Debate contribution: Waiting Lists: Effect on Winter Preparedness

Debate contribution by Mr Alan Robinson on 20 January 2026.

MLA

Mr Alan Robinson

Party at the time

Democratic Unionist Party

Date

20 January 2026

Type

Debate contribution

Business

Private Members' Business

Heading

Waiting Lists: Effect on Winter Preparedness

Assembly identifier

Official Report component 5348403

Read the official Assembly record

Text

Like others, I appreciate the motion that has been proposed today. All winter to date, just about every day, the evidence across social media and from the accounts of our constituents and medical staff has been that EDs are totally gridlocked, ambulance handovers are under exceptional and unprecedented pressure and waiting lists across outpatient, inpatient and diagnostic services are at levels that would have been unthinkable even a decade ago. Official statistics for emergency care waiting times from July to September 2025 show that just 44·7% of patients were seen within four hours and that 10,879 patients spent over 12 hours in EDs in September alone. On the evening of Wednesday 7 January, when I wrote my speech, the statistics for the winter period had not been released. I dread to think what poor statistics will be produced. On that evening, I looked at the average waiting times in Altnagelvin, which is the main and largest hospital in my constituency: they were sitting at 418 minutes — just under seven hours — just to be seen. That was reflected across the hospital network. The Royal College of Emergency Medicine's snapshot on 8 December 2025 of all nine major EDs found cubicle occupancy for patients awaiting beds at 137%, with 401 people waiting for an inpatient bed and 49% of them receiving care in non-designated spaces, including in corridors, on floors and in chairs. One patient had been in the ED for 124 hours — five days. Clinicians unanimously reported patients coming to harm in current conditions; indeed, the RCEM says that applying the standard mortality ratio to Northern Ireland's 12-hour admitted patient waits suggests a conservative estimate of 1,122 excess deaths in 2024 linked to long waits and unsafe conditions. We all know that overcrowding is not just an ED problem; rather, there is a whole-system flow failure, a phenomenon that the RCEM has documented extensively, including the mortality risk already referred to that is associated with long delays from arrival to admission, including ambulance offload waits of eight hours. When an ambulance cannot hand over, it cannot respond; when ED staff cannot move patients into wards, in effect, the front of the hospital jams; and, when inpatients who are medically fit cannot be discharged, beds remain blocked. That is the simple cascade that leaves patients in hospital corridors and has the RCEM telling us that staff morale is at an all-time low and that people dread coming into work simply because they cannot provide the high standard of care that they wish to provide. The Northern Ireland Fiscal Council's 'Sustainability Report 2022: special focus — Health' warned about the throughput constraints and the need to improve the efficiency of care delivery and hospital flow. Those warnings remain painfully relevant, even more so today. The winter preparedness plans published in recent years saw a range of measures, but, while they were worthy, with little funding for some they just have not been enough to prevent overcrowding and prolonged waits. The RCEM's several recommendations included calling for social care arrangements to be improved to help with delayed discharges, thereby restoring patient flow. The 2025-26 winter blueprint acknowledges the structural drivers, such as ambulance handovers, bed flow, discharge problems, proposed improved handover targets, vaccination clinics and extra GP sessions, but bed occupancy and discharge pressures remain through the roof.

The RCEM's recommendations did not stand a chance this winter. At the start of the winter pressures period, my colleague Diane Dodds revealed that, on 1 October 2025, 589 inpatients who were fit to leave had been left languishing in hospital. Addressing delayed discharges needs to be at the top of the agenda. Any plan that does not properly resolve patient discharge and care package issues is doomed to fail, and hospitals and emergency departments will only ever operate at a fraction of their real capacity if the elephant in the room is not dealt with decisively.

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

Assessment

Not flagged

Jev’s structured answers

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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