In previous discussions in the Chamber on the Health Service, I have said that the most important people are the users of the service. On this occasion, I am sure that everybody agrees that the direct needs of those for whom the cancer service exists - the patients - must be uppermost in our minds.

Time and again, in submissions to the Committee, individuals strongly expressed their desire for the development of a patient-centred cancer service, with the threefold purpose of early diagnosis, prompt referral and early consultation. On early diagnosis, much greater emphasis must be placed on heightening public awareness about the symptoms of cancer. Information on the symptoms must be presented in an easily understood format. Urgent diagnosis will lead to patients being admitted to hospital for immediate treatment or being placed on a waiting list for non-urgent treatment. Screening is a vital tool in the early detection of the disease and contributes to improved survival rates.

The breast screening programme was mentioned. It has contributed to the best survival rates in the UK. However, we must do more, especially in educating the public and in targeting the uptake of screening programmes among the poorer people in the population, because it is there that uptakes are well below average and cancer rates are at their highest.

There is scope for the Health Promotion Agency, together with the health action zones and primary care professionals, to promote greater public awareness in the areas of highest deprivation.

With regard to referrals, the Campbell Report indicated an expectation of a two-week deadline between GP referral and a patient's being seen by a consultant. However, with the exception of breast cancer referrals, waiting times are longer. The Eastern Health and Social Services Council reported that patients wait six to seven weeks for radiotherapy.

In the matter of early consultation to improve waiting times, Northern Ireland must learn from such initiatives in GB as the Cancer Services Collaborative to maximise the benefits of multidisciplinary teamwork and redesign services from the patient's perspective.

Progress towards a new target of one month from diagnosis to treatment will require significant investment in equipment and in staff. On the community care side, more patients are treated as day patients and cared for at home. Although that is good, it places more pressure on that service. More skilled staff are needed, together with more domiciliary care packages. In some submissions to the Committee there was evidence that the number of referrals was growing every month. I ask the Department of Health, Social Services and Public Safety to ensure that the necessary funding is in place to provide support for the increasing demand on the community care service.

Many patients live not only long distances from the cancer centre but also long distances from cancer units. There must be a strong focus on the delivery of services at local hospitals to cut down on transport. The new cancer units are a welcome development and have brought 50% of chemotherapy treatment closer to the patients. The Committee supports, for example, the idea of a local nurse practitioner's carrying out reviews at local hospital clinics. The Committee also welcomed the improvement of primary care facilities to support taking blood samples nearer the patient's home and sending the results electronically to the regional cancer centre as an example of overcoming the problem of distance.

With regard to patient involvement, the poor level of communication at all levels was cited as a concern by patients, especially when it came to the breaking of bad news. Patients valued the personal touch in those circumstances. The point was made repeatedly that patients want to be treated sensitively and as people. Members might think that that goes without saying, but what the Committee heard indicates that improvements could be made in that area.

I refer now to a regional workforce plan. Effective investigation and treatment of cancer requires the combined services of specialist doctors, nurses and others, and I support the tributes and complimentary remarks on the work of volunteers for the service. To meet the growing demand for cancer services, the Department of Health, Social Services and Public Safety must work alongside the boards, the trusts and the voluntary sector to bring about a detailed workforce plan for the recruitment and retention of the expanded range of staff, to include surgeons, GPs, nurses, scientists, therapists, technicians and administrative staff.

Steps must be taken to examine the pay, flexible working hours and structured career progression of cancer staff, particularly in areas with labour market shortages. The Committee agrees that planning for such a complex operation must be detailed and, therefore, will take time and involve additional resources.

Progress towards an expansion of patient-centred services for Northern Ireland must be supported by the implementation of a realistic regional cancer plan with clear leadership, targets, milestones and effective auditing mechanisms. We need a comprehensive strategy similar to the NHS cancer plan for England.

Prevention has been mentioned. Smoking accounts for 30% of all cancers and 80% of lung cancers. There is scope for the Health Promotion Agency to work with others. Combined efforts must be made to increase public awareness of the dangers of smoking, particularly among young people. The Health Promotion Agency's initiative should be given appropriate financial support.

