Debate contribution: Cancer Waiting Times

Debate contribution by Mrs Diane Dodds on 12 May 2025.

MLA

Mrs Diane Dodds

Party at the time

Democratic Unionist Party

Date

12 May 2025

Type

Debate contribution

Business

Private Members' Business

Heading

Cancer Waiting Times

Assembly identifier

Official Report component 4937410

Read the official Assembly record

Text

I beg to move

Thank you, Mr Deputy Speaker. I welcome the opportunity to debate what, I think, is a hugely important issue for everyone in the Chamber and in Northern Ireland. I submitted the motion last month. It was agreed by the Business Committee and was included in the provisional Order Paper that was circulated on 30 April. I was a little surprised, albeit delighted, that the Minister came to the House last week with his statement on waiting lists and the unacceptable times that people wait. I am sure that the timing of his statement could only have been coincidental.

How long we wait for healthcare services is an indicator of people's view of the overall state of our health service. I specifically wanted to debate the topic of cancer waiting lists because I am extremely concerned that, although the Department continues to issue appalling statistics for Northern Ireland, those statistics get only a cursory mention in the press or in the House. Cancer Focus Northern Ireland indicates that none of the departmental targets for cancer has been met since 2012. Are we now so immune to such shocking statistics that they pass us by without our noticing them, or have we decided that that is just the way it is? I want those who are dealing with a cancer diagnosis or who have lost loved ones to cancer to know that the Assembly is determined to do better and that we will continue to hold the Minister of Health to account on that very important issue. For us to do anything less would be a failure of our duty as the scrutiny body of the Executive. Cancer touches everyone in Northern Ireland, with half of us expected to receive a cancer diagnosis in our lifetime. The most recent cancer waiting times, published last month, reveal that 87·5% of patients started treatment within 31 days of diagnosis, against a target of 98%. The percentage decreased from that in the previous quarter and that in the same quarter of last year, with the poorest-performing areas being urology, gynaecology and skin cancer treatment. Minister, in your response to the debate, perhaps you will explain the issues that specifically relate to skin cancer treatment in the first quarter of this year. Percentages for the 62-day treatment target for GP referral were worse. The target time was achieved in only 37·9% of cases, which falls far short of the 95% required. For the 14-day breast cancer target, 31·7% of women were seen within the target time, against a specified target of 100%. That means that less than a third of women are seen within the target time, and that figure is down further on that of a year ago. Just imagine the fear and distress of a woman who finds a lump in her breast and then has to wait a significant time before being seen by a consultant. The situation is letting down women in Northern Ireland, and it must be rectified. Minister, in the response to my question for written answer that you provided on 7 October 2024, you explained previously announced plans to regionalise breast cancer waits into a single list. I hope that you have good news for us today, and I ask whether you can provide an update on that regional list and how effective it is proving to be. We hope that that is proving to be much more effective than the previous system, as indicated by the percentage of 31·7% for the 14-day referral target. If the regional list is not fully in place, the House deserves an explanation for its slow progress. I will digress ever so slightly to give a voice to children in Northern Ireland who languish on waiting lists. Minister, you recently provided me with the startling statistic that almost 25,000 children are on waiting lists to see a paediatrician in the Belfast Trust and the South Eastern Trust. Some 2,000 children are on a waiting list for surgery in the same trusts. I suggest that, by any departmental standards, that represents abject failure. I welcome the ring-fencing of funding for health waiting lists. The issue will require prioritisation in the Health budget and additional funding from the Executive. I hope that, as we progress to having multi-year Budgets, the focus on waiting lists that was promised in the Programme for Government (PFG) will continue. I note the SDLP amendment, but I fear that it would diminish the responsibility to be placed on the Minister of Health to act in conjunction with his Executive colleagues, unless the Member who speaks to it can persuade me otherwise.

The Minister does not appear, either last Tuesday or at any other stage, to have picked up or embraced the potential for the delivery unit, which is referenced in the motion, to provide assistance. There can often be value in another set of eyes examining problems and offering a different perspective. That is why I have also referenced that in the motion. As I have said before, I fear that the elective care framework is not nearly ambitious enough. I am not alone in that. It promotes more of the same through more small-scale offerings to our relatively modest independent sector, the majority of staff in which are already busy working for local trusts. Rather than really tackle root-and-branch reform of the elective care system, the Minister seems to prefer to resurrect a drip-feed reimbursement scheme in the form of the waiting list reduction reimbursement scheme. The Department will pay full price for every procedure as part of that scheme, and it turns the principle of the NHS on its head by allowing the wealthy to jump the queue. What possible benefit does the Minister's Republic of Ireland-first scheme really offer? A finite sum is available for all waiting list activity, so if every person who has the financial means to travel south to Dublin or elsewhere for treatment does so, that money will be gone and will not be available for treatments locally in Northern Ireland. Those who are next in line, who have waited the longest, will miss out. It does not broaden capacity, and I struggle to see the benefits. It does not result in more people being treated: it just means that companies in Dublin will benefit financially. I suggest that the Minister looks again at the proposed scheme. Health and social care (HSC) workforce statistics demonstrate that, in the six and a half years since the end of March 2018, the number of doctors in Northern Ireland has increased by 24%, which is more than 1,000. Over the same period, our number of nurses and midwives has increased by more than 2,500, which is a 17·5% rise. With all those additional staff, why do waiting times, emergency department (ED) performances and other metrics continue to head in the wrong direction? At paragraph 50, the updated elective care framework states:

"surgeons – one of the most expensive resources in the Health and Social Care system – spend less time in theatre than surgeons in other jurisdictions."

The Royal College of Surgeons advises that surgeons want to have more theatre time and be able to operate more. What progress has been made on improving that position? The Secretary of State for Health and Social Care, Wes Streeting, said that, without better productivity and health prevention measures, health costs could "dwarf" other areas of government spending. Indeed, Professor Bengoa pointed out in the autumn that, without reform, our system, which now takes up more than half of the block grant, would soon require all the block grant. While Northern Ireland's performance deteriorates, NHS England confirmed last month that it has hit a key waiting target for the first time. NHS statistics confirm that 80·2% of patients who were urgently referred for suspected cancer were diagnosed or had it ruled out within 28 days. The Health Secretary and the Prime Minister have announced innovative plans to slash the waiting lists in England, although they are nowhere near as bad as ours. Patients are to be offered community diagnostic centres that are open 12 hours a day, seven days a week, where you can book scans after work or at weekends.

Thank you. Minister, I hope that you have some good news for patients who are on those waiting lists.

1,395 words. Text as published by the Northern Ireland Assembly.

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