Social Security (New Deal Pilot)
Regulations (Northern Ireland) 2000

Since not all Members may be familiar with our procedure on Statutory Rules, I remind the House that a Statutory Rule which is subject to confirmatory procedure becomes law once it has been laid before the Assembly. However, it will cease to have effect unless it is approved by the Assembly within a specified period. This particular Statutory Rule was made on 27 November 2000 and will expire on 27 May 2001 unless it is approved by the Assembly.

I beg to move

I seek the Assembly's approval for a set of regulations that support the New Deal pilot scheme for people aged 25 and over. There is a range of New Deal schemes. They are aimed at specific groups such as lone parents, disabled people and the younger long-term unemployed. These regulations are to specifically support a pilot scheme for unemployed people aged 25 and over.

These pilot schemes are part of the welfare-to-work strategy and the efforts to tackle long-term unemployment. They have been operating in Northern Ireland since 30 November 1998, testing a variety of innovative ways of helping unemployed people into work. They are aimed principally at those who have been unemployed for 18 months or more. However, there is provision for people unemployed for less than 18 months and who face particular difficulties in returning to the labour market. The pilot schemes have provided individually tailored help designed to address barriers to work that had been identified, including lack of recent work experience and lack of relevant skills.

There were no new places on the New Deal pilot schemes after 21 March 2001. From 1 April new provision for the long-term unemployed was introduced across the United Kingdom under the enhanced New Deal for 25 plus. The new programme is designed to reflect the lessons learned from the pilot schemes, ensuring that a range of help is always available and investing more in advisors to enable them to provide continued support. The Department of Higher and Further Education, Training and Employment administers the pilot schemes and the enhanced New Deal for 25 plus.

To facilitate the operation of the New Deal pilots for 25 plus, changes were made to social security regulations. This ensured that people could participate in the pilot schemes while continuing to meet the conditions for receipt of jobseekers' allowance, and also provided for sanctions for non-attendance under the programme. Under the provisions of the Jobseekers' (Northern Ireland) Order 1995, the regulations underpinning New Deal pilot schemes can be in operation for only 12 months at a time, but they can be renewed as required.

They first came into operation on 29 November 1998 and were renewed in November 1999. The regulations before us today renew the provisions that were already in place, enabling the pilots to continue for a further twelve months and to take people into the scheme until 31 March 2001. Entrants to the scheme up to that date may remain on that scheme for the full twelve-month period.

I do not propose to explain the detail of each individual regulation, but I shall, of course, be happy to respond to Members' questions. The New Deal pilot regulations prescribe the categories of people who are required to participate in the New Deal pilots and the impact on their benefits of non-participation or leaving the programme without good cause. They also ensure that payments that participants may receive as part of the pilot, including top-up payments for childcare and self-employed earnings, will not affect their benefit.

The only substantive change from the earlier pilot regulations is that these regulations now define the date on which the last participant could join, which was 31 March 2001. Technical changes reflect the introduction of joint claims to the jobseeker's allowance from 19 March 2001 and the fact that some people could enter the pilots for a second time. I hope that this opening explanation has helped Members. I commend the regulations to the Assembly.

I rise to lend my support. This House should be glad to give its support to the introduction of this Statutory Rule. However, the Minister might be able to clarify a couple of questions for me. Regulation 5 stipulates that a person may be penalised by losing out on benefits if he or she fails to participate without good cause. I was unable to ascertain the definition of "good cause". I want the Minister to identify that, if possible.

Will each case be judged on its own merits? How will that be measured? It may seem a small point, but these things can sometimes cause quite a lot of difficulty for people and their benefits.

I welcome the Minister's reference to childcare costs and people's eligibility to continue to receive them. However, it appears from the Statutory Rule that this applies only to lone parents. What about couples? Is there any variation here? There have been some cases in the past where childcare allowance has been affected. For example, if it were established that a couple could access costs when one of the parents is on the New Deal pilot, the regulation would have to allow for childcare costs so as not to affect the job seeker's allowance (JSA) of the second parent. That may sound difficult to absorb, but I hope that the Minister can pick it up.

