Ó d’ainmnigh an Chéad-Aire agus an LeasChéad-Aire sinn, d’fhreastail an Ridire Reg Empey agus mé féin cruinniú earnála na Comhairle. Bhí Micheál Ó Máirtín, an tAire atá freagrach as an Roinn Sláinte agus Páistí (RSP) ann thar ceann Rialtas na hÉireann.
Fuair an Chomhairle tuairisc bhéil ó Mhartin Higgins, Príomhfheidhmeannach eatramhach Bhord Cothú Shábháilteacht an Bhia. Chuir an tUas Higgins baill na Comhairle ar an eolas is déanaí faoina chuid oibre i mbunú an bhoird, agus ar fhorbairt imlíne chorparáideach an bhoird, arbh iad a aidhmeanna cur chun cinn shábháilteacht an bhia, taighde ar shábháilteacht an bhia, scéala ar airdill faoin bhia, faire galar a iompraítear ag an bhia, cur chun cinn comhoibriú eolaíoch agus ceangail idir saotharlanna agus forbairt chostas-éifeachtach áiseanna do thástáil shainfheidhmithe saotharlainne.
D’áirigh an Chomhairle an staid fá láthair, agus go dtabharfadh an tUas Higgins tuairisc shonraithe don chéad chruinniú eile, ina mbeadh dréachtphlean corparáideach agus struchtúr foirne le moladh. Tuigim nach mbeidh dréacht-phlean corparáideach agus mionchuntas ar struchtúr na foirne ar fáil don chéad chruinnú earnála eile ar an 4 Iúil. D’áirigh an Chomhairle fosta go mbeadh a chruinnú bunaithe ag an Bhord Comhairle san iarnóin sin agus bhí siad ag dúil le bheith ag obair go dlúth le Bord Cothú Shábháilteacht an Bhia.
Mheas an Chomhairle ceisteanna in achar na Sláinte, a shíl cruinniú iomlán na Comhairle in Ard Mhacha ar 13 Nollaig 1999 ba chóir a phlé. Is iad na ceisteanna, Pleanáil don Timpiste agus don Éigeandáil, Móréigeandálaí, Comhoibriú ar Threalamh Ardteichneolaíochta, Taighde ar Ailse agus Cothú na Sláinte.
D’áirigh gach Aire samplaí den chomhoibriú éifeachtach atá ann cheana sna hachair sin ach, ag cuimhneamh ar staid na sláinte ar fud na hÉireann, d’aontaigh siad go bhfuil mórán eile le cur i gcrích. Tugadh suntas go háirithe do mhinicíocht tinneas croí agus ailse bheith doghlactha ard sa dá chuid den oileán agus aontaíodh go bhféadfaí a lán a dhéanamh i gcomhar le stíl bheatha ba shláintiúla a chothú.
D’aontaigh an Chomhairle gur chóir feidhmeannaigh an RSSSSP agus an RSP sna cúig cheantar a choimisiúnú le páipéir a ullmhú don chéad chruinniú eile, a leagfadh amach conas a thiocfadh oibriú i gcomhar i ngach ceantar.
D’aontaigh an Chomhairle go dtionólfaí an chéad chruinniú eile go luath i mí Bealtaine agus go n-ullmhódh an Rúnaíocht sceideal cruinnithe don chuid eile den bhliain.
D’aontaigh an Chomhairle ar théacs scéala oifigiúil a eisíodh i ndiaidh an chruinnithe. Cuireadh cóip den scéala oifigiúil i Leabharlann an Tionóil.
With permission, Mr Deputy Speaker, I wish to report to the Assembly on the meeting of the North/South Ministerial Council held in sectoral format in Belfast on Friday 4 February. The meeting considered — [Interruption]
My problem — this happened at the Forum too — is that I sometimes have a hearing problem. I am afraid that I did not hear anything which seemed to me to constitute a great disturbance.
Further to that point of order, Mr Deputy Speaker. For a Minister to speak in a language that most people even on that side of the House do not understand is a waste of the Assembly’s time and is the most gross type of discourtesy. People have complained about Members turning their backs and not being interested. But how can people be interested in listening when the vast majority of Members do not understand the language? It is simply wasting Members’ and the House’s time.
