Northern Ireland Assembly
Tuesday 27 June 2000 (continued)
Mr B Hutchinson:
Many points have been covered today, and I do not want to reiterate them. I do, however, want to lend my support to some of them, particularly those that Mr Ford made. There is no question that we need an integrated transport policy; the question is how long we have to integrate it so that we can meet the objectives and have them written into Assembly policy. We need to focus on a ten-year period for achieving this, but we could make a start, and quite quickly too, as David Ford said, with ticketing. Mr Ford came up with the good example of the Ballymena express at Templepatrick, but this is not just about buses. We should also be able to get a ticket that can be used on buses and trains. If those were dovetailed, it would be quite good.
The Little report talked about needing investment of £183 million. What shocked me about that £183 million is that it was for safety measures alone. To improve the railway system overall, we need £300 million, not just £183 million. That is a point we need to look at.
I talked to a colleague of mine from Coleraine who travels by car and by train. He tells me that if one travels from Coleraine to Belfast, it takes two hours or more on the train. The same journey can be done by car in one hour and twenty minutes. I do not know whether that involves breaking the speed limit or not, but at least it is in the comfort of one's car. He also tells me that the train is cold, damp, unattractive and uncomfortable.
We continually talk about wanting to get people out of cars, but how can we do that? We need to have attractive alternatives. I suggest that we need adequately funded public transport. We need priority bus lanes and dovetailing timetables so that public transport can work.
In south Belfast a few weeks ago, Translink decided to introduce new bus stops and a new timetable. The new timetable showed the new bus stops, but the old ticket prices. People got irritated when they found out that they were going to have to pay another 20% per ticket. Also some of the timetables were old ones, so people were at the wrong places at the wrong times. These are just some examples of the problems. There are things that we can do at the very beginning.
We also need to do something about our airports. It has been said that our airports are strategically placed in economic terms, particularly Aldergrove. However, to get from Aldergrove to the city of Londonderry, I understand, is difficult. If one wants to get to Belfast, one can go by the airbus, which is quick. The Minister needs to talk to the management of the airports to find out if they are prepared to pay some of the costs. I think that they would be interested in looking at the costs and at putting some of their money into a rail link. We could have rail links with, for example, Londonderry airport and also the airport at Belfast harbour. We need to pursue those sort of things that would not just help businessmen, or the people who live in Northern Ireland, they would also encourage tourists - many tourists find it hard to get around the Province.
This is an interesting debate, and I thank Mr Byrne for bringing it forward. Some Members seem to want to use this debate as a "whinger's charter". I refer in particular to Mr Dallat's very poor and inept contribution. He seeks to blame the Minister for the problems that the railways and roads have had over the years.
We might as well blame Minister Rodgers for the BSE crisis, Minister Farren for the tuition fees, and Minister Durkan for the lack of money from the British Exchequer. I do not intend to go down the same silly line as Mr Dallat. It is time that he got real, grew up and moved away from council-chamber politics. He should realise that he is now in a place where he can make decisions, not just whinge and moan about what is going on.
We need to back up what we are saying today. We can tell our local newspapers that we spoke in support of public transport, but did we? Do we support public transport? Are we prepared to put it on the record that we will not take the money that John Prescott will allocate to Northern Ireland for its railways and distribute it to health, education, agriculture or some other budget? Are we prepared to earmark that money for the sole purpose for which it was intended, or are we prepared to let it be diverted to other areas? Do we make a statement today but not back it up? I believe we would be failing in our duty if we were to do that. It is evident that public transport needs massive investment - £2 billion over the next 10 years for the railways alone - and one would then have to look at the bus service.
We have a lot of space in Northern Ireland for the development of our roads and public transport. We cannot do without the roads network. Another £200 million a year is needed to maintain our roads in their current condition - never mind carry out major improvements. Are we prepared to pay for this? Are we prepared to do what is required, or are we going to sit back and blame the Minister? There is a saying in our part of the world that you cannot whistle without an upper lip. The Minister needs the money if he is to deliver a good rail network and a good bus service, not only for taking children to and from school, but one which will be used by people travelling back and forward to work. If you want decent roads throughout the Province, the Minister needs the money to implement this. [Interruption] He definitely can whistle. I welcome the commitment to major safety improvements and the undertaking that the railways will not operate unless they are safe. Safety issues are important and the general public may feel that our railways are unsafe. They are not what they should be, and we need to look at safety management, safety culture, operations, structures, the permanent way, signalling and telecoms, level crossings and engineering. All these matters need to be dealt with and improved.
I would like to find out how much terrorism has cost the railway service over the years. I vividly recall, morning after morning, switching on the radio to hear that the Belfast to Dublin line was not running that day because either a device had been planted at Killeen or the trains had been attacked at Lurgan. Various attacks have been carried out over the years, and I would like to know how much it has cost to replace all the buses that were burned out during riots in Belfast and other places.
I would also like to know if this task force serves a useful purpose. My Colleague indicated that there have been five reports over the last five years - it is not reports we need, it is action. Does the task force serve a useful purpose, or did the previous Minister for Regional Development introduce it as an excuse not to make the decisions that needed to be made?
I want to support the motion, but we need more than that: we need the money to back it up.
Although a number of Members still wish to speak, we have come to the end of the time allocated for contributions. I therefore call the Minister for Regional Development, Mr Peter Robinson.
The Minister for Regional Development (Mr P Robinson): Many points have been raised during the debate. If I cannot touch on all of them in the course of my response, I shall, of course, do so in writing. I welcome this debate and am grateful to Mr Byrne for availing of the opportunity to raise this issue and start a debate in our community as a whole about this vital issue.
