Thank you, Madam Principal Deputy Speaker. I thank all those who spoke in the debate. We can agree that it was a constructive discussion on a very important issue. I will touch on the contributions of other Members shortly.

We have spent much time discussing the many pressures facing our health and social care services, and social care, specifically, is facing unprecedented pressures. That is a consequence of increasing demand and constraints around funding and workforce. Short- and long-term vacancies are increasing across all aspects of social care. One particular concern is the uncertain future facing many workers who have come from EU nations, following the UK's departure from the EU.

Funding shortages remain a significant concern, which provides another example of the unsustainability of our current funding model, as we have discussed on previous occasions in this place. We also need to acknowledge that more people live longer, which, while it is undoubtedly a good thing, increases demand on social care services. We need to adjust how we approach social care to accommodate that. It is estimated that, over the next 20 years, the number of people in Northern Ireland aged 65 and over will grow by nearly 50% and overtake the number of children in Northern Ireland for the first time. To tackle those challenges, we need to see the urgent prioritisation of the recommendations from the social care collaborative forum. That includes maximising capacity by testing new models and rolling out innovative digital solutions.

We also need urgent progress on the social care workforce strategy, the social care career pathways and the continuous learning framework. We must provide specific support to unpaid carers who, along with paid staff, provide an invaluable service to those most in need. The collaborative forum recommended an expanded carers register for Northern Ireland to provide more information for unpaid carers and to help to improve their outcomes. That should involve consideration of the complete review of the 2006 carers' strategy that our motion calls for, ensuring that the strategy's aims and objectives continue to deliver the necessary decisions to improve the lives and conditions of our carers.

Greater research into and investment in supported living are another priority outlined by the collaborative forum. A clear definition is needed, along with clarification of the services provided by HSC and community and voluntary services, with the intention of ensuring an interdependent approach to maximise the planning and delivery of social care services.

All of that must be urgently progressed. Unfortunately, we have not seen such progress from the Department of Health, as has been pointed out. Other Members raised the risk of the Department and the Minister focusing too much on consultation rather than delivery. In some respects, that has been a problem in the work of the Department and the collaborative forum.

I welcome the DUP amendment, which we will support. As other Members and I have outlined, the current funding arrangements are unfair and require urgent review.

I will now move on to Members' comments.

Nuala McAllister proposed the motion, noting that investing in domiciliary and community care is an early intervention action and that our social care workers must be supported. Noting the 2017 'Power to People' report, she said that little has changed since and suggested that consultation is delaying change. She asked, "When will we reach the point of action, and when will people see the benefits?". She mentioned third-party contributions and the impact on families of the outdated guidance. She also highlighted the need for a regional approach to data collection.

Diane Dodds moved the amendment, raising an issue that has come to her constituency office: delayed discharges and appropriate costs of care. She called the number of beds that are out of action for acute care an "obscenity", highlighting the fact that, in March of this year, 628 patients were needlessly in hospital, in some cases for long stays, which is equivalent to one large hospital and one small hospital closing their doors. She said that, if the Government and the powers that be do not value social care, why should anyone else? She also highlighted the potential for a price regulator, noting that families who are trying to pay top-ups are in desperation, and the need to improve carers' career opportunities. She asked the Minister for an update on the ability of independent care homes to reclaim VAT on expenditure in the same way as care homes elsewhere in the UK, which he delivered.

Liz Kimmins, Chair of the Health Committee, noted that the debate was similar to that on children's social care this morning. She referenced a recent visit to Northern Ireland Ambulance Service headquarters, highlighting the bottleneck in the system that results in failure to deliver safe and reliable care. Liz also pointed out that families wait months for care packages, which puts incredible strain on unpaid carers.

Colin McGrath talked about the lack of meaningful progress since the 'Power to People' report in 2017. He highlighted workforce shortages and long waits for support, stating that the system is in crisis and that the work of the social care collaborative forum is vital. He called on the Minister to bring forward key priorities and highlighted vacancy rates in social care. He asked where the new social workers would come from and called for a review of the 2006 carers' strategy.

