5.

asked the Minister of the Environment if there has been any contact from the Government of the Irish Republic over its opposition to the nuclear reprocessing plant at Sellafield.

(AQO 506/01)

My Department has had no contact with the Government of the Irish Republic over its opposition to the nuclear reprocessing plant at Sellafield. The issue was raised at the plenary meeting of the British-Irish Council in Dublin on 30 November.

It has been agreed that the Sellafield issue should be considered by the environment sector of the British-Irish Council on the basis of a joint paper on Sellafield that the Irish and Manx Governments had previously agreed to prepare. I shall participate fully in those discussions and ensure that relevant Northern Ireland considerations are put forward. As the Member knows, neither I nor my Department has any jurisdiction over the operation or regulation of the Sellafield plant. Therefore, it would not be appropriate or productive for the Irish Government and the Northern Ireland Executive to deal with the issue bilaterally. The British-Irish Council provides a forum within which all Administrations with an interest in Sellafield can be represented.

The Minister will be aware, especially after last week's debate, that the issue is emotive. Can he point out any reliable scientific evidence that shows whether the mixed oxide (MOX) reprocessing plant represents a greater danger to Northern Ireland than existing dangers?

The MOX plant causes much concern, and we are keeping a close eye on emissions. However, as I said earlier, we have no power over that matter, other than to make representations on behalf of the people of Northern Ireland. I assure the Member that we shall watch the situation closely. The events of 11 September in America have created a fear that there will be an attack on a plant such as Sellafield. We shall make every representation that we can and do all that is within our power, and all that our permanent structure allows, to deal with that problem.

Go raibh maith agat, a LeasCheann Comhairle. Has the Minister been in contact with his counterparts in the Irish Government, particularly in the light of the cross-party concerns that were highlighted in the House last week about the welfare and health of the people on this entire island?

I re-emphasise that we are aware of this Administration's concerns and those of the Administration South of the border. We are willing to work with anybody for the benefit of all people where possible, but, as I have said, Sellafield is a matter for Her Majesty's Government, to which we shall make representations where and when we can. There is great fear about the MOX plant emissions, especially since the events of 11 September and the concerns that there are about nuclear security in America. I stress that I shall make what representations I can. The situation is difficult, and there are concerns abroad.

I welcome the fact that the Minister will keep the situation under surveillance. Will he tell us what specific measures his Department will put in place to ensure ongoing monitoring of the effects of the MOX plant in the coming months?

My Department arranges for the Centre for Environment, Fisheries and Aquaculture Science to take samples and analyse sea water, fish, shellfish, seaweed and sediments on the bed of the Irish Sea. That work has been ongoing since the early 1950s. Northern Ireland's results consistently reveal minimal amounts of radioactivity at levels that are consistent with normal background levels. Those results are published in the 'Radioactivity in Food and the Environment' annual report. They also appear in the Northern Ireland digest of statistics. People in Northern Ireland receive an average of 2,500 microsieverts of radiation a year from natural and artificial sources. Exposure to radon in the home accounts for 50% of that total, with 12% coming from medical exposure. Nuclear discharges account for less than 0·1%. A recent study undertaken in collaboration with the Radiological Protection Institute of Ireland and University College Dublin on radioactivity levels in Strangford Lough shows that the radiation dose from artificial radioactivity is of negligible significance.

6.

asked the Minister of the Environment what representations he has made to British Nuclear Fuels Ltd concerning the commissioning of the mixed oxide plant at Sellafield; and to make a statement.

(AQO 491/01)

I have made no representations to British Nuclear Fuels Ltd concerning the commissioning of the MOX plant at Sellafield. I acknowledge the concerns expressed about a range of potential safety risks from the operation of the MOX plant, which we have just referred to. As I said in last week's debate, my officials have written to their counterparts in the Department of the Environment, Food and Rural Affairs to seek confirmation that all relevant risks were fully taken into account in the MOX decision. Their reply pointed to those parts of the decision document that dealt with the safety, security, environmental and health issues, and, in particular, to the advice from the Office for Civil Nuclear Security. I have since written to Margaret Beckett, Secretary of State for Environment, Food and Rural Affairs, with a copy to Patricia Hewitt at the Department of Trade and Industry, seeking further information and assurance about the regulation of Sellafield and the security arrangements following the events of 11 September. I await their responses.

