Northern Ireland Assembly, 14 May 2001

86 contributions from 38 members. The official report.

Assembly Business

John (Speaker, Belfast East)

Order. During Question Time on Tuesday 8 May, the Deputy Speaker, Mr McClelland, was asked to rule on whether Standing Order 19(2)(b) had been breached during a supplementary question by Mr McGrady to the Minister for Social Development. I have read Hansard Volume 11 No 1, pages 21 and 24, and I am satisfied that Mr McGrady was asserting variability of quality in the work of housing associations. The Member’s remark was not, in itself, an allegation of malpractice, and I do not believe that a breach of that Standing Order occurred.

Later that day, during the debate on the motion of no confidence in the Minister of Education, I was asked to rule on an allegation that Rev Dr Ian Paisley had made unparliamentary remarks from a sedentary position. I remind Members of my previous ruling of 4 December 2000, recorded on page 425 of Hansard, that unparliamentary remarks made from a sedentary position are no more acceptable than those made from a standing position.

I have examined Hansard and found some ambiguity over whether Dr Paisley was referring to Mr Adams, the Member speaking at the time, or to the person being quoted by Mr Adams. Mr Peter Robinson made clear his view of to whom Dr Paisley was referring, but I have also previously ruled that no Member may make an interpretation of what another Member said. I therefore call on Dr Paisley to say to whom he was referring and to clarify his remark.

Ian Paisley (DUP, North Antrim)

Page 40 of Hansard clearly shows that what I said was in relation to the letter and to the accusation made in it.

I was not referring to the Member. I was referring to the man whom he quoted as having made the very serious statement that I was trying to set up Roman Catholic people, probably to be murdered.

John (Speaker, Belfast East)

A remark can be unparliamentary only if it refers to other Members. If, as Dr Paisley has clarified, he was referring not to Mr Adams but to the man whom Mr Adams was quoting, then the remark cannot be deemed to be unparliamentary.

Dr Paisley also rose on a point of order, contending that the remarks were not true and that they were an incorrect quotation of him. That in itself would be unparliamentary. Therefore, I ask Mr Adams whether he accepts Dr Paisley’s contention that the remarks that he quoted were not remarks that Dr Paisley had made.

Gerry Adams (Sinn Féin, Belfast West)

I accept your ruling on the matter but draw your attention to when Dr Paisley made his interruption. I had said that

"Dr Paisley asked the people of the Shankill what was wrong with them, because there were papists living at 425 Shankill Road, 56 Aden Street and 38 Crimea Street. I forgive the Rev Dr Ian Paisley for these remarks."

Then he interrupted to say "Liar".

Secondly, I believe that what I read is an accurate reflection of a report of remarks made by Dr Paisley at that time.

John (Speaker, Belfast East)

The Member has said that, at that point, he was not quoting from the person from whom he had earlier been quoting but was speaking in his own right. That is a clarification of Hansard. However, Dr Paisley’s point is that the report was not factually correct and that that is not what he said. That is what the Member maintains. To quote a Member as having said something that he or she did not say is unparliamentary. Dr Paisley has said "This is not what I said." It may be that someone else put it in a newspaper, but I have often said that newspapers are not entirely reliable in some of these matters. Does Mr Adams accept Dr Paisley’s contention that he, Dr Paisley, did not say the things that he was quoted as having said?

Gerry Adams (Sinn Féin, Belfast West)

I do not accept his contention. I note what Dr Paisley has said, but I only have his assertion about this. I believe fundamentally that he addressed the word "liar" to me and not to anyone else.

John (Speaker, Belfast East)

I will have to give further consideration to the matter, because when a Member says quite clearly that the report that another Member is quoting from is not true, it is normal practice to accept that. The Member is saying that he does not accept the contention that the Member makes and that it is not a true report. It may be a report that was given in all good faith — indeed, if it were not, that would be unparliamentary — but that is not the question. The question is whether the Member now accepts Dr Paisley’s contention that he did not say these things and that they are not true.

Gerry Adams (Sinn Féin, Belfast West)

I do not accept his contention, but I have noted what he has to say. In fairness to him, I will check the report, and if it is then my view that I am wrong, of course I will come back and make that clear.

John (Speaker, Belfast East)

I will make two points, and the Member will be given an opportunity to respond.

Whether it is a correct quotation of a newspaper report is not actually the point, because the newspaper report may not be true. That would be the reporting of an untruth, if one accepts what Dr Paisley has said.

The Member will, of course, have an opportunity to reflect, as will I, and to review Hansard. I emphasise the view about what would constitute unparliamentary language. Whether a report is true is another matter.

Ian Paisley (DUP, North Antrim)

I do not need the forgiveness of a man of the ilk of the Member for West Belfast. I never made any such statement, and if he was so keen to search for and get one, why did he not bring the proof? Other matters were mentioned, and we now have Hansard to refer to. I will be making a personal statement to the House about other matters that are incorrect and untrue.

John (Speaker, Belfast East)

I ask Members to reflect on what they have said and what has been said. I will be reflecting upon the matter, studying Hansard and taking a view on what Members subsequently say. I hope that I have made the position clear. If any Members are in doubt, they should consult ‘Erskine May’.

During the same debate on 8 May, my attention was drawn to an allegation that a Member made gestures across the Chamber. These were not observed by the Speaker. I asked for the videotape of the proceedings to be viewed, but no gestures were recorded.

There are some circumstances where gestures between Members would be a return to a more primitive form of communication. Sometimes it may be the only direct form of communication between Members, and in such circumstances it may be interpreted as an advance. I have consulted ‘Erskine May’, and there is no indication of what may constitute unparliamentary gestures. They do not seem to have needed to rule on this matter in other Chambers. It is difficult enough to identify unparliamentary words, without trying to identify unparliamentary gestures. One could understand that there would be some gestures that would not only be unparliamentary but would also be extremely rude. I hope that such behaviour would not become practice in the Chamber.

On page 389 of the current edition of ‘Erskine May’, the Speaker rules on the question of Members using diagrams to elucidate their statements. The Speaker has said that

"Members should be sufficiently articulate to express what they want to say without diagrams."

I trust that I may refer to this as a precedent for gestures or hand signals. I emphasise that Members should communicate only through the Speaker — and in words.

Gerry Adams (Sinn Féin, Belfast West)

Tá mé buíoch díot ar son na hoibre a rinne tú faoi mo ghearán. Ach ar chuir tú aon cheist ar an Uasal McCartney? I appreciate the work you have carried out in investigating my complaint. Did you ask the Member, Bob McCartney, about the gesture he made?

John (Speaker, Belfast East)

I did meet with Mr McCartney; I always try to be in touch with any Members on whom a ruling is going to be made in order that they can be in the Chamber if possible.

It is not always possible actually to speak with such a Member, but I do try to make contact with him or his representative. However, I was able to make contact with Mr McCartney and meet him.

The Member and the House know that it is not appropriate for me to divulge what happens or is said between a Member and the Speaker. I treat such meetings less as time in the confessional and more like appointments I would have had during my previous professional practice. However, as a result of that meeting, I am satisfied that no untoward intent was meant by any of the gestures or gesticulations made in any part of the Chamber at that time — I am content about that, and I think that I have followed the matter up with some due diligence.

I trust this is of some reassurance to the Member — although perhaps not a full reassurance. Members from all parties often have conversations with me, and it would be wrong to divulge those conversations other than as I have done.

Gerry Adams (Sinn Féin, Belfast West)

Further to that point of order. It may be appropriate for you, as a former psychiatrist, to use those rules. I welcome your ruling about hand signals or gestures. However, my Colleague gestured towards me as if pointing a gun and pulling the trigger, and I want that on the record.

John (Speaker, Belfast East)

As Mr McCartney has been referred to, I will give him an opportunity to respond.

Robert McCartney (UKUP, North Down)

I am grateful, Mr Speaker. I find it ironic — almost a macabre joke — that the president of a party inextricably linked with an organisation reeking with blood should suggest —

John (Speaker, Belfast East)

Order. An accusation has been made. If the Member wishes to respond to the specifics of that — to whether the accusation is true — he may do so briefly in context. However, this is not an opportunity for a speech on the matter.

Robert McCartney (UKUP, North Down)

I accept that.

The Member suggested that I made a gesture as if pointing a gun, and that needs explanation. After a particularly unctuous speech by the Member, in which he talked about cleansing streams flowing under bridges, he sat down, looked across the Chamber at me and put up his hands as if in resignation or supplication — looking hard at me. I indicated to him by gesture — because I do not converse with the representatives of terror — the following: shaking my head, which meant "No", and making a gesture with my hand, which meant "guns". I will have discussions at any time with any representative of a political party, whatever his previous background, when he no longer fronts organisations armed and dedicated to terror, whether Republican or Loyalist. That explains entirely my response by gesture to the good Mr Adams, who had just made this horribly unctuous address.

John (Speaker, Belfast East)

Order. I trust that the House can see my dilemma. There appears to have been no direct communication through the Chair on this occasion, and what communication there was was by way of hand signals. I am hesitant to intrude upon that. I call on the House to communicate through the Chair and to do so in words, since I cannot hope to convey the meaning of gestures.

Gerry Adams (Sinn Féin, Belfast West)

I want to welcome what is obviously a big advance in communication for the Member. However, I reject entirely his explanation.

John (Speaker, Belfast East)

Order. Sadly we must bring this matter to a close and give the Minister an opportunity to communicate to us on the very serious matter of foot-and- mouth disease.

(Mr Deputy Speaker [Mr McClelland] in the Chair)

Foot-and-Mouth Disease

Brid Rodgers (Social Democratic and Labour Party, Upper Bann)

I regret that it has taken 20 minutes to get to this very serious issue, about which people are extremely concerned. There has been some unfortunate point scoring, but as you say, Mr Speaker, if there is communication, at whatever level, that is all to the good.

Because I have been awaiting the final test result from the laboratory in Pirbright, Members will not have received a copy of my statement in accordance with Standing Order 18(1). I apologise for that. Copies are available from the Business Office.

I want to spend a little time bringing Members up to date with the current Northern Ireland foot-and-mouth disease position. I would then like to refer briefly to my policy on movement controls before explaining something about the testing work that my Department is doing, which seems, judging from the media coverage it occasionally gets, to be poorly understood.

The position remains as it has been for some weeks now, with a total of four confirmed outbreaks – one at Meigh, County Armagh; two at Ardboe, County Tyrone; and one at Cushendall, County Antrim. In addition to those confirmed outbreaks, we receive from farmers and vets regular reports of suspicious symptoms, which we thoroughly investigate. We are also performing blood tests on sheep to determine whether any of them have been exposed to, or are harbouring, foot-and-mouth disease. I shall say more about that in a moment.

As Members will be aware, we have been investigating one suspect case relating to sheep at Ballycastle that were exhibiting some suspicious symptoms. Samples have been at Pirbright for testing, and I am happy to confirm that the definitive results — which I received this morning — are negative.

My Department’s vets are continuing to follow up a number of tests that require further investigation. For reasons I will explain in a moment, we can expect that pattern to continue over the coming months, but, as far as those particular investigations are concerned, it is fair to say that we are not unduly worried about any of them at present.

That sums up the present situation. Encouraging though that is, I am acutely aware of the effects that the livestock movement controls have had on the industry since I had to ban all movements just before Easter. Over the last three weeks or so, I have been able to ease that ban progressively. Doing so is a balancing act between the risk of spreading the disease and allowing some semblance of normal farming practices. I have, therefore, permitted the movement of certain livestock in certain circumstances, provided that the necessary disease control conditions are met. I have agreed that my Department will meet the costs of veterinary certification in those cases.

Assuming there is no radical change in the underlying disease situation, further relaxation of the movement controls will be permitted next week. I have already announced the relevant details, in response to calls from Members and from the industry, to allow people to plan accordingly.

I have also announced a further limited welfare disposal scheme for cull sows, which at present have only very limited market outlets available. Members may also be aware that, following representations to the European Commission, I have secured a concession in relation to the completion of integrated administration and control system (IACS) forms in Northern Ireland. While the deadline for the submission of those forms is tomorrow, 15 May, farmers will have until 30 June to make amendments to their forms.

Finally, I have been conscious of the difficulties that the foot-and-mouth disease controls pose for the beef special premium scheme. My staff have been unable to carry out the necessary inspections and ear notching. Therefore I have arranged that when movement controls are relaxed on 23 May and farm-to-farm sales resume, farmers will be able to phone, fax or write to the Department and, on the basis of the relevant ear-tag numbers, establish the premium status of the animals that they are considering buying.

I hope that Members will agree that those measures represent a reasonable response to the industry’s most pressing needs.

I want briefly to clarify the blood testing programme that my Department is currently undertaking. It is a screening programme designed to determine whether foot-and-mouth disease is still present in Northern Ireland. It is likely to extend over the coming summer to all the areas where sheep are traditionally kept. We are starting with the surveillance zones and any related tracings before moving out to the main sheep areas.

The testing is known as serology testing, and it looks for antibodies to the foot-and-mouth disease virus. The presence of those antibodies means that the sheep has been exposed to the virus at some point. Such sheep do not have clinical foot-and-mouth disease, so the discovery of antibodies does not constitute an outbreak.

They do, however, pose a potential threat to other livestock, which could in turn develop foot-and-mouth disease, so our policy is to slaughter them.

The serology testing is carried out by my Department’s veterinary science division at Stormont, which has the capacity to handle 10,000 tests per day. Over 82,000 blood samples have been processed up to 10 May, 43,000 of those in the previous week. This is only a screening test, and it is not 100% accurate. It will produce some false positives. That means that all positive results from serology testing are sent to Pirbright for more exacting tests, and this process can take up to one week. Unfortunately, some of these cases have been picked up by the media and presented as Northern Ireland’s next outbreak. That announcement is at best premature, and at worst wrong. We are not complacent when such a result emerges. The flock involved will be visited, restricted and clinically examined, and additional blood samples may be taken. As we are dealing with a screening test which is a relatively blunt instrument, we can expect to see flocks restricted in various parts of Northern Ireland over the next few months. There will also be an occasional sheep cull. None of this means that we have serious fears that the flocks in question are infected; it means that we are taking no chances.

Looking further ahead, I intend to reopen the case for Northern Ireland to be regionalised for foot-and-mouth disease control purposes. The results of the serology- testing regime will be crucial in achieving that status and reopening our export trade.

