Official Report: Tuesday 27 May 2025

Ms Ní Chuilín: As we speak, John Finucane MP is convening a multi-agency meeting in North Belfast to try to give support to the residents in Annalee Street and Alloa Street who, last week, were subjected to attacks. In case people do not know, a mob of masked men attacked houses with bats and masonry, shattering the windows of rooms where small children were sleeping and residents were watching TV. There was no warning, no provocation and, certainly, no justification. I put on record my thanks to Brian Kingston, who visited the families. He has made his apologies for not being able to be here today. I ask that, collectively, as North Belfast representatives, we stand together to call those attacks out. As if one instance of attacks was not bad enough, the second was reprehensible. We learned at the weekend that at least two other families have been intimidated into leaving their homes. Nearly all those residents have small kids. The news reported that one of them had been waiting for a home for eight years and had moved in last November. All of this came out of the blue.

There is no place for hatred, bigotry or sectarianism in our society, regardless of where it emanates from. In North Belfast, we have done, and continue to do, our level best to work together to ensure that we keep the peace. However, when attacks happen, they need to be called out and the residents need to be supported. Such actions, particularly in an interface area, undermine that work. They undermine peace. More importantly, they strike fear and terror into the lives of families. The PSNI have confirmed that they are treating the incidents as sectarian attacks. I appeal to everyone to, at some stage this week, stand together, shoulder to shoulder, to condemn those attacks, to call them out and to give support to the residents, who are living in absolute terror.

Mr Clarke: I rise following what many of us hope is the closure of the "Sean" saga within the tactical support group (TSG) in the PSNI. For weeks, many people have pushed the narrative of sectarianism within the PSNI. The closure would not have come had it not been for the efforts of retired police officer John Burrows and the 'News Letter', which continued to campaign to try to clear the besmirching of the PSNI and the officers, Catholic and Protestant, who continue to serve on a daily basis without fear or favour. It is disappointing that some decided to continue to back one individual, when, as I said, others from Catholic and Protestant backgrounds in the TSG, current and retired, came out to condemn those words and said that they were a falsehood. If it had not been for John Burrows's continued pushing, the allegations of a sectarian police force would have stayed on the record. I am glad that, eventually, "Sean" withdrew the comments and cleared the names of his former colleagues and, indeed, those who continue to serve. Many in the Chamber should apologise for continuing to appease that narrative and keeping it in the public domain. They should be ashamed of themselves.

I see that the Chief Constable made efforts to bring the issue to an end. I do not think that he did enough; he should have been clearer and firmer in what he said. Last week, at the Policing Board, he indicated that "Sean" is a decent man — I am sure that he is — but more could have been said to stand up for the officers. There should have been an investigation at the time to clear the names of those serving officers. Whilst it was a sorry saga that "Sean" continued to push out the allegations, supported by a law firm, I am glad that he has withdrawn the comments. I am equally glad that he is receiving support for whatever he is going through as an individual. I wish him well, and I am sure that the officers that he worked with wish him well and will be glad that the whole saga has been brought to an end. Considering all the changes that have been made in the police, it is disappointing that sectarianism was ever brought to the fore. I am glad that this has been brought to an end.

Mr Speaker, I am sure that you will give me a degree of latitude to introduce another topic. There is a big birthday in the Building today; someone is celebrating 60 years. Of course, that is you. I wish you a very happy birthday, Mr Speaker, and many more.

Some Members: Hear, hear.

Mr Speaker: Thank you, Mr Clarke. I will show some leniency on this occasion.

Ms D Armstrong: Mr Speaker, I offer birthday wishes to you, too.

I wish to celebrate the remarkable achievement of one of our outstanding young farmers from Fermanagh and South Tyrone. Earlier this year, James Morrison of Maguiresbridge applied to the Aberdeen-Angus Cattle Society's youth programme to represent the UK and Ireland. Despite being the youngest applicant, James was not only selected to the team but appointed captain. That team went on to compete in the global youth competition at the World Angus Forum in Australia — a prestigious event for Aberdeen Angus cattle breed enthusiasts from around the world. Under James's leadership, the team won the group debating competition and was placed third overall. That is an extraordinary accomplishment for a young man from County Fermanagh. Throughout the competition, participants were assessed by unannounced judges on their leadership, teamwork, integrity and engagement. James distinguished himself in every aspect and was awarded the Spirit of Angus award — the highest individual honour in the competition. That accolade is testament to his character, dedication and passion for agriculture. James's deep-rooted knowledge and enthusiasm for the Aberdeen Angus breed is a proud family legacy. His father, Alan Morrison, serves as chairman of the Aberdeen-Angus Cattle Society, and his grandfather Edwin instilled in him the highest standards of pedigree cattle keeping. Alan and his wife, Naomi, also attended the World Angus Forum. It was a moment of immense pride for the Morrison family when James received the prestigious award.

James is not only a skilled young farmer but a committed member of the young farmers' movement. Since joining Lisbellaw young farmers' club in 2017, he has taken on several leadership roles, including assistant club leader, junior coordinator and vice chairman for County Fermanagh. When I spoke with James recently, I was struck by his optimism and determination. He is passionate about the future of farming in Northern Ireland and is calling for more opportunities and a stronger voice for his generation so that it can build its future here, not abroad in such places as Australia or New Zealand. James Morrison represents the very best of our next generation of farmers. His success is not just personal; it is symbolic of the intergenerational excellence that drives Northern Ireland's agriculture sector forward.

I congratulate James on his outstanding achievement at the World Angus Forum. His story is a shining example of what can be accomplished when tradition, talent and tenacity come together.

Mr O'Toole: Today, I want to reflect on an incident that happened in Belfast city centre over the weekend: two peaceful protesters outside Barclays bank on High Street were arrested by the PSNI. It is important to say that there is no more profound right in a democracy than peaceful protest. Over the weekend, dozens more innocent people lost their lives in Gaza as a result of bombardment by the Netanyahu regime. We are witnessing an ongoing genocide in Gaza. People from all over this region, from all backgrounds, of all ages and from all perspectives are, frankly, in complete disbelief at what they see on their screens. They want some way of registering protest and dissent and of challenging what is happening in the Middle East. One means is through peaceful protest.

One of the people arrested is a woman named Sue Pentel, who is in her 70s. She also happens to be Jewish. She will be known to people here because she is often here peacefully and respectfully engaging with MLAs and others on the Middle East. Sue was standing peacefully next to an ATM. She put a sticker around that ATM, I believe, and was arrested for her trouble. I understand that the PSNI has a difficult job to do. I do not trivialise the fact that, sometimes, in fast-moving situations, there are judgements that have to be made by police officers, but I do not think that anybody, certainly not the dozens upon dozens of my constituents who are, frankly, appalled by what is happening in Gaza and have emailed me in the past few days to ask, "What the hell's going on in our society when peaceful protest is met with the arrest of pensioners?", would see that as a legitimate or proportionate response.

I do not want to demonise individual police officers, who have a tricky job to do, but we are in the midst of witnessing a genocide. People in our society want to register peaceful protest. They also want their public representatives, whether at Westminster, at Stormont or on any platform that they have, to register opposition to what, many of them feel, will define their generation's response not just to human rights abuses but to ethnic cleansing and genocide. Peaceful protest in Belfast city centre, even if it is a minor inconvenience, should not be criminalised. I respect the fact that people may have different views, although I do not know how people could have a different view on what we are witnessing in Gaza, which is, transparently, a crime against humanity. That is legitimate, peaceful protest. Police officers have a job to do in all these circumstances — I respect that — but let us, please, be proportionate and respect the rights of ordinary people to register dissent and protest.

Mr Speaker: Before we move on to the next Member, I want to make it clear that the police have a role to play, and it is not our place to second-guess that role. A number of Matters of the Day and questions for urgent oral answer that were submitted question the action of the police at different events. We need to be very careful. When there is a live investigation — it has not reached the stage of there being charges and may never get to that stage — it is not our role in the House to influence police decisions on investigations. They have to run their course. It goes to the Public Prosecution Service (PPS), and there is a due process. It is not for us to seek to influence that. I caution Members on that issue.

Mr Delargy: I raise a matter of pressing concern in my constituency. We all know that waiting times in Altnagelvin hospital and in emergency departments across the North have been continually rising, but, on 15 May, the waiting time to be seen in Altnagelvin was 581 minutes. People had to wait for nearly 10 hours to be seen in our emergency department. That is absolutely disgraceful, nothing short of disgraceful. The average across the North was 190 minutes. The waiting time at Altnagelvin is consistently at least twice the average waiting time of any other emergency department across the North.

It is not just about numbers or statistics. The patients and staff at Altnagelvin are our families, neighbours and members of our communities, and they will not be treated as second-class citizens. We consistently hear from constituents who come into our office about people waiting in corridors and being left there for a long time. People are leaving the hospital having not been seen after nine or 10 hours. That, in turn, increases the pressure on primary care and on out-of-hours services.

The physical infrastructure at Altnagelvin has a key role to play in addressing the situation. The Department of Health needs to step up and do better for the patients and staff there. In January, we had an Adjournment debate on the need for Altnagelvin's emergency department to be adequately sized and resourced, on which there was consensus from all sides of the House, yet nothing has been done about it. I understand that the building of a new emergency department is a lengthy process, but, during the debate, I outlined three aims and objectives that the Department of Health could implement at Altnagelvin on that day. That debate, as I said, took place in January, yet none has been implemented. The Department has failed to commission more inpatient beds, to provide any additional staff training or bring in consultants or to tackle any issues that we raised about domiciliary care packages.

This is about the pressure that is being placed on front-facing staff, who are bearing the brunt of lengthy waiting times. It is about low morale and high staff turnover. I therefore again send a message to the staff in Altnagelvin hospital that we in the Chamber have their back and will continue to be their voice to the Department of Health. Excuses about the situation being related to winter pressures do not cut it. It is nearly the summer. It is now a 365-days-a-year crisis. The Department of Health needs to step up and introduce proper procedures to support patients and staff at Altnagelvin.

Mr Harvey: I pay tribute to the incredible work of so many Christian youth organisations and Church-led initiatives that engage daily with our children and young people, particularly those that provide content for or conduct school assemblies, RE classes and Scripture Union meetings in schools across Northern Ireland. Members will be aware of an attempt to undermine or remove altogether the Christian ethos in our schools by way of litigation. The Christian ethos has been part of the very fabric of our schools for generations. The fact that the matter was before the Supreme Court last Wednesday demonstrates that, despite pupils having the ability to opt out of RE and assemblies in schools, there are those who are determined to impose their position on the majority of parents and pupils in every school sector in Northern Ireland, who wish to maintain their school's Christian ethos. That is deeply concerning.

Teachers, priests, ministers and youth organisations in the sector seek to instil in our young people the core Christian values of love, compassion, respect for themselves and others, respect for authority, justice and the rule of law, and the importance of moral guidance in carrying out our duty as individuals in society. Our children and young people have benefited greatly from exposure to and instruction in the central tenets of the Christian faith, which is the faith of our nation and of the overwhelming majority of our citizens. It is only right that those who seek an education that exposes them to the central tenets of, for instance, the Catholic faith be permitted to do so. Equally, those who do not wish to avail themselves of such expression of faith are well within their rights to remove themselves from lessons, and they have been able to do so freely and ably in the past.

I trust and pray that the autonomy of local schools, under the direction of boards of governors, will be permitted to continue so that education can be delivered in an environment that is acceptable to the overwhelming majority of parents and pupils and that the Supreme Court acknowledges as much.

Mr McMurray: My thoughts are with those who were caught up in the incident at the victory parade in Liverpool last night, which included a large number of Northern Ireland-based Liverpool fans. I turned on the news channels to see and enjoy the parade, only to be confronted by the breaking news of the unfolding situation. It was saddening, to say the least. What was supposed to be an evening of celebration quickly turned into one of horror. It was particularly shocking not only for the four children who were involved but for all those who bore witness to it. No football fan, or, indeed, any sports fan, should go somewhere to show support for their team and return injured. I hope that the people — the fans — who were involved have a speedy recovery.

Mr Sheehan: As those with the power to act enabled Israel to carry out a genocide against the Palestinian people, Kneecap and others such as Sue Pentel shone a light on the atrocities that were being committed. While defenceless men, women and children were murdered in their sleep by Israeli bombs, and homes, mosques and schools were destroyed with impunity, Kneecap never wavered in their steadfast support for the Palestinian people and utter condemnation of the Israeli war machine. Kneecap have used their platform for good while Benjamin Netanyahu, his Israeli Government and the Israeli occupation forces continue to break international law and commit war crimes on a daily basis.

Gaza is on the brink. Famine, disease, devastation and death, caused entirely by Israel, are the daily experiences of the Palestinian people as the world's so-called powers turn a blind eye. While Netanyahu and Yoav Gallant avoid the arrest warrants for war crimes and crimes against humanity that were issued by the International Criminal Court, Kneecap are being dragged through the British justice system. That is the same British justice system that says nothing about the British Government's complicity —.

Mr Speaker: Mr Sheehan, take your seat for a moment, please.

Members will be aware that charges have been brought in this case. There are now active legal proceedings, and the matter is therefore sub judice. The House offers you no protection in respect of sub judice, so I caution you to ensure that, in your remarks, you do not go into matters that are sub judice; you are venturing very close.

Mr Sheehan: The same British justice system says nothing about the British Government's complicity in Israel's path of murder and destruction. Tens of thousands of people have died since the Israeli onslaught began in October 2023, but the people who are being hounded and dragged through the courts are an Irish language hip-hop group from west Belfast. I commend Kneecap on their unwavering determination in the face of a campaign to silence them. Kneecap are not the story. Genocide is the story, and it should stop now.

Mr Brett: As the DUP economy spokesperson, I take this opportunity to recognise that this is Manufacturing Month in Northern Ireland. Manufacturing Month is an annual initiative led by Manufacturing Northern Ireland that celebrates and supports the vibrant manufacturing and engineering sector here.

Manufacturing is a powerhouse of the Northern Ireland economy, driving innovation, developing talent and leading the green growth agenda. Northern Ireland manufacturers are rightly recognised as global leaders in delivering cutting-edge solutions and sustainable, high-quality jobs. It is only right that I celebrate their role and the economic impact that they have on every corner of our country. The Manufacturing Month programme of activities will culminate in the annual Anchor High Leadership Summit, which will take place in my constituency on Thursday.

During this month, Manufacturing Northern Ireland launched the report 'Manufacturing and the Northern Ireland Economy', which highlights the vital contribution that the sector makes to our economy, accounting for almost 14% of all economic output in Northern Ireland. Its output, worth over £6 billion, makes it the second most important sector to the economy in jobs and value. The report also found that the sector accounts for 17% of private-sector jobs and 21% of all turnover despite accounting for just 6% of the total private business population.

We in this party have been champions for our manufacturing sector for many years. We are hugely proud that we delivered the industrial derating policy, which ensures that manufacturers across Northern Ireland benefit from the rate relief that they deserve. As a result of our championing that economic opportunity across Northern Ireland, tens of thousands of people remain in jobs in vital sectors. This party will continue to champion and stand up for the manufacturing sector across Northern Ireland.

Mr McCrossan: Over the weekend, another serious collision occurred on the A5, just next to the Ulster American Folk Park. As most of us do at various times to go about our business, Bernie Cranley, aged 82, left her home in Lifford. She travelled on the A5 and, sadly, did not return home. She died a short time later as a result of that accident. Another lady, who was in the other vehicle, remains seriously ill in the Royal Victoria Hospital in Belfast. Once again, we are seeing the worst possible consequences of travelling on the A5. First and foremost, it is vital that we send our thoughts and prayers to Bernie Cranley's family and to the family of the lady who, hopefully, continues to recover in hospital.

The A5 continues to put people at risk on a daily basis, and our public's patience is wearing thin. Last week, I witnessed a number of accidents. This week, we witnessed a serious accident that claimed another human life. Fifty-seven people have died on that road since 2007. How many more deaths will there be on the A5 before the upgrade is delivered? No section of the road is safe; unfortunately, every part of it has now claimed a human life. It is the most dangerous road on these islands — there is no other way to describe it. I understand that, across my constituency, those whose land and businesses are affected have concerns about the development of the A5, but none of that really matters when it comes to the loss of human life. The knock on the door of every one of those families is devastating beyond all words. It is unexplainable. Sadly, it continues. Every time that there is an accident or a death on the A5, it re-traumatises the families who have gone through the dreadful, terrible, painful, devastating loss of life when mothers, fathers, sons, daughters, grandparents, neighbours and friends have not returned home.

The A5 was closed for 10 hours on Saturday. The bluegrass festival in the folk park was cancelled on Saturday night. The Tyrone and Donegal game was delayed. The road impacts on every part of our life. We need the upgrade, we need to protect people who travel on the road and we need to ensure that no one else dies on the A5.

Mr Buckley: I thought that some Members had come to their senses in understanding the plight that faces family farms, yet months after the hammer blow of Starmer's farm death tax, we again stand at a crossroads, facing yet another assault on our farmers, our rural communities and the very way of life that has sustained this land for generations.

The nutrients action programme (NAP) from the Alliance Party's Minister, Andrew Muir, is not just a set of rules; it is a battering ram that is aimed at the heart of our agricultural heritage. Let us be clear: farming is not just a job; it is an essential service. Our 48,000 farm workers feed the nation, manage 75% of the land and pour their blood, sweat and tears into keeping our rural communities alive, yet Minister Muir's NAP treats them like villains, blaming them for 62% of phosphorus pollution on the basis of shaky computer models, not hard evidence.

Where is the scrutiny of Northern Ireland Water's leaking water systems? Why are farmers the scapegoats whilst others dodge responsibility, Minister? It is a targeted attack, plain and simple.

Members across the Assembly, is it not now time that we called time on the Minister's environmental extremism? He is a man who appears to be fixated on finishing our rural way of life. Does the Alliance Party think for one moment that it is in any way bluffing farmers with its warm words and pictures of wellington boots at the Balmoral show and on departmental Twitter feeds? They are long used to the smell of manure that comes from the Minister's media commentary. They know that the Minister would not know the difference between salad and silage and that it is time he left the field before he ruins the entire crop.

The NAP demands are a death sentence for many farmers. A phosphorous limit of 10kg per hectare is not a regulation; it is a guillotine. Farmers face slashing their herd size or halving the land that they cannot afford because they are already being squeezed out by high prices. Requiring low-emission slurry equipment by 2030 sounds green, but it is a financial noose, which will cost farming families thousands —

Mr Speaker: The Member's time is up.

Mr Buckley: — and we must put an end to it.

Mr Speaker: I call Cheryl Brownlee. You have two minutes.

Ms Brownlee: Thank you, Mr Speaker. I send my congratulations to Graham Fergus: a Carrickfergus man and a veteran of the Irish Guards. We are also proud that he is an East Antrim DUP member.

Graham has just completed a gruelling 10-day challenge to raise awareness of homelessness and to support three incredible organisations in the process. Graham began 'Operation Home' on Friday 16 May, when he set off into the Mourne Mountains with nothing more than a one-day supply of food. He had no tent, rations or home comforts. He relied on the kindness of strangers to meet his daily food needs. That symbolic gesture reflected the uncertainty faced by many who are without a permanent home.

It was a solo challenge. He carried 20kg and covered 93 miles over 10 days. Graham has hailed the kindness of the strangers whom he met. On average, he met eight people a day, and kind strangers donated food to him every day. He summited five of the seven peaks of the Mournes. People welcomed him with open arms, listened to his story and supported him in so many ways, whilst he endured that challenge. He met many from Northern Ireland and further afield.

To date, Graham has raised £5,700 for three fantastic charities: Blesma, the Welcome Organisation and Andy Allen's Veterans Support NI. Those are amazing charities, and they are all close to his heart. Graham will also be on the Veterans Commissioner podcast on 2 June to talk about his challenge. I say a huge, "Well done" to Graham. We are incredibly proud of him and all those who served and continue to serve. The veterans in Northern Ireland should receive the recognition and support that they very much deserve.

Mr Speaker: That concludes Members' statements.

Mr Speaker: I have received notice from the Minister of Agriculture, Environment and Rural Affairs that he wishes to make a statement. I call the Minister.

Mr Muir (The Minister of Agriculture, Environment and Rural Affairs): With your permission, Mr Speaker, I wish to make a statement in compliance with section 52 of the Northern Ireland Act 1998, regarding the seventeenth British-Irish Council (BIC) environment work sector meeting, which was held in Kew Gardens in London on Thursday 8 May of this year. Junior Minister Aisling Reilly MLA, junior Minister Pam Cameron MLA and I represented the Northern Ireland Executive at the meeting. The report has been endorsed by junior Ministers Reilly and Cameron, and they agreed that I should make the statement.

The British-Irish Council was established in 1999 and is a forum for its members to discuss, consult and use best endeavours to reach agreement and cooperation on matters of mutual interest within the competence of its member Administrations. The British-Irish Council environment work sector is led by the UK Government and has proved to be a constructive and unique forum for facilitating evidence exchange and practical collaboration since the Council was established.

During the meeting, Ministers discussed and reviewed the work of the environment work sector from 2020 to 2024. The meeting also focused on restructuring the environment work sector. It was chaired by Mary Creagh MP, Parliamentary Under-Secretary of State and Minister for Nature, and involved Ministers from Ireland and the devolved Administrations of Scotland, Wales and Northern Ireland as well as the Governments of the Isle of Man, Jersey and Guernsey.

Ministers discussed and reviewed the environment work sector 2020-24 policy report and the activities of its subgroups — the invasive non-native species; the Asian hornet task force; marine litter marine environment; and climate adaptation — across the period. We commended the work undertaken and the value of shared cooperation on each of those areas. Ministers agreed that the 'Environment Work Sector Policy Report 2020-24' would be published. Ministers also agreed to the streamlining of the environment work sector, confirming the closure of the marine litter, marine environment and climate adaptation subgroups following the conclusion of their work plans and the mainstreaming of climate action across the British-Irish Council thematic programme.

Ministers affirmed the importance of continued collaboration across Administrations to combat the growing threat of invasive species. We agreed that the invasive non-native species and the Asian hornet task force subgroups would combine and be elevated into a separate invasive species work sector led by the UK Government. Ministers reviewed and endorsed a new work plan for the invasive species work sector, with a focus on the following priority areas: monitoring and surveillance technology; priority pathways — exotic pets; awareness raising; alerts and rapid response; and Asian hornets, which are yellow-legged hornets.

Ministers also considered future priorities for the environment work sector, with agreement to make the circular economy as the immediate topic of focus led by the UK Government. Ministers tasked officials to develop a work sector plan on the circular economy for future consideration in the second half of 2025.

I commend the statement to the Assembly and welcome any questions.

Mr McGlone: Gabhaim buíochas leis an Aire as a ráiteas.

Minister, I have read your statement, and, to be honest, there seem to be plenty of titles, but it is short on detail. For example, the 'Environment Work Sector Policy Report 2020-24' is to be published. Can you give us any idea when that will be published? Secondly, paragraph 11 states that you:

Presumably, that discussion lasted for a while. Can you give us some detail on those priorities?

Mr Muir: The publication of that sits with the British-Irish Council, but I will follow it up and request that it is promptly published, because that is important.

The circular economy was considered to be a relevant topic for future work. England, Scotland, Wales, the Republic of Ireland, Northern Ireland, Jersey, Guernsey and the Isle of Man face similar challenges in regard to that, so it was felt that it was important that we should take that forward, and the UK Government are happy to do that. I said at the meeting that we also need to take into consideration the unique position of Northern Ireland in respect of the Windsor framework and how that fits in to it all.

There are opportunities from the circular economy. There are great examples of businesses in Northern Ireland showing that in action, and, hopefully, we can learn from one another and drive forward more work on it. An element of the circular economy sits with the Department for the Economy. Obviously, it will be invited to future British-Irish Council meetings, if those topics are on the agenda.

Ms Finnegan: Minister, thank you for your statement. We have an ecological crisis happening in Lough Neagh. Are other Administrations facing similar problems?

Mr Muir: We face an environmental catastrophe in Lough Neagh. It is a serious issue not just in respect of its impact on the environment but because 40% of our drinking water comes from Lough Neagh, so it is important that we face up to the actions that need to be taken around that. One of the specific issues that were discussed at the British-Irish Council in regard to Lough Neagh was zebra mussels. They are an invasive species and contribute to the issues that we face with Lough Neagh. The interventions that we can provide regarding that are rather limited. It is key that people ensure that, in any maritime operations, due diligence is taken to ensure that we do not spread the zebra mussels. The matter of invasive species is on the agenda of the British-Irish Council because it affects not just Northern Ireland but the South. We will continue to collaborate on that.

