Northern Ireland Assembly
Monday 24 June 2002 (continued)
The second question is that of delay. I do not suppose that third-party appeals will be made against the vast majority of planning approvals. They will be made in respect of decisions that affect a large section of the community and to which there is popular objection. Ms Morrice made the positive point that we have impact assessments about the birds and the bees, and flora and fauna. In the context of planning, the most important fauna are human. I have often attended and been professionally involved in planning appeals where planners have produced a set of logical guidelines and principles to support their statement that they can do nothing about a development, despite the massive objection of the humans who will be most intimately affected by the decision. The present law does not require planning approval for demolition, so a developer can move into a zoned or residential area and demolish an Edwardian or a Victorian building, which may not be listed or of specific architectural or historical merit, but which is part of the fabric, atmosphere and age of the area. The building's demolition leaves a piece of open ground in an area where a developer is bound to get permission for a residential development. The planners' only control over that is a collection of nebulous guidelines that the proportions of the new building must be roughly similar to those of surrounding developments. Permission for some apartments is then granted to the developer. However - and this is the nub of the matter - the builder builds the development but adds an extra floor comprising an additional six flats costing £250,000 or £300,000 apiece. That has happened in north Down; developers are making a killing. When local people object on the basis that there has been a breach of contract, there is a marked reluctance by the Planning Service to instruct that the building be demolished. There is then much toing and froing, which the builder ignores, and, in 10 cases out of 10 - not nine out of 10 - he is given retrospective permission. At that stage the developer has made a killing, and a coach and four have been driven through the planning laws. The Assembly must think carefully before ignoring third-party appeals or adhering strictly to planning decisions. Third-party appeals would be relatively few, and it would be easy to legislate that, in order to gain a right to such an appeal, a person must present a prima facie case. Under those terms, only where a prima facie case is demonstrated would a third-party appeal be allowed. That litmus test would eliminate many of the fears that envious or vindictive neighbours would, willy-nilly, make third-party appeals. It might also be legislated that costs may be awarded where a third-party appeal is lost and an inspector decides that the case never had merit. Those are not the only methods, but such provisions might remove many of the Minister's fears about third-party appeals. 1.15 pm Some Members who have spoken have heavily canvassed the issue of fines. I endorse the frequent suggestion that the fines are inadequate, even at their present limit. Developers can get £250,000 or £300,000 for an apartment, and if they can get a further four apartments by adding an extra storey, that is very big money. The fines are relatively innocuous in proportion to that and would not deter anyone. The other point I want to make is about the relationship between developers and planners. Developers are there every day. In some cases in which I have been involved, there has been such a multiplicity of plans that the average person going to inspect them cannot understand them unless he brings an architect who has half a day to spend on them. Members must be careful about dismissing the introduction of third-party appeals, because there is a suggestion that developers have a big "in": they are professionals; they know what is required; they have existing relationships with planners; and they often get away with things that an ordinary individual would not. There is a presumption in the planning culture that if developers are providing employment, putting money into the economy and doing something that has a veneer of public benefit to it, such as additional housing, they should get planning permission. That sort of culture must end. I endorse what Mr McGrady said about what is not in the Bill. There is nothing in it about masts. Planning should be for people who live in communities. It is not good enough not to pay strict attention to what a significant number of ordinary people feel about the possible dangers of radiation from masts. That should be provided for in the Bill. Am I being cynical in saying that once again this is a question of big business? Vodafone, Orange or whoever puts up the masts have a subliminal clout that the rest of us do not have. While I support the Second Stage of the Bill in principle, there are worrying omissions and failures to address various matters. The Chairperson of the Committee for the Environment (Rev Dr William McCrea): I apologise to the Assembly and the Minister for being unable to be here at the beginning of the debate, but the Minister for Social Development was in my constituency this morning. As I was unable to hear the Minister's opening comments, I will keep my remarks brief. However, I will read, with great care, what he and other Members said in that part of in the debate. It is important for the Committee to consider carefully the views of Members who are not members of the Committee and cannot make their views known there. I will ensure that the Committee receives a copy of the record and that it gives due recognition to