Transforming Your Care:  Implementation Concerns

Part of Private Members' Business – in the Northern Ireland Assembly at 11:45 am on 3 June 2014.

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Photo of Maeve McLaughlin Maeve McLaughlin Sinn Féin 11:45, 3 June 2014

Go raibh maith agat, a Phríomh-LeasCheann Comhairle.  I speak in favour of the motion.  I acknowledge that the amendment does not detract in any way from the motion.  It is our collective responsibility to pay tribute to the dedication of the front line staff.  That goes without saying.

It is worth noting that we are debating the motion at the same time as the Human Rights Commission has announced an inquiry into emergency care.  It is very serious when a human rights commission feels that it must investigate the people seeking emergency care in our hospitals.  We need to stop and think about what that means.  It means that patients, many of whom are in desperate need of medical intervention, are being so mistreated in A&E that what happens to them there may be a breach of their human rights.  Such a scenario would be totally unacceptable in any state institution, but in hospitals, which should be dedicated centres of care, it is an utter disgrace.  However, it is nothing new.  As some Members said, the College of Emergency Medicine, trade unions, the College of Nursing, the College of GPs, front line staff, patients, families, politicians and the local media have been flagging the issue for over two years.  I suggest that what we see in our emergency departments is only the front window of a system that is failing. 

Let us look at the facts across the system, which the Minister will point out, and let us look at the public opinion of Transforming Your Care.  The system has simply staggered from one crisis to another.  We have seen a crisis with children in care and child sexual exploitation; a ban on blood donations from the gay community; court cases on adoption and on banning trade unions from appointments; a crisis in residential care; 15-minute care packages; crises in our emergency departments; concern about children's heart services; concerns about a magnetic resonance imaging (MRI) scanner; and serious adverse incidents resulting in deaths in the Royal hospital.  We now have the mess that is the payroll system for our front line staff. 

Whilst the shift left of the £83 million for Transforming Your Care is laudable — let us be very clear about that — it is clearly lacking any measurable outcome framework.  There needs to be a particular focus on health inequalities.  In short, what will be the impact of this shift left on, for example, residential care, domiciliary care, our emergency departments, access to GPs, access to connected health and health services staff?  It is unacceptable that that work was not developed alongside the proposals to move towards Transforming Your Care so that wider communities could have confidence in this system.  In its absence, as I stated, we have simply staggered from one crisis to the next. 

I want to make particular reference to the Put Patients First campaign.  The recent Patient and Client Council report on access to GPs found that 26·5% of people were dissatisfied with the access that they had.  The Royal College of General Practitioners has clearly warned that that situation is not going to get better and that it will, in fact, get worse.  On average, and I say this in the context of the wider TYC situation, GPs in the North of Ireland carries out around 12·4 million consultations a year.  According to the Health and Social Care Board, there has been a 7% rise in that activity over the past 12 months.