Debate contribution: Breast Cancer: Waiting Times in Upper Bann

Debate contribution by Mr Mike Nesbitt on 15 October 2024.

MLA

Mr Mike Nesbitt

Party at the time

Ulster Unionist Party

Date

15 October 2024

Type

Debate contribution (made as a minister)

Business

Adjournment

Heading

Breast Cancer: Waiting Times in Upper Bann

Assembly identifier

Official Report component 4593100

Read the official Assembly record

Text

Deputy Speaker, thank you. I thank Diane Dodds for securing today's Adjournment debate. I welcome the opportunity to recognise the situation that so many people living with breast cancer find themselves in. Naturally, much of the discussion about our breast services focuses on performance, and quite rightly so. Since becoming Health Minister, I have had the opportunity to meet a number of people who are living with breast cancer or, indeed, supporting those who are doing so. A key takeaway for me from those discussions is that our breast services in their current format are not performing as they should, hence my desire for reform. I want to be clear that that is by no means a reflection on the dedication and commitment of the staff who work day in, day out to deliver those services. Staff have made an enormous contribution; I wholly endorse that idea. The issues with the services do not sit with the staff who deliver them. The issues that need to be addressed are systemic, and I intend to address them. I wish to deliver a more equitable, sustainable and timely service to deliver better outcomes for patients and more resilience for our staffing complement throughout the region. The particular concern of the Member who secured the debate is the waiting times in Upper Bann. The key hindrance to the breast service's performance in the Southern Trust and a contributory factor to long waiting times is the ongoing challenge of staff availability. In the current delivery model, each trust relies on a small team to deliver its breast services. Therefore, if even one staff member is on leave, falls ill or suffers a bereavement, it can have a catastrophic impact on the trust's performance. Over the past 12 months, staff shortages have had just that effect on many occasions. Mr O'Dowd asked whether a third consultant had been appointed in the Southern Trust, and I can tell him that it is the case. To some extent, that has helped to stabilise the service, but there is still a waiting list backlog, and workforce issues remain: one GP with a special interest has, I believe, gone to another trust, there has been maternity leave, and other issues have affected that small team disproportionately. Members will also be aware of the introduction of Encompass to our health and social care services. It is a major step forward and an exciting innovation. However, with any major change in the way that we work, it takes a little time to adjust, and that impacts on service delivery. As happened in other areas of the UK where a similar system was introduced, there has been an expected downturn in capacity in the South Eastern and Belfast Trusts, and that is expected to be the case when the Northern Trust goes live on 7 November and when the Southern and Western Trusts go live in 2025. Departmental officials and trust staff have worked tirelessly to provide short-term interventions to address the waiting times and backlog. That has included inter-trust transfers, increased waiting list initiative funding for red-flag patients and the coordination of mega clinics on evenings and weekends. We are all aware that breast services here have been under severe pressure for some time. Regionally, we have never met our 14-day target for all red-flag assessments. According to the latest cancer waiting time statistics, between April and June of this year, just 31% of patients were assessed within 14 days of their red-flag referral. The target is 100%. Only 36% of patients started treatment within 62 days of their referral. That target is 95%. Conversely, 91% of patients started treatment within 31 days of diagnosis. It is a clear indication that addressing the wait for assessment is a priority issue, and, once a diagnosis is provided and a decision to treat has been made, the service should be much timelier. That is why I recently announced that single regional waiting lists for breast assessments will be implemented in the coming months. That will enable patients from across Northern Ireland to access the earliest appointment available to them, wherever that might be. I want to deliver equitable access to breast services. I want to end the unacceptably long waits. I want our staff to have a more resilient service. The patients of the Upper Bann region have been highlighted here today. To me, it is unthinkable that somebody from that area who might wait for weeks for a breast assessment could, if they lived just a few miles up the road, wait for only days. That regional inequity in access to breast cancer services will end. More challenges need to be addressed to deliver a service that meets the needs of all who require it. For that reason, I have asked for a wider review of services to be undertaken at pace. Engagement with clinicians, people with lived experience of cancer and cancer charities will all be central to the review. My overriding priority is to secure better outcomes for patients, and the review will include examining options from consolidating the number of locations where assessment and surgery are provided. At the same time, it will consider how aftercare and chemotherapy are provided, and those services should, I believe, be provided as close to home as possible. I am confident that patients are prepared to travel for specialist assessment and treatment, but they want follow-up and continuing care to be as close to their dwellings as possible. A few other areas were mentioned during the discussion. It is unacceptable that our cancer outcomes are not better than they are when compared with other countries, and that is why we need reform, a point that Mrs Dodds made.

I said that I want to tackle health inequalities. For me, that is short for three things: health inequalities, which are about outcomes; health inequities, which are about unequal access to services; and health literacy, which means people understanding how to access health and social care in Northern Ireland. On that theme, the rapid diagnostic centres will be very useful, but you need to know that they are there and how to access them. Even if you know how to access primary care and your GP, they need to be open and responsive when you reach out to them. My final point is on the subject that Mr Buckley raised: confidence. Confidence is absolutely key. If we do not trust our doctors, nurses, clinicians and surgeons, how can the health service operate? I met some of the ladies from Ladies with Letters, and Diane Dodds was in the room at the time. Clearly, confidence is not there. Trevor Harbinson was in the room, not long after he had buried his wife, Erin, who should be alive today. She should be alive today, but she was failed by our system. That is my motivation. Let Erin Harbinson be the last. Let us change the system. Let us make it equitable, accessible and world class. That is my ambition.

1,172 words. Text as published by the Northern Ireland Assembly.

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