The Committee received an interesting submission from Dr Anna Gavin of the Northern Ireland Cancer Registry. The registry collects and analyses information on all people who are diagnosed with cancer. As well as issuing a report for Northern Ireland, the registry contributes to the publication of an all-Ireland statistical report on cancer. Members will understand that that information is useful and important in the battle against cancer. However, data protection issues and the concerns of the General Medical Council mean that doctors are cautious about releasing information about their patients. That reluctance leads to an incomplete picture of cancer patients, which places limitations on research, for example. It is an issue that must be addressed, and while the protection of that data is important, the concerns about cancer should outweigh the risks that I have outlined.

To put patients first, we should reassure them about the confidentiality of their records. The Department must act to overcome the information gap. The Committee believes that the Department should either make cancer a notifiable disease or refer to section 60 of the Health and Social Care Act 2001 for Great Britain, which would resolve the issue.

I thank all who made submissions. I especially thank the Committee staff. The preparation of the report created a demanding workload, and they responded with energy and enthusiasm.

Go raibh maith agat, a LeasCheann Comhairle. Déanaim comhghairdeachas leis an Dr Hendron agus lena Choiste as a dtuarascáil thábhachtach dhea- dheartha ar sheirbhísí ailse. Tá áthas orm go bhfuil deis luath ag an Tionól an tuarascáil a phlé; tuarascáil ar ábhar atá an-tábhachtach ag ár bpobal.

Beidh mé ag féachaint go cúramach ar an 41 mholadh sa tuarascáil, chomh maith leis na moltaí a luaigh Comhaltaí sa díospóireacht inniu. Tá obair thábhachtach ar bun cheana féin ag forbairt seirbhísí ailse, agus tagróidh mé di sin níos déanaí. Déanfaidh mé trácht achomair fosta ar chuid de phríomh-mholtaí na tuarascála.

B'fhéidir go mbeadh sé ina chuidiú ag Comhaltaí dá ndéarfainn cúpla focal ginearálta faoinár seirbhísí ailse. Aithníonn tuarascáil an Choiste gur cuireadh feabhas nach beag le heagraíocht ár gcuid seirbhísí ailse ó foilsíodh Tuarascáil Campbell i 1996.

Bhí feabhsúcháin suntasacha ann. Mar shampla, forbraíodh seirbhísí áitiúla oinceolaíochta sna haonaid ailse, agus soláthraítear breis agus 50% de cheimiteiripe othar lae taobh amuigh den aonad ailse i mBéal Feirste. Ceapadh comhairligh agus oiliúnaithe oinceolaíochta agus altra sa lárionad ailse agus sna haonaid ailse; fágann sin go bhfuil thart ar 500 ball foirne gnóthach ag cur seirbhísí radaiteiripe agus ceimiteiripe ar fáil do othair ailse aosacha. Rinneadh cur chun cinn suntasach ag bunú foirne ildisciplíneacha agus ag oiliúint foirne. Tháinig méadú faoi thrí ar líon na n-oiliúnaithe san oinceolaíocht mhíochaine sna cúig bliana seo chuaigh thart; tháinig méadú ar an líon oiliúnaithe sa mhíochaine cúraim mhaolaithigh fosta. Tháinig borradh suntasach fosta i líon na n-oiliúnaithe atá ag gabháil don raideolaíocht, don histeapaiteolaíocht agus don phaiteolaíocht.

I congratulate Dr Hendron and the Committee on producing an important and well-crafted report on cancer services. I am delighted that the Assembly has had such an early opportunity to debate the report, which covers a subject that is of crucial interest and relevance to the community. I wish to consider carefully the report's 41 recommendations and the many points that Members raised in the debate. Significant work is already under way in developing cancer services, and I shall speak about that later. I shall also touch briefly on several of the report's main recommendations.

It may be helpful if I begin with some general remarks about our cancer services. The Committee's report recognises the very positive achievements that have been made in the organisation of our cancer services since the publication of the Campbell Report in 1996. Significant improvements have been made. Local oncology services have been developed at the cancer units, and over 50% of day-patient chemotherapy is now provided outside the cancer centre in Belfast. That is important because chemotherapy can be provided closer to people's homes, involving less travel and reducing stress for patients who are very ill.

