Debate contribution: Budget Bill: Second Stage

Debate contribution by Mrs Diane Dodds on 24 February 2026.

MLA

Mrs Diane Dodds

Party at the time

Democratic Unionist Party

Date

24 February 2026

Type

Debate contribution

Business

Executive Committee Business

Heading

Budget Bill: Second Stage

Assembly identifier

Official Report component 5404259

Read the official Assembly record

Text

I do not know how long I will take, but I will certainly not wander into the Celtic mists of everything being fine with the health service in the Republic, where you have to pay to see the GP. As health spokesperson for the DUP, I will spend my time talking about the Health budget and the position in which we find ourselves. The Health Committee was briefed on the budget position last week. At first glance, it makes for dispiriting reading. On the positive side, however, the outline figures contained all the anticipated wage pressures. I am pleased that, unlike in the current financial year, the Minister has, at the very beginning of the next financial year, turned his attention to the health service's most valuable asset: its staff. For too long, the Minister and the Department have left that issue until the end of the year, and salary increases that were paid some time ago in other parts of the United Kingdom have been left to the very end of the financial year in Northern Ireland. We will, however, need to see much more detail on public-sector pay, and I hope that the Minister will soon be in a position to provide that detail, particularly on the real living wage for domiciliary care workers. An important promise was made, and the Minister must address the issue. Equally, waiting lists should be prioritised in the budget. The funding in the budget that is directed specifically at waiting lists should be delivered at the outset of the year. Last year, a very difficult precedent was set for the health service budget: £73·4 million allocated to waiting lists went instead to paying off the deficit. That means that we are still not reducing waiting lists at the rate at which we should be and that people continue to wait in pain for a long, long time. While I am on that issue, I say to the Executive and to the Finance Minister, since he is in the Chamber, that the Committee was briefed on waiting lists by the Southern Health and Social Care Trust two weeks ago. They told us that they had interrogated the waiting lists in their trust area and reduced them by 40%. You are the Minister concerned with ensuring that we have accurate data to assess what is going on in Health and with the Budget: surely we should be able to do much better than that. Such figures need much greater interrogation. There has been much discussion about savings and how to meet pay commitments, deliver change and reduce waiting times. This year, to be fair to the Department and the Minister, trusts were able to make significant savings on a range of service delivery options. Importantly, those included a reduction in the use of agency and temporary staff. That kind of interrogation needs to continue in order to see not just savings but long-term investment in staff and service delivery. Investing only in agency or locum staff is not good enough. We need the long-term investment in health service staff that will enable us to build services in Northern Ireland rather than just manage where we are. The interrogation of trust and Department of Health budgets must also include a prioritisation of funding that is aligned to the key objectives of reform and delivery. We need to see the Minister outline his priorities in the Budget, rather than continually asking for more funding from Executive colleagues. Like the Chair of the Health Committee, I was heartened to hear the new permanent secretary in the Department of Health indicate that they all acknowledge that. All of us in the Chamber — I know of no one who would demur from this — want to see more done in healthcare, but other services matter too. When we have an Executive Budget that is under such pressure, each Department must do its best to protect services and deliver value for money. There is certainly plenty that can be done to make sure that we deliver value for money. There are plenty of questions that can be asked to make sure that the trusts and the Department are working to make that a reality. I will give an example of something in which we are completely unsure about and have no evaluation of such spend and its value for money. I recently asked the Minister about the leadership centre. It is a rather obscure centre in the health service; I do not know how many have heard of it. The centre has 326 associate consultants. They have experience in a range of issues: for example, 194 are listed as having experience in facilitation; 176 have experience in investigation of grievances; and 167 have experience in report writing. My goodness, if a star was given for report writing, we would get it. Over the past six years, spending on that centre has doubled from just over £3 million in 2019-2020 to £6·5 million in 2024. The centre also uses consultancy firms. It is unclear how the centre's delivery of value for money is evaluated. We need much greater transparency from the Minister on that issue. Of course, the Minister has told us that he will introduce a Bill on a duty of candour: we could certainly have more candour on departmental spend. Management of the Health budget will require prioritisation and difficult choices. I have led debates on our cancer waiting times, which are the longest in the United Kingdom. That is not just a clinical issue but a moral and ethical one. Cancer cannot wait. Only 6% of women in Northern Ireland who discover a concerning lump in their breast are seen within the departmental target time. In England, the Secretary of State for Health and Social Care is introducing a cancer plan: surely we need a specific action plan for waiting lists. While the Minister argues that that is within his elective care plan, it is clear that it is not working. The prioritisation will also require political parties in the House to make difficult choices. The Health Committee has been told that the implementation of the Hospital Parking Charges Act will cost £7 million. I know that the Minister wants to defer the implementation of the Act but cannot get agreement on the matter, particularly from the party opposite. However, if we consider that the savings on that might allow us, for example, to introduce a full-time, 24/7 thrombectomy service for Northern Ireland, those are choices that we must face up to. That service for stroke sufferers would not just save lives but change lives. Many consultants tell me that access to a thrombectomy a short time after a stroke is the difference between walking out of hospital and a lifetime of disability. It is estimated that 160 lives a year could be saved by the introduction of that full-time service. Surely, it is important for us to make those obvious, evidence-based choices and not just simply grasp at what is popular. The Minister has also indicated that he has put in high-priority bids for the reform of primary care and his neighbourhood health model. Implementation of that reform will ultimately require the transfer of funding from the expensive hospital model to care in the community. I understand that trusts have been asked to make sure that they transfer 2% of their budget in the next year to begin that process. In my view, it should be about new or expanded community services that actively take the burden from secondary services in hospital into the community, but I fear — we already see some of the trusts talking about this — that it may end up being a repackaging under the neighbourhood model of existing services. If we want to see transformation, we need to make sure that the money follows the transformation. That can be done only by trusts ensuring that they transfer money from expensive secondary care into the community. It will also require the Minister to settle his disputes with general practitioners and to make sure that we have a sound footing for that model going forward. We are also currently considering the Adult Protection Bill. The Minister has submitted bids in relation to that, and I understand the need to ensure protection for the most vulnerable. The scandal of Muckamore Abbey Hospital and Dunmurry Manor Care Home has heightened that need for change, so I accept that entirely. However, the Minister has also indicated on numerous occasions that he can implement the Bill only in bits and pieces, as and when he has the funding to do so. That would be a really difficult way to proceed. The Bill allows the state to exercise significant power over the lives of individuals. If we do not give individuals the support and the right to respond to that exercise of power by the state, we will fail those individuals, so I worry that that is an issue as well. I notice that, in the briefings from the Minister and the Health Department, there is nothing in the package about the issue of hospital flow. We cannot get people into emergency departments (EDs) in our hospitals because so many beds are being used by patients who are fit and well and able to go home. Yesterday, that number was 531. At a recent briefing by the Southern Health and Social Care Trust, we were told that over 800 care packages, either partial or full, were still to be fulfilled. We cannot make our health service work if the Minister does not direct his attention and some of the funding to that area. I will spend a little time talking about the Department of Health estates budget.

