5.

asked the Minister of Education to detail the number of pupils who took examinations at AS level last year.

(AQO 386/01)

The only information that is currently available relates to candidates who took GCE AS levels with the Council for the Curriculum, Examinations and Assessment (CCEA). There were 9,561 such candidates, including students at further education colleges, with a total of 19,104 subject entries.

There was a good deal of confusion last year among the public, schools and some of the examination boards. Will the Minister consider taking any steps to prevent a repetition of such confusion this year - particularly as the AS level examinations will be accompanied by the introduction of examinations at A2 level?

On 12 September, I announced new arrangements that will benefit all concerned, both in the number of modular examinations that are taken and in the reduced possibility of timetable clashes. Pupils will now be able to take all the written examination requirements of a full AS level in a single half- day session of up to three hours, instead of a possible four and a half hours in separate sessions. That will mean fewer examinations and, therefore, less chance of timetable clashes.

Further work from the CCEA and the Qualifications and Curriculum Authority (QCA) has been commissioned. I will consider what further action is required on receipt of those reports, which are due to be completed by the end of December.

Go raibh maith agat, a Cheann Comhairle. What other action might the Minister take to deal with concerns from parents and pupils regarding AS levels?

As I said in my previous answer, I have already announced new arrangements that will benefit everybody concerned. We have looked carefully at the way that AS levels have been managed. They are a comparatively new development. We would have been surprised if there had been no initial hiccups or difficulties to be addressed. We have certainly addressed the problems that have been brought to our attention. Problems have been created, not least for pupils, parents and teachers.

The steps we have taken, however, will serve to alleviate those difficulties, and we hope that the problems of the last year will not be repeated.

The Minister answered part of my question, but I will ask it nevertheless. Will he take steps to ensure that one age cohort is not singled out and used repeatedly for future educational experiments?

We are not interested in experimenting with our children. They are too precious a resource. However, we will certainly look - as we do on all occasions - at the particular problems and difficulties which beset us in education. In whatever decision we take, we will ensure that any problems present are overcome.

6.

asked the Minister of Education to outline the timetable for the announcement of schools capital expenditure.

(AQO 396/01)

I hope to announce the schools capital programme in March 2002, following consultation with the Education Committee.

Will the Minister give the Assembly an assurance that when proposals are brought forward next year we will not see the same imbalance as that in evidence over the last two years? Two years ago the ratio of capital spend between the maintained and controlled sectors was 3:1. Last year it was 2:1. Can he assure us that this time there will be an even spread of money?

Perhaps while he is at it the Minister could explain to the House how Members can accept any assurances from him, given yesterday's revelations that he was engaged in handing out bombs to youngsters in Londonderry and organising the murder of a schoolteacher.

Order. The Member put a supplementary question, the second part of which did not relate to the original question.

Some journalists do not let the truth get in the way of what they consider to be a good story.

Concerning the first issue raised by Mr Wilson, I say categorically that the allegations he made were untrue and unjustified. I have consistently maintained that the schools capital building programme is determined by educational needs, be they in controlled or voluntary schools or in any other schools sector. The make-up of last year's conventional school building programme was six Catholic maintained school projects, costing £25·7 million; 10 controlled school projects, costing £24·1 million, including two special schools which were the capital priorities of two education and library boards; and one grant maintained integrated school project, costing £12·5 million. In addition, provision was included for eight secondary projects with a total capital value of approximately £70 million under public-private partnership, and those are grouped under three separate contracting authorities. The Trustees of Catholic Maintained Schools in the Derry diocese have been allocated £34 million, the North Eastern Education and Library Board, £15 million and the South Eastern Education and Library Board, £21 million.

I accept that the Minister will wish to reserve his right to deal with the detail of his capital expenditure plans in accordance with his Department's timetable. However, will he assure me that projects where a clear need has been identified, or where a site has been purchased and an economic appraisal completed, will receive priority? The new buildings for Loanends Primary School in my constituency of South Antrim are an example, particularly because the board of that school hoped to be among the new starts for the last financial year.

I certainly appreciate the concerns of schools and their authorities who have advanced their projects by completing an economic appraisal. My point of view, and that of the Department of Education, has always been that that is a prerequisite of ensuring a school's eligibility for a place in the programme. Projects must be supported by an economic appraisal and be at a suitable stage of planning.

