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Ladies and gentlemen, welcome back. Nice to see you all again. And it's great when you move into the second afternoon of a two day conference and the hall is still absolutely round. So I wonder what you've all been chatting about over lunch. Where's Matthew? Matthew stood up this morning and said The first thing that you said he was quite right was to say just an update. Everything is just the same in Downing Street, and it gives me no pleasure to say to the two or three of you who don't know that things have changed in Downing Street and the Prime minister is not well. She is the prime minister, but she's not the leader of the Conservative Party. So there'll be a new prime minister in a week. Um, and fortuitously, we have to politicians on the platform. So however, they're here to discuss health and we will discuss health. So let me just do a quick introduction like one of the things that we've talked about over the last day and a half is, uh, the political vacuum that exists in Northern Ireland at the moment, Uh, maybe you'll dispute the word vacuum, but certainly the unusual political circumstances in Northern Ireland at the moment, Um, and a lack of functioning political leadership, the way in which the system has been designed. And we know that there's a major problem as well across the water in Westminster. So we will address that. That's the context, as I've said several times for the conversation that we're having. But we do want to talk to to leading politicians about their ambition, their priorities, their commitments for the future transformation of health and social care services. Here. That's very important. So let me introduce my my two guests. So Jeffrey Donaldson is the leader of the Democratic Unionist Party. You don't really need me to tell you that. And Collin Gildan, you equally you will not need me to tell you is, uh, senior sin. Fine politician. Still sin fines. Health spokesperson? Yes. And the former chair of the Assemblies Health Committee. So you're both extremely welcome. You're going to speak for five minutes each and then we'll take about 10 minutes of questions. I have cleared this with you already. I I just want to give you an opportunity. Both of you to say something about the political comings and goings that have been happening in Westminster. Uh, Sir Geoffrey, you were in Downing Street talking to lose trust yesterday afternoon. You backed her leadership. Um, do you feel that the rug has been pulled from under you about 10 minutes ago? Well, first of all, we didn't Barclays Trust. We stayed out of the leadership contest because we believe that every political parties, the right to select their own leader. It's not for us to influence what the Conservative Party does. Clearly they have a problem. But the D. U P is no stranger to having its own problems and having to put them back together again. And I think what the Conservative Party needs to do quickly now, and I believe that it will be a leadership contest in a week. Uh, it needs to move quickly. Uh, and they need to get this resolved because we're in a situation where, um you know, the this is affecting the markets. It's impacting on all kinds of aspects of life, so it needs to be dealt with quickly and promptly. When I met her yesterday, she was I'd say there was no indication that this was coming. But when I stood in the lobbies last night and saw the Conservative Party at each other's throat, I knew that the end was just around the corner. And and so it has happened. Um, I've been at Westminster for over 25 years. Leaders come and go, Um, but there's a job to be done over there, and and we just got to continue working with whoever is the new prime minister. Okay, I guess when I said you back, let's trust I didn't mean directly during the election campaign. I just mean you were. You were comfortable with a list trust, lead, conservative party and government. You felt that you could do business with her and she might represent, well, your interests. It gets more difficult now for you. Does it? Potentially? It certainly does. It gets more difficult, I think, for all of us. But we need to say stay focused on getting solutions. And that means in particular in relation to the negotiations with the European Union. I think there's a window here of a few weeks where we can make a real progress, get an outcome and get the institutions restored. We want to do that well in advance at the end of this year so that we can launch into 2023 towards the 25th anniversary of the Belfast agreement and and really launched the next stage of the process which is building prosperity in Northern Ireland for everyone. Okay, sure, people want to talk to you about some of that in a moment or two. Collin Guild Your response to what just happened within the last quarter of an hour in Downing Street? Well, I suppose I have to say it's it's one of dismay for for people out there who so badly need direction so badly, need decisions we're facing into what is going to be very difficult and a very challenging winter in terms of the cost of living crisis. We already dealing with significant health crisis here in relation to coated, which is still ongoing. All of those additional winter pressure's all of the pressures that were already in the system around health and social care, and people need stability and structure and decisions. And I think the the shambles and the chaos that's unfolding in London is really worrying for people out there who are already very anxious about how they're how they're making ends meet at the minute where their mortgages are and all of that. So it's not good. Yeah, and people will also say that that's fine. Fair comment. Perhaps they may say about Westminster, but you know, local politicians as well are responsible for a dysfunctional legislation, legislative assembly and a dysfunctional executive. At the moment, I'm not inviting the two of you to point fingers at each other, but the reality is that our politicians here aren't doing the job fully in the way that they're being paid to do it well and equally the reality. And people know that it's a reality that we in sin fine and four of the five parties are ready right now to sit there and restore that