Debate resumed on amendment to motion:

That this Assembly acknowledges the deepening crisis engulfing the health service; believes current hospital waiting times are unacceptable and must be urgently and sustainably addressed; notes with particular concern the 9·4% rise in the number of patients waiting for a first consultant-led outpatient appointment in the Northern, Southern and Western Health and Social Care Trusts between June 2023 and June 2024; reiterates support for the full and timely implementation of the 'Systems, Not Structures' report by Professor Rafael Bengoa in order to deliver a more effective, efficient and responsive health service; recognises the importance of transformation being clinically led, as well as the need to value and reward our dedicated front-line health professionals; expresses concern that the stabilisation package agreed with the Government in December 2023 is insufficient to enable the immediate sustainability of public services or to take forward the much-needed transformation agenda; further believes there is a need for a new, long-term financial settlement with the Treasury; calls on the Minister of Health to work with Executive colleagues to strongly make the case for additional funding from the Treasury; and further calls on the Minister to prioritise and allocate additional resources to tackle the backlog in hospital waiting lists in the delivery of the Executive’s forthcoming Programme for Government. — [Mrs Dodds.]

Which amendment was:

Leave out all after "responsive health service;" and insert: "agrees that delivering the ambitions of health and social care transformation will require political leadership and an emphasis on service quality; recognises the importance of transformation being clinically led with genuine co-design and partnership working with the health and social care sector; further recognises the need to value and reward our dedicated front-line health professionals; expresses concern that the stabilisation package agreed with the Government in December 2023 and lack of multi-year Budgets is insufficient to enable the immediate sustainability of public services or to take forward the much-needed transformation agenda; further believes there is a need for a new, long-term financial settlement with the Treasury; calls on the Minister of Health to work with Executive colleagues to strongly make the case for additional funding from the Treasury; and further calls on the Minister to prioritise and allocate additional resources to tackle the backlog in hospital waiting lists in the delivery of the Executive’s forthcoming Programme for Government." — [Miss McAllister.]

I call Danny Donnelly to make a winding-up speech on the amendment. Danny, you have up to 5 minutes.

Thank you, Principal Deputy Speaker. I thank all Members who contributed to the debate. The tone of the debate was quite right. I thank my DUP Health Committee colleagues Mrs Dodds and Mr Robinson for tabling the motion. We proposed the amendment for the reasons that were outlined by my party colleague Nuala McAllister. In my winding-up speech, I will refer to some of those and to some comments that we heard during the debate.

The first addition in our amendment was to agree:

"that delivering the ambitions of health and social care transformation will require political leadership and an emphasis on service quality".

That was referred to by Mark H Durkan as he alluded to Northern Ireland's not being a big place, saying that you could

"travel for two hours or wait for two years".

We do have to focus on quality over geography. That is very important. Our services are provided by specialist units, and one hospital will deliver higher-quality outcomes. We know that, and that prevents unnecessary duplication. We will see that going forward.

Liz Kimmins referenced Professor Bengoa's burning platform analogy from 2016. It is notable that Professor Bengoa will return to the Northern Ireland Assembly in a couple of weeks, so it will be interesting to see what his consideration of our current situation is eight years on. Obviously, there are still a lot of challenges, and the platform has burned significantly since then. That is where we are, unfortunately.

Alan Chambers referenced the elective care framework, which, obviously, has begun to show some success. We are starting to see waiting lists come down in certain areas of care delivery in Northern Ireland because of the implementation of those. Alan also mentioned the inability of the Assembly to deliver a multi-year Budget, and I was encouraged by the Minister's comments about his hopes for a multi-year Budget in, I think, 2026-27. I hope that those ambitions will be realised, and we will do what we can to support the Minister in that.

Linda Dillon mentioned shared services on the island of Ireland. Linda will be aware that the Health Committee had a meeting with the Health Committee from the Oireachtas — I think you were there, Linda — and discussed a lot of the shared services that are available, particularly around cancer, and that is something that we are working together on. It is very good to see that.

Will the Member take an intervention?

Yes, certainly.

As the Member is aware, we are also going to Dublin to meet the Oireachtas Committee there, and it is definitely worthwhile for us to raise this when we are down there. As I said, it is important, particularly in the border areas, where we really could have better access. In the likes of Fermanagh, there could be a difference of two hours in being able to access emergency surgery.

The Member has an extra minute

Thank you, Principal Deputy Speaker. I certainly agree with that, and it is something that we can work together on.

Alan Robinson reiterated the failure to meet treatment targets, and it is appalling. I think Mrs Dodds referred to it as "obscene", and I agree. Mr Robinson highlighted the fact that the people to whom we refer in the targets are not just numbers but our constituents. I have personal experience of constituents who are spending their life savings and borrowing money to pay for surgery. They are being forced into the independent sector to buy surgery that they should get on a timely basis in our health service. That was a well-made point.

Órlaithí Flynn talked about the health inequalities that women face and the shocking statistic that some women can expect to live 14 fewer years in good health than those in more prosperous areas. That is a very shocking statement, and she made the point strongly. Thank you, Órlaithí.

Timothy Gaston referred to the growth of the waiting lists during the years of stop-start government, and he is right. Timothy is not here, but he is right that we have gone on and off. We should be aware in the Chamber that on-off government makes delivery of transformation in the health service impossible. If the Assembly is not functioning, we cannot deliver transformation, and we certainly cannot deliver multi-year Budgets.

