Debate contribution: Neurology Services

Debate contribution by Mrs Diane Dodds on 9 December 2025.

MLA

Mrs Diane Dodds

Party at the time

Democratic Unionist Party

Date

9 December 2025

Type

Debate contribution

Business

Private Members' Business

Heading

Neurology Services

Assembly identifier

Official Report component 5296270

Read the official Assembly record

Text

I beg to move

Thank you, Madam Principal Deputy Speaker. Minister, just in case you are interested in how we think about health issues and those that we should debate in the Chamber, I recently attended an event at which a lot of neurology patients were present. At that event, I found groups of people who felt abandoned, who have lost hope and who felt that, even though they were able to speak to MLAs, they had no clear answers. So I made up my mind that we would have a debate through which you could, perhaps, give them the answers that they deserve. The review of neurology services, launched in 2018, followed the, at that time, largest patient recall in the history of the NHS. Nearly 5,500 people met the criteria for recall, and over 4,000 patients were reassessed. Almost one in five patients was advised that their original diagnosis was insecure. That illustrates a system that was not functioning properly or offering a high standard of care. Seven years on from the review, it is time that some action was taken to implement fully its recommendations. An estimated 40,000 people in Northern Ireland are living with a chronic neurological condition and rely on regular access to neurology services. The review was clear: we need more neurologists, more neurophysiologists, more neurology nurses and advanced nurse practitioners, and more allied health professionals (AHPs), psychologists, pharmacists and neuropsychiatrists. Yet, for those people in that room that day, it seemed that there had been next to no progress. Some could not even get a diagnosis. On-site neurology opinion should be available at every acute hospital receiving unscheduled admissions, with patients being seen by a neurologist within 24 hours, in line with recognised standards. We do not have that in Northern Ireland. In fact, one trust does not have a neurology service. In response to a question for written answer on the neurology review, the Minister stated:

"Progress on taking forward the agreed priorities set out in the report will be subject to available funding."

Another answer was:

"I will need to secure significant additional funding to take these matters forward."

I am disappointed that it seems to have become the norm for the Department of Health to have a new strategy, plan or service development, and even to have the adult protection legislation that we are considering, but to have no idea where the funding is to come from to implement them. As an Assembly, we should agree to end that approach, because we are promising people something that the Department is not delivering. The responsibility for review and reform lies firmly with the Department and the Minister. We cannot expect everybody else to fund those initiatives. That priority must be within the Department. At the weekend, the My Waiting Times NI website showed that those referred for a routine neurology outpatient appointment were waiting 192 weeks in Belfast — 192 weeks. The figure was exactly the same in the Southern Trust. In the Western Trust, it was 263 weeks. According to the website, those figures were up to date at the weekend. That is just over five years for a first routine neurology appointment. Minister, can you confirm the waiting time for routine appointments in the South Eastern Trust? At the weekend, the My Waiting Times NI website stated that that was 16 weeks; previously, it had been 14 weeks. I would like to know whether that is accurate, particularly in light of the figures in every other trust. The referral time for urgent cases is twice as long, at 35 weeks. Those figures do not seem to be quite right, but I would be delighted if they were correct. I would like the Minister to give some answers on those. Northern Ireland has only 25 full-time equivalent neurologists, with limited 24/7 emergency cover beyond the Royal Victoria Hospital. Only two of 138 core medical training places are allocated to neurology. How are we going to make up the deficit? How will we get more people in place to tackle the backlog of that terrible waiting list? The lack of timely access to neurology care causes deterioration in health conditions and a preventable rise in disability across Northern Ireland. Delayed access to neurology treatment can also be life-threatening. The economic implications as well as the implications for individual well-being are significant. Direct costs include ambulance call-outs, emergency admissions and longer hospital stays, while indirect costs due to lost productivity and the impact on informal care contribute to that economic burden. A 2024 study by the Economist Intelligence Unit estimated that 14·5 million people in the UK live with neurological conditions. The total direct and indirect burden was calculated as 4·3% of GDP, or £96 billion per year, as far back as 2019. Presumably, that figure is much higher now. The same study suggested — this is the most interesting part for us all — that timely intervention and timely and improved access to care could reduce those costs by a third. The figures are probably an underestimate, not just because they are based on 2019 data but because the study considered only 10 common neurological conditions, whereas, in fact, there are many. The impact of those waiting lists on people who are unable to secure a diagnosis, or even, as one person at that event explained to me, on people who have obtained a diagnosis privately, is that health services are almost impossible to access as well. I cannot emphasise enough, Minister, how much we need to invest in the neurology workforce and the introduction of minimum standards to ensure that all trusts provide timely access to care. Consultant time is not being used efficiently, because the workforce lacks the right mix of skills. A shortage of specialist nurses and allied health professionals means that many people go directly to consultants when other options may have been more suitable. I again plead with you on the issue of GPs. Your instinct to shift care to the community is right, but there will be great difficulty with that if GPs do not have the support to manage neurology patients who have complex needs. The report on the neurology review recommends the development of a broader skill mix through extended roles such as advanced nurse practitioners and advanced practice AHPs. That would ensure a more efficient use of resources. I presume, Minister, that the roll-out of the multidisciplinary teams in your reset will help with that as well. Those who suffer from neurological conditions, such as Parkinson's disease, epilepsy and the wide range of other such conditions, deserve something better than what is being provided. I would like you to address the waiting lists and the issues with the workforce. Unless we can address those two things in the debate, we will not give answers to the many thousands of people who are on waiting lists, without hope and in pain.

1,158 words. Text as published by the Northern Ireland Assembly.

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Assessed 21 October 2026 at 14:08 UTC by jev-1.13.0 (requested as typesafe/jev) under rubric 2026.10-r9, methodology 1.9.

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