Amendments to Standing Orders

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Mr Speaker:

Members will see from the Order Paper that 15 motions to amend Standing Orders have been tabled. Those relate to the Committee on Procedures’ report, ‘Review of the Legislative Process in the Northern Ireland Assembly’, which the House debated on 26 February 2002. Four motions are substantive; the others are consequential. However, as amendments to Standing Orders, all motions will require cross-community support if they are to pass.

I propose to conduct four debates on the four substantive motions. Members have not only the Order Paper and the Marshalled List of amendments for debates scheduled for later today, but a proposed grouping of the 15 motions into four sections. The first debate will take place on motions (a), (b) and (o); the second debate on motions (c), (h), (i), (j), (k), (l) and (m); the third debate on motions (d), (e), (f) and (g); and the fourth debate on motion (n).

Although the motions are not pieces of legislation but changes to Standing Orders, the Business Committee took the view that the business should be conducted as if the House were dealing with amendments to a Bill, as that is what the House is most familiar with. I shall call the first motion, and then we shall debate motions (a), (b) and (o). We shall then continue through the other debates as I have outlined. If that is reasonably clear, we can proceed.

I beg to move:

Go raibh maith agat, a Cheann Comhairle. This first group of motions arises from the Committee on Procedures’ report on its review of the legislative process as debated by the Assembly on 26 February 2002. They will give effect to the recommendations contained in that report, which the Assembly has already endorsed. I covered the background to the recommendations at some length during that debate. Therefore, I do not intend to go over the arguments for those changes in detail.

The first group of motions relates to the recommendations of the Committee that the requirement for accelerated passage be reduced from leave of the House to cross-community support.

The substantive motion outlined at (o) in the Order Paper makes a change to Standing Order 40. Consequential motions are required to Standing Order 25, and those are detailed at (a) and (b) on the Order Paper. The consequential motions are technical amendments that simply make it clear that Standing Orders can make provision for decisions of the Assembly to be resolved by more than simple majority.

During the debate on 26 February, concern was expressed by the Chairperson of the Committee for Social Development about potential abuse of the accelerated passage procedure. In its consideration of the comments expressed by Members during the debate, the Committee on Procedures acknowledged that concern. It, therefore, proposes that if a Minister wants accelerated passage for a Bill, his or her reason must first be explained to the Committee. I emphasise that that does not impose a requirement for a Committee’s consent; however, it does mean that the Committee is aware of the intention to seek accelerated passage and the reasons behind that intention. These motions insert into Standing Orders what we have been advised should happen as part of a Department’s pre-legislative consultation.

I beg to move:

Go raibh maith agat, a Cheann Comhairle. This group of motions deals with Further Consideration Stage. The substantive motion is outlined at (m) in the Order Paper. During our review it became evident that, although it was important that Members had a second opportunity to amend a Bill, the present procedure for the Further Consideration Stage as a complete re-run of the Consideration Stage should be refined to avoid Members being asked to vote again on clauses or schedules that may have already been agreed in the previous week.

The proposed amendment to Standing Order 35 will have the effect of focusing Further Consideration Stage on amendments proposed. Therefore, the Assembly will not be asked to vote to let a clause or schedule stand part of a Bill. Instead, in future, debate and votes at Further Consideration Stage will be only on amendments selected. That is in keeping with the practice in other places.

Seven amendments arise from this proposed change. The substantive motion at (c) is to amend Standing Order 29(d) to make the definition of Further Consideration Stage consistent with the more focused purpose now proposed.

The six consequential motions that are detailed at (h), (i), (j), (k), (l) and (m) are technical and relate to Standing Order 33, which deals with the establishment of an Ad Hoc Committee on conformity with equality requirements. Those amendments are necessary because they facilitate the interruption of Consideration Stage and Further Consideration Stage should a motion be agreed to for the appointment of such a Committee after either of those stages has begun.

