I remind Members that the proposer of the debate will have 10 minutes to speak. All other Members will have approximately seven minutes.

Go raibh míle maith agat, a LeasCheann Comhairle. Thank you very much, Mr Deputy Speaker. I am grateful for the opportunity to debate the issue.

According to the regional acquired brain injury unit admission policy, as clarified in the recent ministerial review, patients between the ages of 16 and 65 may be admitted. It also states that people over 65 years of age can be admitted to the unit depending on their general health and rehabilitation prospects — at least, that is the theory. However, I wonder whether that happens in practice. The statistics suggest otherwise.

The only way that a patient’s prospects can be ascertained is through assessment of his or her condition, but does thorough assessment actually take place?

In the case of Mr Michael Hanratty, who was admitted to Daisy Hill Hospital on 7 September 2007 with an acquired brain injury, CT scans were sent that day to the Royal Victoria Hospital where they were read by a neurosurgeon and the results sent back to Daisy Hill Hospital. At that stage in Mr Hanratty’s illness, the family was told by Dr A in Daisy Hill Hospital that the approach would be to “wait and see”.

The following week the family was told by Dr A that a specialist would be coming from the brain injury unit to Daisy Hill Hospital to assess Mr Hanratty on 19 September. On the day before the assessment was due to take place, the family was told by Dr A that a specialist would not now be coming to assess Mr Hanratty as has was over 65 years of age.

On 19 September, Dr A told a member of the family that “this is as good as it gets” and that the outlook for Mr Hanratty was poor. Dr A said that Mr Hanratty had frontal lobe and temporal lobe damage, but when asked to explain what that meant he said that he could not say, as there were no specialists in that field in Daisy Hill Hospital and that that was why he had personally requested an assessment from the brain injury unit. Much of that was said at the patient’s bedside during visiting hours, and without due deference to confidentially. It subsequently emerged in a letter from Belfast Health and Social Care Trust that no formal referral was made by the staff at Daisy Hill Hospital in respect of Mr Hanratty.

The following morning Dr A apologised to the family for his approach the previous day, but told Mr Hanratty’s wife that Michael would not get any better.

Dr A made that judgement, having earlier admitted that there was no appropriate expertise in the hospital and without having received the assessment that he had requested of the regional acquired brain injury unit.

The family asked Dr A if it was possible for any specialist to see Michael, and said that they were prepared to pay. Dr A said that he would investigate. Later that afternoon, he told them that he had tried everywhere, but that no specialist was prepared to see Mr Hanratty because he was over 65 years of age.

The following morning, another doctor — whom we shall call Dr B — was in charge of Mr Hanratty’s case. That doctor verbally abused a member of the family because she questioned the age-65 restriction for admission to the brain injury unit. She was so distressed that she was reduced to tears and was afraid to visit the hospital again for three days.

The Northern Ireland Human Rights Commission became involved in the case at the behest of the family, and it contacted the Minister of Health, Social Services and Public Safety and the Belfast Health and Social Care Trust. As a result, on 19 October, a consultant in rehabilitation medicine, Mr McCann, was sent to Daisy Hill Hospital in order to assess Mr Hanratty. The family was only told shortly in advance of Mr McCann’s visit, and no specific time was given. Consequently, no member of the family met Mr McCann.

In his letter to Dr McDowell in Daisy Hill, Mr McCann said that his first thought was that Mr Hanratty would have benefited from a CT scan of the brain in case he had developed post-traumatic hydrocephalus. If that had been the case, he might have required neurosurgical intervention, which might have led to an improvement in his status. So much for Dr A’s prognosis that that was as good as it would get.

Dr McCann’s assessment and the results of the scan were not communicated to the family until a member of the family contacted Mr Colm Donaghy, the chief executive of the Southern Health and Care Trust. They eventually received the scan results six days after it had taken place. Dr McCann’s assessment was made available to them 10 days after it had taken place.

Since then, the family has sent the scans to a hospital in Dublin that has a highly reputable neurology and neurosurgical department, where they were read by a neurologist, a neurosurgeon and a geriatrician. All three experts said that it was a given that Mr Hanratty should have been assessed in the early days after his injury and that specialist rehabilitation was required.

The family now believes that the treatment that is available to Mr Hanratty in Daisy Hill Hospital will not lead to his recovery and, because of the upper-age restriction imposed by the regional acquired brain injury unit and by Thompson House Hospital in Lisburn, that suitable treatment is not available in Northern Ireland for a person over 65 years of age who has suffered a traumatic brain injury. In the meantime, Mr Hanratty’s GP has referred him to a unit in England that does not operate an age restriction.