Significant progress has been achieved by the establishment of the multidisciplinary cancer teams and by staff training. Additional consultant oncologists, specialist trainees and nurses, along with support staff, have been appointed to the cancer centre and units. That brings the total number of staff who are involved in the provision of radiotherapy and chemotherapy services to adult cancer patients to about 500.

It is important to plan for the future, as John Kelly and Tommy Gallagher said. In that respect, the number of trainees in medical oncology has trebled in the past five years, as has the number in palliative care medicine. In addition there have been significant increases in the numbers of trainee radiologists, histopathologists and pathologists. The Department has established international links with the National Cancer Institute (NCI) in the United States, and the Department of Health and Children in Dublin, to create a cancer consortium, which was mentioned by the Chairperson of the Committee, by Sam Foster and others. As they said, these arrangements afford world-class links to our research community. The enthusiastic involvement of the NCI is, in part, a response to the quality of the research that is being carried out here.

The cancer consortium, which links the health and research communities, North and South, with the NCI in the US, is an outstanding practical example of co-operation. Through the consortium, the research and development office has already secured two jointly funded, three-year epidemiology fellowships, which are linked to the Belfast and the Southern cancer registries. The close co-operation and collaboration registries will, for the first time, make data available on the incidence of cancer throughout the island of Ireland. The consortium is also fostering a scholar exchange programme among the three partners, as well as a major clinical trials initiative. The latter will enable cancer patients throughout the island of Ireland to participate in clinical trials.

We will also take part in international conferences. One such conference will take place at the Royal Victoria Hospital in October 2002. We will oversee the establishment of the Telesynergy network, which can facilitate exchanges of data and images between the National Cancer Institute in the USA and ourselves. The institute is anxious to improve palliative care arrangements in the USA, and are looking at our palliative care arrangements as a model.

I am pleased that the Committee has acknowledged the improvements that have been made in areas such as the development of cancer units, the innovative work in palliative care services and the improvement of chemotherapy treatment.

Bob Coulter, Sue Ramsey and the Committee Chairperson also made the important point that many more patients are now being referred for cancer treatment. Twenty per cent more patients are receiving chemotherapy now, by comparison to four years ago, while radiotherapy treatments have increased by 14% in the last year alone. Although the growth in demand is evident, cancer services staff receive large numbers of patients for diagnosis, treatment and review.

I echo Members' acknowledgement of the debt of thanks that we owe to the staff working in that crucial area. Their hard work, commitment and dedication underpins the developments in that area and ensures the continued development and improvement of our cancer services.

Since the publication of the Campbell Report, cancer-related specialities have been given priority for increased trainee numbers. The number of trainees working in the medical oncology field has trebled in the past five years, as has the number of trainees working in palliative care medicine. There have also been significant increases in training numbers for radiologists, histopathologists, and haematologists. The Department's development of workforce planning is proceeding as a matter of urgency, and I am committed to putting in place the steps necessary to ensure that we train, recruit and maintain the base of specialist staff necessary to provide modern cancer services.

Although substantial progress has been made, much remains to be done. In particular, I appreciate the Committee's concerns about the speed of progress and the building of the new cancer centre. There has been no undue delay in advancing that vital development. I inherited a planned investment of some £32 million and a PFI process in train.

If time allowed, I could go through the steps taken by former Ministers and others in the service in the six years since the Campbell Report was published. However, I shall highlight only one issue. Last year, the trust and clinicians involved made the case that we needed a state-of-the-art facility, incorporating new and emerging technology, and building on advances in patient care and treatment. They stressed that the cancer centre must be designed and equipped to serve the community well into the next century, therefore calling into question the planned investment level of £32 million.

Thus, I had a decision to make, and I have made that decision. I decided not to proceed simply on the basis of what had already been there, but I agreed that a revised business case should be produced to achieve the vision of a modern, patient-friendly centre. That work, which has drawn on expert advice and the latest planning guidelines available, has resulted in a substantial remodelling of the centre. The business case for the new centre has been improved and now stands at £57 million, and I am considering urgently the financing of the new facility. I will be seeking funding for this major building project from the next tranche of Executive programme funds and appreciate the support that the Committee has offered me in securing that funding.