This group of motions deals with the extension of Committee Stage. The substantive motion is at (d), and (e), (f) and (g) are consequential amendments. A key recommendation in the Committee’s report was that Committee Stage should be lengthened from its current 30-day calendar limit. Committees have complained that 30 calendar days do not give them enough time to scrutinise Bills. Indeed, our research has shown that to be true, because the average length of time taken for Committee Stage is nine weeks. As I said during the debate on the Committee’s report on 26 February, the Committee is confident that if the Executive pick up on the Committee’s recommendation that draft Bills should be submitted to Committees as part of the pre-legislative consultation, that nine-week average will be reduced. As such, the Committee believes that it is more appropriate to lengthen Committee Stage from 30 calendar days to 30 working days, which will give Committees six weeks. It is therefore proposed to amend Standing Order 31(3) accordingly. Consequential amendments are required to Standing Orders 31(5), 33(5) and 33(7), which will clarify that Committee Stage will now be 30 working days instead of 30 calendar days.

As I said in the previous debate, the change has been introduced to make our procedures more efficient. However, if the change, like the others tabled, does not work, the Committee will revisit the issue.

I beg to move:

This amendment would remove the five-day period required between the Second Stage and the Committee Stage. When a Bill passes its Second Stage and is referred to a Committee, the Committee cannot commence its consideration until five days have elapsed. That reduces the 30-day period that the Committee has to consider the Bill and report on it. As I said earlier, Committees believe that the time allocated to the Committee Stage is too short. The amendment would give Committees an additional five days. The five-day rule would be removed only between the Second Stage and the Committee Stage. It would remain in place between the other stages of the legislative process.

In Standing Order 40(3) delete all and insert:

"(3) Where, exceptionally, a Bill (other than a Budget Bill) is thought to require accelerated passage, which shall exclude any Committee Stage, the Member in charge of the Bill shall, before introduction of the Bill in the Assembly, explain to the appropriate Committee:

"Friends of Hospitals"

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Amendments to this motion and the next motion have been proposed. Both motions are time-limited; therefore, I ask the proposers to limit themselves to around seven minutes and those who are speaking — whether to amendments or to the motion — to around five minutes. There will then be the opportunity for the Minister to sum up, and for both the proposer of the amendment and the proposer of the motion to make a winding-up speech.

I beg to move

I tabled this motion because we have heard so much recently about the funding problems faced by the Health Service. Looking at the current position of the Health Service takes me back many years to a time when the community in Ballymena became concerned about the high level of cardiac problems in the area.

Several of us got together and decided that something had to be done to assist the local hospital and, in particular, the specialist whose wonderful cardiac research was being inhibited by a lack of funds and equipment. We met the business community, and in the course of a few years a tremendous amount of money was collected and specialist equipment was installed in the hospital. Great work was done in the Waveney Hospital in Ballymena, and the effort was such that it became the pattern for hospitals, not only throughout Northern Ireland but across the UK.

The idea came to me some time ago as a result of hospital visits. Staff were saying that they had problems with the provision of capital equipment, the lack of space and the funding of nurses and other staff. I began to think about the voluntary element of the Health Service. Volunteers have been a feature of health provision since the beginning of healthcare. Florence Nightingale, the lady with the lamp who nursed the sick and wounded of the Crimean war in the 1850s, and who is widely credited with the foundation of the modern nursing service, was a volunteer. The concept of volunteers in the hospital service is not a new tradition, but a long and honourable one. It has its roots in the Christian philanthropy of the industrial revolution during a pre-welfare age, when the only provision was voluntary. It is interesting that Bishop Maddox of Worcester is credited with being the founder of the movement in 1746.

When the National Health Service began in 1948, the then Health Secretary, the formidable Aneurin Bevan, spelt out the role of volunteer workers in a welfare age. His words are still relevant today. He said that personal and voluntary work in hospitals would always be needed, and here is the punchline:

The National League of Hospital Friends was formed by 49 representatives from 40 hospital leagues. It later became the National Association of Leagues of Hospital Friends. In 1998, to reflect the growing importance of its work in the community, the title was changed again to the National Association of Hospital and Community Friends. It has 804 affiliated groups. Voluntary work is a thriving tradition and a significant element of Health Service provision. The National Association of Hospital and Community Friends conducted its most recent survey in 1999. It shows that leagues of hospital and community friends had 36,000 members who actively and voluntarily contributed some eight million hours of work a year to the National Health Service. However, what intrigued me most was that the survey also found that the leagues donate some £36 million a year to NHS hospitals.

