Northern Ireland Assembly

Will the Member give way?

No, the time is short. Otherwise I would give way.

Finally, I want to deal with the points raised by Esmond Birnie and the thoughtful speech of Bob McCartney. The Ulster Unionist Party's amendment is of relevance, but the SDLP cannot support it at this time.

It is of relevance because there are three important themes raised in the amendment that need to be acknowledged.

First, there was a process of consultation and that must be acknowledged. Whether that process was adequate, either in the fine detail or in its conclusions, has yet to be fully determined. The Assembly will have to decide what is, and is not, adequate consultation in terms of managing its own business.

Secondly, it is arguable that the Minister's decision - and it is an executive power that we have to be careful to protect, otherwise we will impede executive authority - was right or wrong. We think that it was right, but we accept that there is an argument that needs to be fully rehearsed and determined.

Mr Attwood, your time is up.

I would like to deal with Dr Esmond Birnie's amendment.

First, the amendment is fundamentally flawed as it throws the responsibility back to the Minister to bring this issue before the Assembly.

Members consider that the Minister has treated the Assembly with contempt. She treated it with contempt by ignoring the Health Committee. She treated it with contempt by putting out a statement on a most important and controversial issue at midnight, rather than bringing it before the House, where she could be questioned and asked to explain the reasons for her actions. She treated it with contempt by ignoring the Executive Committee, as Dr Birnie has said. And, as we have seen today, she treats the House with contempt when matters are raised with her. Members ask her questions in English, and she answers them in the language of the leprechauns, which nobody understands.

Despite this contempt, we have an amendment which throws the ball back into the Minister's court. It says "You bring it back to the Assembly and let it make a ruling". That is why I believe that, despite there being some aspects of the amendment with which we would agree, it is flawed and it is weak. Once again the Ulster Unionist Party are giving IRA/Sinn Féin the benefit of the doubt with this amendment.

With regard to the Minister's actual decision, I am not on the Committee, but through my role in Belfast City Council I have heard all the arguments advanced by both sides in this debate. Medical politics seem to be as cut-throat as party politics. There were no holds barred in the way the arguments were put forward.

On the surface there would appear to be a strong case for the retention of services at the City Hospital. The fact that, out of the 214 maternity services across the United Kingdom, only 12 are linked to children's hospital facilities indicates that it is not absolutely essential to have the two linked. Even the Royal College of Obstetrics and Gynaecology points out that the link is not between the children's hospitals and maternity units; rather it is the other way round.

When it comes to the evidence we have heard so far - Dr McKenna's report and the decision of the previous Minister - it is significant that those who have advanced the argument for the Royal have talked about the economic importance of this unit to west Belfast. They have stressed that west Belfast is an area of economic deprivation and that therefore the facility should be maintained at the Royal. It has nothing to do with medical reasons; it is for economic reasons. It is significant too that the Minister represents the area.

If we do not lay down rules in the House quickly to ensure that Ministers are democratically accountable, we are going to see this happening time and time again with a Minister from a minority party. All parties in the House are minority parties. All Ministers represent minority parties, and if a Minister can take decisions against the wishes of the majority of the people of the Assembly, we will not have gained democratic accountability. We will be back to the old direct-rule system with Ministers who are not accountable. We must sort this out very very quickly.

The Minister ought to be censured for the contempt in which she has held the House. She has displayed this contempt since she was appointed - over the holiday period she was more interested in tearing down flags than dealing with the crisis in the Health Service. This is yet another example of that type of -

Order. Your time is up.

Go raibh maith agat. Ba mhaith liom a rá ar dtús báire go bhfáiltím roimh an deis an cheist seo a phlé sa Tionól. Tuigim go bhfuil ceist úsáid na Gaedhilge agus úsáid an Bhéarla ag gabháil a bheith idir chamánaibh roimh i bhfad, a Cheann Comhairle. Mar sin de, labhróidh mé go gasta i nGaedhilg agus rachaidh mé ar aghaidh i mBéarla.

I very much welcome the opportunity to debate this important issue. The issue of the use of languages was raised earlier this afternoon, and the Interim Presiding Officer has indicated that he will be looking at it. Having spoken briefly in Irish now, I will speak only in English for the rest of this debate.

On a point of order, Mr Speaker. Is it right for the Minister to refer to you as the Interim Presiding Officer when you are now the Speaker of the House?

I do get called quite a lot of things, as Members are aware. Technically, of course, the Member is absolutely right: I am to be referred to as Speaker or perhaps Ceann Comhairle.

Gabh mo leithscéal.

I would like to reiterate to the Assembly my view that the Jubilee and Royal Maternity Hospitals both provide crucial, regional maternity services as well as more local services to mothers-to-be in Belfast. My aim throughout has been to guarantee the provision of the highest possible care and treatment for women, mothers and babies.

