Northern Ireland Assembly
Tuesday 18 September 2001 (continued)
Ms Hanna:
I support the motion. The statistics are depressing. The headline rate of increase is accelerating. The three months up to June saw an increase of more than 47% of the yearly increase. If the rate of increase continues unchecked, there could be a waiting list of more than 64,000 by June 2002. The last quarter did not include the winter pressures.
The only qualitative criterion for determining whether a patient needs an operation is an assessment of clinical need. The emphasis on waiting lists distorts clinical priorities, and the pressure on acute hospitals to meet heart targets means that there has been undue emphasis on performing larger numbers of routine operations at the expense of patients who need longer, more complex and ultimately more serious operations.
Doctors with outpatients waiting for investigations such as magnetic resonance imaging (MRI) scans, possibly to diagnose serious illnesses, have to resort to admitting patients into acute beds to move them up the waiting list, and that compounds the problem.
We do not live in a perfect world. If a quantitative benchmark is to be used, the length of time that a patient is on a list is a better measurement than the number of patients on a list.
3.30 pm
The situation is not just drifting; it is out of control. On 11 September the Minister said that she was very concerned at the growth in the number of patients awaiting admission. I am sure that she is, but, with respect, she is paid to do much more than that. She went on to say that the basic problems are money, lack of investment and past underfunding. Nobody will disagree with that.
We want to know what specific proposals the Minister has put to her Executive colleagues. We need details, chapter and verse. We need to know what monitoring is taking place to ensure that the actions outlined in the framework for action on waiting lists are being implemented and monitored. If we do not know what is being measured, we do not know what actions are effective. The Minister is in a difficult position. She has a complex portfolio -
Mr Shannon:
In my constituency there is one of the largest hospitals in Northern Ireland - the Ulster Hospital. It has repeatedly been in the news over the length of time that people have had to wait before getting medical attention or a necessary operation. A source told me just last week that the waiting time for emergency theatre treatment was three days. If someone required a bone pinned or a wound stitched, they would have to wait more than 72 hours.
I would expect the sort of scenes that patients described to me last week to have come from a war film or a Dickens novel. There were people waiting on trolleys and in corridors, and some critical surgeries were taking place in the wards alongside other patients. This situation is not only deplorable, but also deadly dangerous. Infections are rife in wards, with methicillin-resistant staphylococcus aureus being a killer disease that affects every hospital in the United Kingdom. The carrying-out of procedures in wards where an infection that attacks open wounds is present is unbelievable, but we can understand how desperate doctors are to administer the aid that they are trained to give.
Many people, including myself, are further angered because the Minister and the Department do not seem to know how to spend money or time wisely. We were recently told in an article that the Ulster Community and Hospitals Trust was to receive an investment of £20 million, yet the lists keep getting longer.
I was made aware yesterday of a new scheme operating in the trust area. A social worker's assistant delivered folders to each person claiming disability living allowance. The folders contained five sections, and every time a home help, social worker or health visitor pays a call to a client, they must write the purpose of the visit on the folders. Two things have been highlighted by that: first, the money spent on the folders, dividers, paper and, not least, the petrol; and secondly that a member of staff was specifically sent out to do that job. It is a waste of money.
Much money is wasted annually on the administrative side of the Department of Health, Social Services and Public Safety. The old Newtownards Hospital is a prime example, having had many of its wards, such as the Thomas Bailie ward, turned into offices. It was converted both physically, with bricks and mortar, and also decoratively. The bill was staggering. I suggest that some of the money spent on the decor should be spent on reducing hospital waiting lists.
Ms de Brún:
Go raibh maith agat, a LeasCheann Comhairle. Tá mé buíoch den Uasal Mac Bhradaigh as an rún tábhachtach seo a chur síos ar chlár. Phléigh díospóireacht an lae inniu le hábhar atá ina chúis mhór imní do mhórán daoine.
Chuir mé suim, agus mé ag éisteacht go cúramach, sna pointí a rinne an tUasal Mac Bhradaigh agus Comhaltaí eile. Is ionann cuid mhaith de na tuairimí a nochtadh agus mo chuid tuairimí féin: is cás liom daoine tinne ag fanacht ar feadh tréimhse fada le cóireáil; is cás liom na brúnna atá ag dul i méid ar ár ngéarsheirbhísí - agus ar ár seirbhísí pobail; is cás liom ár bhfoireann, a leanann leo ag cur seirbhís ghairmiúil ar fáil.
Amhail Comhaltaí, ba mhaith liom seirbhísí ardchaighdeáin soghluaiste a chur in áit; seirbhísí a bhéas ar fáil dóibh sin a bhfuil siad de dhíth orthu - nuair a bhéas siad de dhíth orthu.
Mar sin, cad é atá ag teacht idir sinn agus an chomhaisling seo?