Mr Dodds, what is wasting Members’ time is the making of speeches of a repetitive character in place of a point of order. I have made comments about points of order before, and Members should be aware of them. First, they should relate to Standing Orders. Secondly, they should be points and not little bristles, and thirdly they should not be occasions for speeches.
On a point of order, Mr Speaker. I wish to remind Members that Standing Order 71 permits Members to speak the language of their choice. Also, in relation to the last point from Minister Nigel Dodds, it is inappropriate that he and Peter Robinson — two Ministers who may well be treating all of the electorate with contempt — should be treating people here with contempt. They were both speaking while the Minister was making her statement.
Order. Mr Maskey, I have already said that points of order should be points and not a series of points. However, you did make an extremely good point that I commend. You had taken the trouble to attach your point of order to Standing Orders.
On a point of order, Mr Speaker. This is a point of order, which I trust you will rule on. Is it in order for any Member to say that another Member should be treated with contempt? The hon Member has said that two Ministers in our Government should be treated with contempt. Surely that should be ruled out of order.
The meeting considered food safety and co-operation on health matters. Following nomination by the First Minister and the Deputy First Minister, Sir Reg Empey and I attended the sectoral meeting of the Council. Micheál Martin, the Minister with responsibility for the Department of Health and Children, represented the Irish Government.
The Council received a verbal report from Martin Higgins, interim Chief Executive of the Food Safety Promotion Board. Mr Higgins updated the Council members on his work to date in establishing the board and on the development of an outline corporate plan for the board. Its functions are the promotion of and research into food safety; communication of food alerts; surveillance of food-borne diseases; promotion of scientific co-operation and linkages between laboratories; and developing of cost-effective facilities for specialised laboratory testing.
The Council noted the current position and that Mr Higgins would be bringing a detailed report to the next meeting which would include a draft corporate plan and a proposed staffing structure. I understand that a draft corporate plan and detailed staffing structure will not now be available for the next sectoral meeting scheduled for 4 July. The Council also noted that the advisory board would have its inaugural meeting that afternoon and looked forward to working closely with the Food Safety Promotion Board.
The Council considered issues in the area of health, which the plenary meeting of the Council in Armagh on 13 December 1999 had agreed should be discussed. The issues are accident and emergency planning, major emergencies, co-operation on high technology equipment, cancer research and health promotion.
All Ministers noted the examples of effective co-operation already taking place in these areas but, given the health status in the whole of Ireland, agreed that much more could be achieved. Incidences of heart disease and cancer in both parts of the island were particularly identified as being unacceptably high, and it was agreed that much could be done jointly to promote healthier lifestyles.
The Council agreed that the leading Department of Health, Social Services and Public Safety and Department of Health and Children officials for each of the five areas should be commissioned to prepare papers for the next meeting, setting out for each area how common work might be taken forward.
The Council agreed that the next meeting would take place in early May and that the secretariat should prepare a schedule of meetings for the remainder of the year.
The Council also agreed the text of a communiqué which was issued after the meeting. A copy of the communiqué has been placed in the Assembly Library.
Perhaps the Minister will tell us what advice she got from her personal adviser, one Louis Green, who, after being charged with and found guilty of the murder of a police inspector, went on hunger strike. Did he give her any advice about food safety promotion? After all, he may have had some personal experience in the matter.
Knowing that the Minister has a deep interest in employment, and especially in the employment of Protestants in her Department, will she ensure the House that this advisory board will be set up in such a way that fair employment will be taken into consideration? Will she assure us that there will be no breach on that? Protestants can also be employed under the fair employment legislation and the largest sum of money ever paid out by the authorities was paid to a Protestant who was treated shabbily by the Arts Council, and that led to the resignation of the officers of that council.
Fuair mé comhairle ó chuid mhaith daoine sa Roinn sula ndeachaigh mé chuig an chruinniú sin ar an 4ú lá de mhí Feabhra. I dtaca leis an duine a luaíodh, tá ardmheas agam air. Tá sé de cheart ag an Aire a rogha féin a cheapadh don phost áirithe sin.
