Debate contribution: Reconfiguration Framework: Consultation

Debate contribution by Mr Mike Nesbitt on 1 October 2024.

MLA

Mr Mike Nesbitt

Party at the time

Ulster Unionist Party

Date

1 October 2024

Type

Debate contribution (made as a minister)

Business

Ministerial Statements

Heading

Reconfiguration Framework: Consultation

Assembly identifier

Official Report component 4562392

Read the official Assembly record

Text

I thank the Member for his question. All the royal colleges were involved, and all the chief executives and the trusts were involved. Indeed, a couple of weeks ago, I was at the headquarters of the South Eastern Trust and met the chairs of all the arm's-length bodies that are involved in delivering healthcare. Therefore, extensive consideration has been given to this plan. The big challenge that has been faced by, for example, the people who represent the five geographic trusts is, "What does it mean for me and my service?". One of the most important exchanges in the feedback has been my sense that they need to collaborate and cooperate more deeply and that they have to address the issue of productivity. If you talk to the clinicians, they will tell you about the barriers that prevent them being more efficient and more productive, and then, when you speak to the management, you maybe get a better sense of what management perceives to be the barriers to delivering that efficiency and productivity. The one thing about healthcare that I discovered very early in my tenure is that there are so many moving parts. You can see one moving part and say, "Well, if we do something here, that will be really productive and positive", but there will be three or four other moving parts that might say, "Well, if you do that, you will have a negative impact on me". Those are the sorts of conversations that we have been having. Ultimately, as, I think, I said in my very first remarks in the Chamber as Health Minister, everybody wants reform, but everybody has a different idea of what reform should look like. As we go forward, I know that people will object to this proposal or that proposal, but that is the value of the consultation. I am certainly happy to discuss offline with the Member some more detail, if he is interested in the specifics of the feedback.

I thank the Member for her question. If I understood her correctly, she is talking about local hospitals. As I said, I think that, by and large — 80% at least — people are willing to travel for a procedure if they feel that they are going to a centre of excellence. I have said before that, if your local hospital does the procedure that you need once a week but that, by travelling a bit further, you can get to somewhere that does it 10 times a day, five days a week, you are more likely to want to go to that centre of excellence. The local hospitals will deliver the aftercare. I want aftercare to be delivered as close to the home as possible. That, primarily, is where I see a role. It is about delivering day-to-day, non-acute services. There is so much that local hospitals can do; they should be in no doubt about their short- and medium-term future.

I thank the Member. I can offer that guarantee; we need every square inch of our hospital estate. The next challenge, having put hospitals into four tiers, is to determine exactly what services are offered by which hospital. That is a fairly significant piece of work, but, if it is approached with logic, it should not take that long to get to where we want to be. I assure the Member that I want every hospital to do whatever it is doing to the best of its ability, and to be recognised as such by the community that uses that facility.

I thank the Member. SWAH is a very good example of separating out emergency and elective care. It has become an elective-care centre of excellence in Enniskillen. That works really well. It gives an assurance to the staff and healthcare workers who are based in the SWAH that they have a really sustainable future and a worthwhile role to play in delivering as part of the network of our Northern Ireland hospitals.

I thank the Member. I understand the nature of the question. It is going to be a rolling programme. For example, as I indicated, officials in my Department have been liaising with officials in the Department of Health and Social Care in London about the Tobacco and Vapes Bill. It is our intention that whatever legislation is brought in for England will apply here in Northern Ireland. I would love to see a smoke-free generation as soon as possible. Smoking is one of the social determinants of health inequalities. I am sure that the Member will join me in hoping that we can tackle that. I have talked about minimum unit pricing of alcohol. We, as a Department, have already consulted on that. I am at the early stages of discussing with officials how we take that forward. It is something that I hope to bring to the Health Committee. I apologise for missing my slot last week due to illness. I think that it is something that the Committee and the Department can work together on. That will not have to wait until January and the end of the consultation. I want to go ahead with trying to see whether we can get agreement on minimum-unit pricing for alcohol. Officials have been told to press on urgently with work on breast cancer screening. I want to get as soon as possible to the point at which every woman can go online and have control over her own appointment. If she wants the earliest available appointment, wherever that might be in Northern Ireland, she should be able to click a button and book herself in for that. If she would rather go local, even if it means waiting a bit longer, that is her choice, and I want her to have that choice. Those things are part of a continuum. It is not that we will get to the end of January and a whole series of initiatives will come. I am doing every one of those as quickly as I can.

Sorry, Deputy Speaker. Which hospital?

Are you asking whether it can be a centre of excellence? Are you talking about the Royal Belfast Hospital for Sick Children?

Sorry, could the Member repeat the question? I did not quite catch it.

I am sorry that I missed the question the first time. It is my understanding that, in many ways, it already is a regional hub. Certainly, it is my intention that that is the case going forward. Certain services, like percutaneous endoscopic gastrostomy (PEG) treatment, are only available at the Royal.

1,099 words. Text as published by the Northern Ireland Assembly.

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Assessed 21 October 2026 at 11:16 UTC by jev-1.13.0 (requested as typesafe/jev) under rubric 2026.10-r9, methodology 1.9.

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