I shall also ensure that Northern Ireland considerations are fully taken into account when the environment sector of the British-Irish Council discusses the paper on Sellafield which is being jointly prepared by the Irish and Manx Governments. I assure everybody that my objective is to be fully satisfied that Northern Ireland's interests are sufficiently protected. To that end, I will convey to the Assembly as much of the information obtained in these exchanges as the constraints of national security will allow.

I thank the Minister for his response. It is the sixth response on Sellafield in the Chamber this afternoon, which is very welcome indeed. Will the Minister take on board the fact that there were two prerequisite elements for the licensing of the MOX plant that were not covered in his reply? First, the Health and Safety Executive had not reported before the licence was granted. Secondly, he completely omitted the economic case, which is also a requirement of the European Atomic Energy Community (EURATOM). That was omitted deliberately, because it is infeasible.

The Minister is the one person who can drive this on behalf of the House. Will he assure the House that he will be proactive in representing last week's debate and today's questions? He must ensure, in co-operation with all relevant parties, that the British Government are made fully aware. The strongest possible expression of discontent, to put it mildly, must be made to them, and we must be proactive.

I can assure Mr McGrady that, as far as we possibly can, we will make undoubted representations for the protection of Northern Ireland.

7.

asked the Minister of the Environment what consultation he has had with his ministerial counterpart in the National Assembly for Wales on the benefits of a statutory best value regime.

(AQO 498/01)

My Department has received papers from the Welsh Office on the best value process in Wales, including details of the plans to review that process over the next few months. I have also spoken to my counterpart in the Welsh Assembly, Edwina Hart, the Minister for Finance, Local Government and Housing, to learn at first hand what the review is likely to address. My understanding of the position is that the principles underlying the statutory framework for best value in Wales are not being questioned. Rather, the review will address details of its implementation and arrangements for its scrutiny. The broad objective of the review is to provide a workable model for best value in Wales that will give practical effect to the existing framework within current statutory provisions. Following a consultation process, the review group aims to have revised guidance in place by 1 April 2002.

The Local Government (Best Value) Bill currently before the Assembly includes five clauses that provide for a basic framework in the interest of council residents and ratepayers.

I hope that, after his consultations with his Welsh counterpart, the Minister will take this issue seriously and reconsider the process of introducing statutory best value to Northern Ireland, which he is currently engaged in. The Bill appears to be inappropriate at this time, and it does not have the support of the local authorities or the unions that represent those working in local authorities. It has already cost local authorities an immense amount of money. Much valuable staff time has been tied up in the operation of voluntary best value, and much more of that time - which could be put to better use - will be tied up in the operation of statutory best value.

I thank Mr Poots for his question, but I am not sure whether the sentiments expressed come from Edwin Poots MLA or Cllr Edwin Poots; he may wish to declare an interest.

Best value is designed as a framework within which councils should deliver local services according to the wishes of residents and ratepayers, at a price that they are willing to pay. People are entitled to know how their council is performing, how well their money is being spent and what future plans the council has for local services.

I am committed to avoiding the imposition of unnecessary bureaucracy on councils, but their views should not be given precedence over the rights and needs of ratepayers, residents and users of council services. Equally, the Assembly, with its preponderance of district councillors, should not allow its judgement to be clouded by the wishes of councillors at the expense of the views of local people, who deserve value for money and who are entitled to transparency and accountability in local service provision. Openness and transparency are vital elements of the Local Government (Best Value) Bill.

As Chairperson of the Public Accounts Committee, I am aware of the issues relating to accountability. Does the Minister agree that there should be a robust public accountability framework for local government, as there is for central Government? I declare an interest as a councillor, but I speak as Chairperson of the Public Accounts Committee.