I sought and received advice from several people in my Department before going to the meeting on 4 February. With reference to the person named, it is for the Minister to appoint special advisers, and I am absolutely, totally and utterly content with the person I have appointed. I have every confidence in him.
I presume that the question about the setting up of the advisory board refers to staffing. The board has already been established. Indeed, it had its first meeting on 4 February. Unlike the other North/South bodies, the Food Safety Promotion Board inherits no existing staff. An interim chief executive is currently employed in the Food Safety Agency Authority of Ireland, and he has been appointed by the North/South Ministerial Council. He will draw up a proposed staffing structure which we had hoped would be available for consideration at the meeting on 4 July. However, it is clear that the staffing requirements will be based on the future workload of the Food Safety Promotion Board. Open competitions will be held for posts and advertised in the European Union. Terms and conditions will comply with fair employment and other legislation, as directed by the European Commission, and I anticipate a staff of about 30, which will include some scientific and promotion expertise.
Although it does not specifically refer to my statement on the meeting in February, I have heard reference, several times, to my interest in the employment of Protestants in the Department. I wish to state that I have absolute faith in all those working in my Department to carry out their duties; I have never shown, nor do I intend to show, any interest in whether or not they are of one religion or another.
I welcome the Minister’s statement and the ongoing co-operation between the Northern and Southern Administrations. I am not sure from her report on the Food Safety Promotion Board whether the Minister is aware of the increase in salmonella food poisoning in Northern Ireland. I am not sure of the reasons for that, but hope that the matter will be examined.
The Minister also referred to the accident and emergency planning co-operation and to the high technology equipment that is needed for cancer research and health promotion. Co-operation in high technology, and especially for cancer, is extremely important. One in four people will contract cancer, and one in three of those will die from it. The technological investigation of cancer is done by means of computerised axial tomography (CAT) and magnetic resonance imaging (MRI) scans. Further down the line is what is known as PET, positron emission tomography, which is high powered technology that can be used in the diagnosis of cancer. It is extremely expensive equipment, and I know that major hospitals in Northern Ireland and the Republic would dearly like to have it. I imagine that the Administrations here and in the Republic are looking at that. It is very important for the people on the island of Ireland.
Fáiltím roimh an cheist sin, ó tá baint aici leis an sábháilteacht bia. Is cinnte nach dtig linn glacadh leis go bhfanfadh ceisteanna den saghas sin ar aon taobh amháin den teorainn.
I welcome the Member’s question. It is precisely because diseases such as salmonella and BSE do not respect borders that it is so vital that we work on an all-Ireland basis. People will be aware of the new Food Standards Agency and Food Safety Agency that have been set up. Clearly since most food safety regulation now flows from Europe, standards are becoming increasingly similar in both jurisdictions. It is absolutely key that we work on an all-Ireland basis precisely, as the Member said, because such diseases do not respect borders.
Ó thaobh comhoibriú ar threalamh ardteicneolaíochta, comhoibriú ar sholáthar, maoiniú agus úsáid trealamh ardteicneolaíochta de.
I particularly welcome the points that he made about co-operation on high technology equipment such as positron emission tomography.
Co-operation on high technology equipment, whilst clearly a smaller and more discrete area than the other four areas of co-operation which have been mentioned, is, nevertheless, extremely important. It has two main elements: first, co-operation on the purchase of expensive leading-edge equipment, and secondly, sharing its use when perhaps only one machine is needed to serve the whole population. A good example of buying expensive equipment together was the purchase of MRI equipment in 1992. An example of the second element of sharing a machine is the photophoresis machine in haematology located in the Belfast City Hospital. I expect a scoping paper for future North/South Ministerial Council meetings to identify the kinds of equipment for which joint purchasing arrangements could be developed, but certainly, fertile areas for exploration include new imaging modalities such as positron emission tomography and new types of laboratory equipment. Clearly, that is an important point. This is, of course, a highly technical area, and it will be important to bring together the right expertise.
