Northern Ireland Assembly
Monday 21 May 2001 (continued)
Ms de Brún:
Dr Hendron has highlighted a wider problem - the shortage of consultants here, despite an increase of 22% since 1995. Difficulties remain in filling consultant posts in some specific services. With the numbers completing specialist training over the next three years, there is the potential for a further 10% increase in consultant numbers in general. Some local services are badly affected by the loss of even one consultant. Therefore, specialist medical staffing is reviewed regularly.
My officials have been working closely with trust and board personnel to alleviate the current acute staffing shortages. Clearly, the number of orthopaedic surgeons per head of population here is lower than in the NHS in Britain. We have been increasing the number of specialist trainees over recent years, and we will be keeping that under review.
I also understand that there have been difficulties in accessing bed and theatre availability caused by increased demand. The regional spinal surgery service at the Royal Victoria Hospital (RVH) will begin as soon as the theatres in phase one of the new RVH become fully operational. We hope that that will improve some aspects of the service. However, I totally accept that both foreseen and unforeseen changes are impacting on the service and that we need to keep the measures needed under constant review.
What action, other than apologising to patients, does the Minister propose to take to deal with the shortage of beds at the Ulster Hospital, Dundonald?
Mr Deputy Speaker:
The question was about orthopaedic consultants. Do you want to make your question about that matter, or are you asking something that is not relevant?
It is relevant.
Mr Deputy Speaker:
Is the Minister prepared to answer that question?
Ms de Brún:
I fully answered all questions on the Ulster Hospital when I replied to Mrs Robinson. I refer the Member to those answers.
Does the Minister plan to create an orthopaedic consultancy post in the Southern Board area?
Ms de Brún:
As I said, we are currently keeping the necessary numbers and locations under review. That is not my intention at present, but I can write to the Member when we have a clearer idea of the way forward.
Surgical Procedures: Waiting Times
asked the Minister of Health, Social Services and Public Safety to detail (a) the waiting time for cardiac surgery in October 2000, and (b) the current waiting time.
asked the Minister of Health, Social Services and Public Safety to detail her plans to reduce the waiting times for all surgical procedures in Belfast hospitals; and to make a statement.
Ms de Brún:
Le do chead, a LeasCheann Comhairle, glacfaidh mé ceisteanna 6 agus 8 le chéile mar go mbaineann siad araon le hamanna feithimh.
With your permission, Mr Deputy Speaker, I will take questions 6 and 8 together, as they both deal with waiting times.
Ag deireadh Mheán Fómhair 2000, bhí 591 duine ag fanacht le máinliacht chairdiach. De na daoine seo, bhí 437 ag fanacht níos lú ná 12 mhí chaighdeán na cairte. Ag deireadh Nollaig 2000, an dáta is déanaí dá bhfuil eolas ar fáil, bhí 570 duine ag fanacht agus 414 acu ag fanacht níos lú ná 12 mhí.
At the end of September 2000, 591 people were waiting for cardiac surgery, of whom 437 had been waiting for less than the Charter standard of 12 months. At the end of December 2000, which is the most recent information available, 570 people were waiting, with 414 people waiting for less than one year.
I am concerned about the length of time that people are having to wait for treatment. My proposals for action are set out in the framework for action on waiting lists and in the priorities for action. This year, I have set a target of a 50 % reduction in the number of people waiting for longer than the Charter standard and the complete elimination of such long waits by March 2003.
I also set a target for waiting lists to be reduced to 48,000 by March 2002, as a first step towards bringing the numbers down to 39,000 by March 2004. That reduction will have a direct impact on the length of time that people must wait.
Those are quite alarming figures. Many of the 160 people who have been waiting more than 12 months for cardiac surgery are dying because of the delay. We hear that targets for reduction are being set. How are those targets going to be achieved? How can the Minister demonstrate that those targets can be achieved under the current Administration?
Ms de Brún:
With regard to the number of people who are waiting for operations, one of the factors is that much more can now be done for patients with heart disease, including those who have had previous operations, and the elderly. Consequently, the patients who have cardiac surgery tend to be older and sicker than was previously the case. They often need longer hospital stays in cardiac surgery and in intensive care in the few days following surgery. That has reduced the throughput of patients.
