Debate contribution: Budget 2026-29/2030: Reports

Debate contribution by Mr Danny Donnelly on 11 May 2026.

MLA

Mr Danny Donnelly

Party at the time

Alliance Party

Date

11 May 2026

Type

Debate contribution

Business

Committee Business

Heading

Budget 2026-29/2030: Reports

Assembly identifier

Official Report component 5524126

Read the official Assembly record

Text

Thank you, Principal Deputy Speaker. I speak today as Alliance health spokesperson. There is almost broad agreement across the Chamber about the need for a fairer financial settlement from the UK Government. Northern Ireland continues to be underfunded according to objective need, which places enormous pressure on public services, especially health. However, we also need to be honest with ourselves: over many years, we have continued to put increasing amounts of money into health — it now accounts for over half of the Executive's overall Budget — but outcomes have not improved at the pace that patients and staff deserve. We have heard warnings that, unless the service is transformed, that proportion is set to increase to 75% by 2050. Something fundamental needs to change, and we need a three-year Budget. Mike Farrar, the permanent secretary, has said that another one-year budget would make it almost impossible to deliver the necessary savings and that it would jeopardise the vision to transform Northern Ireland's healthcare system. The Fiscal Council is right to warn that the current position is not sustainable without either new recurring funding or significant reform. If we do not strategically review departmental expenditure and prioritise sustainability, we will simply continue to lurch from one financial crisis to another. Last week at the Health Committee, the permanent secretary said that Northern Ireland could be in a prime position to successfully deliver a neighbourhood care model because of the size of our health system. That should be seen as an opportunity. It was also confirmed at Committee in December that efficiency work was only beginning. Frankly, that should have happened much sooner; it should not have taken the arrival of a new permanent secretary to kick-start serious work on efficiency and sustainability. The Minister should have been driving that agenda long ago, but real change requires action. That is why transformation cannot remain just another slogan. "Shift left" has to mean more than just words; it has to mean real investment that reaches the front line of community care. That means properly supporting GPs, community pharmacy, mental health services, social care and early intervention services. We also need urgency around reform. When we see 12-hour A&E waits increasing by 14% in the past year and when we are repeatedly warned that that has a direct impact on excess deaths, with over 1,000 a year being associated with 12-hour waits in A&Es in Northern Ireland, it is clear that difficult decisions need to be made. Had they not been avoided for so long, we could deliver meaningful change. We cannot continue to ask front-line staff to carry the burden of a system that, everyone knows, is not working. Alliance welcomes the Minister's previous commitments to prioritise healthcare staff pay from the beginning of the financial year, because staff deserve certainty and fairness after years of pressure and instability. However, those commitments need to be delivered on. Carers also deserve the real living wage, as was promised. It should go without saying that there is no health service without healthcare workers. Health workers have carried the system through some of its most difficult years. They deserve more than just warm words; they deserve proper support, fair pay and a health service that is sustainable for the future. There are also opportunities for invest to save. One example is the expansion of the thrombectomy service from a nine-to-five service to a 24/7 service, which would end the inequality in the delivery of a treatment that saves lives and prevents disabilities following a stroke at a saving of £47,000 per patient treated. That cost-effective service should be invested in. The Budget must be about more than simply managing crisis after crisis. It must be about reforming how services are delivered and focusing on creating a sustainable health service, not just cutting costs to meet a budget target until it is the next Minister's problem. That means that all parties need to step up and get behind the genuine transformation of the health service.

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

Assessment

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Jev’s structured answers

Assessed 21 October 2026 at 15:38 UTC by jev-1.13.0 (requested as typesafe/jev) under rubric 2026.10-r9, methodology 1.9.

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