Northern Ireland Assembly Flax Flower Logo

Northern Ireland Assembly

Monday 11 March 2002 (continued)

Mr M McGuinness: Yes, I do. The reality is that academic selection for some children means academic rejection for many more.

Moreover, research has shown that academic selection at age 11 prematurely closes down opportunities for the majority of pupils. It creates a sense of failure and results in a loss of self-esteem and confidence at a stage of their educational, social and emotional development when every encouragement should be given. Teachers have to work extremely hard to restore that loss.

We should also understand that children are individuals whose educational development progresses at different rates. We recently heard that from Prof Gerry McKenna of the University of Ulster. He made a significant point, which is backed up by Prof George Bain, the vice- chancellor of Queen's University. Only 50% of students come via A level to the new University of Ulster. Where do all the others come from? That is the big question. That clearly shows up the extra and incredible abilities of our young people. It is important that options are kept open until a child's needs and aspirations have developed more fully.

I have heard it suggested that the idea that every child can be a success is pie in the sky. On the contrary, every child can be a success. I have been in special education schools with autistic children, and it has done my heart proud to see a child on one day being able to count to six and on the next day to count to eight. That is how success must be measured. Children have different abilities, and unless we get our heads around that, and realise that our challenge is to provide an education system which opens doors for all of our children, we will always struggle against the backdrop of an education system that is not world class and which lags behind New Zealand, Korea and many other such countries.

Mr S Wilson:

I am sure that the people of the Shankill Road will be touched and pleased to hear about the Minister's concern for their children's future. It is a pity that he did not share that concern when his associates bombed their parents not so long ago.

How is the Minister's consultation video to inform the debate on the issue of post-primary education? Eighty per cent of that video is directed towards the promotion of his party political point of view and of the Burns proposal.

If the Minister rejects academic selection, on what basis does he expect youngsters to be selected for oversubscribed schools? Is he in favour of social selection based on their parents' ability to pay, their contacts, or their ability to buy a house in the proximity of the popular schools?

Mr M McGuinness:

The objectives of the video and household response form are to provide clear and objective information on the consultation arrangements and on the Burns proposals, to inform the debate and to explain to people how they can respond. The video will be sent to schools, further education colleges and community groups, and it will act as an aid to discussion on the proposals. It will also be sent to public libraries and made available to the public.

The content of the video sets the context for the review by explaining why change is necessary and by referring to the weaknesses identified by the Gallagher and Smith research and the Save the Children research. The Burns proposals are explained, and answers are provided to frequently asked questions about them.

The video puts the Burns proposals in the context of the wider review of post-primary education and invites comments. The response form asks questions on key issues and includes a summary of the main proposals made by Burns, with information on how everyone can respond to the consultation.

The materials we launched this morning explain the key elements of the Burns proposals and include views and concerns expressed by a number of education professionals about the document and about current arrangements.

A wide range of views is represented. The materials serve their purpose, which is to provide information about the Burns proposals and the context of the review of post-primary education in order to stimulate discussion.

Last week, a 10-and-a-half-year-old child uttered one of the most powerful statements that I have heard in the course of this debate. During the Save the Children research, she was asked what the 11-plus meant to her. Her words were more powerful than those of any adult who has articulated his or her views on selection. She said that if she passed, she would go to a smart school, but that if she failed, she would go to a stupid school. I rest my case.

3.00 pm

Mr Speaker:

Order. Time is up for questions to the Minister of Education.

Health, Social Services and Public Safety

Belvoir Park Hospital: Radiotherapy

TOP

Mr Speaker:

We will now move to questions to the Minister of Health, Social Services and Public Safety. Question 1, standing in the name of Mr Byrne, question 3, standing in the name of Rev Robert Coulter and question 12, standing in the name of Mr Gibson, have been withdrawn and will receive written answers. Question 9, standing in the name of Mr McHugh, has been transferred to the Office of the First Minister and the Deputy First Minister. Question 17, standing in the name of Mr Conor Murphy, has been withdrawn and does not require a written answer.

2.

Ms Armitage

asked the Minister of Health, Social Services and Public Safety if she has any plans for, or if she would consider, using part of Belvoir Park Hospital for radiotherapy treatment only.

