In conjunction with the Business Committee, the Speaker has given leave to Michelle Guy to raise the matter of the lack of respite provision in the South Eastern Health and Social Care Trust area. I call Michelle Guy, who has up to 15 minutes.

Thank you, Mr Deputy Speaker. I will speak on behalf of families in Lagan Valley and the South Eastern Health and Social Care Trust area who are desperate for respite services. Not only are those families being failed by our system but they are being traumatised by it. I have been privileged to speak to many families who have been impacted on by this. They love their family members dearly, they are experts in caring for them and they are simply asking for some support. When describing their experiences, families have expressed to me feeling threatened, manipulated and misled by their interactions with the South Eastern Trust. Others have spoken of a get-it-spent culture that creates wastage and focuses energy on quick-win-style solutions aimed at making the numbers look good rather than meaningful interventions that will make a real difference. A lack of strategic thinking and a failure by trusts to work collaboratively in a focused way to solve the acute and specific issues of overnight respite completes the picture.

Families recognise that most staff are doing their best — in fact, many go above and beyond in really challenging circumstances — so they are very much looking up the chain for accountability, action and, importantly, leadership. Minister, families recognise that you have personally met them and organisations supporting them recently and have made commitments in relation to pressing for a culture shift in the trust. That is welcome, but the level of mistrust that exists will only be overcome by delivery, not warm words.

Starting with my constituency, Minister, I know that you visited Lagan Valley in relation to adult services back in January at the invitation of my colleague David Honeyford. Preceding that, respite services were stood up again at the Hillhall facility in November. The families benefiting from that are grateful, but what is amazing about this community of families is their deep empathy and willingness to support each other. Each of those carers has a unique understanding of the pressure that other families are under, and they have been keen to speak to me as passionately about the needs of others as for themselves. One family told of their relief to now have respite on a monthly basis restored but were quick to highlight very elderly carers, including one in their 80s who has gone for a year with no break. However, such is their lack of trust in the system, they expressed concern that the help that they are now receiving could be withdrawn or reduced suddenly. Their specific concern is that the boost in adult provision is only being sustained by slippage in restoring services for children with complex needs. How is that possible? Minister, I hope that you can provide an assurance today that a feared trade-off between adult and children's services will not materialise and there will be no rollback of restored services in Lagan Valley or the South Eastern Trust.

That concern is not without reasonable foundation, because it is the case that money allocated in the previous financial year for children's services did go unspent. The catalyst for that investment announcement was the BBC documentary 'I Am Not Okay', which provided a shocking insight into the experience and daily challenges of four mums as they care for their much-loved autistic sons who have extremely complex and challenging behaviours. Your response to the public outcry was to announce a welcome commitment of £2 million in emergency funding for respite care, followed by a commitment of £13 million annually to expand services. The families featured in the programme, and others in similar situations, felt relieved that, with that investment, something was going to change. However, not all the £2 million was spent, and what was spent was invested in increasing some therapeutic services and early intervention rather than addressing the current and acute needs. As one person explained, parental classes or early intervention measures are no use to a teenager with profound needs deemed to be on the edge of care. They need respite, and watching limited money that was meant to support them be spent on other things was exasperating and compounded their sense that their children, as one mother put it, are the forgotten children.

Minister, when you made your announcement, you created an expectation of improvement in a matter of months. The latest position that I have been given from the South Eastern Trust is that 83 children with disabilities, whom we know of, are waiting on a residential short break and that many who have been promised one have had short breaks cancelled at short notice. It remains the position that Lindsay House is unavailable for respite and that Redwood will not open until September, leaving families with the prospect of a summer without support. Families have also asked about capacity at Greenhill, specifically about an additional chalet that they were told will not now go forward. They were offered no explanation for that.

Even if all those facilities were opened and staffed tomorrow, it would be doubtful that the capacity that they offer would meet demand. The question that many are asking is why the response to the crisis is not regional in nature, such is the level of crisis, and most families could not care less about trust boundaries and are willing to travel to access support. The sense among families is that trusts continue to have a silo mentality and that firm direction needs to come from the Department that trusts must collaborate better and be solutions-focused, with the interests of the children and their families at the centre of resource planning.

In the meantime, families have told me of their fear of admitting how bad things have become, in case that is weaponised. In conversations with families, they have told how raising concerns is met with the threat of their children being moved out of jurisdiction, and some have told how they have been accused of abandoning their child simply for asking for help. Others have told of being patronised or having their child placed on the child protection register, which implies that they, as a parent, are a risk to their child when, in fact, they have been hospitalised following an assault by their child.