Even though we have had no new outbreaks for several weeks, it is vital that we keep up our guard. We have been here before, just prior to the Ardboe outbreak at Easter. While we still do not know how the disease got from Meigh to Ardboe, it is certain that illegal movement of livestock was to blame. It is important that farmers continue to practise fortress farming, and that everyone continues to adhere to the movement controls that are in place. Our biggest threat continues to be complacency.

Ian Paisley (DUP, North Antrim)

I welcome the Minister’s statement and thank her for letting us know that this statement would be made.

The House will be happy about the good news from Ballycastle. We are thankful to Almighty God that the disease has not affected Ballycastle, because with sheep running on the mountain tracks, it would have been impossible to contain the disease. Is this the final statement from Pirbright?

I welcome the forms. Do they go with the forms being filled out by farmers using the mountains in south Down? In 2000, the Minister helped farmers in that area. Will those farmers be helped in the same way this year?

How is the process of compensation advancing, and how many farmers have already been compensated?

Brid Rodgers (Social Democratic and Labour Party, Upper Bann)

Full testing has been carried out for Ballycastle, and that is the final result.

The situation in the Silent Valley in south Down remains as I have previously explained. The force majeure concession cannot be applied in 2001 because the grazing ban has now been in place for some time and must be taken into account. Farmers were aware of that in time to make other plans. Consequently, the farmers affected cannot claim the Silent Valley land in their integrated administration and control system (IACS) land declarations for 2001.

As far as I am aware, the compensation paid to date is almost £1·3 million, and that is just in the Meigh area and that of the south Armagh cull. No other compensation has been paid to date, but I hope that it will be fairly soon.

George Savage (UUP, Upper Bann)

It is gratifying to note that there are no more outbreaks of foot-and-mouth disease and that that is the final report from Pirbright. I also welcome the news that the cull sow scheme has started to get under way. It is long overdue. There are many things that one could say about the present situation. Dr Paisley raised the issue of compensation for farmers affected by this disease. I hope that something can be done about that fairly soon.

We can all learn from what has happened. We should be starting to think about a common enforcement policy between the North and the South. There seems to be a variance between the actions of the two Departments.

I have been taking many calls over the weekend about the Minister’s decision to ban horse racing, especially at Downpatrick. I ask the Minister to look very seriously at that, because this is an industry that has come through a lot. There are so many people involved in the horse racing world. If they do not get a race or two, all their work over the last year will have been to no avail. The situation in the South is totally different to what it is up here. I know that she is very conscious of the regionalisation system, but I ask the Minister to look seriously at horse racing.

Brid Rodgers (Social Democratic and Labour Party, Upper Bann)

In relation to a common enforcement policy North and South, I am very much aware of the need to co-ordinate our efforts throughout the island in order to ensure that we are not faced with similar difficulties again. I have, as Mr Savage will be aware, asked the vision group, or a sub-committee of the group, to look at the lessons to be learned. One of the things that they will be looking at is the need for the tightening up of legislation on ear tagging. I am in discussion with Minister Joe Walsh about those very issues, because they are looking at the same things. We will be co-ordinating our approach, because I think that that is important, and I take the point.

I also take the point that horse racing is an important industry. I had a meeting last week with the industry on the possibility of resuming horse racing. The Executive will be considering the matter this week, and at that point I will be in a position to make a further announcement.

P J Bradley (Social Democratic and Labour Party, South Down)

The Minister’s statement contained a substantial amount of good news, particularly from Pirbright, and I thank her for it. My question is about the temporary regulations regarding the dos and don’ts of the imminent sheep-shearing programme, which is causing a good deal of concern. Has there been a review of the original restriction, or is a review being considered?

Brid Rodgers (Social Democratic and Labour Party, Upper Bann)

I am aware that the difficulties with sheep shearing are causing welfare problems. The season is upon us, and it cannot wait. It also creates real risks, particularly for those farmers who no longer do their own shearing and have to bring in contract shearers. I do not have to spell out the risks of having contract shearers moving from farm to farm. I am reviewing the situation. My officials have been working on protocols. I hope to have the protocols in place by next Wednesday, so that sheep shearing can then begin in, I repeat, extreme welfare cases only because of the risk.

The protocols will be in place and will be in the farming papers, but where farmers are doing the shearing themselves, they will be given advice about the procedures to follow. Licensed contact shearers will be given very strict protocols about cleansing and disinfection when they move on to the next farm. However, I am aware that this is a very real problem; it is being reviewed, and I hope that it will be dealt with very soon.

Conor Murphy (Sinn Féin, Newry and Armagh)

Go raibh maith agat, a LeasCheann Comhairle. I welcome the Minister’s statement and the news that the recent testing has proved negative. The Minister indicated that she and her officials do not know precisely how the disease got from Meigh to Ardboe, and that indicates that they are firm in the belief that the disease originated in Meigh. What evidence is there of that, and is there any evidence of where the outbreak in Antrim originated?

Finally, is there any indication yet of when the marts will be reopened for sales? Although farm sales may be welcomed, there is a severe loss of business as a result of the closure of marts, and it does not benefit farmers to have to sell on a farm-to-farm basis. There is much greater benefit from selling in the mart scenario.

Brid Rodgers (Social Democratic and Labour Party, Upper Bann)

In relation to Meigh and Ardboe, I was simply making the point that we had one case in Meigh and that the next case was in Ardboe. I am not saying that there is a connection but rather that we have not been able to establish whether the disease came from Meigh to Ardboe and, if so, how. I am not making any assumptions except that illegal trading was clearly the cause of it. We have traced back all the possible legal traces, and it did not come from those sources. Members can draw their conclusions from that.

In relation to marts, Members should understand that we have not completed serology testing, and even when we have completed it, we will not be in a position to know that we have dealt with the infection that is in the sheep flock. To reopen marts before we are sure of that would be taking too much of a risk.

I understand and recognise the difficulties, and that is why we are taking the step next Wednesday to allow farm-to-farm sales. I also understand that the owners of the marts are looking at other ways of facilitating sales, perhaps video sales, for instance. Certainly I am anxious to look at that as soon as it is possible to do so without risk, but, at present, we are quite a bit away from that.

David Ford (Alliance, South Antrim)

I too welcome the Minister’s statement and the continuing efforts that she and her Department are making. The Minister referred to extending serology testing to all areas where sheep are traditionally kept. My understanding was that serology testing was to be extended to the whole of Northern Ireland, particularly in the light of what she has just said to Mr Conor Murphy.

Can the Minister say whether this is indeed to happen and, if so, what is the anticipated timescale? Would it be possible to have any trade in sheep before the tests were completed? This could take until the autumn and would probably present major problems until then.

Secondly, with regard to a potential mass burial site, which we pray will not be needed, have any sites been identified yet, and should I believe the words of Sam Foster or David Burnside in that Nutt’s Corner is a possible location.

Brid Rodgers (Social Democratic and Labour Party, Upper Bann)

Having tested the sheep flocks in the surveillance areas, we move on to the glens, Sperrins and lowlands. We intend to get to all sheep flocks, because otherwise we could not be certain that we had dealt with all possible infection. That testing will take some time.

In relation to a burial site, as the Member will be aware, the Executive decided that we need contingency plans for the worse-case scenario, and my Department was asked to employ a consultant to identify possible sites.

Work is in progress on that. I do not yet have a final report, but the Executive will discuss the matter this week. However, with regard to Nutt’s Corner, no burial site has been identified or decided upon.

Jane Morrice (NIWC, North Down)

I thank the Minister for her statement. It is valuable for the House to be kept informed of the situation. The Minister has permitted the movement of certain livestock in certain circumstances. What impact will that have on the movement of animals between England, Scotland, Wales and Northern Ireland and on cross-border movement? Is the Minister satisfied that the controls in place at ports, et cetera, are effective enough to ensure that the disease does not continue to spread here?

Brid Rodgers (Social Democratic and Labour Party, Upper Bann)

I am not considering allowing the movement of animals from Great Britain to Northern Ireland, because as the Member will be aware, the situation is much worse there than it is here. I am not even considering such livestock movement. I am trying to deal with the difficulties being faced by Northern Ireland’s farming community because of the present movement restrictions.

William McCrea (DUP, Mid Ulster)

I thank the Minister for her statement. Farmers are facing some practical problems. Following a cull they are left with meal, which in some cases is worth thousands of pounds. Will farmers receive compensation for that? Some farmers have also had to make workers redundant after a cull, and redundancy payments have had to be made. Will they be compensated for that?

May I ask the Minister if there is any news about rate relief for the livestock market providers, given the redundancies that have occurred in those markets? Will they get rate relief? We do want the markets opened as a matter of urgency, but in the meantime can Members be assured that the livestock market owners will get financial relief?

Brid Rodgers (Social Democratic and Labour Party, Upper Bann)

I thank Mr McCrea for his questions. Unfortunately, meal that has been left over comes into the realm of a consequential; it is not a direct result. However, the Department of Agriculture and Rural Development will pay for any meal that it has confiscated due to fear of contamination. As the Member will be aware, consequential compensation is being looked at on a national level, and I will ensure that Northern Ireland is not treated any less favourably than anywhere else in the United Kingdom.

The redundancy of some workers is an unfortunate consequence of the present terrible situation, and it is a matter for the Department for Social Development. That Department has made special arrangements to help people in such situations, and one person has been designated to deal with the farming community. People who have been made redundant will get some assistance from the Department for Social Development.

The Department of Finance and Personnel is working on rate relief, and it is hoped that it will have something very soon. I appreciate Mr McCrea’s point about the marts that have been put completely out of business. That matter is being looked at by the Department of Finance and Personnel, and it is hoped that there will be progress there soon.

Jim Wilson (UUP, South Antrim)

Can the Minister say how many holdings adjacent to the McCambridge holding at Newtowncrommelin were culled?

Did any of the culls prove positive for foot-and- mouth disease?

Brid Rodgers (Social Democratic and Labour Party, Upper Bann)

I do not have the statistics to hand, but I will write to the Member with the information.

Eddie McGrady (Social Democratic and Labour Party, South Down)

I thank the Minister and her Department for the work they are doing in this respect and also for this morning’s progress report, which, it is hoped, points the way to a complete return to normality.

I refer to the answer the Minister gave to the Chairman of the Agriculture Committee regarding the sheep farmers in the Silent Valley and the Mournes. Will she confirm that had there been proper consultation with the Minister for Regional Development last year, then the doctrine of force majeure could be used this year also? Notwithstanding that historical fact, will she re-examine the situation as a matter of priority for the double and treble jeopardy in which the Mourne and Silent Valley sheep farmers are engaged?

In response to the Deputy Chairperson of the Agriculture Committee, I make a special plea with regard to the horse racing in Downpatrick and also at Down Royal in Lisburn. They have wisely postponed their meetings and have now obtained from the Jockey Club the dates of 1 June and 2 June. Taking into account all the protocols they have put in place, it is imperative that the Minister give the green light to that event. Otherwise that company, the Maze company and much of the horse-breeding, rearing and training fraternity in the North will go into bankruptcy.

Brid Rodgers (Social Democratic and Labour Party, Upper Bann)

In relation to the force majeure, my officials have been in consultation with officials in the Department for Regional Development since the decision was announced. However, once the information was relayed to the farmers that their sheep would not be allowed onto the mountain, force majeure could not be used this year, as the sheep farmers were warned well in advance.

In relation to horse racing, I take Mr McGrady’s point. I know that it is an important issue. The Executive will be considering the matter this week.

Paul Berry (DUP, Newry and Armagh)

The Minister has announced a further limited welfare disposal scheme for cull sows. Can the Minister confirm that the fixed amount for cull sows is only £30? If this is the case, surely that is inadequate compensation for the farmers.

When does the Minister intend to re-open Gosford Forest Park in Markethill? As she is aware, it has been closed since the outbreak and is causing much concern and distress in the area with the loss of tourism and business. I am aware that there are animals in the vicinity and that that is the reason for the closure. Surely something can be done to alleviate this problem and get Gosford Forest Park reopened.

Brid Rodgers (Social Democratic and Labour Party, Upper Bann)

The cull sow welfare scheme was initiated in response to demands and concerns expressed by the industry. As I understand the situation, the factory concerned would not be able to take all of the cull sows. The opportunity exists to bring the cull sows to the factory or to put them into the welfare scheme. There is not much difference in price. The same price for the cull sow scheme is being paid in GB.

There are susceptible animals in Gosford Forest Park, and that is the reason the park has not yet been opened. Above all, the Department has to be seen to be abiding by its own guidelines, and I will continue to be guided by the veterinary advice on that matter. I do recognise the problem, but everyone has problems at this time.

Derek Hussey (UUP, West Tyrone)

I welcome the good news contained in the Minister’s statement. The Minister will be aware that I had a written question down, believing that the Agriculture Committee was dealing with the costs of veterinary certification for movement certificates.

Will the Minister request her officials to look at the administration of this so that payment can be made directly to the vets, rather than burdening the farmers with additional administration?

Brid Rodgers (Social Democratic and Labour Party, Upper Bann)

My understanding is that the vets are dealing directly with the Department and that the Department is paying the vets. That is, and should be, the case. If there is some misunderstanding about that, I will be able to clear it up. I made the position clear at the industry meeting 10 days ago. The farmer does not pay the private vet, but the vet is paid directly by the Department on production of the necessary documentation.

Joe Byrne (Social Democratic and Labour Party, West Tyrone)

I thank the Minister for her statement, and I welcome her comments on the efforts to regain regionalisation for those parts of Northern Ireland that have had no foot-and-mouth disease so far. Does the Department of Agriculture have any guidelines for those people, particularly the candidates involved in the local government or Westminster elections?

Brid Rodgers (Social Democratic and Labour Party, Upper Bann)

My Department has been in touch with the returning officer. He has agreed to issue the Department’s guidelines to all the candidates with the rest of their papers. Candidates and canvassers are asked to abide by the guidelines. This means staying away from farm land and farm animals. I do not need to spell out that people traipsing from farm to farm would be extremely risky. I want to underline that, because there are sheep on some of the farms, and we are concerned about the sheep flocks.

I imagine that people seeking election — and many of them are in this Chamber — will already be aware of the guidelines and will adhere strictly to them. However, there may be some candidates who are not as aware of the risks as those of us who are in the Chamber. It is important that all know that the guidelines apply to canvassers and candidates as well as to ordinary members of the public. We are no different.

Ian Paisley Jnr (DUP, North Antrim)

I too welcome the Minister’s statement and the good news about the tests on flocks in north Antrim, as will many people in that area. I understand that compensation has been paid for only 11,000 of the 46,000 animals that have been culled to date in Northern Ireland. Can the Minister explain what has caused the delay in paying three quarters of those who have lost animals?