Several important issues that highlight the discrim­inatory effects of the age-restricted admissions policy of the regional acquired brain injury unit have arisen from Mr Hanratty’s case. That unit’s admission policy is, in my view, based on a stereotypical view of older people that considers them to be “old, frail individuals”, which are the words of Dr Barnes, who is quoted in the ministerial review and who provided commentary for the initial business case for the unit.

Many older people have good health and are fit, and they increasingly take part in sports such as swimming, cycling and even marathon running. Until the day of his injury, Mr Hanratty ran a farm with 200 cattle — he was a fit and able person.

The age restriction imposed by the unit is totally arbitrary. It is based on the evidence of an English specialist, who, in his commentary on the original business case, said that it was difficult to set an upper age limit. Yet he went ahead and did so.

People over 65 who suffer brain injuries are not adequately assessed in local settings. Mr Hanratty’s case, as I have outlined it, and through the experience of his family, proves that beyond the shadow of a doubt.

Mr Hanratty would not have been assessed had it not been for the pressure that was applied by his family, myself, the Human Rights Commission and, eventually, by the Minister’s office. Is that what every 65-year-old person in Northern Ireland will have to do to receive an assessment? I hope not.

The treatment available locally is not of a specialist nature and does not afford people over 65 the best possible opportunity for recovery. There are other issues, but time will not allow me to elaborate on them today. My colleague Mrs Hanna will deal with some of them later.

The ministerial review into the matter has resolved nothing. The Minister must examine the case again and take a personal interest in it. He must ensure that each case is assessed on its merits and that patients are admitted to the regional acquired brain injury unit based on their general health and rehabilitation prospects, regardless of their age. The only way in which that can be achieved is through proper assessment by specialists in the field at local level.

I am sure that it will have come as a shock to many of us to hear of the circumstances surrounding the referral from Daisy Hill Hospital to the Regional acquired brain injury unit of a Silverbridge farmer who sustained serious head injuries after being kicked by a bull.

I am sure that the majority of people in Northern Ireland would also agree that, after sustaining serious head injuries, one would expect to receive the highest level of assistance available. However, it transpired that the patient and his family were left in an unacceptable situation after being told that, due to the patient’s age, he would not be transferred to the regional acquired brain injury unit at Musgrave Park Hospital or receive a visit from a specialist.

Most people in Northern Ireland would find that as shocking as the family did. Despite a review by the Department, Minister McGimpsey found that the unit’s admissions policy was correct. However, Minister McGimpsey stated that the current policy does not prevent people over the age of 65 being admitted to the unit providing:

“it is the most appropriate place for them.”

I ask the Minister why, after the gentleman sustained a serious head injury, his family was told that the regional acquired brain injury unit was not an appropriate place for him, and that he would not receive a visit from a specialist? That is a difficult policy to defend, given that everyone expects to have the best possible chance of recovery despite their age.

Why was it that a visit by a specialist from the unit was hastily arranged following representations from the family’s solicitor? Should that visit not have occurred in the first instance? The Minister also stated that the policy would be examined by the Equality Commission, and I ask him to confirm to the House the conclusion of the commission’s deliberations.

The family of the gentleman in question has been left with a bitter taste over the incident, which has led to claims that the treatment afforded to those over 65 is inferior to that offered to younger patients. That perception must be addressed, and I ask the Minister to outline how he intends to do that.

Go raibh maith agat, a LeasCheann Comhairle. Ba mhaith liom cúpla focal a rá. I would like to say a few words on this matter.

My colleague Sue Ramsey raised this issue with the Minister of Health after a meeting of the Health Committee, and the Minister indicated that he would look into it and review the age policy.

I welcome the opportunity to speak on this issue and I thank the Member for bringing it to the Chamber. I want to highlight how the issue has arisen with regard to the statistics, but I will also be speaking from personal experience. My uncle tragically died from a brain injury. Thankfully, because he lived in Monaghan, he had access to treatment in Dublin and that made it a bit easier on the family. Sadly, though, he passed away.

Traumatic brain injury can result from a closed head injury or a penetrating head injury, and is one of two subsets of acquired brain injury. The other subset is non-traumatic brain injury — for example, strokes or meningitis. The effects of a brain injury can vary widely. Head injury patients may experience physical effects such as headaches, seizures, difficulty in walking or coma; it goes from one spectrum to another. There can be emotional problems, including mood swings, poor impulse control, agitation, low frustration threshold, depression and many other effects.