what is said. No one would say that all is well and that we have effective planning laws that reflect the demands of our society. Many matters need to be brought to the attention of the House, and the Planning (Amendment) Bill ought to consider other matters that the Minister and the Department have not taken into consideration. I will confine my remarks to three areas. Ms Morrice and Mr McCartney touched on them, as did others. I want to make it clear that the Minister cannot duck the question of third-party appeals, nor will the Assembly allow him a way to do that. The Committee for the Environment fundamentally supports the necessity for third-party appeals, and we have been strong in our representation to the Department, as the previous Minister and the current Minister both know. The issue cannot be put on the long finger. Developers have priority over the community under current planning legislation, and that cannot be permitted to continue. Mr McCartney said that when developers are mentioned we hear about how they provide employment and invest in the economy - and rightly so. No one in my Committee wants to stop developers doing anything that will benefit the community. However, they are not the only ones putting something into the local economy and providing employment; the people in the community are also putting a lot into it. Let us never forget their value and commitment to their areas. It is vitally important to ensure that the rights of the ordinary citizen in a community are taken into consideration. If an applicant is refused, he has the right to appeal. However, if a community feels that its rights are being trampled over, it has no right of appeal. I gather that the Minister said that he is not taking forward third-party appeals at this time. Several Members have drawn that to my attention. The rights of individuals can be violated, and they ought to have the right to appeal. This issue, whether pursued by my Committee or by individuals, will not go away. It will be on the agenda, and the Assembly will have the opportunity to give its opinion. If the Minister had listened to the will of the House in past debates, then he would have introduced the right of appeal in this Bill. Even at this late stage, the Minister should accede to that will. If he does not accept that it is the will of the House, then we should put it to the test in a democratic fashion through a vote. This is a live issue, and it will be dealt with in the Assembly, whether through the Minister's intervention or through the intervention of others. I hope that that gives some assurance to Members that the matter is being taken seriously. I want to deal with the level of fines being suggested in the Bill. Those fines are as nothing when measured against the high profits that developers can make by breaching planning law. The answer will come that cases can be taken to the Crown Court, where there is no limit on the fines that can be imposed. If that is so, and if the Department believes that it is a serious issue, then local courts should also have the right to impose fines relevant to the huge profits being made. What is £20,000 to a developer who is probably making £1 million from his development? It is absolutely nothing. He laughs all the way to the court and out of it, and he laughs at the community, which feels aggrieved by what has been done. Serious consideration must be given to this. The Minister and his officials have told the Committee that the Secretary of State would have to agree to a large increase in fines. If that is so, the Committee requests that the Secretary of State be approached. Northern Ireland has particular needs, so if fines cannot be increased without the Secretary of State's intervention, he should listen to the will and desire of the House and do something about it. There must be proper enforcement. I am told that the Minister said that more staff would be employed in the Department's enforcement section, which has an abysmal record. There must be real enforcement, because many people in Northern Ireland think that they can breach planning law and that nothing will be done about it. Mr McCartney said that there was hesitation in forcing people to demolish buildings. I have not found that to be the case with regard to ordinary people, who seem to be faced with greater threats than those who have financial clout. I want to see building development in the Province, and I want to see planning permissions being granted. However, the Planning Service must be sensitive to particular areas and to older buildings that are being pulled down, with new buildings being erected in their place. New buildings are often out of place and are more of an eyesore than the original good-quality buildings. That has been the scenario in Belfast recently. The Committee will listen carefully to what the Department has to say. However, the Minister is aware that the Committee has a mind of its own and will challenge the Department. If the Department is not willing to yield on matters on which the Committee has strong feelings, the Committee will not be behind the door in telling the Minister and the Department what it thinks. If it must bring the matter before the House, it will be happy to do so. Mr Nesbitt: I am trying to ensure that when I move the Dispatch Box I do not cowp or demolish my glass. Rev Dr William McCrea: Do you have planning permission to put the glass there? Mr Nesbitt: I have placed my glass where others have placed theirs, so we are in accord with one another. It is good to note that the Chairperson of the Committee for the Environment and the Minister of the Environment are acting in harmony and accord. Ms Morrice: There may be a third-party appeal. Mr Nesbitt: Someone may wish to lodge a third-party appeal on where the glass is situated. However, that is a serious matter with regard to the Planning (Amendment) Bill. Eight or nine Members have spoken, and much concern has been expressed about inadequacies in the planning system in Northern Ireland. I am mindful of economist John Simpson's words in the business section of the 'Belfast Telegraph' some weeks ago that everyone has something to say about the Planning Service, just as everyone has something to say about the weather - but at least, on some days, the weather is good. That gave food for thought, and I referred to it at the start of my address. The Planning Service has been under pressure and needs more resources. There are difficulties that must be addressed, and I am not ducking them, as I said in my opening remarks. I thank Mr McGrady for his comments about the empathy that I have shown. I reiterate, in the presence of the Chairperson of the Committee for the Environment, who was not present earlier, that I empathise with many of the comments that the Committee has made to my officials and to me. Mr McGrady mentioned the House of Commons Select Committee on Northern Ireland Affairs inquiry into planning in 1995, and that many issues dealt with then are being discussed again. I am conscious of that. It is mentioned in the paper that was sent to the Environment Committee today. 1.30 pm Mr McGrady also mentioned urgency and immediacy. He said that he was unsure about the scope of enhanced provisions to prevent demolition because the Department will have to quickly identify important buildings that might be demolished. He talked about the listing of buildings. He said that it is fine to have a new rule preventing demolition, but that such orders must be enforced, because once a building has been demolished, nothing can undo it. Contrary to Ms Morrice's belief, spot-listing is contained in the Bill. I am not sure where the Member heard that it had somehow been taken out. It is not out. Spot-listing is clearly provided for in the Bill. Mr McGrady stressed that it is fine to have the Bill, and fine to have these provisions - as long as one uses them and knows when they must be used. Surveys have been carried out. The first, conducted in 1970, was on a wing and a prayer. It ended up comprising just one photograph of a building because resources were not available. The problem with listed buildings is threefold. First, we do not know the status of some of those buildings. Secondly, we do not have the resources to deal with them. Thirdly, we do not have the enforcement measures to deal with them. More resources are needed, and we must be clear about those buildings that can or cannot be listed. I mentioned that point in an article that I wrote in the 'Belfast Telegraph', in which I invited people in Northern Ireland who feel that there is a building that could, or should, be listed to notify the Department. I was responding to and empathising - if I may use that word again - with that paper's editorial, which commented that we must work together as a community to make sure that our built heritage is protected. [Interruption]. My time is limited. I am not being disrespectful to Mr McGrady. [Interruption]. If I have as long as I like, I will give way to Mr McGrady, but I will not give way ad nauseam to all and sundry. Mr McGrady: It has been so long since I spoke that I can hardly remember what it was about. The Minister said that it will be possible to list buildings to prevent their demolition. Is he conscious that listed buildings are being demolished and virtually no action is being taken? Mr Nesbitt: That may be the case. I cannot comment on specific examples. However, I have stressed that part of the Bill is to ensure greater rigour of enforcement. Penalties will be made very clear. The Department and I are serious in our intentions; not only about built heritage, but also that the planning regime is clear and transparent, and that those who abide by the law will have a speedy decision while those who breach the law will be swiftly penalised. I abide by my opening comments to that effect and will ensure that they are reflected throughout this Bill. Mr McGrady mentioned third-party appeals. That issue came up quite often. He also hoped that the three documents that have been issued to the Environment Committee would be made available to the Assembly. That is a reasonable request. It has taken some time for officials and myself to deliberate those issues. Indeed, we worked on them over the weekend to ensure that we got to grips with their nuances in preparation for this debate. The papers were sent to the Committee today, and other Members should also have them. Mr McGrady said that I have set my mind against third-party appeals. I am less sympathetic to, and not completely persuaded by, third-party appeals. However, I want more consultation. He said that all political parties and most district councils want them. I wish that Mr McCartney were here, because he said that there was a desire for third-party appeals, regardless of their difficulties. This is not an exact analogy, but many people have a desire for speed and cars that can travel at 160 miles an hour. However, the fact that people have a desire for something does not mean that the law permits them to realise that desire. I am sorry that Mr McCartney is not present. His criterion of desire is not - The Chairperson of the Committee for the Environment (Rev Dr William McCrea): The desire to speed is irrelevant; that is an illegal desire. Mr McCartney referred to the will of elected representatives and the public. The Department