There is common ground among all Members. We have inherited a transport system that is in an appalling state. I am determined to bring about major improvements in public transport and to provide Northern Ireland with the system that it needs and deserves. Substantial additional resources will be required. Members will play an important role in ensuring that public transport receives the necessary share of the Northern Ireland cake. I will return to the matter of resources later.
First, I want to differentiate between funding for buses and for trains. Bus transport receives a relatively low level of subsidy, whereas rail transport requires to be heavily subsidised. This is the case, not just in Northern Ireland, but in Great Britain, the Republic of Ireland and throughout Europe. My Department gives grants to the bus companies to cover fuel duty payments and 50% of the cost of new buses. Our aim is that vehicles be replaced as they reach their target replacement ages: 12 years for coaches, and 18 years for buses.
Over a period this would give average fleet ages of six and nine years respectively, which would be similar to the English average fleet age target of seven and a half years. Our problem is that currently we do not have sufficient resources to grant-aid bus replacements at the rate needed. Consequently, the bus companies have to keep buses in service long after they reach their target replacement age. This is clearly unsatisfactory in terms of customer comfort and bus reliability. In the current year my Department has only £1·7 million for bus purchase grants, while over £20 million would be needed to meet our objective. That gives some idea of the shortfall.
Turning to the more intractable problems of the railways, I am sure that all Members have known for some time that the railways face serious problems. The release of the A D Little review of railway safety last March brought home the scale and immediacy of these problems. Briefly, the review said that while Northern Ireland Railways was currently operating at not unreasonable safety risk levels, an estimated £183 million, plus or minus 30%, would be needed over the next 10 years to maintain safe operation. The review went on to say that most of that £183 million - £117 million, to be precise - would be needed in the next three years. To put these sums in context for Members, last year Northern Ireland Railways - [Interruption]
Mr C Murphy:
Mr P Robinson:
Last year Northern Ireland Railways received grants and subsidies of just under £20 million. Now we are looking for £117 million over three years. Obviously, if we are to keep the current railway network operating, the Assembly will have to allocate substantial extra resources to it. I will come to the Member's point in a minute.
When my predecessor, Mr Adam Ingram, was presented with the A D Little report last March, he decided to establish the railways task force to identify the costs and benefits, both monetary and non-monetary, of a range of options for the future of the railway network in Northern Ireland. I suspect that Adam Ingram was wearing his finance and personnel hat, rather than his regional development hat, when he devised those requirements. Be it Adam Ingram or Mark Durkan, the Minister of Finance and Personnel would require any Minister to make a business case for any proposal they were bringing forward that required such substantial finance.
The work of the task force includes a large-scale public consultation exercise, which is currently under way. There have been some complaints about the limited period allocated for the consultation exercise, but Members should realise that the task force must complete its work in time for its conclusions to be considered in this year's spending review.
The stark reality is that if we do not succeed in obtaining more resources for the railways in the spending review, then a large proportion of the railway network will close down in a piecemeal fashion. Northern Ireland Railways has repeatedly said that it will not run trains unless it is satisfied that it is safe to do so. It has my full support on that.
Unless more resources are allocated to improve the infrastructure of the railways, it will become unsafe to run trains on many lines. Unless Northern Ireland Railways can purchase new trains, the level of service will deteriorate as old trains repeatedly break down and are taken out of service permanently. The motion calls for a comprehensive integrated public transport policy to be implemented. I am in complete agreement with this sentiment, and I will explain the steps I am taking to deliver such a policy.
The preparation of the regional development strategy is nearing completion. It has become clear that the provision of a modern, sustainable, integrated transport system which will facilitate the rapid, efficient, predictable and safe movement of people and goods is a key factor in the successful implementation of the strategy.
Within the Department for Regional Development I have established a dedicated regional transportation division which is tasked to formulate a 10-year regional transportation strategy. I agree with Mr B Hutchinson's remarks. It is essential that we do this on a 10-year basis, which gives us the opportunity to implement decisions taken by the Assembly. The transportation strategy will set out a bold vision for transport, including the expected outcomes and the necessary steps required to achieve these. The strategy will serve as a daughter document to the regional development strategy. Subject to the ultimate approval of the Assembly - and necessary resources - it will have the potential to transform transport in the region, to get the public back on public transport and to provide a modern integrated transportation system that will strive to rival the best in other comparable regions of Europe.
I have alerted the Regional Development Committee to the fact that a sum in the region of £2 billion over the next 10 years - additional to the wholly inadequate current budget of just over £200 million per annum - will be required to transform transportation in the region. This is in the context of a comprehensive presentation which I gave to the Committee on 14 June. My Department will happily provide copies of this to Members on request, particularly to those who are seriously interested in tackling these important issues. I have allocated significant departmental resources to service the railways task force established by Adam Ingram. Some 21 sub-committees are working on the completion of an interim report, which I will receive at the end of July.
With regard to the future of railways let me be very clear. I have a presumption towards rail. It is an important strategic regional asset, but I will not compromise on the safety of the travelling public and Northern Ireland Railways employees. Either the Assembly will decide to have a modern and positively subsidised rail service that we can all be proud of, or we will, de facto, end up dramatically curtailing that network. The days of indecision are over. The A D Little review simply confirmed what we have known for years. It is time to put up or close up. For our part we will ensure that the Assembly has the earliest opportunity in the autumn to consider the importance of the railways task force interim report. I trust that the remarks made in support of rail in the House today will, by that time, have been translated into practical action.
I will respond to some of the comments made during the debate. Mr Byrne, happily, set the scene so well in moving the motion that he has enabled me to leave out many elements of the transport issue as he had already covered them. He made a strong case. He outlined a history of neglect which many Members have agreed with. Under both Labour and Conservative Governments, the money that should have been going into our public transportation system has gone elsewhere. Now we face the consequences of 30 years of neglect of the system.
