Altnagelvin Hospital

Private Members' Business – in the Northern Ireland Assembly at 5:15 pm on 16 September 2014.

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Photo of Mitchel McLaughlin Mitchel McLaughlin Sinn Féin 5:15, 16 September 2014

The Business Committee has agreed to allow up to one hour and 30 minutes for the debate.  The proposer of the motion will have 10 minutes in which to propose the motion and 10 minutes in which to make a winding-up speech.  All other Members who are called to speak will have five minutes.

Photo of Pat Ramsey Pat Ramsey Social Democratic and Labour Party

I beg to move

That this Assembly recognises the importance of Altnagelvin Hospital in delivering excellent health care in the north-west of Ireland; praises the professionalism and commitment of staff working throughout the Western Health and Social Care Trust; and calls on the Minister of Health, Social Services and Public Safety to ensure that the radiotherapy unit and cardiac centre at Altnagelvin Hospital are progressed without delay resulting in the delivery of critical services to the population of the north-west.

Altnagelvin Hospital serves the population of the north-west of Ireland with vital and high-quality health care.  In 2010, the present Minister announced that a much-needed radiotherapy unit would be completed and opened by mid-2016.  The Minister is not in the Chamber, but I am sure that he will be.  It was most welcome news that the Minister, after a few weeks in office, approved the radiotherapy unit — the Minister enters the room.  Yet, in a recent letter to the Committee for Health, Social Services and Public Safety, the Minister announced a potential six-month delay due to a budget shortfall.  Delays of that kind do and will put lives at risk and could have a serious detrimental effect on the quality of care that staff are in a position to provide.  The Minister of Health must ensure that that type of delay never happens and that such critical and vital services are never threatened with such delays.

I would like to emphasise our praise for the admirable level of professionalism and dedication that is displayed by the staff in the Western Health and Social Care Trust.  This weekend, for example, they met their target of a four-hour turnover for every patient who was admitted to accident and emergency.  It is important that we key off the debate on a very positive and constructive note.  The commitment and hard work of staff saved the life of a local taxi driver, Christie O'Donnell, who suffered a heart attack.  The quick action of the staff in Altnagelvin ensured that Mr O'Donnell was seen to and placed in a bed in the hospital's coronary care unit within one hour.  To be able to continue to provide that exemplary model of care, Altnagelvin has to have the necessary funding in coronary care.  Its high-quality health care cannot continue in the face and the threats of cuts and delays.  Whilst meeting the challenging targets is certainly not a rare occurrence in the trust, credit is due for the tremendous effort by medical and non-medical staff that made that particular incident over the weekend possible. 

Again, the Western Trust is leading the way in providing outstanding care and the delivery of ambitious initiatives, and I have no doubt that the newly opened primary coronary intervention unit at Altnagelvin will provide the same high standards of care and professionalism.  However, in order to maximise the quality of service that that new unit can deliver, I urge the Minister — I am delighted that he is in his place — to do his utmost to implement the next phase of that project.  It really is crucial. 

This is 24-hour access to a safe and high-quality cardiac catheterisation laboratory, which will service people and patients seven days a week.  With almost 40% of hospitalised heart attack patients suffering from STEMI, the most serious kind of cardiac attack, the PCI unit in Altnagelvin will complement the unit in the Royal Victoria Hospital in Belfast.  So I have to say that this is not an issue of bolstering what we have in Derry.  It is a facility and provision for Northern Ireland and the cross-border regions.  It is envisaged that the Belfast unit will serve 75% of patients and will be supported by Altnagelvin, which will handle the remaining 25%.

 

Yet disturbing uncertainty surrounds the radiotherapy unit, which is an enormous worry for staff.  In a meeting of Derry City Council's regional services committee on 2 September, the chief executive of the Western Trust, Elaine Way, welcomed the fact that the infrastructure will not be affected by budget cuts, yet she clearly expressed concern about the very real possibility that the funds would not be available to recruit and train the necessary staff.  As the capital funds for the radiotherapy unit and a new north wing have been agreed, it is imperative that the revenue funds needed to bring the capacity of staffing to that new unit are well financed. 

In the face of Northern Ireland running out of radiotherapy capacity, the Minister's announcement that the unit faces delay is extremely worrying.  It is expected that, as soon as 2015, radiotherapy demand in Northern Ireland will exceed capacity.  The radiotherapy unit at Altnagelvin needs to play a critical and crucial role in tackling that.

Northern Ireland radiotherapy capacity will reach "saturation point" if the new radiotherapy unit is not in operation by the year 2016.

I want to focus on some issues to ensure that the Minister gets the point of why the SDLP felt it appropriate to prioritise this motion.

"A reduction in funding of £1·1 million would be taken from project's revenue funding in 2014/15 financial year".

That would impact on the trust's plans to:

"advance recruitment of key staffing disciplines whose appointments are critical for service planning.  Any proposal to freeze the revenue funding allocation until the end of the current financial year would delay the appointment of at least 20 key personnel".

That includes clinical and medical staff.

"The consequences would be significant for the vast majority of these hard-to-fill posts and there is a real risk",

Minister,

"that potential candidates would seek posts elsewhere instead."

This morning, I saw a report in 'Radiotherapy News', a UK-based magazine, that gives details of the Minister's announcement on the cuts that will delay the cancer unit at Altnagelvin.  At the best of times, it is difficult to attract, encourage and motivate staff to come to the north-west.  However, when highly qualified potential candidates see that, it will certainly put them off.  I am saying, Minister, that we need confidence and we need to acknowledge that, for Altnagelvin and the trust to encourage and attract the best possible candidates, this type of news is not good.  The radiotherapy project team has endeavoured to plan for the recruitment of staff only at the key time periods required, and we therefore argue and suggest that any further delays will clearly impact on the operational date of the opening of this unit.

I acknowledge that, literally within days of the Minister coming into office, he overturned a prior decision and took the brave decision to proceed with this unit, which was welcomed not just by those in the north-west but across Northern Ireland.  It is for the capacity of Northern Ireland.  This is not a wee project in Derry, and it is not a whinge from the Derry ones; it is a project and a unit that will provide care and treatment for half of the Northern Trust, the entirety of the north-west and all of Donegal and further afield.  So, I do not want to hear any sniping.  I am sure that I will not, under the circumstances.

"Should recruitment be delayed, any proposal to recruit larger teams of staff during 2015/16 would be very challenging for the Northern Ireland Cancer Centre to provide capacity to support the disciplines of medicine, therapeutic radiography and medical physics."

So, I think that it is an eye-opener for many of us who have been working on this project.  We have all been working on it.  The parliamentary team representing Foyle has been very diligent, with a unity of purpose, in trying to ensure that we are getting the importance of this message through and giving hope to so many people in our communities.  There is nobody in the Chamber, including me, who does not have family members who have cancer.  Those family members are dependent on the hope and desire that they are going to have treatment closer to home rather than facing the delays involved in having to come to spend a few days in Belfast, or in many cases weeks at a time, to get a 10-minute treatment during the day.  That is what is happening at the present time. 