I could go on speaking about such statistics, but I came across one statement that brought the point home to me. Neil Hidgely, a 22-year-old volunteer from Reading, said that the youthful "Friends of Hospitals" in Reading had many volunteers in their teenage years or in their twenties. His group had presented a chair to one of the hospitals. He said:

The "Friends of Hospitals" in Northern Ireland — those little groups that look on the local hospital as their hospital — are quite willing, as my contact with them has proved, to play their part in assisting the Department of Health, Social Services and Public Safety to achieve what could not otherwise be achieved because of limited funding.

It would give the community a sense of belonging. In other words, it would be the community’s hospital, and people, having received healing, help and health through the work of their hospital, could give something back to it. It would reduce departmental spending. If the Department were to match pound for pound the amounts raised by the community groups — the "Friends of Hospitals" — expenditure would be reduced. That would also foster a team effort in the community that would bring everyone together.

I must reject the amendment, especially the restrictions that would be placed by the wording in the final line, which says:

I want the community to be free, in consultation with its local hospital board, to decide on the priorities that can be met through its contributions.

I have received one amendment to the motion. It is published on the Marshalled List of amendments in the name of Ms Sue Ramsey and Mr John Kelly.

Go raibh maith agat, a Cheann Comhairle.

I beg to move the following amendment: Delete all after "to" and insert

In moving the amendment, I wish to pay tribute to "Friends of Hospitals" and congratulate them on the immense contribution that they have made to hospital care. The amendment does not seek in any way to detract from the very good work that they have done. Rather, it seeks to broaden the scope of that work and to ensure that social need is met. We need to avoid a situation in which the rich would become healthier and the poor would become sicker. We need to have an equitable distribution of the funds that are available to the Department, and that is why we have moved the amendment. We do not seek in any way to diminish, demean or dismiss the work done by the charitable organisations.

There will always be room for the charitable provision of extra items and projects, but it is essential that charities should not be called upon to provide core funding. The Health Service should have sufficient funds to meet its obligations. We could see a situation arising in which the Government would be quite happy to see charitable organisations carrying out the functions for which they should be responsible. They might not provide the money for health that they should do because charitable organisations were trying to provide it.

Targeting social need is important. The current situation requires much greater funding than is provided under the Barnett formula, which needs to be strongly opposed by the Minister of Finance and Personnel. Given the lack of resources for the Health Service, it is important that the resources that we do have, including those that come from the charitable sector’s sterling efforts, are used as fairly and efficiently as possible.

That is why, at Executive level, the Programme for Government is agreed and why, at departmental level, priorities for action are drawn up. Those are used carefully to identify the greatest needs and to allocate resources accordingly. If we abandon the Programme for Government and the priorities for action, we abandon the possibility of co-ordinating services. Moreover, we abandon the chance to assess the appropriateness of the use of public money, and we abandon safeguards against the possibility of a needless duplication of services. Most dangerously of all, however, we abandon the system by which the equity of resource allocation is ensured.

If the motion were to become departmental policy, the communities that could raise the most charitable money would get the most money from the Department of Health, Social Services and Public Safety. It is not hard to imagine that those communities would be the richest ones. Therefore we would have a situation that would make a mockery of the Department of Health’s campaign to end inequalities in health provision. As I said in my opening remarks, the rich would become healthier and the poor would become sicker.

Having said that, I commend Rev Robert Coulter for tabling the motion and congratulate the "Friends of Hospitals" on the immense contribution that they have made to hospital care. However, these are the small dangers — maybe great dangers — that we envisage in the adoption of this motion. I support the amendment.

I stress that I am speaking on this matter as an Assembly Member, and not on behalf of the Committee for Health, Social Services and Public Safety.

I welcome the opportunity that this motion gives us to speak on the involvement of voluntary groups with the Health Service, and Colleagues will agree that support from local groups such as "Friends of Hospitals" is to be welcomed. Members are only too aware that severe budgetary constraints on the Health Service have meant that it has not always been possible to provide better facilities and more comfortable surroundings through public funds. Voluntary fund-raising undoubtedly helps, creating a sense of ownership of the public services.