Under regulation 15, will the payments be disregarded if another parent is on benefits? I would appreciate clarification of these small points today or when next possible.

The requirements of the programme are spelled out very clearly to participants at all stages. No one is sanctioned by accident. Sanctions are a direct result of things that people do or fail to do. Operations systems are in place to ensure that people are treated sensibly and fairly. The law provides for people to be able to demonstrate good cause and provides them with the right of appeal. With hardship payments to protect the most vulnerable, I think that the system as a whole just about strikes the right balance. It is not only firm but fair.

Mr ONeill has also raised a point to which I do not now have the answer. I assure him that I will come back to him with a full and detailed answer in writing.

TOP

Public Health/Health Inequalities

I beg to move

Tá gliondar orm an rún a thabhairt os comhair an Tí inniu. Beidh a fhios ag Teachtaí go bhfuil ár meánionchas saoil níos faide ná mar a bhí ariamh - 77 mbliana i gcomparáid le 47 mbliana tá céad bliain ó shin. Ach níl staid fhoriomlán ár sláinte go maith. Táimid oiread agus trí bliana chun deiridh ar an chuid is fearr de réigiúin na hEorpa; tá básanna den ghalar corónach croí beagnach dhá uair chomh hard leis an mheán Eorpach; tá ár ráta báis de ailse scamhóg do mhná dhá uair níos airde ná an meán agus é ag méadú leis.

Níl sna rátaí báis ach forbhreathnú leathan. Nuair a fhaigheann duine bás de cheann de na riochtaí seo, go minic i ndiaidh tréimhse fada de thinneas agus de mhíchumas, fágtar cuid mhór eile faoi mhéala. Baineann an fhulaingt le teaghlaigh, cúramóirí agus cairde. Caitheann an eacnamaíocht agus an tseirbhís sláinte anseo na billiúin de phuntaí ar thinneas agus ar mhíchumas inseachanta.

Tá a fhios againn ó thaighde leighis agus ó eispéireas tíortha eile gur féidir a lán de na básanna agus den fhulaingt a chosc. Is féidir seo a dhéanamh tríd an dul chun cinn sa leigheas agus tríd sheirbhísí cúraim agus cóireála a eagrú agus a mhaoiniú. Ach níos tábhachtaí arís, trí pholasaithe agus chláir trasna an Rialtais agus trí ghníomhaíocht ar fud na sochaí.

Is dó sin atá an Coiste Feidhmiúcháin tiomanta.

Is eol do Theachtaí na héagothromaíochtaí móra atá sa stádas sláinte i ngrúpaí éagsúla an daonra anseo; éagothromaíochtaí atá ceangailte go soiléir le dálaí sóisialta agus eacnamaíocha daoine. Is léir ón fhianaise gurb í an bhochtaineacht an chontúirt is mó don tsláinte - i mbeagán focal, dá shaibhre tú, is amhlaidh is faide do shaol agus is lú an chontúirt go mbuailfidh tinneas ainsealach nó míchumas thú. Tá seo amhlaidh d'airde dhréimire na n-aicmí: de réir mar a théann duine suas an grádán sóisialta thig feabhas ar a shláinte.

Tá cúig bliana de fhad saoil ar meán ag an ghrúpa socheacnamaíoch is toiciúla anseo ar an ghrúpa is lú toice. Idir fir, tá oibrithe neamhoilte trí huaire chomh dóiche le bás a fháil roimh 65 ná gairmithe nó bainisteoirí. Tá páiste sa ghrúpa is lú toice 16 huaire chomh dóiche le bás a fháil i ndóiteán tí agus cúig huaire chomh dóiche le gortú a fhulaingt mar choisí le páiste ón ghrúpa bairr.