I acknowledge the fact that the Member has declared an interest. I agree that there is a need for a robust public accountability framework for local government, but the application of best value across the wider public sector goes beyond my remit as Minister of the Environment.

Central Government already operates a type of best value framework. Indeed, in many ways, it is more rigorous than the best value framework that I propose for district councils. It includes the Programme for Government, public service agreements, published departmental and agency corporate and business plans, the work of the Northern Ireland Audit Office, value for money studies and the work of the Public Accounts Committee and other Statutory Committees of the Assembly. That accountability framework was designed for central government, and it would be too burdensome for local government as presently structured. The Local Government (Best Value) Bill, on the other hand, is designed to fit the specific circumstances of the local government sector.

I am aware that proposals for regulating best value in housing and education are being considered and that the Department of Education is drafting legislation covering the application of best value by education and library boards. Similarly, the Department for Social Development is examining proposals to formulate best value in the housing sector. My ministerial colleagues in the relevant Departments are responsible for the detail of those proposals, but I can assure Mr Bell that best value and accountability are seen as an absolute necessity.

8.

asked the Minister of the Environment if he plans to place contentious planning applications on hold until such time as the reform of local government is in place.

(AQO 504/01)

The Executive gave a commitment in the draft Programme for Government for 2002-03 to launch the review of public administration by spring 2002. The organisation of local government services will be considered in the context of that review, which will cover all aspects of the public sector and will be led by the Office of the First Minister and the Deputy First Minister. Good progress has been made, and we are on target to launch the review in spring 2002.

It would not be practical or lawful for me to place contentious planning applications on hold pending the outcome of the review. Once all material planning information relating to an application has been received and considered, my Department is under a legal obligation to determine that application. I have no powers to hold applications - contentious or otherwise - in such circumstances.

The Member may also be aware that article 33 of the Planning (Northern Ireland) Order 1991 gives applicants in all but major cases designated under article 31 of that Order the right to appeal to the Planning Appeals Commission on the grounds that his or her application has not been determined by my Department within the timescales laid down.

I thank the Minister for his answer, even though it may not be the one that I wanted. Does the Minister at least agree that his experiences as a local councillor show that the current planning system is chaotic? The review of local government could consider how to ensure that all planning cases could be considered on their merits. Individual planning applications should be dealt with according to the needs of the local area and the residents, which is not happening at present.

Our time is up. I ask the Minister to give his reply in writing.

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Programme for Government

While I have a lot of reservations about many aspects of the Programme for Government, as outlined by my Colleague, Eileen Bell, earlier in the debate, I welcome the decision by the Executive to prioritise, and I am thankful that health is now the number one priority for all. Despite the extra funding for the Health Service, waiting lists continue to lengthen. Bed blocking is also continuing to increase, and facilities for people with learning difficulties are being stretched to the limits. Cancer service problems and problems with other services must be tackled immediately. Our sick people deserve better, and with the funding that is going in, they expect better.

However, I am relieved that free nursing care is to be provided - the sooner, the better. I hope that the necessary legislation will come along shortly; we do not want to see any delays. There is real disappointment because free personal care is not being provided for. I appeal to the Executive to work extremely hard on that as soon as possible. One section of care is as important as the other, and this needs urgent attention.

There is deep disappointment that the Minister of Health, Social Services and Public Safety's request for funding for free digital aids for people with hearing difficulties has not, to my knowledge, been granted. Again, the disabled are left to suffer. If the Executive are to mean anything, they must listen and act as far as humanly possible to assist everyone to have confidence in the National Health Service.

There are many other concerns to do with health and other areas of daily living, and Eileen Bell spoke about some of them earlier. My party leader, David Ford, will shortly follow with what the Alliance Party feels needs in-depth attention. I support the amendment.