We are told that the available budget will allow work on the new children's hospital to proceed, but I do not see any contingencies for a situation where the budget overruns, which it almost certainly will. We already know that it is in difficulties, because the chief executive of the Belfast Health and Social Care Trust indicated to the Health Committee during her briefing a couple of weeks ago that new laws would mean changes to the contract. It defies logic that Construction and Procurement Delivery (CPD), presumably, and the health estates directorate are signing off on stuff that they know will have to be changed and will cost the taxpayer more money.

I have repeatedly called for an inquiry into how the Health Department and the Belfast Trust have handled the new maternity hospital on the Royal site. As the Chair of the Health Committee said, that hospital is long overdue. It is sitting there, brand new, looking lovely and cleaned every day, but it cannot be used. In fact, it is not safe to be used. In March — in another couple of weeks — it will be two years since the building was handed over to the Belfast Trust, but it is not safe for the mothers and babies who need it so badly. My sources tell me that, a few weeks ago, signs went up all over the building, indicating that the water was unsafe to drink. The trust's latest information to the Health Committee indicates that the repair work could take another 28 months. It should concern every single party in the Assembly that, if the trust holds even to that 28 months, it will be a staggering four and a half years since the building was handed over, and at a cost of many more millions. The trust openly acknowledges that that timeline is dependent on its fixing the problem. We could be facing a longer delay. Minister, I asked you questions about that in the House a couple of weeks ago. You seemed unconcerned; you said that that was a matter for the Health Minister to sort out. I ask you again: what are you, as Finance Minister, doing to hold the Health Department and the trust to account for that appalling situation? It cannot continue. Craigavon Area Hospital in my constituency, which was built in the 1950s or 1960s and has not changed, whose windows shattered and came in around people during a recent storm, cannot be rebuilt because we are literally flushing money down the drain with the flushing regime for the maternity hospital. I cannot understand why people do not want to grasp that issue and hold someone to account for it. It will take some kind of independent look at what happened to make sure that we learn lessons, so that it never happens again. I am disappointed that some things have not been acknowledged in the Budget. The Health Committee spent weeks on end discussing the palliative care situation in Northern Ireland. None of us knows when we might need the services of Marie Curie or the hospices in Northern Ireland. Currently, we leave dying to charity. We fund it at less than 40% of the actual cost, and charities and people who leave money in their will are left to make up the difference. If your family has experienced hospice care, you will want to give back. That is great, but the state needs to look seriously at how we fund palliative care and what we are doing to support people at a really vulnerable time in their life. These should not be things that are optional. They should be core principles and services of the Department and the Executive. It is to our shame that they are not. In closing, there are many, many challenges for the Health budget in Northern Ireland, but there are also some amazing, brilliant things that go on within the health service involving our health staff. We owe them a debt, because, as I have said many, many times, they are the glue that keeps our system together and keeps us running. It is up to you, Minister, to allocate the funding; it is up to the Health Minister to make sure that that funding is allocated in the right way; and it is up to the trusts to make sure that every line of their budget goes where it should go so that we stop seeing the waste that we see, particularly in relation to the capital budgets in Health, which I can only call a disgrace.

2,397 words. Text as published by the Northern Ireland Assembly.

Assessment

Not flagged

Jev’s structured answers

Assessed 21 October 2026 at 15:01 UTC by jev-1.13.0 (requested as typesafe/jev) under rubric 2026.10-r9, methodology 1.9.

Disagree with this assessment?

Classifications can be challenged. A person reads every challenge, and any change is recorded publicly above with its reason.

Challenge this classification