Recruitment and retention of nursing staff trained in cardiac surgery is also a major challenge. This is a very specialised area, and it is a professionally demanding one to work in. The cardiac surgery review is addressing the matter in detail, and it will advise on immediate and long-term actions to help to strengthen the nursing complement.
With regard to improving the situation for cardiac patients while the review has been taking place, I have allocated additional funding for supernumerary nursing posts in cardiac intensive care to support the existing staff and to allow additional nurses to receive specialised training. That will help to increase bed capacity and, therefore, the number of operations possible.
The boards have been using some of the extra waiting list moneys that I have allocated to offer cardiac surgery to patients who have been waiting for a long time for operations elsewhere. That also frees up capacity at the Royal Victoria Hospital for those who do not wish to travel. Angiography facilities will soon be open at Altnagelvin Hospital. That will increase overall capacity here for this diagnostic testing, and that will help to reduce waiting times.
I have also published a framework for action on reducing waiting lists. I refer Mr Poots to the number of different actions contained in that. That will significantly impact on waiting lists in general as well as on waiting lists for this speciality.
I was surprised that questions 8 and 6 were grouped together, because there is not a great similarity between them. My surprise was confirmed by the Minister's answer, which was primarily on question 6. However, the Minister will share our concern that waiting lists appear to be extending and developing, and the problem is not being resolved. Hidden underneath that, there is a further waiting list to get on the waiting list for people awaiting serious and urgent operations.
The setting of targets is wonderful and grand, but there is no point in setting targets unless they are achievable. What new action has been taken to reduce this expanding waiting list? The hospitals are chock-a- block. People cannot even get into Belfast City Hospital, yet this weekend another ward was closed in the Downe Hospital -
Mr Deputy Speaker:
You are going a little beyond the question.
The question is about waiting lists. These people are on waiting lists to get into Belfast City Hospital. They cannot get into Belfast City Hospital or the Royal Victoria Hospital, yet they are also being chucked out of the Downe Hospital. Where is it all going to end?
Ms de Brún:
I thank the Member for his election speech and for his question. An extra £3 million has been allocated this year for action on waiting lists. On top of that, last year's non-recurrent allocation of £5 million has been made recurrent, bringing the total additional resources available for action on waiting lists this year to £8 million. That in itself will make a difference.
With regard to ensuring that the targets for reduction are achieved, the boards and trusts are bringing forward their waiting list action plans for 2001-02. I will want to be sure that practical and robust arrangements for achieving the reductions are in place. I will be closely monitoring progress during the year against the very specific points that were laid out for them in the framework that I issued in September 2000.
These include, for example, setting clear targets for reducing the number of patients waiting and the number of people who fail to keep appointments, thereby enabling others to have appointments. An improvement in efficiency should ensure that as many patients as possible are treated - for example, by making sure that waiting list information is up to date and that co-ordination of services is better, particularly between hospitals and the community. A number of other clinical, managerial and monitoring arrangements were laid out in my framework statement.
The particular ward in Downe Hospital that the Member refers to was opened in response to winter pressures. The observation ward was open only for the winter period, now at an end.
Can the Minister detail her plans to reduce the waiting times for brain and heart surgery? Can she confirm that placements can be made in Scottish hospitals more quickly than in hospitals here?
Ms de Brún:
Concerning heart surgery, I refer to my answer to Mr Poots, unless the Member is perhaps talking about some other aspect that I missed. At present, it is easier to get surgery in this speciality in Scotland. That is why those who are willing to travel to Scotland for heart surgery are facilitated by the boards. That reduces the waiting list here for those who do not wish to travel.
Mr Deputy Speaker:
Question 10, in the name of Mr McMenamin, has been withdrawn and will receive a written reply.
asked the Minister of Finance and Personnel to detail his proposed discussions with the Chancellor of the Exchequer concerning the allocation of consequential loss allowance for those affected by foot-and-mouth disease in the farming, tourist and commercial fields in Northern Ireland; and to make a statement.
