here for the past two years, paralysing our officials, preventing them from managing the health service properly and causing the environment that has driven up the waiting lists — has done so. If you cannot draw the line between inactivity, having no Executive and no Government, and the driving up of our waiting lists, that shows a major disconnect from reality. We are where we are, however. We have waiting lists, and, as I mentioned, a two-pronged approach is required. We must seek a cash injection that will allow the backlog to be cleared. The figures need to be driven down, down, down. That will happen only by asking our already overstretched staff to do more, which is not possible because many of them have been driven to the edge, or by using our private sector. It is there, and we will have to use it, but let us not fool ourselves: such places are often staffed by medics who work in the NHS as well. How many of our constituents have said, "I went to the doctor, and he said that I cannot be seen by a consultant for another six or eight months, but he told me that, if I go privately, I can be seen next week."? Often, it is the same consultant. We need to clear the backlog, and we will have to use the private sector. That is where our amendment comes in to help, by explicitly calling on the Health Minister to re-fund the cross-border healthcare directive to allow patients to utilise hospital and health services that are often closer to their home than the places to which they have to travel. The scheme was successful and was used by hundreds, if not thousands, of people. There is an opportunity for that to help. If we did something right in the past, let us do it again. The second prong of the approach that is required is the need to sort out the mess in order to see true and meaningful transformation. It is only through transformation of our health service that we will ensure that waiting lists never again grow to such lengths. We must transform so that patient flow improves. Just a few months ago, 4,000 people were waiting on a domiciliary care package. How many of them lay in hospital when they did not have to? They could not get home because there was no care package. That backlog goes out of the ward, down into the emergency department, out into the ambulances that are parked outside and ends up with people dialling 999 but not being able to get an ambulance to come and help them. The backlog has a chain effect, and we have to break that chain. To do that, investment is needed. It means recognising and valuing our workers in domiciliary care so that it becomes a career that attracts people. Our cancer waiting times are also horrific, with many of the established targets not being met. Breast cancer patients is just one example. The target is for 100% of referrals to be seen within 14 days. We have not reached that target in 12 years: 12 years. Another example, which people probably do not think is at the top of the list, is dental waiting times. Before we talk about dental waiting times, let us talk about accessing a dentist. Many in our community struggle to get a dentist with whom to register. They struggle to get an appointment, and if they are NHS, forget about it. What is the problem? It is that we do not fund our dental sector properly. It literally costs dentists to deliver NHS work. Who would go to work if it would cost them to do their job? That is not a real-world model. It is not working, and when it is not working, it is people who suffer. We therefore need to see a transformation plan, with a budget, an action plan and a timescale for implementation of that transformation. We need to see what the changes will be, and, crucially, we need to hear what the benefits will be. The public need to be engaged with and informed so that they can see that the loss of a service from one medical centre, the gaining of another service from somewhere else and the inclusion of a different or changed one will mean better services, better delivery, shorter waiting times, improved outcomes and happier, healthier people. Then the waiting lists will come down. If this is an effective, proper, legitimate scrutiny Chamber, we will never again let waiting lists get to the lengths that they have.

1,414 words. Text as published by the Northern Ireland Assembly.

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