Northern Ireland Assembly Flax Flower Logo

Northern Ireland Assembly

Monday 24 June 2002 (continued)

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

Go raibh maith agat, a LeasCheann Comhairle. Beidh mé ag cur i gcoinne an leasaithe seo. Rinneadh díospóireacht ar dhá rún ar 27 Feabhra; ba é an tUasal Kieran McCarthy a chuir an chéad cheann síos ar chlár, agus chuir an tUasal Nigel Dodds agus an tUasal Ian Paisley Jnr an dara ceann síos ar chlár. Bhain an dá rún le cúram fadtréimhseach do dhaoine scothaosta. Ritheadh an dá rún.

Tharraing mé aird an Choiste Feidhmiúcháin ar rún an Tionóil ar 3 Bealtaine 2001, agus, i ndiaidh díospóireacht a dhéanamh, d'aontaigh an Coiste Feidhmiúcháin i bprionsabal cúram altranais saor in aisce a thabhairt isteach agus d'iarr an Coiste Feidhmiúcháin orm moltaí sonracha a chur faoina mbráid. D'aontaigh an Coiste Feidhmiúcháin fosta go mbunófaí grúpa idir-rannach le scrúdú a dhéanamh ar na himpleachtaí agus ar na costais a bhainfeadh le cúram pearsanta saor in aisce do chónaitheoirí tí altranais agus tí chónaithigh a thabhairt isteach; agus tuairisc ar na torthaí a thabhairt don Choiste Feidhmiúcháin.

Táthar ag súil le tuairisc an ghrúpa idir-rannaigh ag deireadh na míosa seo agus leagfar amach inti na himpleachtaí agus na costais go mion lena mbreithniú ag an Choiste Feidhmiúcháin. Ar an Choiste Feidhmiúcháin a bheidh sé ansin a chinneadh an gcuirfear an maoiniú breise ar fáil i gcomhthéacs tosaíochtaí eile sláinte agus tosaíochtaí i Ranna eile sula gcinnfear arbh fhéidir cúram pearsanta saor in aisce a thabhairt isteach do chónaitheoirí tí altranais.

4.15 pm

I oppose the amendments. Two motions relating to long-term care for the elderly, the first in the name of Mr McCarthy and the second in the name of Mr Dodds and Mr Paisley Jnr, were debated in the Assembly on Tuesday 27 February 2001. Both motions were passed. I brought the Assembly's resolution to the attention of the Executive on 3 May 2001, and, following discussion, the Executive agreed in principle to the introduction of free nursing care and asked that I bring forward detailed proposals.

The Executive also agreed that an interdepartmental group should be established to examine the implications and costs of introducing free personal care for residential and nursing home residents and to report its findings to the Executive. The terms of reference agreed for the group were: to research and define the current policy and position with regard to charging for and provision of personal and nursing care in domiciliary and residential settings; to examine the implications - including equality and new TSN implications - and the costs of introducing free personal care; and to draw on the findings of the Scottish Executive's care development group and report them to the Executive.

In the debate last year, I pointed out that any decision to extend free care for the elderly would bring with it major budgetary considerations for the Executive. My Department estimated that to provide free personal care could add at least £25 million to the health and social services boards' annual costs. The report of the interdepartmental group is due at the end of this month, and the implications and costs of free care will be set out in detail in that report for consideration by the Executive. It will then be for the Executive to decide whether, in the light of other priorities in the Department of Health, Social Services and Public Safety and other Departments, the additional funding can be made available, before deciding whether to provide free personal care for residential and nursing home residents.

In the meantime, I recognise that the cost of care is a concern, particularly for those whose care requirements are met in nursing homes. They are the only group of people that is currently required to contribute to the cost of a provision that, for all others, is a health service free of charge at the point of delivery. To remove this inequitable system and to prevent people here from being disadvantaged in comparison to those in England and Wales, I have developed this legislation to introduce free nursing care here.

Nursing care is only one element of the total cost of providing care in nursing homes. People being cared for in care home settings will still be subject to an assessment of their ability to contribute to the cost of their personal care and accommodation. The proposed legislation will remove the cost of the nursing care element from that means assessment. A decision on the amount paid at individual level has not yet been made. Some Members spoke about suggested costs this morning, but that decision has yet to be taken.