Minister, I appeal directly to you to carry out your function to enable Altnagelvin and the trust to fulfil their obligation to provide a radiotherapy centre for people in Northern Ireland and, in a contract with the Irish Government, for those suffering from cancer in Donegal.  Minister, I think that you have to examine and scrutinise forensically your other finances in the Health Department to ensure that crucial, vital, important services, such as radiotherapy and cardiac services, are protected. 

I think that we have to be clear that we are demanding this.  We are not saying that this is a need; we are saying that this must happen.  We cannot under any circumstances allow a delay in the opening of the radiotherapy unit in Altnagelvin.

Photo of Jim Wells Jim Wells DUP 5:30, 16 September 2014

I suspect that this will be one of many similar debates that we will be holding during this financial year.  In his letters to the Health Committee in April and August, the Minister made it very clear that he cannot deliver the health service that we all want within the present budget.  He has outlined commitments of £160 million, which were put to the Executive, and he secured £20 million.  So, we are at least £140 million short of where we want to be in funding.

The Minister and the Department have been very committed to the Western Trust.  In the Minister's time, the Western Trust has had a brand new acute hospital in Enniskillen, for instance; we have the start of a new hospital for Omagh; and, of course, there has been the £66 million capital commitment to the radiotherapy unit at Altnagelvin.  So, I do not think that the Western Trust representatives here this afternoon can complain about a lack of commitment to their area.  Indeed, many of us in other parts of Northern Ireland feel somewhat envious of the new capital build in that trust area.  The capital for the new radiotherapy unit at Altnagelvin is, of course, committed.  However, the problem is that there are considerable costs in the manning of the unit — and I use "manning" in the widest possible term, because I am sure that some of the staff will be ladies.  That is going to be very challenging, and we have to accept that it will cause great difficulties.

The Minister finds himself in a very difficult position.  No one in the Chamber has contested the fact that he needs the extra £160 million.  Everyone accepts that we need extra money, but so much of the budget is tied up in salaries, wages, national insurance and pensions, and in contracts — if he tried to get out of those, we would be straight into court — that the actual amount of money available to make the cuts is relatively small as an overall part of the budget.  Therefore the Minister has to find options that may not be the most desirable but which are the most deliverable.  Unfortunately, that means areas of expenditure where we are not committed legally to deliver, and Altnagelvin —

Photo of Roy Beggs Roy Beggs UUP

Will the Member give way?

Photo of Jim Wells Jim Wells DUP

Certainly.

Photo of Roy Beggs Roy Beggs UUP

Does the Member accept that the fact that such cuts have had to be implemented at the last minute shows a degree of mismanagement of the Budget by the Northern Ireland Executive?

Photo of Mitchel McLaughlin Mitchel McLaughlin Sinn Féin

The Member has an extra minute.

Photo of Jim Wells Jim Wells DUP

I accept entirely that, had the Executive in their wisdom decided to give the Minister the money that everybody accepts he needs, we would not be in this position.  As you know, however, a lot of horse trading went on, and many people went into denial and did not give the money that was required.  Having made that decision, we will have to live with the consequences.  The Minister is not going to hijack or ambush Members; he is going to say it as it absolutely is and tell all 108 MLAs what the implications are for their area if we do not provide adequate funding for health.  That is the open and honest way of doing it rather than letting us drift through the financial year and suddenly finding that we have not sufficient money and that services start to deteriorate.

I also accept that the primary percutaneous coronary intervention (pPCI) unit is an excellent facility, but similar problems arise with it.  It is unfortunate that both facilities are based in Londonderry; I can understand the concerns of the representatives for that area.  Remember, however, that this is a Minister who has already delivered £490 million of savings in his three years in office.  That is an incredible achievement and, of course, is more than the annual budget of three of our Departments put together.  That has been achieved, and there is a further commitment of £170 million for the present financial year.  That £170 million is going to be extremely demanding of the five health trusts, plus, of course, the Ambulance Service

Let us not underestimate for one minute how hard the trusts are working to achieve that.  Five hundred and sixty million pounds' worth of savings have been achieved.  We will find that the cumulative effect of this will have a very difficult and deleterious effect on health, and we have not even considered the issue of welfare reform.  People say that welfare reform is not related to this.  This year, we are handing back £87 million to the Exchequer in London.  If that £87 million were passed over to the Health Department in the monitoring round, it would go a very, very long way to deal with this issue, including Altnagelvin.  We have to look forward and think that things are going to get much more difficult if we do not resolve this issue.

We all hope and pray that we will be able to find the money to deal with these issues.  The Altnagelvin radiotherapy unit is an excellent unit, and we should give it full support.  The honourable Member for Foyle said that, several weeks after he came into post, the Minister committed himself to reversing Mr McGimpsey's decision.  He did not; he did it on his first day in office.

He went up to Altnagelvin that day and reversed the decision, so that is the Department's level of commitment to Londonderry.  I think that we are being a little bit naive in criticising him for that.

This is a difficult issue.  As an Assembly, the best thing that we can do is not to pick off individual projects that we are concerned about but to lobby together for adequate resources to be given to health so that Mr Poots and the Department can deliver an adequate service.

Photo of Maeve McLaughlin Maeve McLaughlin Sinn Féin

Go raibh maith agat.  I thank those who tabled the motion and welcome the opportunity to speak in this important debate.  The motion quite rightly recognises the importance and status of Altnagelvin and its regional capacity to deliver excellent health care in the north-west.  I fully endorse those comments.  The motion calls on the Health Minister to ensure that the radiotherapy unit and the cardiac centre at Altnagelvin proceed as planned.  As someone who is familiar with the campaign for the radiotherapy unit, as many others in the Chamber are, I acknowledge the role played by individuals and groups, particularly the local Pink Ladies group, in making a very strong case not only for Derry but for the wider north-west region.

It is clear that, on that issue, an outcome was agreed and a consensus was reached that the people of the north-west deserve, which will ensure that there is a fully functional radiotherapy unit that will serve the needs not only of the Western Trust area but of Donegal.  It is correct and apt to point out that cancer remains a leading cause of death across the island, and it does not respect class, creed, gender or borders.  In some ways, the radiotherapy unit has set a model of best practice on the island in looking at how we deliver health across the island.  Increasingly, we are seeing this mindset in the delivery of health care across the island.  We see it with the current debate on children's heart services.  We see it in the current discussions on an air ambulance, and, hopefully, we will see it when we reflect on the need for an all-Ireland addiction strategy.

As someone who took part in the launch of the construction of the radiotherapy unit during the summer, I can assure the House that the unit is being built, the equipment has been bought, and it will become operational.  However, as some Members pointed out, it is not useful to hold up a potential £1·1 million cut across the radiotherapy unit.  That creates negative commentary and would or could impact on recruitment.  I am sure that the public, when they reflect on this debate, will see how the health budget is being spent to date, with £34 million going to consultants for bonuses and £60 million going to the independent sector annually for elective care, and struggle with the fact that we cannot find £1·1 million for a vital project that is already on stream.