Approximately 7,800 incidents of head injuries are reported each year in the North of Ireland, of which approximately 3,300 involve admittance to hospital. The majority of those are caused by road accidents involving cars, motorbikes, bicycles and pedestrians. That is the major cause of head and brain injuries for those under 75 years of age. Falls are the major cause for those over 75 years of age. Approximately 20% of brain injuries are due to some form of violence; 3% are sports-related injuries; and 50% involve some form of alcohol intake by the patient or those who caused the injury.

The regional acquired brain injury unit at Musgrave Park Hospital opened in March 2003, and was the first of its kind in the North. The facility is a specialist unit to which patients can be transferred as soon as possible after care in an acute hospital, which frees up valuable bed space and provides a comprehensive rehabilitation programme on an inpatient and outpatient basis. A full range of modern therapy facilities are provided. When it opened, it was to be the centre of excellence for research into the management of acquired brain injury. The facility accepts only patients from the North of Ireland referred by GPs or medical consultants. It has 25 inpatient beds and can provide services for 15 outpatients.

Herein lies the problem. The regional acquired brain injury unit is a top-class facility with dedicated, profess­ional, and hard-working staff. However, approximately 3,000 people are being admitted to hospitals — whether it is Daisy Hill Hospital, the Royal Victoria Hospital, the Mater Hospital, Altnagelvin Area Hospital or even Antrim Area Hospital — and only 5% of them require the service of that facility; that amounts to 150 patients a year who will need specialised treatment. They could be there for two, three, four or six weeks, or more. That obviously puts the facility under severe pressure, and that pressure filters down to regional hospitals. It is as a result of that that individuals are told that they are too old or too young, and that they would be better off at home. That is unacceptable, and it is clearly not good enough. Everyone is entitled to the best healthcare available; there should be no clauses as to who should or should not receive treatment.

If health experts in the regional hospitals cannot give their patients the proper care required, they are morally bound to raise the issue with the Department of Health, and to inform all of their elected representatives of their concerns.

In conclusion, I call on the Minister to initiate a comprehensive review of brain injury treatment in order to ensure that fair and equal treatment is available to all, regardless of age or gender. Go raibh maith agat.

I am conscious that this is a very important issue, yet it impinges greatly on the emotions of one particular family, who are highly respected in the south Armagh area.

It impinges specifically on Mr Michael Hanratty. Members are all — and should be — conscious of the sensitivities that are involved as they consider the motion. I am sure that at this enormously trying time we would not want to add in any way to the distress or emotional pressure that has been placed already on the Hanratty family.

I am aware that Mr Hanratty enjoyed good health and was very active, not only at home and on his farm, but in the local community. The sudden onset of his medical condition has obviously caused great distress and shock to his family, and Members would do well to remember that.

Early in the consideration of the matter, I raised it with the Minister and his private office in the hope that any available assistance could be given as quickly as possible. I do not doubt the professionalism of either the medical staff at Daisy Hill Hospital or the Department of Health, Social Services and Public Safety. Least of all, I do not doubt the personal commitment of the Minister himself to try to assist in every possible way.

The overwhelming number of patients at Daisy Hill Hospital receive first-class medical and health treatment. No one would say otherwise. We do not doubt the dedication or professionalism of the nurses, doctors or ancillary staff.

The case has highlighted the more general issue of how patients who are of a certain age and condition are treated. The staff who are involved in such treatment have to make delicate and enormously difficult judgements. However, those judgements are most difficult for families that are coming to terms with a new, complex and difficult medical situation.

I join Mr Boylan in his call for the Minister, having reviewed the operation of the regional acquired brain injury unit at Musgrave Park Hospital, to extend that review Province-wide to see whether any new consider­ations can be given to the overall issue. I have no doubt that such cases will continue to be highlighted in the public domain.

It is good, therefore, that the debate has taken place today. I thank Mr Dominic Bradley for bringing it to the attention of the House and for the sensitive way in which he has approached it. The Members and the Minister are all on the same side: the side of the Hanratty family. We want to see what can be best achieved for Mr Hanratty and, in general, for those who find them­selves facing great difficulties as a result of brain injuries.

I ask the Minister to consider whatever possible additional assistance he can give in respect of this case, and, more generally, to consider extending his inquiry to the whole of Northern Ireland.