I understand that 10,000 serology tests can be carried out per day. Is the Minister convinced that she has adequate resources to deal with the extensive serology testing required? How soon does she expect to have those tests completed?

Finally, can she tell the House whether the Department of Agriculture and Rural Development has traced all the sheep that were unaccounted for at the beginning of this crisis — and which appear to lie at the heart of this disease — so that we can ensure that the disease does not spread any further? I also endorse the comments that have been made by several Members, right across the House, about the equestrian industry. I hope that special relief can be given to that industry so that those involved do not lose further income.

Brid Rodgers (Social Democratic and Labour Party, Upper Bann)

I thank Mr Paisley Jnr for his question. There is no delay in the compensation payments. They are being processed, and they will be paid out as soon as that has been done. We have accounted for all of the sheep that came in the consignment that caused the initial concern.

They have all been accounted for and have been culled or had already been slaughtered in abattoirs.

I cannot remember the other question.

Donovan McClelland (Social Democratic and Labour Party, South Antrim)

It concerned resources for serology testing.

Brid Rodgers (Social Democratic and Labour Party, Upper Bann)

When we initially began the serology testing, we clearly had to get up to speed. The problem was not the capacity to do 10,000 tests a day, but rather the capacity to take 10,000 blood samples a day. We have brought in private vets to help and are also bringing in other people in the Department who have expertise in taking bloods.

We are almost at 10,000 tests a day. I am happy that we are able to deal with that number. Clearly it would be better if we could do 20,000 tests a day, but 10,000 a day are as much as we can deal with. Unfortunately, it will take a few weeks to finish the serology tests.

Billy Armstrong (UUP, Mid Ulster)

I welcome the cull sow scheme, which will alleviate many of the stock problems on the pig farms. It is very disappointing that the fixed amount is only £30 — again, somebody is making a great deal of money out of the farmers. However, it is very good news that the farmers have up to 30 June to complete the IACS form.

Will the Minister consider letting beef cattle that would be over-30-months old before the 10 km area ban is lifted move to abattoirs on welfare grounds? I believe that her officials, and a meat plant, are in favour of that type of operation’s happening this week.

Brid Rodgers (Social Democratic and Labour Party, Upper Bann)

The issue to which the Member refers is being addressed under welfare considerations. I anticipate that some limited direct slaughter from the 10 km surveillance zone may be possible.

Gardiner Kane (DUP, North Antrim)

I report to the Minister, and to the House, the enormous sense of relief among the tourist trade and the farmers following her announcement that there has not been a further outbreak at Murlough in north Antrim.

Can the Minister confirm that there is a determination to progress the farm-to-farm sale of livestock from 23 May? What measures will be required of farmers to ensure that that is done with as little risk as possible? These transfers are desperately needed and are a welcome development for farmers’ cash flows and animal management and welfare.

Brid Rodgers (Social Democratic and Labour Party, Upper Bann)

The details and protocols of the farm- to-farm movement of animals on 23 May will be in the farming press at the weekend. In addition, I will be having my regular meeting with the industry and getting the information out to the farming community through that. The union, in particular, will be made aware of the situation.

James Leslie (UUP, North Antrim)

In common with the other Members for North Antrim, I echo the considerable sigh of relief following the news that there was not a further case of foot-and-mouth disease in the Ballycastle area.

I commend the Minister and her Department on the serology programme. I must say that processing 43,000 tests in a week is a very impressive figure — I trust that the testing is, indeed, robust. The Minister has pointed out that the testing may produce false positives, but I trust that it will not produce false negatives. The results of the testing so far seem to completely contradict the view of the rumour factory. That is a great relief, and I hope that that will continue.

To what does the Minister attribute the confirmed outbreak in Cushendall?

Does she consider that this resulted from the illegal movement of animals, and, if so, where did those animals come from?

Brid Rodgers (Social Democratic and Labour Party, Upper Bann)

The results of blood tests so far confirm our suspicion that there is blatant infection in the sheep flock. Fifty-five cases recorded with the ELISA titres were sent to Pirbright, as they were inconclusive or false positives. Of those, three proved positive on the Pirbright test, which meant that although they did not have the disease, they had been exposed to it. In the case of one inconclusive result at Pirbright, we have restricted the herd and are clinically inspecting and resampling it.

With regard to the three positive results that were found, one small flock of approximately 64 sheep was culled, and the other two had already been culled under the precautionary measures. We are discovering that there is a danger in some cases, and we are getting to it little by little. I cannot answer the question about the Cushendall outbreak, because we have not reached its source. However, it is being investigated and followed up. In those cases we follow up all known connections with any other flocks or movements, but we can run into a blank wall. This is not necessarily the fault of the farmer concerned, but it can suggest that somewhere along the line there has been illegal movement. However, I cannot say at present.

Game Preservation (Amendment) Bill: First Stage

Sam Foster (UUP, Fermanagh and South Tyrone)

I beg leave to lay before the Assembly a Bill to amend the Game Preservation Act (Northern Ireland) 1928.

Bill passed First Stage and ordered to be printed.

Donovan McClelland (Social Democratic and Labour Party, South Antrim)

The Bill will be put on the list of future pending business until a date for its Second Stage is determined.

Family Law Bill: Consideration Stage

Donovan McClelland (Social Democratic and Labour Party, South Antrim)

Members will have a copy of the Marshalled List of amendments detailing the order for consideration. The five amendments all relate to clause one and have been grouped together for debate.

Clause 1 (Acquisition of parental responsibility by father or step-parent)

Mark Durkan (Social Democratic and Labour Party, Foyle)

I beg to move amendment 1. In page 2, line 10, leave out

"section 13"

and insert

"paragraph (a), (b)(i) or (c) of Section 18(1)."

The following amendments stood on the Marshalled List:

No 2 (clause 1): In page 2, line 23, leave out "Accordingly" and insert "The Children (Northern Ireland) Order 1995 shall be further amended as follows". — [Mr Durkan]

No 3 (clause 1): In page 2, line 23, at end insert

"( ) in Article 3(4) (circumstances in which the court must have regard in particular to matters listed in Article 3(3)), after sub-paragraph (a) there shall be inserted —

‘(aa) the court is considering whether to make an order under Article 7; or’;" — [Mr Durkan]

No 4 (clause 1): In page 2, line 24, leave out "of the Children (Northern Ireland) Order 1995" — [Mr Durkan]

No 5 (clause 1): In page 2, line 30, leave out "of that Order " — [Mr Durkan]

I also want to take this opportunity to speak to amendments 2, 3, 4 and 5.

Amendment 1 corrects an inaccurate reference to the legislation in Scotland dealing with the joint registration of births by unmarried parents. There has been some confusion about the appropriate sections of the Scottish legislation to which this Bill should refer.

Amendment 2 is a drafting amendment and is consequential to amendment 3. Although amendment 2 is a drafting amendment, it does not stand alone. Amendments 3 to 5 depend on amendment 2’s being passed. Amendment 3 is the only substantive amendment to clause 1.

It requires a court, when making an order under article 7 of the Children (Northern Ireland) Order 1995, to have specific regard to the best interests of the child. In particular, it requires the court to take account of the wishes and feelings of the child when making a parental responsibility order in favour of the child in respect of an unmarried father or a step-parent. This amendment flows from the Committee Stage of the Bill, and I am happy to take it forward.

Amendments 4 and 5 are, again, purely drafting and technical amendments following from amendment 3. They in no way alter the substance of the Bill. They reflect the way in which amendment 3 has been drafted.

Joe Hendron (Social Democratic and Labour Party, Belfast West)

I am very pleased to support the amendments brought forward by the Minister in relation to the principle of the best interests of the child. I am particularly pleased that the Committee’s report on the Family Law Bill, which deals primarily with the acquisition of parental responsibility by unmarried fathers and step-parents, enjoys the unanimous support of the Committee. I thank all the members for their industry and commitment in considering the detailed and sometimes complex arguments in relation to this short but significant Bill.

On behalf of the Committee, I also extend my appreciation to the Committee for Finance and Personnel for its co-operation in affording us the opportunity of scrutinising the Bill, which makes appropriate amendments to the Children (Northern Ireland) Order 1995. The Committee further wishes to place on record its gratitude to the 16 individuals and organisations who provided such a high standard of detailed written and oral evidence.

The Bill, although short and containing only five clauses, was widely accepted as significant but complex, and, in addressing three broad areas, it provoked a series of arguments relating to sometimes competing equality and human rights issues. It was with particular regard to the rights of the child that the Committee sought the amendments to clause 1 that have been brought forward by the Minister. They basically reinforce article 3 of the 1995 Order, which states that courts must place paramount consideration on the best interests of the child when making a decision on its upbringing.

The Bill relates to three broad areas. First, it provides that an unmarried father who jointly registers the birth of his child with the child’s mother shall have parental responsibility for that child. It also provides for a step- parent to apply to a court for an order conferring parental responsibility on the step-parent in relation to a child of his or her spouse.

Secondly, the Bill creates a statutory presumption of paternity where a man was married to a child’s mother at any time between the child’s conception and birth, and where he has been registered as the child’s father in the Register of Births, Deaths and Marriages. In both cases, that parental responsibility may be terminated only by a court order.

Thirdly, the Bill updates the law by enabling courts to direct the taking and testing of bodily samples to prove or disprove a child’s parentage. Currently, the courts are confined to directing the taking and testing of blood.

The backdrop to this Bill lies with the Government’s recognition of the changing patterns of family life. Fewer people are marrying, and increasing numbers are choosing to live together. In 1999, almost 7,000 children were born outside marriage in Northern Ireland, representing 30·3% of all live births. Of those, 4,487 — 64·5% — were jointly registered by the unmarried father and mother.

Under the 1995 Order, unmarried fathers can acquire parental responsibility for their child only by entering into a parental responsibility agreement with the mother of their child, or by obtaining an order from the court. However, the level of take-up through these mechanisms has been low. In 1999, less than 200 parental responsibility orders were made in respect of unmarried fathers.

Nonetheless, it appears that that trend does not reflect unwillingness on the part of unmarried fathers to assume parental responsibility, given that substantial numbers of live births outside of marriage are registered jointly by the mother and father. As current legislation does not confer parental responsibility on the unmarried father who registers the birth of the child, the vast majority of unmarried fathers have no formal relationship with their children.

It is, therefore, widely accepted that clause 1 of the Bill is fraught with difficulty; it involves competing human rights and equality arguments. Some say that the Bill discriminates against unmarried fathers by not granting them automatic parental responsibility for their children. The Committee acknowledges that the rights of unmarried fathers are firmly embedded in the rights of children and mothers.

In that context, the Committee had particular regard to the case of McMichael versus UK. The European Court of Human Rights found that the rights of an unmarried father were not infringed by the fact that he did not have parental responsibility. The court upheld the UK Government’s view that the non-automatic granting of parental rights to unmarried fathers was a justified interference in family life to protect the rights of mothers and children from unworthy or abusive fathers.

Therefore, favouring a degree of caution, the Committee took the view that any differential treatment between parents on the basis of gender or marital status in articles 8 and 14 of the European Convention on Human Rights was reasonably justifiable on the basis of the need for protection for mothers, fathers and children.

The Committee was content with the provision in clause 1 for a step-parent to apply for a court order conferring parental responsibility for a child of his or her spouse. It accepts that in many second marriages a strong bond is built between a step-parent and a child who may have lost contact with the natural parent. From a practical perspective, for taking decisions with the other parent on the child’s education and welfare, it is important that a legal relationship be established between the step-parent and his or her new children.

The fact that the natural parents will continue to have parental responsibility and can alert the court to objections that they may have — objections that it must take on board — provides for fair representation and should help to guard against the absent natural parents being sidelined. The inclusion of the best interest test, for the court to consider when making an order to confer parental responsibility on the step-parent by way of the proposed amendment to clause 1, is most welcome. The rights of children lie at the heart of the Bill. Consequently, there is a clear duty to protect their best interests.

The Committee is satisfied that the Bill provides a mechanism for the courts to divest unmarried fathers and step-parents of parental responsibility, which is viewed as a sensible safeguard to protect children and mothers from violence, abuse and intimidation. The Committee also considered the argument that the Bill should provide equally for married parents to lose parental responsibility where the circumstances warrant it. However, the Committee was satisfied with the current provision in such circumstances, whereby parental responsibility can be held additionally by the health and social services where it is felt that the child is suffering significant harm and will be taken into care.

The Committee considered the arguments for the Bill to have retrospective effect but concluded that that could impose unfair obligations on the unmarried father who had not registered his children with the intention of securing parental responsibility. On the other hand, an unmarried father can avail of the existing procedure of entering into a parental responsibility agreement if he wants to establish a legal relationship with a child born prior to the commencement of the new legislation.

Several witnesses made compelling arguments for the acquisition of parental responsibility to be linked to the provision of emotional and practical care, direction and guidance to the child. Some proposed that the definition of parental responsibility in the Children (Northern Ireland) Order 1995 be amended.

(Mr Speaker in the Chair)

Although the Committee accepts the arguments against redefining parental responsibility, particularly because this would have effects outside the Family Law Bill, it strongly agrees with the many witnesses who stressed the importance of developing an effective, high-profile and widespread publicity campaign about its implications.

A public information document about how to obtain parental responsibility must be made available to all new parents, and the document must set out what parental responsibility entails in clear terms. The publicity campaign must place as strong an emphasis on rights and powers as it does on the duty to provide emotional care, direction and guidance for the child. The importance of showing respect and support to the mother should also be highlighted.

Clause 2 is accepted as a sensible provision. It puts the common law presumption that a man who is married to a woman between the conception and birth of a child is the father of that child and the new legal presumption that any unmarried man who is registered as the father of a child is the father of the child on a statutory footing. The Committee was satisfied that the Bill provides for the presumption of paternity in both instances to be rebutted on the balance of probabilities.

Clause 3 is a welcome, technical measure that will provide the courts with additional powers to help determine the parentage of a child in a less invasive and distressing way. Existing mechanisms allow for blood samples to be taken only from the child or putative father. However, the new legislation will provide for courts to direct that bodily samples, such as saliva or hair, be taken for the purposes of scientific tests to determine parentage.