(AQO 961/01)

The Minister of Health, Social Services and Public Safety (Ms de Brún):

Go raibh maith agat, a Cheann Comhairle. Ag teacht le Tuarascáil Campbell, soláthrófar seirbhísí radaiteiripe ón lárionad réigiúnach ailse atá le tógáil ar shuíomh Ospidéal Chathair Bhéal Feirste, áit a mbeidh fáil ar raon iomlán seirbhísí géarliachta agus seirbhísí tacaíochta diagnóiseacha. Níl aon phleananna agam Ospidéal Pháirc Belvoir a úsáid do sholáthar seirbhísí radaiteiripe ó bheidh an lárionad nua ailse tógtha.

In line with the Campbell Report, radiotherapy services will be provided at the regional cancer centre, which is to be constructed on the Belfast City Hospital site, where a full range of acute and diagnostic support services will be available. I have no plans to use Belvoir Park Hospital for the provision of radiotherapy services once the new cancer centre has been constructed.

Ms Armitage:

I understand what the Minister has said, but I ask her to reconsider. Some £600,000 has been spent on Belvoir Park Hospital already. Friends of Montgomery House have secured funding for a new magnetic resonance imaging (MRI) scanner, and they will take care of the recurring costs. If the Minister were to consider using Belvoir Park, it would be in the Department's financial interest to keep it simply as a radiotherapy treatment centre. Moreover, given the waiting lists, to do so would take some of the pressure off the new cancer centre, which may or may not be open in 2005. Belvoir Park has a good reputation, and the new cancer centre will take time to develop. Does the Minister agree that that option should be considered, given the amount of money that has already been invested in Belvoir Park and the amount of money that the Friends of Montgomery House are prepared to invest in the hospital? When -

Mr Speaker:

Order. This is an opportunity for the Member to ask a supplementary question, which she has done. It is not an opportunity to make a robust case in favour of a particular view.

Ms Armitage:

I would never dream of doing that, Mr Speaker.

Mr Speaker:

Order. I call the Minister to respond.

Ms Armitage:

I have not even asked the question.

Mr Speaker:

The Member has already asked at least one question.

Ms de Brún:

The Campbell Report recommended that radiotherapy and chemotherapy services should be moved from Belvoir Park Hospital to Belfast City Hospital and become an integral part of the regional cancer centre. The report recognised that changes in treatment, together with the increasingly elderly population, will require clinicians to deal with people who are likely to be more ill and suffering from complex medical problems. Therefore, the report concluded that radiotherapy and chemotherapy services should be delivered in an acute hospital setting, where there is the full back-up of acute and diagnostic services. The relocation of radiotherapy and chemotherapy services from Belvoir Park to the City Hospital will give acutely ill cancer patients direct on-site access to general and specialist physicians and surgeons. For that reason, those services are better placed at the City Hospital site.

Mr McHugh:

Go raibh maith agat, a Cheann Comhairle. What has been done to keep Belvoir Park Hospital going until the new cancer centre opens? When will the opening date for the centre be announced?

Ms de Brún:

Pending the opening of the cancer centre, I am determined to ensure that cancer sufferers have the best possible treatment and care. I have made it clear that services at Belvoir Park are an important aspect of cancer treatment and that the hospital has an important and continuing role. I have underpinned current service provision by approving the acquisition of two linear accelerators at a capital cost of £3·8 million. I have also approved an investment of £550,000 for urgent remedial work to the building infrastructure and equipment at Belvoir Park, my officials are urgently considering the case for a replacement CT scanner for the hospital and I expect to announce the way forward soon.

The regional cancer centre is a keystone of the pattern of cancer services that I wish to develop. It is critical that we have a modern state-of-the-art facility, and it is my intention that that becomes a reality as soon as possible. Significant progress has been made on the Belfast City Hospital site. With regard to the cancer centre, I inherited a planned investment of some £32 million and a private finance initiative (PFI) process that had been set in motion by the previous Administration. Last year, the trusts and clinicians involved said that a state-of-the-art facility was needed that incorporated new and emerging technology and that advances made in patient care and treatment must be built on, so I had to decide whether the original proposal was adequate. The trusts and clinicians made the case that the rapid evolution of the concept of a cancer centre meant that the original proposal was no longer adequate. My Department and the Department of Finance and Personnel have now approved the revised business case at a cost of £57 million, and I will make an announcement on that before the summer recess.