Some of the parents have expressed some cautious optimism that people are saying the right things now, but they have been let down many times already and remain scarred as a result of the toxic culture. One outworking of that culture is a likely under-representation of the number of families on the edge of care. That is currently 81 in the South Eastern Trust, but some families are aware that they are not counted in the figure because their request has been categorised as "parental request" rather than "assessed need". If the orientation is child-centred, it is in no one's best interests to underestimate the true level of need.

I thank the Member for giving way. She makes a very important point in relation to how children's needs are assessed. One of the issues around the South Eastern Trust, in particular, is the number of families who are still waiting for contact with a social worker. That is a very issue. The South Eastern Trust is completely out of kilter with other trusts in relation to that number of families. Does the Member agree that that leads to an exacerbation of the problem and that things can get out of hand quicker because help is not available or assessed?

I thank the Member for her intervention. I absolutely echo her words. That exact concern has been expressed to me: parents have raised that same issue of getting access to a social worker and, even if they do, getting the help that they need. I thank the Member for that; I appreciate it.

In the Minister's funding announcement in October, he, rightly, identified workforce as a key barrier to progress — one that needs to be tackled head-on, with improved pay and terms and conditions to attract people to the roles. Connected to workforce is the fact that, increasingly, our special schools are providing de facto respite for children, as there is no other outlet available to give parents a break. Staff in those settings are doing all that they can, but they are ill-equipped to deal with such complex needs. Indeed, some families have built up £10,000 to £12,000 in direct payments instead of respite, where there are no suitable services to spend it on. I also had one family reach out to say that they had found someone to accept direct payments for overnight support in the home, but their request for additional direct payments to cover that was yet to be assessed and was initially dismissed. Such examples really jar, because the problem of sourcing and employing resource — to compensate for system failures — has been pushed back to the families, only for them to be presented with a "Computer says no" response.

I can say with certainty that the Minister feels the same level of compassion and concern in his dealings with these families as other Members and I do. However, the difference between us is that he has the power to act. Members have been afforded a platform, tonight, to speak on behalf of the families; to tell their stories; to ask that the Minister gives clear direction and timelines to the South Eastern Trust and every trust for delivery for these families; and to ask that, going forward, all carers are treated with the level of respect, dignity and professionalism that is befitting of the pressures that they are living with as they care for their cherished loved ones.

Given the high number of Members who have indicated that they wish to speak, time will be limited to four minutes per Member, with the exception of the other Lagan Valley representative, David Honeyford, who will have five minutes. I caution in advance that interventions could also impact on the number of Members who are called to speak, as we are time-limited in an Adjournment debate.

I assure Members that I have not moved to the South Eastern Trust area, but I retain my interest in carers and respite. In fact, I raised the issue this morning in Members' statements.

I welcome the opportunity to take part in the debate today. The lack of adequate respite services in the South Eastern Trust and, indeed, across the North deeply impacts on countless families in my constituency as well as those in the South Eastern Trust area. Respite care services provide essential relief for adults and children with learning difficulties, complex needs, physical disabilities or other needs and are a key support for their carers. Respite care is not a luxury; it is very much a lifeline for carers. It is essential for their physical and mental well-being and for the continued care of those whom they look after. It offers a break from the relentless 24/7 care that they provide to loved ones, ensuring that those loved ones receive the highest level of care. Respite often supports carers so that they can manage some of the day-to-day activities that are taken for granted by those of us who do not have to provide care. It also provides a safety net for carers if they fall ill or are hospitalised or if either the carer or their family member needs a break.

Those who work in respite services absolutely deserve our respect and praise for their work in very challenging circumstances. Respite facilities face issues with staff retention, due to the mounting pressure on those who provide respite care. That is not their fault; it is a reality of the situation in which they are working. Many facilities cannot cope with the increasing demand of planned respite and the pressing demand of unplanned and emergency respite that can arise. Sinn Féin believes that ongoing co-production with families, carers and front-line staff is essential to ensure that funding is targeted effectively and delivers meaningful improvements in respite care where it is most urgently needed.

We welcome the Department of Health's allocation of up to £2 million for the remainder of the financial year and an additional £13 million annually that is aimed at expanding and improving respite care services. However, families affected by the crisis have reported that there is little evidence of tangible improvement on the ground as a result of that funding. Families are all too familiar, unfortunately, with receiving a last-minute notice that their respite has been cancelled. Minister, that situation arose once again with Woodlawn House in Dungannon in the past week. Families, some members of whom are in their eighties, who look after loved ones with very complex cases had, with only a week's notice, the respite that they were so badly looking forward to taken away. As someone tweeted, if any of us were told that the leave that we were looking forward to had been scrapped, we would be devastated. Carers are doing their utmost, but late cancellation, in particular, and the lack of regular and sufficient respite leave them feeling hopeless and abandoned at times.