I acknowledge the important role that the Assembly Committee responsible for the scrutiny of the Department for Regional Development has played in regard to this issue. I trust that it will continue to do so as we deal in detail with transportation policy.
The Member referred to the possibility of an additional 70,000 vehicles being on our roads over the next 25 years. It is going to be something like 10 times that. It will be about 700,000. In the next 20 years we expect the number of vehicles on our roads to double. If people consider that there is congestion now, then let them imagine, as the Member for North Down did, what congestion will be like in the future.
Mr McFarland referred to the congestion problems that presently exist. He also wisely related the issue of transport to the regional strategic framework. He pointed out the conundrum that we all face in wanting to get people out of their cars and onto public transport, but that they are not going to get onto public transport until we provide them with a comfortable, regular and dependable service. That requires funding. The Member for East Antrim, Mr Roger Hutchinson, brought us back to road issues. He was right to do that, because the majority of our public transport users use buses and the road system and that, therefore, is a key and vital issue. It is an issue that must figure prominently when it comes to the necessity for funding. He mentioned one of my predecessors, Lord Dubs, referring to the shambles. I do not think that a much more appropriate word could be found for what exists, although I can imagine the effect that it had in the Department when he used the term.
In relation to the railways, the Member for East Antrim was right to say that the trains are 30 years old, that in many cases the lines need to be relaid, and that if this did not happen, a reduction in services would result.
Will the Minister give way?
Mr P Robinson:
If the Member is brief.
I welcome the debate. I also welcome the £15 million for the A5 road. The SDLP and its cohorts in Sinn Féin grudgingly did not acknowledge it. They said it was only a line on the map. I welcome the provision of the Toome bypass. I further welcome the fact that the A5 is to include the Strabane bypass, the Newtownstewart bypass and the Omagh throughpass, which were all predicted not to happen. Thank goodness for a progressive Minister.
Mr P Robinson:
I am glad that I gave way. [Laughter] I shall be quite happy to give way again if anybody else wants to make similar comments.
The Member for South Antrim, Mr Ford, made a very useful contribution. I agree with him entirely that, on one hand, I am looking for more funds for railways and buses in Northern Ireland, and, on the other hand, through the Chancellor's initiative £25 million is being clawed away from the Northern Ireland Transport Holding Company and Translink. It just does not make sense, and clearly that issue needs to be addressed. However, I think that the Member will recognise that the emphasis of the Chancellor's package was one of putting money into roads. The whole emphasis of what I am doing is on telling people that we need to get off the roads and into public transport. Mr Ford also gave me a very good cue when he referred to quality bus corridors.
In the early hours of this morning, while the Member was still in his bed, I was travelling by bus along a quality bus corridor. I recommend it to all the people on the Saintfield Road. The Saintfield Road is the fourth busiest road into Belfast, after the two motorways and the Sydenham bypass. We had a very smooth run on the most up to date transport in a new, quality bus lane. I hope that the public will take advantage of this method of getting into Belfast cheaper and faster than by car. That is the only way that we are going to get people onto public transport.
I thought that some of Mr Dallat's remarks dragged the debate down a little, and I will leave them to the side. However, I will deal with his comments relating to transport and the comparison with the Irish Republic.
Proportionately, I wish I had the resources to put into public transport and roads that my counterpart in the Irish Republic has. Do not take the colour coding as being indicative of anything else, but I am green with envy at the funds that are available. It is probably the kiss of death to have a Sinn Féin Member saying that he agrees with me during the course of the debate and I will probably be cross-examined by my party leader afterwards.
Mr Dallat raised a number of issues about public expenditure. In the Irish Republic, public spending is supplemented by European structural funds, and a substantial amount of money comes in from the private sector. If I had had more time I would have gone into that issue and how it has contributed to our situation in Northern Ireland.
As regards the issue of being in the Executive, let me make it clear to Members - and I know they like to make party political points - that the neglect that we have had for 30 years comes as the result of Ministers who were in joined-up Government. It did not help them in the past. Perhaps we need somebody outside the Government blowing the whistle, saying what needs to be done on the railways and not being compromised by loyalty to other Colleagues in the Executive. Perhaps Members should rejoice in the fact that they have a Minister who is not tethered by responsibilities to Colleagues in an Executive.
One of my Colleagues asked a question about the cost of terrorism. Apart from the emotional cost to the staff and employees of Translink, £300 million has been lost as the result of the destruction of buses, trains, and bus stations. That is without even touching on the issue of the cost of disruption and the loss of money that would have come in using those services. That money would pay for A D Little, and you would have plenty left over to buy buses as well. It is an important matter.
The issues involved are complex, and the cost implications are considerable. The immediate public transport funding problems can only be solved by increasing the public expenditure allocation from the Northern Ireland block. In this year's spending review I am seeking an additional £250 million for public transport, and that will be necessary for each of the next three years. Expenditure on this level will enable us to start improving public transport from its current poor state, and set us on our way to providing a public transport service of a standard which the people of Northern Ireland desire and deserve.
Within weeks the United Kingdom Government will announce the 2000 spending review figures, which will likely signal a significant increase in funding for transport. There has been press speculation that up to £140 billion will be made available over the next decade, half of which might come from the private sector. It is essential that we advance the Northern Ireland transport agenda in tandem with any new priority in Great Britain. We must insist that Northern Ireland at least receives the Barnett hypothecation. Northern Ireland must secure the maximum possible benefit from any such public expenditure decisions taken at national level to advance transport. On the assumption that the Barnett hypothecation can be secured for Northern Ireland, those funds must be allocated for the purposes envisaged and not diverted elsewhere. This autumn we will begin to rectify the years of under-investment in transportation and we will thereby reinvigorate our railways, modernise our bus fleet and services, and improve our strategic roads network.
