Debate contribution: Support for Young Adults with Learning Difficulties and Complex Needs: Mid Ulster

Debate contribution by Mr Mike Nesbitt on 20 January 2026.

MLA

Mr Mike Nesbitt

Party at the time

Ulster Unionist Party

Date

20 January 2026

Type

Debate contribution (made as a minister)

Business

Adjournment

Heading

Support for Young Adults with Learning Difficulties and Complex Needs: Mid Ulster

Assembly identifier

Official Report component 5348952

Read the official Assembly record

Text

Thank you, Deputy Speaker. Before I turn to the prepared remarks that you would expect me to have, I want to acknowledge — not just acknowledge but admire — Emma Sheerin's passion in trying to help her constituents and in ensuring that Callan gets to live his best life. His particular set of circumstances mean that he needs help to do that, and I get it that that help is not there.

I also get that Cherisse, the mum, was not happy when I said that I would not meet her and instead referred her to officials.

I just hope that the Member understands that there is a kind of line that differentiates what I do from what I do not do. I will go out and meet patients, service users, their families and Health and Social Care (HSC) providers who work with children and adults with learning difficulties to inform myself about what is and is not working as a system. What I do not do, however, is meet individuals who are advocating for themselves or their loved ones. I have not added up the number, but the reason for that is that I have a strong sense that, since coming into post in late May 2024, I receive, I reckon, on average six requests a day via email and social media saying, "Please intervene. Please help". Some of them would break your heart, such as, "I'm sitting with my 91-year-old mother in an ED. She's been here for 18 hours, and nobody's looking after her" or, "We need a life-saving operation for my husband". I do not need to go into it. You get the picture. Again, I have not added them up, but, over that time, that is probably between 6,000 and 7,000 requests. If I start responding to all of them, we would have a two-tier system. We would have the Health and Social Care system for most and a Minister of Health national health system for 6,000 or 7,000 people. It feels brutal, but, if I did it, it would create an imbalance and a huge bias, and there would be no time left to do the strategic vision stuff as Minister of Health. I am sorry if that sounds brutal, but that is the reality of the position that I am in. As Robbie said, the Department of Health may lead on the issue, but there are other Departments that have to look at Callan's long-term needs, not least in education and housing, which are beyond my remit, in order to help him. Unfortunately, it is the case that, across the five geographic trusts, there is no specific programme of support for people with learning difficulties as distinct from people with a diagnosed learning disability. The appropriate support for people with learning disabilities will be determined by their specific needs. For example, if a person has complex needs that relate to healthcare, physical disability or sensory issues, it is a trust physical disability services team that assesses the individual and provides them with the relevant supports. Those might include, for example, the provision of specialist equipment, social care or signposting to other sources of support. If an individual has mental health issues, it is the local community mental health team that should provide that support. If it relates to employment or education, however, the trusts have no statutory remit to provide services. I will touch on direct payments, because it is something that came to me early in my tenure. I have taken a specific interest in it, and I came to the conclusion quite early on that we have overcomplicated it. We put too much responsibility on parents. We are asking them to be employers, and a lot of them say, "We don't want to be employers. We just want the right help for the child whom we love". It was put to me that the regime in the Republic of Ireland is a lot more user-friendly, and I have asked my officials to look at it. I think that it will all come under what I am coming on to now, which is our desire to introduce a learning disability service model. The Member asked what the model is: we are talking about a new model that takes a new approach to supporting adults with a learning disability through Health and Social Care services across the jurisdiction. I will set out the key outcomes that we want to achieve, the principles that will guide delivery and the actions that we need to take to improve services for people such as Callan and his mum. We have several key ambitions for people with complex needs so that they can receive lifelong, coordinated support that is tailored to their specific needs and enables them to make the right choices and have the appropriate level of control. As part of that model, we have consulted and have hosted regional, in-person roadshows that were largely attended by families and carers, as they should be. The topic of services for people with severe autism was raised during the events, as well as lengthy waiting lists for diagnosis, access to services and the lack of support and self-training. At the roadshows, concerns were raised about IQ testing as it relates to access to services for people with severe autism who present with a level of vulnerability that requires specific care and support. I want to be clear: trusts are commissioned to deliver health and social care services to adults who have a confirmed diagnosis of a learning disability. That is identified by trust psychology services and is done through the standardised testing of a significant impairment of both intellectual and social functioning during the developmental period, typically before the individual reaches the age of 18. For individuals who are deemed to have a learning difficulty, there is no dedicated commissioned service. An individual presenting with complex health and social care needs can avail themselves of a multidisciplinary assessment with specific and specified support and intervention, regardless of their learning disability or difficulty. While trusts will often consider which programme of care or service area will best meet an individual's needs under their "best fit" principles, it is acknowledged that it can be challenging to meet the ongoing social care needs of individuals who do not meet the access thresholds for existing statutory support services, such as learning disability, mental health or physical and sensory disability services. Most individuals with autism will be higher-functioning — that is having an IQ of over 70 — and will not, therefore, meet the criteria for accessing adult learning disability services. The analysis of the service model public consultation responses will be used to inform consideration of how individuals with severe autism who present with complex needs in adaptive and social functioning should access suitable social care services in a regionally consistent manner. I will not get through the rest of my notes, Mr Deputy Speaker, but I will say that, for Mid-Ulster, the Northern Trust's adult autism service offers short-term therapeutic interventions aimed at helping autistic adults to identify and understand their differences and find helpful ways of coping. All individuals aged 16 and over in Mid-Ulster who are waiting for an assessment and post-diagnosis support can also access the Northern Trust's adult autism advisory service. That service offers monthly drop-in advisory sessions across the trust area, along with virtual educational awareness sessions. I may be straying a little, but, on children's short-term breaks, Health Committee member Nuala McAllister was well aware that we were able to find some money to provide additional support. However, that is one of the rare areas in health and social care delivery where the primary obstacle to delivering better outcomes for the service users and their parents is not money; it is the workforce. You need a highly specialised and motivated workforce and the physical infrastructure such as buildings. That is where, frankly, we have faced massive challenges since we announced that we had found additional money to help in that area. The whole area is incredibly important. If we are going to let those young people have the opportunity to live their best lives, we need a coordinated and multidisciplinary approach. I finish where I began: we need the passion of MLAs such as Emma Sheerin to keep the issue at the top of the agenda for health and social care delivery.

1,407 words. Text as published by the Northern Ireland Assembly.

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Assessed 21 October 2026 at 14:16 UTC by jev-1.13.0 (requested as typesafe/jev) under rubric 2026.10-r9, methodology 1.9.

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