must get on with reform, because the desire is not illegal, and it should have the backing of the Department. Mr Nesbitt: I am dealing with the choice of words, which are important to lawyers, and, therefore, to Mr McCartney. He used the term "desire"; I said that desire alone does not justify an action. All aspects must be assessed. However, I said that I wished to discuss the matter further with the Committee and others. Mr McCartney said that the phrase "no legal imperative" was an odd one. The legal imperative to which I referred was European Convention law, whereby a body outside the jurisdiction of the United Kingdom could dictate how something must be done, as with European Directives, which when passed through certain procedures, automatically become Northern Ireland law. That legal imperative has been tested in the courts, and we have not contravened it. Mr McCartney said that it was strange that mobile phone masts were not included in the Bill, and he spoke of their dangers. Some Members must have a mental block; that matter was dealt with. Some Members said that we had an obligation to bring forward the matter; it was brought forward. The Planning (General Development) (Amendment) Order (Northern Ireland) 2002 came into force on 21 June 2002, and copies are available in the Library. Full planning permission for mobile phone masts is required. We followed the Stewart principles on precautionary measures, and Policy Planning Statement No.11 made clear our modus operandi in respect of telecommunication masts. Why do Members say that we have omitted to deal with mobile phone masts, when the reverse is true? I thank Mick Murphy, a member of the Committee for the Environment, for his comments on our progressive approach to trees and other matters. There is much good in what has been said, as well as some bad. Trees should be replaced like for like. Another Member mentioned the protection of the undergrowth, the habitat of birds and wildlife, but we can protect only trees. Mr ONeill, who is not present, asked whether a tree preservation order would continue to apply if the ownership of the land changed. If trees are removed from an area protected by a tree preservation order, the trees must be replaced, and the order still applies. The trees cannot be removed to create space for development. Mr Mick Murphy and Mr McGrady stated that, given that third-party appeals are provided for in the Republic of Ireland, they should be included in this Bill. I am not against implementing measures because they are law in the Republic of Ireland. In fact, research issued to the Committee for the Environment about practice in the South and in Northern Ireland projects that, contrary to Mr McCartney's belief, there could be between 500 and 700 more cases a year in Northern Ireland, costing £1 million. In the South, cases are subject to an 11-month delay because of third-party appeals. The research found that, by involving district councils, the North has a more consultative-deliberative planning process than does the South. We are therefore not comparing like with like, and we must deal carefully with the issue of third-party appeals. I thank Mr McCarthy for remaining in the Chamber. Mr Ford: Mr McCarthy has manners, unlike some Members. Mr Nesbitt: I did not catch what the leader of the Alliance Party said. However, having made a comment, does he now resile from repeating it? That is most unusual. A Member: It was a complimentary comment. Mr Nesbitt: If it was a compliment, I accept it, but only because a Colleague of mine on my left says so - in case it was not a compliment. I agree with Mr McCarthy that the Committee has much work to do. We all do. I empathise with many of the Environment Committee's recommendations, and my officials and I want to work with it. I note the extension to 17 October 2002 that Rev Dr William McCrea seeks for the deliberation of the Bill. I say yes; we have weeks in which to work together to achieve a resolution based on evidence, not emotion. Mr McCarthy also said that the absence of third-party appeals, and the fact that objectors have no right to appeal, is unacceptable. I concur that there must be balance and that we must avoid vexatious claims from people on neighbouring properties. It is a complicated process, and that is why I wish to issue a consultative document to determine the best way forward. Mr McCarthy stated that listing powers are useless if adequate resources are not available. Again, I agree with him, and for that reason I will target enforcement for resources. Mr Watson referred to a planning system that is biased in favour of developers. I want a system that is biased in favour of law-keepers, not lawbreakers, regardless of whether they are developers or Mr and Mrs Joe Bloggs in the country. I want the planning system to be efficient and effective for law-keepers; and, for lawbreakers, I want a service that will ensure that penalties are imposed speedily. Therefore if the planning system is biased in favour of developers, I trust that it will not be in the future. It is a simple matter of right and wrong. It is a question of having a law that reflects the Assembly's wishes and of ensuring that they are enforced rigorously. Mr Watson stated that fines of £20,000 are not a significant or adequate deterrent and that he has seen no evidence that the new measures will work. To determine whether the new measures will work, we must implement them. It is therefore illogical for Mr Watson to claim that there is no evidence that they will work. 1.45 pm He said in his conclusion that the Committee would be diligent. I concur that the Committee has been diligent, and I have no doubt that it will