Debate contribution: Health and Social Care: Three-year Plan

Debate contribution by Mr Mike Nesbitt on 10 December 2024.

MLA

Mr Mike Nesbitt

Party at the time

Ulster Unionist Party

Date

10 December 2024

Type

Debate contribution (made as a minister)

Business

Ministerial Statements

Heading

Health and Social Care: Three-year Plan

Assembly identifier

Official Report component 4715502

Read the official Assembly record

Text

It was a very emotive start, and I certainly join the Member in expressing sympathy for the loss of Jody Gormley. When we think about the dignity of Sir Chris Hoy, who now faces a terminal illness, it is remarkable how some of our sportspeople give examples to all of us to follow. As to the Member's substantive point, he should not imagine for one second that the workforce is not an extreme focus. Although we have more doctors and nurses than ever before, we have severe workforce challenges. I assure the Member, however, that, by and large, every day, when somebody has to go to hospital and stay as an inpatient, they are well looked after. I am not sure that what was actually a rant advances anything.

I thank the Member for his question. The most appropriate thing that I can do is take that away and get you the sort of detail that you are looking for, rather than trying to recall it on the hoof. I take your point: what you quoted from the plan is a generalisation; you want the specifics. I accept that, and you have a right to request them.

I thank the Member. Of course, any review will look at the financing. We are very aware of the pressures, and not just in dentistry. We used to worry about nurses or doctors going off to Australia; now we worry about their going to Athlone, because, if you are talking about just salaries, it is very difficult to compete with Sláintecare. However, I gently say this to the Member: your party voted for the Budget. The Budget is a key factor in how much money we are able to devote to dentistry, GPs, rolling out multidisciplinary teams and all the rest.

I am entirely unaware of what the Member is stating, but clearly it is something that, if true, is very serious. I will take it away immediately after this session and ask the appropriate questions.

I thank the Member for his question. There will be an analysis. Let us say that there is an elective list that is scheduled for this afternoon. If, for reasons beyond the trust's control, a key member of the workforce, such as the anaesthetist or the surgeon, is unable to attend — perhaps they have been involved in a road traffic collision — it would be unfair to penalise the trust for that situation. However, there are other situations in which the trust has some control. For example, it may have a week's notice that the anaesthetist will not be available next Tuesday. We would expect the trust to take action to try to make sure that that list goes ahead and is completed. We are going to take a very practical and reasonable approach to those things.

I acknowledged to Mr McNulty that the broader workforce challenge is a daily one for us. Although it is up to the trusts to manage those workforce challenges daily, it is up to us, as the Department, to look at a five- and 10-year plan, to anticipate what the needs are going to be, and to make sure that the training place numbers are right and that the universities and the other teaching areas have the facilities and the courses that we need to ensure that we have a workforce for the future and that we future-proof our workforce as much as we can.

I thank the Member for the question. Yes, I am satisfied. I meet periodically with the chairs of the geographic trusts — in fact, the chairs of all the arm's-length bodies, including the Ambulance Service. I do not think that anybody in that group is unaware of the need for reform. Part of the measure of success of reform will be increased efficiency and productivity.

The reason for the lack of detail on winter preparedness in the plan is that a statement on winter preparedness has already been issued. On the substantive issue, one thing that we are trying to do is provide alternative pathways to EDs. For example, there are ambulatory services in many of our acute hospitals and specific respiratory areas to which people can be signposted without having to go through the ED. There is the same for cardiac services. We are trying to get to a point where a GP who would currently assess a patient and refer them straight to the ED might be able to refer them so that they do not have to go through the ED and have a second assessment if that assessment is not needed. Let us say that a GP assesses that a patient has respiratory problems and there is a respiratory unit that is probably approximate to where the ED is geographically. The GP will refer the patient straight to the unit. That is how you take a bit of pressure off EDs, as well as, of course, trying to make people healthier and keep them healthier for longer.

None.

I thank the Member for bringing up a very important issue. The serious adverse incident process is supposed to be a learning process. It is far too slow and is not fit for purpose. That is why it is under review. It will be reviewed within the broader context of the introduction of a duty of candour. The House has debated whether the duty of candour should be organisational or individual and organisational, and, if it is to be individual, whether there should be criminal sanctions where people have not been open and candid. The proposed Hillsborough law that will come from the UK Government will also play into that. They are promising that legislation before the next anniversary of the Hillsborough disaster, so by April 2025, which is ambitious. Here are the opportunities as I see them. There is an opportunity to be open and to have a Being Open framework, which I am about to publish for consultation. It is about looking at a duty of candour that might be placed on all public servants, not just those who are in the health service. Part of that is recognising that, if there is a serious adverse incident and something goes wrong, you and your family deserve to be told at pace what went wrong, why it went wrong and what we are doing to try to ensure that it never happens again. Yesterday, I met a family who lost a loved one to cervical cancer in the Southern Trust. This is my duty, and it is a privilege that those families feel that they can share their experiences with me. I say this to the Member: I would like to get to the position where I never have to meet another family in that situation.

I thank the Member for his comments. He will be aware that the Live Better initiative, which will come on stream very soon, has two demonstration areas, one of which is in West Belfast. When we spoke with people in that area about the services that they want, their feedback put dentistry on the list. That will be important, because if we can get better results and show empirically that the Live Better initiative in West Belfast has delivered better dentistry outcomes, we can use that evidence to roll it out further across Northern Ireland. Ultimately, it comes back to this: can we reform in a way that encourages dentists to do more work in the health and social care system rather than to use their time to offer private services, as is the trend at the moment?

1,272 words. Text as published by the Northern Ireland Assembly.

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