executive. There's been an election that that process been held. It's incumbent on us to sit down together, to get ministers around the table, working on the issues that we need addressed. Okay, let's talk about health because that's what you're both here to do. Um, we'll take questions from the floor in about 10 minutes time, but can I invite you first of all, so Jeffrey as the party leader to come up and share your thoughts with the assembled audience on what you think the challenges are and what the solutions might be for health and social care in Northern Ireland at the moment. And you are very welcome. Good afternoon, ladies and gentlemen. And thank you so much for this invitation to be here this afternoon. And I really do want to be engaging and continue to engage with people who work in the health and social care sector. And I've met as party leader many of the organizations that you represent and we'll continue to engage. I've got Pam Cameron with me today. Who is our health spokesperson in the Assembly. Pam is meeting regularly with the groups, the party leaders. This morning. You'll be glad to know Mark met Stormont. We are continuing to meet as parties to look at what we can do to ensure that people get the support they need at this time. And that support primarily comes from Westminster because that's where the money is to deliver the support. And we're continuing to work on that. And I know that the theme for this conference is about recognition, ambition and mobilization. I just want to very briefly address those three aspects of of your theme into at the outset. Very sincerely. Thank you for all that you have done not just through the pandemic, but continue to do within the health and social care sector. Um, and that covers the whole range of the sector, from virologist to, um, administrators to the people on the front line in the wards and hospitals. And I know how difficult and challenging it can be at times. And secondly, ambition. Um, that And I understand that you want to have the ability to do the job you were trained to do to the best of your ability. Uh, and it is true that at the political level, we need to look seriously and how we can help you to do that more effectively. We've talked for many years about reform, and there are lots of reports on the shelves. Stormont, about reform. We sit in our manifesto in May that we want to translate that reform into action that makes real change and delivers real change to how we do health and social care and deliver for the people in Northern Ireland. That remains our position. And we're engaging palm as part of a working team working alongside Robin Swan to take forward the measures that are required to deliver that reform. So even though we have ministers in place, Stormont, Yes, The executive is not meeting formally, but those ministers continue to do the work. And it is not true to say that nothing is happening. That group, that working group, is working towards the delivery of healthcare reform in Northern Ireland. And my party fully supports that and wants to see it and once recognizes it must be radical. Uh, we're we're not going to hold back. We know what needs to be done, and the political will is required to do it. Uh, and I can assure you, from our perspective, we are determined to deliver that to its fullest extent so that we change the way in which you are able to deliver the care and support and the treatment that people need. And then thirdly, mobilization. I recognized as a big problem at the moment in terms of retention and recruitment within the health and social care sector. A lot of that is down to pay and it is my view on the view of my party that we need to sort this out once and for all, that we need a decent pay awards that invests in our healthcare workers that enables people to feel they are valued and can stay working in the health service because we can do all the reform we want. But if we don't have people who feel they are valued and and who are working to deliver those reforms on the ground, then it will fall flat on its face. So we need to invest in in the health and social care workforce. We need to deliver decent pay awards, um so that not only are people rewarded for what they do, but that that we we drive up recruitment and retention in the health service itself. We all know that in primary care there's a major problem at the moment with our GP practices and we're looking at ways in which we can ensure there is better support for the delivery of primary care were engaging with GPS about how we can make that more effective. Palm and I've been meeting the GPS to see where the problems are and to design and deliver the solutions that are required. Uh, and in my own constituency, for example, we've got a new primary healthcare center. Cool. Okay, Did with the leg in Valley Hospital and we're joined up Approach to delivery of primary care with diagnostics and with treatment that will be, I believe, will be make a transformative difference to the community that that primary care center and hospital will deliver. And that's what reform can look like. That's what change can look like when you invest properly and cleverly in how you deliver effective healthcare. So, Mark, it's a pleasure to be here. I'm more than happy to further engage and thank you for this opportunity, Jeffrey. Thanks very much indeed. Let me invite Collin building you to, uh, share his thoughts with us. And you're also very welcome, Gourmet. Mark. I'm Tasha on her more dementia. It's very great honor and delighted and I want to thank the necon for inviting us. I would also like to extend Michelle O'Neal's apologies. She hasn't been able to make the meeting today, given everything that's going on. Um, so I just like to say first of all, the symptoms are completely committed to universal healthcare, free at the point of delivery based on a person's need, not their ability to pay. We want to transform and modernize the healthcare system to ensure that the provision of universal healthcare not only survives but thrives and improve the lives of those that rely on them. That needs to be done in partnership with health professionals, staff, trade union representatives, service users and communities. And I'm absolutely delighted to