continue to be so. Ms Jane Morrice said that Members would themselves propose amendments providing for third-party appeals if others did not. My advice is not to do that. Those points have been covered. She suggests that fines should return to the voluntary sector - that the money raised should be repackaged and passed on to that sector. That request is interesting, and the Minister of Finance and Personnel would also find it interesting. I have already covered Ms Morrice's point where she alleged that someone had removed the line on spot-listing. I wrote "No, definitely not" in my notes. It was not taken out. I agree with Ms Morrice when she said that cramming in towns, and other such issues, must be dealt with. We do need a new culture; we need change, and we also need to know people's views. However, I was concerned when she said that she would put her trust in the Committee, because I hope that she also has some trust in me and in what I am doing. Working with the Committee, we will deal with the issue. I have noted carefully what Mr McCartney said. Indeed, I note what all Members say, but Mr McCartney is judicious and correct in his use of words, I trust. He referred to third-party appeals, and he said that it is quite clear that, regardless of the difficulties, there is an overwhelming desire for such third-party appeals. That is a criterion alone. I have already referred to the use of the word "desire" in my answer. Ms Morrice: Third-party appeal is interesting, because the Minister compared our legislation with that in the South, referring to the delays, and so forth. He said that there is more consultation in Northern Ireland than in the South. He cited the role of local government in that consultation process. Is it not true that even if an entire council opposed a development, it could still proceed? What value is the consultation process if it serves no end? Mr Nesbitt: That is the position to a certain extent, but I am the Minister who is accountable for decisions. The council is consulted. De jure, I make all the 24,000 decisions that must be made in the year; de facto, I may make some decisions on significant or contentious issues. Ms Morrice may recall that I mentioned the review of public administration. On other occasions the House has recommended that we wait for the outcome of the review of public administration, as it did in the case of the Local Government (Best Value) Bill. As a result of the review of public administration, it may be that the authority for deciding on these matters would reside with a district council or its replacement. That could be the elected body to make the decision, and, therefore, a third party might take that decision out of its hands to a planning appeals commission. That highlights the difficult issues that we must address, assess and assimilate. As I said, we base our decisions on evidence, not emotion. Mr McCartney also said that I said that third-party appeals would interfere with legislation. He then said that the argument that third-party appeals may interfere with legislation lacks any merit. Let me make it clear - and the record will show, as I repeat it - that when I referred to legislation, I said that the impact of legislation would be in the planning process and the operational efficiency of planning. That is the outcome of changing legislation. Of course we can change legislation, and we have the authority to do that. However, we must weigh the impact and the merit of changing the legislation. I simply point out that changing the legislation will have a significant impact on the planning process and its operational efficiency. Rather than my argument lacking merit, it has merit. A judgement must be made. The Assembly is about balancing judgements against competing demands. Mr McCartney stated that " in 10 cases out of 10" the developer is given retrospective planning permission and thus builds bigger. Mr McCartney also stated that "The Assembly must be careful in ignoring third-party appeals". I do not want to see that happening; the Assembly must ensure that the law is adhered to. Mr McCartney also spoke about mobile phone masts. I cannot understand his statement that there is nothing in the Bill about masts. We have already dealt with it. I accept Mr McCrea's apology for his absence at the start of the debate. When I stand to speak, I check that the august Chairman of the Committee for the Environment is present, as his presence always makes the debate more interesting. I said to myself, "William is not here today", but I am glad that he appeared later for the final analysis. Mr McCrea said that I cannot duck the question of third-party appeals - I am not ducking the issue. I have referred to significant matters that must be addressed. I am not putting them on the long finger. Mr McCartney and Mr McCrea also said that developers seem to have priority status. I do not want that to be the case. Mr McCrea also said that the value of the ordinary citizen should not be forgotten. I agree entirely. The matter is a question of right and wrong, and of ensuring that the law is implemented - it has nothing to do with the size of the development; whether it be a small bungalow or a multifaceted development. Mr McCrea asked whether I should meet the Secretary of State. I have had initial discussions with him. We are progressing the matter positively through the Committee's deliberations and through my meetings with my officials. Those meetings will run parallel to discussions with the Secretary of State. The final three words that I noted down are those of William McCrea. He said that we "need real enforcement" - I agree entirely. Question put and agreed to. Resolved: That the