I accept that the point of order has been made. However, I stress that we are talking about the provision of medical and health facilities. That being the title of the Adjournment debate, it must be allowed to cover all areas that are considered to be medical and health facilities. You have specifically made the point concerning your reference in your opening remarks, but I will allow Mr Murphy to continue under the heading "medical facilities".

I must support what Mr McGrady has said. Mr Mick Murphy has not even related what he has been talking about to any specific problem in the Mourne area. He is talking about a general social services problem that is experienced throughout the Province. Are we allowed to wander throughout the Province rather than deal specifically with an actual issue?

I have already ruled on this subject. We are talking about the provision of medical and health facilities in the Mourne area.

Go raibh maith agat. That section of the Chronically Sick and Disabled Persons Act 1970 places a legal obligation for the safety of the disabled in their homes on the health authority in the area. After those procedures are carried out, the Northern Ireland Housing Executive receives positive recommendations from the occupational therapists. The grant inspector visits the dwelling to determine its fitness. The process for a means test begins when the dwelling is passed as fit for grant aid. However, before that is done, the Housing Executive needs proof of legal ownership of the dwelling. Once proof is given, the application forms for the preliminary means test are sent out.

Order. Mr Murphy, you are straying into the area of grants and housing allocations. Keep as close to the subject of the debate as possible. There are others who want to speak.

I understand what you are saying, Madam Deputy Speaker, but you must recognise that disabled people in the Newry and Mourne area and in south Down must go through a process involving the Northern Ireland Housing Executive and the Health Service to get these grants. Therefore the point that I am making is part and parcel of the proceedings.

I have allowed you to make those points. There have been too many points of order, and I want the Member to continue as briefly as possible. I accept that it is perfectly appropriate for you to talk about health facilities, but the area of grants and housing is beyond the remit of the debate.

You are not allowing me to continue with my prepared speech on health and social services in the Newry and Mourne area. I must change and move on. Therefore you must give me a bit of time.

I ask that the health and social services board takes into consideration - even though Members do not seem to want to - the process that disabled people in Newry and Mourne and in south Down must go through to get proper health facilities in their homes - [Interruption].

I did not interrupt Mr McGrady, and I do not expect him to interrupt me. If he is not happy with what I have said, he can deal with it in his summing up.

The Minister sums up, not me.

I stand corrected; the Minister will deal with it.

The Assembly must provide adequate funding for all elements of the system. We must meet the needs of those disabled people who wish to remain in their homes. Disabled people are not asking for special deals; they are demanding the right to equality and the quality of life to which they are entitled - and that the Assembly is required to provide - under the Good Friday Agreement. We have the means to streamline the bureaucracy into a straightforward working format. We must put it into action and get on with it. I have seen some of the bureaucracy working here today. Go raibh míle maith agat.

Madam Deputy Speaker, your generosity knows no bounds. How can I say that without getting myself into bother? You have allowed Mr Murphy's interpretation of the subject of the motion to stretch to its absolute limits. I hope that the next time that I am proposing an Adjournment motion that, Madam Deputy Speaker, you are in the Chair. I will be able to add some extraneous subjects that no doubt I would not normally be allowed to do. However, the subject, I believe, is writ narrow.

On a point of order, Madam Deputy Speaker. The point is not what Mr Wells believes; it is what the person under the health system is entitled to.

The Adjournment motion is a very useful exercise. It allows Members to come to the House and to raise specific matters and issues of local concern in the presence of the Minister. The subject of the debate this afternoon is the stuff that Adjournment motions are made of. To some extent it devalues the whole process if Members wander down "by-path meadow". Therefore, I shall come directly to the subject of healthcare provision in the Mourne area, which is very much related to the lack of a proper integrated primary care facility in Kilkeel.

Kilkeel is an area that I have the privilege to represent. It is a wonderful place in many ways. Someone once said to me that Kilkeel men were not born, they were quarried. To some extent that explains their nature - they are rugged individuals who have made a living from fishing, quarrying and agriculture. Kilkeel is a unique community that has prospered over many years in a peripheral part of Northern Ireland. It has done very well for itself. It is a very proud community, but it is also very isolated. To get to Daisy Hill hospital, one must travel 20 miles along a road that is very inadequate in parts and that passes through Newry town, where there can be a bit of a bottleneck. If one considers that, one realises how difficult it is for people of the Mourne area to obtain primary healthcare.