In coming to my decision, I took great care to consider the relevant information. I considered and reviewed the responses to the consultation process carefully, and that included responses from individual women, mothers from community groups, a wide range of health professionals and support groups from both hospitals.

I also made a point of visiting both maternity hospitals to see the situation for myself. I spoke to management, staff and mothers. I also spoke to the groups in support of each maternity hospital. All the people I met asked me, in the interests of the maternity services, to decide quickly on their future location.

In addition, I also considered the specially commissioned PAFT analysis and high level economic appraisals of the long-term and interim options. Copies of these documents, along with the summary of the consultation responses, will be placed in the Assembly Library. I also benefited from the advice of the Assembly's Health Committee.

It is worth placing on record that not only did I go to the Committee, speak to it and ask it to provide me with further advice corporately as a Committee, but I also invited individual members who wished to do so to advise me on a personal basis. I took all of this into account, along with the other factors that I have mentioned that were my responsibility.

It is also worth placing on record that I agreed with the Committee that a decision was needed urgently; that a new maternity hospital was required, and not a refurbished one; that a decision was needed at the same time on the interim and long-term solutions; and that the interim solution should not become the final solution.

I also recognised the Committee's preference that the Jubilee and Royal Maternity should both remain open, but I agreed with their advice, stated in a letter they sent to me, that in the prevailing circumstances

"There is no alternative but to locate maternity services at the Royal Maternity in the interim."

The arguments from the consultation process in my Department's own analysis underlined the need to provide a new-build maternity unit. Choice between the new build on either site was a close one. Given the points that Members have made, I reiterate that this argument was one of a number which I looked at, but in the final analysis the clinical arguments came down to the potential linkages of the new hospital to other on-site clinical services.

My conclusion was that maternity services would be more clinically effective if located adjacent to regional paediatric services at the Royal Belfast Hospital for Sick Children and near to the accident and emergency department. My decision does not adversely affect gynaecological oncology, as gynaecology is currently provided on both sites. No decision has been made on the future provision of gynaecology.

When compiling his report, Dr McKenna did not have the opportunity to consider the new-build option, for it was not an option at that time.

With regard to the Committee's being informed of my decision, I totally acknowledge the points made by Dr Hendron. I sought to speak to the Committee Chairman. I sent word, and Dr Hendron returned my call. I advised him of the detail of my decision and that a press release was being drawn up for that evening. The press release was issued after 8.00 pm. I spoke to Dr Hendron at 6.45 pm, and the content of the press release was embargoed until midnight - several hours after I had spoken to him. There was no intention whatsoever of treating the Committee with anything other than reverence, and I pointed this out to the members during my visit.

Regarding the amendment, I would like to pick up several of the points raised by Dr Birnie. The decision on the future location of maternity services in central Belfast is an important one for women regionally and locally. However, I cannot accept that it could be described as a key decision. It was primarily an operational one, and I did not identify any significant cross-cutting dimensions which would have suggested that the matter should have been raised with ministerial colleagues.

Consequently I am confident that this decision was dealt with appropriately. While I do not accept that this decision was a key one as provided for in the Belfast Agreement, I made no secret of my intention to reach an early decision. As stated previously, those I met while taking views on board asked me to make an urgent decision, and at all times in those conversations, in the press, in briefings from my Department to the First Minister and the Deputy First Minister and in press releases, which are routinely copied to the Executive information service, it was clear that my intention was to reach a decision as soon as possible - certainly before the end of the month.

All of these were routinely available and copied as a matter of course to the Office of the First Minister and the Deputy First Minister.

Regarding Dr Birnie's point about the failure to engage with the Health Committee, I took care to work with the Committee in the lead-in to my decision. I wrote to the Chairman of the Committee before Christmas and copied the PAFT analysis and an initial summary of consultation responses to Committee members prior to meeting with them. And I made a point of ensuring that there would be an early meeting; I met with them on 10 January.

At that meeting I invited members to give me their views on the way ahead, in advance of my decision, and I explained the urgency to them. They agreed with me on the urgency, and I asked them to have written responses with me by 20 January in order to ensure that I could give their comments due weight when I came to take the decision. I took close account of the advice from the Committee, and I accepted a number of the points, as I outlined earlier, such as the need for the decision to be made urgently and the need for a new maternity hospital.

I carefully considered this alongside the outcome of the consultation process, my visits to the maternity units, my meetings with management, staff, health professionals and support groups as well as the PAFT analysis, the economic appraisals and the professional advice from my Department. I also sought Dr Campbell's advice on oncology.

Order. The time is up.

I call Dr Birnie to wind up.

The clinical arguments in favour of the Jubilee as opposed to the Royal Maternity have been well rehearsed this afternoon, but I moved this amendment because the Minister has overridden her Committee and made a unilateral decision without further reference to her Executive Colleagues or the Assembly.

