Debate contribution: Waiting Lists: Effect on Winter Preparedness

Debate contribution by Mr Danny Donnelly on 20 January 2026.

MLA

Mr Danny Donnelly

Party at the time

Alliance Party

Date

20 January 2026

Type

Debate contribution

Business

Private Members' Business

Heading

Waiting Lists: Effect on Winter Preparedness

Assembly identifier

Official Report component 5348368

Read the official Assembly record

Text

I beg to move

We tabled the motion on behalf of the patients who are waiting hours for an ambulance; those who are waiting outside a full A&E in the back of an ambulance, unable to get in; and for the patients who are in overcrowded emergency departments on trolleys, chairs and, appallingly, as we have seen, even on the floor. The motion is for the patients who are in corridor beds and wards and who are pushed into any available space, and for the staff — my colleagues — who have dealt with those pressures for long periods and who I have seen impacted on from working under those conditions. It has been a long road of continued warnings and repeated failures that have resulted in yet another year of crisis-point pressures on staff and patients in our healthcare system. When the Minister and departmental officials were called to an urgent meeting of the Health Committee in January last year, amid a spike in winter pressures, I took the opportunity to raise the winter preparedness plan. I was told by officials that planning for 2024 began in March, yet the plan was not published until November. At the time, the Royal College of Emergency Medicine (RCEM) described it as "too little, too late". That was a stark warning from front-line clinicians on the dangers of winter planning delay. The explanation offered for the delay was that the document had to pass through multiple layers of review with numerous stakeholders. We were then told by the Minister that the 2025 winter plan would be even more expansive, involving even more stakeholders and a blank-page approach that would begin in late February or early March at the latest. However, that is exactly when planning began the year before, and we already knew where that approach led. Publication was in November, when services were already under strain. Why repeat a process that demonstrably failed, particularly when starting from a blank page and promising even more consultation? I want to be very clear. I support co-design. I advocate for the involvement of healthcare professionals and experts at every level of health policy, but doing so in a way that slows delivery to the point of ineffectiveness is not meaningful co-design. To me, as a healthcare worker and as a politician engaging with stakeholders, it seems that those blank pages and big discussions were more of a big distraction from accountability. It is something that looks comprehensive on paper and something to say when asked that fails to translate into improved outcomes or reduced winter pressures. At the urgent Health Committee meeting in January last year, the Minister acknowledged that they would not crack winter pressures outright, but he said that they had to deliver:

"a significant, measurable and noticeable difference, not least for staff morale",

recognising the significant level of burnout across the health service. Yet, by October, the tone had shifted. At Question Time in the Chamber, the Minister said that he was not sure that he agreed that delays had any impact on staff morale and claimed that we were way ahead of the previous year. With respect, a rushed plan, published only three weeks earlier than the year before, is not way ahead. It is marginally less late. Ten days after that statement, a Health Committee briefing that was, bizarrely, mainly pictures acknowledged that moral injury to staff was one of the red lines that had already been crossed. Then, on 17 December, the Royal College of Emergency Medicine published its report, stating that morale was at "an all-time low". Its report contained deeply troubling testimony from clinicians, describing the harsh reality inside Northern Ireland's emergency departments. It was very clear that corridor care is undignified, causes harm and must be eradicated. Somewhere between acknowledging burnout and dismissing the impact of delay, the Minister's position changed. Unfortunately, the lived experience of the staff did not. Just before Christmas, the Chair of the Health Committee, Philip McGuigan, and I carried out a visit to an emergency department, unannounced, to understand the reality on the ground directly from the patients and the staff. I place on record my sincere thanks to the healthcare workers who took time in the middle of their exceptionally busy shifts to speak with us so openly and honestly. What we saw made one thing very clear: the winter preparedness plan had not delivered a significant reduction in pressure. It was a Sunday at around 9.00 pm, and during our visit there, up to nine ambulances were queued outside the department. At that point, the longest wait in the back of an ambulance was six hours and 21 minutes, and we were told that it had been seven hours the night before. Inside the department, there were 114 patients. Thirty of those patients had infectious conditions requiring side rooms, and 52 patients were waiting on trolleys. The longest wait for a bed in a ward in the department was four days and 16 hours. There were between 14 and 16 corridor beds in use, and there was no spare cardiac capacity. Only one respiratory bed was available for any patients who might require specialist non-invasive ventilation. Staff told us that flu was placing significant additional pressure this winter, with several patients requiring admission but no beds available. Wards were running with three extra patients each without additional staff. We were told that flow had stopped. When it becomes that blocked up, it becomes very dangerous for patients if emergency care is needed. While winter pressures are not new, ambulance delays and corridor care are no longer seasonal issues but are now year-round features of our system. On the night that we visited, around 100 patients in the hospital were medically fit for discharge but were waiting for care in the community. The figures speak for themselves. Patients are waiting far too long in inappropriate settings, and it is clear that harm will occur as a result of those delays. In 2022, the Royal College of Emergency Medicine, using the standard mortality ratio, worked out that there were approximately 1,400 deaths associated with long waits in EDs in Northern Ireland. In Scotland, in 2024, there were around 800 deaths. We have almost double the number of excess deaths here in Northern Ireland, where the population is three times smaller. The Minister wanted measurable differences, yet, when I have asked repeatedly about the standard mortality ratio, the response has been to say:

"Determining causality in such cases is complex and not possible due to limitations in current data collection systems."

You cannot credibly claim that progress is measurable if you are not measuring the harm that you are trying to prevent. When the plan was published, I submitted a question for urgent oral answer, specifically to ask how the plan would reduce winter pressures. The Minister talked about vaccination uptake programmes, yet vaccination uptake by staff was not above 40% in any trust in Northern Ireland this winter. He discussed improving mental health and learning disability bed pressures to reduce demand on EDs by ensuring that the right care is available in the right place, yet the mental health strategy has been 80% shelved, with only 16% funded overall. We know that the PSNI is taking more than 100 concern-for-safety calls every day, almost none of which involves crime but people who need mental health care. He talked about supporting social care delivery in the community and improving the system flow in hospitals, yet independent domiciliary care workers, one of the most essential parts of our social care system, did not receive the promised pay uplift to the real living wage. Last week, the RCN released a report on the crisis in corridor beds. As previously highlighted, the Royal College of Emergency Medicine released an alarming report with testimonies from clinicians exposing the harrowing reality inside Northern Ireland's EDs. The Minister has spoken about avoiding ED attendance and admission for end-of-life care for people who have a preference to be at home; yet we recently had an inquiry into palliative care in Northern Ireland that concluded that palliative care is fragmented and under-resourced. I hope that the Minister will implement the recommendations in the report to improve that vital service. The winter preparedness plan was a rushed and uncoordinated paper, containing little that was genuinely new, and it was even released on social media before it was provided to members of the Health Committee. These may have been things that the Minister wanted to fix, but patients and staff are still suffering harm from severe consequences of winter pressures and a lack of planning and transformation. I call on the Minister to deliver detailed plans for winter 2026-27 no later than the summer of 2026. Warm words and good intentions are not enough. The impact of the Minister's winter preparedness plan was not significant, measurable or noticeable, and the staff are now more burned out than ever. This year's plan has failed.

1,502 words. Text as published by the Northern Ireland Assembly.

Assessment

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Assessed 21 October 2026 at 14:13 UTC by jev-1.13.0 (requested as typesafe/jev) under rubric 2026.10-r9, methodology 1.9.

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