The Committee was satisfied with the Office of Law Reform’s assurance that, under article 3 of the Children (Northern Ireland) Order 1995, a court shall have regard to the wishes and feelings of the child in relation to tests for determining parentage. Members were satisfied with the general principle that responsibility for the costs of determining parentage will be decided after the event. If a parent with care instigates proceedings to obtain a declaration of parentage and is successful, the absent parent who has disputed parentage will pay the costs.

I commend the Bill, as amended , as a progressive and balanced piece of legislation that takes account of the rapidly changing basis on which people are choosing to live together by encouraging unmarried fathers to have meaningful and legal relationships with their children. The Bill sensibly seeks to recognise and accommodate changes in family structures. However, the Committee is satisfied that it contains safeguards to ensure that the rights of children are promoted and not compromised.

John (Speaker, Belfast East)

I would like to say something to ensure that a precedent is not established here. The Chairperson referred not only to the matter under debate — the amendments to clause 1 — but to a number of other clauses as well, for which he provided explanation and comment. This is a reasonably short Bill, and it was not necessarily an unreasonable thing to do at this juncture. However, it is important that it should not set a precedent. Chairpersons, when dealing with one clause, cannot, for instance, take into account the following 65 clauses that some more substantial Bills may have.

The Member referred to the Bill as amended. I have little doubt about what the House will do, but at this point it is not amended — he should have referred to the Bill as presented.

Mark Durkan (Social Democratic and Labour Party, Foyle)

I welcome Dr Hendron’s comments on the amendments and some of his broader remarks. I am glad that he is able to record the Committee’s support for the amendments as well as for the broad purposes of the Bill. The Committee for Health, Social Services and Public Safety scrutinised this short but significant Bill thoroughly, and that thoroughness was reflected in Dr Hendron’s coverage of the issues that were of particular concern and interest to the Committee.

I am grateful for the role that he and Committee members have played, and, like him and his Committee, I am grateful for the role of the Committee for Finance and Personnel in allowing scrutiny in this particular way. I welcome the fact that the Committee has been able to give the Bill some thought and that its thinking has facilitated some of the amendments before us. I am glad too that the good working relationship that I have previously acknowledged between the Office of Law Reform and the Committee for Finance and Personnel has been matched by the relationship between the Office of Law Reform and the Committee for Health, Social Services and Public Safety.

John (Speaker, Belfast East)

Amendment 1 — moved or not moved?

Mark Durkan (Social Democratic and Labour Party, Foyle)

Moved.

Amendment agreed to.

Amendment (No2) made:

In page 2, line 23, leave out "accordingly" and insert

"The Children (Northern Ireland) Order 1995 shall be further amended as follows" — [Mr Durkan]

Amendment (No3) made:

In page 2, line 23, at end insert

"( ) in article3(4) (circumstances in which the court must have regard in particular to matters listed in article 3 (3), after sub-paragraph (a) there shall be inserted —

‘(aa) the court is considering whether to make an order under article 7; or’;’ — [Mr Durkan]

Amendment (No4) made:

In page 2, line 24, leave out "of the Children (Northern Ireland) Order 1995" — [Mr Durkan]

Amendment (No5) made:

In page 2, line 30, leave out "of that Order" — [Mr Durkan]

Clause 1, as amended, ordered to stand part of the Bill.

Clauses 2 to 5 ordered to stand part of the Bill.

Long title agreed to.

John (Speaker, Belfast East)

The Bill stands referred to the Speaker.

Code of Practice on Access to Workers During Recognition and Derecognition Ballots

Sean Farren (Social Democratic and Labour Party, North Antrim)

I beg to move

That the Code of Practice on Access to Workers During Recognition and Derecogntion Ballots, laid before the Assemby on 13 April 2001, be approved.

I refer to the draft code of practice on access to workers during recognition and derecognition ballots as the draft code. It was laid before the Assembly on 13 April 2001 and is subject to the affirmative resolution procedure of the Assembly. I will provide background information for Members.

From 8 March 2001, under the trade union recognition process, trade unions were given a statutory right to seek recognition for the purpose of conducting collective bargaining in the areas of pay, hours, holidays and other agreed matters. There is also a right for employers to seek derecognition of a trade union where the statutory acceptance criteria no longer apply. Where disputes arise about recognition, they may be referred for adjudication to the Industrial Court, the Northern Ireland body equivalent to the Central Arbitration Committee (CAC) in Great Britain.

The draft code corresponds closely with that in operation in Great Britain from June 2000. It is important to emphasise that that code only comes into play in limited circumstances, when the Industrial Court orders a ballot to be held. That would happen at the later stages of the adjudication process on trade union recognition. The court will give notice to both the employer and union that a ballot is to be held. The aim of the draft code is to provide practical guidance to both employers and employees about the issues that arise in such circumstances.

Given the purpose of the legislation, focus is placed on the rights of unions and workers in relation to employers. However, it is important to appreciate that that rests on the presumption that a voluntary agreement should always be preferable. That presumption is demonstrable at every stage of the adjudication process and in the code of practice. It follows that unions and employers are expected to show good faith and act reasonably and responsibly throughout the process. If the question of recognition comes to be resolved by ballot, which implies at least some degree of impasse in resolving it, the draft code sets out how employers and trade unions are expected to conduct themselves before and during the ballot arrangements.

The code itself does not impose legal obligations, and failure to observe it does not, in itself, leave anyone open to legal proceedings. However, it is important to appreciate that provisions of the code are admissible in evidence, and are to be taken into account before any court, tribunal or, indeed, the Industrial Court itself, where considered relevant. It is also important to appreciate that full consultation has taken place in Northern Ireland on the code’s content. I understand that there is general and widespread acceptance of its provisions. The code itself has also been subject to some discussion and deliberation in the departmental Committee.

I commend the code to the Assembly.

Mervyn Carrick (DUP, Upper Bann)

Members of the Committee are grateful that the Department consulted us on the draft code of practice, enabling us to examine it in detail and to highlight several concerns.

The Committee notes that the code of practice should take effect only towards the end of a potentially lengthy adjudication process, based on the Employment Relations (Northern Ireland) Order 1999, which gives new rights, principally to workers and trade unions. However, there is also a right contained in the legislation for employers to seek derecognition of a trade union. Both the legislation and the code of practice presume that a voluntary agreement is always preferable. Unions and employers are expected to act reasonably and responsibly throughout the process. The Committee welcomes the fact, in the light of its response to the Minister, that that duty is now more explicitly stated in the code.

Members also questioned where more guidance was needed in the code to cover situations when agreement cannot be reached on access to workers. We have noted the Minister’s response that a more prescriptive approach may be neither practicable nor successful in that area, given that individual circumstances are likely to be highly varied. We also note that the Industrial Court panel has been empowered to stipulate access provisions in such cases when necessary.

There are also potential difficulties for employers when any multiple-union applications are made. We have noted that the industrial court will not accept competing applications on the presumption that it would not be appropriate for it to adjudicate on that matter, nor to become involved in inter-union disputes.

In Great Britain, the Trades Union Congress (TUC) has confirmed its commitment to resolving such inter- union issues before application stage. In Northern Ireland, the Northern Ireland Committee of the Irish Congress of Trade Unions (NIC-ICTU) expects to adopt a similar stance. Multi-union applications are very much the exception rather than the rule, and they are likely to remain so.

I approve of the principles contained in the code and note that an almost identical code of practice has been operating in Great Britain since June 2000. Very few cases have needed to proceed as far as a ballot, and there has been no indication of difficulties with the laid-down procedures.

The Department is aware that the code cannot be a static document and will need to keep pace with developments. The Minister has given a commitment that this area will be closely monitored over the coming months to ensure that the intention of the code is being delivered. The Higher and Further Education, Training and Employment Committee looks forward to receiving the results of that monitoring in the future and will be keen to ensure that the code of practice is operating effectively in Northern Ireland. I commend the motion to the House.

John Dallat (Social Democratic and Labour Party, East Londonderry)

I support the motion, and I thank the Minister for bringing it to the House. As indicated, the nature of the legislation dictates that it will come into force only in the very rare circumstances when voluntary agreements between employers and unions cannot be reached. One hopes that the voluntary route would be used more often. Indeed, that has been the case in Britain. The motion recognises the preference for voluntary settlements and facilitates that. However, it also sends an important message from the Assembly that it will, if necessary, empower the unions to have access to their members.

We must not forget that the unions have played a key role in the development of labour relations and in the evolution of modern industry and commerce. We salute the work of the unions in many fields, which has transformed the rights of workers, not simply in terms of pay, but also in conditions of employment, health and safety and as partners in the development of successful businesses. Unions will continue to play a key role as we enter a new era, which is fraught with difficulty but also brings exciting challenges.

We have concentrated in the Chamber recently on the issue of skill shortages in certain sectors. The Committee is currently looking at the relationship between industry and further education. These are good times for the economy — unemployment is at an all-time low, and there are many more people in employment in Northern Ireland than ever before. Nevertheless, progress brings with it problems — real problems in which the unions have a critical role to play.

However, we must not forget the bad times. Just over 10 years ago, unemployment stood at more than 15%. Economic times were not so good, and industrial relations may not have been as good either. It is important that we bear that in mind when considering the motion.

Sean Farren (Social Democratic and Labour Party, North Antrim)

I express my thanks to the Members who have spoken, particularly those on the Committee for the consideration they have given to the code of practice and for the general support they have expressed for that. I have been pleased to take account of some of the comments that have come from Committee members, and those have been incorporated into the code. I want to emphasise that the code represents a further step in the strengthening of rights on both sides in the work place — the rights of employers and, significantly, the rights of people in the workforce and the rights of the trade union movement.

In recent years, we have seen a series of measures adopted with respect to industrial relations and employment legislation that have sought to strengthen those rights. The code will be monitored, and I want to emphasise the voluntary approach to recognition and derecognition. The code will indicate how both sides should proceed on those rare occasions where the voluntary approach has not resulted in a positive outcome.

Question put and agreed to.

Resolved:

That the Code of Practice on Access to Workers During Recognition and Derecognition Ballots, laid before the Assembly on 13 April 2001, be approved.

Social Security (New Deal Pilot) Regulations (Northern Ireland) 2000

John (Speaker, Belfast East)

Since not all Members may be familiar with our procedure on Statutory Rules, I remind the House that a Statutory Rule which is subject to confirmatory procedure becomes law once it has been laid before the Assembly. However, it will cease to have effect unless it is approved by the Assembly within a specified period. This particular Statutory Rule was made on 27 November 2000 and will expire on 27 May 2001 unless it is approved by the Assembly.

Maurice Morrow (DUP, Fermanagh and South Tyrone)

I beg to move

That the Social Security (New Deal Pilot) Regulations (Northern Ireland) 2000 (SR 369/2000) be approved.

I seek the Assembly’s approval for a set of regulations that support the New Deal pilot scheme for people aged 25 and over. There is a range of New Deal schemes. They are aimed at specific groups such as lone parents, disabled people and the younger long-term unemployed. These regulations are to specifically support a pilot scheme for unemployed people aged 25 and over.

These pilot schemes are part of the welfare-to-work strategy and the efforts to tackle long-term unemployment. They have been operating in Northern Ireland since 30 November 1998, testing a variety of innovative ways of helping unemployed people into work. They are aimed principally at those who have been unemployed for 18 months or more. However, there is provision for people unemployed for less than 18 months and who face particular difficulties in returning to the labour market. The pilot schemes have provided individually tailored help designed to address barriers to work that had been identified, including lack of recent work experience and lack of relevant skills.

There were no new places on the New Deal pilot schemes after 21 March 2001. From 1 April new provision for the long-term unemployed was introduced across the United Kingdom under the enhanced New Deal for 25 plus. The new programme is designed to reflect the lessons learned from the pilot schemes, ensuring that a range of help is always available and investing more in advisors to enable them to provide continued support. The Department of Higher and Further Education, Training and Employment administers the pilot schemes and the enhanced New Deal for 25 plus.

To facilitate the operation of the New Deal pilots for 25 plus, changes were made to social security regulations. This ensured that people could participate in the pilot schemes while continuing to meet the conditions for receipt of jobseekers’ allowance, and also provided for sanctions for non-attendance under the programme. Under the provisions of the Jobseekers’ (Northern Ireland) Order 1995, the regulations underpinning New Deal pilot schemes can be in operation for only 12 months at a time, but they can be renewed as required.

They first came into operation on 29 November 1998 and were renewed in November 1999. The regulations before us today renew the provisions that were already in place, enabling the pilots to continue for a further twelve months and to take people into the scheme until 31 March 2001. Entrants to the scheme up to that date may remain on that scheme for the full twelve-month period.

I do not propose to explain the detail of each individual regulation, but I shall, of course, be happy to respond to Members’ questions. The New Deal pilot regulations prescribe the categories of people who are required to participate in the New Deal pilots and the impact on their benefits of non-participation or leaving the programme without good cause. They also ensure that payments that participants may receive as part of the pilot, including top-up payments for childcare and self-employed earnings, will not affect their benefit.

The only substantive change from the earlier pilot regulations is that these regulations now define the date on which the last participant could join, which was 31 March 2001. Technical changes reflect the introduction of joint claims to the jobseeker’s allowance from 19 March 2001 and the fact that some people could enter the pilots for a second time. I hope that this opening explanation has helped Members. I commend the regulations to the Assembly.

Eamonn ONeill (Social Democratic and Labour Party, South Down)

I rise to lend my support. This House should be glad to give its support to the introduction of this Statutory Rule. However, the Minister might be able to clarify a couple of questions for me. Regulation 5 stipulates that a person may be penalised by losing out on benefits if he or she fails to participate without good cause. I was unable to ascertain the definition of "good cause". I want the Minister to identify that, if possible.

Will each case be judged on its own merits? How will that be measured? It may seem a small point, but these things can sometimes cause quite a lot of difficulty for people and their benefits.

I welcome the Minister’s reference to childcare costs and people’s eligibility to continue to receive them. However, it appears from the Statutory Rule that this applies only to lone parents. What about couples? Is there any variation here? There have been some cases in the past where childcare allowance has been affected. For example, if it were established that a couple could access costs when one of the parents is on the New Deal pilot, the regulation would have to allow for childcare costs so as not to affect the job seeker’s allowance (JSA) of the second parent. That may sound difficult to absorb, but I hope that the Minister can pick it up.

Under regulation 15, will the payments be disregarded if another parent is on benefits? I would appreciate clarification of these small points today or when next possible.

