Debate contribution: Excess Deaths Linked to Long Emergency Department Waits
Debate contribution by Mr Mike Nesbitt on .
- MLA
- Mr Mike Nesbitt
- Party at the time
- Ulster Unionist Party
- Date
- 20 April 2026
- Type
- Debate contribution (made as a minister)
- Business
- Question for Urgent Oral Answer
- Heading
- Excess Deaths Linked to Long Emergency Department Waits
- Assembly identifier
- Official Report component 5493737
Read the official Assembly record
Text
In an ideal world, I would be with Mr Carroll in saying that the delivery of health and social care would be done entirely by Health and Social Care (HSC). We are far from being in an ideal world, however. For example, to tackle waiting lists through the initiatives that we began with last year's budget and that we hope to continue when we get a budget for this year, we will inevitably have to go to the independent sector, because we would otherwise not have the capacity in the HSC. Yes, I get what the Member says. His argument would be, "That is because you are putting money into the independent sector rather than investing it in building capacity", but, if we were to do that, tackling waiting lists would slow down and people would suffer, and the logic of that is that more people would die.
A multi-year Budget would be much better than a one-year Budget, but a one-year Budget would be much better than the position that we are in. I am not unique among Ministers in saying that the budget allocation that the Finance Minister has proposed is not enough for me to do everything that I need to do, never mind everything that I want to do. I am not an outlier in saying that. It just happens that my quantums are a lot bigger than anybody else's, even those of the Department of Education. As with last year, however, should we come to a position in which the question, "Do you support this allocation, even though it leaves you hundreds and hundreds of millions pounds short of what you think you need?" is put to me, my answer will be "Yes, but", and the "but" will refer to the fact that my budget is short of what I need and that something will need to happen between now and the end of the financial year or there will be an overspend. Last year, as the leader of the Opposition knows, what happened was the loan on the Treasury reserve. I got the thick end of £200 million from that. Had I not got it, we would not have been able to balance the books by that amount. It is worse this year. I am hoping for a Hail Mary pass — some sort of miracle — along the way, but I am not for walking away, because challenges should not be viewed as insurmountable obstacles that justify inaction.
I do not have that number, but I am sure that it exists and will certainly try to get it for the Member. On the issue that the Member spoke about, my focus is on the desire of the Police Service of Northern Ireland to move at pace — I think that it wants to move more quickly than before — towards a system called "Right Care, Right Person". The Police Service says that its officers are not trained in mental health matters, so they need to withdraw, and that they should not be spending many hours sitting in EDs with patients. I get all that, but I remain concerned that there may be a hiatus between the police withdrawing and the health service being able to fill the gap. All we need is one patient to leave an ED and self-harm or harm somebody else and we will have another crisis and another moment at which people describe the health and social care system as "broken". I do not think that it is broken. Many of the pathways into it are badly damaged, hence the long waiting lists, but I believe that, once a person gets to the point at which care is administered, it tends to be world class. There are exceptions, of course, where things go wrong, but, by and large, it tends to be world class.
We are working on the Release to Rescue initiative to try to improve ambulance waiting times. There is a proposal that we start to roll that out on 27 April, which is only a week away. I have engaged with stakeholders, trade unions, the Ambulance Service and, more recently, the chief executives of the trusts. We are a little shy of certainties and reassurances. One thing that we need to do is to start to discuss how we might perform Release to Rescue emergency department by emergency department and hospital by hospital. To be clear, the intent of Release to Rescue is that no patient will wait for more than two hours in an ambulance before being handed over to the trust.
That is certainly an ambition. Corridor care is not unique to Northern Ireland. I think that I have said that I was in a brand new build in Washington DC — a new wing of the Georgetown University Hospital — that cost in the order of $700 million. It has a very large emergency department, compared with ours, in terms of its physical size and its capacity.
There was corridor care throughout it, with trolleys head to toe. I asked the clinician, "Has something happened? Is this unusual?", and he said, "No. This is a day-to-day occurrence, to the point where we have corridor care teams. We have doctors and nurses, and all they do is corridor care". That illustrates how difficult this will be. I do not want anybody to be waiting in a corridor, on a chair or on a trolley, so, yes, there is an ambition to see the back of it as soon as possible.
926 words. Text as published by the Northern Ireland Assembly.
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