Health, Social Services and Public Safety

1.

asked the Minister of Health, Social Services and Public Safety to explain the differential in mileage allowance paid to social workers, health visitors and community nurses while engaged on Health Service business.

(AQO 1631/00)

De réir téarmaí agus coinníollacha a bhfostaíochta , tá oibrithe sóisialta nasctha le rátaí an liúntais mhíleáiste a íoctar lena macasamhla de fhoireann i seirbhísí údarás áitiúil sa Bhreatain Mhór. Maidir le cuairteoirí sláinte agus altraí pobail, tá an nasc leis na rátaí a íoctar lena macasamhla sa tSeirbhís Náisiúnta Sláinte.

Under the terms and conditions of employment, social work staff are linked to the mileage allowance rates payable to similar staff employed in local authority services in Great Britain. The link for health visitors and community nurses is with the rates paid to similar staff in the NHS.

The Minister will be aware that the division in mileage allowance arose in England when departmental responsibilities for health and social services were separated. Does she not recognise that these workers are carrying out work in the Health Service? They are travelling the same miles, driving on the same roads, and as employees in the Health Service, they deserve to be paid the same mileage rate.

The health services agreement contained in the Finance Act 1971 requires that staff employed in health and personal social services receive the same rates of pay and conditions of service as their counterparts in the NHS and local government respectively in England and Wales. The rates were agreed for staff in the NHS. Organisations that represent staff in health and personal social services in agreeing terms and conditions of service for here and GB were consulted and agreed to parity being maintained.

2.

asked the Minister of Health, Social Services and Public Safety to give her assessment of the guardian ad litem service in Northern Ireland.

(AQO 1642/00)

A Cheann Comhairle. Tá mé sásta gur labhair Gníomhaireacht an Chaomhnóra ad Litem ó seoladh í i mí na Samhna 1996 go héifeachtach ar son páistí sa dlí poiblí agus in imeachtaí uchtaithe agus gur chuir sí seirbhís mheasúil ar fáil do na cuairteanna.

I am satisfied that the Guardian Ad Litem Agency, since its launch in November 1996, has provided an essential voice for the child in public law and adoption proceedings and a valued service for the courts.

To clarify, I should explain that I have carried out the duties of guardian ad litem as an employee of a health and social services board, though it is not an interest to declare. It seems that with the setting up of the agency, there is now less consistency in the work of individual guardians, and they may take different attitudes in accordance with their professional judgement. I would not wish guardians to be in the same position as, perhaps, psychiatrists or doctors, by finding that they disagree with each other in court. To ensure consistency, is there not a case for considering greater regulation of the way the entire panel works?

Each case is unique and must be treated on its merits. It is ultimately for the court to determine the action to be taken, based on the evidence before it and its assessment of the Guardian Ad Litem Agency's recommendations. The Social Services Inspectorate is empowered to carry out inspections of the agency to ensure that its services adhere to acceptable standards and that it continues to satisfy legislative and departmental requirements. The Social Services Inspectorate will shortly plan its business programme for the next five years. Together with the Department's childcare unit, it will consider whether there is a need to include an inspection of the Guardian Ad Litem Agency during the planning cycle. I am informed that the courts value highly the work of the Guardian Ad Litem Agency; it is my assessment that they are satisfied with the agency's work.

Can the Minister comment on the likely interface between the Guardian Ad Litem Agency and any future commissioner for children?

I cannot speculate on that matter, because the proposed appointment of a commissioner for children is under consultation. However, when the commissioner's powers and remit become clearer, I will speak to the Member further.

3.

asked the Minister of Health, Social Services and Public Safety to detail the steps she is taking to ensure that the new anti-TNF drug therapies for the treatment of severe rheumatoid arthritis, Etanercept and Infliximab, are reaching those who most need them.

(AQO 1650/00)

Tigim leis an tuairim gur forbairt thábhachtach iad na drugaí seo do roinnt othar le airtríteas réamatóideach trom agus forchéimnitheach nach dteachaidh na teiripí drugaí atá ann faoi láthair chun sochair dóibh.

