Debate contribution: Waiting Lists: Action Plan

Debate contribution by Mr Danny Donnelly on 20 February 2024.

MLA

Mr Danny Donnelly

Party at the time

Alliance Party

Date

20 February 2024

Type

Debate contribution

Business

Private Members' Business

Heading

Waiting Lists: Action Plan

Assembly identifier

Official Report component 4380597

Read the official Assembly record

Text

I thank Mrs Dodds and Mr Robinson for tabling the motion. I look forward to working with both of them as fellow members of the Health Committee. My party will support the motion. The current waiting times in Northern Ireland are deplorable and unacceptable. As stated in the motion, none of the formal waiting targets for health and social care services in Northern Ireland have been met since 2014. Some of the more specific statistics are truly shocking.

The Northern Ireland Audit Office report has highlighted just how rapidly the number of people on waiting lists has risen. For example, from March 2014 to March 2023, the number of people waiting for an initial outpatient appointment rose by 216%; the number of people waiting for hospital admission rose by 147%; and the number of people waiting for diagnostic tests rose by 151%. The same report highlights how, without imminent action, those numbers will only get worse. For example, the Department of Health's elective care framework has projected that outpatient waiting numbers could grow by 91%, from 335,000 in 2021 to 640,000 by 2026, and the inpatient waiting list could grow by 206%, from around 100,000 in 2021 to 306,000 in 2026. Those numbers are surely not sustainable in a population of approximately two million. Those are huge numbers, but it should not be lost on any of us that they are our families, our friends, our neighbours and people in our communities. People are living in pain, losing their mobility and suffering from mental health issues and loss of well-being while they wait for tests to see whether they have a serious illness. Previous attempts to reduce waiting times have not been successful. A previous departmental initiative, the elective care plan in 2017, had a target of ensuring that all patients would be seen within one year but did not meet its prescribed targets. On the basis of the aforementioned 2026 projections, the Department will not meet its targets as set out in the elective care framework from 2021. We need to ask why waiting lists are so long in Northern Ireland, especially when compared with the rest of the UK and Ireland. Many of the issues facing Northern Ireland and our health system have been national or international in nature, such as the impact of austerity, Brexit and, especially, the COVID pandemic. However, we do not see such devastating numbers in England. We cannot ignore or forget the damage done by political instability in this place, particularly the fact that we have not had an Executive, a Health Minister or a Health Committee for five of the past seven years. In the two years when those positions were filled, the people in them, understandably, had to prioritise managing the pandemic, which made meaningful reform impossible. It is welcome that we are back in the Chamber debating this and other vital issues, but, until we have a truly sustainable political system, we will not be able to deliver the transformation that is urgently needed. With that in mind, we must reform the institutions to ensure that one party can never again hold down the entire political process. It will not be lost on anyone that waiting lists got much worse during the period when the Assembly was not functioning. There are key issues specific to the health system that I encourage Minister Swann and the Department of Health to consider. One of the reasons why our waiting lists are so long is that too many people are referred on to them in the first place rather than being diagnosed or treated quickly along a more appropriate pathway. As highlighted in the Bengoa report, the majority of HSC resources are invested in delivering acute care, and, as a result, some services have been delivered suboptimally. The evidence is clear: specialised procedures concentrated on a smaller number of sites and dealing with a higher volume of patients will improve outcomes. We support such reforms, focusing on providing diagnostics and treatments far more quickly, especially in primary care. That will assist in bringing down waiting lists. Another issue that remains is the difficulties in recruiting to the workforce and, in particular, vacancy levels. On 30 September 2023, there were 6,920 HSC vacancies across Northern Ireland, which is a vacancy rate of 8·2%. That represents a 14% increase when compared with September 2018. A major issue remains the lack of legislation on safe staffing and adequate pay. Those are two very important issues, and I encourage the Minister to legislate on them before the end of the mandate. There are other issues that are specific to Northern Ireland. For example, the higher wages available in the Republic of Ireland have led many consultants to work there while continuing to live in Northern Ireland. That has exacerbated consultant vacancies. On top of those factors is the intensity of the COVID-19 pandemic, which our health service has not fully recovered from. I know that those issues are well known to the Health Minister, and I look forward to his plan —

— for beginning to address and progress transformation.

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

Assessment

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Assessed 21 October 2026 at 09:38 UTC by jev-1.13.0 (requested as typesafe/jev) under rubric 2026.10-r9, methodology 1.9.

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