My Lords, I, too, thank the Minister for presenting this budget. I feel rather sympathetic towards him in that he cannot come here for happy debates. One day, I hope that he will be able to do so. Luckily, much of what I was going to say has been said but, in particular, I would like to say that the noble Lord, Lord Alderdice, looked at this from an objective point of view and gave one or two extremely appropriate conclusions. I think we get too bogged down in the details of what is going on when we must look at how it really might all collapse.
Of course, our biggest problem is that we have a lack of local democratic accountability, with the absence of an Executive currently as a result of the protocol. Therefore, at present, there is only one democratically accountable legislature: here. Of course, we have heard how the civil service is currently unable, because the Government dictates this, to take many of the actions we would like to see. We have this void, or crevasse, between the refusal of the DUP to take part in the Executive and the refusal of the Westminster Government to interfere with theoretically devolved issues—although there have been cases where they have done so, so it is not an impossibility. Abortion may well have been one of them. They can do it if they wish but they do not wish to do it; of course, they have their reasons for that.
However, it is the 1.9 million people in the Province who suffer the long-term hardship—hardly the politicians or the Government. They suffer the damage to civil
society without this democratic accountability and they do not have a say in here. We keep hearing that the position of the Government and the EU is that the protocol, after the Windsor Framework, works okay. I am not totally against it but, to a certain extent, I am fed up with hearing that it is okay because big businesses say that it is. Big businesses can afford to have a back office with half a dozen people scribbling out to cover the regulations but Northern Ireland is not a country of big businesses; there are very few of them. There are thousands of micro-businesses and small SMEs. I know of a haulier whose company, A1 Transport in Fermanagh, employs 85 people. Since this started, he has had to produce 70,000 documents to move his lorries back and forth across the border and to this country. He literally has not got the room to store them. This goes on and there will be even more documents as this business gets tighter.
The DUP has continued, rightly or wrongly, to make a stand against the protocol and the Windsor Framework. I do not like to admit it but the big problem is that so many things that this Government have done have made the average person so very angry in Northern Ireland that they have gone to the extremes. I dare say that the support for the DUP comes largely because people are so unsatisfied with what the Government have done. Legacy was one thing the other day. It has really had a big effect on people; there is a lot of discontent.
However, they are the UK Government and, as the noble Lord, Lord Alderdice, said, they are responsible for the United Kingdom, regardless of devolution or anything else. We, the people in the Province, are caught between two immovable rocks: the DUP and the Government. They are the only people who can ultimately solve this challenge. What we need is real leadership, but we are not getting it. It needs to come from outside those two groups—perhaps from the Prime Minister; we have not seen him involved very much. I am hesitant about the Taoiseach after the things he has said in the last few days; that does not help things either. If we have a compromise or fudge, this problem will return; without a shadow of a doubt, we would be in this position again in no time.
We have major decisions on infrastructure to be made, such as on roads, education and, as we have heard, health. The noble Lord, Lord Alderdice, talked about the disintegration of health, and I will highlight one particular example, without going through all the different parts. South West Acute Hospital in Enniskillen was a state-of-the-art new build opened by the late Queen in 2012. Believe it or not, it has hundreds of single rooms—no wards—clean air technology in the theatres and everything else. It has served a population of 83,000 people. The Western Health and Social Care Trust has suspended the acute services at the hospital due to financial difficulties and other reasons, such as the absence of direction from a democratic authority telling it to get on with the job. I am aware that the decision is statistical and due to a problem with recruitment—that may be so.
I was once on a hospital board in Belfast. It is a medical requirement for most important hospital interventions, such as childbirth, accidents, disease and whatever else to have acute services somewhere in
case things go wrong—the noble Lord, Lord Alderdice, knows that better than anybody. Therefore, those somewhat straightforward interventions now have to go somewhere else, in case the patients need acute help. They have to go to Altnagelvin Hospital in Derry. That means that 83,000 people—if they need treatment; obviously not all at once—have to travel for 60 minutes or more. Of those, 68,000 will have to travel for 90 minutes or more, and 25,000 will have to travel for two hours. That is travel time, let alone the acquisition of an ambulance, which is a totally different subject.
In this country we have a universal postal service, as well as the equivalent in education, although we do not call it that, and health—the right of our citizens to access a service, whatever it is. We know that it costs more to post a letter to, or to run a school in, the outer isles—that is what the universal service is about. The removal of services from such a large number of people in Fermanagh and South Tyrone should be considered unacceptable behaviour on the part of an unaccountable body. But it does not have to be unaccountable if the Government make provision for interfering where things are quite clearly wrong. The health status of 83,000 people is being compromised in a manner that is incomparable anywhere else in the United Kingdom.
It has long been NHS policy to take account of the geographical situation and to compensate where necessary. According to the NHS Technical Guide to Allocation Formulae and Pace of Change for 2019-20 to 2023-24:
“Travel time to the next nearest hospital is an indicator of whether or not consolidation of services onto fewer sites is feasible”—
it is not feasible. We used to have a measure called the golden hour; what has happened to that? Believe it or not, the Western Health and Social Care Trust has said that things have changed and the golden hour is no longer the mantra. But what has not changed is the need; it is identical. The road accidents, childbirth issues and diseases are the same, so what has changed? All that has changed is its decision to not go by the golden hour.
There was a consultation and one of the documents was signed by 30,000 people—30% of the population. It was treated by the trust as one entity. It did not like it at all and virtually disregarded it. I know about consultations; we did one for an inquiry here into bank closures. Every major bank that came to us said, “We’re consulting; don’t worry”. We never saw one bank that failed to close or was turned around as a result of any consultation, so I think that the definition in the dictionary ought to be slightly different.
Will the Government live up to what they should be responsible for: ensuring equal treatment and opportunities throughout our nation, regardless of whether the devolved system is in place and working? That says a great deal about levelling up in our nation, does it not?
1.45 pm