The Chairperson of the Committee for Health, Social Services and Public Safety quoted Patrick Johnson in his opening remarks. I will quote from a recent press release issued on behalf of Belfast City Hospital Trust in which that internationally acclaimed professor of oncology, based at Queen's University and Belfast City Hospital, confirmed what has been said about recent developments in the cancer centre.

In his opening comments, the Chairperson said that value for money is a primary consideration, so he will understand why I have to look carefully at any rise from £32 million to £57 million in the financing of such a centre and ask my officials to do the same. I am delighted that my Department and the Department of Finance and Personnel have approved the business case.

Another important development is the forthcoming provision of MRI scanners for each cancer unit. These new scanners, along with the installation of an MRI scanner at the City Hospital and a replacement MRI scanner for the Royal Group of Hospitals, will make a key contribution to cancer care and will effectively reduce waiting lists. Meanwhile, I am acutely aware of the importance of maintaining current services, particularly at Belvoir Park Hospital. As the Committee's report recognises, the equipment there is ageing, and when it breaks down, it can disrupt patient care. I want to ensure that safe and effective services are available at Belvoir Park, and I will take any steps that are necessary to achieve that. In that context, I am glad that my Department has been able to secure funding to install two new linear accelerators at Belvoir Park, and these will be operational by June next year.

In addition, I have approved a list of urgent remedial repair work and some £550,000 to fund immediate repairs to the building infrastructure and equipment to improve the current services. I am conscious of the increasing pressure on services at Belvoir Park, and my officials are liaising with boards and trusts to see what additional steps can be taken to enhance services at the hospital pending the installation of the two new linear accelerators. I assure Members that none of this work detracts from the ongoing planning or timing of the new cancer centre.

The Committee's report recognises that cancer treatment and care is a resource- and cost-intensive service. As all Members said, funding is essential to ensure that continuing developments can be made to our cancer services, and, since I took office, I have provided £11 million of additional revenue for that. On top of the additional resources provided in 1999-2000, we are now investing £18 million more per annum in cancer services than in 1998-99. This is a significant investment, which I plan to supplement to a modest extent in 2002-03.

The Chairperson, Mrs Robinson and others pointed out that the Committee also highlighted the serious underfunding of our health and social services in recent years by comparison with the funding for those in England. Costs here are inescapably driven by developments in England. Just think of the pay review body's recommendations, drug costs, clinical and other professional standards. The great bulk of my budget is effectively pre-empted by costs determined in England.

Mr Shannon, Mrs Robinson and Mr Gallagher also referred to the need for a regional cancer plan and to the NHS cancer plan. The Campbell Report provides the core of such a plan for the development of cancer services here. It is further underpinned by our wider public health strategy 'Investing for Health', the report on palliative care and separate initiatives on screening for breast, cervical and colorectal cancer. As I said already, survival rates for breast cancer are better here than in Great Britain at present. Many elements of the national cancer plan in England are already in progress here. The modernisation and improvement of our cancer services has been under way for some time. This programme, which is well advanced, includes the development of a regional network with the cancer centre in Belfast and cancer units at Antrim, Belfast City Hospital, Altnagelvin, Craigavon and the Ulster hospitals.

Mrs Iris Robinson also referred to genetic cancer and the 'Daily Express' report. Genetic testing is available here for families with a known genetic predisposition. Specialists dealing with breast cancer cases are aware of the importance of increased frequency of screening for families with a genetic predisposition. Studies into the best way to treat people with a high genetic risk are under way.

I appreciate the Committee's strong desire to increase funding in line with England, Scotland and Wales and to ring-fence any increase. However, I am also conscious that such an approach is only possible if our Health Service is adequately resourced overall. If the proposal were taken up at present, it could seriously undermine the funding of other vital health and social services. I am determined, however, to maximise the scope for the development of frontline services. In the coming year the modest level of developments that I envisage in my budget proposals for health and social services overall will only be possible because of the savings of £12 million that the service will achieve, which I mentioned, a further £3 million recurrently and £3 million non-recurrently that I am squeezing from my overall baseline.