Local Health and Social Care Groups

TOP

4.

Mr Beggs

asked the Minister of Health, Social Services and Public Safety to detail the total number of additional staff required to run the proposed new local health and social care groups.

(AQO 997/01)

Ms de Brún:

Beidh ar gach grúpa áitiúil sláinte agus cúraim shóisialta, a mbeidh 15 ar fad díobh ann, bainisteoir a cheapadh. Is é is dóiche go gceapfaidh grúpaí ar a laghad comhalta amháin eile d'fhoireann tacaíochta, cé gur faoi na grúpaí iad féin a bheidh sé cinneadh a dhéanamh faoin líon iomlán foirne a bheidh riachtanach. Ar an chuid is lú de, mar sin de, beidh 30 duine nua foirne de dhíth le tacaíocht a sholáthar do na grúpaí áitiúla sláinte agus cúraim shóisialta.

There will be 15 local health and social care groups, all of which will be required to appoint a manager. It is likely that groups will appoint at least one other member of support staff, although the total number of staff required will be a matter for the groups themselves to decide. As a minimum, 30 new staff will be needed to support the local health and social care groups.

Mr Beggs:

Does the Minister acknowledge that she already has a sizeable number of administrative staff in her Department, as do the health boards and trusts? Does she further accept that she has created yet another layer of bureaucracy in the Health Service through the creation of local health and social care groups without making significant reductions in other bureaucratic levels in the service? What purpose do health boards serve other than to deflect criticism from her Department? When will the layers of bureaucracy be removed so that money goes to the patients instead?

Ms de Brún:

The ending of GP fundholding and the creation of local health and social care groups will not only allow local people to take local decisions about local services, it will also allow money to be moved from administration to front-line care. I anticipate that £2·5 million will be freed up and that money that was spent on administration will be spent on front-line care.

The wider structures will be addressed in discussions that the Executive will hold on the proposals and recommendations made in the acute hospitals review group's report and as part of the review of public administration. The continued existence of boards and trusts, how many there will be, what their functions will be and how other structures will fit in will be addressed in that context.

Whatever emerges, it is important to ensure that the arrangements support the close working of all parts of the health and personal social services and that the interconnection between health and social services, education, housing and other key public services is facilitated.

From the outset, I have ensured that the new local health and social care groups will be set up and operated in such a way as to be flexible enough to be accommodated within any wider structural changes in health and social services that emerge from the planned review of public administration.

Mr McCarthy:

I welcome the Minister's response to our debate earlier today. Given that the majority of people being asked to serve on these new groups are from the health professions, can the Minister assure the House that these medical people will not be required to carry out clerical or administrative work to the detriment of ordinary patients?

Ms de Brún:

Compensating people for the time that they give to these boards will allow GPs and pharmacists, for example, to employ locum cover. That will ensure that they are able to carry out this work and that their other work will not suffer as a result. It is not my intention that anybody should be out of pocket because of these arrangements. I have put forward a figure of £3 per head for the management of these groups, and I will keep that under review.

Ms Ramsey:

Go raibh maith agat, a Cheann Comhairle. Can the Minister answer the criticism that boards and trusts will dominate the management boards of new local health and social care groups?

Ms de Brún:

Such fears have been expressed, but they were not borne out by the commissioning pilots, which also have board and trust managements on their boards, and on which the new groups have been based. Board and trust representatives will together fill only six of the 18 places on the management board, and GPs will fill five - so no one group or profession will dominate the new groups. Also, as part of their quota, boards and trusts must nominate a nurse, a social worker and a professional allied to medicine, which means that there will be two nurses, two social workers and two professionals allied to medicine on each group. In that regard, I point out that the generic term "nurses" refers to nurses, midwives and health visitors whose names are on the register of the United Kingdom Central Council for Nursing, Midwifery and Health Visiting (UKCC).

