Debate contribution: Programme for Government 2024-27

Debate contribution by Mr Danny Donnelly on 3 March 2025.

MLA

Mr Danny Donnelly

Party at the time

Alliance Party

Date

3 March 2025

Type

Debate contribution

Business

Executive Committee Business

Heading

Programme for Government 2024-27

Assembly identifier

Official Report component 4826281

Read the official Assembly record

Text

I will speak on the Programme for Government in my role as the Alliance Party's health spokesperson. It is important to begin by welcoming the publication and agreement of the Programme for Government that outlines the Executive's priorities for the remainder of the mandate. Of course, it should have been agreed and published in 2022, within months of the most recent Assembly election, but, as we all know, the Assembly was prevented from functioning until February 2024. I appreciate that any Government involving multiple parties will take time to negotiate their Programme for Government. However, in the South, it took the two parties and associated independents two months to publish their Programme for Government, which is a more reasonable time frame than three years. The solution here is reform. We must reform the institutions, so that the Assembly and the Executive can properly function without interruption for five years. If we do not do that, the cycle of dysfunction will continue. We welcome the Programme for Government, and, specifically, I welcome the commitment made to act on cutting health service waiting times as one of the nine main priorities. Over recent winters, we have witnessed, at first hand, the unprecedented pressures on our hospitals, staff and ambulances, with patients waiting outside hospitals in ambulances or in overcrowded A&E departments or lying on corridor beds in wards for several days or even longer. I witnessed those pressures when I worked as a nurse, and things have significantly worsened in the years since I started working in the profession. I am encouraged by the inclusion of addressing waiting lists in the Programme for Government, particularly the £76 million investment approved for 2024-25 and the focus on supporting those on cancer and time-critical waiting lists. The Programme for Government rightly states that current funding is not enough. That is true, and, as I have said in previous debates, I understand the Minister's frustration with the lack of funding. However, it should not be forgotten that the Department of Health gets over 50% of the entire Budget. The Minister's plan to shift left must result in investment in primary care to stabilise GP practices, community pharmacies and other service providers. We must take decisions that will deliver genuine reform and transformation, which will save money in the long term. HSC transformation, including hospital reconfiguration, based on the Bengoa principles, will deliver better outcomes for patients in Northern Ireland and reduce waiting lists, but that requires all parties to back it, rather than supporting it in principle and then opposing it the moment that a difficult issue arises in their constituency. It also requires the political stability to deliver multi-year Budgets: another reason why institutional reform of the Assembly and Executive is desperately needed. It has been said that the Assembly is as stable today as it was the day before the last collapse. To reform the health service and improve the delivery of healthcare in Northern Ireland, we need stability in our political institutions. All Departments are under huge pressure and should take steps to use existing resources as efficiently as possible. Some ways in which the Minister of Health could do that are, for example, by focusing on prevention so that fewer people need to be on waiting lists in the first place; moving towards a single-system approach that can more effectively arrange and deliver specialised services in a smaller number of locations; making greater use of surgical hubs and other similar organisations; and ensuring proper governance arrangements for all aspects of spending. We have seen examples of trusts signing care home contracts worth over £600 million a year without the normal procurement processes. I encourage the Minister to focus his attention on practical ways of ensuring that the services that his Department provides are more efficiently managed and delivered, while maintaining the highest standards of service that our constituents deserve. It also reflects the need for action on social care reform, which has been referenced. We can improve the outcomes for patients who rely on social care only through the fundamental reform and transformation of key services. That will bring practical benefits, such as improving the flow through hospitals, releasing some of the pressures on areas in hospital settings, including on staff, their time, the beds available and all the associated costs. It will, therefore, play a key role in reducing waiting times and waiting lists. While the Programme for Government does not provide more detail on reform and transformation, a timeline for those actions should come in this mandate.

There are other examples of strategic projects that could improve outcomes and save money that do not seem to be being prioritised. They include the new care homes contract and developing Northern Ireland Ambulance Service mental health practitioners, just to give two examples. As the Programme for Government states:

"the journey of reform must continue."

There are some useful guidance points about investing in the workforce, delivering digital capability and innovation and, most significantly, taking the difficult decisions on reconfiguration. From some of the parties in the Chamber, however, we have sadly not seen that reflected in reality. Some important individual actions refer to mental health. Under the "People" mission, reference is made to the overlap between economic deprivation and poor mental health and to the importance of sport and exercise in maximising community well-being and mental health. We need to support mental health services, including through the full implementation of the mental health strategy 2021-2031. Mental health should be prioritised on exactly the same basis as physical health. It is important to welcome the Programme for Government as a direction of travel and to have all parties working together on it. I highlight the point that just because something is not in the Programme for Government does not mean that it will not happen. The document is the baseline for delivery, not the height of our ambition. Hopefully, this is the first of many regular Programmes for Government, given the huge gap since the previous one due to two Assembly suspensions and a pandemic. I hope that we will be back here discussing the next Programme for Government shortly after the 2027 Assembly election. From a health perspective, I welcome the focus on reducing waiting lists, and I hope to see further details and plans, along with a wider approach to all aspects of physical and mental health in order to stabilise and improve the health service on which we all depend.

1,081 words. Text as published by the Northern Ireland Assembly.

Assessment

Not flagged

Jev’s structured answers

Assessed 21 October 2026 at 12:07 UTC by jev-1.13.0 (requested as typesafe/jev) under rubric 2026.10-r9, methodology 1.9.

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