Additional research on Lough Neagh has been published, and I will lay that in the Assembly Library for Members to access. The research is about the contribution to water quality, and hopefully it will aid consideration of the issues affecting Lough Neagh.

Mr T Buchanan: Minister, your statement talks about the "value of shared cooperation". What cooperation do you and your Department have with the farming community here on your nutrients action programme (NAP) proposals, which have the potential to put many farmers to the wall and are creating huge concern in the agriculture industry?

Mr Muir: The statement is about the British-Irish Council environment sector, and I am glad to say that that cooperation occurs across all the member organisations of the British-Irish Council. We work collaboratively, which is good.

On your question about the nutrients action programme, that is out for consultation. I took a decision to extend it by four weeks, and I encourage people to feed back alternative solutions to tackle the challenges that are in front of us or to raise any concerns about that. The consultation is just that: a consultation on proposals. I understand that it is complex, and that is why I agreed to extend the consultation by four weeks.

Mr Blair: I am pleased to hear that the British-Irish Council has commended the work that is being done on marine litter and the marine environment more generally. Minister, what action is being taken to protect blue carbon habitats and the wider marine environment?

Mr Muir: Thank you, John. My Department has worked with stakeholders to co-design policies, strategies and action plans that are needed to address the dual climate and biodiversity crises that face the marine environment. They include a revised marine protected area strategy and a blue carbon action plan. I launched the blue carbon action plan on 23 April, and the revised marine protected area strategy will be published later this year. That will be followed by the seabird and elasmobranch strategies.

Ms Murphy: Minister, when do you expect the environment work sector policy report to be published?

Mr Muir: I will follow up on that. That sits with the British-Irish Council, and I will seek to have it published as soon as possible.

Miss McIlveen: I thank the Minister for the short statement; I am not sure whether that reflects the fact that it was a short meeting.

In an answer to a tabled question last month, the Minister informed me that there were 55 exotic pets or, as he referred to them, "dangerous wild animals" registered in Northern Ireland. In the absence of any detail in the statement, will the Minister explain why the matter of exotic pets is being considered as a priority pathway and outline the terms of reference for that work stream and whether we should expect a change in the licensing of such animals?

Mr Muir: Thank you, Michelle. Your Assembly question was useful in bringing out a bit more detail on the number of exotic pets that are registered in Northern Ireland. I continue to encourage people to register any exotic pets, because there is a requirement to do that. It is important that we recognise the risks to broader society if we do not properly manage that, and that is why it was agreed that it should be part of the work programme. Once the terms of reference are agreed, I will write to you to set them out. It is important that we do that.

At the meeting, we discussed some of the information that we have gathered on the situation that has presented itself. We want to work collaboratively because, as you know, those pets are likely to travel throughout the areas that are within the remit of the British-Irish Council, and I am very conscious of the associated risks. Again, I urge people who are in possession of any of those animals to register them.

Mr McMurray: Minister, what will the invasive species work sector focus on?

Mr Muir: Thank you very much. That is an important area. The invasive species work sector will focus on monitoring and surveillance technology, developing new technology, including AI, for monitoring invasive species across the islands; priority pathways, including exotic pets, as we have just talked about, to address exotic pet escape and establishment of actions across British-Irish Council member Administrations; and prompting awareness-raising campaigns such as Be Plant Wise and Check Clean Dry and coordinating the annual Invasive Species Week. It also includes alerts and rapid responses and, as was discussed in the statement, preventing the spread of Asian hornets, which threaten honeybees, native invertebrates and human health.

Mr McAleer: I thank the Minister for his statement. He mentioned the value of shared cooperation and collaboration. Will the recent reset in EU-UK relations have any beneficial impact on the environment work sector?

Mr Muir: Yes, it will. It was set out in the statements that were issued on Monday of last week that there will be further cooperation around those areas. That will be for the collective benefit of the EU, Northern Ireland and the UK more broadly. That is wise, because a lot of the issues that we are discussing with the British-Irish Council also extend to the European Union. It is important that we cooperate on those. I already cooperate quite a lot with my colleagues in the South, and I am seeking further engagement with my colleagues, particularly around Lough Neagh and nature recovery and also on agriculture and veterinary matters. That liaison already occurs, but the reset with the European Union allows us to broaden and deepen that collaboration. It is set out in the statement, and I welcome that particular paragraph.

Mr Buckley: This watery two-page statement says to me that there continues to be zero self-awareness from the Minister about the huge pressure and strain facing agriculture in Northern Ireland. When he was discussing environmental work schemes, was there any consideration of the thousands of jobs that are at risk from his environmental extremism?

Mr Muir: I continue to undertake my responsibilities to the environment because they are statutory responsibilities that need to be discharged. It is important that we take cognisance of that. We also need to take cognisance of a report issued last week by the Office of Environmental Protection. It states:

The first item in the list of future topics is:

That is the context in which I operate, and I am very clear that the proposals for the nutrient action programme are just that: they are proposals. There is a commitment in the Programme for Government to tackle the issue of Lough Neagh. There is significant pressure, whether from the Office of Environmental Protection or others, to do that. I am striving to strike a balance between addressing those issues and concerns that are being set out to me and ensuring financial sustainability for the agri-food sector. That is something that I am very much committed to. I was the only Minister in the UK to secure ring-fenced funding for agriculture, agri-environment, fisheries and rural development. Additionally, I secured over £12 million for a just transition fund for agriculture. I am doing that work. I am delivering for the farming community, but I am also very conscious of my statutory responsibilities, which I cannot shirk.

Mr Donnelly: Addressing climate change is the greatest challenge of our time, and cooperation on the issue is very welcome. Minister, when will the third Northern Ireland climate change adaptation programme (NICCAP3) be published?

Mr Muir: I recently shared a copy of the Northern Ireland climate change adaptation programme with my ministerial colleagues and requested any final comments before my Department launches an eight-week consultation on it. Subject to no major concerns being raised, I hope to launch the consultation late this month or early next month.

Mr Gaston: Minister, given the continued application of EU law in Northern Ireland and many issues relating to the environment, was there any discussion about alignment for the whole of the UK with the EU, and, as a consequence, subverting the result of the 2016 referendum?

Mr Muir: That was not a matter for discussion for the environment work sector. I outlined in the statement what the meeting focused on. To be honest, Mr Gaston, I think that the EU lives rent-free in your brain.

Mr O'Toole: Minister, this very short statement is the only substantive Executive business today, so it would be good to hear some substance. Of the jurisdictions that you met at the British-Irish Council, Northern Ireland is the only one that does not have an independent environmental protection agency. Even the Isle of Man and the Channel Islands can prosecute environmental crime. Did you give your colleagues an update on when the environmental governance panel will report? When will the House see the outworkings of that?

Mr Muir: There is an inaccuracy in your question: you said that only those areas could prosecute environmental crime. Northern Ireland can prosecute environmental crime, so it is important to set the record straight on that, Matthew.

Mr O'Toole: I did not say anything inaccurate.

Mr Speaker: Order.

Mr Muir: The independent panel is continuing its work and will report in due course. I will not be found wanting in coming forward with my response to that. When the SDLP had a chance to vote for an environmental protection agency as part of an amendment to the Climate Change Bill, you did not even turn up.

Mr Speaker: That brings to a conclusion the ministerial statement.

Mr Blair: On a point of order, Mr Speaker.

Mr Speaker: Yes. I remind Members that debate takes place through the Chair and not directly. I will take your point of order, Mr Blair.

Mr Blair: Mr Speaker, I seek your ruling on the comments made and wording used by Mr Buckley during —. [Interruption.]

Mr Blair: And again, it appears. It was during questions on the ministerial statement that we have just heard and during Members' statements earlier.

Mr Speaker, will you rule on whether it is appropriate to mention a person's attire and to accuse a person of being an extremist? Those comments were contained in a Member's statement and in a question. Do such remarks constitute a direct and personal attack on a Member, whether that Member is a Minister or not?

Mr Speaker: I am happy to look at what has been said and to take some consideration of that from my staff.

Mr Buckley: On a point of order, Mr Speaker. Would it be appropriate for me to receive the exact words that Mr Blair found so offensive? I have not one clue about what on earth he has just said.

Mr Speaker: That is why we will look at it ourselves. When Hansard produces the transcript, we will, in due course, consider it with cool heads.

Ms Bradshaw: I beg to move

Madam Principal Deputy Speaker: The Business Committee has agreed to allow up to one hour and 30 minutes for the debate. The proposer of the motion will have 10 minutes to propose and 10 minutes to make a winding-up speech. An amendment has been selected and is published on the Marshalled List, so the Business Committee has agreed that 15 minutes will be added to the total time for the debate. Paula, please open the debate.

Ms Bradshaw: Thank you, Principal Deputy Speaker. The Alliance motion highlights the challenges facing dental practices, which cause difficulties for our constituents in accessing their services; calls on the Minister of Health to introduce a new oral health strategy to address access to services and workforce challenges; and calls on him to conclude and publish the general dental services cost-of-service review as soon as possible.

I welcome the amendment from colleagues in the DUP, which calls for proposals to improve access to dentistry, including ways to address regional inequalities.

Unfortunately, as MLAs, we will be all too familiar with the difficulties in accessing dental services through our health service. Whilst we all get contact from constituents who are unable to access GP services, almost as many get in touch because they are unable to source dental services on the NHS.

According to the most recent working patterns data from the General Dental Council (GDC), which had looked at the number of dental practices that are committed to at least 75% of their work being provided through the health service, Northern Ireland has had the largest shift away from NHS dentistry in the direction of private services, with only 43% of practices here being committed to meeting that 75% target. Furthermore, statistics that emerged last month have confirmed that, of the more than 350 dental practices in Northern Ireland, only two are now fully NHS practices, while more than 53,000 health service patients have been removed from practices' lists over the past two years.

We are currently witnessing the end stages of the privatisation of a crucial section of our health service. Oral healthcare plays a major role in the prevention of diseases, not least of oral cancers, and dentists are often on the front line of recognising the need for further treatment and referring patients on. Oral healthcare is especially crucial for children and young people. Tooth decay, which is an almost entirely preventable condition, remains the leading cause of hospital admissions among children in the UK. I acknowledge that the Department of Health consulted on new oral health improvement plans for children and older people last year. We now need to see action on those plans as a result of the consultation.

There is another glaring example of Northern Ireland's ever-growing two-tier healthcare system. As a South Belfast MLA, I am regularly contacted by constituents who are experiencing extreme dental pain but can neither afford to pay for treatment nor access it on the NHS. As the British Dental Association (BDA) has put it, it is those who need healthcare the most who are the most affected. During his tenure, the Minister of Health has not outlined many priorities from his Budget allocation, but one priority that he has spelt out is that of tackling health inequalities. I therefore ask the Minister to give an example of where inequality is as glaring as in people's inability to access health service dentistry.

We cannot wait. Urgent action is needed now if we are to turn the tide of privatisation. Ultimately, it is a funding issue. I appreciate that the Department of Health created the dental access scheme as a way in which to assist individuals to access health service dentistry, but the reality is that it does little but buff the edges of the problem. Only 29 out of 364 practices have signed up to the scheme, with practices being given little incentive to get involved. If we are to ensure that dental practices are in a position to provide health service dentistry, the Department of Health needs to ensure that independent contractors are on a sustainable financial footing.

It is my understanding that discussions are ongoing about investment proposals for general dental services (GDS) for 2025-26. I remind the Minister that we are almost into the month of June, so the first quarter of the financial year is almost complete, yet general dental practitioners still have no clarity on what financial arrangements will be in place for undertaking health service work.

A number of other outstanding issues need to be addressed. How will funding be allocated to support the increase in employers' National Insurance contributions? As is mentioned in the motion, where is the cost-of-service review, and will it be expedited, as it is an urgent matter? The British Dental Association has engaged with the Minister and his officials on several occasions since February 2025 on the proposals, which, if implemented, could enable practitioners and practices to maximise GDS health service activity and, in turn, deliver better patient access. It is my understanding that there has been no engagement with the BDA in return. I therefore appeal to the Minister of Health to expedite the cost-of-service review as a priority; to develop a new oral health strategy; and to engage with the BDA on proposals to improve access to health service dentistry as a matter of urgency.

Mr Robinson: I beg to move the following amendment:

Madam Principal Deputy Speaker: Alan, you will have 10 minutes in which to propose the amendment and five minutes in which to make a winding-up speech. All other Members who are called to speak will have five minutes. Please open the debate on the amendment.

Mr Robinson: Thank you, Madam Principal Deputy Speaker. In keeping with what tends to be the case with health motions, we hope that Members across the Chamber can support our amendment.

We believe that including a call to "address regional inequalities" helps to strengthen the original motion. We thank the Alliance Members for bringing the motion to the House.

It is right and positive for the House to collectively give a voice to the thousands of people across the Province who find it increasingly difficult, if not impossible, to access basic dental care. Access to dental care should be a fundamental part of our health system, but data shows that, for too many individuals and families, particularly those on lower incomes, NHS dental care is becoming a service that is out of reach and one that, dentists tell us, hinges on urgent reform and fair funding. The British Dental Association has consistently made that clear and warned of the growing shortfall between what dentists are paid by the Department and the cost of delivering treatment. On the other hand, the Minister and the Department of Health have warned about similar shortfalls in the Health budget; indeed, the Minister recently told us that he was not confident that he had enough budget to cover the forthcoming pay rises for health workers. I cannot help feeling that the people who depend on us are the ones who are being caught in the middle of the shifts between those two tectonic plates. The only positive is that things could have been worse had the ban on amalgam fillings from January 1 2025 been implemented. That can has been kicked down the road for another day.

It is well documented that many dentists are either scaling back or withdrawing from NHS contracts because the numbers simply do not add up in their practices. That means fewer places for NHS patients, longer waiting lists and, ultimately, worsening oral health outcomes. National Insurance and wage increases have meant that dental services are teetering on the edge, with the likelihood of reduced opening hours and even cuts to staff numbers. To compound a depressing state of affairs, a cohort of dentists are approaching retirement. It feels that, for dentists, the perfect storm is above them, below them and, now, around them.

The figures for 2023-24 show that there were 364 dental practices and 1,195 dentists in them. However, what struck me was that 114 dentists — nearly 10% — handed back their NHS contracts in 2023-24. Worse still, only two of those practices are fully NHS practices. What is worrying is that oral health is not separate from general health. Even those of us who have no special health experience know that untreated dental problems can lead to serious infections, nutritional issues, chronic pain and even hospital admission. In addition, dentists are on the front line in identifying oral cancer. On whom will that fall most heavily? Our most vulnerable: children, older people and those already facing huge barriers in accessing NHS dental care.

While dental treatments are important, early and preventative care is key. Regular check-ups normally prevent serious problems down the line and reduce the pressure on other parts of our health service, such as GP surgeries and A&E departments. It is always better to deal with the issues upstream than it is to try to deal with a dam that is leaking heavily. My party supports the call for the Minister of Health to develop and publish a new oral health strategy that sets out clearly how the Department will improve access, invest in prevention and build a dental workforce that is supported, valued and funded.

As I said, we want to see regional inequalities being addressed, regardless of someone's income, postcode or background. We people to have access to the dental care that they need when they need it. One glaring regional variation is in Fermanagh and South Tyrone, where fewer than 49% of the adult population are registered with a health service dentist. I go further: just over three quarters — 76% — of children in Northern Ireland are registered with a health service dentist, with children in the more deprived areas less likely to be registered with a dentist and much more likely to have dental decay. The Minister has outlined his commitment to addressing inequalities and improving access to NHS services, but our constituents face the reality that dental treatment is costly and is becoming a financial burden rather than a public health provision.

Mrs Erskine: I thank the Member for giving way and for raising Fermanagh and South Tyrone. Does he agree that, when dentists switch to private models or close their doors in rural areas, people in those areas will have problems in accessing transport in order to access dental treatment? That is a huge problem in rural areas and adds to the health inequalities.

Mr Robinson: Absolutely. As usual, Ms Erskine, who is a capable and avid Member for Fermanagh and South Tyrone, pinpoints the issue well.

The inequality must be tackled so that better health outcomes can be afforded to all our people. It is clear that access to dental care is becoming increasingly determined by one's ability to pay, and that will only deepen existing health disparities.

We cannot lay the blame at the feet of dentists, who are just trying to keep their businesses afloat. We cannot blame patients, who are worried about access to treatment. Dentists play a vital role in the healthcare system, and we cannot sit by and watch as oral health is privatised. The benefits of routine dental care in early intervention and treatment must be recognised.

We must remember that dentists do not go on strike — they leave. The rising costs of business and a lack of financial support are pushing them out. If we do not save NHS dentistry, more dentists will leave, worsening the problems that our constituents face in accessing dental services.

We also support the call for the immediate conclusion and publication of the general dental services cost-of-service review. Without understanding the true cost of delivering NHS dental care, the Department surely cannot fix a dental service that is under so much pressure and strain.

Mr McGuigan: I thank the Alliance Members for tabling the motion and the DUP for its amendment, both of which we will support.

MLAs know, because our constituents have been telling us, that, in recent years, an increasing number of patients are and have been struggling to access NHS dentistry services, as more and more practices go private due to a lack of investment and rising costs in the industry. We have also heard from dentistry representatives that, unless action is taken soon, more dentists will inevitably leave the system and the crisis in NHS dentistry will deepen further.

The BDA's general dentist service survey, which was carried out last March, stated that almost 90% of dentists said that they intended to do less NHS dentistry in the coming year and almost half stated that they intended to go fully private. We have seen those figures become reality. More than 53,000 NHS dental patients have been removed from dental practice lists over the past two years. During 2023-24, 114 dentists handed back their NHS contracts to the Department of Health, with many of them now doing private work only. Out of 360 dental practices in the North, only two are fully NHS practices. My household received three letters a fortnight ago to tell us that our dentist was going fully private over the summer.

We know that the loss of more NHS dentistry practices will have a disproportionate impact on patients on lower incomes and on children, who, as a result, may go without regular check-ups and preventative oral care for many years. Therefore, I agree with the other Members who have stated how important dental care is. Dental care is not a luxury but a necessity, and it is vital for good general health. However, having the right to free dental treatment has no value or meaning when you cannot find an NHS dentist with the capacity to provide you with treatment.

Access to dental care cannot be just for those who can afford to pay for it; it is a fundamental aspect of our health and well-being. Our public health service was designed to prevent health inequalities, yet we see that being eroded across the board. With private healthcare becoming more and more prominent, nowhere is that development more stark than in dentistry, as we see.

It is imperative that the NHS dental contract be revised and made reflective of the current cost of delivering modern dental care to ensure that practices are not pushed towards privatisation through financial necessity. Everyone deserves to be fairly paid for the work that they do, so the call in the motion to:

is an important aspect of getting this right and moving forward on it. Learning should be taken from the payment model followed in Scotland. The reform and investment there will clearly benefit both the dental sector by improving the NHS offer and patients by giving them increased NHS provision.

Last August, the Minister announced the dental access service, the enhanced child examination scheme and the 30% enhancement to the fees paid for fillings. That is a short-term measure that speaks to the urgent necessity for action and reform.

The Health Minister must bring forward a plan to stabilise NHS dentistry in order to avoid the complete collapse of the service. We are all aware of the budgetary constraints within which the Health Minister and every other Minister work. I have no doubt that he will articulate that in his response. However, the Health budget is vast: 50% of the entire Budget. The Minister has committed, in his three-year plan for Health and Social Care (HSC), to develop an action plan and programme of work for the reform of general dental services by April 2027. By April 2027, we will not have any health service dentists left.

I urge the Minister to work with dentistry representatives to address access to NHS dentistry and workforce challenges and to restore public confidence in that vital part of our health service.

Mr Chambers: As an MLA, I am well aware that, in recent years and especially since the pandemic, it has become increasingly difficult for people to access health service dentistry. Whilst it is clear from regular media reports that access to NHS dentistry is a problem in every corner of the United Kingdom, there is an undoubted problem and challenge in Northern Ireland. Although the number of practices and dentists has remained broadly stable, the trend over a number of consecutive years has been that more and more opt to deliver greater private dentistry work instead of health service dentistry.

The number of patients who are no longer registered — perhaps, it would be much more accurate to state that they have been deregistered — is a further clear illustration of the shift from NHS to private work. Whilst there are various reasons for the move to private dentistry, money is undoubtedly a driving factor behind it. Some people claim that delivering a National Health Service dentistry service is a loss-maker, but I note that that has been strongly refuted in the past. One thing is undeniable: private dental work is much more lucrative for individual dentists and practices.

I am not sure whether, as the state, we could ever afford to fully reverse that, as it would come at an enormous cost. I am glad, however, that, despite the unprecedented funding challenges that face the health service locally, the Minister, like his predecessor, has decided to prioritise what limited funding exists for high-priority registered patients who are in need of urgent care. Initiatives such as the current dental access scheme, with a multimillion-pound budget allocated to it, have helped thousands of people across Northern Ireland, as has the enhanced child examination scheme. I know from engaging with the Minister that work has been under way on further initiatives, some of which will be innovative and unique to Northern Ireland. I welcome that, because no one — not us as MLAs, not the profession and especially not the patients — can be satisfied with the current state of NHS dental provision here.

Mr McGrath: I support the motion and the amendment, which highlight the growing crisis in our dental service that is affecting people across the North. We have heard it from patients and practitioners and through the Assembly: accessing NHS dental care is becoming a struggle for far too many people in our communities.

Let us look at the facts. According to the British Dental Association, NHS dental services in Northern Ireland now operate under a model that is simply not financially viable. Dentists are being reimbursed at rates that do not cover their costs. As a result, many have to make the painful decision to limit or stop seeing NHS patients altogether. There is a little reflection in that — let us just take that for a moment. Who would do something when it costs them to do it? If you provide a public service to the public, you should be reimbursed the costs that you are out and not have to pay and contribute to that. The result has been that, now, only two dental practices in the North conduct solely NHS work.

A recent survey by the BDA found that 90% of dentists in Northern Ireland are unable to take on new NHS adult patients. We know that that is much more than a statistic. It represents hundreds of thousands of people in our communities — the people whom we represent — who are no longer able to access NHS treatment. They are effectively locked out of the care that can be provided for them. It goes to the very basis of the value that we place on the NHS and the public's ability to access timely healthcare, free at the point of delivery, which is still something that we should be trying to get.

Early and preventative dental care is not a luxury; it is a necessity. Left untreated, tooth decay — I have personal experience of that — can lead to lots of pain; it can lead to infection; you can miss time from school or work; and, in some cases, there can be emergency hospital admissions as a result. It is estimated that dental issues account for thousands of hospital admissions across the UK each year. Having to deal with those cases in hospitals costs our NHS more in the long run than it would to make the small investment that is needed in our dental services.

As for equality, it cannot be right that where you live in Northern Ireland determines whether you can see a dentist and whether you will have to pay. We know that there are significant regional disparities, with rural areas disadvantaged and hit the hardest. For that reason, the SDLP particularly welcomes the amendment, which focuses on addressing those inequalities.

I will make my usual and gentle remarks as a member of the Opposition. We have the situation in which there are four parties in this Chamber that are in government. Four parties sit around the same Executive table, yet today, one of those Executive parties brings a motion and another an amendment, both calling for urgent action from their own Health Minister.

People care about seeing a dentist when their child has toothache. They care about not having to choose between going private or going without. They care about action. That is why the Opposition can support the motion and the amendment, so let us get on with fixing the system.

Mr McGlone: I appreciate the Member giving way and thank him for that. Will he accept that it is not just about dental health? When you visit a dentist, other issues, such as oral cancers, can be spotted by a dentist when they are examining a person's mouth?

Mr McGrath: I thank my colleague for that remark. It fits in that dental practitioners are medical practitioners in our community and part of our wider NHS medical fraternity. They can spot things. They can intervene. They can provide support.

We need a system that is supported back the way and funded so that it can undertake all the work that it needs to. One way to get on with fixing that system is to see the general dental services' cost-of-service review published. Dentists need clarity, patients need access and the Department of Health needs a strategy that is fit for purpose.

The SDLP will continue to speak up for those left behind by the current system. We will work with all the parties committed to improvement and support any genuine efforts to deliver the care that people deserve.

Ms Flynn: I agree with the points that were made by all Members who have spoken. We are not debating the motion as just a policy concern or a policy issue. We know that the BDA has raised it time and again at the Health Committee — certainly, for the past number of years — and has warned of the sense of collapse across dentistry, because dentists cannot afford to supply the care to their patients. It is basically not worth the money that they receive.