On 30 September last year, the Minister announced the roll-out of the regional cardiac service for heart attack patients.  As Mr Ramsey said, only on Friday, we heard the story of a local person, Christie O'Donnell, who felt unwell and drove to Altnagelvin to be informed that he was having a heart attack and would undergo surgery within an hour.  I acknowledge the front line staff and others who made that happen, because we do not often hear good stories about the service.

So, the roll-out of the cardiac scheme is good news for patients suffering the most severe form of heart attack.  The next phase was due to go ahead this month.  Anything less than 24/7 would mean a secondary service for the north-west region and seriously undermine delivery there.  I support the motion and urge the Minister to proceed as planned with those two vital services for the north-west.

Photo of Jo-Anne Dobson Jo-Anne Dobson UUP 5:45, 16 September 2014

I also welcome the opportunity to speak in the debate.  It is a case of déjà vu all over again.

From the outset, I want to make my party's position absolutely clear.  We want to see the Altnagelvin radiotherapy unit and the cardiac centre open as soon as possible.  Indeed, it was Michael McGimpsey who backed the project for a radiotherapy unit at Altnagelvin from the very start and reiterated his backing on 23 March 2011, when he spelt out to the previous Assembly that there simply was not enough money for it in the DUP/Sinn Féin Budget.  He was very clear that the Budget passed by the Assembly, despite warnings from him and his most senior departmental officials, seriously —

Photo of Jo-Anne Dobson Jo-Anne Dobson UUP

No, I want to make my points. He was clear that the Budget seriously undermined the ability to deliver it, especially because of the absence of revenue funding.  At the time, some political opponents said that it was a heartless decision.  Nevertheless, the DUP and Sinn Féin claimed that the project would go ahead as proposed.  That was in 2011, and look where we are today.  In fact, at the time, the First Minister said:

"We are going to proceed with the Altnagelvin extension for cancer care and that's the end of the matter."

Once again, history has proven the First Minister wrong.  It was not the end of the matter, as today's debate proves. 

To be fair to the Health Minister, however, by 2016, he may well have a very nice new building; he will just not have staff with the required training to run it.  When my party warned of that scenario in 2011, it was lambasted by, among others, the deputy First Minister, who described the warning as:

"shameful, highly political and sectarian".

He went on to say:

"If you can be sure about anything in life, you can be sure that this radiotherapy centre will be built."

How true — it has been built, but without the full funding behind it and with no staff to operate it.  You have to ask who was being political.

The cardiac centre has, regrettably, also been caught up in the Budget fallout.  As already said, the 24-hour emergency PCI service was proposed in 'Transforming Your Care', but, like so much else in the document, it is losing its focus, and time frames are slipping.

Altnagelvin was to become Northern Ireland's second primary PCI centre.  I hope that that can still be achieved, sooner rather than later.  Unfortunately, until then, patients outside the Belfast service's catchment area will remain disadvantaged.

The most frustrating thing about the current situation is that it was entirely avoidable.  The Minister left it so late to acknowledge the problem that it is probably too late to do anything about it without causing immense hurt elsewhere.  Any Minister, alongside senior officials with responsibility for budgets and expenditure, should have been able to see that the figures simply did not add up.  Nevertheless, rather than asking for extra support in the summer of 2011, in 2012 or even in 2013, he left it until now.  Speaking out earlier would have made it much easier to fill the £160 million gap in his budget over a number of years, rather than in less than one year.  The Minister is in the position of making the best of an incredibly bad situation.  The people of the north-west deserve better.

Minister, although you refuse to acknowledge it, this is a problem that was created in 2011.  I am glad that you have asked for help now, although you should have done it long ago.

My party is determined, however, to work cooperatively with you in order to ensure that public safety is not further compromised and that the radiotherapy and cardiac units are progressed as quickly as possible.  Therefore, I support the motion.

Photo of Kieran McCarthy Kieran McCarthy Alliance

I welcome the debate and I am happy to support the motion.  These investments in the north-west are matters of huge importance but have always been marginal in the budgetary commitments.  The project was in major jeopardy at the end of the last Assembly mandate, as has been mentioned already.  In fact, as I understand it, the project had been withdrawn at that time.  Indeed, at the time, the local people and their representatives were shocked and dismayed, despite the fact that the then Derry health chief said that these developments and the operation of the satellite radiotherapy unit at the Altnagelvin site were vital.

At that time, there was cross-party support in the Health Committee for the service, which also had the support of the Dublin Government.  Thankfully, after the 2011 election, promises were given to build these new facilities but once again, in the context of the massive Budget uncertainty, this is back in question as the Minister has indicated that development of projects such as the Altnagelvin radiotherapy centre and cardiac centre, along with others, may have to be delayed in the short term or even longer term.

Although the Health Committee, the Assembly and others will want to scrutinise what the Minister is saying in general about the overall health budget and the potential or otherwise for reform, today provides an opportunity for us to restate our commitment to these investments in the north-west.  There is a very strong logic to this; we are all too familiar with the scourge of cancer on our society and the very real difference that early diagnosis and effective treatment can make to prospects of recovery and full life expectancy.  Moreover, the siting of such facilities at Altnagelvin Hospital is strategic in nature.  In particular, the radiotherapy unit holds out the prospect of effectively servicing a wide catchment area that significantly spans the border counties.  We have also taken advantage of support from the Dublin Government.

Many of us have regularly stressed the opportunities for a more efficient use of resources through the shared delivery of services on a North/South basis and this is surely a golden opportunity for that.  I am, however, disappointed that these items have appeared on the Minister's proposals for so-called savings.  Many of the proposals he has set out are, in fact, false economies; short-term measures or deferred expenditure will simply delay opportunities to do things better.

It is difficult to have this debate in isolation from the wider financial situation facing the Health Department and the Executive as a whole.  First, there are major questions to be asked about how the Department ended up in this situation.  This pressure has clearly been building up over several years and the fact that a mess has arisen now predates the crisis in welfare reform as, no doubt, we will hear.  Secondly, what is presented by the Health Minister needs to be properly scrutinised.  Although problems have been building in the health service over time, it is difficult to understand how things can tip into crisis on the basis of a funding gap.

The failure of the Executive and the Assembly to agree the way forward on welfare reform means that money has to be handed back to Westminster that could otherwise have been invested in health.  This is a shameful, disgraceful and unforgivable situation; no one in this House supports the welfare cuts.  I desperately appeal to both blocs in the Executive to come together and agree a way forward for the benefit of all our constituents to ensure that no funding has to be handed back to Westminster.

Let us remind ourselves of all those in our society who are crying out for cancer drugs, our multiple sclerosis, ME and muscular dystrophy patients and our elderly dependants. Let us remind ourselves of the shortages in our A&E departments and our community meals schemes, all of which are at risk.  The list goes on.  It simply would be a dereliction of MLAs' duties — in fact, totally obscene — if we have to return moneys to Westminster coffers when we know the need is desperate at home.

Alliance is open to considering additional resources for health and social services, but that has to come in the context of a proper strategic review of expenditure across the board by the Executive.

Photo of Mitchel McLaughlin Mitchel McLaughlin Sinn Féin

The Member's time is up.

