Debate contribution: Budget 2025-26

Debate contribution by Mr Danny Donnelly on 19 May 2025.

MLA

Mr Danny Donnelly

Party at the time

Alliance Party

Date

19 May 2025

Type

Debate contribution

Business

Executive Committee Business

Heading

Budget 2025-26

Assembly identifier

Official Report component 4968635

Read the official Assembly record

Text

I will reflect on the 2025-26 Budget through the lens of health, which is a subject that affects every person and family across Northern Ireland. I begin with a welcome but also with some realism. The Budget arrives against a backdrop of sustained austerity from Westminster in a period of rising inflation and growing demand on a health system that is under immense pressure. I welcome the intent, but let us be honest: money alone will not solve the problem. How we use it will define whether the Budget represents a turning point or a missed opportunity. Yes, the £8·5 billion that was allocated to Health is significant — it is over 50% of all day-to-day spending — but, if we do not change how we work and not just how much we spend, we will keep cycling through the same crises. The Budget, though imperfect, gives us a platform. The challenge now is to use that platform not reactively but strategically. It is right that £215 million has been earmarked for elective care and to reduce waiting lists. That is essential. Patients have waited far too long, many of them in pain, and for some, sadly, it will be too late. This is not about queue lengths but about dignity and people being seen when they need help, not when it is too late. We have been through waiting list initiatives before, but what has changed structurally to stop them growing again? What is there to stop the Assembly collapsing tomorrow and there being another five years of inaction in this place? If the money simply buys short-term outsourcing and does not reduce the need for repeated cycles of intervention, we will be right back here next year. I turn to primary care, the bedrock of our health system and, as we have heard today, a part of the system that has been neglected for far too long. I welcome the £3·5 million that has been allocated to support GPs, dentists, pharmacists and family health services with increased employer costs, but let us not pretend that that addresses the deeper truth, which is that our entire primary care model is outdated for the demands that are being placed on it. GPs are dealing with complex and unmanageable pressure, and many have now been forced to consider returning their contract. They need adequate funding in order to prevent those contract hand-backs. They need multidisciplinary teams to be built up around them, with mental health professionals, social workers and physiotherapists, but many practices still do not have access to those supports. Our pharmacists have stepped up again and again by delivering vaccines, offering triage and keeping pressure off GPs and hospitals, but they are barely breaking even under the current model. Many are using their savings to keep their services running. That is not resilience; that is fragility wearing a brave face. Dentists are absorbing high-risk caseloads of children and vulnerable adults, yet they still operate under a contract that was designed for a different time. As we all know, few dentists in Northern Ireland now take on NHS patients. Then, there is the voluntary and community sector. So often the glue between statutory services and people's lived experiences, organisations in that sector work at the sharp end of health, tackling important issues such as sexual health, HIV awareness, addiction, domestic abuse, cancer support and mental well-being. Year after year, however, they are left in limbo, waiting to know whether funding will come through. Now we are seeing something even more worrying. Organisations such as Positive Life and others that were previously supported through the reduced core grant scheme are being left without the necessary funding to continue, and some are facing closure. Let us be absolutely clear: if those organisations disappear, the cost will be felt not just in our communities but across the whole system in GP practices, A&E departments and mental health crisis teams and in care for long-term conditions that could have been prevented, treated or managed earlier.

It is not just a moral failure; it is a strategic one. That is not a system that values prevention but one that chronically undervalues what works because it is not hospital-based.

Let us talk about transformation. The £21·3 million allocated from the transformation fund is welcome, and the further £25·7 million held centrally represents an opportunity. Let us not allow that money to sit idle. It must be activated quickly and aimed at shifting the foundations, not just tweaking at the top. I welcome the commitment of £69 million this year towards the new mother and children's hospital as part of the broader £671 million project, but that must not repeat the infrastructure mistakes of the past, whereby capital builds that went way over schedule and way over budget were still unfit for purpose before they were even open. We need real and working infrastructure that delivers for people, not just headline ribbon-cutting. This Budget does not solve everything, but it sets a tone. The question for the Assembly and for every Department and every Minister is whether we have the political courage to follow through. We cannot afford to paper over the cracks again. We cannot afford complacency or cynicism. What we can afford, and what the public expects from us now, is leadership. Let this Budget be the start of doing things differently. No more of the same, but better.

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

Assessment

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Assessed 21 October 2026 at 12:38 UTC by jev-1.13.0 (requested as typesafe/jev) under rubric 2026.10-r9, methodology 1.9.

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