The management boards of the groups must devise effective mechanisms to ensure the involvement of other stakeholders and members of the wider local health and social care group who are involved at the grass roots. It will be up to the management boards of the new groups to ensure that there is a bottom-up approach. I am confident that the management structure and representation on the boards are such that no group or profession will dominate. We now have a unique opportunity for primary care professionals and others, working at local level with local people, to have a way of ensuring that local people and primary care are at the centre of our health and social services.

Elective Surgery

TOP

5.

Mr Berry

asked the Minister of Health, Social Services and Public Safety to outline the total number of elective surgery procedures scheduled to take place in each hospital in 2002.

(AQO 962/01)

Ms de Brún:

Níl fáil ar an eolas atá á lorg san fhoirm ina n-iarrtar é. Ba chóir go mbeadh eolas ar mhéid na ngnáthamh roghnach atá pleanáilte do 2002-2003 ar fáil níos déanaí an mhí seo. Socróidh mé go gcuirfear é sin i Leabharlann an Tionóil agus cuirfidh mé an Comhalta ar an eolas dá réir.

That information is not available in the form requested. Information on the volume of elective episodes planned for 2002-03 should be available later this month. I shall arrange to have that information placed in the Assembly Library, and I will notify the Member accordingly.

Mr Berry:

Surely the Minister will recognise again that she has failed - she has not grasped the waiting lists problem in the hospitals and the recent crisis in the Royal Victoria Hospital's fracture wards. How many elective surgical procedures have been cancelled in all hospitals in Northern Ireland to date?

Ms de Brún:

The waiting lists question is not one that can be tackled in isolation from the broader pressures on hospital services, which have seen the number of emergency admissions rising steadily over the past year or so. Regarding capacity, the only cure is more resources. We need sustained long-term action, supported by the resources and the service capacity necessary to bring waiting lists down.

On efficiency, there is a significant programme of work under way to improve the flow of patients through the system. That includes reducing the number of people who fail to keep their appointments; putting in place alternatives to hospital admission, such as physiotherapists in the community treating patients with back pain; making sure theatres are operating at maximum capacity; and validating lists to ensure that they are accurate.

In spite of our difficulties, three out of four people get treatment within three months, and 95% of those people are treated within a year. Not all the same people are waiting at the same time. The people on the waiting lists are constantly changing.

3.15 pm

I answered several questions recently about the elective procedures that have been cancelled. I refer the Member to those answers, and I will ask officials today what other detailed information they can give to the Member.

Mr Watson:

Given the high level of cancellations and the emergency pressure on beds, what measures is the Minister considering to protect beds that can be solely used for elective surgery?

Ms de Brún:

The service will be asked to increase the level of protected elective capacity during the next year - units that will not be affected by pressures. Altnagelvin Hospital already has a good model in place with doctors performing approximately 1,000 procedures a year. Some of the recommendations in the acute hospitals review group's report also mentioned that point, so it will be included in the Executive's discussion about proposals for the way forward in wider acute service provision. As well as that, an extra 1,000 community care places will be available next year, which will help to reduce the number of people in hospital, thus freeing up hospital capacity for operations.

Mr M Murphy:

Go raibh maith agat, a Cheann Comhairle. What actions is the Minister taking to tackle waiting lists?

Ms de Brún:

In addition to the points that I have outlined in my answer to the previous Member, 262 patients have been offered the opportunity to have cardiac surgery in Glasgow or elsewhere this year rather than wait for treatment locally. For example, the Northern Health and Social Services Board hopes that 51 patients will be treated in Scotland by the end of March, which would deal with all the board's excess.

The Royal Group of Hospitals has confirmed that by the end of March doctors there will have completed more than 700 procedures. The Western Health and Social Services Board has held additional ophthalmology clinics at Roe Valley Hospital, reducing the number of waiting inpatients from 360 to 30 and thus reducing the average waiting time from two years to six months.

Ward 8 in the Royal Victoria Hospital has been re- organised as an elective surgery ward for six months of the year and as an emergency admissions ward for the other six months. A mobile magnetic resonance imaging unit was brought in to provide a scanning service to help the Northern and Western boards reduce waiting lists there. Additional scanning capacity from a mobile unit is also available at the Royal Victoria Hospital. Those are some of the specific actions that have been taken to help individual patients - who did not have to wait as long as they otherwise might have had to.