Maurice Morrow (DUP, Fermanagh and South Tyrone)

The requirements of the programme are spelled out very clearly to participants at all stages. No one is sanctioned by accident. Sanctions are a direct result of things that people do or fail to do. Operations systems are in place to ensure that people are treated sensibly and fairly. The law provides for people to be able to demonstrate good cause and provides them with the right of appeal. With hardship payments to protect the most vulnerable, I think that the system as a whole just about strikes the right balance. It is not only firm but fair.

Mr ONeill has also raised a point to which I do not now have the answer. I assure him that I will come back to him with a full and detailed answer in writing.

Question put and agreed to.

Resolved:

That the Social Security (New Deal pilot) Regulations (Northern Ireland) 2000 (SR 369/2000) be approved.

Public Health/Health Inequalities

Bairbre de Brún (Sinn Féin, Belfast West)

I beg to move

That this Assembly welcomes the commitment in the Programme for Government for all Departments and their statutory agencies to work resolutely and energetically together to tackle the root causes of preventable disease and disability and to reduce inequalities in the health status of different groups in our population.

Tá gliondar orm an rún a thabhairt os comhair an Tí inniu. Beidh a fhios ag Teachtaí go bhfuil ár meánionchas saoil níos faide ná mar a bhí ariamh — 77 mbliana i gcomparáid le 47 mbliana tá céad bliain ó shin. Ach níl staid fhoriomlán ár sláinte go maith. Táimid oiread agus trí bliana chun deiridh ar an chuid is fearr de réigiúin na hEorpa; tá básanna den ghalar corónach croí beagnach dhá uair chomh hard leis an mheán Eorpach; tá ár ráta báis de ailse scamhóg do mhná dhá uair níos airde ná an meán agus é ag méadú leis.

Níl sna rátaí báis ach forbhreathnú leathan. Nuair a fhaigheann duine bás de cheann de na riochtaí seo, go minic i ndiaidh tréimhse fada de thinneas agus de mhíchumas, fágtar cuid mhór eile faoi mhéala. Baineann an fhulaingt le teaghlaigh, cúramóirí agus cairde. Caitheann an eacnamaíocht agus an tseirbhís sláinte anseo na billiúin de phuntaí ar thinneas agus ar mhíchumas inseachanta.

Tá a fhios againn ó thaighde leighis agus ó eispéireas tíortha eile gur féidir a lán de na básanna agus den fhulaingt a chosc. Is féidir seo a dhéanamh tríd an dul chun cinn sa leigheas agus tríd sheirbhísí cúraim agus cóireála a eagrú agus a mhaoiniú. Ach níos tábhachtaí arís, trí pholasaithe agus chláir trasna an Rialtais agus trí ghníomhaíocht ar fud na sochaí.

Is dó sin atá an Coiste Feidhmiúcháin tiomanta.

Is eol do Theachtaí na héagothromaíochtaí móra atá sa stádas sláinte i ngrúpaí éagsúla an daonra anseo; éagothromaíochtaí atá ceangailte go soiléir le dálaí sóisialta agus eacnamaíocha daoine. Is léir ón fhianaise gurb í an bhochtaineacht an chontúirt is mó don tsláinte — i mbeagán focal, dá shaibhre tú, is amhlaidh is faide do shaol agus is lú an chontúirt go mbuailfidh tinneas ainsealach nó míchumas thú. Tá seo amhlaidh d’airde dhréimire na n-aicmí: de réir mar a théann duine suas an grádán sóisialta thig feabhas ar a shláinte.

Tá cúig bliana de fhad saoil ar meán ag an ghrúpa socheacnamaíoch is toiciúla anseo ar an ghrúpa is lú toice. Idir fir, tá oibrithe neamhoilte trí huaire chomh dóiche le bás a fháil roimh 65 ná gairmithe nó bainisteoirí. Tá páiste sa ghrúpa is lú toice 16 huaire chomh dóiche le bás a fháil i ndóiteán tí agus cúig huaire chomh dóiche le gortú a fhulaingt mar choisí le páiste ón ghrúpa bairr.

Ach is i measc Taistealaithe is géire atá na difríochtaí seo le sonrú. Tá a n-ionchas saoil beagnach 20 bliain faoi sin an phobail shocraithe. Tá páiste Taistealaí faoi bhun 10 mbliana d’aois 10 n-uair chomh dóiche le bás a fháil ná páiste socraithe. Níl ach 10% de Thaistealaithe os cionn 40 agus níl ach 1% os cionn 65.

Níl áit gan a ról a bheith aici: is sna bardaí toghchánacha is mó díothacht atá na rátaí báis is airde. D’fhéadfaí 2000 bás anabaí a chosc gach bliain dá dtiocfadh linn stádas sláinte na ndaoine sin a bhfuil cónaí orthu sna comhairlí ceantair is measa rátaí a ardú go dtí sin na gcomhairlí is sláintiúla

I am delighted to have the opportunity to introduce this motion in the House today. Members will know that our average life expectancy now is longer than ever before — 77 years, compared with 47 years a century ago. However, the overall state of our health is still not good. Compared with other regions in Europe we are as much as three years behind the best. Deaths from coronary heart disease are nearly double the European average. Our lung cancer death rate for women is already twice the average, and rising.

Death rates only give a broad overview. For everyone who dies from conditions such as I have mentioned — often after a long period of illness and disability — many more face enormous personal tragedies. The suffering extends to families, carers and friends. The annual costs of preventable disease and disability to the economy and the Health Service run into billions of pounds.

We know from medical research and the experiences of other countries that much of the death and suffering can be stopped. It can be stopped by advances in medicine and in the organisation and resourcing of care and treatment services, but, more importantly, it can be stopped through Government policies and programmes and by action across society. That is what the Executive have committed themselves to do.

Members will be aware that there are substantial inequalities in the health status of different groups in the population here which are clearly linked to people’s social and economic circumstances. There is clear evidence that poverty is the biggest risk factor for health. The better off one is, the longer one can expect to live and the less likely one is to be ill or suffer from a chronic disease or disability.

That applies all the way up the class ladder. Average health prospects improve as one moves up the social gradient. The most affluent socio-economic group here live on average five years longer than the least affluent. Among men, unskilled workers are three times more likely to die before the age of 65 than professionals and managers. A child in the least affluent group is 16 times more likely to die as a result of a house fire, and five times more likely to be injured as a pedestrian, than a child from the top group.

Travellers and their health status are an extreme illustration of that point. Travellers’ life expectancy is almost 20 years less than that of the settled community here. A traveller child under 10 years is 10 times more likely to die than a settled child. Only 10% of travellers are over 40 years, and only 1% is over 65 years.

The point can also be illustrated by location. Electoral wards with the worst deprivation also have the highest death rates. Two thousand premature deaths each year could be prevented if we could raise the health status of those living in the district councils with the worst rates to that of those of the healthiest.

Although those facts have been neglected for many years, they should not surprise us. Poorer people have less money to spend on the physical sources of health such as food and comfortable housing, and their children are less likely to achieve the educational qualifications that are the key to their pulling themselves up the social ladder. They live and work in more difficult conditions; they have borne the brunt of the conflict, and they lead more stressful lives. They are excluded from the benefits of prosperity that the rest of us take for granted, and, in a culture that places so much emphasis on success and achievement, they are more likely to suffer from low self-esteem and to feel powerless and depressed. Those factors bear down on the same group of people, and the damage that they do to health is cumulative.

This health gap — the inequalities in health between rich and poor — is an affront to the principles of equality and social justice that unite us. Members cannot ignore that.

For all the reasons that I have given, the Programme for Government recognises the need for major improvements in the health of our people. One of the Executive’s central priorities under the heading "Working for a Healthier People" is to focus on

"reducing preventable disease, ill-health and health inequalities".

To achieve that, the Programme for Government commits the Executive to develop a cross-cutting public health strategy which maximises efforts to improve health and well-being and to reduce health inequalities across all sectors.

This holistic approach is vital if the Assembly is to bring about the improvements in health that need to be made. It is estimated that 70% of the factors that affect our health are outside the responsibility of the Health Service. The 30-year gain in average life expectancy over the last 100 years has been achieved through improvements in areas such as education, pay and working conditions, housing, food safety, water supplies and waste management.

In July last year, the Executive agreed that as Minister for Health, Social Services and Public Safety, I should take the lead in drawing up a new public health strategy to realise the commitments in the Programme for Government. The Executive agreed that all Departments would work closely together to ensure success.

As a first step, I re-established the ministerial group for public health, of which I am chairperson. The group is made up of senior officials from all Departments. Through this group, each Department is making its contribution to making the strategy work. Each member of the group will assume responsibility for taking forward action in his or her Department.

Last November, the group launched its consultation document. It set out the Executive’s proposals for the new approach and invites all interested parties — which means everyone — to comment on them. We decided to call the process ‘Investing for Health’, because we recognised that by making a little extra effort now we would be able to secure substantial health gains in the future.

The purpose of ‘Investing for Health’ is twofold. First, to improve the health of our people by bringing our health standards up to at least those of the best regions in Europe. Secondly, to reduce the inequalities in living and working conditions that cause ill health by raising the status of those with the worst health to the level of those with the best.

‘Investing for Health’ addresses the wider social determinants of health. It aims to improve health by improving social and economic conditions, living and working environments and people’s ability to cope with difficult circumstances. It complements and reinforces the work of other cross-departmental initiatives, including the action we are taking to ensure equality across the groups identified in section 75 of the Northern Ireland Act 1998 and the new targeting social need initiative.

‘Investing for Health’ will succeed only if it engages energies across the community, including the general public. For this reason, we have initiated an unusually wide-ranging consultation process. As well as inviting written responses to the document, we are seeking to engage individuals and groups who may have had difficulty in making their voices heard. Often, these are the very people who experience the worst health, and it is by helping them that the most improvement stands to be gained. To this end, we have designed and are running the consultation project in partnership with a federation of voluntary and community organisations, the community development and health network. We are keen to hear the views of as many people as possible about what affects their health, what can be done to make it better, who needs to take those actions and how they will work together.

My officials have recently given presentations on ‘Investing for Health’ to a number of Assembly Committees. I see those meetings and today’s debate as a very important part of the ongoing process of ‘Investing for Health’. The consultation process will continue until 31 May. We extended it from 10 April due to the impact of foot-and-mouth disease on public meetings, particularly in rural areas. We will make announcements on the outcome of the strategy later in the year.

‘Investing for Health’ is a continuing, long-term project and process. There is much to be done, and priority areas for action need to be identified. Overall, the consultation document focuses on poverty and inequality, since poor people suffer the worst health. Beyond this, we propose three priority groups for action: the very young, to ensure that babies and young children get the best start in life; children and young people, to equip them with the knowledge, skills and self-esteem to make responsible choices in their lives; and older people, both to extend life and to improve the quality of life in those added years.

‘Investing for Health’ also proposes that action should be organised around settings where people spend much of their time, such as homes, schools, workplaces and communities. The document suggests seven priority topics, factors which we know contribute substantially to death and illness. For each of those topics we know that properly resourced and effectively organised action can produce results. We recognise that transforming ‘Investing for Health’ from a vision to a reality will be a challenge. The document sets out areas where action is required to ensure success.

As chairperson of the ministerial group on public health, I will co-ordinate efforts across Departments on behalf of the Executive. The other Members of the Executive and their Departments will ensure that health factors are given due consideration in their areas of responsibility, and they will take the lead in those areas.

Because we recognise that all Departments’ activities have important implications for health, we are putting proposals together for assessing the health impacts of new policies and programmes. That will enable us to minimise their health risks and maximise their health benefits.

We have also proposed that four health and social services boards should lead local ‘Investing for Health’ partnerships. These would draw together the key interests in each of their areas. There are already good examples of such a partnership approach in the health action zones and, at local level, in healthy living centres. We intend to build on the best of existing good practice.

‘Investing for Health’ sets out an important and challenging agenda for action. It is a great opportunity for all of us to work together to make real improvements in the health of our people. It provides the Administration with an excellent opportunity to promote the public interest by breaking down the barriers to co-operation between Departments and their agencies.

I am delighted to take this opportunity to pay tribute to the officials from all the Departments on the ministerial group, which has already shown enthusiasm in working together on the new approach. I look forward to hearing Members’ views during the debate, and I assure them that these will be considered carefully. I ask Members to join us in carrying forward this approach and to support the motion.

Tommy Gallagher (Social Democratic and Labour Party, Fermanagh and South Tyrone)

I support the motion, and I am sure that none here could disagree with its content. However, it remains to be seen whether there will be the strong commitment and necessary resources from all Departments. We look forward to next year’s report on the targets and how they have been met.

The Programme for Government makes a commitment to raising the quality of the Health Service and tackling issues of poor performance. As we discuss this motion, we are all embarking on consultation on the issue of primary care and awaiting the report of the review group on the acute hospital service. We hope that it will be possible to put in place measures that will deliver a better primary care service to patients and take a greater variety of health care closer to people on the ground.

In relation to the review of acute hospital services, we know that our waiting lists are the worst in the UK, and they continue to increase. There are a variety of issues surrounding waiting lists, not least the odd situation that some hospital units lie vacant while others are working above capacity. That is exerting a particular kind of pressure. On the other hand, some hospital units have spare capacity but are unable to increase the intake of patients due to lack of money for specialist staff. The Health Committee will be looking at issues like that when we measure the targets in the Programme for Government a year from now.

Another concern is what the Minister referred to as "equality of access". That is a major issue, whether it relates to access to GP facilities, accident and emergency facilities, surgery or any other service. It should be the policy and practice of all Government Departments to ensure that all members of the community have equal access and fair treatment. That applies to the activities of the Department of Health, Social Services and Public Safety in particular.

The unacceptably high levels of unfit housing have been mentioned in debates on the Programme for Government. Everyone knows that there is a direct link between the quality of housing and the quality of an individual’s health. Levels of unfit housing are still too high in rural areas, especially in the west of the Province. People are living in appalling conditions in those houses. At the same time, because of the legislation on closing orders, those people are being told that they should not be living in those houses and by doing so, they are breaking the law. Given these serious health and human rights issues, the legislation on closing orders must be given a high priority.

We are also awaiting a report on the Ambulance Service. Throughout the North of Ireland, especially in rural areas, there is a great deal of dissatisfaction with the present service. I welcome the commitment in the Programme for Government for an improved ambulance service, and that is a key area that must be addressed in the coming year. Members of the Health, Social Services and Public Safety Committee would also like to see a much improved level of service as quickly as possible.

There are many concerns about general health, and many recent reports will have been brought to the attention of Members. Cases of TB are on the increase. Many parents have voiced concerns about the safety of immunisation. We need a campaign to address those concerns about immunisation. Once they have been discussed, we must send out a positive message and make clear to parents the need to immunise their children and the inherent benefits.