After reading the motion, it is clear that the proposer has managed to get round the constraints, which you referred to earlier, about financial matters. That is because the motion contains a commitment to follow a comprehensive and integrated public transport policy. The commitment is contained in the word "implementing". The motion does not ask for the preparation of a policy because the Member knows we were preparing it. It does not indicate anything about an amount of money because the Member knows that. It calls for implementation, which is the putting in place of financial funds to allow the Minister to carry out the task.
I would like to thank everybody who has spoken in the debate. I think there is a consensus of support for the sentiments of the motion. There is no doubt about it, every one of us here and the wider public are extremely concerned about the current state of the public-transport system.
A number of common themes have run through the debate, the most important being public safety. Many referred to the Little report and the areas of concern it flagged up. Translink have stated that on the Bangor to Belfast line, trains that should be able to do 70 miles an hour currently cannot travel at that speed for safety reasons. They are currently restricted to doing 50 miles an hour, and by the end of next year, if there is no new investment in that line, that speed will be reduced to 30 miles an hour. That is the extent of the crisis on one line. Our railway network is small - we have railway lines from Derry to Belfast, from Belfast to Bangor, from Larne to Belfast and the southern line to Dublin - and if it were to be reduced further, it would be a joke.
Public transport is currently very much in vogue. Members and the public at large are talking more and more about the quality-of-life issue; they are talking about the environment, and they are talking about traffic congestion. Several hundred thousand new cars are going to be adding to this congestion over the next 20 years, especially in the Greater Belfast area, and so I am glad that this sort of debate is now opening up and that we are beginning to focus on the real issues.
As someone who comes from a constituency that has no railways whatsoever, I could be asked why I get involved in such a debate. I am the regional development spokesperson for my party, and there is an onus on all of us to consider the problem throughout Northern Ireland and not just in our own home patch.
Northern Ireland's economic potential was referred to by a number of Members, and I fully agree that if we are going to develop this regional economy, then having an adequate, integrated public transport system is essential. Inward investors are greatly influenced by communications and by transport networks, and those of us who live 75 miles from Belfast know the handicap of having a poor transport system in our part of the region and appreciate how that affects us.
A number of Members, including the Minister, made reference to the regional development strategy. This is the most crucial issue that has been raised in Northern Ireland over the last 10 years. We are beginning to look at the future. 'Shaping Our Future' is the phrase that was used on the original document. There is an onus on the Department and its civil servants to listen to the issues and the concerns of elected representatives, be they councillors, Members of this Assembly or, indeed, MPs. Reference has been made to this dichotomy between bus and rail. Many Members, including David Ford, mentioned the fact that there needs to be a common ticketing system between rail and bus services - something which should certainly be feasible, since Translink owns and manages both. I hope that that is something they could introduce.
Jane Morrice mentioned the problems that passengers have on the railways, and I fully endorse her comments. Many people have said that timetabling is difficult and that there is no co-ordination between bus and rail. Again I hope that this is something Translink could improve upon.
However we need to pay tribute to Translink, who have been operating for 30 years with very little public investment. They have been doing a stitch-up job in managing to keep a system going despite 30 years of the troubles, during which buses and trains were bombed. We should, therefore, pay tribute to the Translink staff who managed to keep a public transport system going through the bad times.
There has been much discussion about funding, and we all recognise that massive public investment will be required to address the needs of the public transport system. I contend that, in the past, Ministers in charge of Northern Ireland's public transport did not fully reflect the concerns and wishes of people who wanted to see greater investment in it. We now have a new devolved Assembly, and this is something that Members will have to face up to.
Mr Robinson is the Minister with the luxury of this job, and no doubt he will be the person who will have to lobby strongly for the necessary investment. The Regional Development Committee is convinced that we need investment in public transport, but we do not have executive authority. It is the Executive Committee and the individual Ministers that have to make the case and lobby for this funding. I hope that that will happen and that the funding will be achieved.
A number of Members mentioned the many reports on transport that have been produced, and I fully accept that. Mervyn Carrick said that there have been five reports since 1995. One could almost say that we are suffering from "reportitis", since there have been so many. But every Member is looking for action.
It is remarkable that the only part of the railway network that has improved has been the Belfast-Dublin railway line - the Enterprise. It has received substantial investment over the past 10 years. The moral is very clear: if there is adequate investment in the railways and buses, more people will use them. With the necessary investment, there is the potential for more people to use public transport. People need to be encouraged to get out of their cars and use public transport, but they will only do that if the alternative meets their needs and is attractive.
We all know - this is especially true of those of us who live in rural areas - that the public transport system is inadequate. For many years I have commented about five bus fleets - education and library board buses - that are largely idle. They are only used in the mornings and evenings, and it seems to me that this is rather wasteful.
A number of Members, including Mitchel McLaughlin, mentioned North/South co-operation. That is one of the benefits of real co-operation on an economic and social level. We cannot run our public transport in isolation, especially those of us who live in the border areas. There needs to be greater co-ordination between services in the Republic of Ireland and Northern Ireland so that they complement each other, and it will require much greater collaboration to realise that.
The amount of resources required is probably our biggest challenge, but since Mr Prescott is the Deputy Prime Minister of the United Kingdom and since the Labour Government regard the use of public transport - the previous Government's policy favoured road transport - as a desirable policy, we should be able to make a strong case. I hope that the Minister can get together with other Ministers in the Executive, including the Minister of Finance, Mr Durkan, and make this strong case. We are all looking for equality of treatment, and, if the application of the Barnett formula is around 40-1, surely we can make that case.