Last October, Sinn Féin successfully had a motion passed that called on the Health Minister to urgently bring forward a plan to improve respite services across the North. I look forward to hearing an update on those plans and how they will target support for carers. We need assurances that the respite services that were previously closed have reopened and will not be repurposed for residential care, which, itself, is a very valuable and much-needed service. We need clear planning mechanisms to ensure that local healthcare trusts can develop and implement the services that are necessary to significantly increase respite provision in order to provide support for families and carers.

I thank the Member for Lagan Valley for securing this afternoon's Adjournment debate on what is a very emotive subject, particularly for the families who are impacted on by the continued lack of respite provision in the South Eastern Health and Social Care Trust area. Anyone who has watched Tara Mills's 'Spotlight' documentary, 'I am Not Okay', or who has heard the evidence provided to the Health Committee by some of the women who feature in it will have been deeply moved by their lived experiences of life with a child who has severe autism and behavioural problems.

My constituency office team has been navigating that system on behalf of families in Strangford who are crying out for respite. Sadly, those challenges are being faced by growing numbers of families. In 2020, the number of children with autism or a learning disability was 4,500. Today, it is more than 5,600. Despite the ever-growing need for services in that area, it appears that, in some trust areas, provision has stood still; in others, it appears to have diminished.

The 'Spotlight' programme highlighted a societal shame that cannot be allowed to continue. That travesty has been particularly acute in the South Eastern Trust, where 499 children are on a waiting list for disability services. Of that number, 118 are awaiting family support services and 71 are awaiting gateway services. Whilst efforts are being made across all trusts to tackle that crisis in provision, it is unclear, as yet, what impact will be felt among the families who are desperately in need of respite support.

There is an onus, particularly on the South Eastern Trust, to ensure that complex needs cases are given the attention that they deserve and that those families receive appropriate care. Funding has been allocated: it is critical that it is directed to front-line services and to the provision of respite beds and fully trained and professional social services for the families of children with complex needs.

Regular overnight respite is paramount for a family to properly function whilst caring for a child. I found the comments of the late Geraldine O'Hagan particularly harrowing as I watched the 'Spotlight' programme. That the provision of children's disability respite care services did not look much different throughout her 30 years of social work should be deeply troubling to us all. One thing is abundantly clear: the system has failed those children and their families. I applaud those who had the courage to tell their story and bring that travesty to light. That should not have been required. It now falls to the Department and individual trusts to make good on their promises and ensure that other families will not have to endure the pain that has been evident in the lives of those families.

I am sure that we all agree that adequate short-break services, whether day care or respite, are essential to the well-being of families and carers. Respite offers young people and children with learning disabilities and complex health needs a new setting to be supported in. Importantly, they also provide the families of a disabled child with a break from their dedicated caring responsibilities.

From sitting on the Committee for Health, I am aware of the significantly increased demand for family support and short breaks across a wide range of services for children with disability. In the South Eastern Trust, in particular, a significant number of families are on the waiting list for overnight respite. Lindsay House was a lifeline for many families when it served as a short-stay facility, and I know that the trust is making progress on its remobilisation.

Just as demand continues to increase, so do challenges in the provision of residential respite. Workforce pressures and the availability of beds have been greatly impacted in responding to the needs of children and young people who enter medium- to longer-term care. However, I am sure that those are challenges that the trust, the Department and the Minister are alert to.

I applaud every family member and loved one who is involved in the care of a person with additional needs and the bravery of each family that welcomed the BBC into their home for the recent 'Spotlight' programme. The programme effectively and powerfully highlighted the real-life implications of the insufficient availability of short-break and residential provision in the Belfast Trust and South Eastern Trust. Through our television screens, we got only a glimpse of the challenges, but none of us could have been left untouched. The Minister, I am sure, had the same reaction when he watched the programme and listened to the families. I welcomed his swift response in committing additional funding for this new financial year and a proportional allocation for the last. I recall the Minister saying at the time that that would be a challenge to deliver but it was a challenge that he was prepared to undertake. The 'Spotlight' families and the countless others who were not broadcast but likely face the same challenges, deserve no less.

I look forward to the Minister's response on the provision in the South Eastern Trust, but I do so in the knowledge that there is no solution that will fix the issue overnight. It will take commitment, but the Minister has already shown clearly that he wants the system to do better.

I welcome the Adjournment debate and thank the Member for bringing it. It is an incredibly important issue that we have covered at great length in the Health Committee. It is close to all our hearts, because it concerns some of the most vulnerable in society and those who carry the mantle of caring for them. There are few issues that galvanise the political view across this place as much as this one. I pay particular tribute to the families who spoke out so eloquently in the BBC 'Spotlight' documentary and when they have spoken to us in this place and at the Health Committee. The 'Spotlight' documentary was a remarkable piece of film-making on the challenges that they face and the absolute importance of having respite care.

