In conjunction with the Business Committee, the Speaker has given leave to Carál Ní Chuilín to raise the matter of multidisciplinary teams in GP practices in North Belfast. Carál, you have up to 15 minutes.

Go raibh maith agat, a Leas-Cheann Comhairle.

[Translation: Thank you, Mr Deputy Speaker.]

First, I thank the Business Committee for selecting this topic for an Adjournment Debate. I am delighted to see the Minister here in what is his second week on the trot of dealing with issues relating to North Belfast. That is much appreciated. Also, some of the GPs from North Belfast are in the Public Gallery for the debate.

I am sure that if we were to put "GP" into a search of the Hansard public record, we would get thousands of hits. One thing that we are concerned about is that GP practices in North Belfast were supposed to have their multidisciplinary teams (MDTs) fully rolled out at the beginning of April, but that has not yet been done. Priority was given to mental health services, which we all support. For anybody for who does not know, multidisciplinary teams are about the inclusion of a mental health nurse, a physio and a social worker in a busy practice.

Take one practice in Clifton Street as an example. It has 10,000 patients. It is in one of the most deprived areas of Belfast, in the North and maybe even on this island. It is referred to as a "deep end" practice, which is Health Department speak for its needing to be prioritised and resourced accordingly. The Minister is on the record about that, as, indeed, are many other Members. Look at BT15. If you live around Carlisle Circus, the New Lodge or the lower Shankill, your life expectancy is a lot less than it is if you live further up the Antrim Road, which is still within BT15.

Our GP practices have been at the coalface for a long time. GPs often contact me, as an elected rep, about housing, letters of support for their patients to access surgery, getting proper community support for mental health services and supporting families through autism and ADHD medication. I am sure that it is the same for many Members. The difficulty in North Belfast is that none of us wants to say that we are in the most deprived ward on the island. Everyone's focus is on patients' needs, so that is a good place to start. The GPs' patients are our constituents. We all focus on that.

Clifton Street is not the only surgery that has difficulties, but the difficulty for Clifton Street surgery is that it is prepared to develop a bigger site to encompass the services that are part of a multidisciplinary team, as well as any additional services, and land has been identified at Girdwood, but that land is currently held by the Minister for Communities. Minister, I would appreciate it if you could speak to the Minister for Communities about that. That is an example of a practice on a busy road in a busy area that is on an interface. It has patients from across the Constituency and tries to help everybody, regardless, but it is not working. That is a practical example of something that could be done.

I am envious of some of our colleagues in other parts of Belfast, particularly in the west. They have told me about the roll-out of the multidisciplinary team approach in practices. I made it my business to speak to one of the practices in West Belfast, and I was told about what is working. I was also told that, at the minute, everything is dependent on resources, but it is working well. When we look at a joined-up approach and ending silos — we are all familiar with that language — I like the idea that that would be a one-stop shop for people, most of whom would be able to walk through the door and back out again. In West Belfast, a lot of them walk in, get awful news and then get wrap-around service support, and we want to see that in North Belfast.

I appreciate the fact that resources are tight — we all do. I also appreciate that, when it comes to health, we have to fight our corner. I very respectfully say to the Minister that I understand that there is a need to put money into the private sector in order to get waiting lists down for people who are in agony as they wait for operations. We all get that. However, that investment is front-loaded for cases that are almost non-problematic, even though the surgeries are quite severe and people are very stressed out about getting them. We need to remember that the investment needs to be front-loaded towards the point at which people need it: our health and social care system, which is free at the point of need and free at the point of delivery. We all cherish that.

We are lucky, in North Belfast, to work with amazing GPs who, for the most part, in their practices look not just at the person but at all their circumstances. They are proactive in trying to get people the best support that they can. They almost act like social workers, as it is. We can claim some of that as well; we recognise part of that. As an elected representative, however, I want — as do the other representatives who are here in the Chamber — to fight our corner in North Belfast to make sure that we all get the best for GPs and patients.