The Minister of Finance and Personnel (Mr Durkan):
Any new resources for Northern Ireland to address business hardship resulting from foot-and-mouth disease would arise only as a consequence of additional spending in England for that purpose. On that basis, we have established with the Treasury that approximately £1 million will be available for measures here. That will be comparable to rate relief measures in Great Britain.
As I have explained to the Assembly previously, the Executive and Departments have been working on preparing a suitable scheme. This scheme was agreed at the Executive meeting on 17 May and was announced by the First Minister and the Deputy First Minister this morning in a priority written answer. I also sent details of the scheme to the Chairperson of the Finance and Personnel Committee, with copies to the Chairpersons of the Committees for Enterprise, Trade and Investment and Agriculture and Rural Development.
I welcome the written priority answer to my written priority question, explaining the grant aid in respect of rate relief. However, in view of his reply, can the Minister confirm that the hard-pressed businesses in Northern Ireland will get like for like with Great Britain? I assume that the £1 million to which he referred is based on the Barnett formula. Can he confirm that it will not be an all-time cap but that, if the £1 million does not fit the requirement, the Northern Ireland Executive will, with judicial management, address the shortfall and that no person will suffer unduly as a consequence of a lack of funding for that scheme?
I am happy to reassure the Member that the £1 million will come from the Treasury for this scheme to give businesses here similar benefit to the rate relief applied in Great Britain. That money is a Treasury contribution, and those who manage the scheme will not be working to a ceiling of £1 million. No budget has been fixed, because the scheme will be demand-led.
The Chairperson of the Finance and Personnel Committee (Mr Molloy):
Go raibh maith agat, a LeasCheann Comhairle. Today's announcement is welcome to farming and related businesses in rural areas. I hope that the scheme will alleviate some of the stress that the farming community has felt. Does the Minister envisage a cut-off time for applications for grant aid under the scheme? Some farms that have been infected or have had animals slaughtered are no longer in operation, and the farmers may not be entitled to housing benefit in the normal way. Can they claim grant aid under the scheme as well? Cattle marts have been identified as an associated industry- and that is welcome - but could events such as horse shows and the people who make their living from attending and exhibiting at those also be part of the scheme?
I acknowledge the Chairperson's welcome of today's announcement, and I appreciate the constructive interest that that Committee, and others, have taken in this matter.
Businesses should register for the scheme by 20 June. It is entirely reasonable that a date is set, given that the scheme is meant to address hardship that is manifesting itself now. The scheme is for business relief, so it will not be for domestic rating purposes per se. However, the Department of Finance and Personnel recognises, as has been reflected in debate here and elsewhere, that some farms have diversified, particularly into tourism, and so there are some businesses such as those offering bed and breakfast that, because of their scale, are paying only the domestic rate.
The Department is, therefore, making provision to enable such businesses to achieve commensurate rate relief. However, the relief scheme has not been extended to domestic rates as such; that is not the case in Great Britain either. Members asked the Department to create a scheme to ensure that businesses here were in a no less advantageous position for relief than businesses across the water, and the Department has delivered that.
The point about cattle marts was registered here in previous debates and was covered by today's announcement.
The Deputy Chairperson of the Agriculture Committee (Mr Savage):
I welcome today's announcement on behalf of the Agriculture Committee. That Committee heard at first hand of the hardships that are faced by the owners and operators of livestock marts. Today's acknowledgement that the Department closed down the marts and other businesses is welcome.
However, can the Minister detail any additional options that were considered to provide further relief against the ongoing costs of these businesses such as insurance and rent? Will assistance be given towards any capital investment that marts will have to make before they are allowed to reopen? The announcement is welcome to businesses that are related to agriculture, but in the horse world, riding schools have been closed - do they come under that umbrella as well?
Obviously any of the equestrian centres that have seen a reduction in turnover because of the foot-and-mouth restrictions will be eligible to apply in the same way as any other business. This scheme is to ensure that businesses that can show hardship are not liable for rates - as with businesses across the water - during the period of hardship. The Department has achieved that.
The Member raised other issues such as grant assistance in other forms and for other problems. This announcement does not cover those issues.