We know that there are specific staffing issues in the South Eastern Trust. We understand, having heard from the Department of Health at the Committee, that, from April onwards, we will see an expansion of existing facilities and the recovery of the beds that have been lost as a result of COVID and other pressures over the years. I have to be absolutely clear, however, and say that, at one point, 499 children across the South Eastern Trust area were waiting for disability services. That includes those who were looking for respite care. In the Belfast Trust, the figure was 34. In the Western Trust, it was 140. In the Southern Trust, it was 180. In the South Eastern Trust, it was just under 500. That, even in its own right, should speak to the fact that some sort of intervention is required to address the imbalance or at least to assess why there is such extra need in the South Eastern Trust.

Service provision for those with a learning disability is an issue that is close to my heart. I have done a lot of work on it over the past number of months and years. I have asked the Minister many questions about the learning disability service model that will be published and consulted on. It has been co-designed with trusts. It will have a costed action plan. It will be a bit of a game changer and help embed respite care and put it on a more equal footing across the North. I commend the departmental officials who are getting that document ready for publication. I have met them, and I know that their passion is to make sure that the service that is provided in the community meets families' needs. All of us in the House want to see that need being addressed, as it has not been addressed up to now. There should be an apology to the families who have been let down, an apology to the children who have been let down and a promise that, from this point on, we will get it right.

I thank the Member for Lagan Valley for securing the debate. Like her, I am not on the Health Committee, but, like many others, I watched the incredible and very moving 'Spotlight' documentary 'I Am Not Okay', which explored the experiences of four families caring for children with autism and detailed some of the crises in Northern Ireland's health and care services.

In conducting some research for the debate, I came across a petition from the National Autistic Society (NAS), which states:

"Short breaks support is woefully inadequate across Northern Ireland and it is those requiring the highest level of support who cannot access appropriate services. Many short break services have been repurposed as full-time residential homes as families have hit crisis. But even so, there are currently no available residential placements in Northern Ireland."

It appears to me that three distinct areas require improvement. There may well be others. There are probably many Members in the Chamber who are more across the issue than I am. The first area is capacity. We know that, pre-COVID-19, levels of provision and support were far from ideal. Post-pandemic, however, they are really poor. Legitimate questions need to be answered. The second area is staffing. Again, there are differentials between pre-pandemic and post-pandemic levels. The final area is consistency of service provision. It appears to me that each health and social care trust operates its own resource panels, which leads to trusts dealing with cases in slightly different ways.

It also appears that family support services are limited for children with very complex needs. I imagine that the lack of respite care, which is what we are talking about today, must have a significant impact on those children's parents. I am sure that it, in turn, leads to some of them experiencing burnout. I also imagine that it puts significant pressure on their relationships. In October 2024, the Minister allocated a welcome £13 million of additional funding for that specific area. Today, we need to know how that money will be spent, what direct impact it will have and when.

My two requests to the Health Minister today come from people who know the challenge at first hand: to provide immediate access to short breaks and residential care for families who are currently in crisis in Northern Ireland and to provide the resources needed for the commissioning of services to support autistic people with high support needs and their families, such as short breaks and residential placements.

I do not think that anyone in the Chamber will even get close to representing the true feelings of families who are affected by the lack of service provision. The reason for that is that we cannot empathise because none of us is walking in their shoes, but we can ask questions, we can scrutinise and we can demand answers.

My first proper job before I was self-employed was working in the Lisburn assessment and resource centre (LARC) in Seymour Hill garden centre, which provides job opportunities for adults with learning difficulties. They are days that I remember really fondly.

Roll on to 2022, after the election, when I sat in Hilden Bowling Club listening to stories from local parents, some of whom were getting older and were really concerned for their loved ones and some with the most vulnerable residents of Lagan Valley. A couple of other representatives and councillors were at that meeting, and we came away from it really affected by the stories that we heard. I have enjoyed working with those parents since. We are really blessed in Lagan Valley, and, thankfully, we have them, because there is a real powerhouse of energy from a lot of those parents, who fight for the cause. I have been really blessed to have been able to give them some small assistance to get them started. I will give a shout-out to Vivien and Karen who started Sensability and to Philip who started the Live Life Well-being Centre.

I thank the Minister for his engagement in early January. He came to Sensability to listen to parents' concerns around not just respite but transport, the needs and building needs of the area and the wider issues simply to make life better and easier for people.

Prior to the debate, I chatted to some carers. They are the type of people who, when my electricity was out during the recent storm, contacted me to make sure that I was OK. We are talking about the type of people who go above and beyond their own family and look out for society as a whole. I spoke to someone who said:

"David, I can't stress how important respite is. This is not a luxury."

