Debate contribution: Primary Care: Extreme Pressures

Debate contribution by Mr Danny Donnelly on 14 May 2024.

MLA

Mr Danny Donnelly

Party at the time

Alliance Party

Date

14 May 2024

Type

Debate contribution

Business

Private Members' Business

Heading

Primary Care: Extreme Pressures

Assembly identifier

Official Report component 4490297

Read the official Assembly record

Text

I thank my DUP Health Committee colleagues, Mrs Dodds and Mr Robinson, for tabling the motion and my SDLP Health Committee colleague, Colin McGrath, for his amendment. Alliance will support the motion and the amendment, as mentioned. Some of the context has already been described. Certainly, Alan pointed out the many practices that have sought crisis support over the past couple of years. In our areas, as we heard from across the Chamber today, we all know of practices in crisis that have been struggling or have closed. The motion presents an opportunity to acknowledge the valuable role that is played by primary care workers in Northern Ireland. As it rightly states, primary care is normally the first point of contact in the wider health service for people who are unwell, and it encompasses many areas including pharmacy, social work, mental health and physiotherapy, to name a few. One of the issues that the Health Committee picked up on was the impact that waiting lists have had on general practice, as was mentioned. We heard that up to 20% of the workload of GPs is affected by people who are on our extremely long waiting lists here in Northern Ireland. I want to focus on a couple of issues, one of which is the importance of our workforce and, especially, the need for a workforce strategy. It is welcome that the Minister is retaining the additional number of GP training places at 121, which was agreed two years ago, but the Minister and the Department need to go further. A commitment to a workforce plan for general practice would be an important step forward, particularly one that includes an intervention to make general practice positions in Northern Ireland more attractive to boost recruitment and an intervention to provide support to our existing workforce at all stages of their careers. We have heard from GPs — time and time again — that we need more GPs in general practice in Northern Ireland. Urgent action needs to be taken to retain the GP training cohort that finishes in August. That will require a commitment to funding a fellowship scheme across Northern Ireland, but it is also necessary for us to compete better with other parts of the UK, as well as the Republic of Ireland, which is particularly important since the South currently provides more favourable conditions for GPs due to the higher salaries and more favourable work-life balance. Until we address specific conditions here, which are very different from those in GB — due to circumstances already mentioned — we will not have the necessary conditions for a stable primary care workforce. I also want to discuss MDTs, which have been well mentioned in the debate. They are a central aspect of the 'Health and Wellbeing 2026: Delivering Together' report, which envisaged a 10-year approach to transforming health and social care, but progress in implementing MDTs has been delayed by budgetary and staffing constraints and, of course, political instability. Of the 17 GP federation areas, only one has introduced a full MDT in the four years since the launch of the aforementioned report. The evidence in support of MDTs is clear, as we heard from Members who have spoken already. According to data from the Department, 62% of MDT patients are treated entirely within primary care, meaning that there is no need for onward referral. MDTs provide a key stabilising factor for practices in crisis. That is evidenced by the fact that, in a presentation to the strategic planning and performance group (SPPG), 83% of the 18 practice contract hand-backs that occurred from March 2022 to November 2023 were in areas with no MDT allocation. The remaining 17 were in areas where only a partial MDT was in place. It is for those reasons that we need an urgent timescale for the full implementation of MDTs across Northern Ireland. I welcome the planned roll-out, particularly in East Antrim. The call for that is strengthened in the amendment. It has never been more important to see vital changes to how primary care operates in Northern Ireland to support our workforce and deliver for patients, including through the implementation of the MDTs, in line with previous recommendations and commitments. When I speak to GPs, they mention to me that core funding needs to increase for general practice. The recent GMS contract agreed for this year is a good starting point. However, more is needed to prevent GP practices from failing. That would mean that we would have more GPs, which would make general practice more viable for GPs to commit to. The expansion of MDTs is vital. Although it will not be a magic bullet, it will maintain the level playing field between practices that have MDTs and those that do not, which will equalise the delivery of healthcare across Northern Ireland.

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

Assessment

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Assessed 21 October 2026 at 10:23 UTC by jev-1.13.0 (requested as typesafe/jev) under rubric 2026.10-r9, methodology 1.9.

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