Debate contribution: Mother-and-baby Unit

Debate contribution by Mr Mike Nesbitt on 7 October 2025.

MLA

Mr Mike Nesbitt

Party at the time

Ulster Unionist Party

Date

7 October 2025

Type

Debate contribution (made as a minister)

Business

Private Members' Business

Heading

Mother-and-baby Unit

Assembly identifier

Official Report component 5164641

Read the official Assembly record

Text

Deputy Speaker, thank you very much. A mother-and-baby unit is not overdue or long overdue: it is long, long overdue. Mr Robinson took us back 20 years: I will see his 20 years, and I will up it by 10. On 27 January 1995, my first son was born in the Royal Victoria Hospital. The first clinician to come in and examine his mother wanted to separate the two. They wanted to keep the baby, PJ, in the Royal and send Lynda to Knockbracken. I will never, ever forget the look of horror on her face. I found the strength from somewhere to call for a second opinion, and the two were not separated that night. Sian Mulholland talked about the joy and the life-affirming experiences that women have when giving birth, and we should remember that. It is pretty joyous for dads as well, by the way. However, one in five is a huge number that we need to address. Please be in no doubt that I consider the absence of a dedicated mother-and-baby unit in Northern Ireland to be an absolutely glaring gap. As many Members have said, we are the only part of the UK without such a facility; indeed, there is none in the Republic of Ireland, and I will come back to that. We have to go straight to the finances. Members are well briefed on the context in which I operate. The health service is under immense pressure, with unprecedented demand across all areas and resources stretched thin. The funding gap of £600 million is unprecedented, and, at the moment, I am finding it unmanageable. To establish a mother-and-baby unit, we will require significant capital and revenue investment, because it is not just about infrastructure; it is about staffing, training and ongoing service delivery. Let me be clear that I am fully committed to establishing a regional mother-and-baby unit. We began with an outline business case, which was submitted to the Department by the Belfast Trust on 22 September this year. That led to economic and financial analyses. Normally, those are done first by the Belfast Trust and then by officials in my Department.

To minimise further delays, my officials are already working in parallel to review and assess the business case.

I want that to be done at pace, but I also want it to be done accurately. Members will be aware that the Department of Health and Health and Social Care have not exactly had a glowing record with capital projects in recent years. However, when the new, interim permanent secretary took up his post and came to see me, he asked, "What do you expect of me?". I said, "I will tell you in one word, Mr Farrar: urgency. I want to see urgency". My officials know that I do not believe that I have seen urgency — or sufficient urgency — in developing the business case for the mother-and-baby unit. One of the big delays was a debate over whether it should be a six-bed unit or a seven-bed unit. The conclusion is six beds. The projected capital cost began at £11 million. As part of developing the business case, that has to come under review because we know that building costs continue to rise in the current environment. My officials recently secured Department of Finance approval to increase the delegated limit for capital projects. That involves hospital development, so the good news is that that means that time will not be spent on securing Department of Finance approval for the mother-and-baby unit project. However, following the announcement, in June, of the outcome of the UK-wide 2025 spending review, the Department of Finance has commissioned a Budget exercise that will determine the capital budgets for Northern Ireland's Departments for 2026-27 to 2029-30, so my ability to commit funding for any new capital projects will depend on my Department's capital allocation from that Budget process and the identification of sufficient additional recurrent funding to meet any additional resource departmental expenditure limit (DEL) costs associated with a capital project. We do not expect the draft Budget outcome to be confirmed until later this year, but it will inform the development of the Department of Health capital investment plan, and that will set out the projects to be taken forward over the next 10 years. However, let me emphasise again that, in my assessment, a mother-and-baby unit is right at the top of that list. The trusts and my other arm's-length bodies have identified capital funding requirements of around £3 billion over the next four years. That is more than £1 billion higher than the capital funding that we expect to receive. That suggests that the capital budget outcome may only be enough to address inescapable pressures. I simply want to manage expectations here. While I hope that the Budget outcome agreed by the Executive will also allow some partially committed projects, including the mother-and-baby unit, to be taken forward as planned, the possibility remains that there will need to be some form of delay. The position will be confirmed as part of the development of the capital investment plan, with a number of other important projects also to be taken into account. Those include the Antrim Area Hospital mental health inpatient unit, the Cityside Health and Care Centre in the north-west and Altnagelvin's new emergency department. However, before I finally commit to the proposed Belfast City Hospital site, I have asked officials to undertake a short, urgent review of possible alternative options. I want to be absolutely certain that we have considered all possible options, and I stress that that will not cause a further delay. It will be done as work continues on the business case.