The resumption of respite in Hillhall has, thankfully, started to ease pressure on some families after a period of 18 months without any respite. Unfortunately, Hillhall has been closed and open for the past five years. The real concern in the community is, yet again, an emergency placement, which effectively closes the centre to everybody else. During that period of blocking, we heard the same tired excuses from the Department that there was nowhere else to place people. I do not want to get into discussing the situation around the last individual who was there, but there was always an alternative solution. The fact that they are not blocking that facility today is evidence of that.

The system for allocating respite was also raised. The social worker needs to sign it off, and Diane rightly mentioned that. I am aware of quite a few families who cannot access respite care simply because they cannot get to their social worker.

Minister, you met Beth, and you will remember her. She looks after her sister Jenny. Beth is 81, and her concerns are around Jenny. She articulated those passionately to you and to me a couple of times before that, and her concern is about what will happen to Jenny as Beth gets older. Ultimately, she is 81 and will not be around for ever, and her concern is what will happen there. When you met, she was so appreciative, but, today, Jenny still waits for a care package. She has been waiting since Christmas. I heard only recently that Beth has not had access to any respite care and, unfortunately, very recently had a fall.

The question has to be asked: with a care package in place and respite care, would they be as exhausted, and would events have turned out the way that they have? I do not know, but this is Jenny's life, which, I suppose, is when decisions meet reality. The Department is actually placing more cost on itself. Through inefficiency and not dealing with one issue, you create a cost elsewhere.

I want to wrap there. Again, I thank the Minister for coming, but we need an assurance that access to respite in Hillhall will continue in the long term and that it cannot be an option to use that facility for anything other than respite care. I would appreciate the Minister's confirming that without any ifs and buts. We need a firm guarantee for the families that that facility will remain open and that it will be used solely for respite as we move forward.

Thank you, Mr Deputy Speaker, for allowing me in. I thank the Member for Lagan Valley for securing an Adjournment debate on such an important subject. Like the Members from Lagan Valley who have so eloquently made their case, I have represented constituents from across Lagan Valley who have found challenges, not just since COVID but probably from further back.

I will not cover too much ground that has already been covered, other than, perhaps, to offer a challenge to all of us. As you know — I often talk about it — I chair the all-party group (APG) on disability. For quite a while, I have also been a member of the all-party group on learning disability. Having met officials, professionals and politicians, it strikes me that we all want the same thing, but there is something quite wrong in the system that we have developed over the years: our approach to how we share the ambition for people with disabilities and learning disability. We work with their families across every statutory agency, and, only a couple of years ago, we faced down the challenges faced by families who were waiting lengthy times for a statement or a report on their children so that they could access adequate education in our schools, and it is sad to see that played out in other spheres, including Health. To be fair to the Minister, he has already stepped up to the mark in that regard.

That is what we can do in the intervention phase, guys. That is entirely appropriate, and I absolutely agree with some of the comments. We need to ensure that the families get that respite. We need, however, to achieve a massive culture shift when it comes to all things pertaining to learning disability and disability.

What do I mean by that? I will set the tone, if you like, by referring to problems that we also face in getting respite care and homes for children who are looked after. It is not just in learning disability and disability where there is a backlog. There are almost 5,000 children in care. There is a shortage of the foster carers and respite homes needed to help all our children. As a society, we have become desperately busy, and, arguably, we maybe chase the wrong things at times instead of prioritising what will impact on us in the future right across Northern Ireland.

The other thing that strikes me is that we have an ageing population, and we may face difficulties in the future because of the workforce pressures that come with that. As mentioned by Mr Honeyford, in particular, parents who are elderly may be looking after children who are quite elderly and facing challenges.

We need a major shift in how we approach everything to do with disability and learning disability. Future debates on the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD), in particular, could be very useful in helping us to shape our legislative intent and ambition. I hope that, even after the debate tonight, we will be focused on bringing immediate respite to those who need it desperately.

I thank the Minister for being here. I also thank my colleague for securing this very important debate. Adequate short break provision is absolutely essential. Hearing Members' powerful testimonies of some of the interactions that all of us here have probably had has added to the debate and its poignancy.

In February, there were 85 young people on the waiting list for short breaks in the South Eastern Health and Social Care Trust area. Only 13 young people receive regular short breaks. Some 72 families are in crisis every single day and every single night, yet they cannot get the relief and rest that they need. When additional funding was announced last October, parents absolutely expected that there would be new respite beds. A constituent of mine who has a young child with complex needs was told that respite beds would become available at Redwood. She was even given a tour of the building and was promised that it definitely would not be turned into a residential home. She heard on the radio that Redwood would be residential after all. I can begin to imagine how crushing that was, because, when speaking to her, I saw that it was incredibly crushing for her.