The Minister will be well aware of the figures, so I will not recite them, but I will talk about the levels of complexity faced by some. It is no coincidence that, in areas of deprivation, there is a clear link between poverty and ill health. That link is well established and accepted. There is also a recognition, by all of us as political reps, that this place is underfunded compared with our level of need. We are at the bottom of the ladder when compared with Scotland, Wales and England. That is not good enough. We need to get more money in order to make sure that money goes to front-line services, where it is needed, and that it is prioritised.

Within that, you have GPs who, in the whole big Health bubble, are fighting their corner, and we are here today to fight their corner, too, particularly when it comes to dealing with mental health and the legacy of the conflict, which now affects four generations.

I know that it is the case across the board, but, compared with many other constituencies, North Belfast was decimated — absolutely decimated — by political conflict. That is now having an impact on third and fourth generations. I am seeing the impact of the conflict on grandparents, parents, grandchildren and now great-grandchildren. I am not medically trained, but I recognise trauma. Given that some people who go to a GP practice do not even realise that they are traumatised or are suffering from anxiety and stress, we need to give our GPs the time, the flexibility and the space to get help and support to where it is needed and to make sure that that is consistent at the point where people can get it. Right treatment, right time, right place. The best door to walk through without there being any stigma is that of a doctors' surgery. No one knows what you are going in for, and it is none of their business. When you go into a GP surgery, you should not then have to walk round 12 doors to find out which one you go through.

That is why we want to have this debate today. We want to make sure that Clifton Street Surgery and all the other surgeries that have come to us have their ask for support through the full roll-out of multidisciplinary teams met. Those surgeries have 10,000 patients, who are our constituents. Over 50% of them are living in chronic pain, and over 50% of them will probably die well before their time, because of the economic, social and political circumstances in which they grew up. The best thing that we can do is equip our GPs with what they need in order to provide the best care for their patients and our constituents. I will leave it at that.

Thank you. All other Members will have approximately six minutes.

I welcome the opportunity to speak on the issue of multidisciplinary teams in North Belfast, and I thank Carál for bringing the matter to the Floor of the Assembly. MDTs are widely recognised as being central to the future sustainability of primary healthcare. There is no doubt that MDTs represent an important reform of our health system. By embedding professionals such as physiotherapists, social workers and mental health practitioners directly into GP practices, we are moving towards a more preventative, accessible and patient-centred model of care.

I welcome the fact that £61 million was secured for MDTs from the transition fund for the next four years, and I particularly welcome the fact that North Belfast has been included in this phase of the roll-out. The Health Minister confirmed in a reply to me that the plan was to introduce MDTs in 18 of the 21 GP practices in North Belfast in the last financial year and the remainder in this financial year, subject to premises' readiness, with the aim of providing early Intervention, reducing health inequalities and improving well-being through accessible, high-quality services. However, while the ambition is clear, the reality on the ground in North Belfast is more complex.

A number of GP practices in North Belfast that I engaged with agree that MDTs are the right reform but said that roll-out in North Belfast has been too slow, inconsistent and under-resourced. Roll-out depends on premises' readiness, workforce availability in those disciplines and funding. Practices have reported a lack of social workers and mental health staff and delays to or lack of clarity on funding, and many GP buildings are not fit for MDT expansions. As a result, they cannot recruit, plan or deliver the intended benefits. They also highlight the impact of cross-boundary demand from West Belfast in particular, which, of course, has a high level of demand itself.

That has placed an extra strain on the delivery of MDTs, distorting planning and overloading certain practices.

Where MDTs are working well, they reduce GP workload, provide faster access, especially to physiotherapy, and provide early intervention and better patient outcomes. It is the right model, and the progress is welcome. However, a key challenge is that delivery is conditional and not guaranteed. Many practices have not yet experienced a full roll-out of MDT services, and there is growing frustration, not with the model but with the pace and consistency of delivery. From what I hear, there are simply not enough social workers on the ground at present, but that cannot become a reason for continued delay.