Tuigim gur dar le húsáideoirí seirbhísí a bhfuil airtríteas ainsealach orthu go bhféadfadh tairbhe nach beag a bheith sna drugaí nua seo. Ó tá tuilleadh staidéir de dhíth orthu lena n-éifeacht fhadtréimhseach a mheas, tá sé riachtanach go ndéanfaí stiúradh agus monatóireacht dhian ar a n-úsáid, go háirithe mar gheall ar na fo-iarsmaí tromchúiseacha dochracha a d'fhéadfadh a bheith ann.

I support the view that these new drugs are an important development for several patients with severe and progressive rheumatoid arthritis who have failed to respond to existing drug therapies. I appreciate that for service users with chronic arthritis, the potential benefit that these new drugs offer appears to be considerable. However, as further studies are required to ascertain the efficacy of these treatments in the longer term, it is essential that their use is strictly controlled and monitored - particularly in the light of possible serious and adverse side effects.

Boards have agreed to adopt a cautious approach to the introduction of these drugs by taking account of the increasing evidence of their effectiveness and of the resources available. I am awaiting further expert advice on the effectiveness of the drugs. However, in the event of any decision to move beyond their gradual introduction, I will not hesitate to seek the support of the Executive in securing the necessary resources.

Given that these drugs are widely used and widely recommended by the medical profession, will the Minister assure me that she will meet the patients, their families, their doctors and their nurses? Figures do not begin to convey either the pain and frustration that those patients feel, or the dramatic transformation that these drugs are having on those lucky enough to have been prescribed them.

The Member referred to the widespread use of these drugs. Usage here is in keeping with usage in the wider NHS; in fact, it compares favourably with it. The Department continuously assesses the published evidence about these new drugs. It recently received evidence that was submitted jointly by rheumatologists and Arthritis Care. It is likely that that information will form part of the evidence that will be presented to the National Institute for Clinical Excellence (NICE). In addition, my Department will soon meet with rheumatologists and boards. As I said, the drugs are the subject of an appraisal by NICE, which is expected to produce guidance on their use later this year.

Does the Minister agree that the use of new anti-TNF (tumour necrosis factor) drug therapies for other severe forms of arthritis such as ankylosing spondylitis would greatly alleviate the terrible suffering, indeed torture, of so many of her own constituents? Does that not far outweigh purely financial considerations?

The drugs are being introduced gradually in keeping with the British Society for Rheumatology's guidelines. I am waiting for further advice on the drugs' effectiveness. I fully appreciate that for some sufferers the potential benefits of the new drugs appear to be considerable. However, as further studies are required to ascertain their efficacy in the longer term, it is essential that they are introduced gradually and that use is strictly controlled and monitored. The drugs are not licensed for the use that the Member mentioned.

Go raibh maith agat, a Cheann Comhairle. Can the Minister assure us that the approach to access to these drugs is consistent with the human rights agenda?

The decision to promote a gradual introduction of these drugs and to carefully monitor that introduction necessarily means that some patients will receive the drug and some will not. I am awaiting further expert advice on the drugs' effectiveness. My Department is satisfied that this approach is consistent with human rights standards and that it has taken full account of human rights issues in its consideration of the matter.

Question 4 has been withdrawn.

5.

asked the Minister of Health, Social Services and Public Safety to detail the anticipated timescale to complete the review of acute services.

(AQO 1634/00)

Seoladh tuairisc an ghrúpa aithbhreithnithe ar ghéarospidéil go foirmiúil ar 20 Meitheamh. Is mian liom machnamh cúramach a dhéanamh uirthi anois le mo Chomhghleacaithe sa Choiste Feidhmiúcháin.

The acute hospitals review group's report was formally launched on 20 June. I now wish to give that careful consideration with my Colleagues in the Executive.