I outlined earlier the type of work that is under way to improve the flow of patients through the system. Of course, with regard to asking and pleading for extra resources, we cannot carry out the work unless the service has the beds, staff, equipment and theatre time. To reduce waiting lists we need sustained long-term action supported by resources and the necessary service capacity.

Waiting Period for Fractures

TOP

6.

Mr Poots

asked the Minister of Health, Social Services and Public Safety to detail (a) the current waiting period for patients requiring treatment for fractures; and (b) how this compares with previous years.

(AQO 981/01)

Ms de Brún:

Glactar formhór na n-othar ag a bhfuil briseadh cnáimhe isteach san ospidéal mar iontrálacha éigeandála, agus déantar iad a chóireáil a luaithe is féidir de réir tosaíochtaí cliniciúla. Bíonn a n-obráid ag formhór na ndaoine a mbaineann máinliacht lena gcóireáil faoi cheann dhá lá. Níl fáil ar eolas comparáideach ó bhlianta roimhe seo.

Most fracture patients are emergency admissions and are treated as soon as possible in accordance with clinical priority. The majority of those operations are carried out within two days.

Mr Poots:

I hear what the Minister is saying, but what is happening on the ground is different. I have heard about people having to wait more than a week to have fractures repaired. We have also heard the Minister complaining today about not having enough resources. People who have to wait for up to two weeks to get fractures repaired are using much needed resources, and that creates a situation in which mismanagement is eating into the funding that we are giving to the health and social services budget, which has been increased by 37%.

Surely the Minister can do more to ensure that patients get treated immediately and do not have to suffer undue pain and suffering and that we do not have the bed blocking that takes place as a result of mismanagement.

Ms de Brún:

People who sustain fractures are first assessed at an accident and emergency department to determine whether they require surgery at a main fracture centre. If they do, they are transferred to one of the fracture units at the Royal Victoria, the Ulster or Altnagelvin hospitals. I am assured that arrangements are in place to ensure that as far as possible everyone who is assessed as requiring inpatient fracture surgery is transferred to a main fracture centre as soon as possible and within 48 hours at the latest. All patients who are admitted either directly to a main fracture centre or are transferred from a local hospital are clinically assessed at a main fracture centre, and treatment is prioritised accordingly.

It is clearly not acceptable that some people must wait a long time for this treatment. Our fracture services have been under sustained pressure for some time as a result of an increased demand for surgery, coupled with a shortage of specialist staff, such as anaesthetists and orthopaedic surgeons both here and in the NHS. I have outlined the ongoing work. In addition, in planning for the present and the future, my Department has afforded a high priority to training in this speciality. Specifically, the number of trainees in orthopaedics has increased by almost 50% in the past five years, and further increases are planned.

Mr J Kelly:

Are pressures on fracture services affecting orthopaedic surgery?

Ms de Brún:

Yes, unfortunately, our fracture services have been under sustained pressure for some time. Although every effort is made to minimise the impact on other services, the nature of trauma and fracture injuries is such that urgent surgery is often required. Regrettably, that has resulted in the cancellation of some elective orthopaedic surgery.

Primary Care Group Discussions

TOP

7.

Mr McFarland

asked the Minister of Health, Social Services and Public Safety what discussions have taken place with GPs, nurses and community care staff in the light of the Department's proposals for the introduction of primary care groups.

(AQO 979/01)

Ms de Brún:

Tá moltaí ag an Roinn grúpaí cúraim phríomhúil a thabhairt isteach, agus mar sin bhí cruinnithe ag feidhmeannaigh i mo Roinn le gnáthdhochtúirí, altraí, oibrithe sóisialta, cógaiseoirí, boird agus iontaobhais.

In the light of my Department's proposals to introduce primary care groups, officials in my Department have had meetings with GPs, nurses, social workers, pharmacists, boards and trusts.

Mr McFarland:

There is great excitement in the House today, because it looks as if we are going to get past question 7. With questions to the Minister of Health, Social Services and Public Safety, that must be a record.

