Programme for Government

Part of the debate – in the Northern Ireland Assembly at 5:00 pm on 6 March 2001.

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Photo of Dr Joe Hendron Dr Joe Hendron Social Democratic and Labour Party 5:00, 6 March 2001

I support the Programme for Government, including its vision of a cohesive, inclusive and just society. In June 2000 the World Health Organisation confirmed what most people in these islands already knew — that the United Kingdom has a third-rate Health Service. It is rated eighteenth in the world for the effectiveness of care delivered per every £1 spent, and twenty-sixth for its responsiveness to patients and its ability to treat them professionally and with dignity.

The National Health Service is failing in its purpose. Given that the UK is a wealthy nation, its cancer survival rates are appalling; they are far lower than equivalent rates in the rest of Europe, the United States and Japan. Patients with life threatening diseases have to wait unacceptable lengths of time for operations, which means that they live in fear and anxiety. Often, when they do get to hospital, their operations are cancelled.

That was the situation last summer — things may have improved a little because some funding has been made available, but numerous patients still have to wait on trolleys in our A&E departments. Patient discharges from hospitals are being delayed because there are inadequate funds for providing community care and long waiting lists for occupational therapists. These problems are causing great distress to the old and vulnerable in our society. Sadly, similar difficulties are being caused by a lack of resources for the health care of children, the mentally ill and those with physical or learning disabilities.

The NHS Confederation, which encompasses all four health authorities, recently produced figures which show that, in terms of financial resources, Northern Ireland is far behind England, Scotland and Wales. The comparative figures are available.

My Committee held an inquiry into residential and secure accommodation for children in Northern Ireland. It made 36 recommendations. One of the most important of these was the introduction of a commissioner for children, and we are delighted that this is going ahead. Having looked at the public service agreements, it would appear that other recommendations are to be followed through. I hope that all 36 recommendations will be taken on board and that the Children (Northern Ireland) Order will be fully implemented.

It is essential to have good quality community care to meet the needs of young people with learning disabilities, including those discharged from Muckamore Abbey. Those services should be well developed before patients from Muckamore Abbey are resettled.

There has been a good deal of talk about the recent report by the Royal Commission on Long-Term Care for the Elderly, and I am pleased about the introduction of free transport. However, the funding of nursing care but not personal care will lead to inequalities in treatment. As a result, those nursing homes which are intended for the most dependant will be slightly cheaper than residential homes intended for the less dependant. It is also likely that they will be cheaper than certain packages for intensive domiciliary care. Care of the elderly is part of the review of primary-care services, and my Committee will continue to monitor its progress and development.

Our Health Service not just not good: it is the poorest. Our people have to pay the highest price for their health. Inequality in health is evident in every age group. I welcome the Minister’s document ‘Investing for Health’, and I will make two main points to her. First, the term "targeting social need" appears throughout ‘Investing for Health’ and in the public service agreements. We have a few health action zones in Northern Ireland. Each board, the Department and the Chief Medical Officer does its or her own thing in response to targeting social need, but there is no overall co-ordination. I appreciate that the Office of the First Minister and the Deputy First Minister, and the Minister herself, will be looking at all these matters. However, one person should be made responsible for co-ordinating these issues. The Health Promotion Agency is a good organisation, but it is not responsible for such co-ordination.

Secondly, my Committee is very involved in the future of primary care. I would like the Minister’s assurance — if not today, then at some time in the future — that there is no reason why we cannot look at the organisation of the health service within the review of public administration and local government. There is no reason why communities who have lived in deprivation for 20 years should have to continue to do so.

I am not talking about extra resources; I am talking about organisation. There is no reason why we cannot look at that issue. In the Minister’s document on primary care the reason is given over and over again that we cannot look at the boards because there is to be a review of public administration. I resent that, and most of my Committee would support me in my hope that we can look at those other bodies.