Debate contribution: Budget Bill: Second Stage

Debate contribution by Mr Danny Donnelly on 18 February 2025.

MLA: Mr Danny Donnelly
Party at the time: Alliance Party
Date: 18 February 2025
Type: Debate contribution
Business: Executive Committee Business
Heading: Budget Bill: Second Stage
Assembly identifier: Official Report component 4806234

Text

I thank the Minister of Finance for moving the Second Stage of the Budget Bill, and I congratulate him on his new position, along with his colleagues, the new Minister for the Economy and the new Minister for Infrastructure. We will miss the latter at the Health Committee. I will speak in my capacity as Alliance Party health spokesperson. Whilst our difficult financial position is evident in every Department, nowhere faces such overwhelming pressures as our health service. Many times in the Chamber, we have discussed growing waiting lists, challenges around discharging patients from hospitals and the crises in respite care provision and domiciliary care. That is just to mention a few of the many serious issues in the health service. However, we should take this opportunity to acknowledge any progress that has been made. The Minister of Health deserves credit for meeting, through in-year allocations, the pay requirements of our health service staff. Ensuring that health and social care workers, who perform an essential and invaluable role, are paid appropriately must be a priority for the Department of Health. That progress is welcome. Without health service workers, there is no health service. However, although the £36·5 million financial pressure on GP practices, community pharmacies and other social care providers due to the rise in employers' National Insurance contributions announced in the recent UK Government Budget is noted, no mitigation measures have been announced. As has been highlighted many times, Northern Ireland continues to have the most expensive health service and the worst outcomes in the UK. Our waiting lists are among the longest in Europe. Most targets are consistently missed. There is a growing risk, if issues are not targeted, of our moving towards a two-tier system in which only those who can afford to do so can avail themselves of essential treatments. That would go against everything that our health service can and should stand for. In effect, we already have a two-tier system in Northern Ireland, with many people across our communities feeling that they have no choice but to spend huge amounts of their savings, borrowed money or money from family members to access healthcare. That is shameful and a huge failure. As we all know, Health receives by far the largest allocation of the Budget. Clearly, something is going wrong. The challenges that are facing the Department of Health will not be resolved by simply giving it more money. The Health budget has increased by over £2 billion since 2020. Last week in the Health Committee, the Minister mentioned some of the unsuccessful bids that he submitted, most of which would have required more money. While it is understandable that he is seeking additional funding for such projects — it is what he should be doing — it is impossible to facilitate every request from every Department. The Minister must seriously consider how his Department could be run more effectively and efficiently. We need to do things better in healthcare provision. As the Chair of the Health Committee highlighted, there is a clear need for investment in primary and domiciliary care and for the strategies to improve people's healthcare across Northern Ireland, such as the already mentioned mental health strategy, which has been underfunded for many years. Reform and transformation are also needed, and the Minister has spoken many times about his desire to shift left. That is in line with the principles of the Bengoa report, 'Systems, not Structures: Changing Health and Social Care', from 2016. We have discussed Bengoa many times, and, while we always hear positive language from members of all parties on the need for that reform, it is not always reinforced by action. Just a few weeks ago, we discussed the crisis in our health service in an Opposition day debate, and some of the decisions that local MLAs and councillors made contradicted their parties' stated aims on reform through Bengoa specifically. Reform must be more broadly a priority for the Executive and Departments, not just Health. It must include reforming these institutions so that the Assembly and the Executive are never again collapsed and held down by a single party. With the cycle of crisis and collapse, the 2024-25 Budget was the tenth single-year Budget in a row. How can Ministers ever plan for anything in the medium to long term if they are working on the basis of a single-year Budget? That is especially relevant for Health. Much of the transformation agenda will take years to carry out and will require substantial changes to how every trust and hospital operate. We must therefore seek to end ransom politics and move towards being a more mature and properly democratic Assembly, where parties can make difficult decisions and not walk away, collapsing the Assembly, when things get tough. We must address the costs of division. It is estimated that continuing division on the basis of our political and religious divide costs our economy up to £400 million per year. Imagine how valuable that additional funding would be. While the UK Treasury must take some of the blame for our current financial predicament, it is understandable that the UK Government expect us to look at specific options for addressing our own financial problems. Addressing division would be one of the easiest ways to do so. In conclusion, I welcome the passage of the Budget Bill following our useful debate on the spring Supplementary Estimates yesterday. It is an important role for any Executive and it provides an opportunity to discuss what our priorities should be. I look forward to hearing from other Members and to working with the Minister of Health in particular to progress urgent reforms and ensure that Health and Social Care is accessible to everyone in Northern Ireland when it is needed.

964 words. Text as published by the Northern Ireland Assembly.

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