Debate contribution: Ambulance Waiting Times

Debate contribution by Mr Mike Nesbitt on 13 January 2025.

MLA

Mr Mike Nesbitt

Party at the time

Ulster Unionist Party

Date

13 January 2025

Type

Debate contribution (made as a minister)

Business

Private Members' Business

Heading

Ambulance Waiting Times

Assembly identifier

Official Report component 4738607

Read the official Assembly record

Text

Deputy Speaker, thank you very much. I thank the motion's sponsors. It is always important to test our mutual understanding of the issues and our passion for finding fixes. I am sure that there is not a single Member who does not recognise that the health of our people is the single most important issue that we face, although at Budget time some may make an exception. I am loath to pick any specific area or service of the health and social care system for special attention because healthcare is a continuum and there are so many moving parts that are all interdependent. Changing one part may improve that aspect of health and social care, but it may also have unintended and negative consequences for others. The motion states:

"this Assembly expresses grave concern at the pressure facing the Northern Ireland Ambulance Service".

The same could be said about the entire HSC service across Northern Ireland, and, indeed, the entire National Health Service across the United Kingdom. As each day passes, we become more aware of the fact that pressures are being felt UK-wide. The motion references the need to address:

"delays in admitting patients to hospital".

I question how well understood it is that those delays are about hospital flow — the flow from front door to back door and beyond — but I am encouraged that Mr Dickson and various other Members recognised that it is about the flow. You could double the number of ambulances or double the workforce, but those measures alone would not solve the problem. I pay tribute to all health and social care staff and recognise their work over the Christmas and new year period in incredibly challenging circumstances. I also thank the front-line clinical and support staff who work for the Northern Ireland Ambulance Service. Since Christmas, I have visited six emergency departments, and what I have seen and heard is universal to all six and fundamental to the problem that needs to be fixed. In the current circumstances, far too many patients have to surrender their dignity and privacy to spend hours — sometimes days — either lying on trolleys or sitting on chairs, with limited facilities. I have listened to ambulance crews outside EDs, often in the freezing cold of recent weeks. Like ED staff, they are suffering moral injury; they signed up to deliver better than this, as did so many health workers across the UK. We have to recognise that, as is the case elsewhere in the UK, our health and social care system as a whole is under sustained and significant pressure. That is not to minimise the challenges that are faced here, but Members will be aware of reports of a significant number of trusts in other parts of the UK having declared critical incidents, including the East Midlands and Welsh ambulance services. My goal is to develop a better, more equitable, more effective and better integrated urgent and emergency care service. I have already set out my long-term vision to improve services and deliver better outcomes. Part of that involves making it easier to access the most appropriate services as quickly as possible in an appropriate setting. The issues with EDs are not about our EDs; EDs are where the problems manifest themselves and become quite horribly obvious. The problem is about the flow. I do not believe that the answer is about bigger EDs, but I acknowledge that it is essential that we have sufficient capacity, which is why, in the coming months, I will be commissioning an evidence-based emergency care capacity review. It is about identifying the pinch points where the flow gets blocked. Currently, as Members have acknowledged, the problem is not at the front door, where the ambulance crews and their patients seek access; it is at the back door, where trusts seek to discharge patients who no longer need an acute hospital bed. Therefore, the debate could easily, and rightly, have been about community capacity instead of Ambulance Service capacity. On that topic, let me put it in Hansard, the Official Report, that I am committing some £500 million in the next financial year to introducing the real living wage for social care workers. I do so in the hope and expectation that that will help to address the huge gap between demand and capacity in providing social care in the community. For the first time and for the remainder of my term in office, I want to ensure that we take real steps to break the association of social care work with the minimum wage. It is an incredibly rewarding career, and this new plan will see more money put into the pockets of workers. Our ambulance staff are facing the daily challenge of not having sufficient available resource to respond appropriately for timely dispatch, timely response and timely delivery into EDs. Like all staff involved in emergency health service delivery, they are asked again and again, day after day, to make judgement calls not about what is the best option but about what is the least worst option. With that comes a constant worry about whether they have made the right least worst decision, and that is a worry that they often take home with them at night.

I will give way.

884 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