Sometimes, we use the word "crisis" about plenty of different issues that come up, but I do think that this is genuinely verging on crisis, because of the fact that we have got to where we are: National Health Service dentistry has reached a point where parents cannot register babies and young children, and adults are getting phone calls saying that their local dentist is having to go fully private. Alan, in introducing the amendment, mentioned that only two practices are fully NHS — and it has been covered in the media as well. The whole situation is worrying.

I am sure that we are all being lobbied by our constituents, regardless of what part of the North we represent. One of my constituents reached out to say that having been registered with the same dental practice for the past 30 years, and having their treatment with that local dentist — this is similar to what Philip said in his remarks — she and her husband were told, just last week, that they were going to have to pay £500 a year because their dentist is having to put in private dental pans for all his patients. If he does not do that, the practice will have to close, which would mean that there would be no dental care for any of those patients. It is leaving people with no choice: if you can pay for private dental care, all well and good, but if you cannot, you face a hospital admission and having to undergo general anaesthetic and surgery, which is particularly worrying for kids. That is not good.

The Minister's pledge to try to address health inequalities was mentioned by, I think, Alan, when he introduced the amendment. That pledge was welcomed across the House; we were all pleased to see it. It is an important piece of work. The Minister will know that one of the biggest health inequalities is in kids' oral health, and he will know that constituencies such as mine — West Belfast — probably see the highest level of teeth-related admissions to EDs of young children because they do not have access to the dental care that they need. There is a mental health impact when people go through prolonged periods of pain. You know yourself that, if you have a toothache and discomfort in your mouth, it can impact on your attendance at work. Such pain can also impact on kids' attendance at school. People not being able to access a dentist when they need to definitely has a widespread negative impact.

We know the pressures that are on the budget — it is often the same conversation in the Chamber. If I am correct, the Department of Health is allocating just over £9 million to general dentist services in the North — the Minister will correct me in his remarks if I am wrong — which works out at 0·12% of the overall health budget. I know that that budget is going towards many important things, but we need to move this on and find a solution to make sure that, first and foremost, a child can get access to an NHS dentist if they need it.

Mrs Erskine: I support the important motion and want to give a voice in the Chamber, yet again, to the growing frustration and anxiety that is felt by many of my constituents in Fermanagh and South Tyrone, and by people across Northern Ireland, who face increasingly severe difficulties in accessing basic dental care. The previous time that I spoke in the Chamber on this issue, I described my area as a "dental desert". It is not getting any better. I provided options and pleaded with the Minister to act. Unfortunately, in response, I got rhetoric about how my party voted for the Budget. Let us hope that the Minister will come with a different attitude today.

In rural constituencies such as mine, the problem is not new, but it is worsening at an alarming rate. Constituents tell me that they can no longer find an NHS dentist and that the switch to private dentistry models is creating health inequalities in each town and village across Northern Ireland. Others have been removed from practice lists because their local surgeries can no longer afford to keep them under the current funding arrangements. We are not talking about just routine check-ups; we are talking about serious dental pain being left untreated, infections going unmanaged and families having to travel extraordinary distances for care that they used to receive in their own communities. That is not acceptable in a modern healthcare system.

The British Dental Association has been crystal clear: the financial model for NHS dentistry is no longer viable. The fees paid by the Department of Health simply do not meet the real cost of providing NHS dental services. That has forced many practices into making an impossible choice: take on fewer NHS patients, switch to private dentistry or close their doors altogether. We must face facts: the current system is broken. It is not enough to acknowledge the crisis; we need action. The general dental statistics publication for 2023-24 shows that the Fermanagh and Omagh council area had the lowest adult registration rate at 49%, which is 17 points below the Northern Ireland average. That is a staggering picture. Our amendment strengthens the original motion by calling for more urgency and adding in the regional inequalities that must be tackled. We need measures to expand access to services and address the very real regional inequalities that persist, particularly in rural areas such as Fermanagh and South Tyrone.

I also highlight the role of early and preventative care. Oral health is not separate from general health. Poor dental hygiene is linked to heart disease, diabetes and poor outcomes in pregnancy. The cost of inaction will not just fall on the dental system; it will burden our entire health service. The Minister must prioritise the completion and publication of the general dental services cost-of-service review. Dentists have waited for long enough. If we are to rebuild NHS dentistry, we need a funding model that reflects the real-world cost of delivering high-quality care. We must also look to the future. A new comprehensive oral health strategy is long overdue. That strategy must address workforce planning, training, retention and support for dentists working in underserved areas. If we do not invest in the dental workforce now, we will lose more practices and expertise, and, ultimately, our public health will deteriorate.

People in my constituency deserve to know that, when their child has a toothache, they can get an appointment. When an older person needs a filling or a denture repaired, they should not be left waiting for weeks or having to travel for hours. As has been said by others in the Chamber today, that is not a luxury; it is a basic public service. We cannot build a fair and healthy society without it. I urge all Members to support our amendment, and I call on the Minister to act with the seriousness and speed that the crisis demands.

Mr Gaston: The simple act of getting a dental appointment is now out of reach for far too many. According to the British Dental Association, the fees paid by the Department of Health to dentists do not cover the actual cost of delivering care. The harsh reality is that that shortfall has made an NHS dental practice financially unviable for many, so it is no surprise when they leave and turn to private work, or leave the industry altogether. In 2024 alone, over 40,000 NHS patients were removed from dental practice lists. More than 53,000 have been removed in just the past two years. Between quarter 1 of 2023 and quarter 3 of 2024, we lost over 177,000 registered patients from NHS dentistry. The registration of children aged between zero and 17 dropped by over 15,000 in just one year. That has real-life consequences for us all. One mother living in Larne told me how she was on the verge of registering her toddlers with a dentist in Enniskillen — a staggering four hours away — because nowhere closer would take them. Only a chance callback from a Ballymena surgery saved her from having to make that journey. In Belfast, my deputy leader, Councillor McDowell, has described calling dozens of practices on behalf of constituents, only to find none accepting NHS patients. However, there are reports of migrants being transported from Belfast to Banbridge by taxi for dental treatment.

The General Dental Council confirms the flight from NHS provision. Northern Ireland has the largest shift to private practice of the four UK nations. Only 11·5% of practices are now fully NHS. The Minister must bring forward a new and fully resourced oral health strategy that does not rely on goodwill and private income to prop up a public service. We must ensure that early and preventative oral healthcare is accessible to all, not just those who can afford to go private. That —.

Mr Dickson: I thank the Member for giving way. I am curious about the Member's comment about his concern for people not receiving NHS dental care, when his sister party, Reform UK, has been calling for privatisation and insurance-based healthcare, including dental healthcare.

Madam Principal Deputy Speaker: The Member has an extra minute.

Mr Gaston: Thank you very much. The Member has distorted what was said.

Ensuring accessibility means fixing the funding model and rebuilding the workforce. Minister, you know the issues and the problems: it is your turn to get on with it.

Mr Carroll: I declare an interest: I have a sibling who runs a dental practice in Belfast.

NHS dentistry has been under threat almost since its inception, but it is now close to breaking point. People who live here are twice as likely to have filled teeth as people in England, and children here are three times as likely to have multiple teeth extracted under general anaesthetic. As has been mentioned, children in the most deprived areas, including in my constituency of West Belfast, are the least likely even to be registered with a dentist. As has been said, areas in which dentists no longer accept new patients are already being called "dental deserts". These days, most if not every community could probably be described as a "dental desert". That poses massive questions for everyone's oral health but especially that of those who live in deprived, working-class communities.

The core issue in dentistry is no big mystery: when dentists treat NHS patients, they lose money. That is because the fees paid by the state are not enough to cover the costs of providing that treatment. On top of that, because the health service has been underfunded by Westminster to the tune of hundreds of millions of pounds, dental practices are not financially viable. The British Dental Association recently wrote to the Health Minister to seek urgent clarity on this year's investment proposals for general dental services. Its ask, which is reasonable but urgent, is for appropriate funding to stabilise general dental services in the short term. Most dentists can no longer stay in business unless they use income from their private practice to subsidise the treatment of their NHS patients.

As we have heard, in the past two years, dentists across the North have removed more than 53,000 NHS patients from their practice lists. That extremely worrying trend needs to be stopped. Out of 360 dental practices, only two are fully NHS. Some dentists continue to accept and treat NHS patients out of a sense of moral obligation, despite being financially penalised. Fair play to those people, but the state cannot shirk its responsibility to ensure that healthcare is provided. Patients who are priced out of private care find it painfully difficult, if not impossible, to access the services that they need on the NHS. People who cannot afford a private dental payment plan are forced to go without coverage, and, when they need treatment, they turn to the dental access scheme, but fewer than 10% of practices are signed up to that scheme.

A lack of access to NHS dentistry has led to people extracting their own teeth, overdosing on painkillers and making their own fillings just to manage their pain. That is completely unacceptable. Serious untreated dental issues can lead to infection and even sepsis. Antibiotics and emergency surgery are often needed once a patient eventually receives emergency treatment. The indirect costs of patients not receiving the right care at the right time are astronomical. As Members have said, poor oral health has been linked to cardiovascular disease, diabetes and oral cancer.

Dentistry has been starved of the funding that it needs to treat all patients regardless of their income, postcode or where they come from — where they were born. It is not good enough to shrug our shoulders and say that the money is not there. We need much more radical change to NHS dentistry to guarantee that everyone gets the treatment that they need and deserve, not just another strategy.

Ultimately, there is no free market solution to the crisis. Privatisation and the free market caused this disaster, with people left literally to rot because they cannot pay for private treatment. The only way in which to guarantee dental care for all is to bring NHS dentistry into public ownership and fund it properly, with dental staff being employed directly by the NHS. The Member from the UUP mentioned there not being enough money to afford to do some of that, but I say that we cannot afford not to do it, because people's oral health is at stake.

Ms Sugden: I support the motion and the amendment. Every week, I hear from people who cannot get a dentist, whether they are in pain or are trying just to keep up with routine care. They have been left with nowhere to turn, and the situation is getting worse. Across my constituency and, as we have heard, Northern Ireland, people who had a health service dentist for years are now being told that dentists will no longer accept HSC patients. Some practices have gone fully private, while others have waiting lists with no clear end in sight. The result is that people, particularly older people and those on low incomes, go without basic care.

We need to be honest about what has happened. Health service dentistry may still exist on paper, but, for many people in Northern Ireland, it has been privatised. It is no longer available in practice, and we have ended up with a two-tier system. If people can afford to pay privately, they will be seen. If they cannot, they will wait, suffer or simply go without. Even for those lucky enough to remain registered with a health service dentist, the idea of routine, six-monthly check-ups is long gone. I have spoken to patients who wait well over a year between appointments, by which time small issues have become serious and early intervention is no longer an option. That is not just inconvenient but clinically dangerous.

Oral health problems do not wait, and, for some groups, the risks are even higher. For example, we know that hormonal changes in pregnant women can increase the risk of gum disease and other dental issues. Untreated dental infections can have consequences for mothers and their babies. That is why access to timely dental care during pregnancy is so important. If, however, they are not registered or their practice has gone private, it is almost impossible for them to be seen.

Part of the problem is with the financial model, as we have heard. Dentists are under enormous pressure. They want to treat health service patients, but the fees paid by the Department of Health do not come close to covering the real cost of providing that care. We have to remember that dental practices are small businesses. They have overheads, staff, premises, equipment and tight margins, and, if they cannot make the numbers work, they cannot stay open. They have tried begging the Department of Health, but no help has been forthcoming.

I have also heard from dentists about serious delays in payments from the Business Services Organisation (BSO). For practices that are already struggling with cash flow, that creates real risk. Some practices have told me that, months later, they still wait to be reimbursed for treatment that they have delivered. Such dysfunction not just puts pressure on staff but undermines the entire viability of health service dentistry. We need the Minister to publish the findings of the general dental services cost-of-service review urgently. We have been waiting for it for far too long. Dentists need clarity, the Department needs evidence, and patients need reassurance that health service care will not keep slipping further out of reach.

At the same time, we need to focus on prevention. Early and routine dental care reduces the need for complex interventions, improves overall health and takes the pressure off other services. Poor oral health is, as we have heard, linked to heart disease, diabetes and even dementia. It is not just about teeth and a nice smile but about long-term outcomes and the sustainability of our wider health service.

Crucially, we need a plan to stabilise and grow the workforce. Morale is really low. Dentists are burnt out, and many are thinking of leaving the profession. We will not have a public health dentistry service unless we make it viable and attractive to stay in. The Minister needs to act now, with a real strategy, so that health service dentistry can again work for patients and for the professionals who provide the care.

Access to dental treatment should not depend on a person's income. It should be a basic right, not a luxury, and the Assembly has a duty to ensure that right for the people whom we represent.

Madam Principal Deputy Speaker: Minister, you have 15 minutes in which to respond to the debate.

Mr Nesbitt (The Minister of Health): Thank you, Madam Principal Deputy Speaker. I also thank the proposer of the motion, the proposer of the amendment and every other Member who has contributed to the debate.

I met the British Dental Association in February. I am grateful to it for its briefing on the challenges that it faces. My officials have continued since then to engage with it on options for supporting the service. Last week, I announced a £7·36 million investment in general dental services for 2025-26, as well as £2·5 million to cover the hike in National Insurance contributions imposed by the UK Government. Alongside the money, there was the expansion of the Happy Smiles programme, which addresses health inequalities.

That investment is not a panacea. There continue to be many challenges facing patients, particularly those who are not currently registered with a dental practice. As Members have pointed out, over the past five years, access to health service dentistry has been in decline here. One of the underlying reasons for that is that general dental practitioners spend less time treating health service patients and more time meeting the strong demand for private work. As they are independent contractors, how they allocate their time between their health service work and their private work is at each practitioner's discretion.

Access to health service dentistry remains a major challenge, but I hope that that investment evidences my commitment to supporting the service and improving access for priority groups across Northern Ireland. The investment provides funding for a number of measures. First, there is the continuation of the enhanced child examination scheme, which provides children aged zero to 10 who have not been registered with a dentist with an examination, individualised oral health advice and age-specific fluoride application to their teeth, all to assist with preventing dental decay. From its reintroduction in June 2024 to April of this year, over 37,000 newly registered children have been seen under the scheme. Secondly, there is the continuation of the 30% enhancement in the fees paid to dentists for health service fillings, extractions and root canal treatment in financial year 2025-26, all to support public access to priority treatments. Thirdly, there is the allocation of £1·6 million to incentivise practitioners to maximise time spent providing health service care for their patients. The dental access scheme will also continue to provide access for unregistered patients with an urgent or pressing oral health need. Since it commenced on 1 August last year, the scheme has allowed nearly 18,400 high-need patients to receive treatment. It is funded until 2027.

In addition to the investment being made directly into general dental services, funding is being provided to expand the Happy Smiles scheme, which was originally launched in 2016. The aim of the scheme was to improve the oral health of nursery-school children in the 20% most deprived areas of Northern Ireland. The programme is being expanded to include primary 1, primary 2 and primary 3 schoolchildren in the 20% most deprived wards, reflecting the recommendations in the children's oral health improvement plan's theme 1, 'Improving the Oral and Dental Health of Children'.

It should be noted that the investment is being made in the face of a funding deficit of north of £500 million for my Department. That deficit severely limits my ability to implement the kinds of actions that we all desire to see and hampers my Department's ability to sustain and develop services across all areas of health in Northern Ireland.

While the additional investment interventions are necessary to stabilise general dental services in the short term, I am clear that GDS, as with other services, require sustained effort to ensure sustained ability over the longer term. My Department is committed to advancing work on the long-term future of dental services, with an aim of ensuring that patients can continue to access care when they need it whilst taking measures to ensure that the service is sustainable. In keeping with my Department's long-term plans, I have approved the commissioning of a general dental services cost-of-service review that is to be completed in this financial year. That will provide a robust evidence base to inform how the service will develop. My officials are working at pace to identify the correct individual or team with the necessary skills and expertise to complete the review in the required time frame.

General dental services play a key role in improving the general health of the population while reducing pressure on other areas of the health service. Improving oral health is an important aspect of the future sustainability of dental services and has a key part to play in ensuring the delivery of improved outcomes for patients. While I am aware that the Northern Ireland oral health strategy dates back to 2007, I believe that its evidence base and many of its recommendations are still valid. For example, one oral health strategy target was to improve the proportion of five-year-old children who were decay-free — then 39% — to at least 50% within 10 years.

In 2013, the data indicated that we had achieved 60%, and the 2018-19 data indicated that around 70% of our five-year-olds were decay-free. That was great progress, but I am aware of the fact that more can and should be done.

The development of a new oral health strategy, including a dedicated public dental health expert or expert group, would carry a significant resource cost due to the complex and extended nature of developing a new strategy and a prerequisite oral health needs assessment. That does not mean that oral health is not important to me. The children's and older person's oral health improvement plans were completed last year, and they made ambitious recommendations. However, funding those will be a significant challenge in the current financial climate.

I am also very pleased that oral health has been included in my Live Better initiative. I have often stated that my vision for Health and Social Care is to see more care being delivered in primary and community care settings and a move towards a more preventative healthcare model. That approach is not only better for patients but more sustainable in the longer term.

The challenges to general dental services and other HSC services are not limited to healthcare. The same challenges are evident in education, the economy and infrastructure, both built and otherwise. I have made it clear that, in my time as Minister, I will do everything that is in my power to drive for better outcomes for patients here. The actions that I outlined are evidence of that, as is my commitment to take a wider approach to reducing health inequalities through the Live Better programme. However, it is an unfortunate reality that the budget that has been allocated to me is not sufficient to meet the needs of the current service, let alone to introduce the kind of transformative change that I think that we all wish to see. It is also true that improving health outcomes is not solely within the purview of this Department. Addressing access to services, along with the other issues that were outlined today, will require the full weight of the Northern Ireland Executive.

Madam Principal Deputy Speaker: Thank you, Minister. The next contributor is Diane Dodds, who will make a winding-up speech on the amendment. I advise you, Diane, that you have five minutes.

Mrs Dodds: Thank you. I thank all those Members who contributed to the debate. The fact that there is unanimity on the motion and the amendment is a measure of how much we hear from our constituents about issues with dental health and access to NHS dental care. That is very important, and it is a very significant message for the Minister and the Department.

There is absolutely no doubt that our NHS dental services are in an extremely fragile position. That is not just the case for Northern Ireland; all nations across the UK have experienced a drop in access to dental services. However, it is the most significant in Northern Ireland, and it should be addressed. In April 2025, the BBC reported that 53,000 NHS patients were removed from dental lists. However, if we dig into that figure a little bit more, we see that 12,924 patients were removed in 2023 and 40,980 were removed in 2024. The situation is escalating, and it requires urgent attention. Clearly, it is a very fragile situation.

Minister, you talked about the enhanced child examination scheme, and I acknowledge the funding that has been put into it. You indicated that 37,000 children were registered with the scheme last year. That is good, but the number of children who are registered with an NHS dentist has still dropped. In quarter 3 of 2023-24, it was 332,012 children. In quarter 3 of 2024-25, it was 317,000 children. Therefore, even with the scheme, the number of children who have been able to register with an NHS dentist continues to drop. As you said, Minister, it is more likely to affect children who are in deprived areas, who are more likely to have extensive or severe dental decay. I know that health inequalities is one of your priorities, and that needs urgent attention.

It is also clear that, as colleagues on the Opposition Benches outlined, dental examinations are about more than just fillings; dentists check for oral cancers. Again, it is more likely to be prevalent and a more serious issue if we cannot have that examined in areas of highest deprivation. That is extremely important.

I will say a bit about access to dentists in rural areas. It is a significant problem, and I thank my colleague Deborah Erskine for bringing it forward. In the Fermanagh and Omagh District Council area, only 49% are registered with an NHS dentist. That is an extremely low figure. I think that she said that it is 17% less than the average across Northern Ireland. Indeed, the description of that area as being a dental desert is pretty apt. As Colin McGrath said, we really need to think of dentistry not as a luxury but as an absolute necessity.

I thank my colleague Claire Sugden for acknowledging the issue of dental access and women's unique health challenges. Sometimes, I think, we gloss over that particular idea. The Women's Institute did a report on it recently, and it gave evidence that said that women have unique oral health challenges and have poorer oral health in comparison with men over their lifetime. Again, those are the inequalities in access that need to be cleared up.

Minister, we need work on the cost-of-service review, and I note that you said that that will be done in this financial year. Dentists in particular would like to understand how the metrics will be applied to the allocation of the £2·5 million, which we acknowledge that you have allocated for the increase in National Insurance. We acknowledge all the other schemes that you talked about —

Madam Principal Deputy Speaker: The Member's time is up.

Mrs Dodds: — including the Happy Smiles scheme, but they are bits and pieces. We need the overall strategy to improve dental health.

Madam Principal Deputy Speaker: I call Danny Donnelly to make a winding-up speech on the motion. I advise you, Danny, that you have 10 minutes.

Mr Donnelly: Thank you, Madam Principal Deputy Speaker. I thank everybody for their contributions today. It was very striking that the contributions from across the Chamber were very similar, so there seems to be unanimity on the experiences across Northern Ireland. I thank the DUP Members in particular for their amendment, which we will be supporting.

Let us be honest: we are back here again with another day and another crisis. This time, it is dental care, but the pattern is painfully familiar. Services are collapsing, professionals are at breaking point, and the public are left wondering where it will end. Once again, we will hear the familiar lines of, "This is a priority", "You know my record" and "We are engaging". It is the kind of response that we have seen rolled out time and time again, almost as if it is ready and waiting for every crisis to be brought to the Chamber.

If words alone could fill cavities, the people of Northern Ireland would have the healthiest teeth in Europe. The truth is that we have a Minister who can talk the talk, recite the stats, express sympathy and even promise reform, but sympathy does not get you a dental appointment. Strategy announcements do not pay the bills of dental practices that are going under. Good intentions do not bridge the funding gap that leaves NHS dental services financially unviable.

Believe me, I do not underestimate how difficult the Minister's job is, and I am not pretending that reform is simple, but someone has to step up and drive that change. If the answer is, "There is not enough money", that is fine, but what is the plan? Do we keep pouring limited funds into a failing system and call it effort, or do we finally commit to meaningful, lasting reform that actually delivers for people who are depending on it?

This is not abstract policy talk; it is about people across Northern Ireland — we have heard a lot about them today — trying to get on with their lives while dealing with pain that could and should have been treated. It is about missed school, missed work and avoidable complications. It is not just a dental issue any more; it is a system-wide failure that is hitting people where it hurts and reminding them that help is not guaranteed when they need it.

The numbers are shocking. There are 192,780 fewer patients registered with a dentist as of January 2025. In 2024 alone, almost 41,000 NHS patients were removed from dental lists. Since the peak of quarter 1 in 2023-24, we have lost more than 177,000 people from the NHS dental rolls, which is a 13% drop in 18 months. For adult males, registrations were down by nearly 94,000. For women, it was nearly 99,000. Those are not just numbers; they are people and families. That causes pain and puts pressure on the health system, which is now absorbing that in other ways.

It would be an omission if I did not highlight the fact that that decline in access to service has been going on for years, including those years when this place was prevented from working by one political party or another, thus preventing a Minister from being able to address the problem. There will be years of negative effects as a result of this growing lack of access.

Dentists have been explaining to us for years why this is happening. The fees that they are paid no longer cover the costs of care, and they are subsidising the NHS out of their own pockets. More and more are having to transfer to private practice to make ends meet, and that is affecting patients. In fact, GDC data shows that Northern Ireland has seen the largest shift away from NHS dentistry of all the Celtic nations in the UK, and, of the 364 dental practices here, only 29, which is less than 10%, have signed up to the dental access scheme. That speaks volumes about confidence in that system.

Here is the worst part: we know that prevention works. Every pound invested in dental care saves the system multiple pounds down the line in reduced pressure on the NHS, A&E departments and GPs and leads to fewer emergency admissions, fewer antibiotic prescriptions and fewer complications. This is not a moral obligation; it makes economic sense.

What do we need? We need a new oral health strategy that is modern, resourced and honest. We need a cost-of-service review that is published and acted upon. We also need the Minister to show that he can do more than just say the right things but can do them, because, right now — you will have to excuse me if I am not convinced by the words — I do not think that the people of Northern Ireland are convinced. They are tired — tired of excuses, tired of crises without resolution and tired of those in power who say, "We feel your pain" while causing more.