The Hayes Report has outraged most of the residents of County Tyrone. Most of the area covered by Cookstown, Dungannon, Omagh and Strabane district councils has been marginalised. Accessibility and availability of services are not properly provided for in the Hayes Report because of the decline of Tyrone County Hospital. Will the Minister and her associates show serious concern during the consultation period for the residents' heartfelt outrage? It will not disappear until their demands are met.

The report is a frank assessment of the problems that face our hospital services, and it underlines the need for the problems to be confronted. Everyone who is affected by the report should take time to study it carefully, and everyone will have an opportunity to make his or her views known. It is important to stress that no decisions have been or will be taken prior to a period of consultation. Any changes that are proposed for the long-term future of our acute hospitals will be subject to an equality impact assessment. I agree that the question of access to acute hospital services is a matter of crucial interest, and I reiterate that everyone will have an opportunity to make their views known.

The Hayes Report on acute services has caused immense disquiet and anger in Omagh and west Tyrone. The recommendation flies in the face of all logical factors involved in medical care provision. What comfort and consideration can the Minister offer the staff and, in particular, the patients of the Tyrone County Hospital who have genuine fears about the future of acute services provision in west Tyrone?

Finally, can the Minister assure my constituents in Omagh that nothing underhand has taken place to their detriment, and will she give a sincere pledge that her Department will listen to Omagh's case on this matter during the consultation stage in the next few months?

I commissioned an independent review to give me advice on all the complex issues involved and to make recommendations about the way forward. I have now received that report, and I wish to give it careful consideration with my Colleagues in the Executive.

The acute hospitals review group report makes direct reference to the provision of hospital services for Tyrone and Fermanagh. I will explore how best to ensure safe and effective services for people in those areas.

Go raibh maith agat, a Cheann Comhairle. Can the Minister give some indication of the timescale of the consultation period, the mechanism for accessing that consultation process and the timescale for the decision-making that will result from it?

I hope to be able to give more details on the precise timing in the near future. I received the report only last week, and I want to consider it very carefully and discuss it with my Colleagues on the Executive.

By way of preparation, I hope to issue the report soon and to advise staff, medical professionals and the public that they and the wider community can give their views on this. Any proposals for the long-term future of our acute hospitals will go first to the Executive, then through a consultation process and will also be subject to an equality impact assessment. That will take time.

The Programme for Government envisages an agreed way forward by the end of this year. However, when that was laid out, we expected the report to be available at an earlier stage. The Member should now have a general idea of the timescale and mechanisms, and I hope to be able to make further details known soon.

How does the Minister intend to process the provision of the seamless robe of medical care through acute hospitals and primary care?

Allow me to reiterate: I have only just received the report. I believe that it makes a valuable contribution to progress. It will stimulate an important and necessary debate. However, I want to consider all of the issues carefully and discuss them with my Colleagues in the Executive.

In the light of the Hayes Report that has just been published, does the Minister agree that the proposals of the working party regarding the provision of services in Downe Hospital - the Stewart Report - should have been implemented? The Minister placed a moratorium on the building of the new hospital in Downpatrick approximately a year and a half ago. She suspended the architectural work and placed a moratorium on the procurement of equipment for the new hospital. Does she not agree that she should now lift those moratoria? The new hospital buildings will cater for whatever services will go into them. Two years have already been lost, and it is absolutely disgraceful that medical, surgical and nursing staff are expected to work in the archaic conditions that now exist in the Downe Hospital.

I want to resolve the uncertainty about the future of our hospital services as soon as possible. I intend to issue the report shortly to gauge the public and professional reaction to what it proposes. During that period my officials will be considering the issues with other relevant Departments. I will advance proposals for agreement by the Executive, with a view to issuing a consultation paper later in the year.

Members who have raised points about individual hospitals and services will be able to make their views known, first, when I issue the report to gauge public and professional reaction initially and, secondly, during the consultation period.

Go raibh maith agat, a Cheann Comhairle. Can the Minister tell us how the question of rural proofing will be taken into account with regard to the acute hospitals review?