Go raibh maith agat. First of all, I welcome the statement by the Minister of Health, Social Services and Public Safety on the North/South Ministerial meeting. In the statement — [Interruption] Never mind the comments. In the Minister’s statement she pointed out that Mr Higgins would be providing the draft corporate plan and proposed staffing structures. From the report I understand that this is now not to happen. Why will this not be happening, and when will it happen? Also, the Education Minister identified last week to the Assembly the need for greater co-operation on the monitoring of known paedophiles on an all-island level. Can the Minister instruct her officials to work with her counterparts in the Department of Health and Children to address the need for greater co-operation in the field of protecting children from all forms of abuse?
Tuigim anois nach mbeidh an dréacht-phlean corporáideach agus an mionchuntas ar struchtúr na foirne ar fáil, mar ní rabhamar in ann na cruinnithe uilig a eagrú ó tháinig an bord le chéile don chéad uair i mí Feabhra.
While some of the functional meetings have taken place, it has not been possible to conclude the process within the timetable originally envisaged, and, in addition, it has not proved feasible to convene further meetings of the advisory board since the initial meeting in February. The completion of a corporate plan and detailed staffing structure have, therefore, been delayed.
I welcome the question regarding child protection, and I think it is very important. It is important that we work closely together on the island of Ireland and with colleagues in Britain in terms of this. The Member will be aware that the pre-employment consultancy service was established as far back as 1981 and it is operated by my Department. The service enables statutory, voluntary and private organisations working with children or, indeed, with adults with a learning disability to check the suitability of those applying for such work. In all of this, the safety of children is of paramount importance.
I notice that the report came to us in two formats. Did the discussions at the meeting take place in both languages? I presume the minutes would have reflected that if that had been the case.
The major question that I want to address is to do with the issues to be discussed, action and emergency planning, and major emergencies. I imagine that the two major bodies, North and South, that are concerned with this are the Gárda Sióchána and the Royal Ulster Constabulary. Can the Minister outline what input the policing services, North and South, will have in these two major areas?
I dtaca leis an chéad cheist de, labhramar i mBéarla amháin le linn an chruinnithe ach sa dá theaga sa phreasagallamh ina dhiaidh sin agus ag an lón a bhí ann roimh theacht le chéile an bhoird.
The answer to the first part of the question is that, as there are several very different parts, the discussion was conducted only in English. The press conference that followed, and the lunch which was arranged between the members of the council and the members of the board who were meeting in the afternoon, were conducted in both languages.
It must be understood that accident and emergency is a very wide area that takes in a vast number of people working in both services throughout the island of Ireland. In fact, a series of meetings recently took place between the two Departments to identify the potential for closer collaborative working, and a familiarisation visit was recently made to Dublin. If we look at this issue even in terms of the possible future fruitful areas of co-operation, we can see how wide the range is, and the number of people that would be involved: closer co-operation in terms of accident and emergency services in border areas; shared training of specialist staff, such as paediatric intensive care nurses; developing complementary services in local acute hospitals in border areas; establishing combined regional and super-regional services; agreeing protocols and inter-hospital support at times of peak demand in response to, for example, winter pressure; and promoting mutual support through the development of tele-medicine and tele-radiology.
In this area of work the planning for accident and emergency services is of that nature. To give you an idea of the work being carried forward at the moment, Co-operation And Working Together (CAWT), a cause with which the Member will be familiar, has been asked to conduct an exercise covering local, sub-regional acute services to scope the potential for development.
Another small combined team has been established to scope the potential for developing regional and super-regional services. There are statisticians in both departments meeting to establish compatibility of our respective information systems, to support acute service comparison and shared development. As regards winter pressures, a workshop will be arranged over the summer period to exchange good practice. There will be scope for developing shared training modules for paediatric intensive care nurses. I hope that gives the Member a very clear idea of the actions that we hope to take in relation of that area of work.
I also welcome the report from the Minister, and I agree that issues such as disease and health promotion know no borders or boundaries — they affect us all. My question concerns the consequences to one natural area—that of water control.
Why is the Department taking so long to report on its enquiry into the serious health-related questions arising from the Silent Valley water supply, and the equally serious impact this is having on the sheep farmers in that area who are now, it appears, still banned from grazing their flocks on a huge area in the Mournes? Would the Minister agree to an urgent meeting with me to discuss the many consequences of this serious situation?
