Budget Bill: Second Stage

Part of Executive Committee Business – in the Northern Ireland Assembly at 7:45 pm on 9th February 2016.

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Photo of Fearghal McKinney Fearghal McKinney Social Democratic and Labour Party 7:45 pm, 9th February 2016

I have to say that I am deeply worried — I would not say aghast — by some of the contributions. It is not the contributions themselves but the contradictions in those contributions that I am hearing. The last speaker was absolutely right in just about everything she said. She was right to be critical of the commissioning plan. She was right to be disappointed at not seeing targets in the overall Transforming Your Care plan. She was right to point out that waiting times are in disarray and that we are getting quick savings and quick fixes. She was right to say that there are key unanswered questions in the overall healthcare system. She was right to point to the fact that nurses are not getting a 1% pay rise.

Her colleague was also right in his point, although he did not go into the details of it — and I will give him some of them — that some waiting lists for autism assessments are two years long. The children are nearly grown up before they get a diagnosis.

Yet, Mr Principal Deputy Speaker, we have to be proud of all that. We are hearing two voices from Sinn Féin today, one that is deeply proud; and I am trying to work out what the pride is here. Are we deeply proud that we took a whole load of numbers, however many billions, added them up, shared them out, and they added up on the bottom line? The underlying stories are what we really should ask questions about. Those are questions that my colleague from Derry rightly asks and which I will now continue to focus on.

As the Finance Minister and all of us are aware, there are many genuine pressures on the health service, which eats into nearly 50% of our overall Budget. The SDLP has expressed concern over the last number of years, and I think that colleagues agree that questions need to be asked. A lot of it emerges from fiscal shortfall, and the result is intolerable pressures on the Health and Social Care service. I do this in all my contributions because I think that it is important to reflect on it, but those pressures are felt by nearly 65,000 dedicated, professional staff who work to the highest standards, often in difficult circumstances. Their commitment, energy and compassion must receive the highest praise. I think that we should acknowledge that.

I am glad that the Minister has moved to introduce a well-deserved pay rise for staff, although the scale is criticised by unions. Nevertheless, nurses are still not getting what they deserve, and I do not think that that is something to be proud of. It remains worrying that the Minister is still embroiled in a dispute over junior doctors' contracts, while the same issue is to arise over consultants' contracts. We have to be aware of the implications of that, not just for the delivery or ultimately, if they move away, lack of delivery and the overall effect that it could have on the system. Those workers are an integral part of it. It is vital that any changes do not put patients' lives at risk and do not deter health staff from working here.

As we entered 2016, the Northern Ireland public again felt the cold face of the health service crisis, with seemingly insurmountable pressures on A&E and colossal queues for elective care. There are 400,000 people on waiting lists in the health system in Northern Ireland. Can we honestly stand in the Chamber today and say that we are proud of that? Over 20% of Northern Ireland's population is on a health waiting list. We have to start to think differently about how we deal with this. We have home closures followed by the stripping of home domiciliary care services. Maybe we should be proud of that. This is not about arriving at a figure and saying that we should be proud of allocating that over there, a little bit of that over there, or a big bit of that over there. It is about the delivery from what we spend. We need to hear in the Chamber that we are delivering for people, particularly vulnerable people. However, given that we are reaching figures of 400,000 people, this is extending beyond what we would normally think of as vulnerable people living in poverty. This is extending into a much wider circle that has grown over five years.

The system could be said to be at breaking point. Patients and staff are suffering on the front line. It is our responsibility, in the Chamber, to point that out. That is not just being negative; it is what a good Budget is about. It is about allocating the right amount of money to achieve the right outcome. Against that backdrop, the latest winter hospital statistics are not surprising. We have been pointing that out for months. 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 increased demand on the system.

Another fact is that Northern Ireland now has the worst record in the UK on the 12- and four-hour waiting targets for emergency care. That is reflected in emergency departments across the North of Ireland.

Patients are being put at risk, with hospitals continuously breaching targets that were put in place to ensure speedier diagnosis and treatment. Are we to be proud or critical of that? When I say "critical of that", I mean not just negative criticism. I think that the Minister understands that. If I interpret him rightly, he comes from a background that likes to see a sufficient allocation, outcomes for people, and money spent well and properly so that we get the maximum return from it. I do not think that we will disagree on that issue. That is a very important aspect of what we are arguing about.

We have seen a massive crisis in elective care. Once again, we shifted money away from one area to A&E and created a new crisis. As I said, it now extends to 400,000 people. That is worrying on two fronts. First, some of the £40 million that was allocated to elective care operations could not be spent, because the administration was too bloated and the photocopiers could not deal with the system. Secondly, we heard that a number of cancer operations were cancelled, so it is not just elective care but emergency care.