Ach is i measc Taistealaithe is géire atá na difríochtaí seo le sonrú. Tá a n-ionchas saoil beagnach 20 bliain faoi sin an phobail shocraithe. Tá páiste Taistealaí faoi bhun 10 mbliana d'aois 10 n-uair chomh dóiche le bás a fháil ná páiste socraithe. Níl ach 10% de Thaistealaithe os cionn 40 agus níl ach 1% os cionn 65.

Níl áit gan a ról a bheith aici: is sna bardaí toghchánacha is mó díothacht atá na rátaí báis is airde. D'fhéadfaí 2000 bás anabaí a chosc gach bliain dá dtiocfadh linn stádas sláinte na ndaoine sin a bhfuil cónaí orthu sna comhairlí ceantair is measa rátaí a ardú go dtí sin na gcomhairlí is sláintiúla

I am delighted to have the opportunity to introduce this motion in the House today. Members will know that our average life expectancy now is longer than ever before - 77 years, compared with 47 years a century ago. However, the overall state of our health is still not good. Compared with other regions in Europe we are as much as three years behind the best. Deaths from coronary heart disease are nearly double the European average. Our lung cancer death rate for women is already twice the average, and rising.

Death rates only give a broad overview. For everyone who dies from conditions such as I have mentioned - often after a long period of illness and disability - many more face enormous personal tragedies. The suffering extends to families, carers and friends. The annual costs of preventable disease and disability to the economy and the Health Service run into billions of pounds.

We know from medical research and the experiences of other countries that much of the death and suffering can be stopped. It can be stopped by advances in medicine and in the organisation and resourcing of care and treatment services, but, more importantly, it can be stopped through Government policies and programmes and by action across society. That is what the Executive have committed themselves to do.

Members will be aware that there are substantial inequalities in the health status of different groups in the population here which are clearly linked to people's social and economic circumstances. There is clear evidence that poverty is the biggest risk factor for health. The better off one is, the longer one can expect to live and the less likely one is to be ill or suffer from a chronic disease or disability.

That applies all the way up the class ladder. Average health prospects improve as one moves up the social gradient. The most affluent socio-economic group here live on average five years longer than the least affluent. Among men, unskilled workers are three times more likely to die before the age of 65 than professionals and managers. A child in the least affluent group is 16 times more likely to die as a result of a house fire, and five times more likely to be injured as a pedestrian, than a child from the top group.

Travellers and their health status are an extreme illustration of that point. Travellers' life expectancy is almost 20 years less than that of the settled community here. A traveller child under 10 years is 10 times more likely to die than a settled child. Only 10% of travellers are over 40 years, and only 1% is over 65 years.

The point can also be illustrated by location. Electoral wards with the worst deprivation also have the highest death rates. Two thousand premature deaths each year could be prevented if we could raise the health status of those living in the district councils with the worst rates to that of those of the healthiest.

Although those facts have been neglected for many years, they should not surprise us. Poorer people have less money to spend on the physical sources of health such as food and comfortable housing, and their children are less likely to achieve the educational qualifications that are the key to their pulling themselves up the social ladder. They live and work in more difficult conditions; they have borne the brunt of the conflict, and they lead more stressful lives. They are excluded from the benefits of prosperity that the rest of us take for granted, and, in a culture that places so much emphasis on success and achievement, they are more likely to suffer from low self-esteem and to feel powerless and depressed. Those factors bear down on the same group of people, and the damage that they do to health is cumulative.

This health gap - the inequalities in health between rich and poor - is an affront to the principles of equality and social justice that unite us. Members cannot ignore that.

For all the reasons that I have given, the Programme for Government recognises the need for major improvements in the health of our people. One of the Executive's central priorities under the heading "Working for a Healthier People" is to focus on

To achieve that, the Programme for Government commits the Executive to develop a cross-cutting public health strategy which maximises efforts to improve health and well-being and to reduce health inequalities across all sectors.

This holistic approach is vital if the Assembly is to bring about the improvements in health that need to be made. It is estimated that 70% of the factors that affect our health are outside the responsibility of the Health Service. The 30-year gain in average life expectancy over the last 100 years has been achieved through improvements in areas such as education, pay and working conditions, housing, food safety, water supplies and waste management.