I am sure that this subject is one in which the Member has shown great interest, and I do not want to diminish that interest by pointing out that I am not sure where it would have come into the meeting on 4 February that brought forward North/South co-operation. If the Member is content I will write to him shortly on this question.
A LeasChathaoirligh. I welcome the Minister’s statement. I also welcome Dr Hendron’s remarks about capital equipment. Indeed, I brought that up with the Minister’s officials at last Wednesday’s Health Committee meeting. In her report to the Assembly the Minister stated that all Ministers noted the examples of effective co-operation already taking place, but, given the health status of the whole of Ireland, more needs to be done. Instances of cancer on both parts of this island were identified as being unacceptably high, and I agree that more could be done. Has any future action and strategic planning been proposed to try to combat the unacceptably high levels of cancer in the whole island of Ireland?
Ó thaobh taighde agus seirbhísí ailse de, tá cuid mhór oibre ag dul ar aghaidh faoi latháir agus beidh tuilleadh oibre ag teacht faoi bhráid na Comhairle Aireachta Thuaidh/Theas. In terms of cancer research and cancer services, a considerable amount of work has already been carried out, and a further report will be brought before the North/South Ministerial Council. In terms of existing co-operation there is the Memorandum of Understanding, signed on 3 October by the Health Ministers from here, the South of Ireland and the United States, which established the cancer consortium between the National Cancer Institute and the whole of Ireland.
An initial project there, which will be carried forward in the future, will include the enhancement and co-operation of tumour registries in Ireland, the enhancement of the information infrastructure to support co-ordinated clinical trials throughout Ireland, and the development of education and training in scholar exchange programmes. As I have indicated, officials from the Departments were to meet and have been meeting to discuss each of the five areas outlined, and I will report further following the meeting on 4 July.
I very much welcome the report on very important health matters. People’s health must be a number-one priority.
I would like to raise two questions with the Minister. The first is to do with accident and emergency and major emergency planning. The fact that Northern Ireland needs an air ambulance has been raised on many occasions. Perhaps an air ambulance for the whole of the island would be more appropriate. That would certainly be a venture involving cross-border co-operation. Will the Minister consider raising this matter at the next meeting of the North/South Ministerial Council?
My second question relates to cancer research and health promotion, topics which a number of people mentioned this morning. We very much welcome the ongoing co-operation on cancer research between north and south, and, indeed, our American colleagues. However, the figures for cancer patients keep rising at an alarming rate. One in four people will be affected, particularly those along the entire east coast of the island. Many people have been pointing the finger at activities at Sellafield, a few miles across the Irish Sea, as possibly being responsible for these alarming figures. Will the Minister join the Southern authorities, as my party leader has since 1984, and indeed the leaders of other political parties in Northern Ireland, and call for the closure of Sellafield as soon as possible? Let us bear in mind the saying "Prevention is better than cure."
The importance of planning for major emergencies lies in the scale of major incidents whose effects cannot be dealt with by the emergency services and public-service providers as part of their day-to-day activities. The area is particularly suited to North/South links because of geographical proximity and convenience of communication. The specific question of the air ambulance service is addressed in the report of the strategic review of the ambulance service on which my Department will hold consultations until 30 June 2000. I shall carefully consider responses to the consultation before taking decisions on how ambulance services can be improved. I understand also that Ards Borough Council, along with others, is taking steps to establish a charitable trust to fund the provision of such a service. I should be happy to raise this on a North/South basis.
People will be aware that I am committed to the improvement and development of cancer services. This year an additional recurrent £8 million has been allocated, which will enable further progress to be made in the way cancer services are organised and delivered. I am aware of the considerable concern about Sellafield, but to date the specific question of how to develop co-operation on that has not been taken up. Members will understand that we have had only one meeting of the council. The officials were given a specific brief to look at co-operation in developing services and research, so the question has not arisen to date.