The issue of men’s health has previously been discussed in the House. A seminar on men’s health is due to be held in the Long Gallery on 12 June, and that should be of interest to all Members. Twice as many women as men live beyond the age of 75, a fact that requires further work and investigation.

The Programme for Government contains a welcome commitment for additional occupational therapy staff. The figure is quite specific: the aim is to have 20 additional staff within the next year. It is hoped that that will happen, but there is still a major problem. We must ensure that action continues for a number of years to decrease radically the waiting times for housing adaptations.

Recent reports remind us that smoking is on the increase, particularly among young girls. That brings us to other health matters, such as young mothers and the risks of smoking during pregnancy. We must address smoking more effectively to turn around this increase.

Ian Adamson (UUP, Belfast East)

I commend this motion. Belfast is one of many European cities struggling with the concept of integrative planning for health development. A number of issues and developments in the city have combined to have a major impact on the population’s health. The consultation process on ‘Towards a City Health Plan’ produced in June 1998 resulted in the identification of four broad themes and provided the opportunity for a common framework for strategic planning to respond to the health concerns of the citizens of Belfast. These themes were outlined in the ‘Belfast Healthy Cities Annual Report’ of 1999 and included the following strategic aims: to improve public transport provision in a co-ordinated approach to planning in the city of Belfast; to develop a comprehensive integrated information system to increase citizens’ accessibility to information and increase a sharing of information between the public sector bodies in Belfast; to provide the people of Belfast with opportunities for lifelong learning, increasing participation from disadvantaged communities in the formal education system and responding to local learning needs; and to improve the mental well-being of the citizens of Belfast with an increase in counselling services for the well-being and improvement of those with mental health problems.

The key role of the Belfast healthy cities programme was to facilitate the establishment of intersectoral strategic planning groups to support the development of integrated planning on all these themes. It has been the most difficult stage of the process to date, struggling with complex issues and with structures in the city which create barriers to integrated planning. There has, however, been real progress with two of the strategic planning groups — communication and integrated information and mental well-being.

Belfast healthy cities programme has had a major impact on the way in which organisations and individuals think about health. Direct links are now being made between health and transport and information and education, to name but a few. The key task for healthy cities over the years has been to facilitate the establishment of intersectoral strategic planning groups to begin a process of developing integrated plans for health. It is an ambitious task but one which Belfast healthy cities has endeavoured to take forward. Many challenges and barriers have been, and will continue to be, encountered along the way. The concept of partnerships for health led by the World Health Organisation’s healthy cities project implies a common goal and vision and requires new skills, new structures and a major shift in cultures and traditions.

As the Minister so eloquently stated, the new Administration here provides a real opportunity to make a radical move towards the lateral interdepartmental thinking which would enhance the climate in Belfast and Northern Ireland as a whole within public sector bodies to develop visible joined-up plans and address the fundamental social injustice and inequalities of health. The steps taken by Belfast healthy cities are early developments in that process. It has been a new learning experience for the individuals involved, and it has brought with it a mixture of creativity, innovation and the inevitable frustration. A change in the strategic direction of the organisation resulting in an evaluation and Belfast’s redesignation to the third phase of the World Health Organisation’s European healthy cities have resulted in a draft three-year strategic plan entitled ‘Integrative Planning for Health Development 2000-03’, which is also available for comment.

In the meantime, Belfast has contributed significantly to WHO European healthy cities network business meetings, with participation for the first time by politicians and a number of new organisations from the city. Significant progress is also being made in the mentoring of Bosnian cities, and Belfast will continue to support the establishment of a healthy cities network in Bosnia and throughout Europe.

Maurice Morrow (DUP, Fermanagh and South Tyrone)

I welcome the opportunity to contribute to this important debate. It is clear that my Department’s responsibilities impact extensively on health and issues of well-being. It has a key role in targeting social need by tackling disadvantage, improving housing, delivering social security benefits, providing child support services, strengthening and developing the community infrastructure and regenerating the most disadvantaged urban neighbourhoods.

I shall outline some of the important work of my Department. We will consult on comprehensive strategies to address the problems of multiple disadvantage in urban areas. The strategies will target action in the most disadvantaged neighbourhoods and establish new neighbourhood structures as partnerships of the community, voluntary, private and public sectors. They will seek to commit the Government to long-term support for neighbourhood regeneration and support action to improve long-term health prospects.

A prerequisite for meaningful neighbourhood regeneration is the strengthening of local communities. We propose to do this — particularly in the most disadvantaged areas — by building a sense of community, encouraging and supporting all forms of community development, strengthening areas with the weakest community infrastructure and introducing community support plans through district councils to underpin the work of local voluntary and community groups.

I am pleased to say that in addition to proposals for new strategies, my Department has for many years been active in dealing with health-related issues in disadvantaged areas, particularly in Belfast and Londonderry. Good and effective working relationships have been developed with the relevant health boards on a range of programmes and initiatives, from a focus on disability through child- related early-years programmes to the health needs of minority groups.

Members of the Assembly will know that providing decent, affordable housing enhances good health and well-being. This has an important role to play in building communities and tackling social exclusion. Research tells us that deprivation is predominantly concentrated in Belfast, the west, Newry and Mourne and Moy. That is why programmes such as new TSN have sought to promote an integrated approach to tackling the needs of these communities. The improvement of public and private sector housing and the renewal of run-down estates are recognised as part of the programme. Northern Ireland has a good story to tell in this respect. Only 2·4% — and I emphasise that figure in relation to some things which have been said today — of Northern Ireland Housing Executive stock is classed as unfit, compared to 7·3% in England and Wales.

We must not, however, rest on our laurels. Further investment is required to eliminate unfitness and to avoid its recurrence. Getting the necessary resources is crucial to success. When lobbying for additional funds last year, I was particularly pleased to secure £8·5 million for the housing budget. Without that, a number of important programmes, such as disabled adaptations, would have had to be reduced. That would have affected the standard of living of the most vulnerable members of the community.

Having a decent home is one thing. Heating it is equally important. Reducing fuel poverty is a key priority for my Department. Fuel poverty — the inability to afford to adequately heat a home — is a terrible blight on society. Living in cold homes can damage people’s quality of life and health, as well as imposing wider costs on the community. While the risks from cold-related ill health apply to all people, groups such as older householders, families with young children, disabled people and those with a long-term illness and on low incomes are especially vulnerable, particularly when they have to spend long periods of the day — if not all day — at home. That is totally unacceptable. Therefore I am dedicated to bringing fuel poverty to an end.

I have taken the important step of introducing a new home energy efficiency grant scheme called Warm Homes. Starting in July, the high-risk groups that I mentioned earlier will have insulation and central heating installed in their homes to improve the home’s heating. The concept is being piloted in parts of Northern Ireland and has already proven successful, with considerable improvements in comfort levels and reductions in fuel bills for the most needy. I commend the Warm Homes scheme as a sign of my commitment to promoting good health, well-being and social inclusion.

In many respects, good housing is the keystone for addressing many social problems. A good house provides peace of mind, contributing to the overall sense of well-being and creating a feel-good factor. Nowhere are the links between housing and health more obvious than in the travelling community. Their living conditions contribute to poor health, low life expectancy and a higher than average infant mortality rate. Their children stand more chance of being hospitalised with minor illnesses than children in the settled community do. My Department is addressing that problem by providing travellers with the type of accommodation that they need. At the moment, it concentrates its efforts on travellers who require bricks and mortar accommodation in either settled estates or in group housing schemes.

A new housing Bill will extend my Department’s role, as it includes provision to transfer responsibility for providing and managing sites for travellers in mobile home accommodation to the Executive. Many of those sites will require work to bring them up to an acceptable standard. They will also need a continuing supply of finance to fund routine maintenance. If the Programme for Government is serious about reducing inequalities in the health status of different groups, my Department must be given additional resources so that it can speed up that process, make progress on group housing and be ready to take over permanent sites.

Getting financial help to those who most need it through the social security system is another vital element in ensuring a good standard of health in the community. My Department is taking the lead by implementing a major programme of change and improvement to the welfare and labour market services in Northern Ireland. The welfare reform and modernisation programme will continue to improve the health and well-being of our citizens in three ways: by providing clear and accessible gateways to benefit and labour market services for all; by tackling potential child poverty; and by helping the disabled to get the support that they need to lead a fulfilling life with dignity.

The reform of the child support scheme, to be introduced by April 2002, will provide prompt and accurate assessments of maintenance. It will introduce improved arrangements for the regular and reliable collection of that maintenance and its payment to the parent. The new system will be easier for clients and staff to understand. It will be transparent, responsive and accessible. It will get money to children more quickly and will be easier to enforce. The new scheme calls for a radical change in culture, service and approach. Maintenance assessments will be calculated accurately in days. Money will flow to parents and children within weeks, and defaulters will be pursued quickly and effectively. The introduction of those reforms will provide direct support to families to ensure that children are raised with an equal level of financial security regardless of whether their parents work and fulfil their responsibilities.

Old people are among the most vulnerable in society. A major reform of the pension system will see improved advice and support services for pensioners. Steps will be taken to ensure that pensioners receive the support that they are entitled to in the minimum income guarantee. To prevent people becoming dependent after retirement and to help them make provision for the future, simplified processes and incentives will be used to encourage working people of low to medium income to build up an adequate pension. The New Deal project will develop measures to assist those with disabilities or long-standing illnesses who are currently dependent on benefit to move into training or work. It is accepted that continuing unemployment can have a detrimental effect on health and well-being.

There are important developments at the delivery end of the social security system, and the ONE service, which we will be piloting from 14 May 2001 in Dungannon, is a practical example of a joined-up Government in action. This service will combine welfare services that are provided by a number of agencies including the Training and Employment Agency, the Child Support Agency, the Northern Ireland Housing Executive, the Rates Collection Agency and the Inland Revenue, as well as the Social Security Agency. It will offer a single point of entry to the welfare system for people of working age and will provide help and advice on work, training and the benefit system, linking work-focused interviews to the claims process.

Another innovation is the partnership between the private sector and the Social Security Agency which aims to revolutionise benefit processing. The 10-year contract between the agency and private sector construction businesses is designed to deliver new telephone and technology solutions and better information management. The transformation of the three disability benefits — disability living allowance, attendance allowance and invalid care allowance — will begin in the autumn and will be fully implemented by March 2002. Plans will then be developed to introduce similar improvements to incapacity benefits.

The extensive and challenging programme that I have outlined demonstrates both my commitment and that of my Department to alleviating the problems caused by poor health standards. It is my intention that my Department will continue to play a full and useful role in this area, together with other Departments.

John (Speaker, Belfast East)

I remind the House that we must move to Question Time at 2.30 pm. If Mr Hutchinson has not finished speaking at that time, he will be recalled at the beginning of the next section of debate.

Billy Hutchinson (PUP, Belfast North)

I support the motion, especially after hearing what the Minister of Health, Social Services and Public Safety and the Minister for Social Development had to say. What they have said proves that when people have control and can make decisions for their own areas, the right decisions can be made for Northern Ireland. I had some difficulty with the wording of the motion. As a Whip, I am entitled to attend Business Committee meetings. Last week I pointed out that it was not clear that the Minister of Health, Social Services and Public Safety was talking about investment in health. Neither the representative from the Executive nor one of her Whips could confirm that that was what she was talking about. However, in her speech, she did say that she was talking about investment in health.

It is great that we can begin to talk about joined-up Government, the Programme for Government and the way that we spend money. There are a number of layers in the structure of the Health Service; these include trusts and boards. Too much money is spent on managing health when it should be spent on administering health. We need to make speedy decisions on how to move forward in health provision and on how to cut out the bureaucracy.

The Minister for Social Development understands the connection between life expectancy and standards of working conditions, housing, education, waste management and water supply. These are the problems in his Department which impact on health. I am pleased that he has recognised the need to do something about health problems. The Minister made it clear that he could not address the problems without additional resources. We all know that those resources are needed, and it is up to us to find them. One way to do that is by restructuring the Health Service and cutting out all of the bureaucracy.

Elderly people are put into different brackets. For example, one bracket would cover people aged 60 to 69. However, people are put into those brackets up until the age of about 90. The amount of money spent on elderly people increases for each bracket. I think it was the Minister of Health, Social Services and Public Safety who spoke about inequalities caused by social background.

It is nonsensical to spend £1 on sixty-year-olds in north or west Belfast and the same amount on people in north Down, although I know that there are areas of disadvantage in north Down — I could name a number of estates in Bangor where people are totally disadvantaged. The life expectancy of people on the Shankill, the Falls, the Oldpark Road or the New Lodge Road is shorter than that of people who are well off. We must turn the formula around and spend £5 on people in those areas at a very early age, reducing it to £1 as they get older.

We must look at how we actually spend the money. Instead of dividing it among electoral constituencies, we need to ensure that we actually spend it on those people who are disadvantaged and who have reached old age having grown up in a disadvantaged situation. We need to turn the situation around.

Finally, there is no provision for young people under the age of 18 with mental health problems in north and west Belfast, because there is no money. The Minister must look at that.

Kieran McCarthy (Alliance, Strangford)

I welcome today’s debate on inequalities in the Health Service of which there are too many, and I am pleased that the Executive are determined to tackle them all. I will point out some that exist in Northern Ireland.

Preventable measures are most welcome. The effects of radon gas cause more than 60 deaths a year in Northern Ireland. I am disappointed by the lack of urgency to tackle that problem, although I am thankful that the issue of smoking is being tackled.

I would like to draw the Minister’s attention to the problems that cancer patients experience in Belvoir Park Hospital, where equipment often breaks down. Everyone knows that machines fail, but the machines in question are not due to be replaced for a long time, so cancer suffers wait longer and travel further for vital treatment. They should not have to wait one hour longer, let alone days or weeks, for treatment. Action should be taken immediately to see that machines are modernised and replaced frequently.

We are also deficient in our treatment of rheumatoid arthritis. That is a debilitating disease that can strike at any age. Drugs exist to treat this condition but are not available in some instances because of the cost. We must not sentence sufferers of that disease to pain and disability as a cost-saving measure. If drugs are required, patients ought to receive them. Those are only two instances of inequality in healthcare that have come to our attention recently, and no doubt there are many more.

The debate gives us an opportunity to discuss care for the elderly. As we grow older and our bodies become more infirm, we face more obstacles in our daily lives. That is wrong and unjust.