I will highlight the issue of funding reaching GP practices. Practices tell me that, even where roll-out is planned, funding does not always flow in a timely or practical way, and that makes it difficult to plan, recruit and deliver services effectively. I am also deeply concerned about what, I am told, is a current freeze on a full MDT roll-out, which, I understand, is to remain in place until January next year. The Minister can confirm what is happening in that regard. It must be urgently addressed, because, even when approval is given, recruitment takes time. In many cases, the roles are highly skilled. Staff must be recruited from other parts of the system, and notice periods are often three months or more, so any delay today becomes a delay in delivery many months down the line.

Despite those challenges, I want to be clear that having MDTs is the right approach. Where they are operating well, as I said, they reduce pressure on GPs and provide better outcomes, but progress must now match ambition. I therefore call on the Minister to lift the current freeze on MDT roll-out as a matter of urgency; to ensure that funding is released directly and promptly to GP practices; to invest in workforce planning, particularly for social workers and those in mental health roles; to provide a clear, time-bound and full roll-out across all North Belfast practices; and to ensure fairness and capacity, particularly in areas facing cross-boundary demand.

Our GP practices are under sustained pressure. They are doing everything that they can to support their communities, but they cannot do it alone. There must be no more delays. Our practices need that support now. North Belfast cannot wait.

I thank my colleague from North Belfast for securing today's Adjournment Debate.

When the Assembly got back up and running after the 2022 election — two years later, in February 2024 — one of the first announcements from the Minister was on the expansion and further roll-out of MDTs, subject to resources being available. We were glad to hear that North Belfast would be part of the next roll-out, so it is disappointing that there has been delay. We are, however, hopeful that the roll-out will happen in North Belfast soon. The GP federation in North Belfast has over 110,000 patients to see across 20 or 21 practices. Because I sit on the Health Committee and from a Constituency perspective, I have been making my way around a lot of the practices. My colleague mentioned the Clifton Street surgery, which I visited back in April.

Following that visit, I asked a question of the Minister in the Chamber about capital infrastructure support for MDTs, and we later spoke at the Committee about how GP practices would be getting such support. I believe that it was the GP improvement scheme that was supposed to help facilitate the roll-out of multidisciplinary teams, but it seems as though something has gone wrong, because a number of practices are physically unable to fit all the teams and the people who are needed on-site into their practice. We can hopefully get an update on that from the Minister. I understand that, at the time, there was a little bit of a wait for transformation funding. Following the announcement that it had been successful the second time, I had hoped that there would be an update on the GP infrastructure support scheme.

We have raised the point many times in the Health Committee that, if we are to see it successfully rolled out across all areas, we need GP practices to get the support to do that.

As well as Clifton Street surgery, I have been to other surgeries in that vicinity, such as North Queen Street surgery and Carrick Hill medical centre, and they all have the same thing in common; they all have patients from areas of multiple deprivation. They all see patients who have comorbidities and therefore cannot just go and see a doctor about one issue. Often, those patients have many issues. Many of them are also on waiting lists for other services that they could avail themselves of in-house if those services were available. It is important progress, and I am happy to support it as part of the Minister's shift-left agenda, to get more support to our GPs so that it is not just the doctors and nurses who service the patients there.

I have concerns, however, that, in one North Belfast ward in particular, Water Works, one in 20 children are in care or have had a care order placed on them. I am sure that there are others on the at-risk register across other wards in North Belfast. The figure is quite high, particularly in the areas of multiple deprivation. That means that there is a greater need for social workers in North Belfast than in other constituencies across Northern Ireland. One thing that, we hope, will happen with the MDTs is that we will have social workers in some practices. However, we know that they will just move from the family and children support services to GP services, and that will just create gaps. It will not fill posts and create additional jobs, because people will just shift and shuffle around. That is why the workforce aspect is so important, particularly when it comes to social work and GPs.