A large part of this document concerns food safety. I should like to make it clear to the House today that the importance of food safety will be recognised in Northern Ireland. In that respect, will the growing incidence of BSE in the Irish Republic, which now far exceeds that in Northern Ireland, be raised with the food advisory body? Will the over-30-month cattle be banned from Northern Ireland food produce, as is currently the case with home-produced beef? Is food to be imported from the Irish Republic which is not up to required United Kingdom standards, the standards to which United Kingdom farmers must produce?
Regarding the report from the Food Safety Promotion Board and the meeting on food safety, Members will be aware that there are three agencies with responsibility for food safety standards. As well as those three agencies, the Department of Health, Social Services and Public Safety, the Department of Agriculture and Rural Development, the district councils and the Department of Health and Children still retain certain responsibilities. It is clear that in many cases those will also be the agencies which will be taking and carrying forward decisions on these matters.
The Food Standards Agency will give policy advice to Ministers on food safety, food standards and aspects of nutrition, prepare draft subordinate legislation, make representations in EU negotiations, set standards for the enforcement of legislation, and issue, refuse, revoke and suspend licences, approvals and authorisations in accordance with the relevant legislation.
The Food Safety Promotion Board has a leading role in public information and education, and its main functions are promoting and conducting research into food safety, communicating food alerts, carrying out the surveillance of food-borne diseases, and promoting scientific co-operation and links between laboratories and the development of cost-effective facilities for specialised laboratory testing. The body has no enforcement function. Its main role is to ensure that appropriate mechanisms are in place to respond effectively to emergencies as they arise. In this respect, the Department of Agriculture and Rural Development will retain policy and legislative responsibility in this area, as will district councils. The specific question of what will be allowed in the future is not a question for myself alone. If the Member wishes, I can write to him on this.
The Minister has already responded to a number of issues to do with cancer research in particular, and there may indeed be a working paper on it. My question is related not specifically but indirectly to the research. The Minister may be aware that recently in the City Hospital we attended the launch of an extensive survey which was carried out in the Republic of Ireland of women who had experienced cancer. The survey questions related to their knowledge of services and to whether the response of those services was satisfactory or unsatisfactory. Two issues in particular arose from that. First, the way in which the news that she had cancer was communicated to an individual was seen as a major problem, and a great deal of work still needs to be done on how a doctor breaks the news. Secondly, many women did not know the side effects of the drugs that they had been prescribed. I do not believe that we need to replicate that survey in Northern Ireland, because I imagine that the findings would be very similar. The sample size was sufficiently large and, given the similar backgrounds of the women, we now know where the problems lie.
In the working paper that is to be produced, will the Minister pay some attention to the fact that many of these women have started up their own support groups because they felt that the service that was provided for them was basically resourced on the research end rather than on the support side? A great deal more attention needs to be given to supporting those women in particular who are suffering from cancer. Secondly, the Minister may be aware that the permanent secretary reported to the Health, Social Services and Public Safety Committee last week. His intention and no doubt it is also the Minister’s intention as well, is to have a public health strategy review. Is it possible that this could link with the public health strategy in the Republic of Ireland, given that we now have an Institute of Public Health that straddles both sides of the border?
Finally, I refer to a question that I put to the Minister of Education last week. In his report of the sectoral meeting, the child protection register was listed as one of the issues for attention. Will the lead Department in Northern Ireland, which is Health, Social Services and Public Safety, be included in discussions on the register? Does the Minister believe that it could be discussed in a British-Irish Council meeting as well?
Go raibh maith agat. Tá mé ag tabhairt tuairisce inniu ar chruinniú a tharla i mí Feabhra. De thairbhe sin, tá cuid mhaith den obair ag dul ar aghaidh ó shin gan faill ag na baill ionchur nó moltaí a dhéanamh faoin obair sin ag an phointe seo. Tá súil agam nach mbeidh rudaí amhlaidh uaidh seo amach.
I am in the somewhat strange position of making a report today to the Assembly on a meeting which took place in February. I know that this will not be the case, or I sincerely hope that it will not be the case, in the future. Members continued to bring forward suggestions of what could be included in the working paper in my absence. The timetable for this working paper may not allow that much input. However, this does not mean that the points are not extremely important or that it will not be possible to look at them. I welcome suggestions, and I have no doubt that it should be possible to look at them in the future, because this area of work will be carried forward. A report on public health which was recently given to the Health, Social Services and Public Safety Committee showed that this issue can be taken forward on an all-Ireland basis.