The acute hospitals review group was asked to take account of local accessibility as one of the key considerations in its task. I will consider carefully the implications of the review's recommendations on disadvantaged rural areas. Of course, any subsequent decisions will be subject to an equality impact assessment.

Thank you for calling me, Mr Speaker. I know that you are indulging me, and I really appreciate that.

The Minister will realise from questions the concern that is being generated in west Tyrone. To date, she has failed to meet with people who wish to make representations. Will the Minister guarantee the Assembly that she will meet with people from west Tyrone who have concerns about the future implications of the acute services review, whether at council or chamber of commerce level?

The acute hospitals review group report contains many radical and far-reaching proposals that I will now want to consider and discuss with Executive Colleagues. At this point no decisions have been taken, nor will they be taken prior to a period of consultation.

I have already met members from the chamber of commerce during the period of suspension. I have not received a specific request to repeat that particular presentation. However, we do have a lengthy list of councils and others who have asked to meet me to discuss the matter. We made it clear to them that such meetings would be best undertaken after I received the report. My Department is now beginning to organise a series of meetings with those who have already written in, where correspondence is on file.

That concludes questions to the Minister of Health, Social Services and Public Safety. The Assembly will now, by leave, suspend, resuming at 3.30 pm with questions to the Minister of Finance and Personnel.

Mr Speaker, will you take a point of order at this stage?

I do not normally take points of order during Question Time. It is only interrupted by a suspension. Perhaps, during the suspension, the Member might like to draw the matter to my attention privately. I would be content to hear him then.

TOP

Finance and Personnel

1.

asked the Minister of Finance and Personnel to detail (a) the terms of reference of the public finance initiative/public-private partnership working group; and (b) what progress has been made to date.

(AQO 1652/00)

Officials in my Department are concluding discussions with officials from the Office of the First Minister and the Deputy First Minister on the terms of reference for the PPP working group, which I announced on 15 March. I expect to make an announcement on the agreed terms of reference soon, and I will ensure that a copy is placed in the Assembly Library.

In response to part (b) of the question, administrative staff have already been assigned as a secretariat and are developing plans for the composition and operation of the working group.

Can the Minister confirm that the use of PFI/PPP will be guided by need and will be used only after the more traditional approach of publicly-funded investment has been considered?

I am happy to confirm the thrust of that. As the Executive emphasised in the Programme for Government, resources available from taxpayers are finite and stretched by the need to provide services to meet levels of need that are greater than the UK average. The Executive have also had to deal with a legacy of historical underfunding in the infrastructure of our public services, which means that education, for example, has a backlog of capital investment needs of around £500 million. That simply cannot be funded in the traditional manner with the resources available.

It is therefore important that the Executive and the Departments explore new ways of financing public services such as PFI/PPP. Where this is employed, it is invariably because the traditional investment approach has been considered but has been judged to be unaffordable from available resources. PFI/PPP is used to address real needs, but only if deals with private- sector partners are affordable and demonstrably deliver value for money.

Will the Minister assure us that it will be part of the remit of the new working group to consult with other Departments and particularly to look at other innovative schemes for funding the investment deficit such as bond schemes, which are being examined by at least one Department?

It is intended that the group will work with all relevant Departments and for all Departments. It will be trying to ensure that we can make better use of other financing opportunities to provide public services and maximise the amount of investment that takes place in the public interest. We must keep underscoring that we are trying to maximise the amount of investment in the public interest, and we are talking about the provision of better public services for the longer term. That will involve working with all Departments. Some of the ideas are not going to be as straightforward as some of their sponsors necessarily believe, so the working group will have to address some of the issues that arise, for example, in the context of Treasury rules.

2.

asked the Minister of Finance and Personnel to detail the timetable for completion of the procurement review.

(AQO 1654/00)

The procurement review implementation team is aiming to complete its work and present its report to me by the end of this month.

Will the Minister confirm that the use of effective procurement is important, not only in achieving value for money but in helping to achieve other social and economic goals?