In spite of the debates this morning and the questions so far, I am still not clear what has gone wrong, given that all the royal colleges and medical professionals are at odds with the Minister's plan for primary care groups. Will the Minister tell us what has gone wrong with the consultation, or has she decided to take on the royal colleges as a test of strength?

Ms de Brún:

If anyone is deciding to take on anyone else in a test of strength, the Member may want to look closer to home than to ask the question of me. It is certainly not my intention to do anything of the sort. I have talked to many groups, as has my Department. I detailed in the debate earlier the long programme of consultation and meetings that I have had with groups - as late as today.

Within a week of receiving a letter asking for a meeting with the British Medical Association, the Royal College of Nursing and the Royal College of Midwives, I agreed to meet those groups. The letter arrived on 7 March, and I have said that I will meet them on Wednesday of this week. There is no question but that I have spoken in detail and have sent out detailed guidance. That guidance has also been given to Committee members, some of whom have contradicted what was written in the guidance in television and radio interviews, saying that certain things would not happen when they were clearly written in the guidance.

However, I am attempting, yet again today, to ensure that I address people's concerns by telling them that the services of the GP fundholders will be maintained until local health and social care groups have had a chance to make their decisions about them. I expect the professional delivery of those services to continue and the £3 per head that I referred to previously to be sufficient for the management costs. I will look at that, and I am prepared to keep it under review.

There will be very few, if any, redundancies, and given the management structure of the groups, no individual profession will dominate them. The arrangements for the new groups are based on the proposals set out in the consultation document 'Building the Way Forward in Primary Care', which received widespread support. The configuration of the groups has been announced, and action has been taken by boards to ensure that management boards are established by April.

Macmillan Doctors

TOP

8.

Mr Shannon

asked the Minister of Health, Social Services and Public Safety to detail the number of Macmillan doctors currently working in each trust.

(AQO 963/01)

Ms de Brún:

I láthair na huaire, tá naonúr dochtúir Macmillan ag obair in iontaobhais na seirbhísí sláinte agus sóisialta; triúr in Ospidéal Chathair Bhéal Feirste, triúr i nGrúpa Ospidéal Ceantair Craigavon; duine sna hOspidéil Aontaithe, duine in Ospidéal Speirín, Tír na Lochanna agus duine in Ospidéal Ceantair Ailt na nGealbhan.

There are currently nine Macmillan doctors working in health and social services trusts: three in the Belfast City Hospital Trust, three in the Craigavon Area Hospital Group Trust and one each in the United Hospitals Trust, the Sperrin Lakeland Trust and the Altnagelvin Hospitals Trust.

Mr Shannon:

Although I welcome the fact that there are nine Macmillan doctors working in the hospitals, will the Minister say what steps will be taken to ensure that the expertise of Macmillan doctors is made available to the other hospitals keen to use it and co-operate directly with Macmillan cancer care? Will the Minister say if any of the Macmillan doctors will be used to treat teenagers in the Royal Victoria Hospital? What steps will be taken to ensure that advantage is taken of that?

Ms de Brún:

I recognise the significant contribution that charities in the voluntary sector make to providing care for people with cancer. That complements the services provided by the Department of Health, Social Services and Public Safety, particularly in the development of palliative care, and no group does that better than the Macmillan group. I have been honoured to attend several events where I have been able to express my thanks and gratitude for the work they have done - in keeping with opportunities to express the same thanks to other groups. They discuss with local trusts, boards and service users the best way forward and how they can help to complement the other services provided. I expect that that will continue in the same way with the Royal Group of Hospitals Trust as with any other trusts with which Macmillan works. The trusts and boards will be able to discuss the way forward and suggest proposals.

Mr Speaker:

Ms McWilliams, Mr McElduff, Mrs E Bell and Mr Gallagher are not in their places.

Discussions on Primary Care

TOP

15.

Mr Douglas

asked the Minister of Health, Social Services and Public Safety what discussion has taken place between her Department and (a) the BMA (NI) General Practitioners' Committee; (b) the Royal College of Nursing; and (c) the Royal College of Midwives regarding the future of primary care.