I will now go through some of the comments that Members made during the debate. My colleague Paula Bradshaw highlighted the fact that this is another example of the two-tier health system in Northern Ireland and that the inability to access health service dentistry is a glaring issue of inequality. Again, that is something that the Minister highlighted as a priority of his.

Alan Robinson, in proposing the amendment, said that there were additions to the call to address regional inequalities, and we will support that, Alan. Alan very eloquently highlighted the difficulties that people have in accessing NHS dental care and said that a number of dentists have handed back their contracts.

Philip McGuigan, Chair of the Health Committee, highlighted the fact that dental care is not a luxury but a necessity. He said that having the right to free dental care has no meaning when you cannot access it, and I thought that that was a very pertinent statement. Private healthcare is becoming more and more common across Northern Ireland, and nowhere is that more stark than in dentistry.

Alan Chambers pointed out that he is very well aware that it has become more difficult for people to access NHS dentistry over the past few years.

Colin McGrath said that dentists are losing money every time they deliver treatment, and he highlighted his own experience with tooth decay. I hope that that is resolved, Colin.

Órlaithí Flynn said that this has come up time and again and that the BDA has been warning of this collapse for years. She gave an example of a constituent who had to take a private dental plan to remain a patient.

Deborah Erskine highlighted the impact on constituents in rural areas and made a very strong point about people in those areas having to travel long distances to access treatment. She also highlighted the links to heart disease, diabetes and complications in pregnancy, which are very serious issues.

Timothy Gaston gave an example of a mother having to register her child miles away. He also called for a fixed funding model and for a rebuild of the workforce. As usual, he mentioned immigrants, who have very little bearing on this debate.

Gerry Carroll noted the spread of dental deserts and cited stats on the effects of inability to access timely dental care, including people carrying out their own dental work. That is a shocking thing for any of us to hear. He also called for NHS dentistry to be brought into public ownership.

Claire Sugden said that waiting for care is not just inconvenient but clinically dangerous and, again, highlighted the impacts on pregnant women of not having access to dental care. She also said that long delays in payment from BSO are impacting on dentists' cash flow, and, again, we have heard that previously. She stated that she has spoken to dentists, many of whom have low morale and are burned out. We are certainly hearing that as well.

Mike Nesbitt, in his response to the debate, mentioned that he met the BDA in February, which is welcome: it is good to hear that there are ongoing negotiations on the matter. He mentioned the recent investment announced in the budget but stated that investment is not a panacea. Investment is not a panacea, Minister, but it is required to sustain the services. The Minister suggested that dentists are deciding to treat more private patients than health service patients. That conflicts with what we are hearing, which is that dentists have no choice but to do that in order to keep their practices financially sustainable. The Minister announced, I think, that the GDS cost-of-service review will be completed within this financial year, which means by April next year, and that that will provide an evidence base for the funding of the service. I hope that it will be done as soon as possible. The Minister also said that moving towards a more preventable form of healthcare is his plan, but that is not where most people see the service as being at the moment.

Diane Dodds, in her winding-up speech on the amendment, noted the escalating number of people, particularly children in areas of deprivation, who are being removed from dental lists, which is very worrying. I think that we can all agree that it is shocking that only 49% of people in the Fermanagh and Omagh District Council area are registered with a dentist.

We were elected to lead. We need to start doing that for our constituents, for our health service and for the principle that, in our society, access to care, including timely dental care, should never be a privilege. I thank MLAs for their contributions today, and I hope that the Minister will take them on board.

Madam Principal Deputy Speaker: Members, please take your ease while we change the personnel at the top Table.

Mr Kearney: I beg to move

Mr Deputy Speaker (Mr Blair): The Business Committee has agreed to allow up to one hour and 30 minutes for the debate. The proposer of the motion will have 10 minutes to propose and 10 minutes to make a winding-up speech. An amendment has been selected and is published on the Marshalled List, so the Business Committee has agreed that 15 minutes will be added to the total time for the debate.

Mr Kearney: It almost beggars belief that a party in our power-sharing coalition should have to be urged to reconsider its opposition to accepting additional funding that would support the promotion of cooperation on food safety, environmental management, trade and business development, peace and reconciliation, tourism and the promotion of language and culture. The DUP's opposition is even more absurd when we know that acceptance of such funding for that vital work from the Irish Government would actually come without the requirement for reciprocal funding from the Executive, but that is the ridiculous situation that the motion before the Assembly this afternoon has to address. The DUP's obstruction on this matter is totally inexplicable. In the present context of unprecedented pressures on public finances, it defies belief that any party would block additional financial investment into North/South bodies that provide employment and services in this region.

The fact is that Tory, and now continued Labour, austerity and chronic underfunding of the North by the British Treasury has cut the lining out of our public services. Alongside an ongoing cost-of-living crisis, the repercussions are impacting across society, especially for the most vulnerable and disadvantaged in our community.

The facts should not have to be rehearsed, but our health service is in systemic crisis, with the worst waiting lists on record, and working families cannot pay their bills. There is no surprise that this or any British Government will find billions of pounds to invest in their own military and industrial complex or to fund weapons of mass destruction used to arm the Israeli murder machine in Gaza and the West Bank while systematically undermining public services and then causing increased hardship for workers and families here in the North, because English politicians do not care about any of the people who live here. Those are the circumstances within which the DUP chooses to block potential additional funding from the Irish Government for our North/South bodies.

The ongoing research from S2@25, a project supported by PEACE PLUS, records that North/South implementation bodies have made a significant contribution to daily life across the island during the past 25 years, delivering better outcomes for the economy, health, environment and culture. InterTradeIreland has played a vital role in identifying opportunities for collaboration, innovation and investment throughout the island. Cross-border trade, now in the region of a record €15 billion, is evidence of its work. It has promoted economic growth, which promotes and improves the everyday lives of workers and families all over the island, particularly in our cross-border communities. Tourism Ireland is central to promoting the island all around the world, attracting up to €6·4 billion into the Irish economy with eight million visitors, up to 25% of whom travel north. All the North/South bodies, including Waterways Ireland, the Food Safety Promotion Board, InterTradeIreland, Tourism Ireland, the Special EU Programmes Body, Foras na Gaeilge and Tha Boord o Ulster-Scotch have had a positive impact in improving lives. Increased funding for those bodies can only bring more innovation and investment, better food standards and environmental initiatives, improved promotion of our indigenous languages and increased tourism, so I pose the question: what is going on? Is this a case of DUP economic illiteracy, or is this intended to be an act of financial self-harm upon an already cash-strapped Executive within which the DUP has three full Ministries? Have our DUP colleagues decided to simply cut off their noses to spite their faces, in that, of course, DUP supporters will be adversely affected by the consequences flowing from that party's decision? Or is this, perhaps, some type of bizarre plan cooked up by the DUP leadership outside this place in order to undermine the North/South implementation bodies and, by extension, strand two of the Good Friday Agreement?

Perhaps it is none of those things at all. Maybe we will find out today what is really going on. I hope that we will be enlightened. This much, however, is sure: the DUP's blocking of additional North/South funding in the Executive is wrong-headed, foolish and absolutely indefensible. The DUP really should wise up.

Ms McLaughlin: I beg to move the following amendment:

Mr Deputy Speaker (Mr Blair): Thank you. You will have 10 minutes to propose and five minutes to make a winding-up speech on the amendment. All other contributors will have five minutes. Please open the debate on the amendment.

Ms McLaughlin: Thank you, Mr Deputy Speaker. I support the motion's premise but not without serious reservations about those who tabled it. Let us be honest: if you read the motion in isolation, you might reasonably conclude that Sinn Féin is a party of opposition, not the largest party in the Executive and the one that holds the most powerful Ministries in the devolved institutions. The text of the motion is so detached, vague, hollow and bereft of real proposals that it reads like a grievance from a powerless Back-Bencher, not a motion from the leadership of a dysfunctional Government.

That kind of behaviour has become all too familiar in the Chamber. We have seen it before with the DUP walking out of Executive meetings only to reappear with a motion condemning the very crisis for which it was collectively responsible. It is deeply frustrating and, frankly, shameful that Sinn Féin now follows the same pattern: tabling a motion that is full of noise but devoid of responsibility, as though it has no say in the decisions that are being made at the Executive table.

The truth is that you cannot abdicate your duty to government only to pop in here with a gesture motion, pretending that you are on the sidelines. I welcome the motion's focus on all-island funding, which my party and I have long advocated for. As a representative of the north-west, I have seen first-hand the real benefits of that kind of cooperation. The expansion of the Magee campus in Derry — long delayed, still unfinished but moving forward — would not have happened without financial support and political will from the Irish Government. The A5 road upgrade, a life-saving project that has languished for years, would not have made it this far without funding and encouragement from Dublin, albeit it is still to progress while lives are still being lost.

Those investments are not just symbolic but transformational. They will deliver economic and social benefits for all generations and, in the case of the A5, will save lives. That is the power of cross-border cooperation that is real, meaningful and grounded in need. The Taoiseach recently made it clear that North/South partnerships are essential for our shared economic future. Referencing the Economic and Social Research Institute's (ESRI) 'Sharing the Island' report, he highlighted the need for us to work together to attract foreign direct investment. He pointed out the enormous potential of the border counties to become hubs for very significant economic growth, but only if we act together. That is an opportunity that the Executive should be moving heaven and earth to secure, yet what has this place's purpose been? It has been division, delay, dysfunction and, in this motion, a wee bit of deflection.

The Irish Government have offered increased funding to the six North/South bodies at no cost to the Executive. Instead of grabbing that offer with both hands, however, the deputy First Minister has said that, unless the contributions are strictly balanced, the deal cannot proceed. What kind of short-sighted, bean-counting mindset is that?

Surely what matters most is the outcome: better services, better infrastructure and better jobs for our people.

While austerity has undoubtedly wreaked havoc across our economy and society, we cannot continue to fall into the trap of blaming every problem on Westminster while taking absolutely no responsibility for our own failures. Yes, austerity is a political choice, but so is passivity and so is indecision. We have devolution, so we have the tools to lead, but we lack ambition, urgency and courage.

Sinn Féin currently holds three of the most important Ministries in the Executive: Finance, Economy and Infrastructure. If it truly believes that this region has been short-changed, why is it not demanding the devolution of tax and spending powers with the full force of government? Where is the campaign led by the Minister of Finance to secure fiscal powers so that we can properly invest in our public services? Why has that not been prioritised?

I am tired of hearing that things are someone else's fault. We are more than a year into this Executive, yet the problems feel exactly the same; in fact, in many cases, they are getting worse, because the governing mindset has not changed. Let us take a sober look at the facts: our public services are on their knees; our National Health Service is under unbearable strain; our education system is stretched to breaking point; and our community and voluntary sector hangs by a thread. All of that is happening while the Executive's well-being dashboard shows that only 14 out of 51 key indicators are moving in the right direction. That is a damning indictment of the Executive's failure to govern with purpose.

Behind those statistics are real people: people who are watching their income stagnate while prices soar; people whose winter fuel payments have been slashed; and people with disabilities who have been told they must accept less support because that is the price of political choices in London. What about here? What choices are we making? We cannot pretend that additional funding from Dublin — welcome though it may be — will paper over the deep cracks in how this place is run. We need serious, systematic reform that ends the cycle of political walkouts and suspended devolution. In 2017, it was Sinn Féin; in 2022, it was the DUP. Every time that a party throws in the towel, our health system suffers, our schools suffer, our economy suffers and our people suffer.

When we have devolved government, we are trapped in a model of siloed Departments that rarely collaborate, even in a crisis. Just last week, former First Minister Arlene Foster told the COVID inquiry that she did not believe that test, trace and isolate was a cross-cutting issue: that speaks volumes. It is not a one-off but the mindset that infects decision-making in this place and across the Executive. Childcare is siloed, climate change is fragmented and regional balance is probably ignored. We must build a system that promotes shared outcomes, not turf wars.

The offer of additional North/South funding is a threat to no one. It is an opportunity. It is an invitation to build partnerships based on need, not on tribal balance sheets. It is time to stop viewing cooperation through the lens of us versus them, because it is not about green or orange but about delivering public services, tackling poverty and building an economy that gives hope to young people in Derry as much as it does to young people in Dublin or Drogheda. Let us stop wasting time on vacuous motions and get serious about reform. Let the Executive act as though they want to govern, and not as a collection of parties trying to out-grieve one another.

Ms Forsythe: At the outset, I acknowledge the good work of the North/South bodies in a number of fields. In my South Down constituency, I have seen at first hand the delivery of important projects and schemes by the SEUPB and InterTradeIreland. Sunday past was Ulster-Scots Day, so it would be remiss of me not to mention the Ulster-Scots Agency as we mark three years since the Ulster-Scots community was officially recognised as a national minority of the United Kingdom.

The parties opposite are being disingenuous when they try to frame the debate as being one of unionists blocking Irish language funding. They gloss over the fact that the Minister for Communities recently enabled the provision of additional funding of £547,000 to Foras na Gaeilge from the Irish Government and allocated a further £103,500 to the Ulster-Scots Agency as part of a one-off adjustment to the current funding provisions. There are no plans to reduce funding in 2025.

North/South cooperation under the auspices of the North/South Ministerial Council and its six implementation bodies is predicated on cross-community consent and the safeguards put in place by the Belfast Agreement to ensure that proper lines of accountability exist to the strand-one institution, namely the Assembly. The ratio of funding for each of the bodies was conceived on the basis of the assessed benefit of their activities to each jurisdiction. Opening the door for autonomous funding allocations by Departments North or South would represent a departure from that assumption and could, in theory, see either Government bringing undue influence to bear on activities outside their jurisdiction. Again, that engages concerns among unionists on what that would mean for Northern Ireland's constitutional position.

I move to the SDLP amendment. Notwithstanding our overriding objection to the motion, it is baffling that the SDLP amendment removes the line that criticises the cuts to winter fuel payments and the welfare changes: I wonder why that is. The Opposition's calls for more fiscal devolution and a cross-border development strategy have been well rehearsed in the Chamber over recent months. Our position is unchanged: there is already provision through InterTradeIreland to promote mutually beneficial economic opportunities for businesses in Northern Ireland and the Republic of Ireland. Why do we need another development strategy? Is that really about the SDLP wanting to hand Dublin more influence in how the devolved Government in Northern Ireland tackle the social and economic challenges that our society faces? Does it not recognise the immense benefits of being part of the United Kingdom, typified by the Londonderry and Strabane region city deal?

We fully support the amendment's call for a new funding model. The Holtham review commissioned by the Department of Finance provides a platform for renewing that debate in discussions with Treasury. However, the fixation on devolving further fiscal powers, with all the complexity that that entails, at a time when the fiscal deficit between Northern Ireland and the rest of the UK has been widening, is something about which we continue to have deep reservations. Moreover, if that discussion is taken forward, its primary objective will be to transform our core public services in Northern Ireland, not to boost the coffers of North/South bodies or quangos. More fiscal devolution, just like the removal of the checks and balances on the funding of North/South bodies, would inevitably add a new dimension of volatility to the Executive's Budget and to relations between Ministers. That is not something that we are willing to countenance.

I repeat: the parties opposite are being disingenuous in their framing of the debate. The Opposition oppose everything yet offer little, whereas the DUP has long led the campaign to secure a fairer funding model for us in Northern Ireland. Let us not forget that our United Kingdom Government provide over £18 billion in block grant funding to Northern Ireland.

Mr Honeyford: It has been depressing to listen to what has been said. We have come to a point at which our public services are under severe strain. We have had 14 years of Tory Government austerity cuts to our finances, and now we have a Labour Government who seem to be continuing that austerity agenda. We have a health service that is at breaking point and a housing crisis that is growing, mainly because people cannot connect to waste water infrastructure, which stops the building of houses. Our inadequate waste water infrastructure and lack of planning reform are major barriers to economic growth. We are at a critical point: we need to act decisively and secure funding to help protect and grow key services.

Alliance welcomes the Irish Government's commitment to increase funding for the six North/South bodies. We are being presented with an opportunity to fund key services like InterTradeIreland to help grow our economy, create jobs and grow exports without the burden being placed on local budgets. Yet we have just heard that a party in the Chamber — the DUP — wants to reject that. I have listened to what has been said, and it simply sounds like a trap of fear, where we are living in the territorial battle of a bygone day in which everything is about land.

For anyone watching, I stress that failing to support the Irish Government's commitment is indefensible. The excuse for not supporting it has no basis in any reality. The benefits of additional funding to North/South bodies — we are talking about supporting Waterways Ireland and the Loughs Agency — would be the protection of our natural resources and the promotion of sustainable tourism. We are talking about language and culture and strengthening programmes for Foras na Gaeilge and the Ulster-Scots Agency to preserve and promote diverse cultural heritage. We are talking about economic growth and creating investment through InterTradeIreland and the Special EU Programmes Body to drive job creation, innovate and grow further our cross-border trade. Everybody and every expert will tell you that cross-border trade is vital to taking our companies into Europe and increasing our export rates. The argument to reject the funding is just indefensible, especially at a time when we have strained public finances.

All the outcomes that I have just mentioned are priorities of the Assembly, yet we have a mindset of fear that I just do not get. It is as though we would rather have nothing than accept a closer relationship with or investment from the South and would rather further prevent sharing this place and creating growth, which just keeps our people down. As I said at the start, it is beyond depressing. It is a frightening mindset to reject support that would not only help to alleviate the pressures on budgets but help to deliver measurable benefits for our constituents. In doing so, the DUP is undermining the Assembly's credibility and its commitment to pragmatic and practical solutions that will deliver better things for ordinary people. That is further proof that the party's cry at election time to "Make Northern Ireland work" is nothing more than an ironic slogan. It is false advertising. It bears no truth in reality.

The Assembly should act now to secure the funding and translate it into real-world improvements for our environment, our economy and our cultural heritage. Alliance will always champion pragmatic, inclusive solutions that prioritise the needs of everybody here. By embracing that, the Assembly can demonstrate leadership and deliver meaningful change for people here. We are committed to building a shared and prosperous society that is sustainable. A fundamental value is working to share the island and working together to deliver better for people. We are not interested in territorial battles. It is depressing to hear the debate being reduced to arguing over land. Alliance is focused on people and on uniting people, working to bring better things for everybody here and for a shared future where we see true reconciliation between all the people who live in this place. That is laid out before us in the motion. We are happy to support it and the amendment.

Mr Deputy Speaker (Mr Blair): As the Business Committee has arranged to meet at 1.00 pm today, I propose, therefore, by leave of the Assembly, to suspend the sitting until 2.00 pm. The debate will continue following the question for urgent oral answer, when the first Member to be called will be Steve Aiken. The sitting is, by leave, suspended.

Ms Bunting: Mr Speaker, before I call my question, from the banners on your door, indications are that congratulations are in order. Happy birthday to you. [Laughter.]

Mrs O'Neill (The First Minister): May I concur? Breithlá sona duit, a Cheann Comhairle,

on your special birthday. Do you want to tell us what age you are today?

Mr Speaker: I think that everybody knows. [Laughter.]

Mrs O'Neill: Our focus is on delivering meaningful and impactful strategies that will result in delivery across the community and sectors in need. In developing and delivering our strategies, our work aligns with best practice, including co-design and co-production.

The focus in the Programme for Government has reform and transformation of public services at the core of its work, with the new delivery unit at the heart of ensuring that the Executive’s priorities get the focus needed to bring about lasting change and improvement. We have in place an office of AI and digital, which will embrace new technologies and help us to improve efficiency and effectiveness. A tangible example of that is in delivering on the ending violence against women and girls strategic framework. Our officials worked collaboratively on that with all Departments and stakeholders to understand the issues, where there are gaps in provision and, most importantly, how we can improve the experiences of women and girls.

We will continue to work closely with the Departments of Justice and Health in aligning our work with that of the domestic and sexual abuse strategy and will work with key partners, such as the PSNI and the councils, to deliver more effectively and efficiently, ensuring that there is no risk of duplication. The collaborative and coordinated approach across Departments and within the Executive, with a priority accorded to innovation and reform in delivery, will continue to ensure that strategies are delivered in a focused and meaningful way.

Ms Bunting: The Executive programme on paramilitarism and organised crime (EPPOC) team did a piece of work that showed that the number of strategies relating to paramilitarism, for example, was 89. That did not cover all the Departments, nor is there a centrally held list of strategies. A recent report to the Justice Committee indicated that elements of one strategy took so long to implement, due to a lack of resources and failure to agree on which Department was the lead, that it was completely superseded by other strategies.

Given the extreme budgetary pressures faced by Northern Ireland, what can be done by the First Minister's Department to make government more cohesive, to reduce duplication and to have Departments pulling in the same direction, thus getting a bigger bang for the taxpayer buck?

Mrs O'Neill: I concur with the Member: we need to ensure that we do everything efficiently, that we align where we can and that we break down the silo mentality that has always existed. There are some really good examples across all the Departments of how to do that, and, obviously, there are lessons to be learned as well.

We have made a good start by having a Programme for Government that will be aligned, hopefully, with a three-year Budget. The priorities that have been identified in the Programme for Government will also allow us to be more strategic and aligned. In addition, we have the introduction of the office of AI and digital. We have an opportunity to do things more efficiently and better there. Perhaps that will be an opportunity for us to look at all the different strategies that we have to make sure that they are fit for purpose. Every Department will have its own strategies for different reasons. You cited an example of where there are perhaps numerous strategies. There is always an obligation in each Department to ensure that they are fit for purpose and that they do what it says on the tin.

I am certainly happy to take away the general point that the Member makes and to see whether there is any opportunity, particularly with digital and transformation, for us to look at the number of strategies that we have across all the Departments.

Ms Ní Chuilín: Go raibh maith agat, a Cheann Comhairle. Guím breithlá sona duit fosta.

In Joanne Bunting's question, First Minister, she mentioned the ongoing strategies, and you responded to that. One of the long-term commitments made by the Executive goes back to 2010 and is about the building of Casement Park. Can you advise whether the funding for that and, indeed, other projects was raised at your meeting with the British Prime Minister, Keir Starmer?

Mrs O'Neill: Thank you for that. We had a wide-ranging discussion with Keir Starmer on Friday. The deputy First Minister and I raised the funding issue, more generally, of the need for properly funded public services. We made a case strongly, as we do on each occasion. I also raised the issue of Casement Park, once again, and the need for that to be delivered on, given the fact that it is a flagship project of the Executive and one of the stadia still to be built. We look forward to the comprehensive spending review, and I hope that, at that occasion, we will see the commitment that has been made by the British Government being delivered on, so that we can get on with finally building Casement Park and ensuring that it brings all the benefits that it will do to the wider community in west Belfast, to GAA and to sport more generally. That is something that we are going to continue to prioritise — I am certainly going to continue to prioritise it in my engagements. I raised the issue with the Irish Government last week.

Ms K Armstrong: I join others, Mr Speaker, in wishing you a very happy birthday.

Given the fact that the strategies are cross-cutting in nature, what role can the Executive Office play to ensure that the appropriate development and resourcing of strategies, such as the anti-poverty strategy or the LGBTQIA strategy, is being carried out across all Departments?

Mrs O'Neill: We have a role through the Executive Office delivery unit. That could be a focus through which we might align a lot of the strategies and ensure that everything is looked at in the round. You only have to look at the ending violence against women and girls strategy or the domestic and sexual abuse strategy to see that all those things are cross-cutting by nature, and a lot of them are a result of collaboration across Departments and Ministers.

Can we continue to do better, improve and be more efficient in these things? Yes, there is always room for improvement, but we have the right building blocks now. We have a Programme for Government, with nine Executive priorities; we have a delivery unit; we are going to look at digital and AI and the role of all of that; and, for the first time in many's a year, we will have a three-year Budget that will allow better planning into the future. Those building blocks are the right building blocks on which to improve on how we deliver things together. We want to weed out duplication, where it occurs, and we want Departments to complement each other in the work that they are doing. There are opportunities for us to do better in the future.

Mrs O'Neill: With your permission, Mr Speaker, junior Minister Reilly will take this question.

Ms Reilly (Junior Minister, The Executive Office): We have set realistic targets and timelines for delivery against all nine priorities in the Programme for Government. We have already seen real progress. From March 2025, over 15,000 children were registered for the childcare subsidy scheme. When that is combined with tax-free childcare, it is estimated that those working families will have saved nearly £17 million over this period. The scheme will be extended to include school-age children, which will benefit families further. Those targets will be monitored frequently by officials in the Department's newly established delivery unit, the scientific unit and the AI unit. We will also collaborate across all the other Departments to make sure that progress is being made against the priorities.