I support the motion and reject the amendment. This, the second Programme for Government, goes a long way towards addressing the Executive's stated priorities. It also makes a good stab at tackling divisions and inequalities in society. It goes a long way towards delivering the new beginning envisaged by the Good Friday Agreement. As the second home-grown Programme for Government agreed by the Executive, this is another extraordinary document and an extraordinary achievement.

I am not going to speak at great length. The debate has ranged across many wide areas, policies and services. One comment that the Deputy First Minister made earlier struck me and illustrates one element of this programme which is deeply frustrating. The phrase he used was "consultation fatigue". On page 29 of the Programme for Government the Executive have committed themselves to ensuring that

I can only assume that the implementation proposals are those contained in the report of the strategic review of the Ambulance Service, which was published last month by the Department of Health, Social Services and Public Safety. I use the words "consultation fatigue" because the implementation paper has "consultation paper" written all over it.

I will put the proposals in context: in 1998, the Department first set up a team to review the Ambulance Service. That review group reported on 25 February 2000 and then began a consultation exercise, which lasted until 30 June. It took until November 2000 to establish an implementation steering group. A year later, in November this year, that steering group published its implementation strategy. Four years since the review began the Minister still refers to it as a consultation exercise. I find that consultation fatigue is setting in, and that must also be the case for those who are failed, not by the ambulance staff and paramedics, but by the service and its organisation.

According to the current targets for response times, the Northern Ireland Ambulance Service should respond to 50% of all emergency calls within eight minutes, and to 95% of all emergency calls in the Eastern Health and Social Services Board area within 18 minutes, or within 21 minutes in the other three board areas. The Executive should take on board that the vast majority of my constituency, and of most rural constituencies, cannot be reached from a hospital or ambulance station within eight minutes.

A substantial portion of Northern Ireland cannot be reached within the 18- or 21-minute response time. Among those areas are the whole south Armagh border, from Cullaville to Crossmaglen, through Keady to Middletown, vast tracks of the Clogher Valley, including Augher, parts of Fermanagh, and, until recently, parts of County Down and County Antrim. In an emergency, large sections of our community cannot be reached within the agreed safe response times for ambulance provision.

Since the implementation proposals are mentioned so specifically in the Programme for Government, and since they have now been published, will the Executive get on with the job of implementing them? I am not asking for a single extra penny for this service. Reorganisation could achieve savings, while creating the response times and the emergency services that we all want.

Every other emergency service - such as the fire, police and coastguard services - is centrally funded. The Ambulance Service has 800 staff in four operational divisions, which work in four health board areas. The boards commission urgent ambulance services, and in the Eastern Health and Social Services Board area the eight local trusts commission the Ambulance Service. Why is the service not funded centrally in the same way as other emergency services? Imagine the layers of bureaucracy that could be bypassed, the money that could be saved and reinvested in the emergency appliances and the training of the specialist staff who man them.

My plea to the Executive is not to allocate money from a certain budget, nor to rewrite the Programme for Government. After almost four and a half years of consultation, I plead that they put an end to the dithering and implement, without further delay, what is clearly stated on page 29 of their programme.

In answer to my question of 3 December on the state of forward planning in relation to the review of public administration and the children's commissioner, Mr Durkan indicated that he had previously responded to questions about these matters. That is correct, but it does not mean that the responses were adequate. He should not therefore be surprised that I will be returning to those matters. They are matters of concern to the Committee of the Centre, and I hope that the Office of the First Minister and the Deputy First Minister understands that I will continue to raise them until they are dealt with satisfactorily.

In its response to the Office of the First Minister and the Deputy First Minister on the draft Programme for Government, the Committee of the Centre expressed concern about the approach to forward planning there and the lack of specific or measurable targets for a number of areas. The junior Ministers advised that it might not be possible to have quantified time-bounded targets in place in every case. This may help explain why the closest target we have been given for the launch of the review of public administration is spring 2002.