Go raibh maith agat, a LeasCheann Comhairle. I, too, commend Dominic Bradley for bringing the motion to the House. The motion raises wider issues about the care of older people and about ageism in general. It comes as no surprise that a recent survey showed that 73% of older people stated that they felt marginalised.

The Department of Health, Social Services and Public Safety has a policy regarding over-65-year-olds and brain injury, which boils down to the fact that someone over 65 with that kind of injury does not get treated. The perception that older people are frail, dependent and isolated may be a self-fulfilling prophecy. Ageism pervades our healthcare system and prevents older people from receiving optimum healthcare. In turn, that leads to their increased dependency on family and public resources, increased disability and mortality, depression and isolation. That is completely unacceptable.

Like many, I believe in the saying that an ounce of prevention is worth a pound of cure. Mr Bradley highlighted that early intervention in Mr Hanratty’s case could have been beneficial. There seems to be an assumption that pervades society in general, and the health system in particular, that serious medical conditions are an inevitable part of becoming older. The truth is that they are not. Known preventative treatments go a long way to keeping older patients healthy and enhancing their quality of life. Yet, the case of Mr Hanratty — and many others — shows that they often do not receive such treatments.

Ill health is not an inevitable part or consequence of growing older. When an elderly person encounters a health problem, studies show that physicians often use the person’s age, rather than his or her functional status, as a factor in determining the appropriate treatment. Clearly, that ageist bias has infiltrated our Health Service and affected treatment decisions inappropriately.

Can older patients not speak up and demand better treatment? Unfortunately, they too have fallen prey to the mistaken notion that their ill health is simply a part of ageing. I commend the Hanratty family for standing firm to highlight the plight of their father, which in turn has rekindled the ageism debate. I urge the Minister of Health, Social Services and Public Safety to take a lead role in ensuring that the issue of ageism is tackled in the Health Service. More education is necessary across the board if health departments are to provide their older patients with proper care, and those patients are to take charge of their health.

Those over 65 do not have to resign themselves to living their remaining years with a declining quality of life. Proper knowledge can extend lives, and make them happier and healthier. Healthcare should be free at the point of delivery, irrespective of age or other considerations. Indeed, as I said, prevention could have been of benefit to Mr Hanratty had it been in place. Go raibh míle maith agat.

The review into the admissions policy of the regional acquired brain injury unit, initiated by the Minister of Health, Social Services and Public Safety, was prompted by the case of Mr Michael Hanratty. The unfortunate outcome in Mr Hanratty’s case is a sad reflection of an ageist policy.

The review throws up a number of questions connected with the admissions process, not least of which is the restriction of that service to those who are between the ages of 16 and 65. Indeed, the professor who informed the policy has a stereotypical view of older people, as has been said. He views them as frail and not suited to sharing a more dynamic environment with a younger, more aggressive clientele. Many older people — and people of 65 years of age may not be considered old any more — are fit, well and in good health. They may be fit enough to benefit from the treatment in question if the age restriction did not debar them.

It is possible that people between the ages of 16 and 65 may be so frail and weak that they may not benefit from treatment in the unit, and yet they are not excluded. That begs the question: why have restrictive age limits been imposed? Why is each case not determined on its own merits regardless of the age? That seems much more commonsensical.

If the admission of people who are at the lower end of the age scale is determined on their own merits, should the same criteria not be used for patients who are at the upper end of the scale? In other words, why should all patients not be assessed on their own merits? Why have age restrictions in the first place? Why not determine admissions on merit, especially when the admission policy, which was clarified in the recent ministerial review, states that a patient’s prospects are ascertained through assessment of his or her condition. Surely that is what must happen for all patients, whether they are under or over 65 years of age. There is also a strong economic argument for early intervention.

I thank the Minister for calling for an urgent review after a complaint from Mr Hanratty’s family. To summarise that case: Mr Hanratty was fit and up and about on the farm before he was hit by a bull. His family wanted him to be seen by a specialist but was told that he was too old. The Equality Commission’s report and the Human Rights Commission’s views on what happened after that must be made public. Those details are not available.

The media has highlighted disturbing cases in which patients have been denied good-quality treatment because of ageist attitudes. There would not have been any review had Mr Hanratty been someone over 65 years of age who did not have a family to demand that he was given necessary and urgent treatment. I thank the family for its courage in seeing that through. However, the situation should never have happened, and more questions are throw up, such as whether Mr Hanratty’s family is entitled to financial aid should he now have to be transferred to England for treatment. Are there upper age limits on other vital services, such as bypass surgery, dialysis, screening, and so forth? Are older people less likely to be offered health and mental-health promotion and hospital referrals?