(AQO 986/01)

Ms de Brún:

Chuathas i gcomhairle le gach grúpa sa liosta faoi shocruithe sa chúram príomhúil sa todhchaí, agus bhuail mé le Coiste TÉ na nGnáthdhochtúirí de chuid an CMB agus leis an Choláiste Ríoga Altranais lena ndearcadh ar chúram príomhúil sa todhchaí anseo a phlé. Tá mé le casadh leis na trí grúpaí sin le gairid.

All the groups listed were consulted about future arrangements for primary care, and I have met the Northern Ireland general practitioners' committee of the British Medical Association and the Royal College of Nursing to discuss their views on primary care here. I am due to meet all three again shortly.

Mr Douglas:

Does the Minister think that it is wise to continue with her plans for primary care considering the opposition from those three groups? They represent the majority. What steps will she take to allay their concerns?

3.30 pm

Ms de Brún:

In the debate earlier today on primary care the Chairperson of the Committee for Health, Social Services and Public Safety told me that those organisations are in favour of local health and social care groups. I look forward to discussing that matter with them when we meet on Wednesday. On the question of addressing their concerns, I refer the Member to my answers to previous questions today. I am proceeding because of the level of support expressed during last year's consultation on the 'Building the Way Forward in Primary Care' document.

Recent expressions of support have come from the Association of Directors of Social Services; the advisory committee of the professions allied to medicine; the directors of nursing of the four health boards; the Foyle area nurse practitioners in general practice forum; community practitioners in the Health Visitor's Association, and Armagh City and District Health and Social Services Community Forum.

I am proceeding because of the success of the commissioning pilots on which the new groups are based and because I want to put more money into front-line services and so that local people and local health professionals can work together in a multidisciplinary fashion to make local decisions about local services.

Finance and Personnel

TOP

Mr Speaker:

Question 2, in the name of Mr Oliver Gibson, and question 9, in the name of Mr John Dallat, have been withdrawn and will receive written answers.

Public-Private Partnerships:
Working Group Report

TOP

1.

Mr Fee

asked the Minister of Finance and Personnel when the report of the public-private partnerships working group will be available to the Assembly.

(AQO 1007/01)

The Minister of Finance and Personnel (Dr Farren): The working group's report on the use of public-private partnerships is due for completion by the end of March. The Executive will consider the report in early April and will subsequently decide on an early date for publication for public consultation.

Mr Fee:

Public-private partnerships are having an enormous impact on the way in which public services are funded. Will the Minister tell the House what criteria are being used to determine when the public-private partnership mechanism can be used to deliver public services?

Dr Farren:

We are gathering considerable experience in the application of public-private partnerships to ensure the delivery of infrastructural developments and public sector services. In that context, it was important to carry out the review that has recently taken place. Whatever options are chosen, it is essential that the use of public-private partnerships to deliver public services, where appropriate, must be affordable, deliver value for money and provide effective solutions that meet the needs of our public services in the public interest. In that sense, the use of public-private partnerships is not ideologically driven. Their use is only one way of dealing with the real needs of our public services. I trust that that summary of the general criteria will indicate the basis upon which public-private partnerships can be used to help meet our objectives with regard to our public services and the infrastructures they require.

Mr Speaker:

Question 10, in the name of Mrs Eileen Bell, has been withdrawn.

Accommodation Review

TOP

3.

Mr Gallagher

asked the Minister of Finance and Personnel for an update on the accommodation review.

(AQO 1006/01)

Dr Farren:

The consultants carrying out the accommodation review on our behalf have identified several competing issues that require policy formulation and direction before detailed option analysis can be carried out.

Our policy decisions would be better framed in the light of comments from all interested parties. I have, therefore, given approval for the Department of Finance and Personnel to issue, for public consultation, an interim report on the accommodation review. That report is available to Members today.

Mr Gallagher:

I welcome the interim report. When will the final report be issued?

Dr Farren:

The interim report is being issued today for consultation, and six weeks, up until 19 April, have being granted for public comment. It will take time to come to a view based on the various issues raised in the comments that are received. Therefore it would be reasonable to expect consultants to issue their final report in June.