The Deputy Chairperson of the Committee for Enterprise, Trade and Investment (Mr Neeson):
I welcome the Minister's statement, but is he aware that our Committee has received representations from the Northern Ireland Hotels Federation, from people who own bed-and-breakfast facilities and from coach operators? Will the applications be dealt with flexibly? Will small bed-and-breakfast facilities that provide fewer than six places and pay domestic rates qualify for the grant scheme? What plans does the Minister have for an appeals mechanism? That will be important in dealing with such a detailed and sensitive issue.
I am aware, as are the Executive, of the representations that various business sectors have made to Committees and directly to Ministers. We have tried to make sure that the arrangements extend assistance to businesses here similar to that offered to businesses across the water. That has been done. Questions are being asked about further assistance, for which there would be no cover from the Treasury or anyone else.
There will be a review mechanism so that anyone who is refused assistance may have the decision reviewed. Smaller bed-and-breakfast establishments, with fewer than six bedrooms, will be eligible for assistance, provided that they can produce evidence of hardship. We should remember that this is a hardship relief scheme; businesses will have to show evidence of hardship and evidence that the hardship was related to foot-and-mouth disease. To qualify for the grant, businesses will have to prove a 15% drop in turnover. We think that that figure is realistic and that it is not too exacting an indicator of hardship.
asked the Minister of Finance and Personnel in the light of the recent rates increase what consideration he has given to the plight of local community halls, many of which act as a focus of community activity in remote rural areas; and to make a statement.
Orange Halls (Derating)
asked the Minister of Finance and Personnel whether he has any plans to derate Orange Halls and premises belonging to the Loyal Orders throughout the Province, as they are essentially cultural venues.
Mr Deputy Speaker, with your permission, I will take questions 2 and 11 together.
Existing legislation permits rate relief on any hall with facilities that the wider community uses. The degree of relief available is in direct proportion to the use of the facility for charitable and broad community purposes. The review of rating policy will include consideration of all existing relief.
Does the Minister recognise the vital role that rural halls play in the community? How does he intend to alleviate the financial burdens that many such halls have accumulated?
We recognise that many organisations and community groups that use and run halls have funding difficulties, and we address those in many of our spending programmes. There are some rate relief concessions available for halls that are used for wider community purposes. In the context of the rating policy review, we will look at those reliefs and at suggestions for revising them.
I am sure that the Minister is aware that in many country areas the local Orange Halls are the only halls that are available for public use. As those halls fulfil a unique and valuable function, they should be derated. They are primarily cultural venues and, as such, deserve to be derated in the interests of fairness and equity.
I refer the Member to what I have already said. There are existing facilities that allow a measure of rate relief to be accorded to halls where they are used for wider community or charitable purposes. That measure applies only when a hall is used for those purposes. There are no plans automatically to derate any particular category of hall on the grounds that it is used as a cultural venue or anything similar.
Does the Minister accept that he has made a very unfair ruling, as Orange Halls are essentially cultural halls? GAA halls are used for sporting purposes, and he finds it completely reasonable to derate those, yet he asks that Orange Halls prove that they are being used to set up children's groups, youth clubs, youth meetings, and so on, before they can be derated. Those responsible for the Orange Halls have to provide more information than the GAA has to. Surely it is unfair and iniquitous for the Minister not to derate Orange Halls while continuing to give the GAA full rate relief.
I remind the Member that no decision has been taken yet. I am reflecting the current position in terms of the rating regime. There is a rating policy review. That review will look at existing reliefs and exemptions and any possible revisions that may be made to them. Any hall, regardless of who owns or operates it, is eligible for rate relief if it is used for a wider community or charitable purpose. There is not, as the Member suggests, total derating for the GAA. I realise that many halls are used for a variety of activities, perhaps including line dancing. I do not know whether the Member believes that that broader community activity should be eligible for rate relief.
asked the Minister of Finance and Personnel to detail (a) the success rate in the delivery of census forms and (b) the return rate to date.
It is estimated that over 99% of households received a form prior to census day. A census coverage survey that will be carried out later this week will be used to quantify more accurately the extent of any missed coverage. A similar survey was conducted in 1991. It is estimated that over 90% of forms have now been returned. Work is continuing to get all the forms back.