In July last year, the Executive agreed that as Minister for Health, Social Services and Public Safety, I should take the lead in drawing up a new public health strategy to realise the commitments in the Programme for Government. The Executive agreed that all Departments would work closely together to ensure success.

As a first step, I re-established the ministerial group for public health, of which I am chairperson. The group is made up of senior officials from all Departments. Through this group, each Department is making its contribution to making the strategy work. Each member of the group will assume responsibility for taking forward action in his or her Department.

Last November, the group launched its consultation document. It set out the Executive's proposals for the new approach and invites all interested parties - which means everyone - to comment on them. We decided to call the process 'Investing for Health', because we recognised that by making a little extra effort now we would be able to secure substantial health gains in the future.

The purpose of 'Investing for Health' is twofold. First, to improve the health of our people by bringing our health standards up to at least those of the best regions in Europe. Secondly, to reduce the inequalities in living and working conditions that cause ill health by raising the status of those with the worst health to the level of those with the best.

'Investing for Health' addresses the wider social determinants of health. It aims to improve health by improving social and economic conditions, living and working environments and people's ability to cope with difficult circumstances. It complements and reinforces the work of other cross-departmental initiatives, including the action we are taking to ensure equality across the groups identified in section 75 of the Northern Ireland Act 1998 and the new targeting social need initiative.

'Investing for Health' will succeed only if it engages energies across the community, including the general public. For this reason, we have initiated an unusually wide-ranging consultation process. As well as inviting written responses to the document, we are seeking to engage individuals and groups who may have had difficulty in making their voices heard. Often, these are the very people who experience the worst health, and it is by helping them that the most improvement stands to be gained. To this end, we have designed and are running the consultation project in partnership with a federation of voluntary and community organisations, the community development and health network. We are keen to hear the views of as many people as possible about what affects their health, what can be done to make it better, who needs to take those actions and how they will work together.

My officials have recently given presentations on 'Investing for Health' to a number of Assembly Committees. I see those meetings and today's debate as a very important part of the ongoing process of 'Investing for Health'. The consultation process will continue until 31 May. We extended it from 10 April due to the impact of foot-and-mouth disease on public meetings, particularly in rural areas. We will make announcements on the outcome of the strategy later in the year.

'Investing for Health' is a continuing, long-term project and process. There is much to be done, and priority areas for action need to be identified. Overall, the consultation document focuses on poverty and inequality, since poor people suffer the worst health. Beyond this, we propose three priority groups for action: the very young, to ensure that babies and young children get the best start in life; children and young people, to equip them with the knowledge, skills and self-esteem to make responsible choices in their lives; and older people, both to extend life and to improve the quality of life in those added years.

'Investing for Health' also proposes that action should be organised around settings where people spend much of their time, such as homes, schools, workplaces and communities. The document suggests seven priority topics, factors which we know contribute substantially to death and illness. For each of those topics we know that properly resourced and effectively organised action can produce results. We recognise that transforming 'Investing for Health' from a vision to a reality will be a challenge. The document sets out areas where action is required to ensure success.

As chairperson of the ministerial group on public health, I will co-ordinate efforts across Departments on behalf of the Executive. The other Members of the Executive and their Departments will ensure that health factors are given due consideration in their areas of responsibility, and they will take the lead in those areas.

Because we recognise that all Departments' activities have important implications for health, we are putting proposals together for assessing the health impacts of new policies and programmes. That will enable us to minimise their health risks and maximise their health benefits.

We have also proposed that four health and social services boards should lead local 'Investing for Health' partnerships. These would draw together the key interests in each of their areas. There are already good examples of such a partnership approach in the health action zones and, at local level, in healthy living centres. We intend to build on the best of existing good practice.

'Investing for Health' sets out an important and challenging agenda for action. It is a great opportunity for all of us to work together to make real improvements in the health of our people. It provides the Administration with an excellent opportunity to promote the public interest by breaking down the barriers to co-operation between Departments and their agencies.