The European Union was referred to in the context of the structural funds, which are extremely important. The Belfast-Dublin railway line was upgraded largely because of European structural funds, and I believe that the Belfast-Bangor line is going to be improved with 75% grant aid from them. I hope that there can be some examination of the transitional programme's application to Brussels, something else that will require the presentation of a strong, co-ordinated case. I thank Members for their support.
Question put and agreed to.
That this Assembly notes with concern the poor state of the public transport system in Northern Ireland and proposes that the Minister for Regional Development should urgently implement a comprehensive and integrated public transport policy to redress this problem.
The sitting was suspended at 12.30 pm.
On resuming (Mr Deputy Speaker [Sir John Gorman] in the Chair) -
Mrs E Bell:
I beg to move
That this Assembly welcomes the Ulster Cancer Foundation's document 'Cancer Services - Invest Now' and urges the Minister of Health, Social Services and Public Safety to implement, as a matter of urgency, the recommendations contained in the report.
May I start by saying that a delegation from the Ulster Cancer Foundation successfully lobbied at Westminster last week, and were promised support for the document that we are now debating. A delegation will make a presentation to our Health Committee tomorrow. However, we thought it appropriate to debate this motion today so that all Members can hopefully express their support for the funding needed for cancer services. I am delighted, as co-chair of the cross-party group on cancer issues, to present this motion today.
In the Ulster Cancer Foundation's offices some weeks ago we had the public launch of the document 'Cancer Services - Invest Now'. It was a moving experience for all who attended. Among the speakers, who included Assembly Members, were patients and carers who told their own stories and experiences about when their cancer was diagnosed. From their contributions, it was obvious that early diagnosis and treatment was vital, and that it was also necessary to have greater support and more information.
It was made clear that proper financial and manpower resources are dangerously - and I use that word deliberately - inadequate for the prevention and treatment of the many types of cancer that are prevalent in Northern Ireland today. It is widely expected that deaths from cancer will outstrip those of Northern Ireland's other killer, heart disease, in five years time.
Cancer is a condition feared by many, and with good reason. One in three people will be diagnosed with some sort of cancer; one in nine before the age of 45. More males than females die from cancer, and one of the reasons for this is the reluctance of men to go to clinics, which could lead to early detection and successful treatment - a publicity campaign some months ago illustrated that point. Statistics are sometimes misleading, but unfortunately those stating that we have had 8,700 new cases and approximately 3,700 deaths from cancer each year are facts, and if the situation is to change, it is likely that it will not be for the better.
At the risk of being overdramatic - although for the numbers of Members presently in the Chamber it may not be too overdramatic - there is not a Member here today who has not, or will not, experience one form of cancer either personally or through their family or friends.
This was also the case at one of the first meetings of our cross-party group, when each of us gave our reasons, based on our personal stories, for supporting the Ulster Cancer Foundation, which has given 30 years of commitment, help and direct support to cancer sufferers and their families. I know that other organisations are also engaged in similar work, and credit must be given to them as well, since without them, even more research and equipment would be needed than is the case at present.
I come now to the terms of the motion. The document 'Cancer Services - Invest Now' is a response to the recent report by Dr Henrietta Campbell, 'Cancer Services - Investing for the Future'. The Ulster Cancer Foundation's report was drawn up in association with leading cancer clinicians such as Prof Roy Spence and Prof Patrick Johnston from Belfast City Hospital's cancer centre, from cancer units and from the excellent patients' forum of the Ulster Cancer Foundation itself. It heartily supports the Campbell report's major recommendations, but states that investment for the reorganisation and development of cancer services should happen not in the future, but now. This opinion is based on the day-to-day knowledge and experience of clinicians and on research which clearly points out that patients living in the United Kingdom have approximately a 20%-30% worse survival rate than their counterparts living in countries such as Switzerland and Holland and the USA.
The objectives of the Campbell report are also welcomed, and it is acknowledged that these major changes would result in significant benefits for cancer patients, including, among other things, on-site access to a full range of acute services and a high-quality patient environment, something which is extremely important. Many aspects of the report are being implemented, but there are still problems with the proper training of staff and with providing specialists in, for instance, chemotherapy treatment.
There is also a clear need for more oncologists for actual diagnosis. There are 10 oncologists rather than the 20 or 30 necessary to enable the number of patients we have here to be dealt with expertly and quickly.
Great strides have been made in the reduction of deaths and in the increase of successful outcomes in breast cancer cases, and work is being done on the early detection of other common cancers such as stomach and prostate. The most common type is, of course, still regrettably lung cancer.
Resources must be ring-fenced. I know that the Minister is aware and supportive of this, but expert staff and resources must be put into the new cancer centres as quickly as possible to save lives. We cannot afford to wait. It is estimated that proper implementation of the Campbell report will require £24 million instead of the current £13·9 million. Such an increase, although massive at first sight, will be well worth it for every family in the Province.
Such investment would directly save lives and improve the situation for cancer sufferers. That is the bottom line of which we must never lose sight. I hope that Members will support the motion.
I have said enough about what is happening, but it would be fitting to end my address by stating the conclusion of the Ulster Cancer Foundation's document 'Cancer Services - Invest Now':
"It is no longer acceptable for us as a society to accept a situation where a set of diseases that affects one in three of our population and results in the death of one in four people is not adequately resourced and tackled in order to bring our survival figures for cancer up to those seen in the best European countries such as Switzerland and Holland or indeed that seen within the United States. It is therefore imperative that we as a society speak out about the inadequacy of resourcing, both in terms of personnel, and the provision and development of this clinical service for patients until such time as this issue is properly addressed."
I hope that Members will support the motion.
The Chairman of the Health, Social Services and Public Safety Committee (Dr Hendron): First, I would like to thank Mrs Eileen Bell and Mr Paul Berry for bringing this most important subject before the Assembly. Mr Michael Woods, the chief executive of the Ulster Cancer Foundation, who is sitting in the Gallery, has given many years' service in the fight against cancer and is about to retire. I know we all wish him well.