The trust hoped to recover respite beds in Lindsey House and to provide additional nights at Greenhill, but my understanding is that it does not intend to create any new additional respite beds. Even with those very limited plans, our hopes are extremely fragile. I learned today, in a response to a question for oral answer, that only 6% of the £1·3 million that was spent last year to improve respite services actually went into overnight short breaks. That is alarming.

In order to make up for that glaring lack of services, the trust will often offer direct payments in lieu of short breaks. Parents then need to make their own arrangements. That is more work for parents who are already at breaking point. My constituent does not currently receive those payments, as she finds it too difficult to manage recruitment and all the admin that comes with being an employer. I have been told by organisations that work in this sector that direct payments are often returned unspent because parents cannot find care providers either. I asked a priority question for written answer about the exact numbers, but I did not get an answer back in time for today's debate. In any case, that shows me that direct payments do not work for parents, who need respite services rather than cash.

There are so many things that are wrong with the way that children's disability services are being delivered. I could speak on, but I want to say one more thing. In reading through Committee evidence, I can see that there has been an acknowledgement that, at times, compassion and empathy have been lacking in interactions between the trusts and service users. My constituent has also felt let down by that. Parents do not deserve to be spoken to in a way that lacks compassion just because they ask for the help that they need to care for their child, whom they love so much. I believe that the trust has committed to looking at that cultural aspect of disability services, but change cannot come soon enough.

I thank the Member, who is a colleague of mine from Lagan Valley, for securing the Adjournment debate. This is a very welcome opportunity to be in the Assembly to highlight these issues again. As a member of the Health Committee, I have been focusing a lot of my attention on respite services, and for the purposes of today's debate, I will focus primarily on children's respite services.

At the very first Health Committee meeting last year, I raised the matter of the review children's social care services in its entirety, the implementation of Ray Jones's report and, from that, the issue of respite. We did not secure an inquiry then, but it has become a priority for the Committee. It is something on which we have been engaging over the past year. I want to highlight the Minister's commitment to the issue, given the fact that he has appeared before the Committee to answer questions and in the Chamber a number of times. However, I will say that the leadership on the matter comes not just from the Department but from across all the trusts, and therein lie some of the issues.

We are engaging on the South Eastern Trust tonight, but the issue is similar across all trusts in Northern Ireland where families are waiting. Many families have been in touch with all of us on the Health Committee and with their local MLAs. Every time I do a social media post or speak to the media on the issue, a new family comes to me for assistance. It was the same last night when a number of new families reached out for support, many of whom, as my colleague from the Health Committee mentioned, are still waiting for a disability social worker to approach them and assess their respite needs.

I heard from families who said that their child has been deemed to need a 5:1 or a 3:1 care ratio of staff to child. However, those people are being abandoned to look after their child on their own. Why is a parent, who, in most circumstances, is a mother, left to deal with all the issues that their child with complex needs has — the child whom they so care about — every day, on a one-to-one basis, but they cannot get respite because the child's needs are so complex that they require a 5:1 or 3:1 staff ratio? Something is simply not adding up.

There are also a few more specifics that we need to point to, such as Greenhill. It was said that Greenhill would be taking on a new cabin that had four beds — a four-bed unit — that would have brought it up to being a six-bed unit, except they are actually closing the other two-bed unit. Why is that happening? When we asked about it at Committee a number of weeks ago, it was confirmed, after much deliberation, that it would be a four-bed unit. However, I have an answer to a recent question for written answer that says that it will be a two-bed unit seven nights a week. What on earth is the answer? What will Greenhill actually offer to parents? We need that answer.

We also need an answer on Redwood. The Minister committed to the £50,000. Minister, you said, the last time that I questioned you on the issue of fire safety, that if we get that open, we can enable Lindsay House to open as well, transferring the long-term placement from one to the other. What are we going to do when those parents who also need long-term placements come to the door of social services and say, "I cannot cope any more"? Are we going to shut down all the other respite facilities yet again? We do not have an answer for that.

We also have not got an answer about registration when it comes to the Regulation and Quality Improvement Authority and whether we can change the rules to allow short-term and long-term placements to coexist. If someone moves into a long-term placement that is supposed to be short-term, the other beds are shut down in their entirety. That is not acceptable. We cannot allow bureaucracy to stop children from accessing the care that they deserve. Families are in crisis and have been for years. We need answers and deliverables that will achieve more respite in the now. It can be done. We have seen that we can recruit staff. We can see that parents are —

Time is up.

— expected to cope —

Time is up.

— and we should ensure that the trust will cope, too.

