Debate contribution: Cross-border Healthcare

Debate contribution by Mr Danny Donnelly on 18 June 2024.

MLA

Mr Danny Donnelly

Party at the time

Alliance Party

Date

18 June 2024

Type

Debate contribution

Business

Opposition Business

Heading

Cross-border Healthcare

Assembly identifier

Official Report component 4497023

Read the official Assembly record

Text

I thank the SDLP Members for tabling this motion as one of the Opposition day debates. It is good that two important health motions have come before the Assembly this week that recognise the many challenges our health service faces. We will support the motion. It is unacceptable that we have the longest waiting lists on these islands and some of the longest in Europe. In particular, our waiting lists are significantly longer than those in the Republic of Ireland. Based on official figures from last year, twice as many people in Northern Ireland were on a waiting list for an appointment, despite having approximately a third of the population. The disparity was much larger for people waiting over 12 months: approximately four times as many people in Northern Ireland. Anything that can be done to reduce those waiting lists must be done. One aspect of the motion that is particularly encouraging is the recognition that the transformation of our health service will not be achieved solely through increased funding but that fundamental reform is also needed. That will require difficult decisions and, more importantly, political leadership from all Members of the Assembly and the Department of Health. As mentioned, we have had the Bengoa report, 'Systems, not Structures', effectively sitting on a shelf for the past eight years due to years of prolonged political instability. Outside this specific debate, we need fundamental reform of the Assembly and its structures so that it cannot collapse again through the actions of one party, otherwise we can never commit to the required long-term planning and multi-year budgets needed for transformation. We discussed all-Ireland cooperation yesterday in relation to cancer research, but I want to discuss such cooperation more broadly. It makes sense, from a geographical perspective, for example, that, at the North West Cancer Centre at Altnagelvin, which is partially funded by the Irish Government, approximately one third of its yearly patients are from the Republic of Ireland, mainly Donegal, which is just a few miles from Derry; otherwise, such patients would have to travel to Galway or Dublin. On the other hand, there has been an increase in the number of children from Northern Ireland receiving heart surgery in Dublin, since heart surgery services in the Royal Victoria Hospital ended in 2015. That vital network continues through cooperation with Our Lady's Children's Hospital in Dublin, which is very accessible for people in Northern Ireland. It is only a few hours in a car, bus or train. It is important to recognise that one of the main challenges to cross-border health cooperation is the challenge posed by Brexit. Some of that relates to funding. In the short term, much of our current funding continues through PEACE PLUS, but, in the coming years, it will become increasingly uncertain as to whether equivalent UK funding is available. The loss of EU regulations and directives providing benefits in respect of cross-border healthcare is also of significance, not only on this island but across the EU. The temporary reinstatement of the cross-border healthcare directive in 2021, for one year, was a welcome step by former Minister Swann to help reduce the waiting lists. However, we need a more proactive and permanent approach to reduce waiting lists, and cross-border healthcare cooperation should be considered as a part of that approach. As mentioned, pay rates, compared with the rest of the UK and with the rest of Ireland, remain an important issue here in Northern Ireland. We have discussed in previous debates how pay is much lower here compared with other jurisdictions. For example, in last month's debate on the motion on junior doctors' pay, it was acknowledged that junior doctors work very long hours and face the longest waiting lists in Europe for the lowest pay in the UK. It is well known that the Republic of Ireland both higher pay and fairer working conditions compared with here. As such, many healthcare workers are working in the South as opposed to working in their local health service. That is obviously not an issue in England, Scotland and Wales, and it is important that the Minister considers the specific circumstances here in Northern Ireland when addressing pay issues in any discussion of future pay settlements. There are many opportunities for potential cross-border cooperation, particularly in relation to healthcare, but, in order to realise those, we need to confront the challenges and barriers posed by Brexit, and we will need political stability here to deliver the long-term reforms and to establish the long-term relationships needed, North/South, to improve our health service for the benefit of patients across the island of Ireland.

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

Assessment

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Assessed 21 October 2026 at 10:38 UTC by jev-1.13.0 (requested as typesafe/jev) under rubric 2026.10-r9, methodology 1.9.

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