Joe Hendron talked about the need to monitor outcomes and to ensure value for money. I fully support the process of audit throughout the cancer services, and I agree with the Chairperson that it is important. So far, £100,000 has been allocated through the regional medical audit group for cancer-related audit projects, and I fully accept that a systematic audit should be an integral part of the quality assurance process for cancer care.

Bob Coulter and Joe Hendron talked about the need to eliminate competition between various sectors, particularly primary and secondary care. The approach that I have taken, and which the service is taking through priorities for action, is one of co-operation rather than competition, removing the last vestiges of the internal market and making the most of our integrated services. My Department's regional advisory committee on cancer and the Campbell Commissioning Project have already ensured that a great deal of work has gone into the development of professional guidance and the organisation of services, referral pathways and treatment regimes. I am aware that initiatives are in place to improve communication between district nursing staff and specialist staff at the cancer centre and cancer units.

Jim Shannon and Rev Robert Coulter asked about guidance on waiting times. I announced that a two-week referral target would be introduced in August 2000 for people with suspected breast cancer. I have received advice from boards, trusts and specialist staff that it is vital that any progress towards hardening targets must be preceded by adequate resources. To introduce such targets without the right level of resources, staffing and physical capacity would risk distorting services to the direct disadvantage of patients who should have clinical priority.

I have also been advised that recent medical and scientific evidence shows that the two-week target is not appropriate for all cancer types and that earlier treatment may not always significantly benefit patient outcomes. It is important, therefore, that I take account of expert medical advice before making any firm decisions on setting further targets for early referrals. Rev Robert Coulter was also concerned about waiting times, specifically for males. Prostate cancer is a slow-growing condition and may be present for many years. Studies are taking place under the national screening committee into the optimal way to detect and treat the condition.

Paul Berry talked about the need to replace equipment. Indeed, in an ideal world one would be able to replace vital equipment in line with the manufacturers' guidance and also invest in new technology, where and when it is proven, at the same time. However, health and personal social services have simply not been resourced to enable that to happen. I spoke often - in the Assembly and through the media - about funding failures in the past, especially during the leadership of the British Conservative Government. When I arrived in post, I found a service that had not had recurrent investment in staff, staff training, the replacement of equipment or in capacity, either in the community or in hospitals. Lack of capital created a backlog of some £35 million.

I have made real progress in the provision of imaging equipment in recent months, particularly magnetic resonance imaging (MRI), and I welcome the Committee's appreciation of that.

Paul Berry also asked about variations in the delivery of services. I appreciate that in a period of expanding services, some variation in delivery across the service may arise. That will often reflect the availability and recruitment of specialist staff, who are often in short supply. I fully accept that we must ensure that high-quality services are available to cancer patients, regardless of where they live or which cancer unit they attend. I expect any variations in services to be addressed as more staff are appointed.

Sam Foster expressed concern about travel times for cancer patients. I am fully committed to ensuring good access to cancer services. As Dr Hendron has already acknowledged, more than half of all day-patient chemotherapy services are already provided in local cancer units, which are nearer people's homes. That decentralisation of services has significantly reduced travelling times for many patients and has made services more accessible to many people with cancer.

I am also aware of local initiatives by trusts to help patients to access services. Transport to hospital is arranged for any patient who is unfit to travel. Tommy Gallagher will welcome the pilot scheme in the Erne Hospital, which may also provide a way forward for other areas. He asked whether the reviews could take place in local hospitals; therefore, he will be particularly pleased with the nurse-led pilot scheme at the Erne Hospital, the aim of which is to improve local access to services for appropriate oncology review patients. It may be possible to build upon that model. Mr Gallagher also asked about data protection. My Department is preparing a consultation paper that will consider data protection and confidentiality in health and social services. The paper will set out the issues faced by the health and personal social services and the possible solutions, including the option of legislation, which has been mentioned. I expect that paper to be issued shortly.