Although I welcome the endeavour and enterprise of community groups in raising funds for local projects, I strike a cautionary note about making a commitment to match public resources with a carte blanche. Substantial capital investment in hospital equipment, such as MRI scanners, can bring with it heavy recurrent running costs, which need to be factored into future budgets. We have to bear in mind that investment in new technology will be accompanied by the administrative and staffing costs of the nurses and doctors who man it. The Health Committee’s two inquiries into children’s residential care and cancer services both strongly highlighted the importance of the voluntary and community sectors, working collaboratively with the Department, the boards, and the trusts to address priorities in the Health Service.

There is clearly a need for substantial fund-raising activity to improve the comfort of patients. However, that work has to be co-ordinated closely with the work and objectives of the Department in order to fully optimise the benefits for everybody in the region.

I agree with the spirit of the motion. However, the proposed amendment fits in with our Programme for Government and priority for action, and, therefore, my party will be supporting the amendment.

In too many instances, the amount of money needed far exceeds that which "Friends of Hospitals" can raise. However, without that money hospitals would be unable to cope with the demand for sophisticated and up-to-date equipment. I worked in Altnagelvin Hospital from 1961. As everyone is aware, it was the first hospital to be built in post-war Britain. The fact that it took almost 11 years from planning through to construction and the commissioning stage meant that equipment quickly became obsolete — not by the design, but by technology.

At that time there were four acute hospitals in the Derry, Limavady, and Strabane area, plus two psychiatric hospitals, Stradreagh and Gransha, each with a group that raised funds. We had Friends of Roe Valley, St Columbs, Stradreagh, Gransha, Strabane, and Waterside. Altnagelvin replaced all four acute hospitals, and currently Friends of Altnagelvin raises valuable funds through flag days, cake sales, the sale of Christmas cards, and other activities. They raise around £10,000, which, although invaluable, is generally spread quite thinly. Having it doubled would help.

Over the years these groups have bought some invaluable equipment, as have other groups that have raised funds specifically for areas such as cardiac services, neonatology or pain relief clinics. However, other funding priorities have seen donations dwindle, as people try their best to support other charities. For example, in my area, the Foyle Hospice for the terminally ill and relatives’ respite care, Macmillan Cancer Relief and various cancer charities would find it difficult to cope without that community support.

I will give a few examples. In the north-west edition of last night’s ‘Belfast Telegraph’, there were appeals for the sensory impaired and a children’s cancer unit, which has currently raised £47,000. A chain walk across both bridges in Derry has been organised for the weekend. It is hoped that 3,000 people will take part in the event to raise a further £3,000 for the children’s cancer unit. Money is also being raised for a 10-month-old child who was born without a brain stem. Children from the Cathedral Youth Club in the Fountain raised money, through a sponsored walk, to give him an easier lifestyle. We also had an appeal for Help the Aged. These charities are well worth supporting, and any extra funding would benefit them.

Recently, the wife of one of my friends died. She was treated in the Mid-Ulster Hospital. Unfortunately, the time from the diagnosis until her death was short. My friend wished to do something to help the hospital. I can give examples of some of the equipment that the hospital said that it needed urgently: two Colleague intravenous infusion pumps, each costing £1,600; a critical blood pressure monitor, which costs £2,000; an infant resuscitator costing £9,000; a foetal monitor, which costs £5,000; a sofa for the midwives’ restroom at £850; an electric couch for a treatment room at £810; and a new incubator for the children’s unit at £15,000. In total, almost £36,000 was raised, which for a small community was an excellent response to an appeal that lasted only four months. It is obvious that such people give much more to the community and deserve our thanks. Anything that improves funding for vital services is needed.

There was a fire at Altnagelvin Hospital last night, and 60 elderly patients, including stroke victims, had to be evacuated from the geriatric unit. Thanks to the excellent care and extra service that was provided by the hospital, the Fire Service and the ambulance crew, all the patients were evacuated safely to other parts of the hospital. I commend not only the staff there, but those who returned during their off-duty time to ensure that the elderly were not left in a more traumatic condition. As we know, it is difficult for an elderly person to be moved to unfamiliar surroundings. For that reason, all those members of staff deserve our thanks.