Photo of Kieran McCarthy Kieran McCarthy Alliance

I hope that the Minister will give assurances today that these will be provided.

Photo of George Robinson George Robinson DUP

I welcome the opportunity to compliment the management and staff of the Western Health and Social Care Trust at Altnagelvin Hospital.  I would especially like to thank the chief executive and her senior team and staff for all their assistance in the provision of essential health services over the years.

I can truthfully say that when I had cardiac problems a few years ago, I was treated with great dignity, dedication and professionalism by all health care staff at Altnagelvin Hospital.  Therefore, as someone who deeply appreciates their professionalism and diligent work, a thank you for the critical work that they carry out is well-deserved from me personally, my family members, and indeed the entire population of the north-west and further afield.

During briefings with the Western Health and Social Care Trust, the important role that it has played and will play for those of us in the north-west and western areas of Northern Ireland was very apparent, despite the current budget pressures, which the trust has managed skilfully.  Indeed, contracts have been signed for the construction of the much-needed radiotherapy unit.

Photo of Gregory Campbell Gregory Campbell DUP

I thank the Member for giving way.  He talks about the resources that have been made available for the radiotherapy unit.  He spoke earlier about the truth.  Would he agree with me that the truth is unlike what we heard from Mrs Dobson a few moments ago, when she indicated that the previous Minister did not have the resources to commence work on the radiotherapy unit?  The present Minister managed to get those resources in his first week in office, and they were already there when the previous Minister was there.  If we are talking about truth, people should stand up, put their hands up in the air and say that they were guilty of not proceeding with the unit when they had the opportunity to do so.

Photo of Mitchel McLaughlin Mitchel McLaughlin Sinn Féin

Members should keep interventions short.  The Member has an extra minute.

Photo of George Robinson George Robinson DUP

I fully agree with my colleague's assertions.  The radiotherapy and cardiac units are essential and very welcome.  They will also relieve pressures on the services being delivered in Belfast and, importantly, reduce journey times for patients and relatives alike.  Those are points that patients and relatives will greatly benefit from and appreciate.  Patients from the glens of Antrim to Enniskillen will benefit greatly from the new development and service provision at Altnagelvin.

There is no doubt that cancer is widespread throughout our population.  Therefore, it is essential that, when finances permit, the best treatments are delivered by the health trusts for the benefit of the population.  The Altnagelvin centres for radiotherapy and cardiology will provide exactly that.

The Minister last September outlined the benefits of a PCI service for patients.  This enables lifesaving treatment such as stents to be deployed even if the patient is having a heart attack.  I believe those to be value-for-money procedures that have an immediate and positive benefit for patients.

I fully appreciate that the Minister is under severe budgetary pressures not of his own making.  We cannot deny that.  I also appreciate the great need for those services to be provided in the west and north-west of Northern Ireland.  However, I fear there may be a delay in the timetable we would all want due to the unwillingness of some Members of this Chamber, i.e. Sinn Féin and the SDLP, to agree the implementation of welfare reform.  Where is the benefit to society of denying much-needed medical services?  Is it proper that they deny society improvements in cancer and cardiac care?  Perhaps they can tell us how the Minister will find the £140 million shortfall that has been caused.

Urgent progression of the radiotherapy and cardiac units is essential, but I have also highlighted the problems of refusing to face our Budget crisis, which is damaging the patients who need life-saving treatment.

When those parties responsible for the Budget cuts realise the consequences that their actions are having in this community, the Minister will be able to progress these critical health projects with the speed the motion calls for.

Photo of Raymond McCartney Raymond McCartney Sinn Féin 6:00, 16 September 2014

Go raibh maith agat, a Príomh-LeasCheann Comhairle.  Beidh mé ag labhairt i bhfabhar an rúin seo.  I support the motion.  Given the tone and the way it has been presented, most speakers have accepted the crucial importance of Altnagelvin hospital to Derry and the greater north-west region.  People have rightly praised the staff and the dedicated professionals who staff that hospital and other aspects of the health service, not just in the north-west but across the North.  That is welcome.  Christie O'Donnell must be the most recognised taxi man in Derry because of his situation and how it was remedied.

Photo of Gregory Campbell Gregory Campbell DUP

The Member said "most of the speakers" have recognised the importance of the project.  I have not heard anyone say that they did not recognise that.  I got the distinct impression that there was unanimity on the project.

Photo of Mitchel McLaughlin Mitchel McLaughlin Sinn Féin

The Member has an extra minute.

Photo of Raymond McCartney Raymond McCartney Sinn Féin

I did not say that to challenge anyone.  Some Members spoke about particular aspects of the debate and did not centre on Altnagelvin.  I am not saying that anyone is questioning the importance of Altnagelvin hospital if that is the point that the Member is trying to make.

I made the point about Christie O'Donnell, and we should wish him well.  The Speaker will know the benefits of Altnagelvin hospital because that is where he is currently housed, and I am sure that he is getting the best of treatment.

I do not think that any of us would argue, particularly in terms of health and the health budget, that there are not always pressures and strains on the system.  That is where good management, good leadership and good direction can come in by sometimes bringing efficiencies into the system and alleviating some of the issues that we are addressing.

Too often, and this can be a comfortable way of doing things, the situation is labelled as a "crisis".  "Crisis" is the first word that comes to people's lips, which creates a reaction in itself and sometimes we loose sight of the debate.

Photo of Jim Wells Jim Wells DUP

Will the Member give way?

Photo of Raymond McCartney Raymond McCartney Sinn Féin

I have limited time and have already given way.

That is what we have to watch, because even in the debate on this issue we have heard people in the DUP talk about "the aura of a crisis".  So, we have to define the problem.

Jo-Anne Dobson gave a particular commentary about the radiotherapy unit in Derry, which was challenged by Gregory Campbell.  In my opinion, Michael McGimpsey made a mistake.  He may have had particular pressures and he may have had particular concerns about his budget and how it was being deployed, but he picked on something because he felt it was the most vulnerable and would get the most reaction.  However, he got the wrong reaction.  There was total unanimity, particularly in the north-west and Derry.  It featured greatly in the election campaign, and all the people who stood for election in the area were in favour of the radiotherapy unit.  Indeed, the First Minister and the deputy First Minister publicly stated that, if they got the mandate, one of the first things that they would do would be to ensure that the decision was reversed.  Credit to the Minister, he delivered on that promise.

However, therein lies the problem for the Minister.  The radiotherapy unit is on schedule, it is near completion, the equipment has been ordered and recruitment is going to take place.  It is not tenable to have a scenario where the unit is built and not staffed.  To use it as one of the areas of contention in the particular stresses and strains that you find your Department under — and you are entitled to fight your corner — was not proper.  You will come to realise, like Michael McGimpsey, that it was a mistake to use the radiotherapy unit in that way.

Maeve McLaughlin has said on a number of occasions in the Assembly and in the local media that we have not heard any interrogation of the fact that £32 million in bonuses is being paid to consultants.  Many, many people out there are asking, "Why is it that, when it comes to this type of debate, it is automatically the radiotherapy unit, or the cardiac unit, or hips or all the good things that the health service does, but we never ever seem to talk about the fact that £32 million is paid out in bonuses?  Why not seek some way to address that as we go forward?"