I have no doubt that every Member welcomes the Ulster Cancer Foundation's document 'Cancer Services - Invest Now'. We most certainly urge the Minister of Health, Social Services and Public Safety to implement as a matter of urgency the recommendations in the report. I would like to thank the Minister for being here for the debate.
The facts are there for all of us to see. The professional experts and statisticians have spoken and action is needed now. Furthermore, I guess that every Member has someone in his immediate or extended family who has cancer or who has died from it. Therefore, we can no longer be complacent. The Ulster Cancer Foundation, Action Cancer, MacMillan Cancer Relief and similar organisations, all deserve our thanks. I cannot help but think of Dr Gerry Lynch who worked for so many years in Belvoir Park Hospital - it used to be called Montgomery House. He played a major role there and has himself succumbed to cancer.
A key concern of patients is waiting time and the uncertainty that produces. I am not just talking about waiting time for the first appointment but about the time spent waiting for test results, for further appointments and for treatment to start. The Calman Hine Report, to which Mrs Bell has already referred, was the first major report in these islands that attempted to draw the various strands of cancer, diagnosis and treatment together. It was a major report and it led to a re-organisation of cancer services throughout the United Kingdom. Following that, our own Chief Medical Officer, Dr Ella Campbell, produced her report, which has also been referred to. Many of her recommendations have been or are being implemented.
The Belfast City Hospital as everyone knows is to contain the main cancer centre for Northern Ireland and be supplemented by four cancer units. Patients should be managed by multi-disciplinary cancer teams. That is a key point in all this re-organisation. That was the reason the move was made to Belfast City Hospital, and those who had loved ones treated in Belvoir Park Hospital felt very strongly about that. Indeed, at one time I supported retaining all the services at Belvoir Park, but I was wrong. The experts on the subject were totally correct, so services including radiotherapy and chemotherapy, are to be situated at the City Hospital. Its cancer registry, on which there has been a major move forward, is to be adequately resourced. It is only in recent times that we have had a register of cancer in Northern Ireland and, indeed, on the island of Ireland. Dr Anna Gavin is leading on this. Since we now have a standardisation of the figures for cancer, proper comparisons can be made with the figures of other countries.
With regard to cancer research, Members will know that last year a memorandum was signed at Stormont by the then Health Minister, George Howarth, the Republic's Health Minister, Brian Cowen, and by the Secretary of Health from the United States.
Dr Ric Klausner, Director of the National Institute for Cancer at Bethesda in Maryland, played a pivotal role in these matters as did Prof Patrick Johnston, professor of Oncology at Queen's and Prof Roy Spence, senior cancer surgeon at the City Hospital. I am delighted to see the Minister of the Environment here, Mr Sam Foster, as he was a spokesperson for health at that time. He and I played some small role in promoting that.
While this development is to be warmly welcomed, we must nevertheless face the fact that the amount currently spent on cancer services in Northern Ireland is around £13·9 million, yet it would take about £24 million per year to provide the type of services needed. I agree with the conclusions in the Ulster Cancer Foundation's document, and this point was also made by Mrs Bell. It is no longer acceptable for us as a society to accept a situation in which so many people are dying of cancer.
We must bring our survival figures for cancer up to those in other countries such as Switzerland, Holland and the Unites States of America. Prevention is better than cure and early diagnosis usually leads to a much better prognosis. In comparison with cardiovascular disease, it is projected that within the next five years cancer will be the biggest killer in our society.
The Health Promotion Agency and health action zones must be properly resourced to teach our children and young people to have a healthier lifestyle. Much will be said over the coming months about health action zones. Each child and young person should be encouraged to know and understand the European code against cancer. It should be mandatory in the education system that each child be taught the cancer code. I pay tribute to our Chief Medical Officer, Dr Etta Campbell, in whose annual report a lot of these matters have been highlighted.
Apart from genetic factors, smoking is by far the biggest cause of cancer in Northern Ireland. Excess and persistent alcohol intake is another factor. Research throughout the world has consistently shown that increasing your daily intake of vegetables and fresh fruit results in better health. I do not have a share in the production of fruits and vegetables, but five portions of fruit and vegetables, in whatever combination, on a daily basis can play a major role in cancer prevention. That point is accepted round the western world and parents should emphasise that to their children. For years, cereals with high fibre content have also been known to help prevent cancer.
Then we have the sun and suntan. A dermatologist in the Belfast City Hospital gave a talk one time on the subject of melanoma and the many deaths that result from melanoma in Northern Ireland. Years ago we remember people in movements in the United States of America saying "Black is beautiful". In relation to melanoma, white is beautiful and people should remember that. I have never seen a happy face lying in the sun on my many holidays. I would love to elaborate on that point, but I am sure that I would be ruled out of order.
Obesity is another factor, and we need to limit fatty foods. Physical activity on a daily basis is very important. These points are all known. Young people nowadays do not participate in enough physical activity. Certainly, families that queue up for burgers and such rubbishy food - and I have been guilty of this many times - are preparing their children for atherosclerosis in their coronary arteries in later years. They are also setting up the conditions for cancer.
At least two out of three cancer-related deaths are preventable. I said at the beginning that action is needed now. I know the Minister wants to do everything she can, but I do implore her to take that action and to make sure that the necessary resources are ring-fenced.
Mr Deputy Speaker:
Given the number of Members who wish to speak, we can afford 10 minutes for each, 15 minutes for the Member winding-up and for the Minister. That will keep us within the two hours allocated for this debate.