A Programme for Government subcommittee of the Civil Service board has been formed. It will drive forward delivery through a single point that will have a strategic focus, as well as scrutinise, support, monitor and ensure good governance. We also have a well-being dashboard that tracks long-term well-being at a population level. That will be updated continually, as and when new data becomes available.

We will also keep track of delivery, and we will publish an annual delivery report. That will allow us to consider whether projects and programmes are being delivered on time and within budget and what more we need to do, or what we can do differently, for projects to be effective and efficient.

Mr Chambers: Recently, I submitted a question to the Executive Office regarding its assessment of a part of the Programme for Government. The question was rejected, and I was advised to address my query to the particular Minister who had written the part of the programme that I was referencing. Is that the policy of the Minister's office regarding questions about the content of the Programme for Government? Is there a danger that that could lead to a silo mentality?

Ms Reilly: I have not seen the question that the Member submitted. I am happy to take that back and look at it.

Ms Murphy: Does the junior Minister agree that the PFG represents a vital commitment by the Executive to collaborate on enhancing the lives of all those whom we represent?

Ms Reilly: Gabhaim buíochas leis an Chomhalta as a ceist.

I agree with that. The Programme for Government reflects the shared ambitions of the Executive. It has been designed to make things better for people in areas such as health and tackling waiting lists; our environment; growing a globally competitive economy; providing more social, affordable and sustainable housing; building safer communities; ending violence against women and girls; and much more. That will require a sustained whole-of-government commitment if we are to deliver a real and positive difference in the lives of people, families and communities. There will, of course, be tough financial challenges as, simply put, we do not have the level of public finances that is required. Our shared focus is to make a real difference in improving people's lives. That is why our commitment is to maximise on delivery. For my part, I will continue to deliver the positive change that people want to see on the issues that matter most to them and their families.

Ms Bradshaw: I also wish you, Mr Speaker, a very happy birthday.

Junior Minister, you mentioned in your original answer the annual report on delivery. Given that we have less than two years left of the mandate, do you not feel that that is too long a period between the reports being published? Will you also speak to how the targets could be amended if they are not delivering for constituents?

Ms Reilly: Next February, the Programme for Government will have been in place for a year. As I said, we will publish an annual report on it. The Programme for Government needs to be reviewed yearly. That will give us the opportunity to make updates in line with, for example, budget decisions. It will be monitored more regularly than that in order to measure progress against our priorities. The well-being framework will be updated throughout the year, as and when the data becomes available.

Mr Speaker: I call Diane Forsythe. Sorry, I call Matthew O'Toole. There is a slight difference. [Laughter.]

Mr O'Toole: Thank you, Mr Speaker. I did not get a chance to do this earlier, but I add the Opposition's good wishes to you on your birthday. The Opposition, unlike one of the members of the Executive, would not dream of naming the number, but happy birthday to you, in any case.

Mr Speaker: I hope that I get 60 birthday wishes.

Mr O'Toole: It has been said that the PFG is a critical delivery tool for people's priorities. Why does the Budget, on which we voted last week, commit only 2% of the Executive's entire Budget to PFG priorities?

Ms Reilly: I do not think that any of us is under any illusions: the Executive are working within incredibly tight financial constraints. Our communities and public services feel that pressure every day, but that does not mean that we should sit back and do nothing; if anything, it makes the need for joined-up, collective action even more urgent. The Programme for Government gives us a clear plan to deliver real change. We all have a part to play in that: all Departments, all Ministers and, most importantly, the people on the ground who know where the gaps are and how we can best close them.

Mr Gaston: Following the Supreme Court judgement on the definition of a woman, does the Executive Office now have an agreed position, and what impact will that have on the ending violence against women and girls strategy?

Ms Reilly: This issue has to be approached with compassion, understanding and dignity. We await the guidance of the Equality Commission in light of its consideration, which will come out later this month. Regardless of how they define themselves, every person deserves the same love, equality, respect and compassion that we claim to strive for on behalf of everyone. I want an inclusive society that is based on equal rights and opportunity for all our citizens. I want people in the Chamber and beyond to remember that we are talking about people. We are talking about human beings. They are our brothers, sisters, family members and friends. Please remember that. Language is so important.

Mr Carroll: Minister, as you stated, ending violence against women and girls is a priority in the Programme for Government. Will you detail what dedicated funding, beyond the local change fund's being rolled out through councils, exists for families and women who are in an emergency and seeking to get out of that dangerous situation?

Ms Reilly: I am happy to get the details of the groups for you. The groups and organisations on the ground that work with women who are fleeing domestic violence, and work to end violence against women and girls, should be commended. They do stellar work. I am happy to come back to you with a list of those groups and the funding that they receive.

Mr Speaker: Now, the real Diane Forsythe.

Mrs O'Neill: Arm's-length bodies, including non-departmental public bodies, are established to deliver public services, provide expert advice or regulate sectors at arm's length from Ministers. Whilst they operate with a degree of independence from Departments, they are accountable to them. Those that fall under the remit of the Executive Office align with TEO's strategic priorities. Departments have been conducting their own reviews of arm's-length bodies, in line with the New Decade, New Approach commitment, as well as their existing sponsorship and governance requirements. The findings of those departmental reviews will inform the next steps. The introduction of a public bodies Bill to facilitate Departments in making any legislative changes will be dependent on the completion of the departmental reviews of their arm's-length bodies and the decision of the Executive to an agreed approach. The timing of any such legislation will be subject to prioritisation by the Executive.

Ms Forsythe: I also wish you, Mr Speaker, a happy birthday.

I thank the First Minister for her answer. I look forward to hearing the responses from the different Departments following their reviews.

With over 120 arm's-length bodies and quangos across Northern Ireland public services, we see a lot of cost associated with back-office functions such as running boards. We see duplication of finances and requirements for individual accounts and audit services. Does the Minister have any idea of the cost of that to her Department?

Mrs O'Neill: You referenced a number of bodies that are within TEO's remit. There are 12 bodies under TEO, some of which we have reviewed. That includes the Commissioner for Survivors of Institutional Childhood Abuse (COSICA). The Strategic Investment Board (SIB) also recently had a review, which we are working our way through. A number of bodies under our remit, including the Historical Institutional Abuse Redress Board, which was established to ensure that payments were made to victims and survivors, will come to an end soon. The redress board will come to an end once all the payments are fully disclosed. The Victims' Payments Board is open until August 2026, and then it will start to wind down.

A number of bodies, including a number within our remit, will change. We will have to come back to the matter once all Departments have reviewed their arm's-length bodies. Given the unique political context here, it is, at times, vital to maintain independent oversight bodies for the sake of public trust. There are different reasons for having bodies, and there is good work under way to review all of that.

Miss Dolan: Does the First Minister agree that it is essential for public confidence that all Departments' arm's-length bodies and non-departmental public bodies live within their budgets and that, where that is not the case, action is taken?

Mrs O'Neill: Thank you for that question. To state the obvious, yes, I do. However, more than a decade of Tory austerity, which is being followed through by a Labour Government, has caused huge challenges for our public finances. We see the detriment of that every day across our health system, education system and all public bodies. That is why we have been working to get our finances back on a stable footing and why we must protect the public funds that we have and ensure that they are used to best effect.

The reality is that, where that does not happen in our non-departmental public bodies, Ministers will have to take action. I welcome the fact that the Infrastructure Minister, Liz Kimmins, has engaged forensic accountancy services to investigate why NI Water has been unable to live within its resource allocation for this year. It is important that we get to the bottom of such things and that everybody is efficient, given that we are dealing with limited finances. Ultimately, our objective will clearly always be about having maximum accountability and transparency in public expenditure. Importantly, that is what the public expect us to do.

Mr Blair: I add my good wishes to those that have been expressed to you on your birthday, Mr Speaker.

First Minister, given that each Department is a separate legal entity that is free to set up arm's-length bodies and non-departmental bodies as it sees fit, within reason, what role does the Executive Office have in implementing efficiencies in that regard? If it has none, is that not another strong case for reform?

Mrs O'Neill: You are right that each Department has its own remit, legislatively, to set up bodies. In some ways, that is important. However, as an Executive, if we want to look at being efficient and transforming how we do things, we have to look at the issue in the round. That is an Executive discussion for a bit further down the line, when all Departments have conducted their reviews.

All of the bodies have to be relevant. There has to be a strategic relevance in order to have a body in the first place. You have to avoid duplication, maximise efficiency and secure public confidence and independence. I made a point earlier about trust: trust is very important, particularly when it comes to the performance and accountability of some of the bodies. The Member is aware, however, that we have some of the bodies that we do because of the political context here and the fact that we need to engender public trust and oversight for some work. As an Executive, we will definitely revisit the matter.

Mr McGrath: Does the First Minister agree with me, in my role as the chair of the all-party group on youth participation, that, regardless of the number of bodies that we have, there are not enough young people represented on them? When I say "young people", I include those, like the Speaker, up to the age of around 30. They could give their views and bring young people's perspectives to those boards to help them to be more responsive to the needs of young people.

Mr Speaker: Thank you, Mr McGrath.

Mrs O'Neill: One might fear that the Member is trying to curry favour with the Speaker with that comment. In general, yes, it is crucial that more young people come forward into public life to shape the bodies and how we design policy. Again, the best example that I have of that is the role that young people played in the ending violence against women and girls strategy. However, if we are to design policies and strategies that will deliver on the needs of the public, that process needs to be inclusive, so, on the general point, yes, absolutely, having more young people, more people from an ethnic minority background and more people who reflect the society that we live in will always lead to better policy and decision-making.

Mrs O'Neill: There is no agreed position on the issue.

Mr Kearney: Gabhaim buíochas leis an Chéad-Aire as an fhreagra sin.

First Minister, I note from your response that there is no agreement in your office on the issue. However, it is the democratically expressed will of the Assembly that voting rights be extended to citizens across the island to elect the Irish head of state. Do you therefore agree that the extension of voting rights in Irish presidential elections to Irish citizens living in the North should be taken forward by the Irish Government as a matter of priority?

Mrs O'Neill: Yes, I absolutely agree with that, and I thank the Member for bringing the issue to the Chamber for debate a short while ago. The outcome of that debate — the vote in the Chamber — was decisive in showing the support of elected Members in the Chamber for the right to vote in the presidential election later this year. That is, obviously, my personal view, but I took the time after the debate to write to the Taoiseach to inform him that it had been endorsed in the Chamber.

It is time for the Irish Government to correct what has been a deficit in our democratic right to vote in that election. We continue to encourage the Taoiseach to rectify an anomaly for Irish citizens in the North: you can stand for election, but you cannot vote. The argument for that is not tenable or credible. We are 12 years beyond the constitutional convention and its participants' overwhelming endorsement of the extension of the franchise. It is my view and, now, that of the majority in the House that the extension of voting rights to citizens who live in the North needs to be endorsed.

Mr Brett: The First Minister may have seen the polling published today in the 'Belfast Telegraph' that asked nationalist voters about their priorities for the work of the Assembly and the Executive. Not a single person mentioned presidential election voting rights. Does the First Minister agree that the Irish Government, in rejecting the proposal, are more in tune with the electorate of Northern Ireland than she is?

Mrs O'Neill: The Member ignores the reality, I am afraid: we had that very debate in the Chamber, and a majority of elected Members voted to call on the Irish Government to ensure that citizens who live in the North have voting rights in the election of the president of Ireland.

Mrs Guy: I join others in wishing you a happy birthday, Mr Speaker. I am sure that there is nowhere that you would rather be.

The implementation of voting rights in Irish presidential elections is a matter for the Government of Ireland, not the Assembly, but, on a point of fact, can the First Minister confirm that the motion passed by the convention was for voting rights for all Irish citizens, with no specific requirement for them to be resident on the island of Ireland and that that would bring those elections into line with common practice in the EU and elsewhere?

Mrs O'Neill: The Member is right that that was the conclusion of the convention. I referenced what we voted on in the Chamber, but you are absolutely right: it is about all Irish citizens being able to vote for their uachtarán.

Mr Speaker: I call Justin McNulty.

Mr McNulty: Breithlá sona duit.

Mrs O'Neill: We have consistently raised the issue during our engagement with all levels of the British and Irish Governments, and, this afternoon, we will meet the Minister for Communities for further discussions, following his recent engagement with the Secretary of State and the GAA.

Mr McNulty: First Minister, Casement Park, which would, you said, be built on your watch, has been in limbo for well over a decade. While there seemed to be an improvement in the mood music over the weekend, with your colleague the Communities Minister's attendance in the box at the Athletic Grounds for Armagh's all-Ireland group stage victory over Derry, progress has been scarce.

When you raised the subject of Casement Park with the British Prime Minister, what capacity and standard of stadium did you push for? Will the new Casement Park be capable of hosting international sporting events as well as being a home stadium for Antrim Gaels? When will it be built?

Mrs O'Neill: We have to put every bit of energy and effort that we have into ensuring that Casement Park will be built. It is an Executive flagship project. I am determined to see it over the line and to work with all partners to ensure that that happens. I hope that the Minister for Communities got a sense of how important it is to Gaels across the island to play games in their own stadiums. I am sure that he got a flavour of that at the weekend. I am absolutely determined to ensure that we get movement on Casement Park. That means working with the Minister, the British Government, the Irish Government, the GAA and all partners who are committed to ensuring that the project gets over the line.

Mr Sheehan: Does the First Minister agree that it is long past time for the British Government to state what their funding contribution will be to the redevelopment of Casement Park?

Mrs O'Neill: Yes. I constantly call on the British Government to let us know exactly what they will do to fulfil their political commitment to building Casement Park. It will take all partners working together to ensure that the project gets across the line. We missed a huge opportunity by not being able to play our part in the Euros, with the economic benefit that it would have brought to us all. As the Member knows, the development of Casement Park is a flagship priority for the Executive, and we are committed to it. It is a long-overdue home for Ulster Gaels, and it is now time to get the stadium built. I am determined to continue to work with everybody to ensure that the funding contribution is put on the table so that we can get on with the project. Let us get Casement Park built.

Mr Buckley: First Minister, with tens of millions of pounds of projected overspend on the original cost of the redevelopment of Casement Park and with public infrastructure and public services under serious financial strain, which public services would you cut to ensure Casement Park's redevelopment on the scale that the GAA suggests? Hospitals, schools or education?

Mrs O'Neill: You see, it is not a binary choice. We can have good public services, and we can invest in our sporting infrastructure. The redevelopment of Casement Park is long overdue. It is the remaining stadium to be built. It is a commitment across the Executive and in the Programme for Government, and it will be built.

Mrs O'Neill: With your permission, Mr Speaker, junior Minister Reilly will answer the question.

Ms Reilly: While we have equality legislation that protects citizens from less favourable treatment, we recognise that there are differences from that of other jurisdictions, and we are committed to addressing any gaps. We will bring race relations legislation before the Assembly in 2025-26 to strengthen protections against racism. We are also considering bringing in protections against age-related discrimination in relation to goods, facilities and services, and junior Minister Cameron and I recently met Claire Sugden to discuss her private Member's Bill. I thank Claire for taking the time to meet us and for continually championing and advocating for our older people. We also welcome the Executive Office Committee's work on its inquiry into the differences between our equality legislation and that in other jurisdictions, and we will consider the findings of the report when it is available.

Ms McLaughlin: Mr Speaker, I add my congratulations and formally welcome you to the club.

We are falling far behind Britain and the South on equality protections: that is unacceptable in 2025. Will you introduce any legislation in this mandate that will close the gaps?

Ms Reilly: I thank the Member for her question. As I said, we will bring race relations legislation to the Assembly in 2025-26. On a broader point, equality is not just ticking a box but a core principle of how we need to shape policy and build communities. We are absolutely committed to addressing any gaps, and I welcome the Executive Office Committee's work on that. No one should feel that their identity, background or culture is any less entitled to dignity or opportunity than anyone else's. We have to be proactive in addressing inequalities.

Again, we need to work together across Departments, with each other in the Chamber and with communities. We need to make sure that nobody is left behind when we progress any equality legislation.

Mr Speaker: We now move to topical questions.

Mrs O'Neill: I have not seen Eoin's comment, but suffice to say that all Governments need to do better when it comes to housing and infrastructure investment. Unfortunately, as you know, there are two jurisdictions across this island: a devolved Assembly with limited powers that has been starved of resources for 14-plus years and a Government in Dublin who are failing on the housing agenda. We have targets in the Programme for Government, and we are determined to try to deliver on those.

Mr O'Toole: The reason that I ask, First Minister, is that your party is making robust criticisms, many of which, perhaps, are legitimate, about performance in the South, but when it comes to social housing in the North, the Chartered Institute of Housing has warned today that there could be a £100 million shortfall in social housing investment. There is no plan for investing in waste water. In fact, there is denial from your colleagues that there is even a problem. There are chaotic, contradictory statements on the delivery of North/South infrastructure. You mentioned the lack of fiscal powers here, but your colleague the Finance Minister does not seem to want to take any new fiscal powers. Why is there a contradiction and a difference between the robust way that your party holds the Government to account in the South and the idea that you simply want people in the North to accept inaction and drift?

Mrs O'Neill: I will work in reverse. I do not accept your final comment at all. It is not about inaction; it is about trying to deliver on our Programme for Government commitments within the limitations of a devolved space. I am surprised that you do not understand the difference between the two jurisdictions that, unfortunately, exist on this island. Until we work towards the point at which we can unite people across the island for the betterment of the public services — better health, education and infrastructure — we are stuck with the deal that we have. We have to continue to fight against the austerity agenda with which the Labour Government are continuing in the aftermath of 14 years of it. The fact that our public services are on their knees here is an outworking of the jurisdiction in which we live. It is important that we continue to fight for good public services.

In case you are in any doubt, we continue to make the case for additional fiscal powers, and we have done so for quite a long time. As a matter of fact, my colleagues stood up the Fiscal Commission and brought forward arguments as to why we need more fiscal powers and levers and why we need to invest in our infrastructure after all the years of austerity. We are absolutely committed to doing that and to building more social and affordable homes, but we need a proper funding model. Instead of just talking about it in the Chamber, I put that case directly to Keir Starmer last week when I engaged with him on the funding model for this place: it is not fit for purpose. In the comprehensive spending review, we want to see a fair funding model and a three-year Budget that allows us to plan for the future. We have to recognise that we have been underfunded, but we are making that case. As a matter of fact, you and your party colleagues joined the rest of the Executive parties on day 1 to make that very case.

Mrs O'Neill: As you know, we have made commitments in our Programme for Government in that area. We support the PSNI when it comes to its need for additional numbers. It is also very important that we have an appropriately funded justice system. We also know the significance of neighbourhood policing and how important it is to ensure that those officers are close to the ground and engaged with the local community in which they serve. That is the best way to build community trust and confidence. We will continue to meet the Chief Constable, and we will meet Executive colleagues about prioritising Budget decisions in the aftermath of the CSR.

Mr Middleton: I thank the First Minister for her response. First Minister, through your office, have the Executive undertaken any assessment of the impact of reduced policing numbers on good relations in Northern Ireland, particularly in light of sectarianism and hate crime attacks, in order to see what we can do as an Executive to address those scourges in our society?

Mrs O'Neill: I am not aware of any particular pieces of work on that, but good relations work through Together: Building a United Community (T:BUC) funding is usually done in conjunction with partners, including the PSNI.

When it comes to good relations and looking at where things are, not least with some things that we have seen over the past couple of days with the sectarian intimidation of families, everything needs to be done to ensure that such events do not happen. We continue to make that case to our Department to see what we can do to build good relations and we continue to challenge the PSNI on what it is doing to tackle sectarianism.

Mrs O'Neill: We are going to host the Open, and what a great opportunity that will be for us. In fact, later today, we are hosting an event with the Claret Jug here in Parliament Buildings, and all MLAs are invited.

We are starting to tap into the huge economic potential that that event will have for us through tourism and the sporting event. So many opportunities will come from it. We are a lovely place to visit, and people will see that when they tune into the Open. We are told that a huge number of people will tune in and that 150 countries will broadcast the Open. The economic benefit is £213 million, so that is huge.

The Open is just one of many events that we host here and that we do very well. I look forward to being able to build on that and to have the ambition to reach for even more of those big international competitions.

Mr Harvey: Thank you, First Minister. That leads me on to my next question. Opportunities that are brought by events such as the Open, the Giro d'Italia and others undoubtedly put us on the map. Are the Executive actively seeking to attract other sporting events?

Mrs O'Neill: All Executive colleagues, including our Communities and sports Minister and our Economy Minister, will be interested in it. We demonstrated when we had the Giro that we can host big international events, and that is something that is to be built upon. I would have to look a bit more into what we are chasing right now, but the Open is certainly where we are focused for the next period.

We have to reach for all the opportunities that we have. We missed an opportunity with the Euros because we were not part of that bid. That was a missed opportunity for great investment here. However, let us continue to celebrate what we have that is great, whether it be the GAA Ulster final, rugby, soccer or the North West 200 motorbike racing event, which I went to recently for the first time, or the Open. Our tourism potential here is immense, and we should maximise it right across the island.

Mrs O'Neill: I want this to be a great place for everybody to live where they can be comfortable and achieve their best. Whatever I can do to help communities, whether it be the Polish community or any other community, please feel free to knock on my door and let me know what we can do or where we are perhaps not doing enough. I am more than happy to engage with the Member on that.

Mr Blair: I thank the First Minister for that answer. A racial equality strategy, including ethnic equality monitoring, an update to the Race Relations Order 1997 and an international relations strategy and Europe strategy are key to delivering for that community and all others, so can she give us any indication of what progress has been made on those strategies?

Mrs O'Neill: We are working our way through them. As the junior Minister said, we will introduce the legislation on the Race Relations Order very soon in this political session. We will also move to publish the refugee integration strategy, hopefully, in the next number of days. We are working our way through the international relations strategy. It has to be refreshed, given everything that is happening globally. It is a very fluid situation.

I am determined to get those things published to allow us to do everything that we can to build this society to be an inclusive and welcoming society where everybody feels comfortable and has their space. It will take a combination of those strategies to make that happen.

Mr Speaker: I remind the First Minister about the sub judice and contempt of court issues that may be involved in this issue. Please respond.

Mrs O'Neill: OK. Thank you. Mindful of that, I first send solidarity to both parties that the Member referred to. Highlighting genocide and the inhumane slaughter of defenceless citizens is not a crime. That is certainly my view, and I send solidarity to all those protesting and calling for an end to the genocide in Palestine.

Mr Carroll: I agree, and I thank the First Minister for her answer. Maybe the problem was that the individuals did not have a letter from Jonathan Powell.

First Minister, you said that you met Keir Starmer last week. Did you raise the specific case of Liam Óg with him, and, if not, will you commit to raising that issue and issues regarding other Palestine solidarity activists and how they have been clamped down on, tackled and seemingly silenced over the past week or so?

Mrs O'Neill: Again, I am mindful of any sort of legal proceedings or whatever, but I have made my point about solidarity with the individuals — Liam Óg, Sue and Martine — because I think that anybody who goes out to raise their voice — rightly so, in my opinion — and call for an end to the genocide in Palestine is doing a good thing, because the international community is far too silent, has failed to act and has failed to end the genocide in Palestine.

I can tell you that I raised that issue with Keir Starmer on Friday. I made it very clear that they needed to end their arms sales to Israel, and I made it very clear that they needed to step up sanctions against Israel in a real and detailed way, because to not do so is to be complicit in what Israel is doing.

Mr Martin: Mr Speaker, I wish you a very happy 40th birthday.

Mrs O'Neill: I cannot recall, off the top of my head, any engagement. I assume that we will have met the ambassador when they came, certainly at a First Minister/deputy First Minister level or at a junior Minister level, as we do with all the ambassadors who represent the population here. I will confirm that in writing.

Mr Martin: Thank you, First Minister, for your answer. Given the First Minister's answer, will she commit to organising a meeting as soon as is practicably possible with Polish community leaders in Northern Ireland to acknowledge their contribution to Northern Ireland and to explore potential areas for future collaboration?

Mrs O'Neill: Yes, I am more than happy to do so. The junior Minister informs me that, yes, they have actually met. I am more than happy to engage with all representatives of our community here. If we are to make this the most warm, welcoming and inclusive place, we need to engage with their representatives, particularly consuls general or ambassadors.

Mrs O'Neill: I await the Equality Commission's advice. That has been my position in the House, and that remains my position.

Mr T Buchanan: As I expected, no answer is forthcoming. However, I will ask another question that has been asked on two occasions prior to this, with no answer given. Maybe we will get it today. Does the First Minister now agree that biological men should not be permitted to play women's sports, enter ladies' toilets or be placed in female prisons? A simple answer: yes or no?