If one travels in the other direction the nearest hospital is Downe Hospital, which, of course, has been very much under threat in recent years. Indeed with the closure of the Mourne Hospital and the potential loss of Downe Hospital, one was almost faced with a situation where one could draw a line from Newry to Dundonald and not one primary-care hospital would have been available to anyone living south of that line.

The people of the Mourne community feel very aggrieved by the decision to close their own hospital. It was closed in the face of promises that there would be a new unit provided. Mr McGrady said that those promises were not kept. That is why many people involved in the Downe Hospital campaign take a very jaundiced view of some of the promises that are being made to them.

If a fundamental mistake has been made - if you could call it that - it was the fact that Mourne Hospital was allowed to close before anything was arranged to replace it. In other words, the community groups should have said: "We will allow this hospital to close only when you have the alternative up and running."

The Southern Health and Social Services Board is an organisation with which I have frequent contact. They are under enormous financial pressures. I regularly have meetings with Eric Bowyer and his team, and at times, I worry where the board is going to get sufficient resources to continue to provide primary health care and social services in south Down and south Armagh and the Newry and Mourne area. They constantly have problems with resourcing, and the only way that there will be any movement towards replacing the service that was lost in Kilkeel is if the Department provides capital funding. There is absolutely no way that the board can find the money in its own resources to replace the unit that has been lost. I hope that the Minister will not take the opportunity this afternoon to trot out those horrible letters, PFI - private finance initiative. We have already seen that the private finance initiative does not work for primary healthcare in Northern Ireland. If this facility is going to be provided it has to be provided from departmental funds.

We cannot have the whole process delayed simply because we have to go through the sham of the private finance initiative. That is an expensive exercise that drains away much needed resources from the Health Service and proves what is obvious - it cannot be done. If it cannot be done on the scale of Downe Hospital, it certainly cannot be done in Mourne, which has a growing, vibrant and expanding community. Many new houses are being built in Kilkeel, but it is certain that there will never be the economies of scale to enable a PFI scheme to work there.

Rural hospitals are being considered under the Hayes review, but no matter what is decided, Kilkeel will remain out on a limb, too far away from the main sources of primary healthcare. Kilkeel was the part of south Down that was worst affected by the recent bad snowstorms. The whole area was entirely cut off for several days. It was not possible to drive, for instance, from Kilkeel to Newcastle; it was difficult to get past Killowen. That shows the isolated nature of the area and the need for adequate healthcare there.

We also have an influx of tourists, as Mr Kennedy mentioned. It does not look as though we are going to have a normal summer this year, but in a normal year Kilkeel can be a hub of activity, with tourists making their way to and from the Mournes. We also have the fishing industry, where serious injuries can readily occur because of its inherent dangers. There has been a proposal to remove the helicopter rescue service.

The people of Mourne rightly see themselves as being at the end of the queue when it comes to the provision of services. The promise to deliver a new integrated primary healthcare facility in Kilkeel has to be kept. The present buildings are well past their sell-by date; a new site has to be selected. If devolution is to mean anything in the Province it has to be accountable to local communities such as Kilkeel. It is absolutely essential that the Assembly honours the promises, even if they were made by previous Administrations that perhaps did not have the same political outlook as ourselves. Kilkeel deserves nothing less.

Two more Members wish to speak before the Minister will be asked to respond. I ask them to limit their statements to five minutes to give the Minister time to respond.

I will try to abide by your ruling, Madam Deputy Speaker. It is a pity that we have lost so much time. However, what I wish to say can be said in a few minutes.

I compliment Eddie McGrady, who has been the Member of Parliament for South Down for some time. He has fought a long and difficult campaign to try to restore the necessary health services to the Mourne area. As he outlined in his presentation, that has been a remorseless dogfight. I hope and add to his wish that our present Minister will not be yet another Minister along those lines.

This is an issue of clear neglect - the Health Service for the people of the area has been neglected. We want that completely restored. We require the installation of an integrated healthcare service. As Mr Wells has already outlined, the community is a unique and isolated one, with major fishing, agriculture and tourism industries. All three provide opportunities for risks to health. We are not talking about acute services. We are talking about ordinary services to provide for the greater proportion of accidents. The need to have that in the Mourne area is very clear.