see so many people here today and to see such a buzz and positivity in this room and from so many health professionals, and that gives me significant heart in relation to the quality of leadership we have in this room and outside. Currently. However, despite the best efforts of our work force, patients are often having to wait unacceptably long times in emergency departments to get urgent care. Those including Children suffering with poor mental health, face long delays in receiving the right support. Workers and families are finding it difficult to get timely appointment with the GP, particularly since the coated pandemic and those curing for loved ones are struggling to access your packages and support for vulnerable members. of their families. Of course, no one is more aware of these pressures than those of you who are working in an increasingly pressurized system. We have seen over the past few years how really important all of our health and social care workforce are. And we owe you a huge debt of gratitude for everything you've done in the run up to covered during coated. And in this period of time when we are dealing with so many other pressures. Carmilla myograph color The reality is that health and social care workforce is central to the provision of the universal healthcare system now and into the future. Workers across the system, working in hospitals, care homes, health centers and caring for people in their own homes who are over stretched and under pressure before the pandemic, are now simply exhausted. We have vacancy rates in nursing of over 10% and over 6500 vacancies, right across health and social care symptoms of over a decade of Tori austerity and cuts to public spending. If we want to deliver timely access to services and achieve better health outcomes to the community, then we need to support the workforce. To do that, there's a clear need for work force plan to be put in place and for safe staffing. Legislation to be brought forward and those working in health and social care also need to be valued. Applauding the dedication of health workers during the pandemic was an important expression of solidarity and thanks, but it doesn't pay the mortgage and it doesn't put food on the table. Health workers deserve and are entitled to fair pay and conditions, and the realization of that is vital if we have to keep the workforce. We currently have recruit more staph, which we so badly need, and protect front line services. Ultimately, we need to prioritize health. That is why I said fine. Finance Minister Murphy proposed to make health the executives number one spending priority Minister More for proposed increasing the health budget by 1 billion lbs over three years in his draft budget, a three year budget and that is crucial. A three year budget would give greater clarity to the Health Department and thrusts to invest in services and the workforce. The absence of an executive prevent this from happening. It prevents us from investing in the health and social care workforce, tackling waiting lists, implementing important strategies like the mental health and cancer strategies. The need to do better for our Children as we discussed in an earlier session here this morning and ensuring people can see a GP when they need to. All these and more need an executive in place. Of course, it is also true to say that a re established executive by itself cannot fix all of the problems, Finance Minister Morphy wrote in July along with his Welch and Scottish counterparts to the British Chancellor, urging him to develop a fair approach to public sector pay which values workers. The letter also called for an increase in devolved budgets to deal with significant emerging pressure's, including in the health service. The British government do need to step up and start taking decisive action in response to record breaking inflation. Impacting public finances and what we're seeing and folding across the water at the minute is clearly going to impact the ability to do that. However, notwithstanding the challenges if we as political representatives here genuinely want to start to repair our health service if we want to plan sustainable services for the future. And if we honestly believe that we can make a difference to people's lives, then let's get the executive back up and running. Let's get the executive back working with everyone in this room and with those outside to deliver a better health and social care service for us all, or okay, thank you very much indeed. Come too quick. Questions from me. And then do we have other? We have microphones. Do we? And we can take a few questions on the floor. So, Jeffrey, can I just ask this question? I suspect I'm asking it on behalf of at least some people here today. You talked about the party leaders having met, We talked about ministers remaining in post. Robin Swan was here yesterday, and I made the point that he is probably an old problem. Unless you can tell us otherwise. In all probability, in his final few days as health minister, because of your actions, they will not been swollen, and others will not be in post from next Friday. And we'll be facing a December election when health and social care services are facing the enormous pressures they are. Why is that okay? Well, I've never said it was okay. And it's not my decision to call an election. Uh, that is a matter for the government, but you can decide to go back and say well, and the government can also decide to amend the legislation to extend the period once the negotiations continue with the European Union. I have to say that if the government is really committed to getting an outcome, getting the protocol resolved and then next few weeks and providing the stable basis for government in Northern Ireland, then it doesn't matter for them to decide whether the way to do that is have an election. Personally, I don't feel an election. I'm happy to take my case to the people, but I don't believe in election will change anything. It won't solve anything. Um, and I'm interested in getting this thing solved. I've been patient. I've waited. What's The Conservative Party had their difficulties over the summer? Um, there was nothing happening, I said, Well, then let's at least get back to the table