More and more GPs want to move to part-time practice because they simply cannot facilitate the current hours that are expected of them. Even those who are part-time are doing hours that would be considered full-time in other jobs. All that places an extra burden on GPs. They are managers and are trying to navigate the whole process of incorporating the multidisciplinary teams as well as trying to service their patients every day.

Minister, we have spoken about access to GPs so many times in the Chamber. This debate is not about that, but it is important: we cannot emphasise enough how many of us, in all our constituency offices, are contacted about access to GPs. The simple fact is that there are not enough of them. There are not enough GPs to serve the number of patients who need to be seen, with the increase in ailments that people have.

Therefore, while I support the roll-out of multidisciplinary teams and think that it is the right thing to do, we need to see it done right. We need to ensure that we have the social workers, pharmacists, physiotherapists, occupational therapists and whoever is needed in practices and that they are not simply shifting from other areas to cause pressure elsewhere in the system and are there to properly service the community.

Before I finish, another thing that I want to highlight is that I share my two colleagues' concerns about mental health issues. We cannot overemphasise how important it is that we have mental health practitioners in GP practices in North Belfast, so that we ensure that GPs are not the only people who are able to help those in distress and need. That is seriously impacting on suicide rates in North Belfast and putting stress and pressure on the community and voluntary sector.

In short, I support the roll-out of MDTs in North Belfast. It is disappointing that it has not yet happened and the timeline is moving on. We need the support. If the Minister can touch on that GP improvement scheme and whether we can support practices, that would be helpful.

I think that we will get everybody in agreement here. Although my colleague Carál said that she did not want to go through some of the statistics, it is worth bringing them up. I will go through some of that, but I will keep within your parameters, Mr Deputy Speaker.

All Members — not just those who are here — are acutely aware of the need to transform public services. We are talking about North Belfast, but, of course, that is not to ignore the fact that there are other areas of deep deprivation. North Belfast is a particular case. We all want to transform public services to ensure equal access to first-class services such as healthcare. That involves detailed planning and execution by Departments in order to navigate what has become an increasingly difficult budgetary position. We are all very aware of the budgetary situation. However, we have to try our best within that budget. That will continue so long as Westminster funds the North below its evidenced level of need.

MDTs were intended to be a key component of health service transformation. Since the initial launch in 2018, however, the roll-out has been inconsistent, and many areas remain without provision. The practice in question has 10,000 patients, who come from communities that experience many of the health issues that I will cover in a minute. It is a matter of serious concern that North Belfast, with such high levels of deprivation and health inequality, is one such area. The practice has been categorised by the Minister as a "deep end" practice, serving the most socially and economically deprived population. It is often defined as "blanket deprivation", meaning that 44% to 88% of its patients live in the most deprived areas.

The need for effective MDTs in North Belfast could not be clearer. For context, it is worth covering some of the disparities. North Belfast is in the top three constituencies in the North when it comes to premature mortality rates, ranking second for males and third for females under the age of 75. In the Oldpark ward, which takes in areas such as the New Lodge, Cliftonville, Oldpark and Ardoyne, the statistics are even more severe. The Oldpark ward has the lowest life expectancy in Belfast for men and the second lowest for women. Suicide rates per 100,000 are 70% higher for Oldpark than the regional average.

When we compare standardised death rates for the Oldpark ward against the regional average rates, we see that the treatable mortality rates are 50% higher; the avoidable mortality rate is nearly 100% higher; and the preventable mortality rate is 100% higher. North Belfast consistently scores higher than average in many other categories, including alcohol-related hospital admissions, obesity and low birthweight. Those stark percentages, alongside the trauma and the legacy of the conflict, which Carál spoke about, only reinforce the dire need for the swift and full implementation of an MDT in order to serve the high unmet demand for mental health services and social interventions.