Is eol domh go bhfuil os cionn 54,000 duine ag fanacht le hobráidí otharlainne anois. Tá imní ar mhórán acu faoin mhéid ama a ghlacfas sé go gcóireáilfear iad.
Chuir sé gliondar orm an oiread sin Comhaltaí a chluinstin agus iad ag iarraidh níos mó airgead mar mheán praiticiúil le cinntiú go ndírítear seirbhísí mar is ceart le freastal ar riachtanais ár bpobail. Is eochaireilimint í, leoga, infhaighteacht maoinithe shásúil i liostaí feithimh a laghdú.
I am grateful to Mr McGrady for tabling this important motion. Today's debate has covered an issue of deep concern to many people in our community.
I have listened carefully and with great interest to the points made by Mr McGrady and other Members. Many of the views expressed echo my own thoughts: thoughts about the unacceptability of sick people waiting for a long time for treatment; thoughts about the increasing pressures on our acute and community services; and thoughts about our staff, who continue to provide a professional service. I am grateful to Members for stressing the value they place on health service staff.
Like other Members, I listen to constituents who value our health and social services and feel betrayed when these services are not readily available to meet their needs. I too have spoken to constituents who have to wait, often in pain or distress, for a hospital operation, or support at home. I also share Members' desires to put in place high-quality and responsive services that will be available to support those who need them, when they need them.
What are the obstacles to achieving this shared vision? More than 54,000 people are now waiting for operations, and many are worried about how long it will be before they are treated. Members have rightly spoken about the level of human suffering that lies behind the statistics. I was particularly glad to hear so many Members calling for better resources as a practical means of ensuring that services are adequately geared to provide the level of service necessary to meet the needs of our community. The availability of adequate funding is a key element in reducing waiting lists, although as I stated yesterday, and state again today, there is an allied question of management, which we will also address.
Although this debate is focused on waiting lists, the underlying problems are much broader. Waiting lists are in some ways like a barometer registering the overall levels of pressure on our health and social services. The current high waiting lists reflect both the pressures on our services' overall capacity and a continuing growth in emergency admissions. It is not easy to find a single cause for this. One factor is undoubtedly our ageing population; another factor may be advances in medicine that offer new therapies for previously untreatable conditions. This makes it likely that people can avail of services that were not previously available.
However, this year in the Eastern Health and Social Services Board, medical activity in hospitals has increased by 9%. Increases of this magnitude are difficult to meet, and year-round trolley waits are becoming a fact of life in too many hospitals. The system is simply running too close to full capacity. Increased waiting lists are one symptom of a service that was grossly underfunded in the past. It will take some time, and a great deal of money, to address that problem. I am glad to see that Members have recognised this and made references to the effect that small, or temporary, changes in staffing levels or capacity in any given speciality can have. I am also grateful for their comments regarding historic funding decisions.
Members have also drawn attention to the situation beyond our hospitals. That is of equal concern. People, many of them elderly, are waiting at home for the support needed to maintain their independence and quality of life. Without prompt and appropriate assistance, some of these people will end up in hospital. There will be a delay in returning people to the community after hospital care because the services are not in place to support them, and that is equally worrying.
Since becoming Minister of Health, Social Services and Public Safety I have brought this situation to the attention of the Assembly and sought its support in tackling the underlying problems that face health and social services. Since December 1999 the Executive have found some additional funding for these vital services. However, in order to turn the corner, a sustained increase in funding over a number of years is required. The service faces some difficult choices this year. The additional resources in this year's Budget fall far short of the bids that I submitted, as a number of Members, particularly those on the Health and Social Services Committee, have drawn out.
To make a lasting impact on waiting lists we must address the issue of capacity in hospital and community services. Given the current financial climate, I am greatly concerned - and I note that Committee members share that concern - that I will not receive the level of resources needed to bring about improvements. The situation will worsen without these resources. I am aware that the Health Service can do, and is doing, a great deal to cut waste and to operate with maximum efficiency. I support such action.
Last September I issued a comprehensive framework for action on waiting lists to improve the process. That was the first long-term strategic approach to dealing with waiting lists here. Previous reductions in waiting lists were not sustained because recurrent investment was not forthcoming. I want a sustained programme of action over a number of years to deliver long-term improvements. We need that sustained and long-term action, supported by recurrent resources, to boost service capacity and to reduce waiting lists.
I have put in place the necessary framework, but there is still a long way to go. I am glad to say that it has been possible to allocate some additional funding to reduce waiting lists. In the current year, for instance, I have been able to allocate an extra £3 million for specific action on waiting lists. In addition, last year's non-recurrent allocation of £5 million was made recurrent, thus increasing to £8 million the total additional resources available for action on waiting lists this year.
Following the June monitoring round, I also made available to the service an extra several million pounds to strengthen community infrastructure and services. Although that money is welcome, the service needs more overall investment if it is to meet the demands placed on it. Those demands have been clearly illustrated by the very graphic personal stories that Members have today related on behalf of their constituents.