The area also has a poor road infrastructure.

I want to re-emphasise that, because Mr Kennedy must have had a glaze in his eyes when he was enjoying our tourist facilities. He must not have looked down at what he was travelling over. It is in a very poor state. All we need is a bit of inclement weather and many of the roads are difficult to pass. Accessibility is a serious problem.

I also represent the Members from South Down - they asked me to, and I have continued to do so - on the Donard Commissioning Group, which is a very successful commissioning group in the area. It covers the northern end of Mourne - the Annalong area. That has clearly indicated to me the need for support services in the Mourne area. Current and valued evidence is available as a result of focus groups studying local problems of healthcare and providing accurate and up-to-date information. That is available for examination if there is any doubt about identifying the need factor. I do not believe that there is - identifying need is not the problem. Making the financial commitment is the difficulty. I want to ensure that this is the last Minister who will have to deal with this problem and that she will leave us with a successful outcome.

I too pay tribute to Mr Eddie McGrady for bringing this Adjournment debate to the Chamber this evening. The great thing about the debate - although the Chamber is not packed - is that we are talking about all sections of the community. It goes right across all divides - from fishermen to farmers, and across differing religious and political beliefs. Everyone in the Mournes will be fully supportive of the comments made by the various Members so far.

We are speaking about let-down. In common with Mr Kennedy, I am a member of Newry and Mourne District Council. In 1996, we took the promises that were made to us as being sincere. Prior to that we had a very intensive campaign, led by the Mourne councillors. It was supported by Mr McGrady and probably every other recognised Kilkeel-based group in the Mournes. They drove it along for the provision, but it did not come. We took the promises made in 1996 at face value. We thought that they were sincere. While I cannot say we were bought off because we got nothing, we believed that what was on offer would eventually happen.

Danny Kennedy, Eddie McGrady and then Jim Wells came in on a seasonal note - they were speaking about the summertime situation. Jim Wells touched on the winter problems - winter problems at sea and on the roads. This year in particular the place was closed off for almost seven days. The three roads into it were impassable. The only other place where that happened was in the Outer Hebrides, and I do not think that it was acceptable there. It is certainly unique.

The Minister is still comparatively new to the job and to this case in particular. She will not fail to recognise from the research available to her to date that the Mournes urgently need a Kilkeel-based integrated medical health centre. Basic research will show that. The Minister will learn that very quickly if her homework is properly done. I again thank Eddie McGrady for bringing the issue forward, and I hope that we have advanced the cause of the people of the Mournes.

Go raibh maith agat, a LeasCheann Comhairle. Gabhaim mo bhuíochas leis an Uasal Mag Bhrádaigh as ceist thábhachtach seo soláthar sláinte agus chúram shóisialta do mhuintir cheantar Mhúirn a tharraingt anuas.

Tuigim go hiomlán na deacrachtaí atá ag muintir an cheantair, ag cuimhneamh ar an fhad atá le taisteal acu chun seirbhísí sláinte agus chun áiseanna cúraim shóisialta. Dearbhaím, áfach, go bhfuil mé tiomanta do chinntiú go bhfaigheann ár muintir uilig an cúram agus an chóireáil ardcháilíochta chéanna, cuma cá gcónaíonn siad.

I thank Mr McGrady for raising the important issue of the provision of health and social care for the people of the Mourne area. I fully appreciate the difficulties being faced by the people of the area, bearing in mind - as Members have stated - the distance that they have to travel to avail of many health and social care services and facilities. I assure Members that I am committed to ensuring that all of our people receive good quality care and treatment, regardless of where they live.

I know that the Southern Board and the Newry and Mourne Trust, which are responsible for commissioning and delivering services for the people of the Mourne area, have also clearly stated their commitment.

Mr McGrady will be aware that the provision of health and social care in Kilkeel and the Mournes has been under discussion locally for a number of years. He has outlined many of the twists and turns in those discussions. Several consultation documents have been published by the Southern Board and by Newry and Mourne Trust, which have engaged with the local population. Those resulted in a number of recommendations for provision of services, and some of those have been put in place. They include an increase in the number of nursing home places in the Kilkeel area, the provision of a minor injuries clinic at Brooklands Nursing Home in Kilkeel and investment in a range of community services across a number of programmes of care.

