Debate contribution: Cross-border Healthcare

Debate contribution by Mr Mike Nesbitt on 18 June 2024.

MLA

Mr Mike Nesbitt

Party at the time

Ulster Unionist Party

Date

18 June 2024

Type

Debate contribution (made as a minister)

Business

Opposition Business

Heading

Cross-border Healthcare

Assembly identifier

Official Report component 4497216

Read the official Assembly record

Text

I thank the Chair of the Health Committee for her intervention. Would I like the service to be available locally? Yes, of course. Is it currently possible to do that? No, it is not, so what are the best alternatives? The Chair makes a compelling point about not having to get on a plane and fly. The scoping exercise will be conducted. Mr Robinson made some points about the unacceptability of the service not being available in Northern Ireland. I assure him that I have taken advice from the Belfast Health and Social Care Trust, and it appears that there is a move nationally to centralise services by having fewer centres, which is not the direction of travel that the Member wants to see, because of the international shortage of pathologists with a specialist interest in paediatrics. Alder Hey is one of those new centres. There are currently no trainees in the pipeline, and any internationally recruited postholders are likely to go to those national centres. I remind the Member that the service was stopped because of the pathologist's retirement. I also suggest that, perhaps, it is the sort of job that people should not do for life. For example, when I was on the Policing Board, there were police officers whose job was to look through extensive files of images of child abuse and child sexual abuse. That is not something that any individual should do for a 30- or 40-year career, and that is part of the problem with paediatric pathology services. Mr Robinson also talked about the Health budget. I gently say to him that there was no mention of assessed need in his remarks. The Minister of Finance successfully argued with the Treasury that our block grant should be based not on population but on need, yet it seems that, when it comes to the Health budget, need is forgotten. It is a big quantum, but it is there for a reason. I mentioned the North West Cancer Centre. Based at Altnagelvin Hospital, it serves the whole north-west corner of the island, but it is not the only example of such cross-border cooperation on cancer care. The all-island cancer consortium — the Ireland-Northern Ireland-National Cancer Institute Cancer Consortium — was established in 1999, following the signing of the Good Friday Agreement. The consortium is credited with saving lives and enhancing the quality of life for many cancer survivors by supporting work on cancer clinical trials infrastructure and an all-island joint research project, providing upskilling and training opportunities for scientists, doctors and allied health professionals. Meanwhile, cancer policy units in both Health Departments have had ongoing engagement over the past couple of years on identifying potential projects to submit as Shared Island Fund applications. Such projects include the use of artificial intelligence in screening applications, development of virtual rapid diagnostic clinics, further development of services at the North West Cancer Centre and development of community-based support services. The motion highlights healthcare pay rates. Let me say at the outset that there is no easy fix. Although I acknowledge that pay rates are an integral element of the functioning and efficiency of healthcare services, I must point out that rates of pay across Health and Social Care (HSC) are linked to Agenda for Change terms and conditions. There is an established and valued policy of pay parity with England for Agenda for Change workers. It was hard-won. There is a nationally agreed set of terms and conditions under which all healthcare staff in HSC, with the exception of doctors and dentists, are employed. Those agreements are the basis for my Department's commitment to pay parity with England. The part of the motion that refers to harmonising healthcare pay rates poses me, frankly, an enormous problem. Members will be aware of a Strategic Investment Board (SIB) assessment of pay and related issues across the public sector in Northern Ireland. My Department will engage with the Strategic Investment Board to look at wages, the cost of living, tax and other relevant factors across all neighbouring jurisdictions, including the Republic of Ireland. We need to better understand the differences between jurisdictions and attempt to determine potential areas of focus for our region. We should be mindful that different taxation rates, housing costs and overall cost-of-living factors are key parts of the picture alongside pay. Waiting lists are a big concern for all Members, and, at this point, I make a plea to them. It is easy to make demands in the House for more investment in staff pay, tackling waiting times and a long list of other areas in which improvements are badly needed. We cannot be blind, however, to the current budgetary realities. We cannot engage in denial. Our waiting lists are not good. We can all agree on that. I fully understand the distress and anxiety that long waiting times cause, particularly when patients are suffering pain and discomfort. Long waiting times also have a societal impact that goes much wider than individuals. Waiting times in Northern Ireland are wholly unacceptable, and tackling them is one of the areas on which I have committed to focusing over the next three years. Some progress has been made under the elective care framework, but there is much more to be done. The framework, published in June 2021, was updated on 24 May this year. It sets the strategic direction for the development and reform of effective and efficient delivery of elective care services here over the next five years, and it details measures that are needed to address the unacceptable waiting lists. For many years, we have been heavily dependent on the availability of additional, non-recurrent funding to tackle waiting lists.

The funding has been used to secure extra capacity both in-house and in the independent sector, including providers in the Republic of Ireland, across a range of elective specialities.

Nuala McAllister asked about returning to the Committee with thoughts about bringing back cross-border programmes. We shall do that in due course. The Member also asked when we will have news about the structure of our hospital network and suggested that there would be a statement in June. However, it is more likely that it will come before the House in the week beginning Monday 8 July, because of the general election purdah period. In addition, my predecessor introduced the Republic of Ireland reimbursement scheme in June 2021 as part of the elective care framework to help reduce lists. The scheme provided an option for patients to seek and pay for routinely commissioned health service treatment in the private sector in the Republic and have the cost reimbursed up to the cost of treatment to the NHS in Northern Ireland. I take Mrs Dodds's point that some cannot afford to pay up front. I am running out of time, so I am glad I did not go for the 12-minute option before we broke. I acknowledge that Mr Donnelly said that the Bengoa report is on the shelf: it is not on the shelf. Some actions have been taken: for example, the day procedure units at Lagan Valley and Omagh Hospitals. I can inform the House that I was in discussions with Professor Bengoa as recently as yesterday, and he will have more to say about the reform of our health service in the months to come, certainly before the end of the calendar year.

1,234 words. Text as published by the Northern Ireland Assembly.

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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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