The Member referred to the Institute of Public Health in Ireland. The institute was established specifically in recognition of public health needs that could best be addressed by joint efforts throughout the island of Ireland. Although the institute was not established under the terms of the agreement, it is wholly appropriate that its work programme should now be taken forward under the direction of the North/South Ministerial Council. The institute’s strategic plan for 2000-03 sets out the following objectives: tackling health inequalities, strengthening partnerships for improving the health of the population, maximising the potential of international collaboration, contributing to public health information and surveillance, and strengthening the capacity of those working in public health. I am quite confident that the work that will be carried out in public health, and the work of the institute, will be extremely helpful. The whole idea of working on public health strategy is one that can be taken forward on an all-Ireland basis.
On the question of the register, I indicated in answer to a previous question that it is important that we all work closely, in my Department, in the island of Ireland, and with colleagues in Britain. The matter will be part and parcel of discussions that take place with colleagues in both of those arenas. It is very clear that the issue of the protection and safety of children has to be uppermost in our minds.
I should like to return to the issue of accident and emergency planning, because the Minister failed to answer my Colleague’s question. Was co-operation between the RUC and the gárdaí discussed at the North/South Ministerial Council meeting, as it is an important part of accident and emergency planning? There is a practical need for co-operation on major flooding or a major air accident, which could happen in the border region. Does the Minister agree that police co-operation between the RUC and the gárdai is an essential requirement of effective major accident and emergency policy?
Mar dúirt mé cheana, ba é an rud a beartaíodh ag an chruinniú ná go mbeadh feidhmeannaigh an dá Roinn ag obair ar pháipéar ar na h-achair uilig, achar na móréigeandála ina measc. Bheadh an páipéar sin faoi bhráid an chéad chruinnithe eile den Chomhairle Aireachta Thuaidh/Theas.
On the issues that were discussed at the last meeting, whether major emergencies, planning for major emergencies or other areas, officials were asked to bring forward a working paper and to have such a paper ready for the next North/South Ministerial Council meeting. What the Member asked did not arise specifically at the last meeting of the North/South Ministerial Council.
Obviously, there will be co-operation on emergency planning across a wide range of areas, one of which will be co-operation on training. Accident and emergency consultants are already operating on cross-border courses. Recently a major incident exercise was carried out on the Cooley mountains that involved all the emergency services, including those that have been mentioned.
On a point of order, Mr Deputy Speaker. Is it in order that the Minister for Health, Social Services and Public Safety, on being asked to tell the House whether she believes that there should be co-operation on emergency planning between the police force of this country and the police force of its neighbour, the Irish Republic, declined to answer? That happened twice.
She did mention the police forces, and she mentioned the bodies that she would expect to co-operate. I noticed that the magic three letters did not appear, but no doubt that was an oversight that will be corrected in due course.
The Minister’s statement identified a number of important areas where co-operation would benefit all the people of Ireland. North/South arrangements have a particular significance for those who live in border areas. I am concerned about the unsatisfactory arrangements for after-hours GP cover. Many people in the west of the Province have to travel 30 miles or more to find a GP. In some cases it can be more than 40 miles. Members can imagine the trauma and difficulties for elderly people and the parents of very young children in particular. Currently there appear to be regulations preventing cross-border co-operation on after-hours GP cover. Will the Minister table this issue at the next North/South meeting and begin work on removing the barriers to what would be very useful co-operation between GPs?
Tuigim tábhacht na ceiste sin do dhaoine atá ina gcónaí ar dhá thaobh na teorann agus fáiltím roimpi.
I understand the importance of this issue to those living close to the border, on both sides. I welcome this question and acknowledge the progress made by GPs here on developing out-of-hours services in recent years. However, I understand that patients in some isolated rural areas still have to travel considerable distances to out-of-hours centres. There are already cross-border arrangements, under EU legislation, which allow patients from the North to receive emergency care when visiting the South, and vice versa. The relevant health boards are proposing a feasibility study to examine all the legal, professional, administrative and financial issues of allowing patients to have access to the nearest out-of-hours services, whether in the North or the South.