We do not need additional obstacles in our health system. Unfortunately, that is exactly what happens. We know that older patients are often placed at the bottom of waiting lists. Their concerns are not being met properly. They do not receive first-rate services in all instances. That is a disgrace and should not be tolerated. It seems that age can become a deciding factor in whether one lives or dies. That is an inequality that we must overcome.

Thanks to the recommendations in the Sutherland Report, we hope that nursing care will be free in all nursing homes from October 2001. Those most in need will get help. Westminster has recognised that nursing care must be provided as a matter of course. However, it has not embraced another Sutherland Report recommendation that said that personal care must also be freely available, determined only by need and paid for by the general taxation. The fact that they have not accepted that recommendation is unfair and will mean that there will be inequalities.

Growing old should not mean growing in fear, worried about how one will pay the cost of living in dignity. For many years, the elderly in our society have been afraid that with ageing, they will be forced to sell their homes or their possessions and use any money that they have saved to provide for the basic help that they may need as their bodies grow infirm. To combat that fear we must embrace the Sutherland recommendations in full. Nursing and personal care must be made available based on need and nothing else.

In many ways, the problems faced by our elderly are part of the larger problem of an inadequately funded care in the community programme. Westminster has not provided the resources that are necessary for people to be taken care of in their homes, whether they need that help because they are disabled, mentally ill or elderly. The Government have declared that the need that is brought on by age does not entitle one to basic help in living a dignified life. In that way, they do not have to fund it. Surely that is an inequality and is wrong.

We should not make the lives of our elderly any more difficult by denying their basic right to having their needs cared for, but that is what we are doing at present. Current practice is simply not good enough. We place people in nursing homes because they need help, but our system cannot provide that help to them in their own homes. They spend nights in the hospital because there are no support staff to assist them when they are discharged. In short, our system is not based on their needs, wants or desires, but gives them a service that they may not want. It is most unfair.

The Government’s response to Sutherland’s idea of providing care based on need is to argue that although they have the money to do this, making personal care universally free is not the best use of resources. They prefer not to spend money to ensure that our elderly can lead lives that are as independent and fulfilling as possible. That is contrary to what every Member of this House stands for. Surely we in Northern Ireland can do better.

If the Executive want to fulfil their pledges on inequality and targeting social need, they must act in the best interests of the elderly in our population. Denying free personal care is not unfair just to the elderly. It is specifically unfair to those, for instance, who suffer from Alzheimer’s disease, a medical condition that leads to more and more disability and inability to care for oneself. Dementia is a symptom of that disease.

Currently, the Government refuse to fund the care needed to alleviate that symptom. That is in complete contrast to how it treats the symptoms and outcomes of any other disease. That response by the Government says that because someone is old, they do not need to provide the necessary personal care. The person can provide it him or herself. That surely must be totally unfair and unjust. We must and can do better. We must treat the elderly with respect and dignity but also fairness. We must provide for their needs. We must implement the Sutherland report as far as possible, to provide free personal care and support to our elderly and the people who care for them. We must bring that measure of equality to our Health Service.

Finally, I wish to support the many things that Members said this morning about equality in the Health Service, which the Minister also mentioned. Now that we have the opportunity, let us do it now. I also welcome the Minister for Social Development’s contribution to the debate. Together all Departments have a duty to stop all those inequalities, and I am sure that they will eventually be successful. On my party’s behalf, I support the motion.

Joan Carson (UUP, Fermanagh and South Tyrone)

Through the Programme for Government we hope to have joined-up Government here. The Department of Health, Social Services and Public Safety will take the lead in health. I welcome the Executive’s commitment to the Programme for Government, through which all Departments will work together to tackle the causes of preventable diseases and disability. A holistic approach to that should reduce serious pressure on hospital beds and help to reduce waiting lists. However, what is the action plan that will enable that admirable objective to be realised?

Reducing inequalities in the health status of different groups is an excellent aim, but of what groups? We have to find out yet, have we not? How many groups will be identified, and how will the inequalities be tackled? A list of the groups of people who feel excluded from equality of treatment is extremely large. Will pensioners have true equality of treatment, and how will ethnic minorities be treated? Will they get equality? What about our poor practitioners who do not speak the language of many of the ethnic minority groups who are now here? I am talking not only about the Irish language but about Koreans, Portuguese and other minorities.

What about expectant mothers? Will they have equality of access to maternity services across Northern Ireland? What about Fermanagh and South Tyrone? No later than last Monday, an expectant mother from south Tyrone gave birth in an ambulance as it travelled to Craigavon. That was our fear when the South Tyrone Hospital was closed down, and it is coming to pass.

About a year ago, we were told that ambulance staff were being trained in obstetrics, and I asked whether we were to expect mothers now to have children at the side of the road. Well, that is what we have heard about already. As a result of the heavy emphasis in the health strategy that favours urban areas to the detriment of rural ones, incidents such as that will happen again and again. There is too much emphasis on urban areas, and that affects our ambulance call-out times.

The Ambulance Service needs to be considered, because it is a bit thin in rural areas. There was a critical accident last weekend in Fermanagh and South Tyrone, and the ambulance took exactly 21 minutes to arrive — not 20 or 22, but 21 minutes, so it escaped censure. That is too fine a line to have in a serious emergency.

Much has been said about the need for equality in health matters in areas of economic disadvantage. Centralisation by health authorities is compounding the problems by differentiating between urban and rural areas. That is especially highlighted because practically all major hospital services are located east of the Bann. That has brought about inequalities in the entire area west of the Bann, not just for specific groups but for the whole population there.

Equality of provision is vital if we are to create a healthier population, but I wish to know exactly what action plan the Department of Health, Social Services and Public Safety will use to bring this about. How will that Department co-ordinate with all the other Departments? Reducing inequalities in our health status must also include reducing inequalities in the provision of medical care, and that must also extend to reducing administration in hospitals and addressing the perception that patients are numbers to be processed rather than people to be tended.

Hospital hygiene and nursing staff care need to be of the highest standards to reduce the risk of patients contracting infections.

With the involvement of all the Departments in that review I look forward to a reduction in our health inequalities. The Department’s efforts should concentrate on Northern Ireland. Northern Ireland has to look at its own problems and put its house in order before looking at the problems in the Republic of Ireland.

I support the motion and look forward to increased equality of treatment west of the Bann as well as in the rest of Northern Ireland. I also look forward to seeing an example of joined-up government.

Patricia Lewsley (Social Democratic and Labour Party, Lagan Valley)

I welcome the Programme for Government’s commitment to interdepartmental co-operation in addressing the underlying causes of preventable disease and disability. However, there is little evidence of such Departments getting their houses in order to eliminate current inequalities, never mind interdepartmental co- ordination to tackle those issues.

Northern Ireland has a significantly higher proportion of people with disabilities per capita than the rest of the United Kingdom. As such we need to develop and implement a comprehensive package to deal with the basic factors behind the issue. As has been mentioned, there is still a high incidence of health differentials between the rich and the poor. If one looks at a map of Northern Ireland and marks out the areas of high unemployment and poverty, it is evident that those are the areas that also suffer the greatest disadvantage in healthcare, low awareness of preventable disease, poor diet, less health education and poor access to health services that are taken for granted in areas that are better off. All those issues are interrelated.

Statistics show an increase in incidences of asthma and coronary and respiratory illnesses in those areas.

The Minister of Health, Social Services and the Public Safety and the Deputy Chairperson of the Health Committee, Mr Gallagher, have mentioned many inequalities in health status. However, there are also inequalities in provision between the health boards. Patients in the Southern Health and Social Services Board can avail of a neurocybernetic prosthesis system for epileptics, while those a few miles up the road in the Eastern Health and Social Services Board cannot. Why is that?

Infertility treatment is also class-oriented, because many couples on low incomes cannot access it because of the high costs of private treatment.

Other areas of long-term illness, or hidden long-term illness such as rheumatoid arthritis, do not receive the same type of funding or attention as chronic long-term illnesses such as the cancers. Will the Minister set out a strategy for dealing with patients with those long-term illnesses and provide the funding for the treatment of rheumatoid arthritis and other less recognised long-term illnesses? Limited respite care for people with disabilities, the elderly and those suffering from long-tem illnesses is causing much distress.

Care in the community is underfunded and often varies greatly between geographical areas. The Assembly must look at the low rates of benefit for carers. Despite extensive savings on resources and their invaluable contribution in caring for their relatives and friends, many carers suffer extreme financial hardship and are caught in the poverty trap because they have to depend on the benefits system.

Carers contribute much to the community and deserve support and recognition for their work. Without them the pressures on an already overburdened system would be impossible to cope with. Over the years, with the reduction in social services provision for care in the community, these people are often left with sole responsibility for someone who is ill or disabled. The carer can become isolated and suffer from low self-esteem and low self-confidence. Caring for someone should be recognised as a profession and not taken for granted because it is seen as a family responsibility.

Carers are often put on hold or are totally forgotten about when caring for a relative or friend. They deserve our respect and recognition. They need support in return for their invaluable contribution to society. None need that support more than the growing number of children who, from a young age, take on the responsibility of caring for a parent, or even parents, through circumstance rather than choice.

Day care for people with learning disabilities is essential and is a basic human right. It should be mandatory to reduce social exclusion and to provide people with training and more job opportunities. The impending crisis we face as a result of the reduction in European funding, means that many voluntary and community groups in the sphere will cease to exist. The increased pressure on existing service provision and on the individuals concerned could cost society dearly. Closer co-ordination between the Department of Health, Social Services and Public Safety and the Department of Education is needed to alleviate that hardship.

The Deputy Chairperson of the Health, Social Services and Public Safety Committee talked about immunisation and vaccination. However, 5,000 children across Northern Ireland have neither been tested for tuberculosis nor given the BCG vaccination. Admittedly, there has been a drop in the number of cases of TB here, but there are still instances. We could easily find ourselves in the same situation as a town in England that had an outbreak of TB not so long ago. What action is the Minister’s Department taking to address that?

Many of the issues cannot be taken in isolation. They are not just health issues but have to be viewed in terms of human rights, equality, education and social development. They need to be tackled on an interdepartmental basis. I support the motion.

Robert Coulter (UUP, North Antrim)

I support the motion and welcome the statement by the Minister. I commend the Executive on their initiative for an interdepartmental approach to healthcare. The concept that health is the sole domain of healthcare practitioners has been around for far too long. It is great that the consultation document ‘Investing for Health’ recognises that the health of the community is the concern of the whole community. The old maxim that prevention is better than cure is very relevant today. The Executive’s initiative to involve all Departments in making health central to all our activities should be supported by everyone.

Health education must begin at primary school, or even at nursery school. Children should be brought up to believe in their community’s health, not just in their own or in their family’s health. When that attitude is instilled in the mind early in life — although it may take some years to develop — it will result in the health of the community becoming central to everyone’s thinking.

However, there are one or two problems. Consider the pollution in some of our rivers and in our countryside. Private companies are correctly penalised for creating that pollution, yet Government agencies escape with an apology when raw sewage escapes into the rivers. Will the Minister and the Department see to it that Government agencies do not get away with polluting the countryside, leaving private companies to pay the bill?

I am a little cynical about the boards working in partnership. People in the trusts, and particularly the regional hospitals, tell us that they cannot get the boards to agree on the amount of money to be given to update essential equipment. How will the Minister and her Department make sure that the boards will work in partnership? A new spirit of co-operation among the boards, rather than one of competition, will guarantee the health of the community.

It is not just the environment. The whole of the Health Service in Northern Ireland needs to be looked at from top to bottom, or vice versa. It is an indictment of the nature of our Health Service when we are told that some cancer patients will die without even seeing a consultant, or when we are told that someone had to sit for eight hours in an accident and emergency unit because that was the only way that the GP could have that patient seen by a consultant. Something has gone sadly astray.

We are faced with the increase in the elderly population. That will demand greater powers for the Health Service if we are to cope. Yet I am encouraged; ‘Investing for Health’ — the health of the community — is something to be commended. I commend the Department, the Minister and the Executive on the initiative. Together we go forward to a better and healthier community.

Alasdair McDonnell (Social Democratic and Labour Party, Belfast South)

I, in common with other Members who have spoken, would like to add my appreciation for the fact that this motion is being debated today. I welcome the commitment of the Government and the Department of Health, Social Services and Public Safety to work energetically to tackle the root causes of preventable disease and disability and to reduce the inequalities in health status of our different population groups.

Perhaps I speak with a touch of cynicism, although I mean no disrespect to the Minister or anyone engaged in the struggle. When I first looked at this document I thought that it was good, decent, sound and that it reflected the way we wanted to go. However, after a second look, I said to myself "How much will we achieve? Does this mean anything, and, more importantly, will it ever mean anything to the vast majority of our people." I am talking about the ordinary people at street level who could be referred to in some circumstances as working class — people at the poorer end of the social spectrum.

Although I am concerned about the poor levels of health, health promotion and disease prevention across Northern Ireland, particularly among the working-class people, I am concerned about the plight of people in that socio-economic group in inner-city Belfast. My concern stems from knowledge gained while working for 20 years as a full-time GP in the inner city, and I continue to work there part time as circumstances here permit. Making my observations from that position, I view the health and disease promotion programme as all too often being middle class in its attitudes and values. Often it imposes these values on a working-class problem, which is not a solution for success. Often the language and expectations are different, as is the access to wealth.

Those who have resources can access better quality food, living conditions, housing and everything else. At a simple level it is easy to give someone a lecture on the dangers of the lard content of the Ulster fry and the risk it carries for coronary heart disease.

However, in many cases, people do not have — or do not perceive that they have — the option to adopt a healthier diet.

As a doctor in inner-city Belfast, I noticed that many of the resources, facilities and programmes operated out of relatively middle-class bases, such as Finaghy, Dunluce Health Centre and Holywood Arches. Although Holywood Arches Health Centre was adjacent to Sydenham and the working-class area of east Belfast, much of its catchment area was the area around Stormont. Such facilities were excellent for people with cars, but, in many cases, they were inaccessible, because the bus routes were unsuitable and, quite often, the people who needed to get to those facilities could not walk to them.

I worked in the Health Service on the lower Ormeau Road. We worked in the original health centre in three old terraced houses. There were few resources and only limited facilities to serve a deprived inner-city community that crossed the divide. We covered the Markets area, Sandy Row, Donegall Pass, lower Ormeau, Annadale and the lower Ravenhill Road. Those were the people who could not access the facilities that they needed. Not only were those areas deprived, but they were hammered by the troubles and the social unrest of the last 30 years.