The issues that face general practice and patients who are accessing GP services have been well rehearsed in the Chamber. GPs are under increasing pressure, and the implementation of MDTs should serve to alleviate at least some of the pressures on the wider service. However, as noted in the 2024 Audit Office report, a lack of available qualified staff, as others have mentioned, is a key constraint when it comes to the wider roll-out.

Added to that is the need for sufficient physical space to house the teams, which, again, has hampered their full establishment. The roll-out in North Belfast would offer mental health practitioners, social workers and physiotherapists, but, due to a lack of space, the practice has been able to take up only 50% of the mental health practitioner allocation. Because of restricted space, it has been unable to provide any rooms for social workers and physiotherapy to date. There have been ongoing discussions with the Department for Communities about a move to Girdwood since May 2019, despite cross-party support. It is essential that that move happens as soon as possible, especially given the wider development of the Girdwood site that is being progressed by Belfast City Council, as, I think, the Minister will know. Ultimately, that has presented challenges that prevent people, some of whom are already experiencing some of the worst health inequalities, from accessing and benefiting from proper healthcare and support.

The Minister and the Department frequently and with justification point towards the difficult fiscal position that we are in. However, investment in the service will deliver genuine transformation to health service delivery. It will not only reduce future costs and deliver savings but improve health outcomes. That is where our focus needs to remain. Delivering improved health outcomes is not just for those who can afford to access private healthcare.

I am delighted to speak on behalf of the SDLP in my second North Belfast Adjournment Debate. I am the son of an Ardoyne man, and I am a former resident of Ashley Gardens on the Antrim Road, off Somerton Road and Lansdowne Road, so I feel like I am almost a local. I have been so impressed by these Adjournment debates that I have managed to secure one next week for South Down, so any North Belfast Members who would like to come along will be more than welcome.

We know that MDTs have the capacity to transform primary care. They ease the pressures on GPs by offering a range of services in health centres. It is also about quicker access to those services. I remember visiting one of the GP practices in my area, and the GP was really clear about MDTs. He said, "Do you know what? I am not an expert in knees, joints and moving legs. That is why we have a physio. If somebody needs to get those issues seen to, it is better to get them directly to the physio rather than have them come to me and for me to then refer them to the physio, which adds an extra layer". Having that ability in-house to make referrals quickly helps people to get treatment much quicker and more locally, and it helps to address health inequalities. The vast need to address the health inequalities in North Belfast has been eloquently put by others here today.

Of course, the system has not been fully realised; it has only been partially implemented. I spoke at the South Belfast GP Federation's annual meeting last year, and GPs from one surgery in South Belfast talked about how difficult they found it when one GP practice, which was basically a couple of hundred yards away, was able to offer a raft of additional services, yet theirs was not because it was on the border with an area that had MDT services. That inequality in its own right was felt very sorely by those practitioners who were not able to offer that range of services. The jealousy tipped towards those GPs who were able to offer those services, so it is something that is absolutely seen as being valued in the medical fraternity. Therefore, it is something that I would like to see pushed, rolled out and offered as far as possible. I know that that is an aspiration. I appreciate that the Minister does not have a storeroom of social workers, practice nurses and physios down in the Department that he can just hand out. That is the aspiration. It is about how quickly we can make that a reality and how quickly we can move on.

If there is full roll-out and partial roll-out, that does not represent fairness or equality of service provision. We do not want to see that two-tier system, as has been referenced, where some can get access to services and others cannot. Somewhere in the region of half a million people across the North are not part of areas that have MDTs. Those people are being left behind, unable to access the full range of services without having to go through extra hoops and going to other secondary care locations. While today's debate is important, we must not lose sight of areas that need to have that MDT service introduced. If we are serious about reforming our health service, about that shift left and about getting treatment for people as close as possible to their homes so that they do not have to travel, the MDT model provides an excellent opportunity to do those things, but that will mean full roll-out, sustainable funding and additional resources. That is probably where there will be some problems. I am happy to support that for North Belfast.

