Debate contribution: Ambulance Handovers

Debate contribution by Mrs Linda Dillon on 24 March 2025.

MLA

Mrs Linda Dillon

Party at the time

Sinn Féin

Date

24 March 2025

Type

Debate contribution

Business

Opposition Business

Heading

Ambulance Handovers

Assembly identifier

Official Report component 4864636

Read the official Assembly record

Text

Go raibh maith agat, a Phríomh-Leas-Cheann Comhairle.

We all know that ambulance waiting times across the North have worsened significantly. That, alongside the growing delays in ambulance handovers at emergency departments, paints a deeply concerning picture of how patient safety is at risk and the wider health system is being undermined. The recent report from the Audit Office laid that out clearly and highlighted not only the human cost to patients and their families but the serious pressure that is being placed on Ambulance Service staff and resources. We need to hear directly from the Health Minister on how he intends to respond. Recommendations have been made: we need to see their delivery. I welcome the fact that health has been made a priority by the Executive and, I hope, the entire Assembly. We want to support the Health Minister and ensure that we have a better health service for all our people. Whilst I recognise the significant challenges facing the Minister, people across the North need to see meaningful action, especially in rural areas such as those in my constituency, which stretches from Clonoe to Swatragh. As a resident of Clonoe, I am in the very fortunate position of being 15 minutes up the motorway from Craigavon Area Hospital. However, there are many in Pomeroy, Kildress and Galbally who are much further away from their closest hospital and, therefore, their closest emergency department. Our people need to know that the crisis is being tackled, not just talked about. We are well aware that ambulances are not a stand-alone service. They are a vital part of our entire health system, but they are not the answer to everything. When a handover stalls, it creates a domino effect, and we all have far too many examples of that. Ambulance availability drops, patients wait longer for help and staff are left stuck between hospital corridors and back-to-back shifts. That is not sustainable, and it is not fair on patients or staff. The problem is not unique to the North, but emergency department attendance here is notably higher than it is elsewhere. Some hospitals are clearly under more pressure than others. We need to understand why emergency department attendance is higher here. At the Health Committee, we have heard in evidence session after evidence session that many people who could and should be cared for in the community end up in our emergency departments. That is not where they should be. That is because of a failure to diagnose early enough and to have proper services in primary care and community care, and we need to seriously address both. We need to see solutions that are locally tailored, particularly when you consider the added challenge of delivering timely emergency care in rural and dispersed communities such as those that I mentioned in my constituency. That must be recognised and reflected in how resources are allocated, how services are designed and how we, as an Executive, work together across the board to ensure that we deliver for rural communities. We need to look outwards in order to learn from best practice models elsewhere. I absolutely accept that, but we need to ensure that those are tailored for communities and people here. We need to look at things such as the Getting It Right First Time review of emergency medicine, but any strategy must be rooted in the realities of the North: our rurality, our infrastructure gaps and our stretched capacity across the board. The NHS in the North is broken. The Minister must work across Departments and borders. There is real potential for deeper cooperation with the Minister for Health in Dublin to improve how we coordinate the emergency response in border areas and make efficient use of cross-border health infrastructure, not just in our emergency response but across the board.

As I have outlined, community care is vital, and we should not ignore that when we look at how we can work better together on a cross-border basis.

Those are not just political talking points; they are practical opportunities that could make a real difference to patient outcomes. A truly effective approach must span the entire health system, and that means strengthening primary and community care so that fewer people end up in hospital in the first place. It means ensuring timely discharges with care packages, where needed, so that people are not stuck in beds that they no longer need and, frankly, no longer want. They want to be at home with their family, where they can get better in the way that they want to. The Member for Foyle, Mark Durkan, made the point that the Ambulance Service can be fixed in isolation without the flow through our hospitals being addressed. Having spoken with health professionals who work in our EDs, I do not believe that that is the way to address the issue. I have given the example before, but it is important to say it again.

It is important to look at the flow through hospitals first. My reason for saying that is this, and I have given the example before: when I visited the ED in Craigavon, there were 68 people in beds in the emergency department, and there were 62 people upstairs who were medically fit for discharge but were unable to be discharged for a number of reasons. That is not an acceptable position. The lead clinician on the day said to me, "Please do not allow them to extend our EDs. That is not the answer, and we will not have a resolution". Whilst I accept the motion and ask Members to support our amendment, I say that we need to focus on the flow through hospitals. That means making sure that we have the right workforce in place — I support what the Member said — from paramedics and ED staff to home-care providers and community and primary care staff. Our ambulance crews do incredible work under immense pressure. The delays that we see are no reflection on them: they are the result of a system that is at and beyond breaking point. However, when paramedics are left waiting for hours outside hospitals unable to respond to new emergencies, we all lose. They lose the chance to rest and recover on what are already demanding shifts. We cannot lose sight of the fact that behind every statistic is a person — someone who is waiting in pain and distress, often with a distraught family — and healthcare workers who are doing their best under impossible conditions. We need a joined-up, system-wide approach that is not only reactive but proactive. As I have said before — we need to say it again — all five heads of our trusts have said that we need a focus on social care. We will not fix the problem in our emergency departments and the Ambulance Service — more people dying who should not die and families being left with trauma — if we do not fix the flow-through and fix our social care system. I support the motion. I ask Members to support our amendment. I ask again that our social care system be fixed to ensure that we do not end up with a crisis in emergency care and in order that our ambulance staff can get out to those who absolutely need them. It is important to highlight some information that I was given by the British Heart Foundation. I will not go through all the statistics, but one vital one is that the number of people who self-present at a hospital has increased from 5% to 12% in the last five years. That is concerning, and it means that, potentially, people have worse outcomes. Everything that we have discussed in Committee and with the Minister in the Chamber is about what we will do to ensure better outcomes. We can ensure better outcomes only by having a whole-system approach. Therefore, I ask Members to support our amendment.

1,332 words. Text as published by the Northern Ireland Assembly.

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