Projects are selected according to educational need, not the length of time that they have spent on the schools' planning list.

How will the Executive's commitment to measures such as rural proofing, equality and social inclusion influence the Minister's decisions on the new starts programme for 2002-03? It will come as no surprise to him if I refer to the areas that I represent. St Patrick's Grammar School, Downpatrick, has waited for 18 years; its counterpart, Assumption Grammar School, Ballynahinch, is on the waiting list, and the rural Mourne area of Moneydarragh is in urgent need of a new primary school. How can those specific examples be brought into line with rural-proofing and social-inclusion commitments?

Under the new starts programme, available capital resources are directed at the highest- priority cases, based on educational need. That encompasses the areas of social inclusion and equality, and ensures that rural communities have access to a network of strong rural schools. The Department of Education's equality scheme provides for the school building programme to be subject to an equality impact assessment in the next financial year.

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Health, Social Services and Public Safety

1.

asked the Minister of Health, Social Services and Public Safety if she has any plans to increase rehabilitation facilities for those in the north- west with head injuries; and to make a statement.

(AQO 381/01)

Choimisiúnaigh mo Roinn an Cuibhreannas Réigiúnach Seirbhísí Míochaine le moltaí a fhorbairt do sheirbhís gortuithe inchinne. Tá feidhmiú a mholtaí á thabhairt ar aghaidh ag na ceithre bhord seirbhísí sláinte agus sóisialta, agus aird á tabhairt ar riachtanais mheasta a ndaonraí agus na hacmhainní atá ar fáil. Tugann Bord an Iarthair le fios gur fhorbair sé straitéis le frestal ar riachtanais daoine fásta le gortú inchinne agus go bhfuil sé i mbun a fheidhmithe.

Go dtí seo tá cúig leaba tiomanta ag an bhord i dTeach Spruce i gcomhair measúnú, athshlánú agus cúram faoisimh míochaine do dhaoine le gortú inchinne, agus tá seirbhísí pobail á bhforbairt trí sholáthar fhoireann athshlánaithe pobail ildísciplíneach.

The Department of Health, Social Services and Public Safety commissioned the Regional Medical Services Consortium to develop proposals for a regional brain injury service. The four health and social services boards are addressing the implementation of its recommedations by considering the assessed needs of their populations and the available resources.

The Western Health and Social Services Board has developed a strategy to meet the needs of adults with brain injury and is in the process of implementing it. To date, the board has committed five beds in Spruce House to the assessment, rehabilitation and respite medical care of people with brain injuries. Community services are being developed through the provision of a multi-disciplinary community rehabilitation team. A neuropsychologist and a social worker have been appointed. Funding has also been made available to facilitate the development of other specific community rehabilitation services in the Foyle Health and Social Services Trust and the Sperrin Lakeland Health and Social Services Trust.

I thank the Minister for her response. I was also referring to those young people who are paralysed by a serious head injury. Unfortunately, no treatment facilities exist in the north-west. I know of young men aged 22 and 23 who receive treatment 75 miles from their homes. Members can imagine the extra expense that those families incur should they wish to visit their sons every day. Moreover, there is the added problem of where those people will be treated once they go home. That is a problem for many of my constituents, and I would like the Minister to address it.

I was about to ask the Member whether she was coming to a question. I presume that the question is whether the Minister will look at the issue.

All boards are developing multidisciplinary community brain injury teams in keeping with the findings of the Regional Medical Services Consortium. The need for further community provision is constantly under review, and services are developed as funding permits.

What action is being taken to prevent or reduce head injuries?

Prevention is a major part of the Executive's health and well-being priority area, as we strive to improve the population's health. Males are four times more likely to receive brain injuries than females, and the peak age for such injuries is 15 to 25 years. A third of those injuries are associated with alcohol, and road traffic accidents account for 60% of such cases. The Executive are advancing the cross-departmental drug and alcohol strategy. Public drink-driving campaigns target young males, in an attempt to reduce road traffic accidents, which are the main cause of head injuries in that at-risk group.

2.

asked the Minister of Health, Social Services and Public Safety to make a statement on the proposed withdrawal of maternity services from the Downe Hospital.

(AQO 398/01)

Is eol domh gur cúis imní í forbairt chritéir aistrithe ardphriacail ag aonad Otharlann an Dúin.

