The Northern Ireland Assembly

ANNEX A

To what extent will the Minister's decision be based on the Royal College of Paediatricians' reports determining where they want to practice? Could the m£1.5 recent refurbishment at the Royal sway the decision on where to site the maternity unit? Can the Minister comment on the JAG's argument that the Royal could not take on the Jubilee's entire maternity load? Will the Minister be announcing simultaneously early decisions on both the long-term siting of the maternity unit(s) and her plans for the interim?

A very broad range of issues and arguments has been made that will inform the final decision. The refurbishment at the Royal had to take place in any event and does not pre-empt the decision on the siting of the maternity unit. The Minister fully accepts the importance of making an early decision on both the long-term provision and interim arrangements. Accordingly, she will make a clear announcement on each in the next few weeks having considered all the relevant factors.

There is a concern about the withdrawal of paediatric services from the Jubilee and why this should be so. It seems that there is a big push for the Royal because it is situated beside a paediatric unit. The City seems better as a neutral site and is women-centred as well as being better placed for Private Finance.

In view of the fact that the Royal Colleges have deferred the withdrawal of paediatric training recognition at the City Hospital since last July at the Department's request, the Minister does not feel that they have been unreasonable. If they advise the Minister that something in place is unsafe, she must clearly take that on board. However, no decision on maternity provision has been taken yet and the Minister is still listening to all points raised. The PAFT analysis has shown neither site to be more neutral than the other. When a decision is taken it will be on the basis that it is seen as providing the best and safest service as well as being women-centred.

Some neo-natal staff in the Jubilee are talking of leaving the service as they are disillusioned, and this will have a devastating impact. Can more be done to help staff at the coalface manage change through, for example, meetings to discuss plans for future provision?

The on/off decisions regarding maternity provision over the last few years have had a negative impact on staff morale. An early decision on this issue will be the most positive measure in helping people gel together.

There seems to have been minimal response from GPs to the maternity review. Can any effort be made to find out why?

Every opportunity was given to people to respond, and the consultation did achieve its aims. GPs were involved in the liaison group of the EHSSB, and GPs in both South and West Belfast are acutely aware of the ongoing discussions. They agree that both hospitals provide a good service but they want a decision made so that matters can move forward.

If the Royal becomes the regional hospital this will affect all of Northern Ireland. In such a scenario would antenatal services remain at Belfast City Hospital?

The Minister and her Department are working towards a long-term solution and she has undertaken to look at this issue.

Will all future decisions on Health matters be heavily influenced by the views of the Royal Colleges? There are differences of opinion within the Royal Colleges and their reports should not be beyond scrutiny.

The new Minister will be looking at many different forms of advice, but the Royal Colleges were set up as a safeguard to give the best possible guidance and this needs to be taken on board. The Minister accepts that the Royal Colleges are open to scrutiny but she cannot query their validity.

Discussions began in 1993 but the profile was raised in 1996 after which there were two successful legal challenges to decisions on maternity provision. The PAFT appraisal on the options was only completed in November1999.

There is a concern that the decision to withdraw paediatric services from the City Hospital may have been made by a Royal College consultant based at the Royal. Is there a possible conflict of interest?

A. It is the Minister's understanding that such a decision is made by the Royal College corporate.