Photo of Edwin Poots Edwin Poots DUP

Will the Member give way?

Photo of Edwin Poots Edwin Poots DUP

If the Member were looking to attract to this radiotherapy centre people who are currently on bonuses, would he not pay them that and not have those doctors come?  I am proud that, in Northern Ireland, we have some of the best doctors in the world.  However, you will only get the best by paying the best.  That is what we are doing.  If you do not want the best doctors in the world, that is a matter for Sinn Féin.  I want the best.

Photo of Mitchel McLaughlin Mitchel McLaughlin Sinn Féin

The Member's time is almost finished.

Photo of Raymond McCartney Raymond McCartney Sinn Féin

I have no issue with recruiting the best.  However, when people hear about £32 million bonuses on top of good wages, that is where the issue is, and perhaps you have to explain that.  The run to microphones to close things down rather than to say "I am going to tackle other inefficiencies" — that is the point I am making, and that is the point that has to be taken up.  Pat Ramsey has shown you the Journal.  It may be unintended —

Photo of Mitchel McLaughlin Mitchel McLaughlin Sinn Féin

I ask the Member to bring his remarks to a close.

Photo of Raymond McCartney Raymond McCartney Sinn Féin

— but your comments may have put doubts into people's minds about whether a post in Altnagelvin is a good post to apply for.  I think that that is the mistake that you have made.

Photo of Thomas Buchanan Thomas Buchanan DUP

I rise to briefly add my voice to the debate this evening.  I agree with the sentiments of the motion and acknowledge the importance of Altnagelvin Hospital in the delivery of excellent healthcare services in the north-west region.  I also want to praise the professionalism and commitment of staff to delivering that service throughout the Western Health and Social Care Trust area.  I find it ironic that a member of the party opposite is questioning the payments and so forth that are given to professional people who are delivering an excellent service for people throughout Northern Ireland and not only in the Western Health and Social Care Trust area.  When we have occasion to visit any of the hospitals in the trust area — should it be the new acute hospital in Enniskillen, Omagh, Altnagelvin or any of the other healthcare provisions — we see at first hand that professionalism and commitment being demonstrated.  When we talk to patients, their testimonies bear out the excellent service that they are receiving.

I take this opportunity to again lobby the Minister and the Department for the progression of the radiotherapy unit and cardiac centre and having it delivered and up and running with the minimum delay.  The delivery of this service is critical to the population of the Western Health and Social Care Trust area and beyond.  No doubt, when this building is complete, it will be one of the most important healthcare facilities for people living with cancer in the western area.  When we consider the number of people living with cancer in the Western Health and Social Care Trust area, and the many victims and the families who have had a loved one taken from them by cancer, we can see the importance of having that professional help and care close to hand and the comfort and confidence that it brings in times of great need.

Given that existing services in Belfast are expected to be full by 2015, it is essential that work at Altnagelvin continues and that this service is delivered with the minimum delay.  However, I have to say that I am conscious of the financial pressures that the Minister and his Department are under and the tight financial constraints that he is facing.  I want to commend him on how he has managed, and is managing, his budget.  The difference between Minister Poots and the previous Minister is that Minister Poots has delivered whereas, in a lot of areas, Minister McGimpsey failed to bring forward the finance and deliver.

Photo of Jim Wells Jim Wells DUP

Will the Member give way?

Photo of Jim Wells Jim Wells DUP

Does the Member accept that, although Mr McCartney talked about scaremongering, the Minister never raised an issue of funding in the first three years of his tenure?  It was challenging, but he was able to deliver.  It is only more recently that things have become more difficult.  There has not been a running to the Minister of Finance until recently.  Four years ago, Mr McGimpsey was constantly whinging about a lack of money when, in fact, there was at least £490 million of savings still to be made.

Photo of Mitchel McLaughlin Mitchel McLaughlin Sinn Féin

The Member will have an extra minute.

Photo of Thomas Buchanan Thomas Buchanan DUP

The Member makes a good point, because the previous Minister failed to make the efficiency savings and was afraid to face and to meet the challenges.  However, Minister Poots did that.

Photo of Thomas Buchanan Thomas Buchanan DUP

No, I will not give way any longer.

I call on all Members in the Chamber this evening to support the Minister in his call for the extra funding that he requires because it is only then that he will be able to deliver on the various health care issues that people are asking for around the Chamber.  It is all very well for Members to, on the one hand, call on the Minister to deliver, while on the other hand, they are part of the problem, in that they are continually refusing to agree to welfare reform, which we know will strip the Minister's budget even further.  I believe that it is now time for Sinn Féin and the SDLP to give the leadership that is required on welfare reform and to stop further cuts to our budget, because only then will it be taken seriously that you folk have a concern about the delivery of quality healthcare provision in the Western Health and Social Care Trust area.

Photo of John Dallat John Dallat Social Democratic and Labour Party

I came here with a prepared speech, but I am not going to use it, because I am rather annoyed and upset at the point scoring that has been going on.  I loved my parents dearly.  My father died from a massive heart attack, and my mother died a painful death from cancer.  I am sure that if those people were looking in on the debate today, they would be quite horrified. 

Many years ago, when we had similar financial problems, the cancer centre in Belfast was built.  It is now overflowing, but, my God, what a gift that was to the people of Northern Ireland.  If we apply the same principles today, surely the people of the north-west and far beyond are entitled to the same hope and inspiration from their elected Members as happened in times that I think were more difficult than those we are in now. 

My interest in Altnagelvin is not because I am supporting my Derry colleagues.  Altnagelvin plays a major part in health care in the more immediate area that I represent.  The partnership and cooperation between the Causeway Hospital and Altnagelvin is exemplary and something that I hope the Minister, who initially supported it, will continue to support.  That is because, if you are on the balcony looking down on health care, you do not see borders or health trusts; you see people, and those are the people of Donegal, Derry, Coleraine, Ballymoney and beyond. 

There was, rightly, mention of the taxi driver and that lovely story that came out yesterday, but I can tell Members that good stories come out of Altnagelvin and the Causeway every day.  I hope that the Minister is pleased to hear that.  They are beautiful stories, and I think that that is a solid reason why every Member should put their party political hats to one side and say, "We will do this collectively and provide the facilities that are badly needed for generations to come".  In doing so, we will not only provide for Altnagelvin but will sow the seeds of a very strong medical care service with our neighbours in Donegal, whose government help to fund this, and will help people in the Causeway.  I am not suggesting that the Causeway is in any immediate danger of closing, but I know that, if Altnagelvin had the full range of services, that relationship would be strengthened and would give comfort not just to Altnagelvin but to the Causeway. 

I think that we probably got off on the wrong foot today.  We have probably disillusioned people outside who may have been watching.  This is not about party point scoring; this is about people and their future.  It is about the people who, as we speak, are given bad news one way or the other.  I do not think, quite honestly, that we would want to leave the Chamber having created the impression that we had another wee point-scoring exercise in the Assembly.  God knows, we create enough bad images for ourselves without using something as serious as a motion on cardiac and other facilities to save people's lives.  I think that it is a step too far.