Second Stage of the Planning (Amendment) Bill (NIA 12/01) be agreed. Mr Deputy Speaker The Bill now stands referred to the Committee for the Environment. Health and Personal Social Services Bill: Mr Deputy Speaker: Members will have a copy of the Marshalled List of amendments, which details their order for consideration. The amendments have been grouped for debate. There are two groups of amendments, and we shall debate the amendments in each group in turn. The first debate will be on amendments No 1, No 2, No 3, No 4 and No 10, which deal with extending the Bill to include the costs relating to personal care. The second debate will be on amendments No 5, No 6, No 7, No 8 and No 9, which propose to allow the chief executive of the proposed Northern Ireland practice and education council for nursing and midwifery to sit as an ex officio member of the council. Once the initial debate on each group is completed, any subsequent amendments in the group will be moved formally as we go through the Bill, and the question will be put without further debate. The questions on stand part will be taken at appropriate points in the Bill. If that is clear, we shall proceed. We now come to the first group of amendments for debate. With amendment No 1 it will be convenient to debate amendments No 2, No 3, No 4 and No 10. Clause 1 (Charges for nursing care) Mr McCarthy: I beg to move amendment No 1: In page 1, line 10, at end insert '( ) where the payments made in respect of him under paragraph (3) include any amount in respect of personal care, the amount of such payments lessany amount paid in respect of such personal care;' The following amendments stood on the Marshalled List: No 2: In page 1, line 20, after "registered." insert '(4B) In paragraph (4) 'personal care' means any services listed in Schedule 5A of the 1972 Order.' - [Mr McCarthy.]' No 3: In page 1, line 20, at end insert "( ) After Schedule 5 of the 1972 Order there shall be inserted - 'SCHEDULE 5A . PERSONAL CARE NOT ORDINARILY CHARGED FOR 1. As regards the personal hygiene of the person cared for - (a) shaving; (b) cleaning teeth (whether or not they are artificial) by means of a brush or dental floss and (in the case of artificial teeth) by means of soaking; (c) providing assistance in rinsing the mouth; (d) keeping finger nails and toe nails trimmed; (e) assisting the person with going to the toilet or with using a bedpan or other receptacle; (f) where the person is fitted with a catheter or stoma, providing such assistance as is requisite to ensure cleanliness and that the skin is kept in a favourable hygienic condition; (g) where the person is incontinent -
2. As regards the person's eating requirements - (a) assisting with the preparation of food; (b) assisting in the fulfilment of special dietary needs. 3. If the person is immobile or substantially immobile, dealing with the problems of that immobility. 4. If the person requires medical treatment, assisting with medication, as for example by - (a) applying creams or lotions; (b) administering eye drops; (c) applying dressings in cases where this can be done without the physical involvement of a registered nurse or of a medical practitioner; (d) assisting with the administration of oxygen as part of a course of therapy. 5. With regard to the person's general well-being - (a) assisting with getting dressed; (b) assisting with surgical appliances, prosthesis and mechanical and manual equipment; (c) assisting with getting up and with going to bed; (d) the provision of devices to help memory and of safety devices; (e) behaviour management and psychological support.'" - [Mr McCarthy.] No 4: In page 2, line 3, after "36(4A))" insert "or personal care (within the meaning given by Article 36(4B))" - [Mr McCarthy.] No 10: In the long title, after "nursing" insert "and personal". - [Mr McCarthy.] Mr McCarthy: I begin by declaring an interest in the group of amendments as chairperson of the Assembly cross-party group on ageing and older people. The amendments in my name will extend the Bill's provision to include free personal care as well as free nursing care. I welcome the introduction of free nursing care, but in the absence of free personal care, the Bill would be seriously flawed and would not resolve the issues at stake. My amendments seek to rectify that unsatisfactory situation and to benefit many elderly people. I ask Members to support my amendments for various reasons. First, they enable us to right a wrong. The amendments would assist in the elimination of age discrimination throughout Northern Ireland, ensuring that one of the most vulnerable groups in society no longer suffers in that regard. Is there anyone in the Chamber who has not spent his or her political life condemning discrimination in all its forms? If the amendments are not passed today, we will permit the injustice of age discrimination to continue, to our eternal shame. Secondly, other devolved Administrations are addressing personal care. The Scottish Parliament will be implementing free personal care from 1 July 2002. The National Assembly for Wales expressed an aspiration to make similar provision. Thirdly, on the 27 February 2001, the Assembly passed the following motion: "That this Assembly notes the decision of the Scottish Parliament to provide the elderly with free nursing and personal care and calls on the Executive Committee to make similar provision for the elderly in Northern Ireland". The Assembly unanimously passed that motion. Would the conscience of anyone who voted for free personal care last February allow him to vote against it today? I hope not. What justification could there be for such action? Members could hardly plead ignorance