Debate contribution: Health: Vision Statement

Debate contribution by Mr Mike Nesbitt on 3 June 2024.

MLA

Mr Mike Nesbitt

Party at the time

Ulster Unionist Party

Date

3 June 2024

Type

Debate contribution (made as a minister)

Business

Ministerial Statements

Heading

Health: Vision Statement

Assembly identifier

Official Report component 4493456

Read the official Assembly record

Text

I thank the Member for her question and her point, which is absolutely central. When we talk about the health service, we think about buildings, equipment and medicines; we do not think enough about the people who are the National Health Service and the Health and Social Care staff. In the first instance, I want to assure them that I have my definition of a "good job", and it includes not only terms, conditions and remuneration but how they are treated and respected and how we understand what they do. On a personal level, I go back to my dear mother's final few days in the Ulster Hospital. I mentioned the member of catering staff who had been off for a week and who came into the room where Mum was and burst into tears, because Mum had physically deteriorated significantly over the course of those seven days. To me, that sums up the commitment and care that the staff put in.

There is a head of workforce planning in my Department. I was with him between being here and coming back, and we will have a meeting on Wednesday. I assure you what I assured him, which is that getting the workforce planning right and respecting the staff is absolutely up there in what I want to achieve. I was going to say, "in the initial weeks", but over the next three years, I want to spend as much time as possible not in the Department but out and about, meeting and greeting. In the Long Gallery, about 100 of the 360 volunteers from the South Eastern Health and Social Care Trust were having afternoon tea, just as a thank you for their efforts. It is about not just staff but volunteers; it is about everybody who helps to make the National Health Service what it is. I repeat: I do not accept the narrative that we are in some sort of fatalistic spiral downwards. My confidence in that is based primarily on the people who run it.

I thank the Member for the question and the point. If I understand the question correctly, it is about a different way of looking at our hospital configuration. Traditionally, we have looked at hospitals as stand-alone entities. Of course, there are people who, in an ideal world, would want an acute hospital at the end of every street. We know that we cannot get anywhere near that, nor should we try. In my view — I think that I am in sync with my predecessor, Robin Swann — it is about saying, "Let us view our hospitals as a network". It then becomes a question of who does what where, because not every hospital will do everything. That is right, because if a hospital has a specialism in a certain service, that allows the clinical staff, the consultants, to develop their expertise. Personally, if I needed a fairly significant procedure, would I want to go to a hospital where the team performed that procedure once a week or somewhere where they performed it five or six times a day, five or six days a week? I know which one I would choose. Getting that configuration right is part of what I am looking at for reform. When I say "reform", that is just my preferred term for transformation. I hope that that answers the Member's question to some extent, if I understood it.

I thank the Member for his question. I am aware, as, I am sure, he and the House are, that the health service is an incredibly complex organisation with so many moving parts. To do something in one area inevitably is repercussive and will have implications for another area. As I am sure the Member is aware, I spent a few weeks as my predecessor's Assembly Private Secretary. I tried to use as much of that time as I could to do some reading and thinking, as well as conducting some meetings, including with the five chief executives of the geographic hospital trusts and a number of the royal colleges. I am now keen to have a formal meeting with the chairs of all the committees of the BMA in Northern Ireland, because agreeing to something for one of them clearly has the potential to be repercussive on another, and I do not want to solve an issue in one place only to find that I have created an equal issue in another place. In response to the Member's opening remarks, yes, I think that I have inherited my predecessor's problems. I will try to deal with those problems as positively as possible, because I think that everybody can agree that we want to inject a bit of hope into the future of the National Health Service while being realistic about the challenges, not least the budgetary challenges. I am putting a degree of store by the expectation that the budget will see some green shoots, if I may use that expression, as a result of the June monitoring rounds in a few weeks' time.

I thank the Member for his comments and request. I am most certainly happy to do that. I am aware of the issues and of the fact that there are also issues with access to medicines. To some extent, those are global issues that we have relatively little control over, but that does not mean that we do not need to work hard to try to resolve them. I am aware, from family members who have learning difficulties and issues, of the service that they receive not just from the Department of Health but more generally. I am absolutely sympathetic to what the Member said. I will go away and speak to my private office to see whether we can make that happen.

I thank the leader of the Opposition. I have not had sight of a draft Programme for Government, so I think that the best way to answer him is to say that I am rereading Mark Friedman's book 'Trying Hard Is Not Good Enough', which was the basis of an OBA, or outcomes-based accountability, Programme for Government, although some people might prefer the term "results-based". It seemed to me, when I arrived in the House in 2011, that, as a government, we seemed to put a lot of emphasis on inputs and on outputs. For example, in considering an area of deprivation, you might say, "We have put £x million into it, and the outputs are that we've set up training facilities here and awareness facilities there". However, we did not go to the end of the equation. What were the outcomes? What I found back then on the Economy Committee was that, if you looked at the areas of deprivation that were in the top 10 in the league table, you saw that they were still in the top 10 after 10 years. They might have gone from fifth to sixth, but that was not enough. When it comes to a Programme for Government, therefore, I will be about trying to achieve outcomes. Following on from my statement, one outcome that will be a good test of the Executive and of collegiate, collaborative working is tackling health inequalities, because that is not just a matter for Health. Those issues tend to arise in areas of deprivation. I believe that the Minister for the Economy and I can work well together to try to get our Departments to come up with inputs and outputs that secure actual better outcomes for people. That is just one example. I hope that the leader of the Opposition will accept that I am in the foothills, on day 6 as the Minister, but that is indicative of my thinking. It is not about the Department of Health working in a silo; it is about trying to work collaboratively with everybody else. It is not about just saying to another Minister, "Come and help me deliver". I am very conscious that we talk about educational underachievement, for example. Healthier children tend to do better in school, so there is a role for my Department in helping the Minister of Education. That is my modus operandi.

1,370 words. Text as published by the Northern Ireland Assembly.

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Assessed 21 October 2026 at 10:35 UTC by jev-1.13.0 (requested as typesafe/jev) under rubric 2026.10-r9, methodology 1.9.

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