Last month, the Committee for Health, Social Services and Public Safety visited Altnagelvin Hospital and saw the stroke unit. We know how difficult it is to move stroke patients, and they too were safely moved out during the fire. We support the spirit of the motion because all aspects of the Health Service would benefit. However, the amendment keeps any action in closer line with the Programme for Government and the priorities for action; therefore, the SDLP will be supporting the amendment.

Go raibh maith agat, a LeasCheann Comhairle. Caithfidh mé mo bhuíochas a ghabháil leis an Oirmhinneach Robert Coulter agus leis an Uasal McFarland as an díospóireacht thábhachtach seo a thabhairt anuas ar an chomaoin a bhfuil muid fúithi ag na daoine sin a oibríonn gan scíth ar son othair ospidéil agus daoine leochaileacha eile.

D’éist mé go cúramach lena moladh gur chóir dúinn níos mó úsáid a bhaint as an earnáil dheonach lenár seirbhísí a fhorbairt, agus is maith a thuigim a smaointe.

Tugann díospóireacht an lae inniu deis dúinn machnamh a dhéanamh ar an ról fíorthábhachtach atá ag an phobal ag forbairt agus ag coinneáil na gcaighdeán is airde cúraim inár n-ospidéil agus ar fud na seirbhíse.

I thank Rev Robert Coulter and Mr McFarland for stimulating this important debate on the debt that we owe to those in the voluntary sector who work so tirelessly in the interests of hospital patients and others. I also endorse Annie Courtney’s support for the staff who coped magnificently with safely evacuating the elderly from Altnagelvin Hospital last night. It is at such times when the support of the local community and "Friends of Hospitals" is welcomed.

I appreciate the suggestion by Rev Robert Coulter that we should make greater use of the voluntary sector in developing our services. Today’s debate provides us with an opportunity to reflect on the enormously important role of the community in developing and maintaining the highest standards of care in our hospitals and throughout the service. That recognition was expressed by all Members in the debate, and I welcome that.

The Rev Robert Coulter highlighted the noble tradition of personal and voluntary endeavours in aiding our hospital services. There has been a long history of voluntary sector involvement in the development of hospitals and many other services here. Some of our hospitals were established by local communities through public subscription. Others have been supported through the years by generations of local people who have voluntarily given up their time and money. The new wing at the Mater Hospital was made possible by the efforts and dedication of the local community, and I was delighted to visit it recently. Other Members have spoken of similar visits that they have made to hospitals in their areas.

Voluntary organisations and community groups play a vital role in representing their communities. Those groups often draw their membership from individuals who have direct experience of illness, either personally or through someone close to them, and they may want to give something back to their community. They contribute in many different ways. I pay tribute to all those communities and individuals for their dedication, the commitment of their time and energy and the vital role that they play in the development of our services. They are part of our caring society, and they enrich it.

I also want to pay tribute to the support that "Friends of Hospitals" have given to our trusts. Over the years their contributions have ranged from the provision of support for training to the purchase of much-needed specialist equipment. Given the current funding pressures on our services, and the history of underfunding, their efforts are doubly valued.

I recognise and appreciate the intentions behind the motion. The excellent work and support of the "Friends of Hospitals" are valued by the service, and it is important that their work continues to complement and augment existing services. Therefore, to be of maximum benefit, it is essential that we build on the Health Service’s existing close working relationship with voluntary trusts, societies and the voluntary sector to ensure that such input generates the best return in terms of improvements to patient care and treatment.

It is vital that that collaboration take place to ensure that projects complement and contribute to public service priorities. I need hardly add that if proposals generate a recurring commitment, they must be factored into our spending plans, otherwise they risk skewing resources from priority areas. It is important, therefore, that each proposal be looked at on its merits and that we target support to accord with our overall priorities. Consequently, a separate funding network would not be in the best interests of our service. Indeed, any blanket arrangement for separate funding could divert vital resources from key priorities. That would place greater pressure on our front line services, rather than improve services, and, as John Kelly said, it might also adversely impact on important programmes such as new targeting social need and the equality agenda, which aim to provide care for all our people on an equitable basis.