I can confirm that. Public procurement is first and foremost the means by which the public sector buys in the goods and services that it needs to discharge its responsibilities to the citizens. Securing commercial value for money is an important consideration. With well over £1 billion a year being spent, not only might savings be possible but that activity has the potential to have a significant impact on the social and economic environment. For that reason, the review team has, as part of its terms of reference, the task of exploring the scope to use public procurement to further social, economic and environmental objectives in the context of current EC and international law relating to procurement. I look forward to its findings and recommendations.

3.

asked the Minister of Finance and Personnel, in relation to foot-and-mouth disease, to detail (a) the estimated cost of reimbursing direct and consequential loss to the rural economy; and (b) the estimated financial package expected from Her Majesty's Government and the European Union to assist in this regard.

(AQO 1635/00)

Until the beginning of June, the total cost to Departments of dealing with foot-and-mouth disease was £16·5 million. Included in that figure is £6·9 million spent on reimbursing the direct losses incurred.

Compensation is not payable for consequential losses connected with foot-and-mouth disease controls. However, Members will be aware that the Executive have approved the Help for Business scheme. The costs for the Help for Business scheme cannot yet be quantified, as applications are still being received. There are currently no final figures available for the financial package expected from Whitehall and the European Union. Those figures are the subject of discussions between Treasury and Department of Finance and Personnel officials.

Will the Minister bear in mind that many businesses in west Tyrone have been adversely affected by foot-and-mouth disease? Many of those directly affected were tourist facilities, and others were suppliers connected with the tourist industry. What immediate relief can the Minister offer them by way of financial aid?

I again refer the Member to the Help for Business scheme that has been announced. That scheme is taking applications from businesses that can demonstrate that they have been directly affected and are suffering financial hardship as a direct result of the foot-and-mouth disease crisis. Businesses that fall into that category in west Tyrone should be availing of that scheme. The tests that have been introduced - including being able to show a 15% drop in turnover - are neither complicated nor exacting. I hope that as many Members as possible will encourage any business raising concerns with them to apply for that scheme.

4.

asked the Minister of Finance and Personnel to detail when the senior civil service review will report its findings.

(AQO 1653/00)

The senior civil service review commenced at the beginning of March this year, and the review team is due to report its findings to me in September. When I have had the opportunity to study the findings of the review, I will bring the report, along with my recommendations, to the Executive for final decisions.

Can the Minister confirm that the findings of the review team will be implemented as soon as is practicable and that all promotions and recruitment to that senior group will be influenced by these findings?

The point of embarking on such a significant review was to ensure that the review team's ideas would influence future appointments and promotions. However, I cannot prejudge the outcome of the review. When the review has been completed, I will bring the report to the Executive, along with my recommendations. It will be for the Executive to take the final decisions on the implementation of the review's findings.

5.

asked the Minister of Finance and Personnel to confirm that the proposed Budget timetable will allow for proper input to be made by Assembly Committees.

(AQO 1655/00)

The Executive are committed to giving Committees a constructive role in the development of the Budget for 2002-03. The proposed Budget timetable provides for initial input from Committees - that process will start before the summer - before the Executive consider the draft Budget in September.

The early involvement of Committees, which was not possible last year, will be informed by the Executive's position report 'Developing the Programme for Government and the Budget for 2002-03', which was published this month. Compared to last year, Committees will have two extra weeks in the autumn to scrutinise the draft Budget. Thus, the Assembly will have a meaningful input throughout the Budget process.

I thank the Minister for his undertakings. Can he assure the House that there will be a wider community input into the Budget? Is the Minister confident that, after 30 years of direct rule, people will have a real influence on how the Budget is spent?

We are conscious that we must have consultation on the draft Budget with all the groups listed in the Department of Finance and Personnel equality scheme. There must be similar consultation on the Programme for Government with all the groups listed in the scheme administered by the Office of the First Minister and the Deputy First Minister. In that context, the Office of the First Minister and the Deputy First Minister has already issued copies of the position report to over 1,200 groups and individuals listed in the equality schemes and invited them to comment. The same material that was made available to Committees has been distributed to a wide range of groups. It is also available on the Internet.