of the consequences. People are not easily fooled; they would recognise the shameful political opportunism of voting for such a motion, thinking it would get no further, and then opposing the proposed legislation. Now is the time for us all to put our money where our mouths are. The present Bill, which excludes free personal care, is a result of the Executive's selective response to the motion agreed by the Assembly last year. This is not the first time that the Executive have shamefully ignored the will of the Assembly. The origin of the debate on residential care is the report of the Royal Commission, presented to the Westminster Parliament in March 1999. Is it not disgraceful that those proposals are being only partially addressed now, more than three years later? The dual meaning of the report's title, 'With Respect to Old Age', acknowledges that the care system did not respect people who had become too ill to retain their independence. Many considered the Royal Commission's report as the most accessible and well researched of its kind. The single-volume report is supported by three volumes of research, which I have in front of me. They are so heavy that I cannot lift them to show Members, which demonstrates the volume of work that went into the Royal Commission's research. One of the report's key recommendations was: "In our judgement it is right for the state to exempt personal care from means testing altogether." What is the rationale for that? It is based on the grounds of equity and efficiency. However, it is important to note that neither the Royal Commission nor my amendments envisage that the state will pay for living and housing costs. Those costs would still be met by people whose assets are above the threshold. Nevertheless, older people incur personal care costs when they can no longer be looked after at home or cannot be sent home after hospital treatment. The need for personal care is unpredictable and no fault of those who require it. The Royal Commission argued that personal care costs should be met by the state, because they reflect what it called "the true risk and catastrophic nature of needing long-term care." Paragraphs 6.33 and 6.34 of its report state: "The justification for our view is based on considerations of both equity and efficiency. Whereas the state through the NHS pays for all the care needs of sufferers from, for example cancer and heart disease, people who suffer from Alzheimer's disease may get little or no help with the cost of comparable care needs. All these conditions are debilitating, but Alzheimer's disease cannot yet be cured by medical intervention. However, a mixture of all types of care, including personal care will be needed. This is directly analagous to the kind of care provided for cancer sufferers. The latter get their care free. The former have to pay. For this reason, the distinction between the way care is offered for different diseases has no justification. The situation must be put right. The proposal to exempt personal care costs from means-testing would do that." 2.00 pm One consultee said that many of his contempories had had much NHS money spent on them over the years - on dealing with aneurysms, on heart operations, orthopaedic treatment, and so on - and have not been charged at all. Is it fair that the mentally ill are charged when someone who is physically ill is not, whatever his income? Prof Robert Stout of Queen's University, himself a member of the Royal Commission, reminded the Health Committee that including free nursing care alone would introduce a new perverse incentive: nursing homes would be subsidised while residential homes, which do not have registered nurses on their staff, would have to charge full costs. There would be an incentive, both for individuals and trusts, to admit patients to nursing homes, even if they did not require that level of care. This is contrary to best practice, which is to provide only the level of care needed by an individual. The Royal Commission also believes that making personal care free would enhance the dignity and security of old people and go a long way towards making the services provided for long-term care as valued and jealously guarded as those provided by the NHS. The principle of equal care for equal needs would be properly recognised for the first time. If we really meant what we said when we agreed the concept of equality enshrined in section 75 of the Northern Ireland Act 1998, we can do no less than support these amendments. Remember, too, that today's older generation entered into a contract with the Government and built the NHS in partnership with successive Administrations. They met their responsibilities over the years - paid tax and National Insurance contributions - and, in return, were assured that when they needed it, the NHS would be there. We have often heard it said that they would be looked after from the cradle to the grave, yet they have found, when they are at their most vulnerable, that it is simply not there. Small wonder that older people's organisations and advice lines have encountered such anger and bitterness over this. These amendments detail what personal care is, and I suspect that many Members may not realise what is excluded from nursing care. These amendments show that drawing a line between the two is artificial and unworkable and will cause further confusion, anxiety and bitterness. We need look no further than England to see what the effect has been there. In March 2002, Paul Burstow MP, the Liberal Democrat spokesperson for older people, published evidence depicting the Government's free nursing care as a shambles. He revealed that three out of five health authorities in