To make the required impact on waiting lists and waiting times, we must address the shortage of acute hospital capacity, particularly at peak periods. We must also deal with the under-resourcing of community care services. Against that backdrop, however, there are some rays of hope. Boards and trusts are implementing a wide range of measures to improve the management of hospital admissions and discharges. Every board has devised a comprehensive action plan to address necessary measures, and a great deal of work is being done.
For example, an additional 60 opthalmology patients have been treated as day cases in the Mater Hospital - patients who would otherwise have had to wait for treatment elsewhere. More than 200 patients have been treated in ward 8 of the Royal Victoria Hospital under an initiative by which the ward is used as an elective surgery ward for six months per year and as an emergency admissions ward for the rest of the year.
Many hundreds of people have been offered the opportunity to receive their treatment at a more distant hospital rather than continue to wait. The Eastern Health and Social Services Board has contacted 300 people on long waiting lists to offer them early treatment at Downe Hospital.
Additional cardiac surgery operations have been provided for patients who have agreed to travel to Glasgow rather than wait for treatment locally. A new angiography facility due to open soon at Altnagelvin Hospital will increase overall capacity for diagnostic testing of that nature and will help to reduce waiting times. Mobile MRI scanners operating from several locations have reduced waiting lists. I have also allocated additional funding for new supernumerary nursing posts in cardiac intensive care to support the existing staff, and to allow more nurses to get the specialised training that is needed. That will help to increase bed capacity and the number of operations carried out.
Some Members commented on the structures and organisation of the Health Service and the forthcoming review of public administration; they mentioned that those matters were dealt with by the Acute Hospitals Review Group. As Members know, I have issued a report, and consultation on it will last until 31 October. That consultation will provide the initial information and reaction that will help me to formulate proposals, which I will then discuss with my Executive Colleagues. I encourage Members, and all those with an interest in health and social services, to respond to the consultation.
Members commented on the need for overall efficiency in the service. Despite the fact that since the early 1980s the equivalent of £190 million, in today's terms, has been removed from the Health Service's baseline budget, it has treated almost 10% more patients in the last five years. During that time, there has been a 27% increase in the number of community care packages. In addition, the service plans to achieve savings of £12 million by the end of 2002-03 through a range of improvements, including a review of acute sector performance, improvements in the efficiency and effectiveness of prescribing, improved waiting list management, improved bed management and further rationalisation of the Health Service estate.
3.45 pm
We heard about difficulties specifically in relation to our ageing population. Kieran McCarthy was worried about discrimination on age grounds. I fully accept that there must be no discrimination on the grounds of age, gender or any other such factor. All of our services are covered by equality legislation. That means that we are bound in law to ensure that all patients are treated fairly, and that is what I would expect to happen.
Eddie McGrady talked about co-operation with the South, and I am very keen to encourage the services in the North and the South to work together. I hope that the work already undertaken by CAWT (Co-operation and Working Together for Health Gain and Well-being in Border Areas) can be built upon.
Dr Adamson and some other Members asked about the use of services in other countries. I am happy, in principle, to draw on services available elsewhere in the interests of our patients. We already make very good use of services in Glasgow, London, Dublin and other centres, as part of the overall services available to patients. There is, as Dr Adamson pointed out, the issue of how that draws money into the overall financial resources available elsewhere as opposed to here. However, we want to establish an appropriate balance and to ensure that the services that people need are accessible and readily available.
Eddie McGrady talked about decentralising services to make capacity available. I am very committed to using all of our capacity to its fullest effect. That is evidenced by the increased use of hospitals such as Lagan Valley Hospital to help tackle waiting lists in hospitals such as Craigavon Area Hospital. We are also now making better use of day facilities at South Tyrone Hospital with ophthalmology cases receiving treatment there. I am conscious of the difficulty of the availability of expert staff, and we need to be careful to avoid creating staffing problems in other centres.
A range of specific measures has been introduced to deal with the difficulties in fracture services. The Royal Group of Hospitals Trust and the Green Park Healthcare Trust have put on additional theatre lists. Additional day cases have been taken at the Ulster Hospital. Fracture lists at the Royal Victoria Hospital have been protected, and I am monitoring the situation very closely. There is a shortage of orthopaedic surgeons both here and in the overall NHS, and we are taking steps to increase the number of trainees in the speciality, although that will obviously take time. We have also recently dealt with a difficulty relating to the number of theatre nurses.
I was very grateful to Monica McWilliams for the points that she raised about collective responsibility. It was a very thoughtful contribution, which we need to keep in mind. Prof McWilliams also asked whether 39,000 is a realistic target, and I believe that it is not unless there is a substantial recurring investment in service capacity and in staff. I have repeatedly emphasised that reducing waiting lists will require a sustained effort over a number of years.