Mrs O'Neill: It is not the case that I did not answer; it is the fact that you do not like the answer. Let me repeat it for you: I will await the Equality Commission's advice and guidance. It would be better if everybody in the House were sensitive to this issue as we try to work our way through it on the basis of the Equality Commission advice and ensure that there is consistency across all the Departments.

Mrs O'Neill: I do not know the ins and outs of the case, but, obviously, people should be factual when they are making a claim; that is important. It is also very important that the Police Service is as inclusive as the society that it represents. Trust and confidence in policing are also crucial. All those components need to be right for people to have faith in the Police Service. I have already been to a recruitment event for the PSNI, and I call on people to join the PSNI.

Madam Principal Deputy Speaker: That ends Question Time to the First Ministers. Members, please take your ease for a moment.

Madam Principal Deputy Speaker: Mrs Diane Dodds has given notice of a question for urgent oral answer to the Minister of Health. I remind Members that, if they wish to ask a supplementary question, they should rise continually in their place. The Member who tabled the question will be called automatically to ask a supplementary question.

Mr Nesbitt (The Minister of Health): In December 2024, the strategic planning and performance group (SPPG) and the Public Health Agency (PHA) commissioned an independent, external expert team to carry out a review of the cardiac surgery service in the Belfast Trust. The review concluded in April of this year. The review team was specifically focusing on two principal tasks — safety and team working. The findings in the expert team's final report were presented to the Belfast Trust board at an extraordinary board meeting on Thursday 15 May.

As Minister, I want to say this: it was appalling to read of the staff experiences in the cardiac surgery unit in the Royal Victoria Hospital. I want to thank every staff member who engaged in the important review process. I also want to thank the external review team for its work. The findings on the culture of the unit and the behaviours of some individuals within it are entirely unacceptable. I expect to see meaningful and lasting improvements in the unit, not least in building a culture of respect for all colleagues at all levels. In clinical safety terms, key data provide important assurances for patients. For the avoidance of doubt, I declare an interest as a cardiac patient.

The review highlights that the cultural issues in the unit represent a risk to patient safety, which is of concern. I acknowledge that public confidence in our regional cardiac surgery service cannot be allowed to deteriorate, especially for our patients and their families when they are at their most vulnerable.

The expert team has made a number of recommendations based on the findings, specifically around governance arrangements, communication processes and the review of current processes and support and encouragement for those who are raising concerns. Improved team working across the unit must be an absolute priority.

The Belfast Trust has accepted the recommendations of the review and is now working swiftly to take those forward. I will meet the chair of the trust shortly to seek his assurance that actions are progressing at pace to address all the findings. An action plan is being prepared urgently. In the meantime, my Department will work with the trust to secure the necessary assurances regarding the management of the ongoing issues to ensure and secure provision of service both immediately and in the longer term.

Mrs Dodds: Minister, the report is shocking. There has been a litany of problems and a culture of bullying and poor behaviour. At one stage, an operation was cancelled because of "interpersonal differences in theatre". It reveals that four surgeons were working from home. What really concerns me is the report's conclusion:

Minister, first, will you publish the report and lay it in the Assembly Library for Members to see, so that we can scrutinise and measure the work of the Belfast Trust? Secondly, will you tell us why and how on earth the problem was allowed to continue over such a long, long period? I know that the review started in 2024, but the problem has been ongoing.

Mr Nesbitt: The Member asked two things, starting with whether I will publish the report and lay it in the Library. I intend to do that; absolutely. The Member also asked how it could possibly have gone on for so long. Let me assure the House that that will be a key question when I meet the chair of the Belfast Trust. It is shocking that it was happening, but it is also shocking that it happened over such a long period.

On public confidence and being proportionate about the assessment of risk, the Royal Victoria Hospital is the sole provider of cardiac surgery for the whole of Northern Ireland. While the external team have made a number of recommendations to improve safety, to improve processes and, of course, to improve the culture in the unit, they have also deemed that the service is safe to continue. I want to give that assurance to anybody who is about to go for a procedure with that team at the RVH.

Mr McGuigan: Minister, you said that the report looked at two aspects: safety and teamwork. You kind of answered the question about public assurances regarding safety. On teamwork, what engagement, if any, have you or your Department had with the trade unions since the publication of this damning report?

Mr Nesbitt: I thank the Member for the question. I am not aware of our having, to date, any direct talks with the relevant trade unions. The Member will know that, in this case, the Belfast Trust is the employer of the staff in the cardiac unit. We have seen the trust put in place bespoke support mechanisms for all staff to ensure that they have the opportunity to put forward their views of the challenges that the unit has faced that have been created by this unacceptable behaviour. Any unacceptable behaviour should be dealt with through human resources policies and practices.

In the first instance, as I have said to the House, I need to speak to the chair of the Belfast Trust. Following that, I do not rule out engaging with the trade unions and other representatives whose voices need to be heard.

Mr Donnelly: It is incredibly concerning to hear this today, Minister. A wait for cardiac surgery is a very frightening time in a patient's life, and to hear that that has been going on in the service is very concerning. Can you tell us what the impact on the cardiac service will be?

Mr Nesbitt: I thank the Member for his question. I believe that the number of cancelled procedures was very low: off the top of my head, I think that it was six. I think that there were reports that it was perhaps over twice that number; as I understand it, that is not the case. I am not aware of any actual direct impact on planned surgery from the report or the fact that there has been a really bad breakdown in relationships amongst senior members of that trust team.

Mr Chambers: This report has shone an important spotlight on what was clearly a totally unacceptable environment for some Belfast Trust staff. Is the Minister confident that the scale of the problems in this particular service are rare and that, in fact, clinical staff teams in all services across our hospitals normally work incredibly well together in the best interests of patients under their care?

Mr Nesbitt: I thank the Member for his question. I have been in post now for 363 days. I have not come across anything like this in my first year, nor have I received reports of anything similar having been carried out previously. It is rare, but it is incredibly important.

As somebody who was on a waiting list for a cardiac procedure, I take Mr Donnelly's point that it is a very worrying time. The heart is a very emotive issue, as a lot of health issues are. I can only speak from my own experience. I am glad that I was blissfully unaware of any such issues, because that would have coloured my anticipation of going into the Royal for that procedure.

Ms McLaughlin: I completely agree with the Minister's expression. My son-in-law is waiting for open-heart surgery. I am absolutely flabbergasted by the contents of the report that we have heard about today. They will literally have my daughter's heart in their hands when they operate. Is the Minister able to give us any information about any disciplinary procedures that are going on at the moment in order to address this? We really need to give assurances to all those people in our communities who are waiting to go in that they will be OK and will be looked after. The treatment that my son-in-law has received to date has been exceptional; he could not praise it enough. Today, however, I am really worried.

Mr Nesbitt: I empathise with the Member and wish her son-in-law well. Anybody who is waiting for a procedure should be assured that what we are saying about this expert independent report is that, while there are issues of concern, the procedures that are being carried out are still safe. Obviously, however, this colours how patients may perceive what they are about to go through. You asked about disciplinary issues; I am not aware of any. Again, that is something that I will be asking the chair of the trust about when we meet. I can only assure Members that I am about to sign off on a letter that I have written to the chair. To use the local parlance, it does not miss and hit the wall.

Mrs Dillon: The Minister will be aware that while some people are waiting for their surgery, some people have had their surgery but unfortunately are no longer with us. I hope that this provides us with an opportunity to reassure people that their loved one is not deceased because of what was happening in the cardiac surgery unit. This report was instigated because there were concerns. I want to understand what has been done in the interim. I sincerely hope that we did not wait for a report with recommendations in order to do something about what was going on in the cardiac surgery team.

Mr Nesbitt: If I understand the Member correctly, I do not think that we can draw any inference that anybody who lost their life in recent years because of a cardiac issue should not have lost their life. There would have been serious adverse incident (SAI) reports that would have looked at events on a case-by-case basis. I am not drawing that inference, but I do draw the inevitable conclusion that this is very disturbing for those who are waiting for procedures. What went on, and why was it allowed to go on for so long? Those are questions that I still want to pick up, primarily with the chair of the trust. On a more general point, it is my impression that issues often come to the Department that I feel should have been dealt with by the boards of the five geographically defined trusts, so I am asking them to take more control over how healthcare is delivered on their watch.

Mrs Erskine: Minister, you have said in the Chamber today that you are glad that you were "blissfully unaware" of what was happening. That concerns me, because I would like to think that, as Minister, you would be taking the lead, and it is a Minister's job to know exactly what is going on while working with the trusts.

I turn to the report itself. Over 70 staff were interviewed, and they were treated as whistle-blowers in order to provide anonymity. The situation in the unit was described as "chaos". Junior staff described being bullied, with incidents of implements being thrown in theatre. Why did the Belfast Trust allow the situation to escalate to the stage where, the report states:

Madam Principal Deputy Speaker: Minister.

Mrs Erskine: How were patient —

Madam Principal Deputy Speaker: Thank you, Deborah.

Mrs Erskine: — outcomes affected during that time?

Madam Principal Deputy Speaker: Thank you, Deborah. Minister.

Mr Nesbitt: I am afraid that the Member misunderstood me when I said that I was blissfully unaware. I meant that I was blissfully unaware when I was a patient presenting for a pacemaker and a defibrillator. As the Minister, I am not blissfully unaware.

As for the other part of the question, that is something that I will take up with the chair of the trust as a matter of urgency.

Mr McGrath: Another story about the Belfast Trust, and another shambles has been detailed to us. Given that the Department and the public purse pick up the cost of the investigations, can procedures not be put in place to escalate such a situation — four consultants at one of the only centres offering such treatment working from home — to the Department for a full investigation, rather than leaving it to the trust, which many of us have less and less faith in?

Mr Nesbitt: I accept the Member's proposition that people are continuously losing trust in the Belfast Trust because of incident after incident and problem after problem being reported. My language underplays the situation: what has been going on is incredible, with, as the Member said, four consultants working from home. I find it hard to process how that delivers cardiac surgery. To what extent is it possible to deliver a full service while working from home?

We need to look at this. I think that I am right in saying that the Belfast Trust is the largest trust in the United Kingdom, and that may be cause to reflect on how we deliver better outcomes. That is all that I am here to do: to try to deliver better outcomes not only for patients and service users but for staff, as it is clear that they were not getting good outcomes from the culture of the unit.

Mr Carroll: I am astounded by what I have heard today. Minister, I do not want to cast any aspersions on the chair of the trust, but I hope that your meeting with the chair will not be used as an excuse not to release important information into the public domain.

My question follows on from the question from the Member for Mid Ulster. Is there any indication of how many people have been misdiagnosed? Is your Department looking at the impact on women in particular, given that, often, when they present with heart issues, they are dismissed as having an anxiety or panic attack?

Mr Nesbitt: Let me assure the Member that, first, there is no question of trying to withhold or disguise information. I have agreed that we will publish the report of the independent body. It is not a question of not wanting to give you the information; it is a question of my not having it yet, and that is the purpose of the meeting with the chair of the trust.

As for the Member's other specifics, I am not aware of any particular negative impacts. There was a bad culture and a huge, almost catastrophic, breakdown in relationships — when I say "catastrophic", that relates to four people deciding to work from home — but I do not think that there were any catastrophic impacts on the outcomes of procedures that patients underwent.

Mr Robinson: My colleagues and I have consistently raised the failings of the Belfast Trust in the Chamber and at the Health Committee. We have had the maternity hospital, the children's hospital, the energy centre, the acute mental health inpatient facility and now cardiac surgery, yet the Minister has chosen not to take definitive action on the management arrangements. How many more fiascos do we need to bring to the Chamber before the Minister will take definitive action?

Mr Nesbitt: I am not aware of what the Member means by "definitive". He will be aware that the chief executive stood down some months ago, so we are now in a period of transition, and I am working with the permanent secretary of the Department of Health to see how we can use that period to effect better outcomes, better organisation and better structures and avoid the prospect of my having to return to the House with yet more bad news about the Belfast Trust.

Madam Principal Deputy Speaker: Thank you, everyone. That concludes the item of business. I ask Members to take their ease until we change the top Table.

Dr Aiken: Our party notes with interest the remarks made earlier by the Member who proposed the motion and the Member who proposed the amendment that one of the parties on the Executive, to which they both referred, is blocking access to free money that it would be, on appearances, highly suspect for us to turn down. That money includes resources from the Shared Island Fund and the National Wealth Fund, which is just a small part of the largesse with which our friends in Dublin are apparently so willing to provide us.

It is interesting to follow debates in the Dáil at the moment, with several noteworthy interventions from the Opposition. It is worth recalling the comments of Pearse Doherty TD about people struggling to deal with the cost-of-living crisis, the inability to build social housing or, indeed, any housing and the huge infrastructure deficit and his perspective on the people of the Republic of Ireland:

Furthermore, far from the largesse of extra expenditure that the Members from Sinn Féin, the SDLP and the Alliance have talked about being available, concerns are being openly raised in Dáil Éireann on the public expenditure front. I will list these in ascending order: €808,000 for a printer for Dáil Éireann; €1·4 million for a bike shed; €2·3 million for a bus shelter at the Oireachtas; €300 million spent on Metro North without 1 centimetre of track being laid; €725 million on bailing out RTÉ; and €2·5 billion in medical compensation, as well as the multimillions spent on the overrun of the national children's hospital and whatever will be needed to ameliorate the tariff wars between the EU and the USA. To challenge Mr Kearney's rather naive view on defence spending, the Irish Republic will be obliged to raise its paltry 0·2% of GDP spent on defence to —.

Mr Deputy Speaker (Mr Blair): Dr Aiken, will you bring your contribution on to the North/South bodies?

Dr Aiken: I will. We are getting there.

The Irish Republic will to be obliged to raise that to the average of 3% and then up to 5%. That is a bill that will completely swallow up the National — sorry, Apple — Wealth Fund and more.

Pontificating and freeloading has a price, which the parties opposite should recognise. In saying that we should ask for that free money for North/South bodies, the first question should be this: where is it coming from?

Secondly, anybody who looks at the accounts that the North/South bodies very occasionally present will ask whether that money is being properly utilised, where it is and whether it is being frittered away. Anybody who has been on any of the Public Accounts Committees will know that there have always been problems with that. The other question is this: in the unlikely event of the funds actually being made available, to what degree, given the 60:40 or 75:25 splits for those joint bodies, will our cash-starved Executive be asked to increase our contribution?

Anyone with even the remotest understanding of the Irish Government's spending practices would rightly question the Taoiseach's political promises. My party does, so we have no truck with the fantasy economics of Merrion Street Upper. We will support neither the amendment nor the motion.

Mr Boylan: The motion tabled by Sinn Féin is a simple one: it seeks to highlight the frustration that we should all share around the consistent blockage of additional funding for all-island bodies and calls for the changes that are needed to enable the Irish Government to increase their funding allocations at no extra expense to the Executive. The six all-island bodies, including Waterways Ireland and the Loughs Agency, undoubtedly serve to benefit the entire island: north, south, east and west.

I am therefore bemused that, at a time when the Executive face ever-tightening budgets as a result of the continued austerity agenda of successive British Governments and when the Irish Government have shown a willingness to increase their funding allocation at no additional cost to the Executive, there is repeated resistance by one party to maximising the opportunities for each of the bodies that I have mentioned.

Take the Loughs Agency, which has responsibility for the promotion and development of Lough Foyle and Carlingford lough for commercial and recreational purposes. I fail to understand why anyone would not want to see that body receiving additional funding to ensure that it flourishes. The need to protect our beautiful waterways is often spoken about in the Chamber, and I agree with that. When the opportunity exists to ensure that bodies such as Waterways Ireland and the Loughs Agency have the funding that they need to continue to protect our waterways, educate local students and citizens on the importance of waterways and manage and research new and innovative ways in which to conserve them, I am baffled as to the rationale for blocking much-needed increased funding contributions from the Government in Dublin.

While some say that there is no reason to change the current funding model, I say that we are not in a position to blindly turn down funding. Every funding intervention should be harnessed as an opportunity to design a fair and sustainable funding model to support each of the all-island bodies. I implore all parties to support our motion to support a change in the funding model for North/South bodies to see the benefit that additional funding would have on them and to ensure that they can all continue their good work

Mr Kingston: As my colleague Diane Forsythe MLA stated, cooperation under the auspices of the North/South Ministerial Council (NSMC) and its six implementation bodies is predicated on cross-community consent and the safeguards put in place by the Belfast Agreement to ensure that proper accountability exists to the strand-one institution, namely the Northern Ireland Assembly.

The DUP fully accepts that it is vital for all traditions in Northern Ireland to be respected and supported through balanced and responsible investment. Work has commenced on the development of the North/South Language Body's corporate plan for 2026-28. That will include consideration of funding priorities and needs, which will need to be considered within the wider budgetary position.

Any revised arrangements must adhere to the cross-community consent principle that is at the heart of the Belfast Agreement, successor agreements and the primacy of strand one. Those are interlocking arrangements. Unilateral attempts to change the current funding provisions and establish ratios that are in breach of that principle risk undermining confidence in devolution among unionists and setting back mutually beneficial relations between Northern Ireland and the Irish Republic.

Mr O'Toole: I appreciate the Member's giving way. He used the phrase "the primacy of strand one". Will he point me to where that phrase is used in the Northern Ireland Act, the Good Friday Agreement or any associated documents?

Mr Kingston: I thank the Member for his point. I am coming on to that.

Mr Deputy Speaker (Mr Blair): The Member has an extra minute.

Mr Kingston: I referred to the Belfast Agreement and the successor agreements, including the St Andrews Agreement. I am surprised when I continually hear parties that were champions of the Belfast Agreement say that they want to change the arrangements that are in it.

Nobody should be surprised to learn that the Democratic Unionist Party adopts this stance. The principle that the strand two and strand three institutions must be accountable to Stormont was one that we pushed and secured agreement for at St Andrews in order to ensure that arm's-length bodies would not evolve in a way that undermined community relations. If others want to renege on that principle and on previous agreements, that is a matter for them, and they need to be upfront and honest with the public about that.

The DUP supports the retention of a funding model that is carefully balanced and fair for both jurisdictions. If the only alternative funding model that is on the table is one that breaks the balance between the contributions between the Irish Government and the Northern Ireland devolved institutions, we cannot lend our hand to it. Therefore, we will support neither the non-binding motion from Sinn Féin nor the SDLP amendment.

Mr McMurray: It is no secret that our public finances in the Executive are under severe strain. Every Department is looking for additional money, but it is not easy to come by. We need to look at doing things differently and see where we can establish new sources of funding. We cannot be precious about reviewing funding models and accepting additional money where it is offered.

It was good and welcome that the Minister for Communities was able to match the one-off funding allocation by the Irish Government earlier this year to allow both Foras na Gaeilge and the Ulster-Scots Agency to benefit. However, we all know that scrambling for mid-year injections is not a sustainable way to operate. We need to look at funding models to see whether they can consistently deliver what is needed. If they cannot, we need to be open to changing them and to finding a solution that works. The deputy First Minister has said that she can see no reason to change the current funding model, but it is clear that the funding that it can provide year after year is not enough. I cannot see how that is not a good reason to look at a different funding model.

It will not come as a surprise to anyone to hear that I value cross-border cooperation and want to see a thriving shared island. It is regrettable that the North/South Ministerial Council has not always lived up to its potential, but that does not take away from the very important and necessary work that its North/South bodies do. That is work that can be done through cooperation and from which we all benefit as a result.

Waterways Ireland and the Loughs Agency deal with a range of economic and environmental matters on marine and inland waterways in the border region. Water quality is a big issue that we need to tackle together. Everything flows in rivers and loughs. It is self-evident that cross-border water bodies can only be successfully managed together.

InterTradeIreland is equally important. We all benefit hugely from its efforts to promote trade and business and to increase our global competitiveness on an all-island and cross-border basis, especially in today's difficult global climate. We can only be strengthened by working together.

It is right that both jurisdictions contribute to that very important work. However, in light of the huge pressures that we face in Northern Ireland on bread-and-butter issues such as policing, housing, health, social care and waste water, it is simply not realistic to increase our contribution to North/South bodies in the long term. The Republic is in a different place, financially speaking, and it can contribute more. If it is willing to do that, we should let it.

The deputy First Minister is concerned that a unilateral increase in the funding could break the balance between contributions from the two Governments. It was also said that it would affect the amount of say that each jurisdiction has in bodies' activities and their funding model. I do not see that as an inevitable outcome. A 75%:25% funding ratio is already in place, but that does not mean that Northern Ireland has only a 25% say in decisions. There is nothing to suggest that a change to that ratio would inevitably affect the rules that govern the decision-making of the bodies. They would also have to continue to undertake work according to the agreed ministerial priorities, and Ministers in the Northern Ireland Executive would retain oversight of how the money is spent in their areas of responsibility. If anything, increased contributions from the Irish Government would give the Northern Ireland Executive more resources and control than their contribution warrants. It would be a win for Northern Ireland. I, therefore, welcome and support the motion.

Ms Mulholland: We have all heard it: at a time when our public services are under immense strain, the public rightly expect the Executive to use every tool and every partnership available to them to protect what matters. That includes cooperation with the Irish Government on funding streams that would directly benefit communities in Northern Ireland. In the Chamber, we often hear the phrase "value for money" or the word "efficiency", but those principles fall flat when we fail repeatedly to accept offers of funding opportunities that could provide direct and measurable support to the people whom we represent, simply because they involve joint ventures with the Republic of Ireland. We are more than happy to pursue global trade opportunities — crossing oceans without hesitation — yet, when it comes to engaging in cross-border funding on this small island, too often we either say "No" loudly or we quietly let the opportunity pass by.

This is not a question of ideology — at least, it should not be. It is a question about whether we are serious about building sustainable, inclusive services, or whether we are content to let communities shoulder the consequences of political inaction in this place. In response to Mr Kingston's comment, I say that our response to this issue does not mean that we no longer support the Good Friday Agreement. It is because we see the Good Friday Agreement not as a final destination but as something that needs to be nurtured and allowed to develop as we continue on the post-conflict journey. It is not the be-all and end-all; we know that it is a living, breathing and evolving thing.

Just weeks ago, my colleague David Honeyford MLA asked Minister Lyons what sporting facilities in Northern Ireland —.

Mr Kingston: Will the Member give way?

Ms Mulholland: Yes, go ahead.

Mr Kingston: Does the Member agree that any changes to arrangements under the Belfast Agreement would need the cross-community consent of the Assembly?

Mr Deputy Speaker (Mr Blair): The Member has an extra minute.

Ms Mulholland: I put it back to the Member: if there is going to be cross-community benefit from this funding, surely that is something that you would fight for as an MLA, as any MLA in the House would do.

My colleague David Honeyford MLA asked Minister Lyons what sporting facilities in Northern Ireland would benefit from the Shared Island Fund — a significant pot of funding that has been made available by the Irish Government. The Minister's reply was that he had not corresponded with the Irish Government on the matter. That is a serious, missed opportunity. The Shared Island Fund is there to support infrastructure and connectivity across the island, sporting facilities included. Why would we not actively pursue that type of funding when Departments, such as the Department for Communities, are having to make very difficult cuts? Not to do so is a failure to act in the public interest.

When investment is available, at no cost to the Executive — at no cost to any constituent in any constituency — to deliver services, improve inclusion and empower communities, why would we not take it? The answer, I fear, lies not in policy but in politics. We are witnessing an ideological hesitation to engage in anything cross-border. We saw it with the delays and resistance around the North/South Ministerial Council; we see it again and again when proposals come forward that involve cooperation with Dublin; and now we are seeing it in how funding decisions are made — based not on need or equality but on optics and political comfort.

It is also important to highlight the unsustainable position in which this situation places the Irish language organisations. I say that as communities spokesperson for the party. In recent months, Foras na Gaeilge was forced to announce more than €800,000 in cuts; those cuts impacted on groups working across Northern Ireland. They were reversed thanks only to a one-off intervention from the Irish Government, not the Executive. As someone who engages regularly with the organisations in my constituency, which have engaged with 2,500 people this year alone through funding from Foras na Gaeilge, and whose people do the work and the outreach, I know that it is important. Furthermore, the fact is that they could do so much more. The development officer has told me that she is flat out and busy and that the figures do not represent half of the work that she is doing.

The underlying problem remains: the Irish Government have a willingness to increase their contribution, but current rules require Stormont to match that funding, and proposals to reform that arrangement have been blocked repeatedly. We have to ask why. That means that the crisis will return next January, the January after that and the January after that for those groups unless political progress is made. Why, when Departments such as the Department for Communities are under such intense financial strain, are we not doing everything possible to draw down any available cross-border funding? I want to know what the rationale is for rejecting support that could sustain the very services that border communities in particular rely on, especially during a cost-of-living crisis.