I thank my colleague Michelle Guy for bringing this important issue to the Floor. My party colleagues and every contributor to the debate have very clearly set out the issues, so I will do my best to be brief. I do not want to rehash the numbers and statistics that we have already been through: they have been set out clearly. I will speak from a personal perspective and as a local MLA. I am very conscious of the pressures that are on the South Eastern Trust's respite services. Those issues come through my constituency office regularly, and I have submitted many questions to the Minister on the matter, as I am sure that other Members have. As has been set out, there is a sense among Members that we are not clear on some of the timelines and on when the investment that was announced in October will deliver real impacts.

The 'Spotlight' documentary was referenced. Anyone who watched it could not have failed to have been moved by that depiction of the pressure that some of these families are under. It is clear that the Minister was moved. The Minister acted quickly, which should be acknowledged and welcomed. Now, however, we face the issue that the initial announcement of investment raised hopes and expectations that things would change, notwithstanding the Minister's caveats that the challenge was significant. There is now a risk that trust in this being delivered will be eroded.

I have had the privilege of being able to support one of the mums from the 'Spotlight' documentary through my office in some small way; obviously, I have not been able to deliver everything that the family needs, because the pressures are so great. In my engagements with that individual, the sense of living in crisis every day has struck me. It is not a sense of things getting bad and of struggling to cope; it is crisis every day. My sense is that the services do not engage with those families on the basis that they are in crisis. Rather, there is a sense of there being gatekeeping and of people being pushed back from access to services. I am not trying to be critical of trust staff when I say this, but it has been shared with me — I have found this very concerning — that there is a sense of, "We can give you this, but that will take something away from another family. Are you sure that you're comfortable with that?". That sort of approach is not appropriate for a family that is in desperate need of support but also aware of all the other families in their community that desperately need support and that will not want to be seen to be taking that support away from them. We have to be conscious of the fact that there is so much guilt tied up in all of this for the families anyway, because nobody wants to admit that they are struggling to cope and that their life feels like it is in a crisis every day. Social services should be there to meet families as they present at their point of need, but that does not seem to happen at the moment.

We know that resource is under serious pressure, so these are my questions to the Minister, which have been echoed by other Members. When are we going to see the direct outworkings of the investment that was announced? It seems that Greenhill and Lindsay House in the South Eastern Trust area are being suggested as part of the solution, and I am keen to hear when those beds will be available and what assurances we can get.

As my colleague Nuala McAllister said, we need assurance that there will not be slippage the minute another family presents with longer-term care needs. When will the services be in place, and when will they be there on a sustainable basis, so that all the families who need them can access them reliably?

Thank you, and I thank all the Members who have spoken in the Adjournment debate. I call the Minister of Health to respond. You have up to 10 minutes.

Thank you, Mr Deputy Speaker. In the 10 months or so that I have been in post, I have found this issue to be unique in that money is not the primary issue. I have been able to find some money. We have not been able to spend it all, and that is indicative of the fact that the issues are primarily buildings, beds and workforce.

I will immediately address the point from Mr McGrath about the numbers. The South Eastern Trust has the worst vacancy rates for social workers in children's disability teams. That speaks to what you addressed.

Some of the issues are particular to the South Eastern Trust, but others just reflect broader systemic issues that impact on families across Northern Ireland. It is not confined to one trust or area; it is a regional challenge that I want to see responded to with a regional response.

Across all the geographic trusts, overnight short breaks for children with disabilities have been significantly reduced due to the limited availability of residential provision. Much of that provision is now being used for medium- to long-term care placements. The stark impact was laid bare in last year's 'Spotlight' programme, which so many Members have referred to and which featured the lived experience of five families. It also had input from the Children's Law Centre and the National Autistic Society. The accounts were powerful and touching and impossible to ignore. As a former broadcast journalist, I repeat my admiration for Tara Mills for that powerful piece of journalism. It acted as an accelerant rather than a wake-up call for my Department. In October, as Members have said, I committed an additional £13·1 million of recurrent funding to help address the challenges. That has allowed us to start that acceleration work in the Department and across trusts, expanding capacity and trying to reform our delivery models.

I take the opportunity to provide an update on the South Eastern Trust and to outline our regional response and share how we are working with the families highlighted in that programme. I will also briefly touch on adult respite services, which remain a key part of the overall strategy.

The current position in the South Eastern Trust is deeply concerning. There are just two operational respite beds at Greenhill, and they are available only three nights a week. It is not enough. As of now, 85 children are on the waiting list for short breaks, and families, I understand, are under immense and sustained pressure. Much of the reduction in provision stems from the repurposing of Lindsay House, a dedicated seven-day short-break facility, which has been redirected to care for children entering the care system. That was a decision made out of necessity, but it impacts profoundly on children with disabilities and their families.