Carmel Hanna told the House that 47% of the rise occurred in the last quarter. Both she and Monica McWilliams talked about the last quarter and the factors involved. Some 60% of the increase in the last quarter - therefore some 60% the figure that Carmel Hanna told us was such a large part of the overall figure - was in the ear, nose and throat speciality. That increase can therefore largely be explained by the delays in some operations due to the directive to use single-use instruments for tonsillectomies. There were also some delays caused by the absence of key consultancy staff through illness, and others as a result of patients being transferred to the Causeway Hospital. Those last two factors were temporary and should be overcome quickly - the former less so.
Outpatient waiting lists increased due to an apparent across-the-board surge in numbers being referred to outpatient services.
Madam Deputy Speaker:
I ask the Minister to bring her remarks to a close.
Ms de Brún:
I recognise these difficulties. When I issued the 'Framework for Action on Waiting Lists' last year, I said that only long-term focused management action, coupled with new investment in the service, would improve the waiting list situation.
I have set a long-term programme of work in motion to ensure that the Health Service makes the best use of what it has and that efficiency is improved where possible. I look to the Assembly and my ministerial Colleagues to recognise the pressing need and to agree to put in place the funding necessary to ensure that health and community services are adequately resourced so that we can meet the challenges facing us in the years ahead.
Mr McGrady:
I thank all Members who participated in the debate, and particularly the Minister for the time that she has given to this problem and the detailed response that she gave in the past 16 minutes. She will undoubtedly agree that it will take some time for the lay person to digest all that she has said, and I am sure she will understand that I do not have the capacity to reply to all aspects of her response.
(Mr Deputy Speaker [Mr McClelland] in the Chair)
The main thrusts of the motion enable the Assembly to consider its collective concerns, and its view that immediate action is required. Those are the two important themes - Members' concerns about representing community concerns, and their concerted action with, it is hoped, the Departments to bring about an improvement in the situation.
There were 15 valuable contributions made this afternoon, and it is impossible for me to reply to them all as the Minister has done. However, they had some common themes. The matter of additional funding arose in many contributions. The structures through which the Health Service delivers were strongly criticised for being ineffectual and inefficient. There was an underlying theme that no matter how much money is thrown at the problem, it will not change unless the Assembly does something urgent and dramatic. No Member said that, but that is the feeling one got from many of the contributions.
Many Members also referred to the enormous debt of gratitude owed to the medical fraternity, nursing and ancillary staff. Not only do they deserve credit for what they are doing, but they should be doubly credited for doing it under conditions that we have allowed to be imposed upon them.
Ultimately it is the patients who suffer the prolonged and unnecessary pain that I referred to in my introductory remarks. Sometimes that pain can lead to premature death, and that is what Members must strive to avoid.
I have three pages of notes that I intended to use for my response, but I have given up the prospect of doing so. However, I will nail a remark that was made by Ms McWilliams. I did not come here to bash, or gang up on, the Minister. I came here because my representative role gives me the responsibility of articulating people's concerns. I doubly resent Ms McWilliams's insinuation because, metaphorically speaking, she waded in in her pinstripe wellingtons to a debate to which she had not heard the introduction. The thrust of my introduction was not to bash the Minister. The thrust of my introduction was that finances are needed and we must ensure that that need is properly addressed. In addition, I would point out that the "delicate flower" of ministerial responsibility can well defend herself.
Undoubtedly the crisis with hospital and medical waiting lists is not solely about money, and I have said that time after time. Mismanagement of resources has been endemic for a long time, not just during the past three years but for longer than that. I have asked the Minister to address that problem.
In the Assembly on 17 October 2000, Minister Durkan, speaking about the Budget, said:
"In the Department of Health, Social Services and Public Safety, the budget will grow by over £150 million (or 7·2%) to some £2·3 billion. Within this total, over £1·16 billion will be available for hospital and community health services, and £460 million will be available for personal social services.
Additional provision is also being made to address winter pressures and waiting lists, while family health services show an increase in funding of over 8%."
Even with the additional money, we still have a spiralling waiting list. We must find out if the cause is inefficient spending, misallocation or a lack of funds. I doubt if it is a lack of funds.
In November 2000, an extra £17 million - £5 million of which was carried over - was allocated to the health services. In January this year £14·5 million was given to the health services. In February 2001, £18 million of additional spending was injected into the health services. These are vast amounts of money. The figure of £18 million had been analysed by the Department of Finance and Personnel and by the Department of Health, Social Services and Public Safety as being required. If the Departments made an assessment of what was required, they got it. Where are the funds going? Why are they not having the desired effect? It is important to remember that a further £8 million has been allocated for this year, specifically to reduce waiting lists.