If the figure were 99%, we could be reasonably satisfied. I have some anecdotal evidence of failure to deliver the forms in parts of Belfast, in particular. I do not simply mean the kind of student rented area that might be considered difficult to deliver forms to, but also some residential suburban areas. What procedures will be in place to follow up nil returns, particularly if householders have attempted to contact the helpline and have still been unable to get forms delivered to them?
We appreciate any information that any Member can give us about failure to deliver forms. The helpline has been put in place to try to pick up on that issue. If Members, in the course of any other activities that they and their party Colleagues might be conducting in the next while that will bring them to people's doorsteps, hear of any instances in which people have not had forms delivered, we hope that they will use the helpline to assist them.
There have been some problems and some people missed, for example, in some newer developments. Also, some areas may have fallen between enumeration district boundaries. We have tried to deal with all of those, and we will try to pick up on any other outstanding issues. Enumerators are currently in the field to follow up on households where there has not yet been a return in order to ensure that there will be the fullest possible return of census forms.
Peace II Funding
asked the Minister of Finance and Personnel to ensure that the Peace II funding will be carefully monitored to ensure equality in the distribution of funding.
A number of agreed horizontal principles will govern the way in which the Peace II programme will be implemented. These principles address equality and balance considerations. Furthermore, in accordance with section 75 of the Northern Ireland Act 1998, the special EU programmes body, which is the managing authority for Peace II, has a statutory responsibility to promote equality of opportunity.
Will the Minister acknowledge that there are areas of need in every constituency and every council area? Is he aware that of £22·25 million spent by one intermediate funding body, Proteus, none was spent in the Carrickfergus Borough area? Furthermore, is he aware that I flagged up to his Department two years ago that no funding was being spent by that body in Carrickfergus? Given the failure of his Department and the intermediate funding body to act subsequently, how can he assure my constituents that, in the future, Peace II money will be spent fairly?
First, the programme, the particular measure and the intermediate funding body to which the Member referred are obviously part of Peace I. In due course, we will be conducting a full evaluation of Peace I. As the Member indicates, at the interim stage there were concerns, reflected by the MEPs among others, that not all areas were getting similar access to funding. In many cases that was as much to do with problems with applications as with the allocations themselves. That needs to be reflected.
Across all measures in Peace II, we are trying to ensure that all areas of need and all sectors are able to make viable applications that are worthy of support. We are determined to fulfil the requirements of Peace II. We cannot pretend that every single measure under Peace I could be expected to cover every need in every geographical area - it was just not in the nature of the scheme, and it was certainly not within the scope of the funding involved.
It is important that we monitor to ensure equality in the distribution of funding - that is crucial. Can the Minister confirm that Strangford Lough is the only area of outstanding natural beauty that does not qualify for Peace II funding on the criterion of disadvantage? Does he agree that places like Killyleagh, Greyabbey, Kircubbin and Portaferry have great social need and should be included rather than excluded as at present?
The Member has rightly said that it is going to be important to monitor Peace II. That is why we have put much stronger arrangements in place for the monitoring committees, with much clearer roles. One of their key roles will be to agree the programme complements. We are currently devising them. They have to be agreed by the monitoring committees before we can call for applications for funding.
I should make it clear that under the community support framework, as approved by the European Commission, we are meant to target this programme at areas of social need. There are criteria that we have to be seen to have regard to, and the monitoring committees will want to be satisfied about that as well.
Go raibh maith agat, a LeasCheann Comhairle. With regard to monitoring in particular, can the Minister tell me if there will be consultation with local partnerships? Can we move to having more standardisation or a single monitoring system, which would be better for local areas? The last time a lot of irrelevant questions were asked. We need essential monitoring and evaluation of the programme.
As I indicated, we have new monitoring arrangements in place for Peace II in respect of the new monitoring committee. There is also a new monitoring committee for the building sustainable prosperity programme and for the community support framework overall.
We are also moving towards the new Northern Ireland regional partnership board that will not oversee the detailed work of the district partnerships in the same way but will be responsible for promoting and fostering the wider development of partnership and encouraging best practice. In the new models of partnership which we hope to develop, we want to ensure that better partnership models develop in local areas; those models will depend on local agreement. We also want uniformity to help us achieve the highest possible standards.
asked the Minister of Finance and Personnel whether all Departments have been fully informed about the arrangements for addressing the issue of gap funding and to detail when he made this information available.