I am delighted to take this opportunity to pay tribute to the officials from all the Departments on the ministerial group, which has already shown enthusiasm in working together on the new approach. I look forward to hearing Members' views during the debate, and I assure them that these will be considered carefully. I ask Members to join us in carrying forward this approach and to support the motion.

I support the motion, and I am sure that none here could disagree with its content. However, it remains to be seen whether there will be the strong commitment and necessary resources from all Departments. We look forward to next year's report on the targets and how they have been met.

The Programme for Government makes a commitment to raising the quality of the Health Service and tackling issues of poor performance. As we discuss this motion, we are all embarking on consultation on the issue of primary care and awaiting the report of the review group on the acute hospital service. We hope that it will be possible to put in place measures that will deliver a better primary care service to patients and take a greater variety of health care closer to people on the ground.

In relation to the review of acute hospital services, we know that our waiting lists are the worst in the UK, and they continue to increase. There are a variety of issues surrounding waiting lists, not least the odd situation that some hospital units lie vacant while others are working above capacity. That is exerting a particular kind of pressure. On the other hand, some hospital units have spare capacity but are unable to increase the intake of patients due to lack of money for specialist staff. The Health Committee will be looking at issues like that when we measure the targets in the Programme for Government a year from now.

Another concern is what the Minister referred to as "equality of access". That is a major issue, whether it relates to access to GP facilities, accident and emergency facilities, surgery or any other service. It should be the policy and practice of all Government Departments to ensure that all members of the community have equal access and fair treatment. That applies to the activities of the Department of Health, Social Services and Public Safety in particular.

The unacceptably high levels of unfit housing have been mentioned in debates on the Programme for Government. Everyone knows that there is a direct link between the quality of housing and the quality of an individual's health. Levels of unfit housing are still too high in rural areas, especially in the west of the Province. People are living in appalling conditions in those houses. At the same time, because of the legislation on closing orders, those people are being told that they should not be living in those houses and by doing so, they are breaking the law. Given these serious health and human rights issues, the legislation on closing orders must be given a high priority.

We are also awaiting a report on the Ambulance Service. Throughout the North of Ireland, especially in rural areas, there is a great deal of dissatisfaction with the present service. I welcome the commitment in the Programme for Government for an improved ambulance service, and that is a key area that must be addressed in the coming year. Members of the Health, Social Services and Public Safety Committee would also like to see a much improved level of service as quickly as possible.

There are many concerns about general health, and many recent reports will have been brought to the attention of Members. Cases of TB are on the increase. Many parents have voiced concerns about the safety of immunisation. We need a campaign to address those concerns about immunisation. Once they have been discussed, we must send out a positive message and make clear to parents the need to immunise their children and the inherent benefits.

The issue of men's health has previously been discussed in the House. A seminar on men's health is due to be held in the Long Gallery on 12 June, and that should be of interest to all Members. Twice as many women as men live beyond the age of 75, a fact that requires further work and investigation.

The Programme for Government contains a welcome commitment for additional occupational therapy staff. The figure is quite specific: the aim is to have 20 additional staff within the next year. It is hoped that that will happen, but there is still a major problem. We must ensure that action continues for a number of years to decrease radically the waiting times for housing adaptations.

Recent reports remind us that smoking is on the increase, particularly among young girls. That brings us to other health matters, such as young mothers and the risks of smoking during pregnancy. We must address smoking more effectively to turn around this increase.

I commend this motion. Belfast is one of many European cities struggling with the concept of integrative planning for health development. A number of issues and developments in the city have combined to have a major impact on the population's health. The consultation process on 'Towards a City Health Plan' produced in June 1998 resulted in the identification of four broad themes and provided the opportunity for a common framework for strategic planning to respond to the health concerns of the citizens of Belfast. These themes were outlined in the 'Belfast Healthy Cities Annual Report' of 1999 and included the following strategic aims: to improve public transport provision in a co-ordinated approach to planning in the city of Belfast; to develop a comprehensive integrated information system to increase citizens' accessibility to information and increase a sharing of information between the public sector bodies in Belfast; to provide the people of Belfast with opportunities for lifelong learning, increasing participation from disadvantaged communities in the formal education system and responding to local learning needs; and to improve the mental well-being of the citizens of Belfast with an increase in counselling services for the well-being and improvement of those with mental health problems.