in the autumn and get this sorted out. And I just think that the problem with an election at this time is that it. It moves back the period when we'll get an agreement and we will get this resolved. So I don't I'm not proposing an election to solve anything. Uh, the government has it within their power. The government can do many things and have done many things. They can introduce legislation like that to extend the period further, to allow for the negotiations between the UK and the EU to come to an agreement. I think there's a will now to get it done. Uh, and I think an election actually would get in the way of that. But notwithstanding, if the government decided to hold an election will fight the election. But I'm clear. I'm trying to look at the bigger picture, and the bigger picture is mark. An election won't change things. It won't get us to a solution. And what we need is get that solution, get the political institutions back up and running on a stable basis. And if we do that, I I think we'd be in a better place. I'm not sure this government could introduce legislation, not anything like that, but well, I guess we'll find out in due course. Well, I have the power to do it, Mark, Why couldn't they do? They've done many things in the past, and the next part is falling apart next. Well, next week next week in the House of Commons, we will have the final stages of a bill which deals with a devolved issue which the government decided to take back to Westminster and legislate on, even though that is a matter for the assembly. So I'm sorry, Mark, but the government can do many things and has done many things. It needs to decide what is more important, taking forward the negotiations and getting solution or having an election. My view is very clear. Let's get to the solution and get political institutions restored. Okay, Um let me ask you this question very quickly, and you touched on it in your in your presentation there. Why does seem fine. Continue to give the impression that the reasons that there are funding difficulties in the health service and another department here in Northern Ireland because the Treasury doesn't give us enough money when we get more money in Northern Ireland pro rata than anywhere else in the United Kingdom. Well, we don't give that impression. I don't I don't agree. Um, clearly, Murphy identified from our own budget one billion additional. However, my reference there is in relation to the inflationary pressures to pay uplift. And those are things that are within within Westminster. And I make no apology for people here who pay their tax who work in the health service and who are in need of services that we make that case. And it's also obviously relevant that we've done that in conjunction with Scottish and well and well, sh administrations as well. Okay, let's take a few quick questions here, mindful that there's another session. It's very important coming up. But I think since the day that's in it and the fact that have to significant politicians here, we should We should hear a little bit more from the somebody there just with you, whether yeah, okay, can you keep quick question and we'll get some quick answers. Hello, I'm Joanne Roads from the Health Innovation Research Alliance, Northern Ireland, and we are very much about health and wealth in Northern Ireland. And during this conference we've heard that 1 lb investment in health delivers a 4 lb return to the economy, and we've also identified as we've published our report that an investment in health produces economic returns for the country. This will require cross departmental work across health and economy and also education to actually bring forward the skills and the workforce that we talked about. Are there opportunities without an executive in place to begin to build that, so that when we do have the opportunity, we can move quickly so that we can deliver these things ready for the health of our citizens? Our workforce and our business is here in Northern Ireland. Okay, Do you want to comment on that column? Well, I agree in relation to the impact we get. There is not a health profession in this room. He doesn't understand that if we can move, particularly if we can move those resources out closer in the community to where people are via multidisciplinary teams via better mental health services, via a resource can answer strategy. All of that work should be continuing within the Department of Health. There's absolutely no question about it, however, it will require resources, and that budgeting process is not in place at the minute to carry out new initiatives like that, and it's incumbent on us to ensure we get that done as quickly as we can. Thank you, sir Geoffrey. Yes. And that's why, uh, Pam and the working group that's working alongside Robin Swan are are looking at What can we be agreeing now and putting in place so that as soon as a new minister is appointed, uh, there is a direction of travel, a plan that we can work too, So that work and those discussions are taking place. But I also have to be honest, and we have to be realistic at the cost of living. Doesn't just impact on households in Northern Ireland. Every hospital at the moment is running 24 7 the cost of heating. Our hospitals are clinics are schools are all of our public infrastructure. Northern is going through the roof, and it is eating up all the additional money we have at the moment. The Northern Ireland executive is projecting and overspend this year and overspent in health alone of 450 million and in total almost a billion pounds above what we have in our budget. Now here's the problem. Next year, the Treasury say that that money will come off our budget allocation next year. So if we overspend by a billion, that billion comes off budget next year, so we have one billion less to spend. So what we need to do is make the case to the treasury. And that's what we're doing that to drive forward the reform and change agenda, we need that additional funding in order to be able to create a better return for the money that is spent in health. By doing precisely the kind of things that you're you're talking about. You do have to invest to get the results that you're talking about. So that is going to require, um, a an approach to