Debate contribution: Budget 2025-26

Debate contribution by Mrs Diane Dodds on 19 May 2025.

MLA

Mrs Diane Dodds

Party at the time

Democratic Unionist Party

Date

19 May 2025

Type

Debate contribution

Business

Executive Committee Business

Heading

Budget 2025-26

Assembly identifier

Official Report component 4968641

Read the official Assembly record

Text

Like Mr Donnelly, I welcome the Budget, realising that it is not everything that we may have asked for or wanted but that it is a significant platform from which to move forward for our health service. I also welcome the additional £50 million for waiting lists and the ring-fencing of the £215 million. Those are important steps forward. However, it is the allocation of the Budget that will be so important and that will make the difference. It is about prioritisation — the making of decisions on how best to allocate funding on the basis of the needs of our health service and general population. That may require doing things differently or deciding that an alternative approach is necessary. One thing is certain, and it was reinforced by Professor Bengoa when he was here last October: reform of the health service is essential. As Professor Bengoa said, without reform, and by doing everything the same way all the time, the Department of Health will soon demand and eat up our national Government's entire funding for Northern Ireland. It is really important, therefore, that we look not only at prioritisation but at reform of health services. We in the Chamber should remember that we spend more per head of population on health than anywhere in the United Kingdom, but we have the worst outcomes and longest waiting lists. Our cancer waiting times are an absolute disgrace. Two thirds of women who discover a lump in their breast are not seen by a consultant within the departmental target waiting time. That is a shame on all of us and on the system that has allowed that to happen over a long time, so reform is not an option; it is an imperative. Without it, we will continue to let people down. We will continue to let women down. Last week, I got statistics from the Department that indicated that, in the Belfast Trust and the South Eastern Trust, 25,000 children are on a waiting list to see a paediatrician. Those are not acceptable statistics, so we must use the money that we have in the best way possible to get the best outcomes. Departmental officials recently informed our Health Committee that, of the £8·5 billion, £7·8 billion is simply being rolled over. I do not want to think that this is just more of the same from the Health Minister, because that is not good enough. All the nine programmes of care received a similar percentage increase. There was no indication of prioritisation to allow a focus on primary care, acute care or waiting lists. We cannot continue to do the same thing all the time, because we will just get the same or more difficult outcomes. Last year, administrative costs in the health service totalled £305 million, and management costs totalled £264 million. Well over half a billion pounds was spent on bureaucracy. It would be hard to find anyone in Northern Ireland who thinks that they got value for money for that spend. Department of Health staff now total more than 1,200. That exceeds the number of staff who were in the Department and on the Health and Social Care Board (HSCB) before the board was dissolved. The current £109 million in departmental administrative and management costs exceeds the respective joint total for the HSCB and the Department prior to that board's dissolution. Much of the rationale for removing the Health and Social Care Board was to reduce bureaucracy and avoid duplication. We went through the pain of abolishing it but have ended up with greater costs and even more staff. That is not an example of reform. We need to find genuine efficiencies, not simply moving people out of one office and into another, and provide more funding for front-line services. That is what people expect of us, and that is what we should be given. I should probably not open this can of worms, but trusts have some really good initiatives. I was reading at the weekend about some in the Southern Health and Social Care Trust, but there is no uniform delivery of healthcare across Northern Ireland. What a person in the Southern Trust can expect to get is not the same as what someone in the Northern Trust can expect. I do not think that those inequalities are good enough for a modern-day health service. Other contributors to the Budget debate mentioned health estate funding. Minister, I cannot go past the appalling management of capital projects in the Belfast Health and Social Care Trust. It is 15 months since the handover of the maternity hospital to the Belfast Trust. Last week, the Health Committee received a letter saying that the trust could not give us any indication of when the building would be safe to use and safe to be occupied by mothers and babies. That is just not good enough. I have said this before, and I will say it again: the mishandling of projects needs an independent view from someone who comes in and says what is going wrong and how we can save the health service money. The acute mental health inpatient building in the Belfast City Hospital grounds opened in 2019. It will take potentially millions of public funding to set it right. It is just not right. I turn to waiting lists. Minister, I welcome the ring-fencing of £250 million and the additional £50 million, but the Health Minister said that that would mean his having to find £165 million from his budget. I might be looking at that in a simple way, but I think that the Health Minister's job is to find money in his budget to tackle waiting lists. In his initial brief on the Budget —

— he said that he would ring-fence £76 million. There are many challenges, Minister, and many things to do in the year ahead.

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

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