Mr Paul Berry expressed concern about the haemorrhaging of staff from cancer services here. That would have to be a concern, although there is little evidence to date that that is a reality. Some staff have gone elsewhere to work, but having regard to their place of origin, the numbers have been small to date. However, it is a matter of great importance to me, and I will be keeping that concern to the fore. I am anxious to increase the number of staff being trained, and the human resource strategy is being developed to address real and perceived shortages of specialist staff. Therefore I can assure the Committee that I will continue to work with Colleagues in the Executive to secure the level of funding that cancer services and all our other health and social services so rightly deserve.

As Rev Robert Coulter, John Kelly and others mentioned, the report highlighted that around 6,300 people are diagnosed with cancer each year and that approximately 3,600 die annually from cancer. The Committee has mentioned that the survival rates for ovarian cancer are poor. With the introduction of new treatment regimes, we expect that those rates will improve soon. However, I emphasise that our survival rates for breast cancer are better than GB's. In addition, treatment for testicular cancer has been the great success story of the past 10 years.

As Joe Hendron and Paul Berry said, the Committee's report points out that general practitioners are usually the first point of contact for a cancer patient and can play a pivotal role in early detection, referral, treatment and care. I firmly agree that GPs have a crucial role in cancer care. I want to ensure that guidelines are developed to help to raise awareness of cancer symptoms among GPs and the public. Although we do not want to frighten people, we should aim to make awareness of symptoms part of everyday life and to reinforce the fact that early diagnosis can lead to a cure.

The regional advisory committee on cancer, which was set up by my Department, has already produced a series of guidelines that have a particular focus on the needs of primary care. In general, those guidelines have been produced by multidisciplinary teams, and in some instances the regional advisory committee on cancer has endorsed guidelines produced in England and Scotland, where the material has been suitable.

Sue Ramsey, John Kelly and Jim Shannon talked about the importance of early detection and health promotion. Smoking is responsible for one in three of all cancer deaths, and it is important to tackle tobacco use. A public information campaign has been running since 1999 and aims to increase public awareness of the dangers of smoking. The campaign has included television advertisements, a web site and a magazine aimed at young people.

The latest phase of the campaign includes a hard- hitting television advertisement titled 'Artery' - described very graphically by Jim Shannon - and is aimed mainly at adult smokers. Two additional advertisements promote nicotine replacement therapy, and the campaign, which will run until the end of March, also promotes a telephone helpline service. Members will be pleased to know that there will be follow-up advertising.

Last year I established an inter-sectoral working group on tobacco to develop and oversee the implementation of a comprehensive action plan to tackle smoking. The Department of Health and Children is represented on that group. I remain committed to banning the advertisement of tobacco products, as it undermines the work of health professionals and others who try to prevent the adoption of the smoking habit and who deal with the consequences of smoking. My officials are pursuing how best to progress that issue, taking into account developments in Britain and the South of Ireland.

With the help of the Health Promotion Agency, the Department of the Environment and the Health and Safety Executive of the Department of Enterprise, Trade and Investment, my Department will explore how best to build on the existing provision of smoke-free facilities in all public places and workplaces.

Jim Shannon, John Kelly and Sue Ramsey specifically highlighted smoking among young people. Children are vulnerable, and great care must be taken in the design and content of campaigns aimed at discouraging schoolchildren and young people from smoking. It is essential that such campaigns be pre-tested with the target audience to ensure, as far as possible, that they achieve the desired effect. Two television advertisements aimed at second- and third-year pupils have already been broadcast, and my Department will continue to work closely with the Health Promotion Agency, the voluntary and community sectors, and others, to tackle the problems of smoking among schoolchildren and young people.

Sue Ramsey talked about the importance of diet and the promotion of healthy eating. Nutrition is one of the priority areas identified in the Executive's public health programme, 'Investing for Health', which will be published shortly. Surveys commissioned by the Health Promotion Agency have demonstrated a significant increase in awareness and understanding of key messages on nutrition and health, and my officials have been monitoring the introduction in Britain of the national fruit scheme. From December 2002 the ministerial group on health plans to introduce free fruit in schools as a pilot project, now that we have secured resources from the Executive programme funds.