Seven months have passed since the interdepartmental consultation study and review of the consequences of trust deficiencies were put in place. What progress has been made? Is it near completion, and have any conclusions been reached? These are urgent matters that require urgent answers.
There is an absence of decision making. We have consultation fatigue; we have "paralysis by analysis". No decisions have been made, and everything is under review. However, the Department of Health, Social Services and Public Safety is not alone in being in this situation. Reviews are being conducted in almost every Department, and reviews of reviews. It goes on and on.
Decisions are needed about primary care, acute care and the administrative structure of the health services. There is almost universal agreement today that there are too many trusts -19 for a population the size of Birmingham. The situation is ludicrous, and we cannot wait for reviews of public administration.
There is a lack of co-ordination. Why is Northern Ireland the only part of these isles that has not carried out an audit on the reasons for the waiting lists? An audit could tell us what factors are contributing to the waiting lists, and also whether money is being spent wisely or if a bucketful more money is needed. At least we would know what is happening.
I will finish on a parochial note. Last night in my home town five patients were lying all night in the corridors of the Downe Hospital. That is the epitome. Endemic centralisation should be reversed rapidly, and we should make use of what already exists and enhance it. Surely that is the way forward.
I am not here on a bashing exercise, nor am I here on a political platform. I am here, along with my Assembly Colleagues, to say that the Minister, fortunately or unfortunately, has responsibility for the health services. We look to her to address these issues. We plead with her, and we will back her in any way we can, to ensure that the waiting lists that are literally killing people are reduced as soon as possible.
Question put and agreed to.
Resolved:
That this Assembly views with concern the ever-increasing waiting lists for medical and hospital treatment in our local health services, and requires immediate action to remedy this unacceptable and growing problem.
4.00 pm
Paramilitary Activity
Mr P Robinson:
I beg to move
That this Assembly deplores the ongoing catalogue of paramilitary activity particularly from groups which are allegedly on ceasefire and which claim to accept the premise that only those committed to the use of exclusively peaceful and democratic means can participate in government in Northern Ireland; and further determines it is inconsistent and intolerable that any party associated with active terrorism continues to hold Executive positions.
I am mindful that this is possibly the last debate on the last day - at least before suspension, perhaps even for all time - of the Assembly. None the less, it is vital that the issue be dealt with before the close of business of the Northern Ireland Assembly. The Assembly has been dogged by the issue since its inception, which is no small part of the reason why it faces its present problems.
I consider it a reasonably effortless task to show the Assembly that each of the main paramilitary organisations has violated the terms of its ceasefire. My task is even simpler, because I do not confine myself to their definition of a ceasefire. Rather, I will use the definition that is set down in law - namely, that parties associated with paramilitary groups and all others must show that they are committed to exclusively peaceful and democratic means. There are still some in this community - even after all these years - who refuse to face the reality of the violence in our midst. They still hold on to the illusion of a peace process, shutting their eyes to the violence that surrounds them. When they are pushed to come to terms with breaches of the ceasefires, we hear the hypocritical cant that "it's better than it was 10 years ago". It follows that we are to be grateful to the terrorists for adjusting the nature and level of their terrorism. Setting for a lower level of terrorism may have led to an improvement on the streets, but that does not amount to peace, nor does it justify providing seats in Government for those who are still actively engaged in terrorism.
There are others who - almost convincingly - advise us that we are coming out of a long and sustained period of violence and that we cannot expect an unblemished record in those circumstances. They tell us that terrorism is in its death throes. That is nonsense; we must look at what is happening. We must face the fact that terrorism in Northern Ireland is cranking up - it is not winding down. Moreover, there are those at the head of Government and of policing who refuse to point the finger at the paramilitary organisations involved. They tell us that the act was probably carried out by dissident groups; they tell us that the police are still investigating the incident; they tell us that we have to consider it in the round; and they tell us that it may be the activity of mavericks, not sanctioned by the organisations themselves. Almost any excuse is made for such terrorist activity.
For some in the political world, the highest legal standard of proof and evidence is required before an organisation can be blamed for anything. Yet, it seems that they do not require the same high legal standard for infractions perpetrated by "the other side". I suspect that even an admission from the terrorist organisations would not cause those people to act as if those organisations had been in breach.
There are some in this community who, when their colleagues carry out their terrorist activities - in violation of the declared ceasefires of those organisations - and are arrested, demand a higher legal standard of proof and evidence. Indeed, those people demand more human rights for the terrorists than the terrorists themselves accord when they wear balaclavas and meet their victims in the backstreets of Belfast and other cities and towns in Northern Ireland. That is the reality.
Some things become obvious when we look at the breaches of the ceasefires and the catalogue of incidents. The first is that the failure of the exclusion mechanism has given the IRA the message that it can-literally-get away with murder. The failure to hold Sinn Féin/IRA to account and to remove it from government has shown that there are parties in the House that are afraid of the consequences of the safeguards that they signed up to in the Belfast Agreement.