The House may be interested to note that according to the Collins English Dictionary spring is defined as the period from the March equinox to the June solstice in the northern hemisphere, or from the September equinox to the December solstice in the southern hemisphere. Given the lapse that has taken place, let us hope that the Office of the First Minister and the Deputy First Minister realise that we are in the northern hemisphere and not the southern and that we will have a review of public administration within the next six months.

We have already waited for two years for a review. It was a priority for the leader of the Ulster Unionist Party, Mr Trimble. When the eleven Departments were set up, we were told that a review would help offset the costs of having additional Departments. We should remember that Northern Ireland costs £80 million more to administer now than it did before the signing of the Belfast Agreement. Administration costs are much higher than they were pre-April 1998. That issue must be addressed.

In June the Committee of the Centre was advised of the main issues under consideration with regard to a review. Should the approach be strategic or overarching, or should it take the form of a series of independent departmental reviews of individual sectors? Should it cover all functions at local, sub-regional and central levels? Was the most appropriate mechanism for taking it forward internal, external or a combination of these? What principles should guide the direction of the review? Should it be one all-encompassing review, or a review of the principles of public administration followed by a series of linked reviews of different sectors? How should the timing be phased?

In June of this year consideration was still being given to what the terms of reference should be. I had hoped that by now we would have had those, but I have not been advised that this is so. The Committee was advised that it would receive a further report when progress was made on these issues. Members may be surprised to learn that no such report has yet been sent to the Committee. In view of the approach to forward planning taken by the Office of the First Minister and the Deputy First Minister, I am not surprised.

In paragraph 7.5 of the Programme for Government we are told that

In a press statement following a meeting of the Executive on 14 November, the public was advised that at that meeting the First Minister and the Deputy First Minister introduced a discussion paper on the review of public administration. When are the Assembly and, indeed, the relevant Committee going to be advised of the content of the discussion paper?

What progress, if any, has been made since June? This is one of the most important cross-cutting issues that the Assembly will have to tackle, and it is one that could deliver significant efficiency benefits and cost savings. As the Minister of Finance and Personnel proposes a significant rise in the regional rate and one considers the additional burden that has been put upon ratepayers, a review of public administration will show where £4 million of savings, which would keep the rate rise to the level of inflation, might come from.

The way in which the Office of the First Minister and the Deputy First Minister has handled that does not inspire me with confidence. If that is its approach to such a vital task, how can the Assembly be assured that it will deliver on the other important cross-cutting issues set out in the Programme for Government, such as the community relations strategy and the victims strategy, both of which have slipped from the original dates that were set for them.

The Committee of the Centre and many Members attach a great deal of importance to the appointment of a children's commissioner. Sub-priority 4 of section two of the Programme for Government says that the Executive aim to protect children's rights, meet children's needs and include children's voices. The Programme states that

No Members would disagree, but the Programme for Government sets June 2002 as its target for the appointment of a children's commissioner. The Committee of the Centre carried out an inquiry into the appointment of a commissioner earlier this year. The Committee's report was debated and approved by the Assembly on 26 June. In responding to the debate the junior Minister said that

He advised that the legislation should be introduced to the Assembly early in the new year. I understand that that may happen in February. Even allowing for a smooth passage through all the stages, it is likely to take three to four months for the Bill to go through the Assembly, and it may be May next year before the legislation is finally in place. Can the Ministers explain how a children's commissioner will be in place for June 2002? Will they also confirm if the appointment will be made in accordance with the procedures for public appointments? Will the Ministers explain why they continue to set unrealistic targets in the Programme for Government that unfairly raise the expectations of the public - particularly the expectations of the most disadvantaged and vulnerable groups and individuals in society?

Some concerns about the equality impact assessment on the Programme for Government were drawn to the Committee's attention. Paragraph 1.11 of annexe D states that the Executive recognise that much of their work

and that they are

However in paragraph 1.9 we are advised that

Reliance is instead to be placed on the individual equality impact assessments carried out on various policies.