I do feel a bit emotional about this.  I appeal to my colleagues right across the Chamber, and I am not identifying any party in particular:  for God's sake, this ain't the debate for a bit of craic; this is not the debate for a bit of smirking and laughing; this is serious business.  I passionately believe that each and every person in the Assembly has the capacity to deliver what the people need in Altnagelvin Hospital.  Despite everything that I saw here today, I trust that, on reflection, they will do what is required.  As with the cancer centre in Belfast —

Photo of John Dallat John Dallat Social Democratic and Labour Party

— it is possible.  There are plenty of financial models out there that should be looked at.

Photo of Roy Beggs Roy Beggs UUP

I thank the Members for bringing forward this important motion.  I, too, rise to support the motion.  I recognise publicly the important regional role that Altnagelvin Hospital plays and will play increasingly in the future, not only for the city of Londonderry and the north-west region but, as has been said, its linkages with other hospitals such as Coleraine and the South West Hospital.  There is the opportunity for the mutual benefit of the regional centre, not only for the people of Northern Ireland but for the people of Donegal.  Collectively, a much better service can be provided for everyone.

The Altnagelvin radiotherapy unit was first identified as essential to meet the future needs of the people of Northern Ireland in 2008 when the project was kicked off by the then Minister, Michael McGimpsey.  I understand that capital budget has always been available, but it has been the resource budget that, in previous times, created some difficulty.  We are being told again that it is the resource budget that is causing difficulty today.  There is no point in building such a centre with the resource and not manning it and providing a service.  Therefore, it is essential that the project be taken through to completion. 

In 2011, the outgoing Health Minister expressed his concern about the health budget.  He questioned what had been given and expressed concern that the opening could be put in jeopardy with the budget that had been handed to him.  I agree with other Members that this is not just about the north-west; this is a regional centre, and a centre for Northern Ireland.  Those who are following cancer and health issues will be aware that the cancer centre in Belfast is reaching capacity.  Therefore, unless it is built and operated, there is the possibility that it will even affect me and my family.  I feel passionately that this must proceed on the schedule that was agreed. 

On coming into office in May 2011, Minister Poots advised:

"I have confirmed that I will make the necessary current and capital funding available."  [Official Report, Bound Volume 64, p42, col 1].

Minister, what has happened since then?

In 2011, it was also indicated by the Finance Minister that the Health Minister would have flexibility in his budget without recourse to the Executive but that he could not bid for in-year monitoring and had to live within his budget.  Since then, inflation in the UK has generally been lower than had been expected.  Yes, I understand that health inflation is always considerably higher than general inflation.  However, during those three and a half years, approximately £300 million of additional money in in-year monitoring has been provided.

My understanding of the 2011 Budget was that that money would not be available to the Health Department, so I am pleased that those who set that Budget agree that there were failings in what they did and are trying to correct it quietly.  We will get better value for money if it is done in a strategic fashion rather than it being dealt with through in-year monitoring, because that mechanism can create a stop/go effect.

It is vital that the Altnagelvin project is put back on track and that the essential staff who will be required to man the units — professionals who will be giving up secure and important jobs elsewhere — feel totally secure about their futures so that they can be attracted to undergo the necessary training to man these posts.  We cannot play about with it; it is essential that this is put to bed quickly and that the necessary funding be found.  I support the Health Minister unequivocally in that that additional money must be found to ensure that this happens.  I am not playing politics.

It would be helpful if the Minister were to clarify something in his letter to the Health Committee in August in which he indicated that —

Photo of Mitchel McLaughlin Mitchel McLaughlin Sinn Féin

Will the Member draw his remarks to a close?

Photo of Roy Beggs Roy Beggs UUP

The Minister indicated that there would have to be £160 million in savings:  does he have to save all that, or is it £80 million or now £60 million?  It is essential that this project continues not only for the people of the north-west but for everyone in Northern Ireland.

Photo of Gordon Dunne Gordon Dunne DUP

I also welcome the opportunity to speak to the motion about what continues to be a very important issue for people throughout Northern Ireland.

Our health service is crucial for everyone — young or old, rich or poor — and it must continue to be a priority for our Executive.  There is no doubt that Altnagelvin Area Hospital in Londonderry offers an important service to the people of the north-west and beyond.  I endorse the opening words of the motion, which praise the professionalism and commitment of the staff in the Western Health and Social Care Trust area.  Our health service staff are our greatest asset, and it is vital that we continue to acknowledge their dedication and commend their first-class level of service so that they are not taken for granted.

Funding remains a key challenge across our health service, and, unfortunately, the knock-on impact of the current financial challenges may affect our whole Province.  Both the primary PCI service and the radiotherapy unit are key priorities for our Health Minister.  I know that he recognises the importance of these services for the people of the north-west.  That was underlined when he gave the green light to the radiotherapy unit shortly after taking up office in 2011.

The Minister also visited the hospital recently to confirm the commencement of the 24/7 primary PCI service, which provides state-of-the-art treatment for approximately 300 patients annually:  those suffering from heart attacks.  It is very clear that our Minister fully supports investing in and improving services in Altnagelvin.  We should all stand and work with him and our Executive colleagues at this time to get the best possible deal for our health service as we move forward.

I call on our Minister to work with his Executive colleagues to make available the £1·5 million per annum that is required to ensure the full range of services at the cath lab and to fund the appointment of critical staff to avoid any further delay at the new Altnagelvin radiotherapy unit.  This is an important development because it will serve the people of the Western Trust area who currently have to travel to the regional cancer centre in Belfast City Hospital, which, as was mentioned, is working at almost maximum capacity.  A local cancer treatment unit will provide for the people of the north-west and beyond, into the border areas of Donegal, providing a service for such treatments on a repayment basis.

There is no doubt that savings and streamlining must continue to be a priority across our health service.  I know that the Minister will continue to prioritise effective and necessary savings while reducing wastage.  We must stand united on this issue and ensure that our health service continues to deliver and develop for our day and generation.

Photo of Edwin Poots Edwin Poots DUP

The motion states that the Assembly should recognise:

"the importance of Altnagelvin Hospital in delivering excellent healthcare in the north-west".

The motion:

"praises the professionalism and commitment of staff working throughout the Western Health and Social Care Trust".

At the outset, I wholeheartedly endorse the recognition of the hospital, the staff and their professionalism.  Every one of them is worth every penny.