I am aware of the concerns expressed today that the benefits may not be passed on to those receiving care. Some organisations have said that that situation already exists in England. However, the policy is clearly intended to reduce the cost of care for people in nursing homes. Although the total cost of care for those who fund their own care will be a private matter between the home owner and the resident, officials are currently examining the means available to prevent that problem from arising here.

With regard to the flat-rate payment, one of the aims of the working group chaired by the chief nursing officer was to introduce proposals for a system that will be easily understood by the Health Service and the public, and that will add the least bureaucracy to an already complex care assessment process. It is also important that the additional money go directly to reducing the cost of care to the individual, and not to support and administration. Service professionals and several representative organisations favour the flat-rate approach, which is similar to the approaches taken in Wales and Scotland. I took account of those views in deciding to adopt the flat-rate approach. The working group that was commissioned to develop the assessment tool for the implementation of free nursing care was also required to keep the process as simple as possible.

Stage two of the community care review will look at putting a single assessment process in place to cover all aspects of the care process. The assessment tool has been thoroughly piloted by nursing professionals, and the timing of each assessment has been found to be adequate to take account of all the documentary and physical evidence available. The tool is now out for consultation, and further adjustments, as necessary, will be made following that consultation.

I appreciate the concerns raised about people selling their homes to pay for care in nursing homes. From 22 April 2002 I have introduced a disregard of the value of a resident's former home during the first three months of a permanent admission to residential or nursing home care. Also, I increased the capital limits used in the means test for residential care from £11,500 and £18,500, respectively, to £11,750 and £19,000 from 22 April 2002. That has brought more people into care management earlier and enabled them to retain more capital than before.

It was asked if this provision would extend to patients in hospices. Hospices may qualify for registered nursing home status. Where that is the case, and patients are paying for their care, the nursing care element of the charges will be met by health and personal social services. Where palliative care is provided in a person's own home, the nursing and health care services are provided free, as they are for all other groups of people. Where a hospice is registered, residents may be charged for the care received there, and the nursing care element will be met by health and personal social services from October 2002.

We have instituted mechanisms for people who do not agree with their assessment of nursing care. An individual who does not agree with the assessment of nursing care needs will have the right to seek a review of that assessment, and for the review assessment to be carried out by a different nurse. My Department will require an assessment to be reviewed within one week of the request, and if the individual still does not agree, a panel will be constituted and a further review completed within two weeks. The review process will take no more than three weeks. Statutory direction under article 17(1) of the Health and Personal Social Services (Northern Ireland) Order 1972, which will incorporate the guidance and review process, will be issued to boards and trusts.

In rejecting the amendments, I would like to emphasise that I am not rejecting free personal care. I am simply stating that the Executive have approved the introduction of free nursing care in nursing homes. The Executive have also agreed that an interdepartmental group should be established to examine the implications and costs of introducing free personal care for residential and nursing home residents and to report its findings to the Executive. I must, therefore, reject these amendments at this time, in advance of any future decision by the Executive when the report of the interdepartmental group has been received and studied.

Mr McCarthy:

I am extremely disappointed by what I have heard during the debate, and certainly by the Minister's reply. The Assembly and the Executive took a decision to make health the number one priority for our people, and we all welcomed that decision at the time.

The resolution on 27 February 2002 was clear and unequivocal - it was not aspirational. It was clear about what it asked the Executive to do, which was to introduce free nursing and personal care. The motions put forward by Nigel Dodds and myself were passed unanimously. We all supported it then. Why are Members speaking in aspirational tones today? What justification is there for adopting such a stance today?

It really surprises me that a Member of the all-party group on ageing and older people such as Rev Robert Coulter cannot support the amendment. He referred to the siphoning of funds. I am disappointed by those words. We will not siphon off funds to provide for the needs of the elderly; we will demand that funds are there as a right for elderly people. That statement came from a man who wrote to one of his constituents in December 2001:

"I intend to take part again in the Budget debate in support of finance for the treatment of older people."

I also have a copy of a letter from none other than junior Minister James Leslie. He wrote that

"[the Ulster Unionist Party] will continue to support any attempt to further help those of our senior citizens who are in need of care."