Mar sin féin, féadaim a dhearbhú don Chomhalta gur chuir mé in iúl do Bhord an Oirthir agus do Iontaobhas an Dúin Lios na gCearrbhach go gcaithfear gach iarracht a dhéanamh le próifíl seirbhíse Ospidéal an Dúin a choinneáil, ag brath ar chinní a ghlacfar mar gheall ar thorthaí athbhreithniú na n-ospidéal géarchúraim. Is eol domh gur ghlac an bord agus an t-iontaobhas céimeanna suntasacha le haonad máithreachais an Dúin a chothabháil.

I am aware of the concerns that have arisen from the development of high-risk transfer criteria at the Downe Hospital unit. However, I can assure the Member that I have made it clear to the Eastern Board and the Down Lisburn Trust that every effort must be made to sustain the current service profile of Downe Hospital, pending decisions made following the acute hospitals review. I am aware that the board and the trust have already taken several significant steps to maintain the Downe maternity unit.

Why did the Eastern Health and Social Services Board carry out a further assessment of service in only the Downe Maternity unit, after it had carried out a risk assessment for all the maternity units in the board area last year? Why, following that, did it issue further instructions to staff on criteria for determining high-risk maternity cases? Go raibh maith agat.

All maternity units in the Eastern Board area were advised to formalise their criteria for high-risk transfers in 1999. Lagan Valley Hospital completed the work in 1999 and implemented the criteria for admissions to the unit. I have been advised that no further assessment was carried out at the Downe Hospital. The Downe maternity unit did not finalise its criteria in 1999 and requested an extension until September 2001. The Mater Hospital is in the process of finalising its criteria. I understand that transfer criteria have been introduced at Lagan Valley Hospital and that a revision of risk criteria is nearing completion at the Mater Hospital's maternity unit. Trusts are required to review risk assessments in all maternity units continually, and the screening of referrals at the Downe maternity unit was examined as part of that process.

I thank the Minister for her assurance about the continuing delivery of good maternity care in Downpatrick, but how could she allow a small number of centralised professionals to continue to threaten the provision of maternity and other acute services in our area? Is she content that she and the Department should continue to follow the diktat of those key professionals?

In my main answer, I signalled my clear intention that every effort would be made to sustain the current service profile of all hospitals, pending decisions made following the acute hospitals review. The board and the trust have already taken steps to sustain the Downe maternity unit. Arrangements involving anaesthetists from Belfast have been introduced to maintain a robust anaesthetic service at the Downe Hospital, and those are reported to be working well. Five extra theatre nurses have been appointed to assist with the 24-hour anaesthetic rota, and the training programme for midwives has been reviewed so that all midwives are now offered the opportunity of advanced life support training.

Those measures demonstrate a clear commitment to sustaining maternity services at the Downe Hospital - that commitment is evident in the work of all the professionals in that unit. As a result of anaesthetists' concerns, in January 2001 the Down Lisburn Trust asked the board to arrange for the high-risk pregnancy group to complete its work on the screening of referrals to the unit as soon as is practicable. However, that work was undertaken in the context of an ongoing risk assessment initiated in all units in the board area in 1999.

3.

asked the Minister of Health, Social Services and Public Safety when she will make her formal response to the Hayes report on acute hospitals services; and to make a statement.

(AQO 374/01)

12.

asked the Minister of Health, Social Services and Public Safety to detail the number of responses to her consultation on the report of the acute hospitals review group.

(AQO 384/01)

Le do chead, a Cheann Comhairle, glacfaidh mé ceisteanna 3 agus 12 le chéile mar go mbaineann siad araon le tuairisc an ghrúpa athbhreithnithe ar ospidéil ghéarchúraim. With your permission, Mr Speaker, I shall answer questions 3 and 12 together, as they both relate to the acute hospitals review group report.