We in the Alliance Party believe in inclusion and fairness. We believe that public funding decisions should be guided by need and evidence, not political discomfort. We have to stop treating cultural identity as a zero-sum game. It is not. Fairness for one tradition should never be interpreted as a threat to another.

To conclude on a positive note, the all-island congenital heart disease network literally saves lives. It is another example of what is possible —

Mr Deputy Speaker (Mr Blair): Time is up.

Ms Mulholland: — when we put patient outcomes before politics.

Mr Gaston: The debate up to this point has focused on whether we should accept additional funding from Dublin. I will focus some of my remarks on the money from our Budget that we already spend, and what we get in return.

I will take Safefood as the first example. That is a body that we in Northern Ireland fund to the tune of £2 million a year, but it does not employ a single member of staff here in Northern Ireland. Despite what Ms McLaughlin said, no one in the Chamber represents people living in Cork. That is simply outrageous. The Health Minister recently made a statement to the House following the 26th North/South Ministerial Council meeting in the health and food safety format. We were told that child protection was one topic that was discussed, so I asked the Minister whether he raised the issue of the contribution of Irish institutions to child abuse redress in Northern Ireland. He said that that was a matter for the Executive Office, and washed his hands of it. Who sat beside him at that very meeting? Junior Minister Reilly, but she said nothing. That was a missed opportunity.

The second body that I will look at is the Loughs Agency. Members have been at pains this afternoon to promote the activities that it carries out. I have submitted numerous questions to the Agriculture Minister — sorry, that was a slip of the tongue; he is no friend of agriculture. I should have said "Environment Minister". The answers confirm what many already suspected: that body is bloated, it duplicates and it is surplus to requirements. It currently employs 68 people, which is 15 more than its authorised complement. Of its employees, 21 are temporary, and three work on externally funded projects. Where is the accountability?

In 2024 alone, nearly £1 million went on salaries for the conservation and protection directorate. Another £590,000 went on office costs. After spending that vast amount of money, what was the result? There were zero prosecutions for illegal netting in 2024. There were only three in 2023, and there was none in 2022. We are funding a fisheries enforcement regime with no active fishery to enforce. Worse than that, the functions that the agency claims to perform are already carried out elsewhere. On the Erne and the Blackwater, the Northern Ireland Environment Agency (NIEA) and the inland fisheries inspectorate do the job without the costly duplication. Pollution investigations are already done by the NIEA and the Agri-Food and Biosciences Institute (AFBI). Scientific advice is another one for AFBI. Aquaculture licensing is still handled by DAERA, not the Loughs Agency.

Again, what are we paying for? Despite all its staff, the agency spent £172,000 on external PR and media contractors over the past three years. Why? It claims that it does not have in-house expertise. That begs the real question: why do we have a stand-alone agency that cannot even explain and promote itself?

Its science team cost £322,000 last year, yet that work could be done by existing public bodies. Its aquaculture directorate employs six people, but the Department retains the licensing role. It is not a structure with purpose; it is a structure without function. If the Loughs Agency were to cease to exist tomorrow, its core functions would continue without disruption.

We should not be afraid to ask whether the cross-border bodies are delivering for the people who fund them, and, when the answer is no, we should not be afraid to act. One cannot help but notice that, while the nationalist and republican alliance is happy, as usual, to push a motion like this one, it is not concerned about the fact that Intertrade UK operates without offices, an independent staff or even a budget. My goodness, that sums up how Stormont values unionist concerns.

Mr Deputy Speaker (Mr Blair): Before we move on, I apologise to Sian Mulholland. Sian, I awarded you an extra minute and then took half of it back off you. That was my error.

The Minister of Finance will now respond to the debate. Minister, you have up to 15 minutes.

Mr O'Dowd (The Minister of Finance): Go raibh maith agat, a Leas-Cheann Comhairle.

I welcome the opportunity to participate in the debate on additional funding for North/South bodies. As it is a cross-cutting issue and an alternative funding proposal requires Executive approval, I have pressed, and will continue to press, for it to make it on to the Executive's agenda.

Proposed alternative funding arrangements have been developed by a North/South institutional working group, which includes officials from sponsor Departments, the North/South Ministerial Council secretariat, the Finance Departments in the North and the South and the Department of Foreign Affairs and Trade.

The new funding proposals would allow funding for specific programme activities to sit outside the established agreed funding ratios for core activities and facilitate additional funding streams from any source, including sponsor Departments in the North and the South. Given the constrained financial position that the Executive face, to which many Members have referred, the proposals minimise the risk of bodies losing out on funding that is available through their southern sponsor Departments. No cost to the Executive arises from the funding proposals.

A number of Members from the DUP and the Ulster Unionist Party raised the issue of accountability. This is the important point: additional funding that is received through the new proposal would be included in the annual business planning process. That requires the approval of the sponsor Departments, the Finance Ministers in the North and the South and, ultimately, the North/South Ministerial Council. Therefore, oversight, scrutiny and agreement is required from individual Executive Ministers, the Executive and the North/South Ministerial Council. It is not a free-for-all, as has been suggested.

Dr Aiken: I thank the Minister for giving way. This is probably a moot point. The Minister will be aware that there is a lot of concern about the fact that many of the North/South bodies' accounts have not been reported in sufficient time, and, indeed, that some of them are, to put it mildly, less than qualified. Is the Minister content that the oversight and governance of the North/South bodies are adequate?

Mr O'Dowd: Those are matters for individual Ministers and scrutiny Committees. My understanding is that a number of financial reports have not been delivered on time due to a number of problems, including this place being down. Those are issues. North/South public bodies should — I have no difficulty with this — be open to scrutiny of their financial accounts, as anyone else should. It is public money that is being spent, and those bodies should be scrutinised by the sponsoring Minister, by the Committees involved and by this House. Yes, scrutiny should take place and financial accountability and value for money should be in place.

On the point around accountability and governance of the structures of the Good Friday Agreement and the role of the Executive in them, which has caused concern for a number of Members, any additional funding would be under the scrutiny, and for the approval, of individual Ministers and the entire Executive. It would be counterproductive for bodies to miss out on funding due merely to the different inflexible arrangements that restrict the work of North/South bodies. That is why my Department has asked repeatedly, since last October, for the Executive to consider alternative funding proposals. The new funding model seeks to address the risk of bodies missing out on funding due merely to financial constraints in one jurisdiction.

I see Members' calls, in the amendment, for more fiscal powers to be secured as being a distraction from the main motion. Unfortunately, the SDLP wishes to take attention away from the main issue. The DUP — it is open about this — is blocking additional funding from going to North/South bodies. Even with fiscal powers devolved, if the DUP position does not change, it will continue to block additional funding for North/South bodies. The devolution of fiscal powers is not the key that will open up the issue. It has to be recognised that the DUP's stance is blocking it. I believe that the assurance that any additional funding to be managed through the business plan of the body, which is approved by the sponsoring Minister, with the approval of the North/South Ministerial Council and scrutiny by the Executive, should be sufficient to assure anyone that no one can set an agenda that does not receive the approval of the Executive.

Ms Ennis: I thank the Minister for giving way. Just on that point, I am sure that DUP Members rubbed their hands with glee when they saw the SDLP amendment. I cannot work out whether the SDLP is being deliberately obtuse or genuinely does not know that the DUP is exercising a veto over the additional funding. If parties refuse to call out the problem, they become part of it.

Mr O'Dowd: The Member makes a valid point: political opportunism is not going to solve the problem, and neither will distracting from the real core issue.

It is important that the Executive have the fiscal levers that they need. Members will be aware that the interim fiscal framework signed by my predecessor on 21 May 2024 included a commitment to consider further fiscal powers. However, my immediate focus, as it has been to date, is on progressing the commitments in the interim fiscal framework on the Executive's funding arrangements, which need to be prioritised ahead of the June spending review. It took a number of years to deliver the devolution of further fiscal powers to Scotland and Wales, and it will take time to deliver here, but I am committed to making progress on that matter.

It is also important to acknowledge that the failure to fully replace EU structural funds has had a tangible and negative impact on communities across the North. The loss of long-term, predictable funding has left a gap that short-term initiatives cannot fill. It is therefore essential that all resources are strategically aligned. Without coordination on flexible arrangements, we risk fragmentation and inefficiency. We need a joined-up approach that maximises the impact of every pound that is spent across east-west and North/South dimensions.

I thank Members for bringing the motion to the Assembly. I assure Members that I will continue to work with colleagues here and counterparts in the South to resolve the current inflexible funding arrangements for the North/South bodies and the opportunities lost to communities across the North.

Mr Deputy Speaker (Mr Blair): I call Matthew O'Toole to make a winding-up speech on the amendment. You have five minutes.

Mr O'Toole: Five minutes, Mr Deputy Speaker?

Mr Deputy Speaker (Mr Blair): Yes.

Mr O'Toole: Before I came back to the Chamber to finish the debate, I spoke with a group of young people — I think that they are in the Gallery now — from Rockwell College in Tipperary. They are very welcome, and it is great to have them here, but it strikes me as embarrassing that, in 2025, a group of young people from a secondary school in Tipperary still have to come and endure debates like this about the basic tenets of North/South cooperation. The quality of some of what we have heard today has been — frankly, it has been drivel.

I will touch on a few points. The purpose of our amendment is not, as Ms Ennis incorrectly said, to deflect from the DUP's blocking North/South funding. In fact, the wording of our amendment is exactly the same as that of the Sinn Féin motion when it comes to the DUP's actions on that. We said that they are "nonsensical" — we do not change even that — so it is absurd to say that we are somehow blocking. What we are doing with our amendment, as my colleague Sinéad McLaughlin said, is taking responsibility. We are seeking to create a situation in which Ministers here — that means Sinn Féin, DUP, UUP and Alliance Ministers — take responsibility. That is our job as the Opposition.

It is all well and good for the Finance Minister and his colleagues to come and make assertions about blame. In this case, there is a lot of blame to go to the DUP. I have five minutes, I have plenty of blame to ladle on to the DUP, and I will do that in just a moment's time, but Mr O'Dowd is the Finance Minister for the North. Before him, Caoimhe Archibald was the Minister. Before that, Conor Murphy was the Finance Minister, and, way before that, before the institutions collapsed, Máirtín Ó Muilleoir was the Finance Minister. Sinn Féin Finance Ministers have had the power to go further and faster on greater fiscal devolution. I acknowledge Conor Murphy's appointment of the Fiscal Commission, and I acknowledge the Minister's saying at the Dispatch Box that he intends to do more in that area. However, part of the answer to the underfunding from London and to the DUP's playing the dog in the manger on the North/South bodies is for the Finance Minister and the Executive to take more power over and show more purpose and vision on North/South funding and fiscal powers here, not for them simply to blame the UK Government, the DUP and Uncle Tom Cobley for everything.

I come on to our friends in the Democratic Unionist Party and their long-running dog in the manger act when it comes to the North/South bodies, which has crystallised in the past month or two because they are scared of the TUV's polling numbers. We have seen, I am afraid, a tragic vision of what unionism has to offer, with Member after Member standing up to say, "We do not want that money from the Irish Government". It is genuinely pathetic. I could give you a detailed policy account of why it is pathetic and the impact that it will have on public service delivery, but, to be honest, it all just feels like we have gone back 60 years. It is 2025, and our Speaker, Edwin Poots, turned 60 today, but we might as well rewind 60 years to Paisley and his friends throwing snowballs at Seán Lemass outside, because that is where we are at with the DUP and its attitude to funding. It is pathetic.

It was fascinating to hear Mr Gaston, who, clearly, in effect, leads the DUP in many ways with his mentor, the long-lost former Member for North Antrim, talk about how awful the Loughs Agency is. It is terrible that we have bodies such as the Loughs Agency. I presume that his plan is that we pour concrete and cement into Carlingford lough and Lough Foyle, because it is awful that those bodies of water exist and have to be managed on a cross-border basis. He talked about Intertrade UK and the East-West Council: I remind him — Sinn Féin Members should be reminded too — that the East-West Council and Intertrade UK are products not of any agreement between all parties and the two Governments but of a dreamt-up, stitched-up bilateral deal between the DUP and the Tory Government to calm their nerves over a Brexit that they created. It was not my party that agreed to their being inserted in the Programme for Government with, as you will see if you read the text, apparent but spurious equality with the North/South Ministerial Council and InterTradeIreland. The parties that are in the Executive can account for that decision, because they agreed to it.

The rest of the century will involve enormous challenges and, yes, enormous opportunities. People on this island from all backgrounds see the huge potential of greater North/South cooperation. They want it fulfilled. They want it to improve their lives.

Mr Deputy Speaker (Mr Blair): Time is up.

Mr O'Toole: They do not want to engage in any more —

Mr Deputy Speaker (Mr Blair): Time is up.

Mr O'Toole: — of the generationally nonsensical drivel —

Mr Deputy Speaker (Mr Blair): Time is up.

Mr O'Toole: — that is coming from the DUP and others.

Mr Deputy Speaker (Mr Blair): I call Emma Sheerin to conclude and wind up the debate on the motion. You have up to 10 minutes.

Ms Sheerin: Go raibh maith agat, a Leas-Cheann Comhairle.

Thanks for the opportunity to make a winding-up speech on what has been a lively enough debate. As others mentioned, we had a depressing, almost predictable narrative from the same old corners in some parts of the debate. That is for Members across the House to justify to the people who elected them.

We tabled the motion for a simple reason, which is that increased funding is available. It would not cost the Executive anything. It would help and support a list of agencies, all of which work for the people whom we represent. However, because of an ideological opposition that, frankly, makes no sense, we are not accessing that funding. I am yet to hear any good reason from anyone on the Benches opposite for their continued opposition to increased funding for the aforementioned agencies.

Mr Kearney: Will the Member give way?

Ms Sheerin: I will.

Mr Kearney: Having listened to what the Member said about an ideological or quasi-ideological narrative to obfuscate why the blockage is taking place at the heel of the hunt, I ask this: does the Member agree that, in the midst of all the economic and social challenges that this society faces, with families who cannot pay their bills and who are being put to the pin of their collar, it is absolutely incredible that people who are listening to this debate are hearing one party opposing and blocking additional funds to enable the Executive to do good work?

Ms Sheerin: Go raibh maith agat.

I totally agree with what the Member says. It baffles me. It makes no sense.

I was previously a member of the Executive Office Committee, and we took evidence from Foras na Gaeilge and tha Boord o Ulster-Scotch during a Committee meeting. On that afternoon, we heard about the important work that both agencies do in their communities. As somebody who is interested in history and in how we all came to be here, I find their work to be important and, indeed, integral to the identity of us all. Even when it comes to elements of it that I do not find to be particularly relevant to my life, I can at least identify and respect the fact that that work has value and therefore should be funded. When funding for that work is available and able to ease the pressure that those agencies are under, it is therefore completely unimaginable that any elected representative would refuse it. It is completely unimaginable that politicians who went to the people of the North for a mandate would turn it down in their face. I cannot understand it.

As part of that Committee evidence session, we heard from people who work in the Irish language community and who face, as other Members outlined, incredibly difficult budgetary situations. I have worked in my constituency with parents who have been put out of pocket so that their children can be educated through the medium of Irish because of the difficulties that our public services face. Even getting access to a bus service for children across the North is no longer guaranteed. That is where our public services are at as a result of 14 years of Tory austerity, and we now have more of the same from Labour. It is therefore unjustifiable that anybody would knock back funding in that context. I do not understand it. It should be an easy decision for us all, but some Members are looking a gift horse in the mouth, and that is not acceptable.

I appreciated getting some clarification on the amendment from the Member to my right. It is regrettable that, instead of placing the focus on where it should be, we have seen deflection. As my colleagues the Members for Upper Bann and South Down articulated better than I ever could, work has begun in the Department of Finance on increasing fiscal devolution to here. Sinn Féin has been completely unambiguous in our support of that.

Mrs Dillon: I thank the Member for giving way. I am going to give away my age now, but I remember, in 2007, before I was elected, the very gentleman who sits in front of me and who is now Finance Minister was part of a discussion about fiscal freedom. A motion came before the House, and the SDLP did not think that we were ready for fiscal freedom or to have the levers of fiscal power. SDLP Members should be reminded of that fact.

Ms Sheerin: I thank the Member for her intervention. It shows that we are arguing about semantics. The point is that we can look at the bigger picture and at what we would all like to do in the long term. I have a very clear political ideology that brought me to the House, as do others, but the reality is that there are groups on the ground that are struggling to pay their employees' wages and cover their budget at the moment, yet there is funding available —. [Inaudible.]

Ms Sheerin: Absolutely. The Dublin Government are mismanaging their wealth, but we have funding available that could help us. As far as I am concerned, it is completely unjustifiable for us to refuse it. It is for the Members across the way to justify refusing it if they vote against the motion.

Mr Deputy Speaker (Mr Blair): I have been advised by the party Whips that, in accordance with Standing Order 27(1A)(b), there is agreement that we can dispense with the three-minute rule and move straight to the Division.

Mr Deputy Speaker (Mr Blair): Members, please take your ease before we move to the next item in the Order Paper.

Mr Deputy Speaker (Dr Aiken): In conjunction with the Business Committee, the Speaker has given leave to Danny Donnelly to raise the matter of drug-related deaths in East Antrim. Danny, you have 15 minutes.

Mr Donnelly: I preface the debate by saying that East Antrim is no better or worse than anywhere else in Northern Ireland or, indeed, the UK. The issue of drug-related harm affects every part of our region. However, East Antrim has recently witnessed several tragic drug-related deaths, alongside a BBC documentary that showed the daily realities of addiction devastating lives in our area. That is why I raise the issue today: not to sensationalise but to highlight what is happening and look seriously at what we can do to identify, prevent and reduce the impact of drugs on individuals, families and our communities. Drug deaths are preventable, and we should do everything we can to save lives.

Since becoming a public representative, first in council and now in the Assembly, I have seen time and time again the consequences of problem drug use: addiction, mental health deterioration, overdose and death. Like other MLAs, I have spoken regularly to local groups, the PSNI and support services, and everyone agrees that the problem is getting worse. From 1 May 2024 to 11 May 2025, there were seven drug-related deaths in K district, which encompasses most of East Antrim: four males and three females aged between 23 and 47. Polydrug use was a factor in five of those cases. Those are not just statistics: they are someone's child, sibling, friend or parent. Lives have been lost and families broken.

Drugs are dangerous, and addiction can ruin lives and be fatal. Polydrug use — the use of more than one drug at the same time — is rising. Often that includes prescription drugs, which are sometimes bought online with no way of knowing what is in them or what the dose is. That brings huge risks, especially when combined with alcohol or other substances. I have had drug-related issues raised with me from every corner of the constituency, including rural villages.

There is fantastic work happening locally. My team and I work closely with Extern, which has seen a significant increase in the number of children and young people it supports who are either taking drugs or being impacted by parental use. It includes primary-age children in care, who have been referred through social services. Many of them attend childcare services not just for supervision but for stability during trauma. However, those services are under pressure. From conversations with multiple groups, I know that, until May this year, three known drug houses were operating beside a facility for vulnerable children and young people in East Antrim. That is not acceptable. Children attending the facility had, in some cases, been removed from the care of their parents only to see similar people coming and going from the drug houses next door.

Staff in the area have gone above and beyond. In July 2024, two staff members of one organisation had to walk up a motorway with a young person who was on drugs. That young person, completely unaware of the danger that they were in, was moments away from being struck by an oncoming lorry. Only a last-minute intervention saved their life.

Staff have also supported young females who have been given drugs by individuals linked to drug houses. Their stories are horrific. Some describe being forced to pay for drugs in ways that no young person should ever experience. Others have witnessed or experienced violence, exploitation and blackmail. They are real young women and young people in our communities, and they are traumatised, abused and, too often, unheard. There have been overdoses and petrol bombs; windows have been shot at; and dogs trained to intimidate have attacked family pets. All of that happens near homes where elderly people and families live. It is devastating to see so much fear in a once-quiet area. I have heard it said many times that "The dogs in the street know where the drugs are coming from", the problem being that dogs cannot speak.

Elsewhere in East Antrim, front-line teams worked with 78 individuals last year in Larne and Carrickfergus. Of the 78, 55% were women. Every person was affected by mental health issues and substance use. The connection between trauma, drugs and community harm is clear. Some of the challenges reported include drugs being dealt to minors, including children as young as 11; girls aged 15 being exploited to carry drugs; increased use of drugs such as methedrine, ketamine, heroin and prescription medication; chaotic drug use in public places, including overdoses; and young people taking drugs alone, daily and in dangerous environments. One young woman was found partially dressed and unconscious on Main Street. Another woke up to find that her personal belongings had been stolen. Children are using alone. Young people have severe symptoms such as seizures and cardiac issues, which are now so normalised in some circles that emergency services are not even called.

Families are breaking down under the pressure, with some frightened of their own children. Parents with addiction are losing access to their children. Men struggling with undiagnosed PTSD are too ashamed to seek help. People are living in cars or sofa-surfing. Young people are recruited by gangs to graffiti walls, sell drugs and repay family debts. In some cases, residents have even turned to paramilitaries for protection, reinforcing the cycles of violence in the hope of some form of safety. However, let us be clear: those paramilitary groups should not exist, and they should not be allowed to continue terrorising our communities.

In response to all of that, there are services: counselling; addiction support; needle exchange and harm reduction; youth services such as the Drug and Alcohol Intervention Service for Youth (DAISY) and Voices; peer support; trauma clinics; community mental health services; and multi-agency hubs. One local service has delivered over 40 childcare sessions a week for children placed in foster or kinship care, working closely with carers, social workers and schools to provide stability. Others offer acupuncture, peer groups, crisis response, campaigns and online support.

The truth is that those services are not enough. We see the harm daily. They are overstretched, under-resourced and too often rely on short-term or voluntary support. Mental health services have long waiting lists, high thresholds and dual diagnosis cases. The very people most in need are often turned away or discharged after missing a single appointment.

One mitigating measure would be equipping communities with naloxone, which puts the power to save lives directly into the hands of those most likely to witness an overdose. That emergency medication, which can reverse the effects of an opioid overdose, is an essential part of harm reduction efforts and a vital tool. It must be matched by continued training, awareness and access across East Antrim and beyond.

The reality is that the people in greatest need are the least able to navigate our systems. We must do better. We must expand local trauma-informed services; fund childcare and family support for children in crisis; intervene early where young people are being exploited; build on the work of the multi-agency support hubs and community partnerships; ensure that mental health services can respond to people in crisis with compassion and flexibility; and encourage people with knowledge of drug dealing in our communities that they can share that information safely with the police via Crimestoppers and in other ways.

We must also be honest. What was once a problem confined to urban areas is now present on our doorsteps. Addiction, exploitation, poverty and trauma are interlinked, and they are hurting communities across East Antrim. If we are serious about identifying, preventing and reducing harm, we need sustained investment, a coordinated response and a recognition that those young people, families and workers deserve better.

Mr Deputy Speaker (Dr Aiken): Thank you very much, Danny. All Members who are now called to speak will have approximately seven minutes.

Ms Brownlee: I thank the Member who has brought such an important topic to the House, allowing us to discuss an issue that affects every corner or our community: the tragic rise in drug-related deaths in East Antrim. I welcome the opportunity.

As a member of the Policing Board, I will touch on policing. Drug use is one of policing's main priorities, which includes identifying and supporting those who are most at risk of harm from the misuse and illegal supply of drugs. The cycle of supply and demand is not just criminal but deadly. It fuels organised crime, exploits our young people and inflicts lasting trauma on families and neighbourhoods. Drug dealers are not your friends. They do not care about your health, your safety or your future. In the past year alone, seven drug-related deaths were recorded in the Mid and East Antrim Borough Council area. All but one of the victims were known drug users between the ages of 23 and 47. Tragically, all cases involved suspected polydrug use, with five involving prescription-only medication. Across Northern Ireland, drug-related deaths have risen by 47% over the past decade, and 74·6% of them now involve the use of two or more substances. Those are not just numbers but lives lost: parents, siblings, sons and daughters.