The key role of the Belfast healthy cities programme was to facilitate the establishment of intersectoral strategic planning groups to support the development of integrated planning on all these themes. It has been the most difficult stage of the process to date, struggling with complex issues and with structures in the city which create barriers to integrated planning. There has, however, been real progress with two of the strategic planning groups - communication and integrated information and mental well-being.

Belfast healthy cities programme has had a major impact on the way in which organisations and individuals think about health. Direct links are now being made between health and transport and information and education, to name but a few. The key task for healthy cities over the years has been to facilitate the establishment of intersectoral strategic planning groups to begin a process of developing integrated plans for health. It is an ambitious task but one which Belfast healthy cities has endeavoured to take forward. Many challenges and barriers have been, and will continue to be, encountered along the way. The concept of partnerships for health led by the World Health Organisation's healthy cities project implies a common goal and vision and requires new skills, new structures and a major shift in cultures and traditions.

As the Minister so eloquently stated, the new Administration here provides a real opportunity to make a radical move towards the lateral interdepartmental thinking which would enhance the climate in Belfast and Northern Ireland as a whole within public sector bodies to develop visible joined-up plans and address the fundamental social injustice and inequalities of health. The steps taken by Belfast healthy cities are early developments in that process. It has been a new learning experience for the individuals involved, and it has brought with it a mixture of creativity, innovation and the inevitable frustration. A change in the strategic direction of the organisation resulting in an evaluation and Belfast's redesignation to the third phase of the World Health Organisation's European healthy cities have resulted in a draft three-year strategic plan entitled 'Integrative Planning for Health Development 2000-03', which is also available for comment.

In the meantime, Belfast has contributed significantly to WHO European healthy cities network business meetings, with participation for the first time by politicians and a number of new organisations from the city. Significant progress is also being made in the mentoring of Bosnian cities, and Belfast will continue to support the establishment of a healthy cities network in Bosnia and throughout Europe.

I welcome the opportunity to contribute to this important debate. It is clear that my Department's responsibilities impact extensively on health and issues of well-being. It has a key role in targeting social need by tackling disadvantage, improving housing, delivering social security benefits, providing child support services, strengthening and developing the community infrastructure and regenerating the most disadvantaged urban neighbourhoods.

I shall outline some of the important work of my Department. We will consult on comprehensive strategies to address the problems of multiple disadvantage in urban areas. The strategies will target action in the most disadvantaged neighbourhoods and establish new neighbourhood structures as partnerships of the community, voluntary, private and public sectors. They will seek to commit the Government to long-term support for neighbourhood regeneration and support action to improve long-term health prospects.

A prerequisite for meaningful neighbourhood regeneration is the strengthening of local communities. We propose to do this - particularly in the most disadvantaged areas - by building a sense of community, encouraging and supporting all forms of community development, strengthening areas with the weakest community infrastructure and introducing community support plans through district councils to underpin the work of local voluntary and community groups.

I am pleased to say that in addition to proposals for new strategies, my Department has for many years been active in dealing with health-related issues in disadvantaged areas, particularly in Belfast and Londonderry. Good and effective working relationships have been developed with the relevant health boards on a range of programmes and initiatives, from a focus on disability through child- related early-years programmes to the health needs of minority groups.

Members of the Assembly will know that providing decent, affordable housing enhances good health and well-being. This has an important role to play in building communities and tackling social exclusion. Research tells us that deprivation is predominantly concentrated in Belfast, the west, Newry and Mourne and Moy. That is why programmes such as new TSN have sought to promote an integrated approach to tackling the needs of these communities. The improvement of public and private sector housing and the renewal of run-down estates are recognised as part of the programme. Northern Ireland has a good story to tell in this respect. Only 2·4% - and I emphasise that figure in relation to some things which have been said today - of Northern Ireland Housing Executive stock is classed as unfit, compared to 7·3% in England and Wales.