One of the outstanding elements of the programme is the development of a primary healthcare centre in Kilkeel. Potentially, that will provide a more integrated service between the local GPs and Newry and Mourne Trust and will enhance co-operation between the various services. The trust has been working on a business case for the development of integrated care in Kilkeel for some time. That has been ongoing since before the Executive was established.

Several factors, including changing local circumstances and the failure of the parties involved to reach a timely consensus on what was required, have also contributed to the lengthy delay in the trust's bringing forward proposals for the Department's consideration. In recent months the Department has emphasised the need for the trust and local GPs to reach a consensus on the way forward, which has come about recently. The trust's business case for the development of a new primary care centre in Kilkeel involving the local GPs was finally received by the Department earlier this month. I can assure you that we take this very seriously.

The outline business case proposes to provide a new facility to deliver the range of services currently provided from the Kilkeel Health Centre and the professions allied to medicine (PAMS) and outpatient services now sited in the Mourne Hospital. Those include GPs, community nurses, health visitors, school nurses, speech therapy, psychotherapy, occupational therapy, podiatry, outpatient clinics, obstetrics, gynaecology, general surgery, general medicine, paediatrics, ophthalmology and psychiatry.

With regard to the funding for the business case, there are a number of cases for investment in health and personal social services. Newry and Mourne Trust has submitted a range of business cases to the Department - including this one - totalling £10 million. The level of resources available means that decisions on investment need to be based not only on merit, but also on priority. I cannot say today - and I am sure that Mr McGrady would not expect me to say today - what relative priority the new facility in Kilkeel will have.

The earlier versions of the business case, to which Mr McGrady referred, did not meet the guidelines that govern such investments. In addition, the proposed facility did not then have the support of the local GPs. That has now been secured. The business case now envisages an investment of £1·65 million. That needs to be fully tested - no more and no less than any other investment involving public money.

With regard to the neutral venue, Newry and Mourne Trust now wants to use the site for the new health centre. As a result, action on disposal of the site has been suspended until the trust's proposals have been examined in detail. I am aware that, although the Kilkeel Community Association had hoped to acquire the site for the community centre, the trust is now working with Newry and Mourne District Council with a view to meeting the association to try to find an acceptable way forward for all parties. In taking the whole process forward, it is essential that all of the relevant players - Newry and Mourne Trust, the board, and the local GPs - work together to ensure a satisfactory outcome for the people of the Mourne area.

As for access, there are a number of ways in which that is being taken forward. Several reviews of services have been or are currently being undertaken through the capitation formula, for example, the ambulance service review and the acute hospitals review. There are incentive schemes for GPs to encourage practitioners to provide service in rural areas, but time does not permit me to give you the details of that.

In answer to Mr Mick Murphy's questions about the consultant posts in Daisy Hill Hospital, I can confirm that the necessary resources have been made available to fund those posts, and I also understand that the recruitment advertisements for all posts mentioned will appear in the local press this week.

Both the grant schemes and the housing selection schemes are matters for the Housing Executive. The trust is involved for consultation only on the necessity and appropriateness of the proposed works and on decisions as to referral for occupational therapy assessment.

For the North overall, I have identified an additional 20 occupational therapists in the coming financial year. I have also approved implementation of the recommendations contained in the preliminary report of the joint Housing Executive and Department of Health, Social Services and Public Safety on the review of the housing adaptation service, which is designed to improve occupational therapy response times.

The primary care services are vital for the people of the Mourne area, and I understand that they are the first points of contact for most people who need help from the health and social services. As Members will know, we have just concluded a major consultation exercise about the future arrangements for primary care, and we are in the process of carrying out an analysis of responses to that. I am fully aware of the excellent initiatives developed by the Donard Commissioning Group and other primary care pilot schemes, and we will be encouraging the involvement of local communities and service users in the planning and development of services.

In conclusion, I am aware of the health and social care needs of the people of the Mournes, and I am keen to resolve the issue of providing a new primary healthcare centre for the people in Kilkeel. I can assure Members that the business case for the health centre will be taken forward as quickly as possible.

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