Events have also shown that the legislation was not only ineffective, but incomplete. Members had an instrument with which to punish Sinn Féin/IRA, had they chosen to use it. However, there was no mechanism to deal with parties that were not in government if the paramilitary group with which they were associated breached its ceasefire, especially if they were not in the Assembly itself.
Because of the higher standard required for participation in government, the failure to deal with Sinn Féin/IRA has been the central problem. The SDLP, and even the Ulster Unionist Party, must take the rap. Both parties have failed to vote on the violations of the IRA ceasefire during all the years of this Assembly. The greatest difficulty - particularly for Ulster Unionists - is that they went through the referendum telling the people of Northern Ireland that they had the issue covered and that, no matter what Sinn Féin/IRA might do, they would get it thrown out of the Executive, if it turned to violence. Moreover, they convinced some people in Northern Ireland that they had a belt-and-braces provision. If the SDLP did not answer the call and fulfil an explicit commitment in the agreement by throwing Sinn Féin out, the leader of the Ulster Unionist Party had a letter from the Prime Minister.
The letter said that if those measures proved to be ineffective, the Prime Minister would propose some changes. Many of us said that the letter meant only that such changes would be proposed to co-signatories to the agreement. If two of the parties to the agreement had already refused to comply, it was unlikely that they would agree with any proposal that the Prime Minister might make. The weakness of the Ulster Unionist Party is that it has never actually triggered that mechanism. The party never voted to exclude Sinn Féin and thereby test the Prime Minister on whether he would propose a provision that would ensure that those who were engaged in violence would be excluded from government.
Why has there been no action against Sinn Féin/IRA? Is the case for exclusion marginal? Is there a shortage of evidence? That is not the case.
First, the loyalist paramilitaries, who receive less attention in the House on this issue, because they are not in Government have indisputably breached their ceasefires. That was seen most graphically and tragically when the two organisations went to war with each other. Hundreds of so-called punishment shootings and beatings have been carried out by both loyalist paramilitary groups. Given the frequency and the geographical pattern of the attacks and the co-ordination required, all one's intelligence, judgement and senses would have to be suspended for one to believe that the ongoing attacks on Roman Catholic homes with pipe bombs and other missiles were the work of anything other than a major loyalist paramilitary group. Equally, the bomb left in Ballycastle could not conceivably be the work of anyone other than a member of one of those paramilitary organisations. Those attacks must be condemned without any verbal or mental reservation.
It is a sick irony that the groups responsible were among the most enthusiastic advocates of the so-called peace process and the Belfast Agreement. That the behaviour of loyalist paramilitary groups does not directly impact on the functioning of government has meant that they are under less scrutiny and, I suggest, less pressure than their violent acts deserve.
What should we make of the behaviour of Sinn Féin/IRA? They have representatives in government and are bound by the terms of the Belfast Agreement and the Northern Ireland Act 1998 to employ exclusively democratic and peaceful means of effecting change. They broke their first ceasefire and re-engaged in a campaign of bombing and shooting, murder and carnage. Even while signing up to the Belfast Agreement, they were involved in the planning of the massive bomb attack on London. That shows their sincerity.
Since the reinstatement of their ceasefire on 20 July 1997, the IRA has been responsible for 170 so-called punishment shootings and 250 paramilitary beatings. In July 1997, the IRA was involved in the preparation of a major robbery in the Republic of Ireland. Provos were arrested while staking out the Allied Irish Bank headquarters in Dublin. In January 1998, the IRA murdered a well-known Loyalist, Jim Guiney. He was gunned down in his carpet shop in Dunmurry. In February 1998, the IRA murdered 38-year-old Loyalist Robert Dougan, again in Dunmurry. In February 1998, the IRA, using its DAAD cover name, murdered Brendan Campbell. They claimed that he was a leading drug dealer. In July 1998, 33-year-old Andrew Kearney from New Lodge in north Belfast was shot by the IRA. After the shooting, they jammed the lifts, and he bled to death. It transpired that Mr Kearney had been shot because he had got the better of a local IRA hero in a fight.
In January 1999, author and former IRA man turned informer Eamon Collins was beaten to death by the IRA in Newry, County Down. In May 1999, the IRA murdered Brendan 'Speedy' Fegan. They again justified their action by claiming that he was a leading drugs dealer. They shot him dead in a bar in Newry. In June 1999, the IRA murdered Paul Downey. Once again, they claimed that he had been a prominent drugs dealer. In June 1999, Martin McGartland, an RUC agent who infiltrated the IRA, narrowly escaped with his life after being shot in Whitley Bay, Northumbria, by IRA members. I have a copy of a letter sent to Mr McGartland by Northumbria police. It shows that they had arrested Henry Fitzsimmons and Scott Gary Monaghan, two well known Provisional IRA members, and that they were regarded as responsible for the attempt to kill Martin McGartland. However, even with all of that evidence, the Secretary of State considered that in the round there had no breach of the IRA ceasefire or the terms of the Belfast Agreement.