We must not, however, rest on our laurels. Further investment is required to eliminate unfitness and to avoid its recurrence. Getting the necessary resources is crucial to success. When lobbying for additional funds last year, I was particularly pleased to secure £8·5 million for the housing budget. Without that, a number of important programmes, such as disabled adaptations, would have had to be reduced. That would have affected the standard of living of the most vulnerable members of the community.

Having a decent home is one thing. Heating it is equally important. Reducing fuel poverty is a key priority for my Department. Fuel poverty - the inability to afford to adequately heat a home - is a terrible blight on society. Living in cold homes can damage people's quality of life and health, as well as imposing wider costs on the community. While the risks from cold-related ill health apply to all people, groups such as older householders, families with young children, disabled people and those with a long-term illness and on low incomes are especially vulnerable, particularly when they have to spend long periods of the day - if not all day - at home. That is totally unacceptable. Therefore I am dedicated to bringing fuel poverty to an end.

I have taken the important step of introducing a new home energy efficiency grant scheme called Warm Homes. Starting in July, the high-risk groups that I mentioned earlier will have insulation and central heating installed in their homes to improve the home's heating. The concept is being piloted in parts of Northern Ireland and has already proven successful, with considerable improvements in comfort levels and reductions in fuel bills for the most needy. I commend the Warm Homes scheme as a sign of my commitment to promoting good health, well-being and social inclusion.

In many respects, good housing is the keystone for addressing many social problems. A good house provides peace of mind, contributing to the overall sense of well-being and creating a feel-good factor. Nowhere are the links between housing and health more obvious than in the travelling community. Their living conditions contribute to poor health, low life expectancy and a higher than average infant mortality rate. Their children stand more chance of being hospitalised with minor illnesses than children in the settled community do. My Department is addressing that problem by providing travellers with the type of accommodation that they need. At the moment, it concentrates its efforts on travellers who require bricks and mortar accommodation in either settled estates or in group housing schemes.

A new housing Bill will extend my Department's role, as it includes provision to transfer responsibility for providing and managing sites for travellers in mobile home accommodation to the Executive. Many of those sites will require work to bring them up to an acceptable standard. They will also need a continuing supply of finance to fund routine maintenance. If the Programme for Government is serious about reducing inequalities in the health status of different groups, my Department must be given additional resources so that it can speed up that process, make progress on group housing and be ready to take over permanent sites.

Getting financial help to those who most need it through the social security system is another vital element in ensuring a good standard of health in the community. My Department is taking the lead by implementing a major programme of change and improvement to the welfare and labour market services in Northern Ireland. The welfare reform and modernisation programme will continue to improve the health and well-being of our citizens in three ways: by providing clear and accessible gateways to benefit and labour market services for all; by tackling potential child poverty; and by helping the disabled to get the support that they need to lead a fulfilling life with dignity.

The reform of the child support scheme, to be introduced by April 2002, will provide prompt and accurate assessments of maintenance. It will introduce improved arrangements for the regular and reliable collection of that maintenance and its payment to the parent. The new system will be easier for clients and staff to understand. It will be transparent, responsive and accessible. It will get money to children more quickly and will be easier to enforce. The new scheme calls for a radical change in culture, service and approach. Maintenance assessments will be calculated accurately in days. Money will flow to parents and children within weeks, and defaulters will be pursued quickly and effectively. The introduction of those reforms will provide direct support to families to ensure that children are raised with an equal level of financial security regardless of whether their parents work and fulfil their responsibilities.