Voluntary charities are excellent at reaching people's hearts and minds and play an invaluable role in health promotion. I want to ensure that the statutory sector works with the voluntary sector to further develop the role of charities in health promotion.

I remind the Minister that she is entitled to speak for 10 minutes for each hour of the debate. I ask her to draw her remarks to a conclusion.

The Committee has recommended that all patients should have equity of access to out-of-hours services, and I support that recommendation. The South and East Belfast Trust has a 24-hour rapid-response team that has been pivotal in allowing patients to stay in their own homes, rather than going into hospital.

It is also proposed that a full out-of-hours referral capacity will be introduced in the future as the scope of the cancer unit increases.

The Committee's report emphasised the many positive developments in our cancer services. Much good work has been done to improve and modernise those services, and there is still much to do.

I add my voice to the Committee's praise for the important contribution to cancer care made by the voluntary organisations. I want to ensure that mechanisms like the cancer forum continue to drive forward the crucial partnership between the statutory and voluntary sectors.

As every Member who has spoken emphasised, the future development of our cancer services will depend on the availability of proper resources. I shall continue to work with my Executive Colleagues to secure the necessary funding to provide modern, safe and effective cancer services.

I have referred to several of the Committee's recommendations and some of the issues mentioned in the debate. I shall give careful consideration to the Committee's report, which is most helpful, and shall respond to the Committee in greater detail in the coming weeks.

I thank the Minister for being present throughout the debate and for her comments, and I shall refer later to what she has said. I also thank all those Members who spoke in the debate. I hope that Members will not be frightened by the papers that I have here - I have only made a few sketchy notes. The only problem is that I cannot read my own handwriting.

Rev Robert Coulter and other Members referred to the question of waiting times. Rev Robert Coulter also mentioned breast cancer, and the lack of guidance for the male population on the types of cancer that they might have. Above all, he talked about the decisions that were being taken. I myself referred to the issue of communication with GPs. That is important in order to achieve early diagnosis.

Paul Berry referred to the Campbell Report and to strategies. He talked about the frustrations of patients, comprehensive long-term plans and the pressures on staff. He paid tribute to hospital staff, as did other Members. Mr Berry also mentioned an independent audit. There is no doubt that the workload of GPs has increased. It is also important to replace old equipment.

Ms Ramsey made some similar points. I appreciate the fact that she thanked the Business Committee. That was an important point, as we were not allowed three hours to debate the issue of children in care. My Colleagues all thanked their staff for the work that they have done.

Ms Ramsey and other Members referred to deprivation. The question of cigarettes comes up over and over again. The importance of a healthy diet that incorporates fruit and vegetables cannot be overestimated. I remind Colleagues of the World Health Organisation's advice that five portions of fruit and vegetables should be eaten every day to help prevent cancer. The television advertisements have been very effective.

Ms Ramsey talked about cervical screening and breast screening in deprived areas. I hope that the boards are taking that matter seriously. Many references have been made to Prof Paddy Johnston and Prof Roy Spence. Ms Ramsey also talked about an all-Ireland cancer registry, and mention was made of the work of Dr Anna Gavin of the Northern Ireland Cancer Registry.

Mr Foster described the number of deaths from cancer as frightening. That is especially so when one thinks of the number of Members of the Assembly who might fall victim to the disease. Mr Foster mentioned the memorandum of understanding that marked the tripartite agreement between the United States, Dublin and Belfast to establish a cancer centre of excellence. I recall our involvement as respective health spokesmen for our parties nearly three years ago.

Mr Foster also talked about people in rural areas, as did Mr Gallagher. There is a major problem there. I cannot even begin to address the issue of an area hospital for the south-west, other than to say that people there are entitled to as good a service as anyone else in Northern Ireland.

Mr Shannon talked about service delivery and waiting times, and about the one in three people who contract cancer and the one in four people who die from it. He also applied that scenario to the number of Members in the Assembly.

I referred to the fact that in some hospitals, especially in Antrim, people can wait for nine months for endoscopies. People may have to wait for seven or eight months to have a colonoscopy to find out if there is a possible tumour in their colon.