4.15 pm
In July 1999, the IRA abducted and murdered Charles Bennett, a New Lodge man. Also in July, the men arrested, and convicted in connection with the importation of arms from Florida were shown to be members of the Provisional IRA. It was proven that that activity was sanctioned at the highest level of the Provisional IRA. I will come back to that issue in my winding-up speech. Clearly, those men were members of the Provisional IRA. On the Noraid Internet site, they are described as IRA prisoners in an American jail. An article in 'GQ' magazine shows clearly the links between the Provisional IRA and those who were arrested, and asserts that they were part of an IRA gun running escapade. It is interesting that that activity was being planned at the same time as the organisation's representatives were sitting down with Senator George Mitchell and telling him how sincere they were about trying to achieve progress on decommissioning. While they were telling the senator that they were serious about decommissioning, they were importing guns from the United States to increase their stockpile of weaponry.
In August 1999, the IRA deported five men from Dungannon and one from Belfast for what they judged to be antisocial behaviour. I suppose that they consider their murdering and gunrunning to be civil and convivial. In October 2000, the IRA murdered Real IRA man, Joe O'Connor, in Ballymurphy, west Belfast. In April 2001, the IRA used the usual excuse of drug dealing to justify murdering Christopher O'Kane in Londonderry. In May 2001, the IRA again murdered someone who, it claimed, was a drug dealer. The victim, that time, was Paul Daly from Belfast. He was shot in front of his family.
In April 2001, Londonderry man, Gerald McFadden, from Rathlin Gardens in the Creggan estate was charged after he was found to have personal details of senior RUC officers. He has since been convicted of that offence. That demonstrates that the IRA was engaged in the targeting of RUC officers and that, once again, it was in contravention of the explicit requirement to use only peaceful and democratic means. In June 2001, the Provisional IRA raided Belfast docks and stole about £4 million. Also in June 2001, the IRA raided the house of an arms dealer in Athlone, County Westmeath. The attackers threatened him, tied up his wife and children, and stole over 100 shotguns, rifles and a quantity of ammunition.
In August 2001 came Colombia, another effort by the Provisional IRA to secure the peace process. I will deal with that issue in my winding-up speech. That was an added embarrassment for Sinn Féin, because all three men involved had party connections. According to the Government of their friend, Fidel Castro - to whom Mr Adams is soon going out to talk - one of the men, Connolly, was the accredited representative of Sinn Féin in Cuba and, no doubt, in South America. I have said James Monaghan was on the brigade staff at the headquarters of the Provisional IRA. He is their well known chief engineer and bomb maker. Such an individual would not have been a freelancer; he was on a mission sanctioned by the so-called Army Council of the Provisional IRA. They tried to tell us that those boys were really on holiday. I can think of more attractive places in which to holiday than the malaria-stricken jungles, where the opportunities for the Revolutionary Armed Forces of Colombia (FARC) to kidnap or kill must be greater than anywhere else in the world. Clearly, the Provisional IRA, at the very highest level, sanctioned that mission.
I cannot say anything about the arrest of IRA leader, Eddie Copeland, in north Belfast, as the matter is before the courts. I could have spoken of many other IRA failures to maintain its ceasefire. One wonders, after hearing that catalogue of events, what the IRA must do before the House imposes sanctions on Sinn Féin/IRA. I hope, in what may be the last act before the suspension of the Assembly, that the House will not again dodge the issue and that it will support the motion.
Mr Deputy Speaker:
One amendment to the motion has been selected and has been published in the Marshalled List of Amendments. Many Members have expressed a wish to speak, so I must limit Mr Attwood to 10 minutes and all other Members to five minutes.
Mr Attwood:
I beg to move the following amendment: Delete all after "activity" and insert
"and calls on all parties who profess to be committed to exclusively peaceful and democratic means to unequivocally repudiate any and all such violence and to call on all paramilitary groups to give real effect to the decommissioning provisions of the Good Friday Agreement."
If we - and certain illegal organisations - so choose, the events of the past summer can enable us to deal conclusively with illegal weapons on this island. If some fail to choose that option, they will be failing to acknowledge and accept the impact of the still unfolding events of recent days in the United States, Latin America, Ireland and in the communities that we represent. If some fail to choose that option, they will miss the beat of the people of this part of the world. They will also miss the opportunity to contribute meaningfully to events in other parts of the world. Decommissioning would confirm that we are moving beyond conflict at a time when others seem to be moving towards greater conflict.