That approach has various weaknesses. It will not pick up the impact of combined policies; it will not identify ways to promote the equality of opportunity through joined-up Government; and it places particular emphasis on the quality of individual assessments - and the Committee of the Centre has drawn the Office of the First Minister and the Deputy First Minister's attention to deficiencies there. The equality impact assessments identify adverse impact rather than focus on positive ways to promote equality of opportunity.

Will the Office of the First Minister and the Deputy First Minister reflect on those comments and consider if there is any way in which the deficiencies in its approach can be addressed?

Go raibh maith agat, a LeasCheann Comhairle. The Health Service is in crisis because it has had no one to care for it. At last, we have a Minister who knows what she is doing and who is slowly but surely evaluating the performance of all the separate parts of the Health Service - hospitals, primary care, ambulances, health promotion and education.

However, there are two fundamental facts that we cannot change in the short term. The Health Service has been starved of hundreds of millions of pounds over the past 30 years. The Thatcherite agenda has created a culture of bureaucracy. The internal market and the trusts have taken money from front-line services; an added complication is the lack of nurses and doctors.

At last, the Executive have begun to respond to the Minister's demands for more cash. They have had to; across every political party and throughout every community the demand was clear - give the Health Service more money. However, we must be careful, now that we are taking faltering steps, that we do not demand the unreasonable.

The motives of the motion are very clear, but much more spend would be invisible and improvements slow. Junior doctors are working more civilised hours - and they are safer. However, productivity has been cut. Registrars no longer operate alone; surgeons supervise them - again a cut in productivity.

One of the problems is that politicians cannot wait; they will not let the changes be explored and bedded down and allowed to work. The scale of the long-term underfunding cannot and should not be underestimated. During the lifetime of the Assembly, Mr Durkan has allocated the Minister only a fraction of the resources that she has bid for. This is the responsibility of the Executive.

The trusts that were created to facilitate the internal markets have also had considerable problems in managing their budgets. It is true that a portion of new money, in some cases, has gone to meet health trust defects. Go raibh míle maith agat.

I do not propose any radical changes to the programme. Clearly, any programme necessitates choices, but it also involves good housekeeping to ensure that the public gets value for money.

Since the end of direct rule, the Public Accounts Committee has dealt with several disturbing reports prepared by the Comptroller and Auditor General that clearly show that in the past, and particularly during direct rule, the public did not get good value for money - far from it. The Minister has clearly said that there will be no tolerance of Departments that do not clearly demonstrate that they have managed their finances well, and of course this is most welcome. However, much public expenditure is not controlled directly by the Departments but by a whole variety of quangos, and here the public auditor has produced several highly disturbing reports that show that there has been little regard for proper accountancy practices.

Since the last report on the Programme for Government there have been important improvements to how spending of public finances is recorded and accounted for; I refer of course to the Government Resources and Accounts Act (Northern Ireland) 2000.

I would welcome an assurance from the Minister that he will leave no stone unturned in his determination to clean out all bad practices in how public money is expended. Ultimately, this can only mean that the public will get more services within the constraints of the resources available. I would go further and ask that we do all that we can to measure the quality of the services provided and to ensure that where serious deficiencies exist they are rooted out without delay. However, I should like to see recognition for success.

To date, it has not been shown that there is a quick response to unnecessary waste or a fast track to stem it. I would welcome an undertaking from the Minister that the findings of the public accounts reports will be much more than historical records of past events and are in fact alarm bells for all that there is no tolerance of waste or of substandard service being delivered to the public.

The public will judge the success or failure of the Assembly by the way in which we conduct our income and expenditure and the level of service we provide. It must be clearly understood that the bad practices that crept in during direct rule are gone forever.

While every Department has a genuine case for claiming to be underfunded, there is little doubt that the one single area of local government most in need of investment is the Health Service. No other area of local life has seen such decline over the past few years, and the challenge must be met head-on to prevent further disintegration of healthcare across the Province.