Tháinig an tréimhse chomhairliúcháin ar an tuairisc chun críche ar an 31 Deireadh Fómhair. Fuarthas isteach agus amach le 60,000 freagairt scríofa. Áirítear orthu sin thart ar 24,000 cárta poist agus litir ag tacú leis an chás go mbeadh ospidéal géarchúraim san Ómaigh, thart ar 35,000 ag tacú le hospidéal géarchúraim in Inis Ceithleann agus thart ar 500 ag tacú le soláthar seirbhísí géarchúraim in ospidéil áitiúla eile. I ndiaidh torthaí an phróisis chomhairliúcháin phoiblí a bhreithniú agus plé a dhéanamh le Comhghleacaithe ar an Choiste Feidhmiúcháin, is féidir moltaí ar an bhealach chun tosaigh a chur faoi chomhairliúchán. Tá súil agam bheith i riocht cinní a fhógairt i rith 2002.

Consultation on the report ended on 31 October. Some 60,000 written responses have been received, including about 24,000 postcards and letters supporting the case for an acute hospital in Omagh, around 35,000 supporting an acute hospital in Enniskillen, and around 500 supporting the provision of acute services in other local hospitals. Following consideration of the outcome of the public consultation process and discussion with Executive Colleagues, proposals on the way forward can be put out for consultation. I hope to be able to announce decisions in 2002.

There is concern in many areas - particularly rural areas - about the extended delay in the consideration of the Hayes report. Although the consultation period has just expired, I urge the Minister to bring forward the expected date of the departmental response, particularly in the light of the answer that she has just given about the Downe Hospital, because the maternity unit and the acute hospital are interdependent. The Minister does not seem to understand what is happening on the ground, despite a letter sent to her on 4 October by the Royal College of Midwives. It advised that, unless immediate action is taken on the maternity issue, the Downe Hospital will be closed, because new criteria introduced six weeks ago, without reference to any other Department or hospital, will be implemented in Downpatrick with discrimination.

Does the Member have a question? That seemed to be a statement.

I asked the Minister when she will bring forward the review of the review of the review, so that the maternity unit that she was so concerned about can be saved and does not cease to exist before the review is completed.

The issues involved are far-reaching, as illustrated by the many responses to the consultation. They affect many people, who have a right to have a say in decisions that affect their lives and shape their services. Indeed, the major scope and scale of the matters involved are such that they go far beyond the remit of my Department, and the way forward must be considered by the Executive. Under statutory equality duties, the equality implications will be subject to assessment and consultation.

Were I to move forward without taking any of those steps, I am sure that the Member would be the first to draw to my attention the need to do otherwise. Officials will now examine and analyse the responses, and the Executive must do likewise. We hope that proposals on the way forward can then be put out to consultation as soon as possible.

I thank the Minister for the figures that she has given us. They reflect the high level of concern in the Fermanagh and Omagh areas about the provision of acute hospital services. In view of that, will the Minister give an undertaking to the people in both areas that services will be retained in those hospitals at their current levels, while we await her decision on the location of a new hospital for the south-west?

I have signalled that I expect the current profile of services in hospitals to be maintained, and I expect boards and trusts to make every effort to ensure that they are maintained pending decisions following the outcome of the report of the acute hospitals review group. My officials are in constant contact with the Western Health and Social Services Board and both trusts to ensure that any interim difficulties arising in the trusts can be looked at urgently, as is being done in other board areas.

When will the acute services at the Ulster Hospital be upgraded? How can a service be delivered when the local hospital trust has been told that the number one priority is to break even, and not to spend over its budget? If this continues, there will be deaths, which will be down to the inability and unwillingness of the Minister and her Department to get on with the job. Will the Health Department remove the break-even criteria?

I am not certain that the question is specific to the matter being discussed.

Go raibh maith agat, a Cheann Comhairle. I will have to learn this new trick of asking two supplementaries in one question. Have the Executive had any opportunity to discuss the financial implications of the Hayes report?

It is for the Executive to decide what will be on their agenda. However, it is clear that the Executive are aware of the considerable resource implications, given the amount and the scope of the recommendations made in the acute hospitals' review. The Executive will have to examine the issue, and the financial and serious resource implications will have to be taken on board. It is not possible to say exactly when this will take place. The substantial volume of responses is being analysed by officials, and meetings are being arranged with those who asked to meet with me before the consultation period ended.

4.

asked the Minister of Health, Social Services and Public Safety what steps she has taken to deal with prescription fraud.

