Debate contribution: Home Care Provision

Debate contribution by Mr Mike Nesbitt on 12 May 2026.

MLA

Mr Mike Nesbitt

Party at the time

Ulster Unionist Party

Date

12 May 2026

Type

Debate contribution (made as a minister)

Business

Private Members' Business

Heading

Home Care Provision

Assembly identifier

Official Report component 5528715

Read the official Assembly record

Text

Mr Deputy Speaker, thank you, and thank you to all who contributed to this important debate. When I took up post nearly two years ago, it was put to me that Ministers tend to go out and about at some point on day one. It was suggested that I visit the Ulster Hospital, just around the corner from Parliament Buildings. I said that I did not want to visit a hospital. I was interested in visiting social care settings, because I was conscious that the "H" in "HSC" is very much dominant. I wanted to start an immediate focus on shifting left, because in an ideal world, in my mind, if you need health and social care, you get it at home, and if not at home, as close to your front door as possible. A hospital should be the last resort. I hope that Members understand that I am very much wedded to improving the lot of social care delivery for patients, service users and the people who deliver social care in our community. As we know, demand is increasing. Not only are the numbers going up but so are complexity and acuity. Many of us are living longer — I am a living example of that — and more of us are living with multiple long-term conditions and with frailty and cognitive impairment. Therefore, I will push strongly, in policy terms, to help people to live well and live independently for as long as possible, and home care is and will continue to be an essential service at the centre of that ambition. However, I also fully realise, as the motion highlights, that, like many other parts of the health and social care system, the home care sector is under significant and sustained pressure. Workforce shortages persist, and recruitment and retention remain challenging, particularly when other sectors may offer comparable or higher pay, as many Members have pointed out. As well as offering better pay, those sectors may offer more predictable hours and lower travel demands. I accept that rising fuel and travel costs have also had a disproportionate impact on home care, especially in rural and hard-to-cover areas, where staff often travel significant distances between visits. I understand that those pressures have real and visible consequences, such as unmet need in the community, increased pressure on families and growing strain on our hospitals because of delayed discharges, which, again, Members analysed during the debate. We also know that extended and non-essential stays in hospital are rarely conducive to good health outcomes, particularly for older and frail people. I want to be definitive and say that those challenges are not the result of a lack of commitment or professionalism in the sector. Home care workers and providers continue to go above and beyond, often under the most difficult circumstances. Those pressures reflect long-standing structural issues, demographic change, rising demand and years of financial instability and uncertainty. That brings me to the issue of the real living wage, which is, rightly, highlighted in the motion. The failure to secure agreement on a multi-year Executive Budget has materially constrained my ability to implement the real living wage within the timescales that I want. I have been clear about my commitment to the issue right from the outset, but meaningful reform in health and social care cannot be delivered on short-term financial settlements or year-to-year uncertainty alone. The independent social care sector deserves better than that, workers delivering essential care in people's homes deserve better than that, and Ministers trying to plan sustainability for the future of our public services require better than that. It is simply not credible to speak about transformation, workforce reform or long-term sustainability while Departments remain trapped in cycles of financial instability and constrained annual budgeting. I want to be equally clear that the delay in implementing the real living wage is not due to a lack of political will from me as Minister. It is now a direct consequence of the wider financial constraints and is worsened by the absence of long-term budget certainty. That is a matter of great professional frustration to me, because I completely accept the need to level the playing field for those working in the independent sector and to ensure fair wages for the challenging and important work that they carry out. I listened carefully to Mr McGuigan when he opened the debate, and I agree with him that it is counter-strategic. That is what I said to him and his Committee. However, I listened to him carefully and noted his language: the verb that he used was "demand". He demanded that, as Minister, I introduce the real living wage. I could not identify where to make the cut that would release the money to introduce the real living wage, so I will not demand anything; rather, I invite the Member, not least because he is Chair of the Statutory Committee that scrutinises my work and has a statutory obligation to assist and advise, to tell me where the cuts should be made.

843 words. Text as published by the Northern Ireland Assembly.

Assessment

Not qualifying

Jev’s structured answers

Assessed 21 October 2026 at 15:37 UTC by jev-1.13.0 (requested as typesafe/jev) under rubric 2026.10-r9, methodology 1.9.

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