Older people are often stereotyped and not valued as individuals who have particular healthcare needs. Age discrimination can also be more subtle — for example, through the lack of priority that is given to elderly people’s long-term needs. Surely healthcare should be offered to everyone on a clinical basis. There should not be any age discrimination. Provision and quality of care must not be based on age but on merit and need.

I want to apologise for my late arrival. I was at a meeting of the Committee for Agriculture and Rural Development, and the Adjournment debate is taking place much earlier than I had expected. I thank Dominic Bradley for raising the issue. I know Mr Hanratty and his family. I had the pleasure of doing business with him during a previous career. I found him to be a gentleman.

In the Newry and Mourne area, there is a large population of healthy, energetic people who are over 65 years of age; I am sure that that applies throughout Northern Ireland. While I am on my feet, I want to take the opportunity to congratulate one such person — my neighbour Mrs Moynes, who celebrates her one hundredth birthday today. She is a healthy, hale and hearty lady. It is hard to believe that she is 35 years outside the age bracket for treatment. I congratulate Mrs Moynes on reaching her hundredth birthday today.

The Michael Hanratty case caused much concern when it was first publicised. It triggered much worry among elderly people and their families. Just when we thought that the Health Service was there to lend support when needed, we have discovered that the opposite is true. I am glad that the Minister is present, because I have every confidence in his ability to deal with the issue. To date, his handling of the situation has been fairly satisfactory.

I want to reiterate my thanks to Dominic Bradley for bringing the matter to the Assembly’s attention.

I also want to thank Mr Dominic Bradley for bringing this important issue to the Floor of the Assembly. The issue of admissions to the regional acquired brain injury unit in Belfast was highlighted in the media, particularly concerning the referral of one patient. The patient — who is, of course, one of Dominic Bradley’s constituents — had been admitted to Daisy Hill Hospital with an acquired brain injury.

It might be helpful if I begin by explaining what is meant by acquired brain injury. It is an injury, or assault, that has occurred to the brain since birth. For example, it can be the result of trauma following a car accident, a fall from a height, a stroke, or a haemorrhage. People may think of a brain injury arising as a result of a traumatic incident, such as a serious road traffic accident. However, approximately 4,000 patients each year suffer a stroke, of which approximately one third will be left with a brain injury that has to be managed.

Whatever the cause, brain injury can have a wide range of effects that will vary from person to person, depending on the exact nature of the injury and its severity. Obviously, it can be difficult and distressing for the family and friends of those who have suffered the injury. We must ensure that the right treatment is provided to every patient, meeting their needs and aiding their recovery. A brain injury can affect every aspect of how a person lives, thinks, breathes, walks and talks. Therefore, it is hardly surprising that every patient, and their acquired brain injury, is different and that their treatment and rehabilitation needs will vary.

Generally, treatment is multidisciplinary, and the team treating a patient may typically include speech and language therapists, occupational therapists, physiotherapists and other relevant clinicians. Never­theless, we must also recognise that an individual’s brain injury may be only one of several existing health problems that must be addressed. Older people, for example, may have heart problems, respiratory diseases or arthritis. Other patients may have a physical difficulty, or a difficulty with their sight. All of the co-existing difficulties need to be managed.

In addition to the services that are provided at the regional unit, there is a range of well-established, high-quality services for patients in Northern Ireland, which include the high-dependency rehabilitation unit at Daisy Hill Hospital; the regional neuro-disability centre at Thompson House Hospital in Lisburn; Spruce House, at Altnagelvin Area Hospital; and the twelve-bedded male neuro-behavioural rehabilitation unit at the Main Villa, Knockbracken Healthcare Park.

When the patient — to whom Mr Bradley referred — was admitted to Daisy Hill Hospital, I am aware that his family was incorrectly advised that the regional acquired brain injury unit only admitted patients aged 16 to 65. Mr Hanratty, the patient, is over 65 years of age. Understandably, the family were, and are, deeply concerned that their father’s age appeared to be the reason why he was denied access to the specialist treatment that was available at the regional centre.

When the matter came to my attention, I instructed my officials to carry out an urgent review of the unit’s admissions policy because I wanted to be assured that all equality and human rights legislation was being adhered to. I also wanted to know if — and why — an apparent ageist policy was being applied to health services, and if patients in the regional unit were receiving a higher quality treatment than others.