Although the proposed plan is not the optimum choice at this time, there are real opportunities to consider individual proposals case-by-case. There are many examples where that has worked well, and important projects have been taken forward successfully in partnership. Trusts must listen to the communities that they serve when developing their priorities, and, where a given proposal complements the overall strategic aim, an appropriate business case can be jointly developed to examine the viability of a project, while identifying its benefits and its full capital and revenue implications.

Therefore, our best way forward is to be able to consider proposals case-by-case, with the closest possible linkage between the statutory sector and the voluntary and charitable trusts, and the building of a business case with local trusts to ensure that the tremendous voluntary efforts are advancing the priorities that we have agreed.

Go raibh maith agat, a LeasCheann Comhairle. I thank Rev Robert Coulter and Mr McFarland for tabling the motion. Although I agree with the sentiment and the thinking behind it, support for the motion will cause concerns, which several Members highlighted. Agreeing the motion would result in affluent areas such as parts of north Down and Ballymena, which can raise about £100,000, having that amount matched by the Department of Health, Social Services and Public Safety. Areas such as Falls Road, Shankill Road, and parts of Derry and Tyrone, which might be able to raise only about £10,000, would be entitled to have only that amount matched by the Department. That gives me concern, given that we have priorities for action, a Programme for Government and targeting social needs.

With that in mind, John Kelly and I have tabled an amendment that covers many of the concerns that other Members raised. I thank and commend groups such as "Friends of Hospitals" for their hard work, commitment and dedication in raising much-needed finances for local hospitals. I am sure that without their work, some services would be worse off. The amendment is based on reality. Although a group in north Down could raise £100,000 for an MRI scanner, that might not be a priority for the people there. The Department's money would be tied up because it would be duty-bound to match that £100,000. That goes to the core of the matter.

I agree with Tommy Gallagher, who added a note of concern to the original motion. Fund-raising must be carried out in conjunction with the Department of Health, Social Services and Public Safety, which has produced priorities for action. Those priorities are supported by the Committee for Health, Social Services and Public Safety, which has a part to play also.

I do not agree with Rev Robert Coulter's contention that the amendment restricts people's ability to raise money; it does not do that. We should be thankful that people are raising money. The amendment is designed to ensure that the money will go to the heart of the problem, targeting the established priorities and problems of the community.

I agree with the Minister's assertion that community groups and voluntary organisations have an important part to play in the Health Service. However, trusts must listen to the communities that they serve. That ties in with the priorities for action and the Programme for Government, and it is upon that reality that John Kelly and I have based our amendment.

The fundamental issue of the motion and the amendment is that the Health Service has been seriously underfunded for many years. I welcome yesterday's commitment by Dr Farren to provide more funding for health. The Executive have said that health is a priority. My concern, however, is that the additional money is not enough. It is a welcome start, but we need to get to the core of the problem: if we want changes in the Health Service, we must address underfunding.

I ask Members to support the amendment. Although we cannot prevent people from raising money in good faith, we must not allow those who are unable to raise similar amounts to be discriminated against. The rich will get healthier and the poor will get sicker. We need to ensure that everyone in society has the opportunity to become healthier. Go raibh maith agat.

First, I welcome the Minister's addressing the problem, and I thank her for acknowledging the voluntary sector's vital role in assisting the Health Service and hospitals and helping out sometimes, when the Department cannot find appropriate funds. I thank her for acknowledging the work of "Friends of Hospitals" and for her commitment to continue developing relationships with such groups.

I shall be brief. Mr Gallagher spoke about the contribution of voluntary groups and the vital role of "Friends of Hospitals", with their ability to provide equipment and services that the Department may not always be able to fund. He talked about the need to work with the Department of Health, Social Services and Public Safety - it has never been the intention of "Friends of Hospitals" to work without full consultation with, and in conjunction with, the Department. Rev Robert Coulter's motion covers that point.

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