At the heart of the debate is the future funding of the PCI cath lab service and the new radiotherapy unit.  I never had, nor do I have, any intention of not continuing with those services.  I merely pointed out to Members the reality of the situation because of the budget that was awarded to me in June.  We are already making £170 million of savings this year on top of the £492 million made over the previous three years.  That is just over £660 million.  I met the First Minister and the deputy First Minister on 6 April to explain that there was an additional gap of £160 million that we needed to address.  My party was always of the opinion that we could do with something less than £160 million but that we needed considerably more money.  Therefore, we were looking to get £40 million in the June monitoring round and £40 million in the October monitoring round.  However, when we got to the June monitoring round, which came out five weeks late, we were told, "You're getting £20 million.  That's all you're getting for this year.  Now, go away".  Those are the circumstances in which we find ourselves.  If we got £20 million and no more in this financial year, that is the extent of the cuts.  I said that I was not prepared to deliver those cuts.  I needed the support of the Assembly.  I sought the support of the Committee.  I thought at the start of the meeting that it was going to support me, but, by the end of it, the Chair was not that keen on providing that support, for whatever reason.  I hoped to have a Committee Chair who would have been more supportive of delivering those services, to be quite honest.  It reflects very poorly on the Committee Chair that she did not have the will to give leadership to that Committee to ensure that I received the support to get more than £20 million for the rest of this year.

As we take the situation forward, we have proceeded with the primary PCI unit.  It has been live 24/7 since 15 September.  I would have hoped that Mrs Dobson's people who assist her would have advised her better:  she said that she hoped that we would go ahead with it, but it has already started.  In any event, I was up at that facility last week.  We have the most state-of-the-art equipment available anywhere in the world in Altnagelvin Hospital.  That is good news.  A taxi driver came in and was sitting up in bed an hour and half later having had the treatment.  He potentially has a very good outlook as a result of that intervention.  That is the service that we want to provide.  We do not to provide it just at one o'clock on a Friday or from nine to five.  We want it available at 12 o'clock at night or four o'clock in the morning — whatever time it happens to be.  I do not want it to be available just to the north-west and people from the Northern Trust area; I want it to be available to people from the Republic of Ireland as well.  We can assist the Republic of Ireland by providing top-class healthcare, and they can pay a contribution, which will ensure that we can sustain the service.  That makes completely logical sense.  As we move forward to looking at the potential of having an air ambulance and all of that, there could be a major expansion of the services at Altnagelvin Hospital.  That is where I come from; that is my commitment to that service.  It is not just for the service we are going to provide at this stage.  I want to expand it further and provide assistance to others.

I visited Altnagelvin the day after I took ministerial office and, within a week, I made the decision to proceed with the radiotherapy unit.  I did not think that is was good to create uncertainty about such an important subject.  Mr Beggs rightly pointed out that the service is not just for the people of the north-west, though it is focused on them.  Given the increasing numbers of patients who require treatment for cancer, Belfast City Hospital cancer centre would not have been able to cope:  300 people use that service every day as things stand.  It is absolutely essential for everybody in Northern Ireland that we proceed with it, given than one in three people will contract cancer at some point in their life.  That is why it is important that we have quality cancer services across Northern Ireland that are fit for purpose and able to deal with the numbers going through.

I have no intention — none whatsoever — of delaying this, but I am dependent upon the October monitoring delivering for me.  I did not take on the battle to get more funding for the health service on this occasion without having the intention of winning it.  I am very hopeful that I will win the battle so that I can ensure that those services will proceed as planned without any hiccups or delays.

Obviously, other people may be silly about it and say that you just have to cut your cloth and live within the budget, and they may raise red herrings about things like clinical excellence awards.  Let me say something about clinical excellence awards.  They have been around for years and years, going back to the Sinn Féin Minister's time, I believe.  Legally, they are regarded as contracts.  So, if I go into a situation of saying that I am not going give people clinical excellence awards, which have been pre-existing, I will be challenged and more than likely defeated in court.  I would then have to pay the money out in any event.  So, clinical excellence awards are not something that I think are necessarily the best arrangement; I think that we should be asking for a continuum of excellence as opposed to a demonstration of excellence at a particular point in a career.  Nonetheless, they are there and they are contracts that we are obliged to honour.

We have top-class doctors in Northern Ireland, and we are delivering excellent services with excellent results.  Last week. I spoke to a couple of young consultants who are working in the primary PCI facility in Altnagelvin.  I was absolutely delighted that they chose to work in that facility.  They will save life after life after life in the north-west, and I honestly think that they are worth what we pay them.  I know that doctors are well paid, but they are the cream of the class at school.  It is the brightest young kids who go into the service; I want to attract the brightest young kids into medical service.

I diverge slightly, but I think of Dr Jimmy Douglas, who worked in the renal unit of Belfast City Hospital.  I am sure that Mrs Dobson has come across him, although I think he has retired.  He started out in life as a lawyer, and he did not like it, so he went back to university having decided to become a doctor.  I always thought that here was a man who could have spent his life doing conveyancing and giving advice on legal matters, but he saved hundreds of lives.  He and Professor McGeown were out there doing work that was transforming in terms of kidney transplants.  I want people like that.  You know what?  If I have to pay £20,000 or £30,000 on top of their wages to get them, I am prepared to do it as opposed to having mediocrity in our medical services.

I do not know where I am in my speech now.

We are in a difficult financial situation.  It did not start three years ago; it started last year when the trusts started to report around August that they were facing greater pressures than they anticipated.  They moved from having a £7 million underspend to a £60 million overspend.  We have not recovered from that.

Could I save £140 million in the health service without hitting all of those things?  Yes, I could, but I cannot do it when I am asked to do it in August, because we have already lost four months of the year. 

We have, for example, reduced the length of stay in hospital.  That has been reduced by 10% over the past three years, from 6·9 days to 6·1 days.  We have saved tremendous amounts of money on drugs.  I hear people saying that, if we go down the route that the drugs companies want us to go down, we could supply all of those other drugs.  Yes, we could, but that would mean reducing services from something else.  That is a hard decision that we have to make.

Considerable amounts of money have been saved.  I think Sinn Féin said that it would want an inspection of the books, or something of that kind.  I am quite happy to throw the books open.  I am very happy for whoever to inspect the finances of the Department of Health, because we are committed to spending all of the money that we have on health, social services and public safety.  If money is being misspent, I want to know about it so that we can cut that out.  You ask me whether every penny of a budget of £4·7 billion is being spent right.  Of course it is not.  I want it to be spent right, so if people are aware of things that we are not doing right, let me know, and we will pursue it, seek to reduce that waste and cut it out.  I have no doubt that there is still waste there to be cut out.

We can reduce the amount of spend required, but we have to do it over time, in a way that is thought through.  We will have additional services to provide at the same time, so health is always going to be a problem for every country in the world.  I think we have heard about Scotland facing problems that perhaps have not been as well explained to its public as they should have been.  I note that Dr Varadkar has been in trouble with his Prime Minister, Mr Kenny, for shouting about needing more money for health down there.  Some things do not change.

I think that there is a circumstance that people do not really understand:  we are looking at a 6% growth in health each year and at 1·5% to 2% more funding.  Finding and squeezing that 4% out each year will be more difficult.  It becomes more of a challenge, but our willingness to do the right thing should not be underestimated.  We are quite determined to have first-quality services not just in Belfast but right across Northern Ireland. 