The regional acquired brain injury unit at Musgrave Park Hospital opened in May 2006. The unit was established to address an identified gap in provision for patients with brain injuries. That gap in services was highlighted in the unit’s business case, which was subjected to public consultation and an equality impact assessment. The business case pointed to the fact that traumatic brain injury rehabilitation was mainly provided in settings for older people. The review was completed on 19 October. The report concluded that the admissions policy does not exclude patients who are under 16 or over 65 years of age. Patients outside that age range can, and are, admitted to the unit, depending on their general health and their potential for rehabilitation, which may be influenced by any pre-existing health conditions.

There have been 36 admissions since the unit opened on 1 May 2006. Approximately, 10% of the patients who were admitted were aged between 61 and 70, six of whom were over 65 years of age. In addition, there were 19 admissions of patients who were 18 years of age, or younger, to the unit in the same period. While the admissions policy is clear, I acknowledge that there were serious communication difficulties in the case to which Mr Bradley refers. I want to place on record my sincere apologies to the family for the distress that the incident has caused them, and the breakdown in communications —

I have seen a copy of the referral form that the Southern Health and Social Services Board used. That form clearly states that people aged under the age of 16 or over the age of 65 are excluded from referral to the regional acquired brain injury unit. No exceptions are mentioned; there are no ifs or buts. According to the referral form, both of the aforementioned groups of people are excluded. Can the Minister explain how people over the age of 65 can be referred to the brain injury unit when the referral form makes no mention of any exception to the restriction that is contained in it?

I thank Mr Bradley for making that point. That form was withdrawn on 24 October, and it was part of the communications problem that existed in the trusts and in Daisy Hill Hospital, and that resulted in misinformation in the unit. I have since written to the chief executives of all the trusts to inform them of the true policy, and I have made it a requirement that they inform all the staff in their areas of responsibility of the correct policy.

I have asked the Belfast Health and Social Care Trust about the number of admissions to the unit. Excluding Mr Hanratty, 10 patients from Daisy Hill Hospital were considered for admission. Of those 10, nine patients were subsequently admitted. Thus, there is a clear link. Patients over the age of 65 or under the age of 18 have been referred to the unit, but I accept that there was a clear misunderstanding, to put it mildly, on the part of the trusts and Daisy Hill Hospital. Again, I sincerely apologise to the Hanratty family for the misinformation and poor communication.

Patients of all ages have the right to access the best available treatment, and there should never be any question of discrimination on the grounds of age, or on any other grounds. The review outlined the range of treatment that is currently available to everyone with an acquired brain injury in Northern Ireland. It also explained why, for some patients, the unit may not provide the most appropriate or best treatment.

At present, there is no dedicated acquired brain injury rehabilitation unit in Northern Ireland specifically for children. I expect that to be addressed through the provision of suitable services in the new women’s and children’s hospital. Currently, children under the age of 13 who suffer from an acquired brain injury are usually initially admitted to the Royal Belfast Hospital for Sick Children, and rehabilitation is normally delivered via a range of therapy and community services in acute and community child-health facilities. Older children may be admitted to the regional unit, but only if it is deemed clinically appropriate and suitable for a child to be placed in a unit with adults. The unit’s admissions policy is in line with those in the rest of the UK. In particular, it is important to ensure that clinicians and other health professionals who look after the needs of elderly people have the necessary specialist expertise.

However, as I said earlier, I have now instructed all health and social care trusts to take immediate steps to prevent any further problems with communications over admissions to the acquired brain-injury unit. I have ensu­red that the unit’s admissions policy has been comm­un­icated by chief executives to all Heath Service staff.

I wish to respond to the points that Mr Boylan and Mr Kennedy made. Although the review of the unit highlighted that the policy is not ageist, I recognise that it focused on the unit’s admissions policy. For me, the review raised questions about the unit’s wider service provision. I am therefore announcing a review of the Northern Ireland-wide provision of services for those with brain injuries, and of the protocols and care pathways by which patients can access those services.

I want to ensure that the needs of all those with brain injuries are being met. Let me make it clear that patients of all ages have the right to the best available service, commensurate with their needs. Patients, and their relatives and friends, quite rightly expect the best medical treatment and care to be provided regardless of age, and I am committed to ensuring that that expectation is met.

Adjourned at 5.20 pm.