I offer a slight apology, like Carál did last week. I have to go and chair the all-party group (APG) on youth participation in the Senate Chamber, so I will not get to hear the Minister's remarks, but I have a fair idea of what he will say. We will continue to provide help and support where we can, especially for North Belfast, which is my second home.

I invite the Minister to respond to the Adjournment Debate. Minister, you have up to 10 minutes.

Thank you. Let me begin by trumping Mr McGrath, because North Belfast was my first home. I spent my first five years in a house on the Lansdowne Road off the Antrim Road.

I welcome every opportunity to discuss MDTs, particularly in North Belfast, so I thank the Member for bringing that into focus. I also welcome the GPs who are here to listen to the debate. I understand entirely that, while MDTs are really good for patients and service users, they do not ease the burden for GPs one iota. In fact, it can be argued that they make life more difficult. Do you want to refer somebody to a physio in another setting, or do you want to manage a physio who has joined your team? Arguably that can make life a little more difficult for GPs, but it is really good for patients.

There is an issue with many GP surgery premises not having the space to expand to take multidisciplinary team members on board. I say to the Member that I will contact the Minister for Communities about the Clifton Street surgery to see whether his Department can give some much-needed certainty on Girdwood. I applaud the Member's devotion to her constituents, which I saw in action at the weekend on another matter.

MDTs are currently available in seven federation areas, and we continue to increase the service in a further five areas, securing a rate of 63·5% of patients being handled in primary care in those federation areas. We are avoiding referrals to secondary care, and, personally, I am delighted that that is already happening. As it is at a local level, the model is responsive, accessible and consistent with my desire to shift left into prevention and early Intervention.

Members will, I hope, be aware of my commitment to reform and transformation. I am particularly pleased that we got the £61 million that Mr Kingston referred to from the transformation fund for the next phase of the MDT programme. That gives us the opportunity to commit to expanding the implementation of the programme. Indeed, the North Belfast Federation is currently benefiting from that additional resource, as it continues with its MDT implementation journey. I have to say to Mr Kingston that he needs to have a word with his source, because the idea that that has been frozen is simply not true. We are continuing to implement over the three years of the plan; there is no freeze.

Phase 1 of the implementation plan runs from the 2025-26 financial year to 2029-2030 and will see MDTs being completed in 12 federation areas, including North Belfast. The remaining five will continue with the MDT implementation plan, which runs through to 2033. I know that that is a long time, and I share Members' frustration that it is taking so long to roll it out fully. Mr McGrath talked about the inequity of it being in some places and not in others. Ms Ní Chuilín will be aware, from her work in the former Ad Hoc Committee on a Bill of Rights, of the concept of progressive realisation, and that is where we are at with MDTs.

As of 31 December 2025, working with the GP Federations, practices and the local trusts, my Department had implemented the MDT model across 136 GP practices. We have increased access for 928,000 patients, which is 46% of Northern Ireland's population, to one or more core MDT services, and that includes a total of 276 MDT staff and an additional 107 nursing staff across the region. Some £2·5 million has been invested across the five federation areas that are next to benefit from the roll-out in 2025-26. Approximately £500,000 of that has been spent in the North Belfast Federation area.

The roll-out is well under way in North Belfast. During quarter 4 of the last financial year, 8·4 whole-time equivalent staff were recruited to MDTs, which means that about 90,000 patients currently have access to an MDT in North Belfast. In the current year, a further 10·5 whole-time equivalent staff will be recruited to North Belfast practices, further increasing the number of patients who can access those vital services. That will increase year-on-year, in line with agreed implementation plans, resulting in an additional 45·6 whole-time equivalent staff being employed in North Belfast, with an additional 114,000 patients having access to all services by the 2029-2030 financial year.