I am also a member of the all-party group on cancer care, and I am keen to contribute to the debate as cancer care is an issue of the utmost importance to us all. Responsibility for cancer care falls to the Minister of Health, Social Services and Public Safety. As future funding for health has yet to be decided by the Executive, I wish to make it clear that I am speaking from the Back Benches as a Member for Fermanagh and South Tyrone and not as a Minister or a Member of the Executive Committee.
In spite of the research and technical advances, which have been made in almost every other area of medicine, the stark fact remains that cancer affects one third of the local population and results in the death of almost one person in four. The death rate from cancer in Northern Ireland has almost tripled since the state was founded in 1921 and has even doubled since the introduction of the National Health Service. In the past 30 years we could have argued that we were at war with terrorism. It is now time to declare a new war on cancer, which will soon be the biggest killer in Northern Ireland.
In Northern Ireland more people are killed by cancer in one year than have died during the past 30 years of the troubles. Each year three thousand seven hundred people die due to cancer. If you break this figure down it is the equivalent of 308 people dying each month, 71 each week and 10 each day. That is frightening - in fact, it is terrifying.
As many of you know, I was my party's former spokesman on health, and I was also a member of the Health Committee in the Northern Ireland Forum. During that period, I was directly involved with Prof Roy Spence, Prof Paddy Johnston and Dr Joe Hendron in securing a tripartite agreement with the National Cancer Institute in the USA and with health representatives in the Republic of Ireland to initiate greater awareness of cancer and to promote excellence in cancer care in Northern Ireland.
My involvement increased my admiration for the tremendous work of Prof Spence, Prof Johnston, Mr Michael Wood and his colleagues in the Ulster Cancer Foundation. I am well aware of the competing claims from various sectors for public funding but I believe that the case made by the Ulster Cancer Foundation report is very well founded.
Everyone accepts that there is presently no cure for every case of cancer, but there is a great deal of evidence which shows that survival rates could be much improved if we funded and provided services and facilities flexible enough to meet the ever increasing demands. Service provision will be expensive, and the implementation of the report would require that we almost double the current spend on cancer services from £14 million to £24 million per year. However, the implementation of the report would, if we go by evidence from America and some European countries, result in a 20% to 30% improvement in survival rates. From a political, social, medical and moral perspective that would indeed be money well spent.
Questions will be asked about where the money might come from. The Chancellor, Gordon Brown, received over £22 billion from mobile phone licences. If that money were directed into cancer care in the United Kingdom there would be no great problem.
The Ulster Cancer Foundation is not calling for money to fund cancer services from other parts of the health budget to facilitate this but is, in fact, calling for an increase in the block grant from Westminster. As things stand, and in the continuing absence of further funding, it is calculated that in a decade cancer could be the number one killer in Northern Ireland, responsible for almost 30 deaths in every hundred.
As an Assembly, we cannot, we should not, and we must not accept a situation where a set of diseases, known under the common name of cancer, continue to either kill or seriously impair an increasing number of our population. The motto of the Ulster Cancer Foundation is "from care to cure". The Assembly cannot provide the cure for cancer but we do have the responsibility for ensuring that cancer services are given the highest possible priority in the allocation of funds to provide the necessary care. I am pleased to support the motion.
Mr R Hutchinson:
I welcome the debate on this timely and very important issue. I support the motion and thank the Members for bringing it to the House. Unique is the man or woman who can stand here today and say that he or she has not been affected by cancer in some way whether through personal experience or the loss of a loved one. We have heard how one in three people can expect to experience cancer at some time during their lifetime. Given such alarming statistics, 36 of the 108 Members in the Chamber can expect to have first-hand experience of this illness at some time during their lifetime.
One in four of the population will die from this disease. This is the reality that we must seek to confront. In my constituency of East Antrim, as in others, the death toll is rising on an annual basis. Between 1993 and 1995, 1,827 new cases were reported in the Northern Board area; 816 deaths were confirmed, and concern is growing. By 2007, cancer will have overtaken heart disease as the number-one cause of fatality in Northern Ireland. I am glad that much progress has been made in recent years to break down the wall of silence that previously surrounded cancer and cancer deaths.
MacMillan Cancer Relief, with its open-space campaign, pointed the way towards identifying a need to talk, and thankfully we are doing that here today. The Ulster Cancer Foundation's 'Invest Now' campaign has much to recommend it. However, while promoting itself as a comprehensive document is not a solution to providing a better oncology service in Northern Ireland, it is a tentative first step in the right direction. The document is a broad overview of the optimum funding that must be secured to ensure an equity of access to high quality care for all.
The document raises many questions which must be answered. How much of the money will go towards primary care? How much has been earmarked for palliative care? How many posts is it anticipated that this additional money will fund? What is the intended timescale for phasing in these appointments? The need exists not only to treat the number of new cases arising in the population more quickly, but also the number of prevalent cases - that is the number diagnosed in previous years who are still alive. What percentage of the funding will be used to allow these patients to have treatment near their homes? Each year more people are surviving due to new treatments, but many may need help in coping with the psychological and physical aspects of life after being diagnosed as having cancer.
In our race to find the ultimate cure, we must not forget those who have fought this battle and won. One key concern people have is waiting time. I want to see this money invested in the re-design of services to meet the needs of patients, to reduce waiting times for referral, investigation and treatment and to tackle head-on the shortage that presently exists in the number of specialist medical and skilled nursing staff in Northern Ireland.
The Calman Hine Report of 1995 agrees with the Ulster Cancer Foundation's recommendation for a cancer centre plus four cancer units based on the view that specialisation will improve outcomes. However, we must ensure that all four units receive an adequate share of the funding and that training initiatives are put in place to provide the necessary skills for doctors, nurses and other professionals allied to medicine. Northern Ireland is well below its European counterparts in standards of care and rates of survival, all too often ranking alongside eastern block countries. By supporting this motion today we can as least begin to redress the balance.
