Only a few days to go: We’re raising £25,000 to keep TheyWorkForYou running and make sure people across the UK can hold their elected representatives to account.

Donate to our crowdfunder

Cancer Services: Deterioration

Part of Opposition Business – in the Northern Ireland Assembly at 4:15 pm on 18th October 2016.

Alert me about debates like this

Photo of Trevor Lunn Trevor Lunn Alliance 4:15 pm, 18th October 2016

I thank the proposer for bringing forward the motion. We welcome that it was done on a cross-party basis. We are, of course, fully supportive of the motion and the manner in which it is being presented. It demonstrates that the Executive can and must be challenged in a constructive manner to deliver on behalf of the people. I suggest that, perhaps within the next year on another Opposition day, we bring a similar motion to check on actions and progress.

Of course, the issue is not just a mechanical one about targets not being met, but sometimes, that is the way it seems to be approached when discussed. The issue is that human beings — close relatives, friends and carers — are being left with huge uncertainty about their well-being. That means that not only does successful treatment becomes less likely because time is passing on a waiting list but there is additional strain that only makes their health worse. There is a tendency in the Chamber and elsewhere to talk grimly of figures but not of human lives, long-term plans delayed, big life events put off or the stress and strain of uncertainty. There is also a tendency to not talk even of people who found they were clear of cancer but whose mental health had deteriorated very badly while they were waiting to find out. I would certainly exempt Pat Sheehan and Kellie Armstrong from any criticism of just talking about figures: I thought they both spoke extremely bravely today.

I am cautious about repeating the word "crisis" too often, because it serves to create the impression there is nothing right about our health service. Many thousands of people every year are superbly treated by the service and the people who work in it. Many of the outcomes are nothing short of miraculous, but that is not to say that that word is out of place here. Clearly, when a fifth of the entire population is on a waiting list, something is not working the way it should.

I asked the Health Minister — I think it was in January 2015 — about the extent of the waiting list. The figure at that time was just over 180,000. It is now double that and more at 392,000. To put that another way, there is a tendency to see solving waiting lists by allocating more resources to the people on them when, in fact, the fundamental problem is that too many people are put on waiting lists in the first place. The resources are needed so that primary care services limit the number of people who are referred at all by intervening early to identify and solve the problem. When we say:

"patients receive swift, safe and sustainable healthcare", it needs to mean it happens at the very outset. We cannot just keep dumping thousands of people on to waiting lists and then rely on secondary care, often in the independent sector, to intervene long after the issue should have been dealt with.

Again, we cannot miss the point here that the expert panel chaired by Professor Bengoa presented its report to the Minister some months ago. Since that time, the concern is that she has been busy trying to fudge the outcome by focusing solely on the needs of some of those working in the service rather than those who use it. That is no way to start the process of real, meaningful reform on behalf of the public that, frankly, should have been started after Transforming Your Care and the Donaldson report. We will wait and see what Professor Bengoa has to say, if that is ever revealed to us.

When nearly 400,000 people are on a waiting list, that means you have a systems failure. The system is broken. Just throwing resources at it will not make it less broken. In fact, by failing to recognise this is a systems failure, we are insulting the many people who do such a miraculous job on behalf of patients every day.

The fact remains, however, that reform means change. That has to be managed carefully and sensitively so that, at the end of the decade, the system is fixed by broadening primary care, ensuring that expertise is shared at single locations for entire local areas and making sure that we never again have a fifth of the population on a waiting list. I doubt that that could happen anywhere else in the world.

We have said from the outset that we are not here to oppose for the sake of doing so. The Minister will receive our support where she reforms in line with expert advice but absolutely not where she fails to do so. We will judge the Bengoa report on its merits, not on the Minister's view of it. We warmly commend the motion to the House.