We also see an increase in the injection of cocaine, sometimes multiple times a day. That is a marked escalation from recreational cannabis use pre-pandemic to high-risk, high-harm drug dependency today. Alarmingly, many young people in Northern Ireland are buying what they believe to be cannabis oil but are instead being supplied with synthetic cannabinoids such as spice. Those substances have led to multiple hospital admissions that have required urgent medical intervention. The Public Health Agency (PHA) has called on parents and guardians to have a conversation with their children about the risks from vaping unknown substances. In Carrickfergus in particular, a number of groups, such as CHILL and Carrickfergus Community Forum, have been working on the ground, especially at weekends, and engaging with young people. They have been there when children have taken such substances and have described the scenes as "horrific". They engage regularly with the police and health professionals to address the issue, but we see it more and more. It is very difficult for all involved. I know that everybody is trying to work together, particularly schools, the police, the community and voluntary sector and education bodies, but the situation has now become the norm.

It is no coincidence that 44·5% of deaths from drug misuse in Northern Ireland occur in the most deprived areas. We are witnessing a perfect storm: a combination of poverty, trauma, rural isolation and limited opportunities. The legacy of the Troubles, coupled with paramilitary influence, continues to play a role in the drug trade. What is more is that we are seeing child criminal exploitation, whereby young people are being used as pawns in the supply chain, on which Mr Donnelly touched.

We also cannot ignore the rise in illegal moneylending. People are desperate for support and are falling into that trap. When repayments cannot be met, they are forced into storing drugs, dealing or even worse: sexual exploitation.

I therefore welcome the latest statistics for Mid and East Antrim, where 135 stop-and-search operations were carried out under the Misuse of Drugs Act 1971. Those efforts have led to arrests, seizures of class A and class B drugs and court convictions. A number of RAPID disposal bins have been located throughout Carrick, Larne and Ballymena. In just over a year, 1,400 prescription drugs, including dangerous opioids such as duloxetine, codeine and OxyContin, were safely surrendered.

Fantastic work has been done locally by the likes of the Mid and East Antrim Policing and Community Safety Partnership (PCSP) drug and alcohol steering group, which was established to coordinate a multi-agency response to substance misuse. It has expanded from having four members originally to having over 30 members now. It plays a role in policy, community outreach and awareness campaigns. Those awareness campaigns, such as #StopTheTrend, are important. They allow parents, community leaders, the police and everyone involved to recognise what drugs are on the market and what children or adults could be taking so that they are aware of and proactive about what is in the system.

There is also fantastic work from the likes of Start360, ASCERT, Extern, YMCA, CHILL and many more organisations. They do incredible work on the ground. The community and voluntary sector works tremendously hard daily to support those who are in a cycle, which is a difficult thing to break.

Carrickfergus Community Forum has a successful men's group that has provided a safe place for those who suffering with addiction and mental health issues. It also provides an affordable food club and community advice services that provide support with debt, benefits and housing and the holistic support that many people need. There is also a support hub that brings together statutory, voluntary and community groups to assist vulnerable young people, including those with drug or alcohol misuse issues. It is that sharing of information, dialogue and working together that can help someone in their time of need or time of crisis.

We also know about addiction services in the Northern Health and Social Care Trust. Whilst there are fantastic services available, one of the things that I have noticed most is that, when you are in addiction, the support services may not be on your doorstep. That is understandable. However, if you are in a cycle of addiction, how do you get to the services to access them? Who is there to support you? When someone has an addiction, they lose their family and their close networks of support and are almost left alone. While there are services there, the issue is understanding how we ensure that people avail of them. That is important.

There are a number of things there. I thank the Member for bringing the matter to the Floor. It is a community-wide issue. The Minister of Health is here, but the issue also touches on the remits of other Ministers. It is an Executive-wide issue that we need to address. If you are a parent, talk to your child. Support your neighbour. It is about raising awareness and supporting people. Addiction is an illness; it is a difficult —.

Mr Deputy Speaker (Dr Aiken): Will the Member draw her remarks to a close, please?

Ms Brownlee: Yes. We believe in recovery. People need support, and they need it at the right time and in the right place.

Mr Stewart: Death is incredibly difficult in any circumstances, but it can be even more harrowing and often more distressing when it comes as a result of drug use. Unfortunately, too many people still lose their lives as a result of drugs across Northern Ireland. Behind every statistic is a human being — a son, daughter, mother or father — and a tragedy of someone who was loved and is, no doubt, sorely missed. I send my condolences and thoughts to everyone who has lost someone as a result of drugs not just in East Antrim but across Northern Ireland. Each one is a tragedy.

I thank the Member who secured the debate and the Minister for responding to it. We can all agree that the Minister is one of four or five Ministers who could be sitting here, because the issue straddles Justice; TEO, if we look at it through the lens of the paramilitary crime task force and the effects of the drug-dealing crime gangs that exist on our streets; and even Education, with the raising of awareness in our schools about the tragedies that can result from taking drugs. I thank the Minister for taking the time to be here today.

We have already heard that, regrettably, seven lives were lost in East Antrim in the past year as a result of drugs. As I said, each one of those is a tragedy. Through my constituency office, I know about the problems with addiction that people face daily and how engaging with the statutory services can be a challenge. However, I have also seen first-hand the agility, skills and compassion of staff on the ground who have been engaging with individuals and their families. I pay tribute to each one of those NHS workers and to our charities and community workers. The last Member to speak talked about the great work that is being done in East Antrim by the likes of Carrickfergus Community Forum, our PCSPs and a litany of unsung heroes who are volunteers and help those most in need. They should be praised.

While the numbers change year-on-year, there has been a stark increase in the number of people losing their lives to drug use over the past year in Northern Ireland. I was surprised to learn recently that the drug that is most often mentioned in drug-related cases across Northern Ireland is the prescription drug pregabalin. When it is mixed with other substances, such as opiates, there is a slowdown in breathing. We all know the impact that that can have when there is polydrug use. Of course, the other more commonly recognised drugs, such as cocaine and heroin, also claim far too many lives. They also ruin lives and families on a daily basis. Cocaine, for instance, remains the predominant substance in deaths that involve only one drug.

No matter the drug or the circumstances in which it has been taken, as MLAs, we should drive change to ensure that society does all that can be done to respond to this undoubtedly huge problem. In 2025, with all the information that exists about the dangers of drug taking, nobody should lose their life. Equally, however, I am a realist, and I recognise that we cannot just wish the problem away. That is why the Department of Health, along with the many agencies involved, must continue to do all that it can to stop people taking those substances and, when necessary, support them in their recovery from any addiction while preventing the most at risk dying from overdoses. Time and time again, we have heard about how that will involve a cross-departmental approach. We need more ability in and funding for our police so that they can tackle the importation of illegal drugs; we need our schools to be able to raise awareness among our young people about the tragedies that can ensue; and we need to do away with the criminal gangs that deal this rubbish and push it to our kids up and down the country. That needs to be dealt with.

There is an overall plan in the Department of Health. From the groups that I have engaged with, I know that the substance abuse strategy is broadly recognised as saying and doing the right thing, but, regrettably, as is the case with so many other important strategies in the Department of Health, it has not been fully funded. We need to see that happening, and we need to see it happening now. This is not a time for political point-scoring — it is too big an issue — but we need to make sure that the strategies and everything that can be done to tackle the problems and scourge of drug taking are put in place as quickly as possible.

Mr Dickson: I thank my East Antrim colleague Danny Donnelly for bringing this important topic to the Assembly.

Illegal drugs and the misuse of prescription drugs are serious issues across not just East Antrim but the whole of Northern Ireland. Rising addiction is not just an East Antrim issue. Cannabis, cocaine, synthetic drugs and the misuse of prescription drugs are all in the mix across Northern Ireland, including our constituency of East Antrim. Sadly, we are aware that some schools in East Antrim have to prevent young people going out of school at lunchtime such is the prevalence and proximity of drug dealers at local shops where kids would go for sweets or a bottle of something to drink at lunchtime.

That takes me to the serious concerns about the influence of those who peddle and deal in drugs across East Antrim. Of course, much of that is about getting young people addicted so that they become dependent on the drugs that they have been sold. That leads to serious issues with moneylending and young people being used as county lines, effectively, and transporters of drugs across East Antrim and beyond because of our proximity to Belfast. It is a serious issue and one that is extremely difficult to tackle. As others have mentioned, there are good organisations in the community that have been working hard with young people and those across all ages to deal with the issues. I thank organisations such as Carrick Connect, youth groups across East Antrim and, in particular, Christians Against Poverty, an organisation that helps with debt counselling and supporting families.

This is nothing short of child abuse at its worst, and, sadly, as we have heard, lives are lost. We need to look at the solutions. Education, health support and multi-agency approaches will and can tackle the problem. We cannot set the problem at the door of the police, the health service or schools. Everybody has to work together to address the problems. Good work is going on across East Antrim, but we need to make sure that it is fully supported on a cross-departmental basis. It is important, therefore, that we deliver better services for young people, and it is necessary that we deliver high levels of support. When someone has been identified as a known drug user, particularly through the health service, their death should not be the inevitable outcome. The outcome should be their life, support and an ability to be taken away from the drugs that have been given to them. That is the challenge that all those agencies, particularly the Department of Health, face when dealing with the people across East Antrim who are addicted to drugs.

Mr Deputy Speaker (Dr Aiken): I call Gordon Lyons. Gordon, you have up to seven minutes.

Mr Lyons: Thank you very much, Mr Deputy Speaker. I begin by thanking Mr Donnelly for bringing this important topic to the House and all those who have contributed already. I apologise for not being here for all of the debate due to ministerial business.

This is an issue of the utmost seriousness. We are talking about real people and families and real lives that have been cut short by drugs. The stats will have been well discussed during the debate. Clearly, we need to make sure that we do all that we can and that we take all the action that we can to deal with the issue. I thank the Minister for being here today. Of course, it is not just a Department of Health issue; we all need to work together, as Mr Dickson said, to deal with the pain, sadness and trauma that accompany the use of drugs and drug-related deaths. There is a lot of work that we need to do.

I will focus on the need for us all to tackle the root causes of the issue, and they are many. First, we need to tackle deprivation. People in areas of high deprivation are up to five times more likely to die from drug-related issues. I am pleased that we are taking forward work to tackle deprivation. With my departmental hat on, I thank Minister Nesbitt for the work that he has done with my Department on the drafting of the anti-poverty strategy, which will include steps to deal with deprivation. We know how important an issue that is and how important a cause it is for those who find themselves in this situation. We also need to improve access to mental health support. We all know how difficult that can be for many in our society. I commend the good work that is taking place to make sure that the people who need help get it. I know that, if it were not for those dedicated professionals, we would be in a far worse situation today.

We also need to create opportunities for people, particularly our young people. I do not mean just social opportunities; I mean economic opportunities as well. We need to deal with the availability of the substances in our communities. The PSNI has a particular role in that regard. We also need to break down the stigma that exists around these issues. It is a good thing if someone presents with those problems in order to tackle them. We need to address that stigma and those barriers to treatment. Of course, we need to make sure that we do everything that we can with our young people in terms of education and prevention as well.

We need to recognise the good work that is being done by many organisations in the communities that we represent. I think of the YMCA, Carrick Connect and Extern, which all play a valuable role. One evening in January, I was out in Carrickfergus with CHILL, which does exceptional work with the police to provide safer environments for our young people. However, I heard a story recently from one young user of drugs, who said that he takes drugs so that it does not hurt as much, "when daddy beats mummy and me up". The sad reality of the society in which we live today is that, for too many people, drugs are seen as a refuge from trauma. They are not: that is the message that we need to get across to people in our society. We need to make sure that people never feel that drugs are the only way out. That is the situation that many people find themselves in.

I hope that we can work together across different agencies, Departments and the voluntary and community sector, including many people from a faith background as well. We also need to make sure that families have the resources that they need to tackle the issues. There is no silver bullet to tackle the issue. There is no single measure that Minister Nesbitt can put in place to tackle it.

We are all aware of and have seen at first hand the impact that drugs and drug deaths have on our communities and the pain and sadness that come in the aftermath. I am pleased that there has been cross-party unity on the issue today and hope that that continues, developing into greater cross-departmental working and collaboration, so that we can tackle the issue head-on. As I said at the start of my contribution, we are talking about real people, families and lives here, and it is incumbent on us to do everything that we can to tackle the issue.

Miss Hargey: Thank you, Danny, for raising the important issue of drug-related deaths in the East Antrim area and for securing the Adjournment debate on what is an important and concerning topic. We have seen the recent statistics from NISRA that show that there has been almost a doubling of deaths over the past 10 years. Of course, we are all acutely aware of it, as has been stated today and as we see in the many news articles that appear whenever deaths arise, particularly at times when a few deaths happen in a short period. We are also aware, however, that the stories quickly slip off the front pages of our papers or our online technology, and it is the families who are left to pick up the pieces. We have heard that acutely in relation to the East Antrim area, where seven lives have been lost to seven families over the past year.

Drug-related deaths is an ongoing issue that does not impact on just East Antrim but across all our constituencies and these islands. We know that a siloed approach to the issue will not change outcomes or statistics. We need a more focused, cross-departmental approach and more ministerial and departmental working to set the strategic policy and the strategies. We also need to look at the implementation and at what we can do over the next period. We know that Departments' budgets are stretched and that there is a resource issue. We know the impact that 15 years of austerity has had on public spending and budgets, and we know why we are in the crisis that we are in. You cannot look at those things in isolation, and, for that reason, we need to work more collaboratively and find joined-up working solutions, whether those are at the coalface or the grassroots where the Department of Health can work with the Department for Communities, the Department of Education and the Department of Justice. We need to look at how we can have those cross-departmental teams at the coalface to meet the families and communities that are in crisis, with a focus on delivering preventions and, importantly, interventions. That work needs to include harm-reduction approaches and, importantly, strengthen early intervention and prevention.

We recently saw a review of residential rehabilitation. Our party is one of many that has called for statutory residential services, as we have worked with many families who have felt the impact of this issue, and we call on the Minister to prioritise that. We also call for the full roll-out of multidisciplinary services in our GP surgeries. The work that has been done up to now is having an impact; it is working. The locality planning and approach is bearing fruit, and we would like to see more of that being rolled out. Of course, we also want to see the substance use strategy being fully funded and fully rolled out.

We also know the importance of real-time monitoring and early warning systems, particularly when looking at the issue from the point of view of support. We call for the rapid drug testing pilot, for which Queen's University has advocated, to be funded. When you work in the community and engage with the many groups that have been mentioned today that work in this field, you see how those early alert systems, and the public messaging that follows, are crucial and could, I believe, save lives. I again call for the rapid drug testing pilot to be funded and, more importantly, rolled out.

As many Members who spoke in the debate have said, this issue is not just for the Health Minister, who has turned up to the Chamber this evening, but for many other Ministers in the Executive. There needs to be a collaborative, cross-Executive approach that includes our criminal justice system and the Justice Minister working collaboratively with Health. I sit on the Justice Committee, and our Health and Justice Committees have met on those issues and their impacts on the justice and health systems. It is not just about drugs and substance use; it is about mental health, trauma and support.

Recent police statistics showed that, in a 12-month period, over 35,000 calls related to people in crisis. When you look into those figures, you see the correlation with addiction and substance misuse. We cannot emphasise enough the importance of taking a collaborative, joined-up approach to dealing with these issues.

We also need a robust criminal justice response to criminal gangs, drug traffickers and paramilitaries. In the past month, there have been raids, and a significant quantity of drugs has been removed from our streets. There is an acute need for a robust criminal justice response along with a health-led response. Recent information from a Mid and East Antrim PCSP meeting referred to the case of a young person who was spending up to £50 a day in order to sustain their use of the drug spice, which has a higher potency than normal cannabis. If a young person who is living in that constituency is doing that, I am sure that their story could be replicated across all our constituencies. It is a real issue: that is what is happening in our communities.

Education plays a crucial role for our children and young people, particularly when it comes to the increasing use of vapes in school and the use of other illicit drugs through those vaping instruments. We need the education system to work alongside our family and community supports, including our family support hubs.

Gordon touched on breaking down the stigma. It is a big conversation that we need to have at the heart of our communities. We need to take the conversations to the grassroots in our communities and start to break down the stigma. The community that I live in, the Market area in south Belfast, started that 15 months ago by working with Queen's University's Communities and Place. That took a long time for families, particularly those who have lost loved ones through addiction and substance misuse or through suicide, who are impacted on by trauma —

Mr Deputy Speaker (Dr Aiken): Will the Member draw her remarks to a close, please?

Miss Hargey: — and mental health issues. Feeling that the community is working with you on these things is critical for people.

I commend the Member who secured the Adjournment debate and call for a collaborative, cross-departmental approach.

Mr McGrath: I will not detain Members too long. On behalf of the SDLP, I support our having the debate. My motivation for speaking this evening comes from reflecting on my time as a youth worker nine years ago. There was a group of about 20 or 25 young people who grew up through the centre. They had been there for about 15 years by the time that I left, so I knew them all well from watching them grow up and progress. They are now young adults, and I bump into them regularly around the town where I still live. I bumped into one of them in January. She told me about the work that she was doing in the community; she always had time to stop and talk. Several days later, she died in the very circumstances that we are talking about.

The circumstances that lead people into those situations are one thing, but the fact that they can stay in those situations is another. I feel strongly about that and want to see action taken on it. I welcome the fact that Members have spoken about the cross-party, cross-Ministerial nature of responsibility for that, because I was concerned at the start that it would all be lumped on the Health Minister as the Minister who will respond to the debate. All the approaches that Members have referenced have to be taken because we must tackle this on all fronts. We cannot look at it from a one-dimensional perspective.

When I started as a youth worker, drug education was a big part of our work, but, when I look at youth services now, I see that that is barely part of it. Youth services have completely changed, and it may be that, in those services, we are missing opportunities to do some of the basics.

There is another conundrum, which I have heard about on a number of occasions, that is really difficult to balance. The "dogs in the street" were mentioned. Sometimes, the dogs in the street in our communities do know who is taking the drugs. It is reported to the police, but months and months or maybe even a year or more later, nothing has been done about it. I can understand that, potentially, the police are looking to go further up the line. They get that bit of information and pursue it to get the bigger dealers in the community. However, if you are a family member of somebody who has died, that is tough. It is tough to think that your loved one is sacrificed whilst a different aim is being pursued. That may prevent many more people from getting access to drugs, but it should still be better explained or better detailed to people, because seeing their loved one pass away and the police response being short of what they expect or hope is a bitter pill for those individuals to swallow.

We need to use every opportunity that we can, through the various Departments, to tackle poverty in our community and to use our education and youth services to raise young people's self-esteem and self-worth and give them the resilience to say no to the things that are being offered in the community. We need to have a justice response towards those who continue to break the rules and provide these things, often to our young adults and younger people in our community, that challenges them right where they are doing it so that it is removed from our community. I want to see continued work on that. I welcome the fact that two Ministers have said that they are up for doing something, but I would definitely love to see a cross-Executive response to this. I will continue to ask for that in memory of the face that I saw when I left the youth centre nine years ago and that I saw down the street at the beginning of January and who, unfortunately, is no longer with us.

Mr Deputy Speaker (Dr Aiken): Thank you, Colin. Our thoughts and prayers are with that person and their family. Minister, you have up to 10 minutes.

Mr Nesbitt (The Minister of Health): Thank you, Mr Deputy Speaker. I thank Mr Donnelly and everybody who contributed to the debate.

The statistics have been rehearsed. We can all translate them into an understanding of the human cost of substance use. That human cost impacts on individuals, families and communities. I acknowledge that every life lost is one too many, and I affirm my commitment to doing what I can to tackle this scourge.

The rise in the deaths and the wider harm over the past 10 years has been driven by a whole range of factors, including the availability of new substances, the increased complexity of cases and poly-substance use, as Mr Donnelly said. Behind all that, however, you have a complex picture of determinants. Some are social, some are psychological and some are economic. Often, we talk about the causes of substance use. We say that substance use can cause serious mental harm and serious physical harm, up to and including death, but we need to focus on the causes of the causes: in other words, what makes people want to use substances as they do in the first place. I may come back to that.

Although the conversation often turns to drugs, we should also remember the impact of alcohol. In 2023, there were 341 alcohol-specific deaths registered in Northern Ireland — 341. Rates of alcohol-related deaths here are amongst the highest in the UK, and rates in the most-deprived areas are almost four times higher than those in the least-deprived areas. That is why I think that minimum unit pricing would be a real step in the right direction.

As Members are aware, there is a mix of reserved and transferred responsibilities in relation to substance use. The legal frameworks for the use of drugs, including the Misuse of Drugs Act 1971 and the Psychoactive Substances Act 2016, are reserved to the UK Government. Meanwhile, as has been acknowledged, our Justice and Health Departments work closely with other devolved nations, which work together as well, and with the UK Government on general substance-related issues. There are also established links with Ireland on substance use through the British-Irish Council, which has a specific group focusing on alcohol and other drugs, and through the North/South advisory group on alcohol policy, which was recently renewed. Legislation clearly plays its part in deterring and penalising those who seek to profit from the supply of harmful substances in our communities, but it is vital that we address broader substance use in a holistic way, primarily as a medical and social issue that requires therapeutic interventions and support, rather than focusing simply on the criminal justice outcomes.

I acknowledge the growing support for a public health approach to address the harms of substance use. That is very much at the heart of my approach. Of course, as Members have said, it is not just a matter for the Department of Health. As an Executive and an Assembly, we need to work together to address the wider social determinants that are associated with substance use and the harm that it brings. Those determinants have been well rehearsed, and mental health, housing, economic inactivity and trauma all play their part.

We have an Executive strategy, Preventing Harm, Empowering Recovery, which is led by my Department. We acknowledge that we require a joined-up, whole-system approach, not only in the health and social care system but across all other sectors. The strategy also takes a harm reduction approach by seeking to meet people where they are on their journey, helping them into treatment and ensuring that recovery support is there in the longer term.

When it comes to delivery in Health, the HSC substance use strategic commissioning and implementation plan has been co-produced by the Public Health Agency and the strategic planning and performance group. It creates a new whole-system, outcomes-focused strategic service delivery plan. That covers all tiers of service provision for substance use for the next four years. The plan is part of our wider health reform agenda, which stresses the importance of using our existing services in better ways to meet the needs of our population. However, I also want to be clear that there is already extensive service provision across the region, including in East Antrim and the wider Northern Trust area. That includes services that are delivered in collaboration with the community and voluntary sector, such as youth engagement services in Ballymena, which are delivered by Start360; treatment services for adults who use substances, which are delivered by Extern; and needle and syringe exchange sites along with statutory addiction services, which are provided by the Northern Trust. That is to name but a few. It is important that people know that such help is available, should they need it.

We have made considerable progress in our efforts to reduce harm. By way of example, in financial year 2024-25, 1,533 take-home naloxone kits were dispensed. Naloxone was reportedly used 197 times to reverse an overdose in that same period. Recent legislative changes that I brought forward, which were supported by the House and my counterparts across the UK, mean that even more people can now supply naloxone without a prescription, which, of course, increases opportunities to save lives.

While I appreciate that there is an appetite amongst some Members to go further with harm reduction services, our decisions on which services to prioritise must be evidence-based. I am aware of the overdose prevention facilities that are being piloted in Glasgow and Dublin. While there are no proposals in the strategy for such facilities here at this time, I do not rule it out. We will continue to monitor evidence on the effectiveness of those facilities and other harm reduction interventions. I will also consider what is appropriate under the wider legislative framework.

Finally, I acknowledge the stigma. It is still there. We need to remember that it is about our sons and daughters, our brothers and sisters and our neighbours and friends. It is vital that we do not discourage them from coming forward. It is vital that we acknowledge their issues and permit and encourage them to seek help so that we can make a real difference.

Mrs Dillon: I thank you, Minister, for giving way. I will make it brief, as I do not want to eat into your time. Do you agree that Right Care, Right Person becomes even more important in relation to stigma? It should not be the police that respond to people who are victims and addicts. We should have a health service response for those people.

Mr Nesbitt: I thank the Member for the intervention. Yes, the Right Care, Right Person initiative is the right one, because the police are not generally trained to deal with the mental health issues that we sometimes ask them to deal with.

I will finish by referring to Mr Lyons's assertion that substance use is a refuge from trauma, because I agree with him. I absolutely agree. That is why it is important that we do more to understand the causes of the causes. Perhaps the Executive and the Assembly can inject a little more hope into the lives of those people who are using substances so that they do not feel that they have to inject them. Perhaps we can do more to make people wake up feeling good about life, feeling a bit more prosperous and feeling that using substances is not a valid way in which to feel good about getting through the day.

It is therefore about poverty and hope and about giving people's lives purpose. For me, that is the big challenge that the Executive and the Assembly need to face collectively. Let us give people some hope.

Mr Deputy Speaker (Dr Aiken): Thank you, Minister. I thank Mr Donnelly and everybody else who contributed to the debate.