I support the motion.
I too support the motion. The statistics are that in Northern Ireland, one in three people will get cancer; one in four will die from it; and that 3,700 deaths per annum are cancer related.
We in Northern Ireland are disadvantaged. Our survival rate is between 20% and 30% lower than countries such as France, Holland and Switzerland. We are supposed to be part of the developed world, yet we still rank alongside Latvia and Poland when it comes to cancer treatment. We are not as advanced as we like to think.
The Campbell report, which Dr Hendron mentioned, proposes a regional cancer centre and four cancer units. Today we are thinking about a regional cancer centre based at the Belfast City Hospital. Although I support the motion, I question the necessity to have everything in Belfast. Only 20% of the population live there. I am concerned about putting a regional cancer centre in the City Hospital to the detriment of the rest of Northern Ireland. Cross-border co-operation is increasing. Perhaps there is potential for an all-Ireland centre of excellence, possibly in Armagh. We could charge the Southern Government for treating their cancer patients. That would help subsidise cancer services in our own area.
Cancer-related expenditure is £13·9 million when we really need £24 million. Three years from now we will need £31 million to adequately resource cancer treatment. The projected spend for the next three years does not come near to meeting those requirements. Throughout Britain, less than 1% of the drugs budget is spent on cancer drugs. Taxanes have had considerable success in stopping cancers. In particular, combinations such as Taxol plus platinum are very effective in arresting ovarian cancer. The cost is £1,500 per treatment, and normally eight treatments are required, so it costs £12,000 to treat one patient.
We only have 10·5 cancer surgeons. We really need 25. Are we going to continue to sell the people of this country short? We were elected to deliver. As Mr R Hutchinson and Mrs Bell said, everyone has a relative or friend who has suffered or died from cancer. We need to deliver. People's lives have to be worth something. If we continue to underfund this service, people will not get the treatment they need. Every year 3,700 people die from cancer in this country. That is more than the number of lives lost in the whole 30 years of the troubles.
The Minister of Environment - I know he was speaking in a personal capacity as the Member for Fermanagh and South Tyrone - said that there is a lot of co-operation. The point I want to get across is that Dr Hendron and Mr Foster's tripartite agreement to improve the situation in Northern Ireland is all well and good but if the money is not there to deliver the services, that is where it hits home. Those 3,700 people are being sold short. The Minister said that not all cancers are curable, and we accept that, but much can be done to relieve suffering and many people can be cured.
My Colleague, Dr Hendron, mentioned problems resulting from smoking, alcohol and diet. I am not very qualified to speak on that matter because I am a smoker. However, socially disadvantaged areas tend to have a greater proportion of people who smoke, drink and have poor diets. When we talk about targeting social need, we need to consider those people at the end of the social scale who have poor diets and who do smoke and drink more heavily than people on higher incomes.
The Minister has just left, but there are also a number of environmental concerns which need to be considered. Several questions were raised concerning emissions from Sellafield. We have heard about emissions such as sulphur dioxide from power stations. All these emissions are carcinogenic. These problems need to be investigated; our people cannot continue to be pushed aside.
We were elected here to deliver and if we cannot deliver an extra £10 million this year - which is a tiny proportion of our whole expenditure for Northern Ireland - then there is something drastically wrong with us. I think there will be very few dissenters here on the question of making the extra money available. The Minister will have plenty of support in the House if she takes this forward to the Executive, which I hope she does. Finally, 41% of men and 36% of women will get some form of invasive cancer. It could be me, it could be any one of us. The decisions that we take now are going to impact upon what may, or may not, happen to ourselves. I urge people to support this motion.
As a Member of the Assembly cross-party group on cancer care, I support the motion. Like my Colleagues, I urge the Minister to act on this issue as a matter of urgency. I want to congratulate the Ulster Cancer Foundation for persisting with its message. The increased awareness of the issues involved is very valuable and is an important part of learning how to tackle the problems. The foundation's document 'Cancer Services: Invest Now' is an agenda for action which none of us, and I repeat, none of us, can afford to ignore.
The statistics have been mentioned over and over again in this Chamber. Whether it is one in three, or one in four, the fact is that each of us will be touched by this terrible disease at some time. More than 8,000 people in Northern Ireland and their families are affected by cancer every year - there are more than 8,000 deaths in a year. What I like to do often is to compare our situation with that of our European neighbours and the rest of the world.
If we consider the survival rates then all we can do is bow our heads in shame. The survival rate in the United Kingdom is 20% to 30% worse than that in Switzerland, or Holland, or the United States. We have just 10 consultant oncologists, whereas other European countries would have 30 oncologists caring for that size of population. What are the problems, and how do we go about resolving them? Obviously, as we have seen from the figures, there is a lack of funding and resources, a lack of medical oncologists, a lack of multi-disciplined teams, an inability to access - and quickly access - new drugs, and a lack of structure for clinical funds.
Current spending on cancer services is £13·9 million but the services require some £24 million, perhaps even £30 million. An extra £10 million at least is definitely needed.
I want to conclude on a note of optimism. Yesterday, President Clinton and Prime Minister Blair announced a medical breakthrough which, believe it or not, has been ranked alongside landing on the moon and the creation of the wheel in terms of the impact it will have on society. What happened yesterday was tremendous and I am slightly surprised that it has been bypassed in a blink of an eye. As a result of the discovery it is said that our lifespan will increase by 25 years as of yesterday. There might well be an element of hype in its presentation, but I think that we have turned the key and opened the book of life. Through this discovery I hope that scientists will be able to find cures for the major diseases facing society today. I hope that a cure for cancer will be top of the priority list.