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Budget 2016-17

Part of Executive Committee Business – in the Northern Ireland Assembly at 5:00 pm on 19th January 2016.

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Photo of Fearghal McKinney Fearghal McKinney Social Democratic and Labour Party 5:00 pm, 19th January 2016

I welcome the opportunity to contribute to the debate. As SDLP deputy leader and health spokesperson, I will focus on the Department of Health, Social Services and Public Safety. The SDLP has alternative approaches, and I will outline some of those in relation to health in my remarks. One thing that will definitely not be in those proposals is Chris Hazzard's wacky economics, which propose paying off everybody's credit card bills. That will not be anywhere near what our proposals will be.

Like others, I congratulate the new Finance Minister on his recent appointment. Like all of us, he is aware that there are many genuine pressures on the health service. Throughout the past number of years, I have been expressing, on behalf of the party, our concern about the financial allocation to the health service. Those fiscal shortfalls are provoking severe and intolerable pressures across Health and Social Care. It is important to recognise, as I do in every contribution, the pressures on nearly 65,000 dedicated and professional staff who work to the highest standards in often difficult situations. Their commitment, energy and compassion should receive the highest praise. Remember that the circumstances that they are working under are not of their making.

As we enter 2016, the public are feeling the cold from the health crisis, with seemingly insurmountable pressures around A&E, colossal queues for elective care, 300,000 people on waiting lists, and care home closures, followed by the stripping of home domiciliary care services. Against that backdrop, the latest round of winter hospital statistics are not surprising. As the SDLP has been pointing out for months, there is a real crisis here. What continues to shock the public and others is that the Minister and the Department have continually failed to implement a robust and coherent long-term strategy to deal with increasing demand on the system. To use a health image, it has been all sticking plaster and no strategy. Northern Ireland now has the worst record in the UK for 12- and four-hour waiting targets for emergency care, and that has been reflected all across Northern Ireland. In fact, patients' care is continually being put at risk, with hospitals continuing to breach those targets. Indeed, some of that is emerging now out of the new critical-care building; they are diverting people out of it now because the pressures are still there.

As already mentioned, we also have a massive crisis in elective care, caused by the Minister and the Department effectively redirecting funds away from elective care into those emergency departments. That was in an effort to try to solve the A&E crisis, but all they did was provoke another one in elective care. We have clearly seen that this short-term approach has failed, and we should not be surprised when we have no long-term strategy. We have many people, especially the elderly, who are waiting enormous lengths of time for treatment. In the 21st century, that is simply unforgivable. It was unforgivable when this crisis erupted late last year and we had no Minister in place to respond. That is an indictment of leadership.

The Minister will no doubt point to the November monitoring round, but that has done little to mitigate those pressures, and I do not see any significant additional funding in next year's budget. The extra £40 million given last year is a speck in the ocean, and there are question marks over how it can be spent and whether the Department has made any meaningful attempt to increase public-sector capacity. The resolution of the elective care crisis and future resolutions will not be mitigated until there is that proper strategic focus at the heart of our health service, followed by implementation.

Today's Budget should have been an important opportunity to signal a change. We have known for years the context of the problem, and this was an important opportunity to signal a change. However, the focus is not on older people's care, nor is it on the community side. Nor is there a major signal from the Executive that, once and for all, we will deal with these issues comprehensively. The SDLP has been consistent in that argument.

It is important to remember the context that pressure on the Health budget grows by around 6% annually. As this Budget is presented, there is a massive flaw. In the next year, health and social care will receive an extra 1% in real terms to deal with additional pressure, not to mention recurrent pressures from last year, and I will get to that in a moment. This question remains: where does the Minister intend to get the 5% savings, and what is his plan to mitigate demand for services and increasing spend?

We do not have, for example — I know that a point was made earlier about detail — statistics on trusts' savings plans. The approach taken by successive DUP Health Ministers has been to fundamentally ignore the underlying issues attributing to demand. To continue in this current direction of travel only means that, as we go forward in this short-term way, we will not address the issues as they emerge. Kicking the problems facing the health service down the line, beyond the election — I think there is a motivation there — does not resolve the problems, and the public here deserve better and more.

The Minister's most recent proposal to shut the Health and Social Care Board will not benefit patient outcomes. Of course it addresses a layer of bureaucracy, but there are no savings to be made from changing a name plaque on a building and diverting staff — some of them into the trust. I see the Minister shaking his head. We had figures last week at the Committee, Minister, that reflected that, of the 600 staff, maybe 10% would go. Most of them are going to the Department, and a load are going to the trust. The Minister has provided little detail on his transformation fund, aimed at encouraging reform and innovation. Has it even received any appropriation of funding in this Budget, and has he engaged with staff on that fund? Those are important questions. In the meantime, there is still a chance for change. At its core, Transforming Your Care saw the strain that there was on the health service, particularly on the expensive side, with a growing older population and longer-term health conditions, and the need to reach into communities with meaningful health interventions by bolstering primary care. In 2011, authors recognised and acknowledged that growing demand.