Debate contribution: Ambulance Waiting Times

Debate contribution by Mr Stewart Dickson on 13 January 2025.

MLA

Mr Stewart Dickson

Party at the time

Alliance Party

Date

13 January 2025

Type

Debate contribution

Business

Private Members' Business

Heading

Ambulance Waiting Times

Assembly identifier

Official Report component 4738545

Read the official Assembly record

Text

I beg to move

Thank you very much, Mr Deputy Speaker. I rise to propose the Alliance Party's motion on Ambulance Service waiting times. The motion proposes some tangible measures that, we believe, can be taken by the Department of Health and the Minister to ease the pressures. The motion is not about complaining; it is about trying to propose solutions and bringing them forward. Unfortunately, many will have heard the stories in the media over the past number of weeks that illustrate the pressures on our health and social care services. Often referred to as "winter pressures", the reality is that those unacceptable pressures are with us all year round. I will quote Dr Clodagh Corrigan, the deputy chair of the British Medical Association locally, who put it at the beginning of January:

"we have seen what we would call winter pressure numbers in the summer but now we have seen that doubling. There has been no respite this year".

It becomes particularly clear when we look at the fact that ambulance response time targets for every category of call were missed in every month of the financial year 2023-24. I will return to what we might describe as the definition of a target. That means that regardless of whether calls were for immediate, life-threatening or emergency cases, such as a heart attack, a stroke or any urgent problem, ambulance crews were not in a position to respond in the timely manner that they would like and for which they have targets.

That has led to an unacceptable delay in ambulances' access to emergency departments in recent weeks. We saw a snapshot of that on Friday morning, when it was reported that 19 of 56 ambulance crews across Northern Ireland were sitting outside hospital emergency departments, the longest wait of which was for over nine hours. We know that that snapshot does not adequately describe a full day of movement for hospitals, but, with Fridays tending to bring an easing of pressure ahead of the weekend ramp-up, it is extremely concerning.

We hear statistics and figures, but we must remember who is at the centre of all this: the patient. Generally but not always, it is an elderly and/or distressed patient with concerned family members. Mary Donaghy, whose case was widely reported last week after she was involved in a head-on car collision, was left to be treated in an ambulance outside Royal Victoria Hospital for more than seven hours before finally being admitted. There was the story of Robert, an 88-year-old gentleman with dementia who fell on New Year's Eve and, unfortunately, had to wait a total of 40 hours before being admitted. That included 23 hours waiting on an ambulance to arrive, nine hours waiting inside the ambulance outside the emergency department of the Ulster Hospital and eight hours waiting inside the emergency department. The families of Mary and Robert both made it clear that they had no issue with the hospital staff or the incredible ambulance crews who took care of their relatives. Indeed, Mary's sister Sharon noted the effort made by staff to ensure that Mary was kept warm while in a very cold position in the ambulance and the fact that she received proper pain medication. In my East Antrim constituency, I had to deal with the head of the Northern Ireland Ambulance Service when an ambulance took an hour and three quarters to respond to an incident at an urban special needs primary school, where a young child fell and broke his femur in the playground. Distressed school staff had to look after him with blankets in a soaking wet playground because it took an hour and three quarters for an ambulance to get to him in an urban area that is just off the motorway. That most distressing situation resulted in a number of 999 calls to the Ambulance Service. One of the calls was answered by an English call centre, which is the default backup when calls cannot be answered in Northern Ireland. In an urban area in East Antrim, that is simply unacceptable. A number of years ago and under a previous Health Minister, we had, in East Antrim, the much-lauded Maggie's Call scheme, which would have allowed for alternative emergency services, like the Fire Service, to attend such an incident and perhaps provide further support. Yet, the Minister's response to my question for written answer indicated the sad reality that, despite all the ballyhoo, Maggie's Call has not been rolled out across Northern Ireland. It still exists only in Carnlough. I wish now to take a broader look at why our unreformed health and social care system inevitably leads, as the motion says, to the pressures facing the Northern Ireland Ambulance Service. It is directly related to the sad and predictable, but nevertheless harrowing, crisis that we have seen in our emergency departments. We have all had constituents contact us over the past number of weeks and months about incidents such as those that I just mentioned. Many of us feel frustration when we see ambulances trapped outside emergency departments, unable to provide the services that those working within them wish to provide. It is a problem that we could resolve with the political will of all in the Chamber. We have the road map. The answers are there. They were given to us by the expert panel chaired by Professor Bengoa and, indeed, by many others before that. We need to be clear that, if we have chosen not to implement the panel's recommendations, we have opted against change and, now, we pay the penalty. Fundamentally, the main reason that ambulances are stacked up outside our emergency departments, and that people have to be treated in those ambulances, is that there are too many people in hospital. They do not need to be there. There is a chain of backlog. If people cannot be discharged, they have to be left in hospital wards. If people are left in hospital wards, there will be people left in emergency departments. If people are left in emergency departments, others will be left in ambulances. Patients cannot get into wards, because other patients cannot be discharged into care. That is the chain reaction that we are all facing. Some 700 patients were left in or near ambulances because, at the same time, 500 patients were unable to be discharged from hospital and, thus, were occupying beds to which those in the ambulances should have been processed within the appropriate time targets. The issue of too many people being in hospital and the failure to discharge patients promptly and effectively is, at scale, a particular problem here in Northern Ireland, yet it should not be. In England and Wales, social care, which deals with those people who need to move out of hospital into assisted help in the community, has to battle with local authorities. Here, we have a joined-up — allegedly — health and social care system, yet the joined-up bit has failed us. We could save some £500 million a year if we revised and refreshed our social care budget. That, in large part, means that the Department has failed to adequately address the causes of the ambulance waiting times. One reason for the inefficiency is that our social care system is understaffed and inefficiently funded. Indeed, that £500 million would go a long way to addressing that. However, as we saw last week, it is not just an issue of underfunding, but one of inefficiency. If we had reformed the system, we would have more money. We do not even have a proper procurement system in social services. People are pushed out into the community and into the private sector. There is little or no public-sector accommodation available for people who need it to allow them to move out of hospital and create space to allow a flow through so that our hospitals can deliver on their targets. It is particularly distressing that we fail to meet the four-hour waiting time target in emergency departments. Once that target is breached, the rest of the things that flow from it fail. If you cannot be treated within four hours, if you cannot get the appropriate tests and if you cannot get a hospital bed, the problems are exacerbated. We need to have an opportunity for more direct diagnostic testing. GPs should be able to refer people for diagnostic testing directly rather than putting them through what are quite often pointless appointments systems that result in diagnostic tests being ordered for a second time. The GP might think that the patient needs the diagnostic testing, but that can only be done when a consultant says that it should be done. It is important that we recognise the incredible work that is done by our health and social care staff and the amazing work that is done by our ambulance crews, their management and all the people who have been struggling over this winter to deliver. We also need to take a step back and recognise that we, as politicians in Northern Ireland, have failed to support them and to deliver proper transformation in healthcare. That is what the debate is about. That is why I am appealing to the Health Minister to embark on the Bengoa proposals. Get the negotiations up and running —

— and get them delivered as soon as possible.

1,571 words. Text as published by the Northern Ireland Assembly.

Assessment

Not flagged

Jev’s structured answers

Assessed 21 October 2026 at 11:43 UTC by jev-1.13.0 (requested as typesafe/jev) under rubric 2026.10-r9, methodology 1.9.

Disagree with this assessment?

Classifications can be challenged. A person reads every challenge, and any change is recorded publicly above with its reason.

Challenge this classification