If a decision that involves the spending of £15 million is not a key decision, I tremble for the future of budgetary arrangements in her Department. We could be establishing a very dangerous precedent this afternoon with regard to how decisions are made, and it is essential that the House understands the implications.

We were told that powerful Scrutiny Committees would lie at the very heart of the new arrangements. Now we are in grave danger of seeing a Sinn Féin Minister knocking down the edifice of accountable government through the exercise of untrammelled Executive power. Our point about procedure would remain valid even if, in spite of what has been argued this afternoon, the decision by the Minister were, in itself, a wise decision, which it is not.

It is important at this early stage of devolution that we establish the ground rules for making important political decisions, especially in circumstances such as those we face now where a Minister is in confrontation with her Committee. At the moment the Health Minister's decision cannot be treated as final because it was not made in an open, full and public manner. My concerns and, indeed, the Ulster Unionist Party's concerns are reflected by the Assembly and by a majority of the general public.

We have all heard arguments today about maternity services in Belfast, and it is crucial that we, as an elected Assembly, endorse the motion and give support to the Committee that has been diligent in its examination of the matter. I ask all parties to give their support. Failure to do so will throw the Chamber into confusion.

There is also the question of the role that Committees will play in the future. If a Minister can make decisions which are diametrically opposed to the opinion of his or her Committee, that is saying, in effect, that the Committee is of little value. There was overwhelming agreement in the Committee across party lines. The Democratic Unionist Party, the Ulster Unionist Party, the Women's Coalition and a member of the SDLP fully supported the siting of maternity services at the City. This makes it vital that Members support the motion.

The Health Minister has failed to come up with a point of any weight to support her decision. She followed only her own narrow political interests. The grounds for that decision, in spite of the high-sounding claims that she has made on television and elsewhere, have not been substantiated today.

In fact we have had a very intelligent and powerful set of arguments that have shown the correctness of the Committee's view. I read the recent article in the 'Belfast Telegraph' by the Royal Victoria Hospital's clinicians, which amounted to one point - the transfer of sick babies and the location of paediatricians. If they were correct, then all maternity services in Northern Ireland should be at the Royal. I note with interest that Dr Hendron, who is the Chairman of the Health Committee, was talking about a regional neonatal unit, although that is not what they call it. It is not a regional unit; there is no such thing. There are neonatal units at Altnagelvin, Antrim and Craigavon.

We cannot afford to follow what is a vested interest in one issue and then try to ignore it in another. As Mrs Robinson said, and it is an inescapable point, Barbara Brown has set out in a number of articles her political agenda with regard to the Royal.

I have listened very closely to the debate this afternoon. First of all, we had a member of Sinn Féin/IRA, Alex Maskey, trying to stop this debate. What area does he represent? West Belfast. Then we had the Health Minister, Barbara Brown. Where does she represent? West Belfast. We also had the Chairman of the Committee, Dr Joe Hendron, and Alex Attwood speaking against the motion. These people all represent West Belfast. If this is not political I do not know what is. It is hypocrisy on their part.

Before this debate today, politics were brought into the situation. Dr McKenna's recommendations went against having the maternity services at the Royal Victoria Hospital. The Nationalist politicians said "No way. We must have another review". Then Prof Donaldson moved in, and he recommended that the services be transferred to the Royal Victoria Hospital.

The Minister has done a serious injury to the whole issue of maternity services and caused divisions where none should be. She cannot discard the Health Committee because it has adopted a more rational policy than she has. The Minister has tried to circumvent the work of our Committee. We had substantial consultations. We sat one evening for six or seven hours with the various groups, and people accused us of being political. We went through all the clinicians' arguments. We had the medical men and the support groups coming in to give us their views. The Committee then had a cross-community vote, which was seven to four in favour of the City Hospital. That must not be ignored.

The mothers who will be affected by this must not be ignored. There were 500 responses to the consultation process, plus a pro-City petition of 40,000 names, which appears to have been ignored. That is the way the mothers in this part of Belfast feel this evening. They feel ignored and betrayed. The Minister has tried to cover herself -

Order. The time is up.

I would like to say in closing -

Order. The time is up. The Member will resume his seat.

The amendment and, if we come to it, the substantive motion will be decided on a simple majority vote. If the amendment is carried, we will not proceed to the substantive motion because the amendment, in effect, supersedes it.

Question put That the amendment be made.

This Assembly endorses the decision of the Health, Social Services and Public Safety Statutory Committee to locate maternity services in Belfast at the City Hospital.

On a point of order, Mr Speaker. Will you now give the Minister an opportunity to reconsider her decision in the light of the Assembly's vote?

That is not a point of order, as I suspect the Member knows.