I want to attract the right people to serve in the best facilities in Altnagelvin in both radiotherapy and PPCI.  We have already done it in PPCI.  I would be shocked if we do not get the funding in the monitoring round to help us sustain that, so I am going ahead at risk.  I have no doubt that we will proceed quickly after the October monitoring round to ensure that there is no delay in the opening of the facility at Altnagelvin, unless people are very silly and decide that Poots is calling everybody's bluff.  He is not.  We need additional resources to make those things happen.  I believe that I have the support of all of the parties, but we need to see the colour of the money in October.

Photo of Colum Eastwood Colum Eastwood Social Democratic and Labour Party 6:30, 16 September 2014

Members will note that the wording of the motion was designed to be helpful rather than critical.  Most of the debate has shown that we have support right across the House for what needs to be done.  There is obviously a recognition of the financial difficulties.  There is obviously going to be a bit of discussion and debate around why we are in those financial difficulties and what has actually caused them, but I think that what we can take from this debate is a commitment from the House to ensure that we do not again end up in a scenario where people in the north-west and beyond hear things on a radio or television programme that makes them very fearful of some of the really important projects and proposals that the Executive and Assembly have for them.

I think that one of the difficult parts of the financial debate that has been going on since the June monitoring round is that it seems to us — some people might say that we have a bit of a complex — that every time an argument is made about welfare reform or anything else, the example that is used is one that affects people in our city, whether it be Magee campus, radiotherapy or whatever else.  I think that we just need to be mindful that people are very hopeful.  People came out on to the streets of Derry, went to meetings, wrote letters, signed petitions and did a lot of things the last time that this issue was used to advance a political argument about budgets.  We just have to be mindful that these decisions and, sometimes, these statements have an effect on people. 

Everybody in this House will know somebody who has to travel the long distance to the fantastic cancer centre that we have in Belfast.  We often complain that we have to come up here from Derry three or four times a week.  Imagine trying to do that, maybe for a 10-minute appointment, if you are going through cancer treatment and all the difficulties that that presents.  We have to say that we were and have been very glad that Mr Poots, in his first week as Minister, made a very positive announcement for the north-west.  Think about people from Derry travelling to Belfast:  even more horrendous in this day and age is that people from Malin Head maybe travel to Dublin or Galway.  We come at this in a positive way.  The response from the Minister today has been positive.  The response from most of the speakers has been positive.  I think that that is a good thing.

We also deliberately put in the motion a reference to the health workers who interface with the public every single day.  I think that sometimes we do not say enough about that.  I think that people need to be very mindful of the difficult circumstances.  When we talk up here about budgets, it is the people on the ground on the front line who have to deal with the issues and difficulties that they face because of budget cuts.  Mr Ramsey highlighted that, last weekend, in Altnagelvin's A&E department, a target was met by those workers and staff to treat every single patient within four hours.  It is important to point out that, in the 24-hour period from midnight on Thursday, the A&E department treated 160 patients within that time frame.  While we are often all very good at complaining about those kinds of things, it is important that we recognise good work when we see it. 

I know that Christie O'Donnell has been mentioned.  I know Christie.  I have been in his taxi many times.  He is a very grateful recipient of very good care.  He actually drove his taxi while he was having a heart attack to Altnagelvin and was treated very swiftly and well by the staff there.  That is something that needs to be said.  It is because of the good work around the new cardiac centre that Christie was able to avail himself of those services.  Thank God for it.

I am glad to hear what the Minister said about the 24/7 aspect, because it should not be the case that, if you turn up at a certain time, unfortunately, you might die because the service is not there 24/7.  I think that the Minister said that we are going ahead at risk.  I think that that is a sensible decision.  I know that he was there last Friday when it was not just quite as clear whether we were going for the 24/7 model.  Maybe that is where some of the confusion came about today.  We are very glad to support that and to see it come forward. 

A number of speakers spoke very well.  I note that Mr Wells talked largely around the financial implications of this.  I think that we are all aware of them.  He also recognised that, when you look at the figures, you see that this is not necessarily a welfare-reform issue.  There has clearly been a very real problem in health.  I know that some people will debate when and why that started.  However, we have to commit to a new budgetary process to ensure that we can resolve that.

Nobody wants to see front line services cut.  Nobody wants to see a radiotherapy centre with all the mod cons — equipment and buildings — being held up over £1·1 million, which is a lot of money to some of us, but, in the grand scheme of things, not really a lot of money.  We need to ensure that, in whatever negotiations and discussions around October monitoring — if we have an October monitoring round; there are rumours that we might not get one — that type of project is put at the very forefront of all that we do.

We have to recognise the work that was done.  Ms McLaughlin talked about the Pink Ladies, and about the people of Derry coming out onto the streets to ensure that it happened.  It is important to recognise that.  She also said that cancer does not respect borders.  I have already spoken about somebody from north-east Donegal having to travel even further, to Dublin or Galway or somewhere, to get cancer treatment.  The work being done alongside the Irish Government to ensure that there is a proper, functioning radiotherapy centre at Altnagelvin is important.  Politics should never impede progress in healthcare outcomes.  It is important that that has been recognised. 

Mr Dallat made a very emotional and emotive speech about the need to put people before politics.  I ended up having to scrap half of my speech because of it, but he made a very good point.  An issue like this is far too important for us to use to beat each other around the Chamber.  It is important that we also recognise that issues like this should not be used in bigger debates, around welfare reform or financial constraints, to try to get an easy win.  We know the impact that that has on people out there.  Mr Robinson was able to talk about his own experience of the staff dealing with cardiac issues.  I think that we should all resist the urge, on the radio or in the Chamber, to make announcements about things that have a real impact on people's lives without the issues having been worked forward. 

There is a major job of work to be done to try to get over some of the issues, not least welfare reform.  However, outside welfare reform, there is massive difficulty around the Health budget.  The SDLP and, I am sure, other parties are committed to dealing with those issues.  We have a few issues to deal with.  Peter Robinson spoke last week.  We now have even more issues than we thought we had.  However, this party and other parties will, I hope, come to the fore when it comes to dealing with those.  For far too long, people and their issues have been thrown out there around these kinds of things.  Sometimes we do not have due regard for the impact that announcements on 'The Nolan Show' or wherever else have on people's lives and experiences. 

 

To sum up, I am glad to see a positive approach and response from the Minister.  We offer our support —

Photo of Mitchel McLaughlin Mitchel McLaughlin Sinn Féin 6:45, 16 September 2014

Will the Member bring his remarks to a close?

Photo of Colum Eastwood Colum Eastwood Social Democratic and Labour Party

— to try to bring about those two vital services and ensure that they stay for all the people who need them.

Question put and agreed to.

Resolved:

That this Assembly recognises the importance of Altnagelvin Hospital in delivering excellent healthcare in the north-west of Ireland; praises the professionalism and commitment of staff working throughout the Western Health and Social Care Trust; and calls on the Minister of Health, Social Services and Public Safety to ensure that the radiotherapy unit and cardiac centre at Altnagelvin Hospital are progressed without delay resulting in the delivery of critical services to the population of the north-west.

(Mr Deputy Speaker [Mr Beggs] in the Chair)

Motion made:

That the Assembly do now adjourn. — [Mr Deputy Speaker.]