In that period I and others like me struggled to obtain recognition and investment for that deprived inner-city community from the former Department of Health and Social Services. For all those years, we were on a continuous merry-go-round. I first started discussions about a new building 16 or 17 years ago. The present building has been condemned for health and safety reasons, but we must survive in it. There are no modern facilities. Indeed, the support services that we had have been taken away. I am not talking about my own practice; I am talking about a facility that, at one stage, served most of south and east Belfast. It has shrunk as other people have picked up some of those services, but, by and large, it still delivers a service of sorts to the deprived inner city. There has been pain, grief, worry and stress in that area. The problem is far too important to be entrusted to the Department. The problem is not one of bureaucracy or architecture; it is about providing services for people, and that is where our Health Service falls down.

People could, perhaps, accuse me of pursuing self-interest; that is not so. I intend to withdraw entirely from general practice in the next year or two. However, I want to see adequate resources and healthcare provided for people in the inner city. Judging by what I have seen, there is too much morbidity and ill health in that area. Too many people die young from a whole range of illnesses. Many cases could have been treated or cured, had they not been neglected. Although much of the neglect is the responsibility of the patients themselves, the lack of access to facilities and the absence of a welcoming centre in that area mean that the treatment of cancers, heart disease and other illnesses is put on the long finger.

I do not want to be emotional or sentimental about it. There are gaps, and we do pay a lot of lip service. I am not accusing our current Minister, because this has gone on for many years. However, until something is done about similar situations we will not have done anything for the Health Service, and we will not have the Health Service of which we want to be proud.

We can say that we have lots of wonderful programmes and policies. Those dealt with issues such as women’s health — an issue that particularly concerns me. While the programmes and policies are available, they can only penetrate those who can access them intellectually and physically. Many programmes miss working class people in the inner city totally. They pass those people who have been battered for the past 30 years by social unrest.

At times over the past 12 years I have been conscious about the problems in women’s health and of the fact that a mere male can do only so much. During that time I enlisted three female partners in order to set a high priority on women’s health. We tried every possible way of communicating with the female population, but we could only get a 55% uptake in our cervical cytology efforts. Short of physically grabbing people in the street we could not get beyond that figure. People felt that they could not avail of that service. The Department of Health expected us to have a 75% or 80% uptake. We tried to communicate in ways that we thought people could relate to, but they declined the tests. There is an issue about how we communicate with people and encourage them to avail of proper healthcare after we have provided the appropriate facilities.

Some years ago we thought that we were doing very well. I had one male partner and three female partners, and we were all gung-ho on women’s health. We decided to congratulate ourselves by auditing on our perceived success, and we interviewed 200 women between the ages of 45 and 55. We were quite sure that we would get a tremendous result of about 80% satisfaction because the women were in the surgery every week and, therefore, they had to be healthy.

However, the reality was that they were there every week as messengers for mothers, fathers, grandmothers, grandfathers, children, husbands or grandchildren. They were there as the contact point — the communicator. In many ways they were the secondary providers of healthcare for their families. From the 200 women we interviewed we found that approximately four were in reasonable health. The rest had problems.

I do not want to go into the gory details, but in this day and age, some of the problems were unforgivable. Many of the women had a significant degree of incontinence as a result of injuries received while giving birth 20 years before, or as a result of a clumsy or bad delivery. Many suffered from mental illness such as prolonged post-natal depression, which had not been diagnosed at the time.

One of the great revolutions in the Health Service was the provision of community psychiatric nurses 12 to 15 years ago. However, the service has been cut back to the point where it is barely viable. Community psychiatric nurses were a godsend 15 years ago, yet the service is now tight.

I have given you two examples of conditions that are unforgivable. I could say a number of other things. We pay a lot of lip service. We have a lot of nice reception areas and fancy brochures on breast cancer, cervical cancer, ovarian cancer and a whole array of things specific to women. We have to start putting this into real action and into a form that communicates to working-class people in deprived inner-city areas.

I have said enough, but I would like to switch to the other end of the spectrum before I finish. We spend a lot of time talking about cancers. Thank God, we are steadily winning the war against cancer, and the percentage curability of cancer tends to go up and up — not fast enough, but it is increasing. I am proud of my involvement — however limited — with the new cancer set-up in Belfast City Hospital. I believe that we will, in due course, have a world-class centre there.

I am distressed, however, that, in many such cases, we can be penny wise and pound foolish. Members are probably familiar with the gastroscope, the telescopic instrument that is passed down into the patient. That has been modified, and a version has been produced with ultrasound. It can produce a heart echo or a picture of a baby before it is born and can give an exact picture of a tumour. It is one of the most modern and essential pieces of equipment for diagnosing and assessing the treatability of cancer of the oesophagus, the stomach or the gullet. The surgeon knows exactly what he often has to treat.

That equipment costs about £120,000 or £130,000: we do not have one. I raised the matter with people in Belfast City Hospital and was told that efforts to gather together free funds have produced £90,000 to £100,000. In some cases, people are vulnerable to surgery. They have tumours in the oesophagus or the stomach, but they are perhaps not up to surgery. The surgeon needs to know what he or she is faced with before starting surgery and whether surgery will be too life-threatening to undertake at all. The only access to that equipment on the island of Ireland is in Dublin, and I understand that, in some cases, patients have been sent by taxi to Dublin.

We must get our act together. I emphasise that my concerns are in no way attributable to the current Minister, who has been in the job for less than two years. I support the motion; I say, "Hurrah! Let us get to grips with this!" We should get into more detail, and we need more papers on health. We should take a serious, practical look at the big gaps in provision and at the lack of funding. We must consider how we can provide a health service that meets the needs of people, without promising the world and only delivering half — or less.

Bairbre de Brún (Sinn Féin, Belfast West)

Go raibh maith agat, a LeasCheann Comhairle. Tugaim mo bhuíochas do gach Teachta a labhair sa díospóireacht. Tá an-áthas orm gur spreag an t-ábhar oiread díograise, agus chuir mé suim sa mhéid a dúradh.

Dhearbhaigh an díospóireacht tacaíocht an Tionóil do chur chuige láidir trasroinne le sláinte ár bpobail a fheabhsú; cur chuige a chuireann cúiseanna sláinte agus easláinte go hiomlán san áireamh agus a athníonn go gcaithfidh dul i gceann éagothromaíochtaí sláinte go diongbháilte.

I am grateful to all the Members who contributed to the debate, and I am delighted that the subject has engendered so much enthusiasm. I listened with interest to all that was said. The debate confirmed — as, I hope, will the vote — the Assembly’s support for a strong cross-departmental approach to improving the health of our people that takes full account of the causes of ill health and recognises the need to act resolutely to tackle health inequalities.

Several issues that were raised during the debate served to reinforce the argument that health improvement cannot be left to health services alone, or to Departments alone. That is why it is so important that all Departments and all sectors and agencies work together. The ministerial group on public health, which is made up of officials from all Departments and I chair, has designed a consultation process that is well beyond the usual and will engage all sections of society.

Several Members pointed to the need to improve specific services or ensure that sufficient resources are available to strengthen them. I assure Members that I support the case for adequate funding for all aspects of health and social services including mental health care for young people, the Ambulance Service, community care, primary care, acute hospitals and all other aspects that were mentioned.

It is especially important to ensure that health services are of a high quality and fully accessible to those who need them most, including people who live in isolated rural areas. My Department’s equality scheme sets out how it will pursue access for designated equality groups. I outlined in previous debates steps that have been, and are being, taken by my Department on rurality, and Executive Colleagues outlined other steps during the debate on the Programme for Government.

‘Investing for Health’ is not just about treating disease or caring for the sick, vital as those things are. It is not a matter of traditional health protection activities, such as immunisation or improving food hygiene. It is not confined to the traditional health promotion messages to which Dr McDonnell referred to. It goes beyond the traditional approach to health education with its focus on persuading people to change their behaviour. It is not confined to the professional disciplines of public health medicine, health promotion or environmental health. The World Health Organisation defines health as

"a complete state of physical, mental and social well-being and not simply the absence of disease".

Public health has been defined as

"organised social and political effort for the benefit of populations and individuals while also involving health promotion and personal responsibility for health."

It is important, therefore, that the emphasis in the consultation document is on the wider social determinants of health.

I am pleased to tell Members that the World Health Organisation contributed to the consultation on ‘Investing for Health’. Its comments are extremely supportive and endorse our proposals as an excellent example of the World Health Organisation’s preferred approach.

Mrs Carson and other Members asked what we will achieve in practical terms. Effective monitoring and accountability arrangements will, of course, be essential to the success of the strategy and to ensuring that it goes beyond a consultation document, a discussion and a strategy. The ministerial group on public health consists of senior officials from all the Departments, and it has been fully involved in developing the strategy. Group members will, in their respective fields, continue to play a key role in supporting its implementation. The ministerial group on public health that I lead will also consider, in the light of the consultation responses, what additional monitoring arrangements are needed for the new interdepartmental approach to ensure that the strategy happens and produces results.

Unsurprisingly smoking was referred to. It is one of the priority topics identified in ‘Investing for Health’. I share the Member’s concern about the number of young women who are taking up smoking. Our death rate from lung cancer among young women is already twice the western European average. The Health Promotion Agency has co-operated with the Midland Health Board region in the South to target smoking among young people through a television advertisement. We also looked at the importance of tackling smoking among young girls at school on an all- Ireland basis. The Department of Health and Children in Dublin has nominated a representative to our working group on tobacco that is developing an action plan to tackle smoking.

I thank Dr Adamson for his contribution about the positive role that the Belfast healthy cities project is playing. That project is much in keeping with the proposed approach outlined in ‘Investing for Health’ by focusing on the wider social determinants and working to broaden participation in action for health. I am pleased to hear about the progress that is being made, and I anticipate that the healthy cities experience will be built on as the investing for health process moves forward.

Mr Billy Hutchinson highlighted the need to maximise efficiency in the Health Service. Management and administrative costs in the health and personal social services (HPSS) are already closely monitored and controlled in order to maximise the resources that are available for care. Those costs amount to less than 2% of health and social service boards’ total expenditure, and an average of 4.5% of the expenditure of trusts. Of course, it is paramount that we stress not only the need to get more resources for health, social services and public safety but to make the best use of those resources once we have them.

I agree with Mr Gallagher’s comments on the significance of the rise of TB. I assure him that the number of cases of TB is not increasing here. In the year 2000 the number of cases here was at its lowest ever. The schools BCG vaccine and TB testing programme has recommenced this term, starting with children who are due to leave school this year. Other children who have missed the BCG vaccine will have the chance to get it from September.

On Mr McCarthy’s point about radon, I am informed that the Environment and Heritage Service has offered 90,000 free radon measurements to households, but so far only 20% of households have taken up that offer. If a measurement is above the action level set by the National Radiological Protection Board (NRPB), remedial action is recommended, and grant assistance might be available. The Department of Enterprise, Trade and Investment is responsible for ensuring compliance with health and safety legislation in public buildings, workplaces and schools.

In regard to the safety of the measles, mumps and rubella (MMR) vaccine, my Department issued new information materials for parents and professionals in April. I agree with Mr Gallagher, who raised the point, and with other Members, that we must all stress the benefits and the necessity of immunisation.

A common theme that runs through all the issues raised by Members is that there not only needs to be action within the realm of health and social services, but also on issues that do not respect organisational boundaries and that demand integrated strategic solutions.

I am happy to report that good progress has already been made on the cross-departmental approach to addressing health issues. People have asked whether that would be a new beginning. Mr Morrow highlighted some of the actions that his Department is taking, and I am grateful to him and his officials for their contribution to the process. The Minister of Enterprise, Trade and Investment and I recently signed a joint statement of intent to address the issue of workplace health. The cost to the local economy of illness is immense, and we are committed to a programme of action to make workplaces healthier. I know that work will be done to establish an occupational health forum to meet these needs.

My Department has also been working closely with the Department of Agriculture and Rural Development to address the serious issue of stress in rural communities. Officials in my Department have been working with the Department for Regional Development to pilot a health impact assessment of that Department’s regional transportation strategy. Those are examples of how, by working together, we can make a significant contribution to improving people’s health. Through ‘Investing for Health’ we will be identifying further opportunities for such an approach. That will involve close consideration by all agencies of the positive steps that they can take to promote health, as well as the monitoring of any negative factors that impede good health. Monitoring will be part of the strategy development.

‘Investing for Health’ aims to improve health by broadening participation and action through partnerships which include community groups, voluntary organisations, businesses and statutory partners. It is important that people tell us what they need during the consultation period and during the implementation of the strategy.

The Members who have highlighted that also have a vital role to play. I hope that Members will feel stimulated by today’s discussion to encourage the many people that they come across to respond to the consultation in a variety of forms. We have opened this up beyond the normal consultation processes — written responses and public meetings — by encouraging contributions through videotape or audio tape and other discussion forums. We have had a photographic exhibition sponsored by the ‘Belfast Telegraph’, and we have had sponsorship of drama from the Arts Council of Northern Ireland and others. There are a variety of ways in which people can make their views known.

I hope that the Members who have shown such interest today will also encourage people to make their views known, both before the end of the consultation process on 31 May and as the implementation of the strategy develops in the future. I also encourage them to ask people to think about what more they can do in their own lives to help improve the well-being of their families, friends and communities.

At the outset of today’s debate I said that I wanted the consultation process for ‘Investing for Health’ to be truly inclusive. Everyone has the right to have their voice heard on issues that affect them, and no issue has more universal relevance than health. Therefore I encourage everyone to contribute. I will be taking into account all the views put to me, and they will be used to draw up proposals for the implementation of the strategy, which I intend to put to the Executive in the autumn. Those will be published, together with a report on the outcome of the consultation process, and there will be an equality impact assessment.

The next step is to ensure, as Members have said, that we have sufficient arrangements and resources in place to ensure effective implementation of the strategy and effective monitoring arrangements to see how it is brought forward. My intention is that it will come into effect from April 2002.

I thank all the Members who took part in today’s debate. I hope that I have managed to address the issues they raised. Officials will scrutinise the record of the debate and, if there are points that I have missed, I will write to the Members concerned.

Question put and agreed to.

Resolved:

That this Assembly welcomes the commitment in the Programme for Government for all Departments and their statutory agencies to work resolutely and energetically together to tackle the root causes of preventable disease and disability, and to reduce inequalities in the health status of different groups in our population.

Adjourned at 4.58 pm.