It has been suggested that future meetings of the North/South Ministerial Council be able to consider specific topics within the areas of co-operation, and this would certainly be a useful area of discussion. It is an area in which the relevant health boards are proposing to move forward, and we will see what comes out of that.
Go raibh maith agat.
I welcome the Minister’s report. Will she elaborate on the health issues discussed, particularly the provision of accident and emergency and other services in rural hospitals such as Erne and South Tyrone? Will the Department add to the five areas of co-operation the urgent need for an agreed plan of acute care provision across the Six Counties and the border counties?
Go raibh maith agat.
Ó thaobh pleanáil don timpiste agus don éigeandáil de, tá cuid mhaith cruinnithe ag dul ar aghaidh faoi latháir. In response to a previous question on accident and emergency services, I referred to the possible fruitful areas of co-operation and partnership on the provision of accident and emergency services. As I said, a series of meetings have taken place between the two Departments to identify the potential for closer collaborative working, covering accident, emergency, and acute services. A familiarisation visit was made to Dublin in February, and a return visit is planned for the coming month. I expect to have a scoping paper identifying areas in which co-operation in accident and emergency services can be strengthened for the North/South Ministerial Council health sector meeting in the autumn. At the meeting on 4 February it was also agreed that the Co-operation And Working Together (CAWT) group — which consists of senior managers from the health authorities adjacent to the border, and which has already done some good work in this area — will have a key role in developing areas of strengthened co-operation.
The areas that I expect to be examined include closer co-operation on ambulance services; sharing of emergency admissions when beds are under pressure; agreeing referral protocols, so that GPs and ambulance staff on both sides of the border know where to send or bring patients; agreeing arrangements for transferring patients needing more specialised services; developing proposals for cost sharing; and clarifying the legal framework for staff treating patients. The potential benefits to patients from the pooling of resources North and South in this way are enormous, and they should go some way to address the Member’s concerns. That is particularly so when one looks at the distribution of the population in border areas. Small numbers of people are living in widely dispersed small communities, often some distance from the nearest hospital. Obviously we must do all we can to reduce this isolation and to ensure that accident and emergency services, North and South, work together to optimise response times and to share hospital bed capacity.
Can the Minister comment on the amount of money set aside for cancer research and health promotion for men? Up to now, the amount of money for the cancer care aspect of men’s health has been small, yet the incidence has been increasing, with high figures for prostate cancer in particular. It looks as though prostate cancer could be a bigger killer than lung cancer.
As I have indicated, I am committed to the development and improvement of cancer services. This year, an additional £8 million of recurrent money has been allocated. It will enable further progress to be made in how cancer services are organised and delivered. On bringing forward this work on an all-Ireland basis, the officials who have been asked to have papers for the forthcoming meeting will be presenting the work that they have been doing during the last number of months. Obviously, because we have not been here during the last number of months, it has not been possible for Members to have had an update. I will report following the meeting on 4 July.
Go raibh maith agat, a Chathaoirligh. I welcome the Minister’s report this morning. It was very clear and flagged up a number of cross-border co-operation issues that I am sure all Members will welcome. I am sure that the Minister will have seen the report from the Chief Medical Officer that shows that more children from disadvantaged areas end up in accident and emergency units than from any other areas. Are there any proposals to deal with this issue and, more importantly, to address the issue of obvious social disadvantage and its relevance to children being admitted to accident and emergency units throughout the island?
Is cinnte gur léirigh an tuairisc sin ceist an chomhionnais, chan amháin ó thaobh an phointe atá déanta ag an Teachta Tionóil, ach ó thaobh cuid mhaith pointí eile. Bí cinnte go mbeimid ag tabhairt faoi sin. On the Chief Medical Officer’s report, and wider planning, the issue referred to by the Member is one of many indicators showing the differential between areas of social need and other areas in terms of health.
I will do everything possible to reduce health inequalities through closer co-operation, either on an east/west or an all-Ireland basis.