treasury. We're gonna have to pitch for that money, um, to ensure that we can deliver the investment that's required to get the results. Okay, thank you very much indeed. You're all very polite. I'm going to take one. Last question is from Professor Mark Taylor from the Royal College of Surgeons. Thank you very much, gentlemen. And thank you for acknowledging the dedication of health and social care staff. Thank you for also recognizing the energy in the room. Uh, bingo. A 2016. Obviously had five party support. Um, there was a plan within Bingo? A. It said we need to face the change needed or have unplanned collapse of the health service. How true we were in that document because we had three years of political situation. We had a pandemic that no one saw coming. Uh, and we now have political instability again. Um, how long do you think the survival of the NHS in Northern Ireland has And cannot reflect a change of emphasis on the priorities of Northern Ireland at this present time? Jeffrey Mark. In truth, I don't know the answer to your question. I can't be precise, but I can say this time is of the essence, Which is why we want to get things sorted out now. And that includes I mean, you know, the protocol isn't just some sort of anomalous creation. It impacts on healthcare delivery as well. Uh, and you know, I'm aware of the situation a few weeks ago in Belfast hospital where heart operations life saving operations had to be postponed for three weeks because the protocol prevented that hospital from getting the equipment that needed from a supply and written. They had to go halfway across the world and it took three weeks to get it to Northern Ireland. Three weeks when people who should have been having life saving surgery weren't getting it. So for the sake of all of us, let's get this sorted out within the next few weeks. Let's hit the end of the year, Get the executive up and running and, uh, within the next. And and the plan that we've been engaging with Robin Swan on is to immediately prioritize. Number one. Priority is to is to initiate the healthcare reform process immediately. Um, and you get on with that. So look, I don't know how long we have, but I know this. We cannot delay any longer. As soon as that executive is fully functioning, let's get that reform process underway. The plans are being laid. The discussions are taking place. No time is being wasted. We want this to happen, come well in relation to How long do we have? I don't think we have Any time we're not facing. The crisis were in the crisis and there are significant already challenges, and it's largely down to the goodwill and additional work of staff on the ground that are that are keeping services propped up. So we need to transform. Now we need to engage in the process. We need to get out into communities, and we need to frame this around the opportunities. It cannot all be around costs and loss. We need to go out and set out how things could be done differently. We need to show political leadership to do that, we need to work with everyone in this room. We need to work with staff representatives, and I believe it can be done. But the thing is, we don't have any time to lay in doing it. None. I mean, it's a sad state of affairs. I suppose that you even have to ask the question. Mark. Yes. Marks. Nodding in agreement. Um, is there anybody else wants a quick final one? Are we all? Are you broadly happy? We've covered quite a bit of ground there in a relatively short period of time. Um, final thought parting thought anything for people in this room to be optimistic about in the political world to Jeffrey, that you want to draw attention to to leave people in a positive frame of mind rather than negative. Yeah, absolutely. I I grew up in the Kingdom of Morn and spent most of my childhood with the more mountains as as my main view. And I take the view that when you consider where we come from, the Northern Ireland, the mountains we've climbed already are far higher than the ones that are in front of us. So I believe this can be done. I believe it can be done within the next few weeks. I believe we are seeing now the political will developing an emerging to get it done, to get it sorted out, to ensure that the foundations that are place for political stability and to launch the prosperity agenda in northern for the next 25 years, I think is critically important. So the next few weeks are going to be, I believe, the decisions that are taken in the next few weeks and that includes elections and all of that mark will shape the future of Northern Ireland for some time to come. I've moved in in my journey over the years of the peace process and on that and so I've gone from being a pessimist to being a realist to being an optimist, and I do believe in this place. I believe we can make it work. We want to make it work. But for goodness sake, government make the right decisions over the next few weeks. Focus on what needs to be done and get us a solution. So we're going to see compromising political leadership between now and Christmas. Election. Well, we need to get an agreement. Market agreements mean sitting around the table and hammering out a solution that everyone can support and live with. Okay, calm. Send people away in a positive frame of mind. If you can't, that's all. Well, I have to say like it is. It is apparent, and I'm delighted to see so many people have met over over the past number of years. We have some of the best health leaders and health professionals in terms of their commitment, their passion, their knowledge and their ability to turn this situation around what I think we must do. And this is where I differ from Jeffrey, I don't think we can afford to wait for the order to emerge out of the chaos of what's happening, and I think we need to sit down right now. We need to get ministers around the table. We need to get an executive reformed. We need to clear that budget to put an extra 1 billion lbs into health, and we then need to work together to transform how we deliver health and social care. Okay, we'll leave it there. Folks, listen, we appreciate you both busy people, and we're very grateful to you for making time to be here today, Jeffery Donaldson column tells you. Thank you very much indeed.