Debate contribution: Primary Care: Extreme Pressures

Debate contribution by Mrs Diane Dodds on 14 May 2024.

MLA

Mrs Diane Dodds

Party at the time

Democratic Unionist Party

Date

14 May 2024

Type

Debate contribution

Business

Private Members' Business

Heading

Primary Care: Extreme Pressures

Assembly identifier

Official Report component 4490356

Read the official Assembly record

Text

Thank you, Mr Deputy Speaker, and thank you to colleagues for what has been a thoughtful debate. More importantly, however, thank you to our GPs, allied health professionals, health and social care workers and all who do a sterling job in that front-line service of primary care. Every person in Northern Ireland is registered with a GP, and we all expect an enormous amount from those GPs. The debate has never been about bashing anyone, the Minister or GPs; rather, it has been an opportunity to discuss the problems in a rational, thoughtful way, and I thank colleagues for that today. There has been much talk in Northern Ireland recently about the Covid-19 inquiry — the Minister has borne the brunt of that, as have I — but the best thing that we can do coming out of that is to give our GPs, constituents and community a health service that is fit for purpose. Minister, you have the support of the Health Committee in doing that. It is important to remember that when we have these debates. The challenges in primary care and general practice are enormous. The service that the public receive and the environment in which GPs and some public servants work have fundamentally changed over the past 10 or 20 years. Minister, I absolutely accept your assertion that we are not going back. We need to plan for the future and have a proactive vision of what a really good primary healthcare system can look like. As things stand, however, we know that patients are not being assessed in a timely manner. The workload for GPs is continually expanding, and there really are not sufficient staff to run the service at its optimum. When thinking about the debate, I thought about the general point that I wanted to make. We have talked a lot about transforming our health service. I think that it was Colin McGrath who quoted Bengoa. There is no doubt that there are big, fundamental issues that we need to work at in transforming services for the community, whether for cancer patients, stroke patients or whomever. However, if we do not transform primary care, we will not achieve a knock-on effect in secondary care in elective and other procedures. On that basis, it is good for the House to talk about the challenges that face primary care and those involved in providing it. Sometimes, we think of this being an almost monumental challenge that we cannot overcome, but there are simple things that we can do that will help us to get to that transformation position. Many Members from across the Chamber mentioned funding. I am sure that some might take exception to this, but two million of us are registered with GPs, yet they receive 5·4% of the healthcare budget. We will have to rebalance that and look at it for the future. That is important in transforming the service. While the motion focuses on GPs and GP practices, primary care is about so much more. It is about community pharmacies and mental health support services. It is about the community and voluntary sector, which does sterling work. Many of those organisations work quietly, bit by bit, with the most vulnerable people in our society. That is also very important to remember. I turn to some of the contributions to the debate, because an important theme runs through them. When proposing the motion, my colleague Mr Robinson described and emphasised the importance of primary care, adequate funding and multidisciplinary teams and of having a workforce strategy so that we can have a plan and measure against targets along the way to see how we are doing. He talked about the retention of GPs in the system and training for GPs. We support Colin McGrath's amendment, despite the misnaming of Northern Ireland in the midst of it. It is important to remember that we need to embrace change for there to be transformation. If we do not embrace change, services will collapse — we are seeing that — and we will then be transforming services on an ad hoc basis that suits nobody and will not give us a proper vision of primary care. Mr McGrath is fortunate that his constituency saw the roll-out of a fully staffed multidisciplinary team. That is important, because, in Northern Ireland, fewer than 8% of those teams are fully staffed and equipped. We need to look at how we can manage to do that even though the budget is challenging. Liz Kimmins mentioned the experience of patients and the need to respond to them before conditions become so bad as to be intolerable for them to bear and to cause the time spent in hospital to become much longer. She talked about a permanent solution for the GP indemnity issue and the importance of the community and voluntary sector. Nuala McAllister talked about the impact of handing contracts back and the large number of services involved across primary care. Mr Chambers was a little perturbed that the motion was too late. I think that the motion is very timely, because we are here talking about the importance of primary care, GPs and supporting those services. I wish the Minister or his successor well in achieving suitable and practical solutions for GPs. Mr Chambers also talked about multidisciplinary teams. I have no wish to bring politics into this, but I remind Mr Chambers that the initial funding for multidisciplinary teams came from the additional billion pounds that was found in the DUP confidence-and-supply money. It is really important to remember that. I want us to continue to fund those teams, and I will support the Minister in his bid to do so, because they are fundamental to resolving the issue. Linda Dillon talked about the importance of primary and social care and of taking a holistic approach to well-being in our community. That is important. Well-being is underrated as a value, and it is really important for us to remember that. My colleague Deborah Erskine made really important points about the impact of the crisis in GP surgeries in rural communities and access to those services. I accept that trusts have done an enormous amount of work to ensure that those GP surgeries continue, even though contracts have been handed back. That is massively important. There is also the issue of having accountability for GPs, so that we can understand that the services offered are the same and do not encounter a theme that has been commonly expressed in the Chamber today: the inequality of service across Northern Ireland, which is intolerable. The Deputy Chair of the Committee, Danny Donnelly, talked about the workforce strategy, the plan to retain GPs in general practice and the need to improve core funding. Other colleagues talked about it being important to remember that many in our community have absolutely positive experiences of visiting their GP —

— and it is important to remember that. Thank you, Mr Deputy Speaker. This is a hugely important motion, and I hope that those involved in delivering the service understand that we support them.

1,189 words. Text as published by the Northern Ireland Assembly.

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