Diana Armstrong talked about the importance of social care staff to older people and their families and to patient flow in hospitals. She noted that reforms are needed but that solutions are not solely dependent on funding, and she highlighted the importance of regulation of the independent sector.

Linda Dillon noted that the system is overstretched and underfunded and that, again, seven years since 'Power to People', the problems remain and are even worse in rural areas in Northern Ireland like her constituency of Mid Ulster. She highlighted the importance of collaboration in the community and voluntary sector and of a review of how it is funded, saying that independent price regulation is essential.

My colleague Kellie Armstrong gave us her personal history as a carer for her late brother and her father, and, as Alan noted, that strengthened the debate. She said that the population of older people in Northern Ireland who will need support is increasing. People are impacted by spending long times on waiting lists, particularly for things like hips and knees, and they are suffering unnecessarily. She also highlighted the fact that the Alzheimer's Association said that the social care system is not set up to care for people with dementia. She noted that unpaid carers save the health service a fortune but are struggling under extreme stresses and must be supported. She also pointed out that we need a carers register, which came up a few times.

Minister Nesbitt responded by saying that he understands the frustrations with the pace of reform and that the Department has established a social care collaborative forum that works on short-term solutions and long-term strategies. He spoke of the importance of improving social care as a career, and he mentioned the 'Care to chat?' podcast. He talked about how he is working towards our need to get to a sustainable workforce model. He highlighted the importance of ongoing cross-departmental work to support unpaid carers and talked of a review of social care standards that will be consulted on in due course. The Minister stated that social care reform remains a priority for him, and, on tariff rates, he said that work is under way to establish how social care is delivered.

In his winding-up speech, Alan Robinson made quite a statement when he said that, when you fix social care, you begin to fix the entire healthcare system. He talked about unpaid carers being at breaking point — again, that is familiar to most people across the Chamber and recalled the sad case of a constituent who had tried to take her own life.

Before being elected to this place, I worked in the health service as a nurse, and I have seen at first hand the effect of the overcrowding in hospital wards and A&E departments that results when patient flow is reduced. Wards that can be understaffed end up with extra patients being cared for in inappropriate corridor beds, where there is no emergency equipment and little dignity. Healthcare staff are unable to deliver the care that, they know, their patients need, and that causes undue stress and burnout.

A&E departments become so full of patients requiring admission to wards that they cannot take any more, and ambulances end up stacked outside for many hours with paramedics in the back caring for patients for sometimes their whole shift rather than being on the road attending calls. That results in long waits for ambulances in our communities. Members of the Health Committee who visited the Northern Ireland Ambulance Service will have spoken to paramedics. I was impressed by the paramedics' professionalism but concerned to see the extreme pressures on the service.

I will highlight research from the Royal College of Emergency Medicine that suggests that there is strong evidence that, in 2022, 1,434 people died as a result of delays in Northern Ireland's emergency departments. That claim is backed up by evidence in the 'Emergency Medicine Journal' that suggests that, if you are waiting in an emergency room, you have a much higher chance of dying. Those 1,434 excess deaths in 2022 represent a shocking figure, and I am sure that we can all agree on that.

In conclusion, I encourage all Members to support our motion. We need to address the crisis facing our social care services. Everyone deserves the best outcomes, regardless of their background. The policy priorities have been outlined in previous reports and by other Members throughout the debate. We know what needs to be done, and it is time for action from the Department of Health.

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

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

That this Assembly expresses its frustration at the lack of progress on transforming the social care system since the 'Power to People' report was published in 2017; notes that workforce shortages, care home capacity constraints and long delays to access community care packages are leaving too many people without the high-quality services they need, when they need them; is concerned that current charging arrangements for adult social care in Northern Ireland are unfair and inconsistent; believes the Department of Health should explore the potential benefits of independent price regulation within the care sector; welcomes the contribution of front-line staff, providers and community and voluntary sector bodies in the work of the social care collaborative forum; and calls on the Minister of Health to bring forward the key policy development priorities from that collaborative forum without delay, including the health and social care workforce strategy 2026, revised care standards for nursing homes, review of the carers’ strategy 2006 and residential care home minimum standards.