We are trying to ensure that the broadest possible range of social and economic partners can discuss the issues that the Executive lay before the Assembly and that their views are conveyed to the Office of the First Minister and the Deputy First Minister, in respect of the Programme for Government, and to the Department of Finance and Personnel, in respect of the Budget. Committees will also benefit from those insights.

6.

asked the Minister of Finance and Personnel to detail his plans on the future status of the Rate Collection Agency.

(AQO 1646/00)

7.

asked the Minister of Finance and Personnel if he intends to make changes in the status of the Rate Collection Agency.

(AQO 1643/00)

I will take questions 6 and 7 together. The review of the Rate Collection Agency is coming towards the end of its first stage. The first stage of the quinquennial review examines the organisational options. If agency status is confirmed, the review will proceed to the second stage, which is a forward-looking consideration of improvements in performance. I currently have no plans to change the status of the Rate Collection Agency.

There is some good news built in there. In early May, the team that was asked to consider the purchase of two new computer systems for the Rate Collection Agency was suspended. What was the reason for the suspension?

As part of the Rate Collection Agency's plan for the future, an outline business case for a project to deliver a new integrated computer service was developed and submitted to the Department on 27 April. However, the agency decided to suspend further work on the project until after the quinquennial review, to ensure that any future investment would be maximised.

Pending the outcome of the quinquennial review, the agency is concentrating on securing appropriate business continuity arrangements to minimise the risks arising from the continued operation of its two existing computer systems.

I thank the Minister for his response and specifically for his assurance that he has no plans to change the status of the agency. Can he confirm to the Assembly that the Rate Collection Agency is significantly more efficient than the vast majority of authorities in GB in its collection of rates - or in GB's case, council tax - and that any possible change in status would have to be based on a need to improve what is already an excellent service?

I am happy to confirm the performance efficiency of the Rate Collection Agency. I have made that point before in answer to questions from Mr Ford's Colleague, who seemed to be less impressed by the indications of the Rate Collection Agency's performance.

Stage one of the quinquennial is not yet complete. If agency status is confirmed, we will move into stage two. I have not yet received any report or recommendations arising out of stage one.

Go raibh maith agat, a Cheann Comhairle. To follow on from the same question, can the Minister confirm that there is speculation that the Rate Collection Agency is going out to tender and that BT and NIE are bidding for the contract? There is also speculation that the review team favours the Rate Collection Agency's function being contracted out to the private sector.

No proposals or recommendations have yet come to me. The Rate Collection Agency's chief executive has written to all the staff to inform them of what favoured option was emerging in stage one. That letter was copied to me as Minister and I, in turn, copied it to the Finance and Personnel Committee. It is in the context of that information that the other rumours that Mr Molloy has referred to have been circulating.

Equine Establishments

8.

asked the Minister of Finance and Personnel whether he has any plans to end the levying of business rates on dedicated equine establishments with a view to redressing the direct competition that they experience from farms operating subsidiary equine businesses, but which pay no rates.

(AQO 1641/00)

I have no immediate plans to exempt equine businesses from rates liability, but the matter will be addressed in the rating policy review, which is under way. All equine businesses, wherever they are located, are treated in the same way for rating purposes.

Does the Minister take the view that levelling rates is a primitive and crude method of raising revenue and that, as in certain states in the United States of America, local purchase taxes and income taxes, which reflect more accurately an individual's ability to pay, are a fairer way of raising revenue? Will he undertake to consider that?

In the context of the rating policy review, we are trying to make sure that we have a means of raising revenue that is efficient in giving a good yield but fair in the burdens it imposes on households and businesses. The Member referred to direct taxes, including some examples of states in the USA, but direct taxes of various kinds can be as unpopular and at times as crude and simplistic as he thinks that rating policy is.

TOP

<< Prev / Next >>