The Minister said that the health service should be effective and timely for all, and it absolutely should. The gap between funded capacity and demand that we see is being exacerbated by problems in the health service, and we see things getting worse in some areas. There are areas where things are improving and people are getting more treatments. That is to be welcomed, and we want to support the roll-out of things such as multidisciplinary team (MDT) services in GP practices across Northern Ireland. While they are not a silver bullet for GP practices, they ease the burden on those practices. I know that GP practices have been happy to hear of the extended roll-out of that and of the surgical hubs.

For those reasons, I encourage all Members to support our amendment, which improves the motion and states that the Assembly will provide political leadership to deliver the best outcomes for our health service, work with relevant local sectors and seek to progress agreed multi-year Budgets.

I call Diane Forsythe to conclude and make a winding-up speech on the motion. I advise you that you have up to 10 minutes, Diane.

Thank you, Madam Principal Deputy Speaker. In reflecting on how my colleague Diane Dodds opened the debate, let us remember that we are talking about real lives and real people. We are talking about our families and friends. Diane tabled the motion on a matter that she feels passionately about in order to open up debate in the House, and I thank everyone for their contributions.

The stabilisation package that our UK Government offered, although welcome, does not provide the space or the financial firepower to take forward the public services transformation agenda in a meaningful way. While we are right to highlight the cliff edge perpetuated by the Government's short-term stabilisation package and the benefits that extra funding could achieve, a lack of money cannot be an excuse for inaction.

When devolution was restored in 1999, the Department of Health received one third of Northern Ireland's block grant. Today, it consumes more than half. We already spend more per person on health than any other UK region. That shows that it is not just about throwing money at the problem.

I thank all the contributors to the debate. It was on something about which everyone feels strongly.

Nuala McAllister, in speaking to her amendment, spoke strongly about cooperation, engagement and consultation. Everyone wants that and recognises that we need to move forward here. Liz Kimmins spoke to the fragility of our health system and referenced our local A&E department at Daisy Hill Hospital, about which we feel strongly, the struggles to attract GPs, and workforce planning leading to crises across service delivery. Mark Durkan rightly said that we need to invest to save and agreed on the need to fund the transformation. Alan Chambers noted how waiting times are unacceptable and how people in Northern Ireland are just not getting the treatment that they deserve. Linda Dillon highlighted the challenges, in particular those of the social care system, which, she said, carried the weight of a broken system. She also highlighted the challenges in rural constituencies.

My colleague Alan Robinson rightly said that our health service is at breaking point and that one of the most difficult tasks for GPs is to refer patients to a waiting list, because they know that they will not be seen for some time. That is a real and concerning statement. Alan also rightly highlighted how the Fiscal Council has said that the stabilisation package offered by our UK Government will largely be used up by the recurrent public-sector pay packages. That is why, last December, when others claimed that we should not look a gift horse in the mouth, the DUP insisted that the package did not go far enough.

Órlaithí Flynn talked about tackling health inequalities. In particular, she spoke strongly on issues that affect women and the need to invest to prevent rather than just treat illnesses. Timothy Gaston spoke about the need for a long-term funding package like that for Wales.

I thank our Minister of Health for being here throughout the debate. I welcome his invitation to Professor Bengoa to come here on 9 October, but I am somewhat disappointed, in that I feel that I heard more of the same from him today. He said that the health budget was inadequate and then listed the details of existing waiting lists: we know that, and we have heard it before. We need to see more being done. We want to offer the Health Minister support through the motion and encourage him to take more action.

We welcome the additional £76 million, but we acknowledge that we need to see more. We also call on the Health Minister to publish a transformation plan with degrees of aspiration for how the allocated funds will support the delivery of transformation. He needs to be able to report the outcomes. We need to see transformation, because we all want to see lives saved. We need to stop treading water and managing the decline.

I want us to join together and make the case for fair funding today, but I would also like to see the Minister of Health set out a clear and ambitious plan for investing that money in the right place at the right time with the right results. He has the support of us all. We just want to see the detail and a plan for moving forward. We ask, through the motion, that we unite to see delivery on that. Lives depend on it.

Question, That the amendment be made, put and agreed to.

Main Question, as amended, put and agreed to. Resolved:

That this Assembly acknowledges the deepening crisis engulfing the health service; believes current hospital waiting times are unacceptable and must be urgently and sustainably addressed; notes with particular concern the 9·4% rise in the number of patients waiting for a first consultant-led outpatient appointment in the Northern, Southern and Western Health and Social Care Trusts between June 2023 and June 2024; reiterates support for the full and timely implementation of the 'Systems, Not Structures' report by Professor Rafael Bengoa in order to deliver a more effective, efficient and responsive health service; agrees that delivering the ambitions of health and social care transformation will require political leadership and an emphasis on service quality; recognises the importance of transformation being clinically led with genuine co-design and partnership working with the health and social care sector; further recognises the need to value and reward our dedicated front-line health professionals; expresses concern that the stabilisation package agreed with the Government in December 2023 and lack of multi-year Budgets is insufficient to enable the immediate sustainability of public services or to take forward the much-needed transformation agenda; further believes there is a need for a new, long-term financial settlement with the Treasury; calls on the Minister of Health to work with Executive colleagues to strongly make the case for additional funding from the Treasury; and further calls on the Minister to prioritise and allocate additional resources to tackle the backlog in hospital waiting lists in the delivery of the Executive’s forthcoming Programme for Government.

Members, please take your ease while we change personnel at the top Table.

(Mr Deputy Speaker [Dr Aiken] in the Chair)