The Department of Health acknowledges that the workforce is a key enabler for success, and the recruitment plan is cognisant of the very real challenges in the labour market and the vacancy and recruitment issues that are being experienced already across the trust.

The funding for MDT roll-out is in place, and we are moving as swiftly as we can, given the labour market challenges. To that end, the transformation funding supports critical planned investment for university training places above and beyond the existing intakes, providing a workforce pipeline in key professions that the MDT programme recruits from. Ninety places were agreed annually for 2024-25 and 2025-26. Those additional places comprise 40 social workers, 30 physiotherapists, 10 occupational therapists and 10 mental health nursing places. Phase 2 of the MDT implementation plan will run from 2029-2030 to 2032-33. It will see the completion of phase 1 federation areas and the full roll-out of the remaining five areas.

It is anticipated that the annual MDT consultations will increase to over one million by March of 2033, with over 222,000 consultations in Belfast alone as a whole. That will be a significant contribution to providing closer-to-home access to much-needed services that can be accessed directly through the GP practice. Currently, 51% of referrals to MDT professionals are made directly without the need to go through a GP, freeing up valuable time for appointments.

The MDT programme is an integral part of the reform of health services. It brings services to a local level and reinforces the value of general practice in delivering such services in primary care. Historically, people across Northern Ireland have revered and respected the role of the GP. Indeed, many continue to see the GP as the first point of contact when they feel the need for healthcare intervention. It is right for people to focus on general practice as a front door to health services. However, with the introduction of MDT specialists, people can access them through the GP route without the need to see the GP.

The programme will not sit in isolation of wider primary care reform. It is an integral part of the new approach to healthcare through the introduction and implementation of the neighbourhood healthcare model.

Will the Minister give way?

Yes.

Does the Minister agree that the lack of an agreed multi-year Budget or, indeed, a one-year Budget is preventing him from moving forward with many worthy projects that will contribute to better outcomes for patients, not only, quite rightly, in North Belfast but across Northern Ireland?

I thank the Member. Yes, the uncertainty of not having the Budget is resulting, for example, in us losing momentum. We had good momentum in tackling the waiting lists, so, yes, I would welcome the certainty of a Budget as soon as possible, and preferably a multi-year Budget.

With my remaining time, I will touch on a couple of other points. Nuala McAllister talked about support for GPs. I hope that she is aware that we are now negotiating the next contract with the BMA's Northern Ireland GP committee. That can certainly be part of a broader consideration of how we support GPs.

Minister, there is some flexibility here, if you have remarks that you wish to finish.

Thank you, Deputy Speaker.

GPs, amongst others, will be at the heart of the delivery of the neighbourhood model.

The final thing that I will say is that the MDT roll-out in North Belfast will continue. There is no freeze. I know that it will be well utilised by local communities. It will continue to embed the important general practice for its people, and it will ensure that the GP practice continues to be the heart of the local community.

I will finish with some words on community, because Carál Ní Chuilín talked about North Belfast and the legacy of the conflict. Certainly, if you take a map of the conflict and fill in the hot spots of the conflict measured by shootings, killings and bombings, and if you then take a contemporaneous map of the hot spots of mental health issues measured by completed suicide, attempted suicide, substance misuse and all the rest, you have a match, and North Belfast is as bad as it gets. I am very aware of that. I will not be around for the next mandate, but if I were, I would encourage the next Executive to think about the social determinants of health and ill health — poverty, housing, jobs, education — and about the social determinants of educational underachievement and of economic inactivity. They are the same social determinants across those three great evils, which are really sticky problems. If we came together as an Executive and an Assembly and tried to tackle them, think of the impact that we could have in areas of deprivation. Think of the real change that we could make to people's lives, how that would make us think of ourselves as legislators and how the public would think of this place. It would be a magnificent thing to do, and I encourage those who will be here after May 2027 to give it consideration.

Minister, thank you for that response.

Adjourned at 5.20 pm.