The provision of cancer care requires urgent financial assistance - the local service is rated as one of the poorest in Europe. It was encouraging to hear last week's announcement that an extra £41 million is to be ploughed into the Health Service. It has, however, been acknowledged that that may not be sufficient to maintain the level of healthcare currently required. While it is not all that we wanted, it must be of some comfort to patients whose treatment has been postponed or suspended. I am glad that £12·4 million of that provision is to be allocated to the coronary and cancer fields. The Programme for Government states categorically that there will be a focus on modernising and improving hospital and primary care services to ensure more timely and effective care and treatment.

The current state of our cancer services is exacerbated by the state of the equipment and machinery being used to deliver the services. It is old, outdated, inefficient and in need of urgent replacement. It is with horror that I note that there is not one single reference to investment in cancer care services in the programme. There are only two references to the disease - one in section 3.2, where it states that

A second reference is to the demand for essential drugs in the fight against cancer, in paragraph 3.6. Providing access to cardiac surgery for an additional 150 people by March 2003 is referred to, yet there is no mention of the provision for cancer care. I find that illogical, indefensible and ill thought out. Last year, 31% of eligible women had not had a cervical screening test in the previous five years, and 28% of women aged between 50 and 64 had not had a breast screening test in the previous three years. Primary care services vigorously promote the concept of healthy living but lack both the finance and the resources to enable that goal to be fulfilled.

The Health Service must be able to provide rapid diagnosis followed by speedily planned and implemented treatment and support for patients. As things stand, patients are all too often forced to wait too long to see a specialist, delaying diagnosis and treatment. That delay and the inefficiencies of cancer equipment are causing untold and unnecessary anxiety for patients. It does not maximise the potential of the Health Service to treat conditions properly.

People often have no option but to travel to Belfast for treatment, rather than be treated locally, thus adding to their stress. At present there are no haematologists in the Western Board area, and that forces patients to travel to Belfast. The recent resignation of a radiologist at Antrim Hospital has caused delays in diagnosis. Attracting and keeping qualified staff is an ongoing difficulty. Better financial support across the Health Service would benefit many needy people. That must be addressed.

I am also disappointed to note that there is no reference in the Programme for Government to investment in maternity services. Following the farce that was the review of maternity services in Belfast, it is incredible that there is no mention of the new maternity hospital.

I am glad that the Department has finally realised that failure to provide adequate aftercare services has resulted in the system backing up to the point at which ambulances have had to be used for patients in accident and emergency departments. More than 70 beds in the Ulster Hospital are being used by patients who should not be in hospital. The lack of community care services continues to be the reason for bed blocking, not only in the Ulster Hospital but throughout the Province's acute hospitals. More than 12 patients waiting for operations on life-threatening brain tumours were forced out of the Royal Victoria Hospital for the same reason. Until that problem is properly addressed, services will stumble from one crisis to another.

The long-term care of the elderly is an issue that has gathered great momentum over the past few weeks and months - rightly so. Elderly citizens in Northern Ireland must stand idly by as services in Scotland, England and Wales are enhanced. The Health and Social Care Act 2001 splits care into two parts: nursing care and personal care. In England, residents will not receive funding for personal care, but they will receive up to £35, £70 or £110 per week for nursing care, depending on individual circumstances. In Wales, all residents qualify for £90 per week for nursing care, but, again, they do not receive assistance for personal care. In Scotland, residents receive up to £65 per week for nursing care and up to £90 per week for personal care, while all personal care is free for those living at home.

We should compare all that to what is provided in Northern Ireland - absolutely nothing. Residents of Northern Ireland receive zilch for nursing care or personal care. Although the Department appears to be committed to free care in principle, it was forced to admit that it could not afford to provide that assistance. In any case, that commitment relates only to nursing care and not to personal care, which constitutes the bulk of care costs.

The elderly in this country have been relegated to the status of second-class citizens. Although the commitment to provide free nursing care by October 2002 is welcome, elderly citizens are not best served by having the cost of care split into nursing and personal sections. The state should be responsible for nursing and personal costs. Until such times, elderly citizens will get a bad deal from the Assembly. I hope that Ministers will take those views on board.

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