Yes.

I thank the Member for the intervention. Yes, we are considering them. We are considering all options.

On an interim fix, I will first put on record the best practice requirements, as defined by the Royal College of Psychiatrists. A mother-and-baby unit should be co-located with a mental health acute inpatient unit; located close to an obstetric-led maternity unit; capable of facilitating a six-bed unit, which is the current plan; capable of facilitating all clinical services on the ground floor; have dedicated direct access to secured and exclusive outdoor space, desirably gardens; and offer easy access to wider public open spaces and amenities. As I have said, the Department received clinical advice, including from the SPPG, that there is no such facility that we can use as an interim location. If Members want to challenge that and say that they know of a location, I am all ears. If Members want me to overrule clinical advice, I am very nervous — very, very nervous.

For clarification, does the Member mean the best practice from the royal college?

I can check whether the clinical evidence has been provided to the Committee. Maybe the Chair of the Committee knows. If it has not been, we are more than happy to provide it, as well as the criteria, as defined by the royal college. As I say, we are going to look in order to be sure and potentially rule out any other long-term venues.

Yes.

What I have asked the officials to do is broader than that. I have asked them to look at whether there is any possibility of an alternative venue that could be an interim base for a mother-and-baby unit, and the answer that I have got back is, "No, there isn't". If Members wish, I will ask them to look yet again, because it is an incredibly important issue to me. Several Members mentioned the fact that we are not trapping the data. A group has been set up to try to look at how we start to do that. There had been some coding issues. I do not want to get too technical, and I certainly do not want to hide behind technicalities, but it seems that Encompass should be able to help us in achieving that goal. Transferring a mother and baby to a specialist mother-and-baby unit elsewhere in the UK under an extra-contractual referral has been considered for some cases. However, many mothers have talked about the emotional stress of being separated from their families, friends and local support networks. Often, those considerations outweigh the potential benefits of receiving care further afield. Members talked about building a mother-and-baby unit that would accept mothers and babies from across the island. I have asked officials to check whether there is any legal impediment to a child being transferred into our jurisdiction. I am not entirely confident that there is a solid answer to that, but it is certainly something to be explored. I confirm to Members that I explored with the previous Health Minister in the Government of Ireland the possibility of working together and, perhaps, tapping into the Shared Island Fund to secure a mother-and-baby unit. Unfortunately, those discussions did not produce a positive outcome. We are, therefore, basically on our own in that way. I thank Members who have acknowledged that the Department has been working to strengthen community-based perinatal mental health services across all five of our geographic trusts. We have invested in community-based specialist services, ensuring that mothers can access support close to home. Alongside that, we have been upskilling clinical staff, including midwives, mental health nurses and health visitors, so that they are better equipped to identify and respond to perinatal mental health issues. For my family, one of the saviours — I use the word "saviours" deliberately — was the community psychiatrist nurse, who was incredibly important in the journey that my wife had to go on. I ask the Members who tabled the motion to exert their influence over their party colleague the Minister of Finance, because we need the money — not just the capital, as I said — to make the mother-and-baby unit a reality. It is not just a clinical necessity but a statement of our values and of the extent to which we value one another. The Chair of the Health Committee made the point that if the issue were to affect only men, we would not be talking about a 20- or 30-year wait but, rather, would be celebrating the fact that the unit is in operation and would instead be examining and scrutinising how well it is delivering. I will finish where I began. The mother-and-baby unit is not overdue or long overdue but long, long overdue. If it is the will of the House, I see no reason that we cannot get on with it, but doing that will take time. If we can find a way of doing it somewhere else more quickly, we will do that. If there is a way of putting in place an interim arrangement, I am open to that idea. I will not go against clinical advice, but I will ask the clinicians and others to have one final look at providing an interim solution. I have no confidence, however, that the answer will change from being one of it is not possible. My focus is on making the mother-and-baby unit happen, because I have a vested interest. For 30 years, mothers have been going through the experience that I witnessed in January 1995, and that, by definition, is simply not good enough.

1,892 words. Text as published by the Northern Ireland Assembly.

Assessment

Not flagged

Jev’s structured answers

Assessed 21 October 2026 at 13:21 UTC by jev-1.13.0 (requested as typesafe/jev) under rubric 2026.10-r9, methodology 1.9.

Disagree with this assessment?

Classifications can be challenged. A person reads every challenge, and any change is recorded publicly above with its reason.

Challenge this classification