(AQO 391/01)

Tá tosaíocht á tabhairt ag mo Roinn do thabhairt faoi chalaois díolúine oideas agus is cuid é de mhórchlár gníomhaíochta le cur i gcoinne calaoise, is cuma cé acu daoine as an phobal nó liachleachtóirí a dhéanann é. Tugadh faoi mhéid suntasach oibre cheana féin agus táthar i mbun troda i gcoinne chalaois oideas. Mar shampla, tugadh isteach seiceálacha pointí dáilte, bunaíodh aonad tiomanta frithchalaoise in Eanáir na bliana seo le díriú ar phríomhréimsí na mí-úsáide díolúine, agus le 18 mí anuas tugadh níos mó ná 120 duine tríd an Chúirt Mhionéileamh leis na muirir oideas a seachnaíodh a ghnóthú.

Tackling prescription exemption fraud is a priority of my Department, and part of a major programme of action to counter fraud, whether perpetrated by members of the public or practitioners. Significant work to combat prescription fraud is ongoing. For example, points of dispensing checks have been introduced, and a dedicated counter-fraud unit was established in January 2001 to target the main areas of exemption abuse. Over the last 18 months more than 120 members of the public have been taken through the small claims court procedure to recover the prescription charges evaded.

Next year the Department intends to introduce fixed penalty fines of up to £100, to penalise those who fraudulently claim exemption from prescription payments. Individuals who have been found to have repeatedly evaded payment of prescription charges could be prosecuted and fined up to £2,500. Those measures represent a major advance in deterring members of the public from fraudulently claiming exemption from payment of prescription charges thereby securing additional resources for the Health Service.

How much money has been earmarked to carry out those procedures? How much money will be saved as a result of those procedures in the coming year?

I cannot tell the Member the precise cost of carrying out those procedures. That will depend on how long the procedures take and whether the payment is forthcoming immediately or has to be pursued through a small claims court, for example. It is estimated that in the 2000-01 financial year some £9·5 million was lost to the Health Service on account of false claims of exemption from prescription charges. During the same period, income realised from prescription charges was £10·1 million. The annual loss due to prescription exemption fraud has decreased from £11 million, in 1999-2000, to £9·5 million in 2000-01. However, those figures do not reflect the full impact of the counter-fraud unit, which became fully operational in January 2001.

Go raibh maith agat, a Cheann Comhairle. What is the role of the counter-fraud unit?

The counter-fraud unit, which is based in the Central Services Agency, has a dual remit. It is responsible for the detection and follow-up of exemption fraud cases. It is also responsible for the investigation of cases of suspected fraud by the public and by practitioners.

The figures that the Minister quotes are staggering. How do figures relating to prescription fraud in Northern Ireland compare with those for other regions in the United Kingdom?

The Department does not have comparable figures for incidents of prescription fraud. In Northern Ireland the rate of prescription exemption claims, including prepayment certificates, is 90%. That figure compares with 90% in Scotland and 85% in England.

5.

asked the Minister of Health, Social Services and Public Safety to detail arrangements to ensure that adequate and appropriate resources are made available for occupational therapy for children in special-needs assessment centres.

(AQO 377/01)

Is faoi na hiontaobhais agus na boird seirbhísí sláinte agus sóisialta atá sé a chinntiú go gcuirtear teiripe shaothair ar fáil le freastal ar riachtanais mheasta leanaí ina limistéir, agus aird á tabhairt acu ar na hacmhainní atá ar fáil dóibh. In Aibreán 1999 leithdháil mo Roinn £400,000 athfhillteach orthu do sholáthar breise teiripe do leanaí réamhscolaíochta agus in aois scoile.

I mbliana, bhunaigh mo Roinn comhghrúpa oibre le feidhmeannaigh ón Roinn Oideachais le breithniú a dhéanamh ar an tacaíocht teiripe a theastaíonn ó leanaí le riachtanais speisialta agus an bealach is fearr leis an tacaíocht sin a sholáthar. Cuideoidh obair an ghrúpa cainníocht a dhéanamh ar na riachtanais nár freastaladh orthu go dtí seo, agus eolas a thabhairt ar spriocdhíriú, pleanáil agus forbairt seirbhíse na seirbhísí teiripe, teiripe shaothair san áireamh. Tá an grúpa ag fiosrú deiseanna chomh maith do thionscadail phíolótacha cómhaoinithe le soláthar seirbhíse a mhéadú.

