Waiting Lists

Oral Answers to Questions — Health – in the Northern Ireland Assembly at 2:45 pm on 1 March 2022.

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Photo of Thomas Buchanan Thomas Buchanan DUP 2:45, 1 March 2022

2. Mr T Buchanan asked the Minister of Health for an update on the waiting list for patients awaiting their first hospital appointment. (AQO 3165/17-22)

Photo of Robin Swann Robin Swann UUP

I thank the Member for his question. Members will be aware that virtually all waiting times — not just first consultant-led outpatient appointments — were in crisis at the return of the Executive in January 2020. Whilst the pandemic has exacerbated the situation, we must never forget that it did not cause it. It is not the first time that Northern Ireland has faced issues with waiting times. Prior to 2005, our hospital waiting times were the longest in the United Kingdom, but, by 2009, the situation had broadly stabilised. It remained relatively stable until 2013-14. Then, through a combination of one-year budgets, poor performance management and a lack of serious strategic oversight, the situation shamefully deteriorated to the extent that it did.

As Members will know, last June, I published the elective care framework, which set out a detailed series of time-bound immediate, medium-term and long-term actions to address our unacceptable waiting lists. A number of initiatives are well under way, including the payment of enhanced elective care rates to staff in specific key areas of work; the introduction of mega clinics to maximise patient throughput; the introduction of a cross-border reimbursement scheme; and a move towards leasing Health and Social Care (HSC) theatres to independent providers, at times when they are not otherwise in use, to address backlogs. I made it clear, however, that certainty of investment through multi-year budgets would be absolutely critical for the delivery of the actions and targets that were set out in the framework. The recent resignation of the First Minister has cruelly robbed patients and our staff of the prospect of a three-year budget. I cannot over-emphasise how frustrated I am that some in this place are so willingly repeating the mistakes of the past. The task at hand has been made immeasurably more difficult.

Photo of Thomas Buchanan Thomas Buchanan DUP

I thank the Minister for his response. I note the number of initiatives that, the Minister keeps telling us, are ongoing to bring waiting lists down. As always, he points to the pandemic. It seems that everything else was put on hold because of it.

One thing that concerns me is the people who are red-flagged for cancer. We all know that, when people are red-flagged, there are a number of weeks — six, I think — until they are taken for surgery.

Photo of Roy Beggs Roy Beggs UUP

Will the Member come to his question, please?

Photo of Thomas Buchanan Thomas Buchanan DUP

Yet, some of the people who have been red-flagged are waiting for months on end. What are we doing to deal with that situation? We all know that cancer is much more deadly than COVID has ever been, so what are we doing to address that matter?

Photo of Robin Swann Robin Swann UUP

I thank the Member for his question. He makes a valid point about the work that we need to do on cancer. That is why I have deliberately set out the cancer strategy and the work that we need to do to get on top of that.

The Member will be aware that a number of the red-flag cases that are cancelled are usually rescheduled within a pretty quick time to make sure that those patients can be seen as quickly as possible. It is important for us to be sure that we have as few COVID patients as possible in not only our hospital system but our intensive care system so that we can utilise that capacity for the people who need to come forward for more serious operations. If the Member has a specific constituent in mind and wants to communicate with me about that, I will be glad to get back to him.

Photo of Colm Gildernew Colm Gildernew Sinn Féin

Minister, the three-year Budget prioritised health and, as you stated, set aside funding for the elective care plan. Now that the DUP has walked away from its responsibility, what impact will that have on waiting lists?

Photo of Robin Swann Robin Swann UUP

I thank the Member for his point. I welcomed the fact that health had been given priority by the Executive in the Budget. That commitment was made by all Ministers and parties. However, it is important to note that the lack of recurrent investment received by the health service over the last number of years, not just that that will not be received in future years, means that it is needed simply to ensure that our existing services are funded on a sustainable basis. It will not fully resolve the financial gap that faces the health system as we move forward, but the inability to plan and put those transformation projects on a sound, firm financial basis makes it all the more difficult for us. The likes of our cancer strategy, our elective care strategy and our mental health strategy all become that bit more difficult when we do not have that recurrent Budget.

Photo of Colin McGrath Colin McGrath Social Democratic and Labour Party

Waiting times are impacting across the health service. At the weekend, I had more reports in my constituency of an ambulance taking 30 minutes to arrive, and, regrettably, the person passed away. That happens regularly. What are you doing about those waiting times?

Photo of Robin Swann Robin Swann UUP

I thank the Member for his question. I note that he has a petition out on that issue: I am not sure whether the petition will also address the budgetary pressures that we are under, but I would welcome that being highlighted as well.

The Member will be aware of a number of initiatives that the Northern Ireland Ambulance Service is putting in place to meet the needs of all the population of Northern Ireland, whether that is the rural or urban population. He will note the response to Maggie's Call at the end of last week, through which we will see our Northern Ireland Ambulance Service and Northern Ireland Fire and Rescue Service (NIFRS) working in partnership on cardiac response. I want to see that programme brought in as quickly as possible in phases so that we can truly look at those different ways of working together to address a challenging situation in Northern Ireland.

Photo of Rosemary Barton Rosemary Barton UUP

Minister, will you provide an update on the extra activity that you have been able to deliver following the decision to allocate an additional £90 million of funding, albeit non-recurrent funding in the absence of a multi-year Budget, to tackle waiting lists in the current financial year?

Photo of Robin Swann Robin Swann UUP

I thank the Member for her question. In my initial answer, I indicated what can be done in-year with substantial amounts of money, but it becomes all the more challenging when that money is not recurrent. As of the end of December 2021, an additional 157,687 outpatient and allied health professional (AHP) assessments and diagnostic tests and inpatient and day-case procedures had been delivered through those waiting list initiatives, both in Health and Social Care and through the independent sector. That shows that that £90 million has already brought forward over 150,000 people who have been seen somewhere in our health service. If that money were recurrent, it would really make a large difference to what we could not only strategically plan but strategically deliver.

Photo of Andrew Muir Andrew Muir Alliance

Waiting times in Northern Ireland are now not just weeks and months but years. At what stage do we in Northern Ireland seek assistance outside Northern Ireland to get people off those waiting lists?

Photo of Robin Swann Robin Swann UUP

I thank the Member for his point. He will be aware that we instigated the cross-border initiative, although, again, that was only for one year, because of the financial pressures. We have been utilising that, and we have been able to send people to the Republic of Ireland under a cross-border healthcare directive.

A number of people are already utilising that, and we look for such assistance where we can buy it.

The Member will be aware that COVID is not a problem that only the Northern Ireland health service has faced. All of the health services across the UK and the world have faced it. We would have utilised additional international capacity, but that has been taken up by the health services in different countries. The ability to purchase international procedures is not as readily available as it has been in the past.