Mr K Robinson:

I am especially interested in the Minister's announcement that the interim report is to be issued today. Does he acknowledge that, in considering the relocation of Civil Service functions, he must consider the cost implications, such as new travel costs, the efficiencies and overall costs for the new Civil Service locations? Will he bear in mind that the contents of his written replies to questions posed by me clearly show that Larne, Carrickfergus and Newtownabbey have a lower percentage of Civil Service jobs than Londonderry, Omagh and Strabane, which lie west of the Bann?

Dr Farren:

Issues related to costs will have to be addressed when the recommendations that arise from this important review are being addressed. I am aware, from frequent questions posed in the Assembly, that the review excites much interest across all the constituencies represented here.

The Member highlighted certain council areas. The recommendations must be set in the context of what is feasible and what is appropriate. The Member will have concerns for whatever locations, if any, are to be identified for sections of the public service. The Department will take full account of the facilities that are available, not only in the areas that the Member has drawn to our attention but also in other areas.

Spending Review 2002/Barnett Formula

TOP

4.

Dr Hendron

asked the Minister of Finance and Personnel what discussions he has had with HM Treasury regarding the spending review 2002 and the Barnett formula.

(AQO 1010/01)

Dr Farren:

I have had no direct contact with Treasury Ministers on those issues as the Executive are currently considering the Barnett formula and its relationship with the 2002 spending review. However, my officials are in regular contact to ensure that we are fully engaged in all spending review processes that are under way in the Treasury.

Dr Hendron:

There has been much speculation about the Barnett formula. What is the Minister's position on that?

Dr Farren:

When it comes to such matters, it becomes an Executive position rather than a personal position of the Minister of Finance and Personnel or any other Minister. However, Members will accept that now is not the time to state publicly all that we have in mind for the forthcoming negotiations with the Treasury. The Department of Finance and Personnel is determined to seek a fair and appropriate outcome to the 2002 spending review. The case will be pressed at the highest levels.

Public expenditure allocations to, and consequent spending within, Northern Ireland should be based on a fair and objective analysis of our needs. The key issue is the extent to which the Barnett formula addresses that. The Department has undertaken a detailed and rigorous scrutiny of the Barnett formula to examine carefully whether it currently meets our needs sufficiently and, more importantly, whether it will do so in the future. We cannot accept a situation where the provision for priority services such as health, education and transport is markedly less favourable than in England. That appears to be the consequence of the Barnett formula as it is currently interpreted and applied. For that reason the Department has undertaken a rigorous scrutiny of the formula, and our anticipated allocations as they are currently constructed, during the spending review.

Mr Savage:

Can the Minister confirm that there may be risks as well as opportunities related to the review of the Barnett formula? How is he maximising the opportunities and minimising the risks associated with that?

Dr Farren:

I made a statement to the House last week on the timetable for the Budget, which included indications of the staging of the process with regard to the spending review. I made the point that it was not a no-risk process to address, in however detailed a manner, the Barnett formula and the outcomes from its application to our spending needs.

The Department has been engaged in a needs and effectiveness evaluation across several Departments in order to test the extent to which current allocations meet the needs of those Departments. The six Departments under evaluation spend approximately 70% of the total public expenditure for which the Department of Finance and Personnel is responsible. Therefore, a good picture will emerge of how well current allocations under the Barnett formula enable us to meet needs and how effectively we use allocations. That is a large task in our preparations to address the Barnett formula with the Treasury and how it will be used to determine our allocations under the current spending review.

Senior Civil Service Review

TOP

5.

Mrs I Robinson

asked the Minister of Finance and Personnel to make a statement regarding the report he has received from Lord Ouseley concerning the review of appointment and promotion procedures to the senior Civil Service.

(AQO 985/01)

6.

Mr A Doherty

asked the Minister of Finance and Personnel to give an update on the progress of the review of the senior Civil Service.

(AQO 1005/01)

Dr Farren:

I will take questions 5 and 6 together.

The first meeting of the review team took place on Monday 5 March 2001. Since then Members have met regularly to consider and analyse the many complex issues that have arisen. The team has also undertaken a programme of consultation with key stakeholders and other interested parties. That has taken longer than was anticipated at the time the review team was invited to set about its work.

However, the review team has indicated that it will report to me this week. I will then bring the report, with my recommendations, to the Executive for their consideration and final decisions.

TOP

<< Prev / Next >>