Debate contribution: Multidisciplinary Teams in GP Practices: North Belfast
Debate contribution by Mr Mike Nesbitt on .
- MLA
- Mr Mike Nesbitt
- Party at the time
- Ulster Unionist Party
- Date
- 21 April 2026
- Type
- Debate contribution (made as a minister)
- Business
- Adjournment
- Heading
- Multidisciplinary Teams in GP Practices: North Belfast
- Assembly identifier
- Official Report component 5498159
Read the official Assembly record
Text
Thank you. Let me begin by trumping Mr McGrath, because North Belfast was my first home. I spent my first five years in a house on the Lansdowne Road off the Antrim Road. I welcome every opportunity to discuss MDTs, particularly in North Belfast, so I thank the Member for bringing that into focus. I also welcome the GPs who are here to listen to the debate. I understand entirely that, while MDTs are really good for patients and service users, they do not ease the burden for GPs one iota. In fact, it can be argued that they make life more difficult. Do you want to refer somebody to a physio in another setting, or do you want to manage a physio who has joined your team? Arguably that can make life a little more difficult for GPs, but it is really good for patients. There is an issue with many GP surgery premises not having the space to expand to take multidisciplinary team members on board. I say to the Member that I will contact the Minister for Communities about the Clifton Street surgery to see whether his Department can give some much-needed certainty on Girdwood. I applaud the Member's devotion to her constituents, which I saw in action at the weekend on another matter. MDTs are currently available in seven federation areas, and we continue to increase the service in a further five areas, securing a rate of 63·5% of patients being handled in primary care in those federation areas. We are avoiding referrals to secondary care, and, personally, I am delighted that that is already happening. As it is at a local level, the model is responsive, accessible and consistent with my desire to shift left into prevention and early intervention. Members will, I hope, be aware of my commitment to reform and transformation. I am particularly pleased that we got the £61 million that Mr Kingston referred to from the transformation fund for the next phase of the MDT programme. That gives us the opportunity to commit to expanding the implementation of the programme. Indeed, the North Belfast Federation is currently benefiting from that additional resource, as it continues with its MDT implementation journey. I have to say to Mr Kingston that he needs to have a word with his source, because the idea that that has been frozen is simply not true. We are continuing to implement over the three years of the plan; there is no freeze. Phase 1 of the implementation plan runs from the 2025-26 financial year to 2029-2030 and will see MDTs being completed in 12 federation areas, including North Belfast. The remaining five will continue with the MDT implementation plan, which runs through to 2033. I know that that is a long time, and I share Members' frustration that it is taking so long to roll it out fully. Mr McGrath talked about the inequity of it being in some places and not in others. Ms Ní Chuilín will be aware, from her work in the former Ad Hoc Committee on a Bill of Rights, of the concept of progressive realisation, and that is where we are at with MDTs. As of 31 December 2025, working with the GP Federations, practices and the local trusts, my Department had implemented the MDT model across 136 GP practices. We have increased access for 928,000 patients, which is 46% of Northern Ireland's population, to one or more core MDT services, and that includes a total of 276 MDT staff and an additional 107 nursing staff across the region. Some £2·5 million has been invested across the five federation areas that are next to benefit from the roll-out in 2025-26. Approximately £500,000 of that has been spent in the North Belfast Federation area. The roll-out is well under way in North Belfast. During quarter 4 of the last financial year, 8·4 whole-time equivalent staff were recruited to MDTs, which means that about 90,000 patients currently have access to an MDT in North Belfast. In the current year, a further 10·5 whole-time equivalent staff will be recruited to North Belfast practices, further increasing the number of patients who can access those vital services. That will increase year-on-year, in line with agreed implementation plans, resulting in an additional 45·6 whole-time equivalent staff being employed in North Belfast, with an additional 114,000 patients having access to all services by the 2029-2030 financial year. The Department of Health acknowledges that the workforce is a key enabler for success, and the recruitment plan is cognisant of the very real challenges in the labour market and the vacancy and recruitment issues that are being experienced already across the trust.
The funding for MDT roll-out is in place, and we are moving as swiftly as we can, given the labour market challenges. To that end, the transformation funding supports critical planned investment for university training places above and beyond the existing intakes, providing a workforce pipeline in key professions that the MDT programme recruits from. Ninety places were agreed annually for 2024-25 and 2025-26. Those additional places comprise 40 social workers, 30 physiotherapists, 10 occupational therapists and 10 mental health nursing places. Phase 2 of the MDT implementation plan will run from 2029-2030 to 2032-33. It will see the completion of phase 1 federation areas and the full roll-out of the remaining five areas. It is anticipated that the annual MDT consultations will increase to over one million by March of 2033, with over 222,000 consultations in Belfast alone as a whole. That will be a significant contribution to providing closer-to-home access to much-needed services that can be accessed directly through the GP practice. Currently, 51% of referrals to MDT professionals are made directly without the need to go through a GP, freeing up valuable time for appointments. The MDT programme is an integral part of the reform of health services. It brings services to a local level and reinforces the value of general practice in delivering such services in primary care. Historically, people across Northern Ireland have revered and respected the role of the GP. Indeed, many continue to see the GP as the first point of contact when they feel the need for healthcare intervention. It is right for people to focus on general practice as a front door to health services. However, with the introduction of MDT specialists, people can access them through the GP route without the need to see the GP. The programme will not sit in isolation of wider primary care reform. It is an integral part of the new approach to healthcare through the introduction and implementation of the neighbourhood healthcare model.
Yes.
I thank the Member. Yes, the uncertainty of not having the Budget is resulting, for example, in us losing momentum. We had good momentum in tackling the waiting lists, so, yes, I would welcome the certainty of a Budget as soon as possible, and preferably a multi-year Budget. With my remaining time, I will touch on a couple of other points. Nuala McAllister talked about support for GPs. I hope that she is aware that we are now negotiating the next contract with the BMA's Northern Ireland GP committee. That can certainly be part of a broader consideration of how we support GPs.
Thank you, Deputy Speaker. GPs, amongst others, will be at the heart of the delivery of the neighbourhood model. The final thing that I will say is that the MDT roll-out in North Belfast will continue. There is no freeze. I know that it will be well utilised by local communities. It will continue to embed the important general practice for its people, and it will ensure that the GP practice continues to be the heart of the local community. I will finish with some words on community, because Carál Ní Chuilín talked about North Belfast and the legacy of the conflict. Certainly, if you take a map of the conflict and fill in the hot spots of the conflict measured by shootings, killings and bombings, and if you then take a contemporaneous map of the hot spots of mental health issues measured by completed suicide, attempted suicide, substance misuse and all the rest, you have a match, and North Belfast is as bad as it gets. I am very aware of that. I will not be around for the next mandate, but if I were, I would encourage the next Executive to think about the social determinants of health and ill health — poverty, housing, jobs, education — and about the social determinants of educational underachievement and of economic inactivity. They are the same social determinants across those three great evils, which are really sticky problems. If we came together as an Executive and an Assembly and tried to tackle them, think of the impact that we could have in areas of deprivation. Think of the real change that we could make to people's lives, how that would make us think of ourselves as legislators and how the public would think of this place. It would be a magnificent thing to do, and I encourage those who will be here after May 2027 to give it consideration.
1,531 words. Text as published by the Northern Ireland Assembly.
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