Debate contribution: Health Service Transformation: Funding

Debate contribution by Mrs Diane Dodds on 17 September 2024.

MLA

Mrs Diane Dodds

Party at the time

Democratic Unionist Party

Date

17 September 2024

Type

Debate contribution

Business

Private Members' Business

Heading

Health Service Transformation: Funding

Assembly identifier

Official Report component 4536968

Read the official Assembly record

Text

I beg to move

Thank you. The motion is one of the most important that we could bring to the Assembly. It will have a resonance in every family across Northern Ireland. We all know someone who is on a waiting list; we all know someone who is in pain; and we all know someone on the waiting list who will be diagnosed with an illness more serious than that had they been seen earlier. It is a significant yet difficult issue, but the Minister and the Assembly must grasp it in order to make life better for people in Northern Ireland. Waiting for treatment has been a fact of life since the inception of the NHS, with statistics going back to 1949, believe it or not, on the number of patients waiting for routine treatment. The NHS's founding principle of care being largely free at the point of use means that the length of time we wait tends to serve as an indicator of the state of the service overall. We should reflect on that point, because it is significant: so many people are waiting because so many elements of the service need to be fixed in Northern Ireland. I use the word advisedly, but the waiting times in Northern Ireland have become "obscene". Growing demand, funding constraints and staff shortages have contributed to the fact that none of the departmental waiting list targets has been met since 2014: that is 10 years, and those are the targets that I can verify. The result, tragically, is that people will have much poorer outcomes and many will die because their diagnosis or treatment is delayed. For the debate, I looked at the cancer waiting times in Northern Ireland. There is a 62-day target for patients starting treatment following an urgent GP referral, and only 29·8% of patients with an urgent referral will start treatment for their cancer in that time frame. Imagine the terror and anxiety felt by a woman who discovers that she has breast cancer and realises that, in Northern Ireland, of the patients seen by a breast cancer specialist following an urgent referral — we are supposed to have a 14-day target for that — only 34·1% of women will be seen in the appropriate time. That is obscene and shocking; it is to our shame. It is something that needs to be fixed. Minister, this is not a get-at-the-Minister issue. We want to work to make sure that all of us — collectively — fix these issues. Last year, there was an increase of 9·4% in the number of people waiting for an appointment with a consultant following their referral by a GP. In many specialities, there is a much, much longer waiting time than there is in others. We need to address those issues. They are very, very significant. We have heard for a long time that Northern Ireland has the worst waiting lists in the United Kingdom, but has the approach that we have tried so far brought us any closer to significant progress? We have made progress at the margins, but not significant progress that will help us to address the issue. Does anyone in the Chamber have confidence that we will see significant improvements if we continue to do the same thing that we are doing? I say this, to the Chamber: simply doing a little more and investing a little extra will not make enough of a difference, and continuing in the old way, with small contracts at the end of the year for the private sector, or when money becomes available, will only have minimal impact. Staff, busy in their NHS jobs, doing a little extra at the weekend or, perhaps, one day through the week, is only playing at the margins. We need a fundamentally different approach. Officials have told the Health Committee that we are not far off having the appropriate capacity to be able to deal with the regular, anticipated workload of routine and emergency cases, year-on-year — that is good — and it is the backlog that is the massive challenge. We need a better answer than simply, "Give us more money" or, "We can't fix this until you give us more money". The motion specifically addresses the issue of money. I hope that money becomes available, although, I must say, as devolution was being restored, we were the only party that said we had insufficient amounts of money. However, we cannot simply sit about and do nothing until more money arrives: we need to look at the alternatives. I have suggested seeking to partner with large national or international providers. There are renowned US non-profit organisations that should be encouraged to take an interest in Northern Ireland. Some already operate in the United Kingdom and the Irish Republic, and our political relationship with the United States should be able to assist us in trying to interest those people in helping us address the crisis in our health service. However, we would need to be willing to offer large enough bundles of procedures to release the efficiencies and ensure that those people would come. Other areas that should be pursued include organising our waiting lists on a regional, Northern Ireland-wide basis to permit same-time access, regardless of where someone lives. There are far too many inconsistencies in the wait times across the trusts in Northern Ireland. I know that our Minister speaks about inequality in health service provision, but this is a structural inequality that needs to be addressed. We could include in that Province-wide centres of excellence for rapid diagnostics or scopes, and understand that the very expensive equipment that we use for that should not be simply switched off and shut at 5.00 pm. One of my local hospitals — Daisy Hill in Newry — is a classic example of where we need to ensure that we sweat the asset that we have. For many years, more and more staff have been added, but the number of appointments and procedures has not increased. I do not believe that that is the fault of the staff. The system is far too inefficient, and insufficient emphasis continues to be placed on prevention, leaving too many people with a preventable illness ending up requiring treatment.

One in four adults in Northern Ireland live with two or more long-term health conditions. When patients require treatment, they are not flowing through the system as they should. Staff cannot see as many patients as they would like, and they end up operating old and clunky technology that is unfit for the 21st century.

If there is a problem at the front end with too many patients, there are also problems at other parts. Hundreds of patients today who are fit to leave hospital have to stay there while taking up a vital bed. In mid-March, in a question for written answer, I asked the Minister of Health for the figures for those who were fit to leave hospital but were unable to do so: at that time, it was over 600 people. That is the equivalent of Craigavon Area Hospital and another of our smaller hospitals being consistently out of use. We cannot create an efficient system if that is the situation in our health service. I presume that, during the winter, that might have been much worse. Fixing waiting lists is a complicated issue and requires us to fix social care. Lord Darzi's report last week stated that 13% of beds in England were lost through delayed discharges. What system can operate under that level of delayed discharge?

In England, the numbers of delayed discharges are published each day, and we should do the same in Northern Ireland. Thank you for listening to this. I apologise that I did not get finished, but this is something that I am absolutely passionate about. I hope that the Assembly can support the motion.

1,322 words. Text as published by the Northern Ireland Assembly.

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