All of us have, or should have, real concerns about the conduct of more than one, or indeed all, of the illegal paramilitary groups that are still active on this island. The attitude of some inside and outside the Chamber to illegal organisations now and in the past has been informed by their worst fears. That is a valid and genuine perspective, but it is one that paramilitary organisations and their advocates dismiss with the ritual recitation that "the guns are silent". That is not always the case, and that is not their only obligation. If the worst has been done to someone's family or community by an illegal organisation, their fears will inform their judgements about the nature and intentions of that organisation. If evidence exists that discredits that organisation's claims, mistrust will prosper. That is not to give succour to leaders who alarm their communities or constituencies; I say that to acknowledge the real anxiety in those communities about their future on an island that is changing enormously but which contains illegal organisations which, they feel, have not changed enough.
There are others inside and outside the Chamber who have experienced the realisation of their worst fears in the years of violent conflict and who have consciously sought to allow their judgements about illegal organisations to be informed a little more by their best hopes. Others have attempted to understand the transition that those organisations and those associated with them have tried to make from unambiguous support for armed struggle to exclusively peaceful and democratic means of conducting political affairs. That is a difficult political and moral line to walk. It becomes longer and more difficult to walk when evidence emerges that organisations have acted in a way that is contrary to a commitment to exclusively peaceful and democratic means of conducting political affairs. That is the context for those of us who have expressed and maintained confidence in the ceasefires of various organisations.
Contexts and politics change. Today the context is the unfolding events of recent weeks and months, set against the backdrop of the uncertain and difficult years since the Good Friday Agreement. The new context and the continuing doubts about, and dangers to, the agreement now require a further response. If illegal organisations do not acknowledge the impact of recent threats and terror in the North on our political situation, or the mistrust arising from events in Latin America, or the parallels and consequences of attacks on commercial, civilian and military targets at home or abroad, recently or in the past, they will contribute to an environment wherein the worst fears can gather and the best intentions can fracture.
To rehearse tired and tested responses to the need to put weapons verifiably and completely beyond use, without appreciating the changed and changing local and international environment and the extent of the investment in the Good Friday Agreement, is to ignore unfolding events. If any political party professing commitment to exclusively peaceful and democratic means fails to repudiate unequivocally violence, it contributes to the environment wherein worst fears inform, not merely the judgement of political leaders, but the judgement of the wider community.
There has been ambiguity about sectarian attacks and evasiveness about events in Latin America. There have been parades with ranks of people in balaclavas and articulation of the grievances of one community, coupled with silence about the grievances of the other. None of that aids the resolution of the issue of illegal weapons, nor does saying - rightly - that our best response to events in America is to make our agreement work, while failing to recognise that illegal organisations and their past or present conspiracies and actions, at home or abroad, are at the heart of the threat to that agreement.
The UDA and UFF ceasefire does not exist in any meaningful way. The six UDA and UFF commanders are not likely to meet and declare their ceasefire over, but in at least half of their command areas, and in more than half of their areas of influence, the ceasefire has been breached - and that breach is systemic, to borrow the words of the Secretary of State. The situation requires both political and security responses. First, the UDA should be made aware that in the event of its ceasefire being redesignated, all its command areas will be affected. Secondly, the full weight of the law should be brought to bear on those persons - on licence or not - involved in threat or terror, particularly those directing the operations of the UDA and the UFF. The police must be - and be seen to be - more interventionist in bringing the full force of the law to bear on those carrying out activities that are anti-Catholic, anti-Nationalist, anti- agreement and anti-change.
Yesterday, with regard to the IRA ceasefire, John Hume said:
"Given the current international atmospheres, could I say directly to Sinn Féin please do all that you have to do now and all that you actually can do by taking the necessary actions to ensure that all weapons are put completely beyond use".
That was a request to respond to the particular circumstances of this week. It should be heeded. The IRA will make a monumental error of judgement if it concludes that if it hunkers down and keeps its head down, events will pass it by, and people will return to it on more tolerable terms than might otherwise be the case. The IRA will commit a further error of judgement if it concludes that its engagement with the de Chastelain commission is an adequate or convincing response to that requirement.
4.30 pm
Although the media and the political leadership has its doubts, and the world sees the issue of terror more single-mindedly than before, the IRA may think that that will pass and that people will support the movement again. It may conclude that such isolation will be much as it was in the past : the IRA has been there, done that, survived it and come back stronger. If that is what the IRA concludes, it will have misread the shifts on this island and elsewhere. The sooner that that is recognised, the better it will be for the agreement, for all our citizens and for all of us who are responding creatively and purposefully to the unfolding events in a world that is smaller, more intimate and more familiar - but also more vulnerable - than at any time in history.
Some will refer to a series of real or alleged breaches of the Good Friday Agreement and failures of implementation to explain why weapons have not been put completely and verifiably beyond use. The Unionist political leadership will be blamed for its failure to lead. There is some truth in that, but it ignores the wider unease in pro-agreement unionism about the IRA's intentions.