Debate contribution: Budgetary Pressures

Debate contribution by Mr Danny Donnelly on 10 September 2024.

MLA

Mr Danny Donnelly

Party at the time

Alliance Party

Date

10 September 2024

Type

Debate contribution

Business

Private Members' Business

Heading

Budgetary Pressures

Assembly identifier

Official Report component 4517475

Read the official Assembly record

Text

I support the motion, following on from the contributions of my party colleagues from Upper Bann and Strangford. In particular, as one of the Alliance spokespersons on health, I want to discuss the pressures that are facing our health service. There is no question that Northern Ireland has been underfunded by successive UK Governments, and the 14-year term of the previous Conservative Government has had a particularly devastating impact on public services across the UK. Unfortunately, we will continue to be affected by the long-term impacts of austerity, Brexit and the disastrous mini Budget of 2022. We welcome the interim fiscal framework, which was agreed with the UK Government, as an important first step, but the 124% relative need factor is not sufficient for our needs, especially those of the Department of Justice, as my party colleagues and independent analysis have outlined. Our health service is in crisis, which the Chair of the Health Committee mentioned, and the funding has a role in that. However, we must be honest and acknowledge the fact that additional funding to Health will not solve the many challenges that we face. Per capita, health spending in Northern Ireland has been significantly higher than that in the rest of the UK and has increased at a higher rate than in the rest of the UK, yet we have by far the longest waiting lists in western Europe, as mentioned, and the worst outcomes. We need to discuss why that is. The problem is not exclusively a lack of funding; if anything, the fundamental problem is a lack of reform and transformation. As the Bengoa report of 2016 stated, the options that we face are to see services deteriorate to the point of collapse or to embrace transformation and create a modern, sustainable service that is properly equipped to help everyone who needs care. However, while parties signed up to Bengoa in principle, that has not always been reflected by action. It has been nearly eight years since Bengoa was published, yet we have seen almost none of the transformation that is required, in part because of the resistance to change in the delivery of services, which may be controversial in the short term but which will deliver better outcomes in the long term. We still have certain parties opposing changes that contradict the principles that are required for transformation. That is disappointing, and we cannot resolve the challenges that face our health service until that is addressed. We know that Professor Bengoa will return to Northern Ireland later this autumn, and I cannot help but wonder what he will make of the situation eight years on. We also need to acknowledge that we cannot exclusively fund Health to the detriment of other Departments. Health takes up around half of the block grant. That amounts to £7·6 billion in this year's Budget, which the then Health Minister said was still not enough. Notably, that has increased from £4·6 billion in 2015-16, when the Bengoa report was written. If we were to adopt the additional funding that the Health Minister requested, it would result in substantial cuts to other Departments' budgets. As we heard in yesterday's debate on policing resources, the Health Minister's party was critical of what it perceived to be the absence of progress from the Justice Minister on police funding and police officer numbers, yet it has not acknowledged the impact of the repeated underfunding of the Department of Justice relative to other Departments. That is yet another reason why we need to address the broader under-functioning of the Executive. One issue that we cannot ignore is the need for political reform. Another reason for the crisis in our health service, as well as in other Departments, is the complete absence of political leadership for the last two years and three of the last five years in the previous mandate. The Bengoa report is eight years old, and, in that time, we have had five years of no government. Both the two main parties, Sinn Féin and the DUP, have walked away from the Executive and the Assembly, leaving the rest of us locked out from delivering any change. Until we reform the institutions so that no one party can collapse them and prevent them functioning again, we will not be able to deliver the long-term reforms that are needed for the health service. For example, we cannot plan for the future through multi-year Budgets if there is no certainty that an Executive will be in place. Political stability is necessary for reforming and addressing the challenges in the health service. It should not be lost on any of us that the Assembly is currently as stable as it was the day before the last collapse. As the chair of the all-party group on climate action, it would be remiss of me not to mention the need for the UK Government to invest if we are not only to tackle the climate crisis but benefit from the opportunities that transitioning to a greener economy will bring. As a member of the Health Committee, I look forward to working constructively with the Health Minister and to seeing his plan to deliver the transformation that our health service desperately needs in order to begin to address the huge waiting lists and the service's internal pressures.

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

Assessment

Not flagged

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Assessed 21 October 2026 at 11:02 UTC by jev-1.13.0 (requested as typesafe/jev) under rubric 2026.10-r9, methodology 1.9.

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