To address that, £2·4 million in annual recurrent funding has been allocated specifically to the South Eastern Trust to restore and expand respite services for children with disabilities. Several important actions are already under way. Re-mobilising Lindsay House by relocating children currently in care to Redwood Children's Home will free up much-needed short-break capacity. The target date for this is September, though it depends on the successful completion of key interdependent actions. Minor capital works are in progress at Redwood to ensure that it can safely and appropriately accommodate children, and I am encouraged that all posts at Redwood were filled in one day at a recruitment event in March, which reflects a strong commitment from staff. Plans are in place to expand Greenhill's operation from three to five nights a week. That will require further recruitment, and that is scheduled to take place next month.

Mr Honeyford asked for a guarantee on the Woodlawn facility: I cannot give a guarantee. The system is so fragile that, if one new child presents, the plans need to be redrawn. Miss McAllister talked about bureaucracy, but it is about safety. Alongside its residential provision, the trust is scaling up the LynC Outreach service.

Will the Minister give way?

That provides community-based support during evenings and weekends. Once it is fully implemented, the service will provide day breaks for 80 to 85 children who are on the waiting list. Learning disability nurses will be key to supporting the complex healthcare needs of those children during outreach. I give way briefly.

I appreciate the Minister's giving way. We were talking about the Hillhall site. The issue was an adult who was at that location and was blocking it.

[Inaudible.]

Once one person is there, nobody else can access it. Nobody else could access that facility because there was one person in it. That closed the whole place. That is the issue. That should not happen.

That is the issue, but I take exception to your use of the term "blocking". That person is a service user who needs help.

Last week, I again met the families featured in the 'Spotlight' programme. Also at the meeting were senior officials from the Belfast Trust and the South Eastern Trust. The families have shown immense courage and persistence in advocating change not just for themselves but for other families. I have met them on several occasions, but, in a way, I am meeting them too often: it would be better if we did not need to meet, because that would mean that their needs had been met.

The discussion was honest and constructive, because it was about culture and communication. Mr Mathison and Mr McMurray raised the issue of what some people have said and the tone in which they have addressed some of the families. That was discussed and acknowledged by senior figures in the South Eastern Trust, so I expect to see significant positive change in future engagements. Further work, particularly on the pace of change, is needed, however. I am pleased to say that there will be an oversight panel that will be tasked with supporting, monitoring and challenging — the challenge factor will be important — the remobilisation of short-break services.

As I said, the issues are not unique to the South Eastern Trust. Across the country, families feel the strain and the pain of inadequate provision. That is why we are progressing a new regional framework for children with disabilities that aligns with the findings of the Ray Jones review and reflects the evolving and increasingly complex needs of children with autism, learning disabilities and additional needs. The aim of the framework is to improve the current offer of early help and community-based support; develop additional effective residential short breaks and short-break fostering; rethink our approach to residential provision and out-of-home placements; and improve transition pathways into adulthood.

The £13·1 million of additional funding is helping to stabilise services by creating new beds, restoring lost provision and expanding community supports. Without closing the gap in residential care placements, however, short-break services will continue to be diverted during periods of crisis; that, I am afraid, is inevitable. To deliver sustainable, meaningful change, we must invest in modern, fit-for-purpose buildings, a well-trained, supported and motivated workforce and long-term funding solutions that give trusts the stability that they need to plan and deliver services effectively. Those things cannot be done quickly.

I will speak briefly about adults with learning difficulties. While I am assured that most services function as intended, we know that there is room for improvement. Many families continue to rely on that support to manage the demands of caring for adult relatives who have complex needs. Progress on a refreshed service model for adult learning disability has been slower than anticipated due to the impact of other priorities. Officials have now, however, commissioned additional support from the HSC Leadership Centre that will accelerate that work. Our goal is to move towards public consultation as quickly as possible, with a view to implementing a service model that better meets the needs of adults and their families.

There is no doubt that progress has been made, in the trusts and regionally, but I want to be the first to acknowledge that the pace of change is not fast enough. We are constrained by workforce availability, infrastructure limitations and funding pressures: that is not an excuse, but it is the situation that we are in. I repeat my determination to the House and the families that I will do all that I can to make things better.

Minister, thank you for that response.

Members, with your permission and patience, I will ask you to help me end the plenary sitting in the way that it began. The official who is sitting on my right, Alex McGarel, is having her last day. Unfortunately, I could not be in the Chamber this morning when a fitting tribute was paid to her. I cannot let the day end without putting on record my sincere gratitude to Alex. I have needed advice and a steer from her more times in the past year in this post than I did in the previous six years put together. Alex, thank you.

[Applause.]

Adjourned at 6.26 pm.