Debate contribution: Primary Care: Extreme Pressures

Debate contribution by Ms Liz Kimmins on 14 May 2024.

MLA

Ms Liz Kimmins

Party at the time

Sinn Féin

Date

14 May 2024

Type

Debate contribution

Business

Private Members' Business

Heading

Primary Care: Extreme Pressures

Assembly identifier

Official Report component 4490263

Read the official Assembly record

Text

I thank the proposer and his colleague for tabling the motion. It is fair, and not an exaggeration, to say that our health service is on its knees. Every corner of the system is under severe pressure, and staff are working in the most challenging and, too often, unsafe circumstances. Every day that that situation continues, patients get sicker and need more care, and there is less capacity to provide what is required. Something has to give. We hail the benefits of early intervention and prevention in healthcare, as they undoubtedly promote better patient outcomes and ensure that people live well for longer. Although we know that people across the North are living longer, many live with a range of health conditions and languish, with a very poor quality of life, on waiting lists. Sadly, many even die while on waiting lists. We are in crisis management mode, trying to put money into our health service at the latter stages of a patient's journey — in some cases, when it is already far too late — when more care is needed, which costs more and adds to the already colossal pressure that is on our health service. To turn the ship around, we need to focus our efforts upstream on the first point of contact for patients, which is primary care. A properly resourced primary care service is critical if we want to transform our health service and improve the health of our communities. There is not one Member in the Chamber who has not had constituents come to them for help because they have been unable to get an appointment with their GP. That situation is worsening by the day. Just last week, another GP practice in my constituency announced that it will not renew its contract, owing to the huge pressure that it faces to deliver that important service. That is a very difficult decision for any GP to have to make. We heard very clearly at the recent Royal College of General Practitioners event that that is not a decision that any GP wants to take.

At the Health Committee, we heard just how stark that picture is from the royal college and the British Medical Association (BMA). GPs are experiencing unprecedented pressures as demand for their services grows but the capacity to meet that demand declines because many GPs are leaving the profession prematurely.

There is a real difficulty in attracting new doctors to choose general practice as a career that they want to come to, with much more attractive opportunities in the South, in Britain and overseas with much better pay and conditions. Without a GP workforce, we simply do not have a fit-for-purpose GP service. The impact of that on patients, staff and the health and social care system as a whole is far-reaching. General practice is often referred to as the "front door" of the health service, and every person in our communities will rely on their care at some stage in their life. That is why it is vital that they are supported. The rolling-out of multidisciplinary teams and addressing indemnity are two of the most important issues, and a permanent solution to both would take enormous strain off the entire healthcare system. A GP practice with a full complement MDT, working with nurses, social workers, Community Pharmacy and mental health practitioners, can bring care back into the community and, crucially, will be able to treat a variety of health, mental health and social issues, which will improve patients' health outcomes while alleviating the pressures on the health system overall and utilising the broad range of skills, knowledge and expertise that we have in spades across our statutory services and, equally importantly, in the community and voluntary sector. Across the North, we have a skilled, experienced and agile community and voluntary sector that already provides invaluable support and services to some of the most vulnerable people in our communities who, without that sector, would have none of the services or facilities that are critical for their needs. It is absolutely essential that the community and voluntary sector is an integral part of any future roll-out of MDTs. To conclude, it is fair to say that there is no doubt that the financial picture for the incoming Budget is challenging, but we cannot afford to stand still or do nothing. We need to see a plan for the Budget and a workforce plan, because that will support primary care and it will support staff in the jobs that they have set out to do — they are vocations — but it will also meet the growing needs of patients and the people we represent.

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

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