Debate contribution: PSNI: Pressure due to Health System Failings

Debate contribution by Mr Mike Nesbitt on 1 December 2025.

MLA

Mr Mike Nesbitt

Party at the time

Ulster Unionist Party

Date

1 December 2025

Type

Debate contribution (made as a minister)

Business

Private Members' Business

Heading

PSNI: Pressure due to Health System Failings

Assembly identifier

Official Report component 5269490

Read the official Assembly record

Text

Thank you, Deputy Speaker. There is only one place where I feel comfortable beginning, which is by acknowledging as critical — I repeat: "critical" — the issue of the right person with the right skills responding to somebody in mental health crisis. When I say "critical", I mean "potentially life-saving". I hope that no Member has any doubt that I have a focus on the issue. In fact, when it comes to mental health, others in the House have acknowledged for some time that I was the first MLA to bring a focus to the issue of mental health, long before it was a popular talking point. I will not embarrass people by naming those who derided me and scoffed at me for trying to make it an issue all those years ago. Those names include not only political commentators; I am sorry to say that they also include elected representatives. I like to think that, today, everybody is on board. The motion is interesting. The first sentence expresses "grave concern" at "failings" in the system. Members should be well aware that, in my opinion, the HSC system is the workforce; the wonderful 70,000-odd people who deliver health and social care to a truly high standard daily. I make no apology for refusing to join the Alliance Party in claiming that the health service is broken. I saw a social media video to that effect yesterday. Pathways may be badly damaged, but, when you receive care, you get first-class treatment. The motion states that only 3% of the mental health calls that the police respond to are linked to crime. I do not dispute that, but the motion does not acknowledge the fact that the majority of all PSNI responses are not linked to crime. It is not helpful to isolate the mental health response in such a way as people may consider it as an outlier: it is not. We then get to the old trope: Health gets over half the Executive Budget. The motion refers to half the "entire" Budget. Is there a difference between half the Budget and half the "entire" Budget? There may be. The former is clearly a statement of fact; the latter may read like a party political statement. What happened to objective assessed need? Two Members who signed the motion are members of the Health Committee. Do they not care about the objective assessed needs of our people? I accept that Health needs to rationalise, stabilise, reform and deliver but not because of some random percentage; rather, because it is the right thing to do. It is the right thing to deliver better outcomes. The motion calls for the prioritisation of the mental health strategy, but it does not explain how I should go about doing that. Under section 29(1)(a)(ii) of the Northern Ireland Act 1998, members of the Health Committee have a statutory obligation to "advise and assist" me when they call for the prioritisation of a specific health service. Is saying, "Prioritise mental health", without advising how to do it without damaging other services and service users, really advising and assisting? I will now focus on Right Care, Right Person. I was a member of the Policing Board when the current Chief Constable first mentioned it. I supported the intention. I accepted the Chief Constable's contention that his officers were not trained to respond. That said, I asked whether it would make more sense to fund the training of police officers to be those first responders, but that argument has been lost. When I took up my current role, not only was I aware of Right Care, Right Person; I wanted my officials to explore the possibilities as a matter of urgency. I will touch on the timeline, because some Members have given the impression that the approach has been in development for many years. As I said, I heard about it first when Jon Boutcher became Chief Constable in late October 2023, which is around two years ago. When I took up post at the end of May last year, I jointly chaired an initial meeting between my officials and Assistant Chief Constable Ryan Henderson, who is the lead officer on Right Care, Right Person for the PSNI. That meeting was held on 22 August. For the avoidance of doubt, it was not 22 August just gone; it was 22 August 2024. Within 10 or 11 weeks of taking up post, I was trying to implement the Right Care, Right Person model. In the meeting, I articulated but one concern: we should not move so quickly that we create a hiatus where the PSNI withdraws before HSC is ready to fill the void. Assistant Chief Constable Henderson agreed with me. Where are we now? First, we need a regional partnership agreement. The status of that is as follows. We have submitted our thoughts, suggestions and preferences to the PSNI, so the ball is in its court. In fairness, I expect the police to take whatever time they need to respond to our suggestions. Members will know that these matters tend to be iterative. They go back and forth in search of the best deliverable agreed outcomes, but do the Members who tabled the motion know that? Comments have been made suggesting that my Department is in some way at fault or that nothing is being done. Furthermore, for clarity — this is an important point on the partnership agreement — will the Justice Minister sign it? Will the Justice Minister sign that partnership agreement? Again, I say for clarity that we have established appropriate governance structures, with key stakeholders from across the relevant organisations, in order to ensure a coordinated approach to future implementation. That includes the establishment of a Right Care, Right Person strategic group that is co-chaired by the Department of Health and the Department of Justice. There is the silver operational group co-chaired by the Department of Health and the PSNI. There have been no fewer than 10 subgroups established, which report to the Right Care, Right Person silver operational group. Each subgroup has been tasked with considering the implications of and preparing for the introduction of RCRP. The subgroups include inter-agency working, the issues associated with walkout and missing from healthcare, restraint, acute care pressures, issues relating to places of safety, approved social workers, how medical assessments are carried out, evaluations and outcomes, Mental Capacity Act considerations and, importantly, training. Work is well advanced to develop and agree memoranda of understanding between agencies that set out clear roles and responsibilities for each agency in responding to emergency calls for assistance. I am grateful to HSC colleagues for rising to the challenge, and, again, I reject the accusation of failure. It is vital that we monitor the impact on HSC services when we begin to implement RCRP. We will do that on a phased basis, beginning with the response to calls relating to concern for welfare. I also appreciate that the PSNI has been working in partnership with us to agree a date to begin implementation of the policy based on the assessment of readiness. The motion also refers to the Department receiving more than half of the Executive's resource budget. The Health budget was 50·5% of the 2025-26 Northern Ireland block, but that, in fact, represents a small reduction in Health's relative share of the block grant from previous years. The level of additional spending on health over that in England is now projected to be at a 10-year low in 2025-26, well below the 4% to 7% that, the Fiscal Council reported, may be necessary to meet the additional health need in Northern Ireland. That includes maintaining services, meeting demographic growth and increasing clinical standards. While England is ramping up the capital investment in the NHS to stimulate productivity, our investment in that area is also lagging well behind. There is clear evidence in the HSC of further expected growth in demand in acute and community services associated with an ageing population and year-on-year increases in demand for mental health, learning disability and children's services. The 2025-26 Health budget was not sufficient to cover the significant increases in costs that we faced as a result of pay and price inflation, increased National Insurance contributions for GPs, pharmacists and social care providers, rising demand and the ring-fencing of waiting list funding, which left a significant shortfall of £615 million.

1,403 words. Text as published by the Northern Ireland Assembly.

Assessment

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Assessed 21 October 2026 at 14:03 UTC by jev-1.13.0 (requested as typesafe/jev) under rubric 2026.10-r9, methodology 1.9.

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