Debate contribution: Thrombectomy Service

Debate contribution by Mr Matthew O'Toole on 10 February 2026.

MLA

Mr Matthew O'Toole

Party at the time

Social Democratic and Labour Party

Date

10 February 2026

Type

Debate contribution

Business

Opposition Business

Heading

Thrombectomy Service

Assembly identifier

Official Report component 5435885

Read the official Assembly record

Text

Thank you, Principal — thank you, Mr Deputy Speaker. I was promoting you to Principal Deputy Speaker: I am sure that it will not be too long. Thank you to everybody who spoke in today's debate, and thank you to the Minister for responding. I think that we got some positive progress from the Minister, which I appreciate. Obviously, our job, as Mr Chambers said, is to hold the Minister positively and constructively to account, but I know that he wants to make progress in the area. I welcome some of the progress that he alluded to and that he wants to make in the weeks and months ahead. We in the Opposition and, I am sure, other parties and the Stoke Association will be working to hear more about that and, hopefully, to make progress on the specifics of the work on the business case, the areas for North/South cooperation and the costing that is going on internally in the Department. I thank everybody who participated in today's debate, but I thank, in particular, Clodagh Dunlop and Paul McLean who came to Parliament Buildings to share their stories with us; their colleagues and friends in the Stroke Association who have helped us put together the motion; and the Stroke Association's counterparts in Chest, Heart and Stoke, who have also worked hard in the area. As Paul and Clodagh will testify and as they have testified to us in the Building today, a stroke is not a binary event, as a sprain or a fracture is. A stroke is a life-changing event. It changes the lives of individuals, their families and all who work with them and care about them. To put it bluntly, it also has a repercussive effect on the public purse, because stroke outcomes can be severe — the most severe of all is death — and thrombectomy is a key part in reducing mortality. The level of disability for those who survive is reduced dramatically — dare I say, almost miraculously — if they can get access to speedy thrombectomy. That is particularly the case for people who are in earlier or middle age. They can have the opportunity to live something like the life that they would have led, had they not had a stroke. That is a special and profound thing. Danny talked about moral injury. People who work in the health service say that the most profound thing is the ability to heal, make better or at least minimise damage and that that, ultimately, is the vocation of people who work in the health service. Thrombectomy is a remarkable procedure that allows people to continue to work; be active, physical parents; drive their car; sometimes, to talk; and to retain certain cognitive facilities that they would not otherwise have. It is remarkable. There is, therefore, a profound moral case for us delivering the service on a 24/7 basis. Not a huge number of people will avail themselves of thrombectomy, but the effect for the people who require and avail themselves of the procedure, as Paul and Clodagh have told us today, can be transformational and remarkable. How do we get there? How do we get to a 24/7 thrombectomy service in Northern Ireland? I am pleased that the Minister has indicated that he wants to move in that direction. We are often oppositional here, and we hold Ministers to account for one thing and another. We are holding you to account for it, Minister, but we also welcome the fact that you want to move in that direction. It is true that, when the stroke action plan was published in 2022 and gave an indicative date of 2024 for the introduction of 24/7 services, not long after, the institutions collapsed. That is a quick reminder of why we should never collapse the institutions here. It also means that we need to be realistic about delivering the services, but I think that it is realistic to do this and to do it relatively quickly. The Minister said that cost is a significant pressure: of course it is, and, of course, he and other Ministers but particularly him are operating in an extremely cost-pressured environment. The cost of £5 million has been quoted: I will not cavil at that, because I am sure that it has been arrived at seriously. We would encourage anything that can happen to make the service more achievable. Has every staffing option been looked at? I welcome the fact that the Minister's officials are already engaging with the Irish Government. If we are able to save lives in Donegal and Monaghan and the Irish Government can reduce the overall cost for you of delivering the 24-hour thrombectomy service to the Royal, it is a good thing, regardless of whether the phasing is before or after the service is there. That is a win-win.

My last point — not to sound too much like a wonky economist — is about dynamic scoring: do not just necessarily score the upfront cost but the saving. We have 48,000 people in Northern Ireland living with stroke. First, the people at the more acute end will be living with care of one kind or another every day. Secondly, they will often be lost to the workforce or will work less than they otherwise would. They may have a family member in receipt of carer's allowance. All those things mean that we can perhaps think about dynamically scoring 24/7 thrombectomy in Northern Ireland. I want to touch on a few comments made by Members in an extremely constructive and thoughtful debate. I thank all Members who participated. Órlaithí Flynn used the phrase — I think that I quote her correctly — that it is "clinically transformative and economically rational". That is completely true and was well put. There are many instances when we ask for an innovation in healthcare or a new experimental service where, perhaps, the cost saving is not entirely clear, even if there is a strong moral and medical case for it. This is both clinically and economically rational. It will save the public purse money because it will make people's lives better and improve outcomes. Diane Dodds made similar points and talked about what she had seen at Craigavon Area Hospital. Philip McGuigan talked about it as an invest-to-save project, which it is. As I said, Danny Donnelly, as I said, talked about his experience, which we have heard about before, as a healthcare professional and about the moral injury resulting from a healthcare professional knowing that a person's outcome could have been better and that a worse outcome was entirely preventable. This is an instance when we can prevent that. We often talk about Northern Ireland missing targets profoundly. This is not an area in which we are dramatically far behind other jurisdictions. We are, I believe, on a percentage basis, ever so slightly ahead of England when it comes to provision of thrombectomy, but that does not mean that we should rest there. Patsy McGlone and Linda Dillon made strong points about ambulance availability, and I will come on to that if I have time. Everybody who is eligible for a thrombectomy, whether they live in the most rural area and regardless of what time of day or night they have their stroke, should have access to thrombectomy, ideally at the Royal Victoria Hospital. Those things are achievable. On the cross-border point, if we can get people from Dunfanaghy or Donegal town or from Ballybay, Clontibret or wherever else in Monaghan to Belfast more quickly to get their thrombectomy at the Royal, let us do that, too. That will improve outcomes for them and reduce the cost to the health service up here. That is something that we can do. It is achievable, and I welcome the fact that the Minister is engaged on it. The Minister has been clear and consistent about his priorities around reformulating services and shifting left. This could be a profound shift left for people who get thrombectomy — people like Paul McLean — and their lives can be saved. In Paul's case, his life was saved. It is all about timing. About 18 years ago, I was with my dad down the road in the Ulster Hospital, and he got his last rites. He was not a stroke patient who was eligible for thrombectomy, but he nearly died — but for having been with some friends who spotted the signs of stroke. He had an extremely serious bleed, but he is alive. His life changed. He could not do lots of the things that he would have liked to do and that he did before, but he met his grandkids. That is extremely important. I commend the Minister for the progress that he wants to make in the area, and I hope that we can make progress. I look forward to hearing more about it in the months ahead.

1,495 words. Text as published by the Northern Ireland Assembly.

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Assessed 21 October 2026 at 14:52 UTC by jev-1.13.0 (requested as typesafe/jev) under rubric 2026.10-r9, methodology 1.9.

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