It is the responsibility of health and social services boards and trusts to ensure that appropriate occupational therapy is provided to meet the assessed needs of children in their area, within available resources. In April 1999, the Department allocated them an additional £400,000 of recurrent funding to provide extra therapy for children of pre-school and school age. This year the Department established a joint working group with officials from the Department of Education to consider the therapy support required by children with special needs, and how that can best be provided. The work of the group will help to quantify unmet need and to inform service targeting, planning and the development of therapy services, including occupational therapy. The group is also exploring opportunities for joint-funded pilot projects to enhance service provision.

I thank the Minister for her detailed answer. Would her Department check the situation at Greenwood House Assessment Centre? The full-time occupational therapist there is due to go on maternity leave, but no replacement has been put forward yet. The assistant occupational therapist is not qualified to make assessments or reports and will return to Musgrave Park Hospital after Christmas. The centre will not be able to offer any occupational therapy services, thus denying children their legal right to receive special-needs education.

I will examine the issues raised by the Member. Had she wanted to include that much detail in the question, it would have been open for her to do so. The recruitment and retention of staff involve other issues. Boards and trusts seek to address the wider issues at all times and, at any given time, the specifics of the availability of trained staff in their centres.

The University of Ulster has increased from 50 to 60 the annual intake of students for its occupational therapy course. My Department is carrying out a comprehensive review of health and social services workforce planning to identify further measures that need to be taken to address specific issues in particular specialisms. The review will be completed next year.

Go raibh maith agat, a Cheann Comhairle. In the light of the additional funding allocation to the boards, what action are health boards taking to address service deficits in their areas? We could all stand up at Question Time and ask questions about problems in our own areas; I thought that questions were supposed to be general.

It is open to Members to put specific questions or general questions. However, there is a convention in other places that if Members intend to ask a specific question as a supplementary they contact the Minister in advance so that a reasonable response may be given. It is easy to ask a general question, and to then home in on a specific point, but there is little purpose in that if a proper answer is required from the Minister - and that is the case for any Minister. The convention applies not just to Question Time, but in other contexts where a specific answer is requested of a Minister. On occasion, something unusual will arise, but if it is a Member's intention to ask a supplementary, or a specific question in other contexts, the convention elsewhere is to give the Minister some notice. That makes an immediate reply a much easier prospect. I call the Minister to reply to the supplementary.

Health boards are taking specific actions to address existing identified pressures in their areas. As the pressures in board areas will not be identical, the measures and specific actions undertaken will be different.

The Eastern Health and Social Services Board is carrying out a review of occupational therapy services, including provision to children. The Southern Health and Social Services Board has secured Executive programme funding for a wrap-around pilot scheme to address the needs of children with disabilities. The Northern Health and Social Services Board is reviewing the health and social care needs of children with disabilities who are attending mainstream schools, and has just completed a review of the healthcare needs of children with life-limiting conditions. The Western Health and Social Services Board carrying out a review of its professions allied to medicine services.

6.

asked the Minister of Health, Social Services and Public Safety what action has been taken to increase the number of neurosurgeons in the Eastern Health and Social Services Board area in general, and in the Royal Victoria Hospital in particular; and to make a statement.

(AQO 400/01)

Tá cúigear néarmháinlia comhairleach fostaithe ag Iontaobhas Ghrúpa na nOspidéal Ríoga. Soláthraíonn siad seo iomlán na seirbhísí néarmháinliachta ar fud cheithre limistéar boird.

Tá tacaíocht ag na comhairligh faoi láthair ó dhá shainoiliúnaithe. Tháinig folúntas i gceann de na poist sainoiliúnaithe le gairid agus táimid ag súil go gcuirfear dlús le hionadaí a fháil. Forálfaidh cothabháil thrí phost sainoiliúnaithe d'fholúntais comhairleach a thiocfadh chun cinn amach anseo trí scor ón obair nó trí bhunú post breise.

Five consultant neurosurgeons are employed by the Royal Group of Hospitals Health and Social Services Trust. These provide the totality of neurosurgical services across the four board areas. The consultants are currently supported by two specialist trainees. One further specialist trainee post has recently fallen vacant, and we expect replacement to be expedited. Maintenance of three specialist trainee posts will provide for future consultant vacancies arising through retirement or the establishment of additional posts.

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