England had evidence that nursing homes were failing to pass on payments in the form of reductions in fees for residents, that one in five people eligible for free nursing care were still waiting for a reduction in their fees and that 5,636 people were banded without having been seen by a nurse. Furthermore, problems in administering the scheme meant that payments of up to £11·9 million were outstanding. I doubt that Members would want us to get into a similar situation in Northern Ireland. The current method of assessing those in need of care is under review. The Department has issued a report for public consultation. I am sure that the members of the working group have worked hard to produce the assessment tool, but how satisfactory is it? Assessors have indicated that an assessment would take one to one and a half hours. There are 21 domains to be assessed. I can give an example of what some of those entail. Category 2 measures the "Ability to adjust emotionally, and awareness of moods and stimuli that elicit emotions. Capability of expressing desire for emotional support." Category 3 covers "Knowledge of abilities and constraints and ability to act accordingly in fulfilling personal goals." Category 21 is described as the "Care needs of relatives and carers arising from their relationship with the older person or their role as carer. Needs that are important to the maintenance of an established relationship or the transition to a new role." Allowing an hour and a half for an assessment gives less than four minutes on average for each of the 21 domains. Two hours gives an average of five minutes for each. That does not allow for time to make three final overall assessments or to check the completed 12-page document. Surely this can only be a snapshot. I doubt that anyone here would be happy if an elderly relative had his or her needs assessed in the same way. How many would argue that its use is preferable to the introduction of free personal care that would render it obsolete? The Committee for Health, Social Services and Public Safety has also been influenced by cost. The Executive have established an interdepartmental group to examine cost. The Health Committee's report states that "estimates of providing free personal care are likely to be well in excess of £25 million per annum." That was an approximate estimate by the Right to Care campaign. However, no actual figures or explanation for that statement are given. There is no evidence that any member of the interdepartmental group gave evidence to the Health Committee. The interdepartmental group has not taken evidence from any other groups, not even from organisations such as Age Concern, Help the Aged and others working with the elderly. Although a report from the Health Committee was due this month, it has not appeared in time for debate on this Bill. That is rather strange and, perhaps, irregular. Other people and organisations have a long list of services that they want to see improved, several of which, they argue, discriminate actively against older people. They accept that delivering these improved services will take time. However, they have made the issue of personal care a priority. I am tabling these amendments on behalf of the older members of our community. I believe passionately in the justice of this proposal, and it has been an honour for me to speak on their behalf. I commend these amendments, and I hope and ask for Members' support. The Chairperson of the Committee for Health, Social Services and Public Safety (Dr Hendron): Mr McCarthy referred to the report of the Royal Commission on Long Term Care for the Elderly. I am familiar with that report. Our Committee, like others, spoke to many groups. Mr McCarthy mentioned Prof Robert Stout, a professor of geriatric medicine who was also a member of the Royal Commission. Our Committee spoke to him recently, and I have had several discussions with him. The Committee for Health, Social Services and Public Safety took evidence from a range of organisations on the Health and Personal Social Services Bill. As the Minister will no doubt explain later, clause 1 provides for financial help for nursing care for about 2,000 people resident in nursing homes, and clause 2 establishes a new council to promote and monitor the professional development of nurses and midwives. I thank everyone who gave evidence to the Committee. The submissions received and the opportunity to question those who appeared before the Committee gave Members a valuable insight into the views and concerns of people affected by the Bill. I have nothing but respect for the opinions of Age Concern, Help the Aged, Prof Stout and all the others concerned. I thank the members of my Committee who worked hard on this subject. Although I am speaking as Chairperson of the Committee for Health, Social Services and Public Safety, I have been involved in primary care in west Belfast for over 35 years. I have spent a long time with the elderly and have been involved in their treatment and care. I feel as passionate as Mr McCarthy about the issues, and I congratulate him for speaking today. I respect his integrity in those matters. However, I do not support his amendments. I am concentrating on clause 1. People who gave evidence to the Committee expressed many views on financial assistance for nursing care. They called for self-funding for residents of nursing homes and asked for the approach on personal care taken in Scotland to be adopted here. Mr McCarthy knows that the matter was debated on 27 February 2001, when the Assembly called on the Minister to fully implement the recommendations of the Royal Commission through motions tabled by himself and Mr Dodds. |