Mr Shannon referred to a regional plan and to cancer charities. He also spoke about the cigarette advert that shows the damage caused to the aorta by smoking. That advert is very powerful. John Kelly mentioned the work of Prof Patrick Johnston and others, and he talked about the physical and emotional needs of patients, about the number of new cancer cases and about the comparisons with England and Wales.

I referred to the Northern Ireland Confederation for Health and Social Services (NICON) Report of the four boards in which Mr Brendan Cunningham compared funding in England and Wales with that in Northern Ireland. I shall not repeat those figures, but they are very important.

Mr Kelly dealt with the Health Promotion Agency and the problem of young people smoking. He also referred to health action zones, and I would like to make the point that we have health action zones in north and west Belfast, Armagh and Dungannon. That is medicine at the coalface. Those people do an outstanding job, and I should like to see the number of health action zones increased. Mr Kelly also referred to a workforce plan in education.

Iris Robinson thanked various people including Prof Roy Spence, Prof Patrick Johnston and the Committee Clerks. She referred to the fact that one in three people get cancer. She also mentioned social deprivation and the NICON Report. Mrs Robinson also talked about human resources - doctors and nurses - and the introduction of a cancer plan.

Huge funding is being pumped into cancer services in England and Wales in the next three years. The Minister referred to breast cancer and the importance of the high genetic risk. That screening can be carried out in Northern Ireland. Everyone is agreed that extra funding is needed to highlight the dangers of cigarettes.

Mr Gallagher talked about putting patients first, and no one will argue with that. Early diagnosis is the most important thing, followed by prompt referral to a consultant. He also dealt with health action zones and multidisciplinary teams.

Mr Foster referred to rural areas and the long distances that people have to travel for treatment. Reference was made to patient involvement and their being treated with sensitivity.

With regard to the all-Ireland cancer registry, I pay tribute to all involved in its development, especially Dr Anna Gavin.

I thank the Minister for her attendance. I appreciate her congratulations to the Committee, and I hope that she will study the 41 recommendations in its report. The Minister referred to the great achievements in cancer units - 50% of chemotherapy can now be administered closer to patients' homes. The Committee met the multidisciplinary cancer teams and appreciates the work that they have done. The Minister also referred to the international link. One cannot emphasise that enough - I mentioned the Washington, Dublin and Belfast memorandum of understanding. The Minister also detailed the research and development that has been carried out, the extra staff trained in the treatment of cancer, the major trials that have been conducted throughout Ireland and the introduction of palliative care.

The Southern Board is making a magnificent effort through the use of pharmacists, other primary care professionals and a Macmillan GP facilitator so that people can get access to drugs such as morphine and pain relievers at night, at the weekend or at any other time. The Minister said that more patients are referred for cancer treatment, and I am sure that that is true. We owe a debt to all the staff. She also stated that more training has been undertaken since the publication of the Campbell Report.

I accept that the Minister inherited the problem of the cancer centre. The cancer figures have risen every year, so we need a major treatment centre. I am aware that three business plans have been published, the most recent of those in September 2001. The Department of Finance and Personnel agrees with that.

I wonder when the announcement will be made. She referred to Prof Paddy Johnston and others, and we all accept the point made about value for money. It is easy to want to open the centre tomorrow. However, getting the funding and value for money are important.

The Minister has worked hard on the subject of MRI scanners, and I pay tribute to her. She mentioned the genetic aspects of breast cancer, to which Mrs Robinson also referred. She mentioned the comparisons in funding in England and Wales with that in Northern Ireland, and we accept that there is a lack of capital. Furthermore, she mentioned poor survival rates from ovarian cancer, the early diagnosis by GPs, and diet, which is important for our young people.

I thank everyone who contributed to the debate, especially the Minister. However, my primary question is this: will she give a clear timetable soon for the new regional cancer centre? That is what people want to know. Mr Shannon made a point about banning smoking in public places, and I would like to see that happen. Much has been said about the Health Promotion Agency, but achieving funding is difficult. The agency receives a small amount of funding. However, it is doing a good job, and perhaps it should co-ordinate health promotion across the boards and trusts.

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