Departments have been fully informed and involved in the arrangements for addressing the issue of gap funding since 8 February 2001. That was when the Executive agreed its approach to the issue which I set out in my statement to the Assembly on 12 February. The interdepartmental EU steering group, which is chaired by the Department of Finance and Personnel, discussed the issue at a meeting on 19 February. A working group made up of departmental representatives was then established to manage the arrangements, and it has since met on a number of occasions to review progress and deal with matters arising. I have also been in correspondence with my fellow Ministers.
As the Minister is aware, gap funding provisions are dependent on programme complements being agreed within the timescale set out, which is 21 June. I note that the equality consultation has started, which is important. However, does the Minister agree that there is a need for the complements to be about quality and not just equality? The monitoring committees are expressing some concerns about the clarity and robustness of the indicators that are being produced for inclusion in the complements. Can the Minister update us on that issue?
It is important to ensure that high-quality indicators are in place to enable the monitoring committees to measure the effectiveness of the return we are getting on public investment under these programmes.
The special EU programmes body and the Department of Finance and Personnel, as managing authorities for the Peace II and building sustainable prosperity operational programmes, have included targets and indicators for each measure in the initial drafts of the programme complements. Those are being refined in conjunction with the monitoring committees as part of the ongoing consultation on the programme complements. Those targets and indicators will be further quality assured.
New Targeting Social Need
asked the Minister of Finance and Personnel to detail the progress being made on the review of procurement and to give an assurance that the findings of this review team will reflect the Executive's commitment to new targeting social need and equality.
The review team has now met on six occasions, and it engaged in a public consultation on 3 May. It has discussed its emerging thoughts with the Finance and Personnel Committee and with officials in Departments. That will assist the team to bring forward its proposals, taking account of the equality dimension, for consideration by the Executive Committee in June. Among other things, the review team's terms of reference ask it to identify the scope to use public procurement to further local social and economic objectives in the context of current EC and international procurement law.
Will the Minister confirm that all Departments and their agencies will be required to conform to good practice models of procurement, thereby ensuring that the people of Northern Ireland have value for money and fairness in all public purchasing, no matter where it is carried out?
The original review of procurement carried out prior to devolution showed that there was considerable room for improvement. It will be important to maximise the gains that are possible in terms of value for money and equality for all.
It is important to ensure that guidance on good practice models is promulgated throughout Departments, their agencies and other associated bodies and that procedures are in place to ensure adherence to those guidelines.
Local Strategy Partnerships
asked the Minister of Finance and Personnel to detail the progress being made on the setting up of the new local strategy partnerships.
Arrangements for the implementation of the new local strategy partnerships were discussed at a colloquy in Ballymena on 31 January. It was attended by all the organisations involved in the delivery of Peace I. Following that, the special EU programmes body (SEUPB) convened a focus group to draft guidelines for the formation and operation of the new local strategy partnerships. The SEUPB has initiated a consultation and information process on these arrangements, including a series of seminars that were held earlier this month. The SEUPB has now issued guidelines on the formation and operation of the local strategy partnerships and on the development of integrated local strategies.
Will these new partnerships be encouraged to develop long-term sustainability, and will we see these structures being fully utilised in areas other than EU funding situations, giving local people a better opportunity to influence issues that affect their lives and that of the community?
I do not see the principles of local partnership working as something that can apply only to European funding, to be thrown away once that funding ends. I want to see partnership working become an integral part of how we ensure that local community voices are heard. They influence priorities for spending at local level - not just in respect of European funds, but of all sources of public funding. The input from district councils at a corporate level, and from the statutory agencies that operate at local level, will be important in developing long-term sustainability.
Mr Deputy Speaker:
I want to comment on the failure of some Members to appear and ask their questions. In the early part of Question Time there were at least three questions that did not have a questioner. I beg Members to be in their seats by 2.30 pm for the beginning of Question Time.
Adjourned at 4.08 pm.