Old people are among the most vulnerable in society. A major reform of the pension system will see improved advice and support services for pensioners. Steps will be taken to ensure that pensioners receive the support that they are entitled to in the minimum income guarantee. To prevent people becoming dependent after retirement and to help them make provision for the future, simplified processes and incentives will be used to encourage working people of low to medium income to build up an adequate pension. The New Deal project will develop measures to assist those with disabilities or long-standing illnesses who are currently dependent on benefit to move into training or work. It is accepted that continuing unemployment can have a detrimental effect on health and well-being.

There are important developments at the delivery end of the social security system, and the ONE service, which we will be piloting from 14 May 2001 in Dungannon, is a practical example of a joined-up Government in action. This service will combine welfare services that are provided by a number of agencies including the Training and Employment Agency, the Child Support Agency, the Northern Ireland Housing Executive, the Rates Collection Agency and the Inland Revenue, as well as the Social Security Agency. It will offer a single point of entry to the welfare system for people of working age and will provide help and advice on work, training and the benefit system, linking work-focused interviews to the claims process.

Another innovation is the partnership between the private sector and the Social Security Agency which aims to revolutionise benefit processing. The 10-year contract between the agency and private sector construction businesses is designed to deliver new telephone and technology solutions and better information management. The transformation of the three disability benefits - disability living allowance, attendance allowance and invalid care allowance - will begin in the autumn and will be fully implemented by March 2002. Plans will then be developed to introduce similar improvements to incapacity benefits.

The extensive and challenging programme that I have outlined demonstrates both my commitment and that of my Department to alleviating the problems caused by poor health standards. It is my intention that my Department will continue to play a full and useful role in this area, together with other Departments.

I remind the House that we must move to Question Time at 2.30 pm. If Mr Hutchinson has not finished speaking at that time, he will be recalled at the beginning of the next section of debate.

I support the motion, especially after hearing what the Minister of Health, Social Services and Public Safety and the Minister for Social Development had to say. What they have said proves that when people have control and can make decisions for their own areas, the right decisions can be made for Northern Ireland. I had some difficulty with the wording of the motion. As a Whip, I am entitled to attend Business Committee meetings. Last week I pointed out that it was not clear that the Minister of Health, Social Services and Public Safety was talking about investment in health. Neither the representative from the Executive nor one of her Whips could confirm that that was what she was talking about. However, in her speech, she did say that she was talking about investment in health.

It is great that we can begin to talk about joined-up Government, the Programme for Government and the way that we spend money. There are a number of layers in the structure of the Health Service; these include trusts and boards. Too much money is spent on managing health when it should be spent on administering health. We need to make speedy decisions on how to move forward in health provision and on how to cut out the bureaucracy.

The Minister for Social Development understands the connection between life expectancy and standards of working conditions, housing, education, waste management and water supply. These are the problems in his Department which impact on health. I am pleased that he has recognised the need to do something about health problems. The Minister made it clear that he could not address the problems without additional resources. We all know that those resources are needed, and it is up to us to find them. One way to do that is by restructuring the Health Service and cutting out all of the bureaucracy.

Elderly people are put into different brackets. For example, one bracket would cover people aged 60 to 69. However, people are put into those brackets up until the age of about 90. The amount of money spent on elderly people increases for each bracket. I think it was the Minister of Health, Social Services and Public Safety who spoke about inequalities caused by social background.

It is nonsensical to spend £1 on sixty-year-olds in north or west Belfast and the same amount on people in north Down, although I know that there are areas of disadvantage in north Down - I could name a number of estates in Bangor where people are totally disadvantaged. The life expectancy of people on the Shankill, the Falls, the Oldpark Road or the New Lodge Road is shorter than that of people who are well off. We must turn the formula around and spend £5 on people in those areas at a very early age, reducing it to £1 as they get older.

We must look at how we actually spend the money. Instead of dividing it among electoral constituencies, we need to ensure that we actually spend it on those people who are disadvantaged and who have reached old age having grown up in a disadvantaged situation. We need to turn the situation around.

Finally, there is no provision for young people under the age of 18 with mental health problems in north and west Belfast, because there is no money. The Minister must look at that.

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