That was a response from a junior Minister, who is now not even in the Chamber. This is an opportunity to give further help to those of our senior citizens who are in need of care, and to those who are ill and infirm. They need Members' support today. Support the amendments.

I am also amazed that the Minister of Health, Social Services and Public Safety will not support my amendments, given that they comply with her party's policy. I have another letter, written on 17 November 2001 by Mary Nelis in support of the Right to Care campaign. Unfortunately, she is not in the Chamber. The letter says:

"As you may be aware the Assembly and the Executive have made provision for free nursing care for the elderly from October 2002.

While we welcome this announcement, we also believe that it should have included free personal care."

I am delighted that Mary Nelis said that, but where is she today to defend it? My amendments are also asking for personal care. Sinn Féin now has the chance to back up that commitment. Mary Nelis continues:

"We will continue to work to ensure that the Executive effectively addresses the issue of free personal care."

- now is her chance -

"Sinn Féin's position in relation to this issue is that full and equal access to health and social care services are a right and that any financial barriers to accessing these services should be removed."

By supporting my amendments, Sinn Féin will have honoured that commitment given in Mary Nelis's letter. By voting against the amendments or by abstaining, Sinn Féin will be shown up to all for its waffle and bluster, like others in the Assembly, and going back on its word as evidenced in the Assembly on 27 February 2001.

I would also like to remind Members of a statement made on 27 February 2001 by Mr Dodds:

"Today's debate is, essentially, about principles . If we were to adopt a different course from that followed by the Scottish Parliament, our senior citizens would have every right to ask why they were being treated differently from their Scottish counterparts. They are entitled to receive the same, not as a handout but as a birthright." - [Official Report, Bound Volume 9, p318].

I agree with that.

On the same day the Chairperson of the Committee for Health, Social Services and Public Safety, Dr Hendron, said:

"My Committee hopes that the Minister.will fully implement the findings of the Royal Commission on Long Term Care. If we cannot look after our own folk then we should not be here." - [Official Report, Bound Volume 9, p318].

Hear, hear to that. He continued:

"With its unique integrated health and social services, Northern Ireland has an ideal opportunity to ensure that nursing and social care should be regarded as a seamless continuum, all free at the point of delivery." - [Official Report, Bound Volume 9, p318-9].

On that same day, when we were all delighted and supportive, Mr Dodds also said:

"The Scottish Executive, having come under considerable pressure not least from within its own coalition where the Liberal Democrats exerted considerable pressure on the Labour Party, was forced into a position where it had to recognise that simply allowing free nursing care without free personal care would be running away from the recommendations of the Sutherland Report and the obligations that society has to our old people in need of care." - [Official Report, Bound Volume 9, p317].

I entirely agree with Mr Dodds's sentiments on that occasion.

4.30 pm

We are not saying that we should set down timetables and deadlines today. However, we are saying to the Minister that she should accept that this is the will of the Assembly. We, on behalf of the people whom we represent, believe that people are entitled to free nursing and personal care if they are elderly and in need of it. We recognise that treating people who have cancer, heart disease or other health problems costs money. Is anyone seriously suggesting that we should look at this in terms of people's wealth or the cost involved? Mr Dodds went on to say:

"No Member would ever argue that, because cancer treatment was becoming more and more expensive, we ought not to treat people."

The Human Rights Commission made many recommendations in a recent report and suggested implementing the Royal Commission's views on enhancing the rights of older people.

I reiterate the points that I made earlier. There is no evidence that any member of the interdepartmental group gave evidence to the Health Committee, and it has not taken evidence from any other groups, especially highly respected organisations such as Age Concern or Help the Aged and other organisations working with the elderly. A report from the Health Committee was due this month, but it has not appeared in time for the debate. That is rather strange. Who are the members of that group; are any MLAs on it; and from whom has it taken evidence?

We are told that we should not act on these amendments because the working group has not reported in time for this debate. That is contrary to open government and consultation, and it is not what a devolved Administration should be doing. People talk about secret societies - we need to get all the information into the public domain.

Nearly every Member who spoke said that he agreed with the amendments in principle but that the time was not right. Dr Hendron, Rev Robert Coulter, Mr John Kelly, Mrs Iris Robinson and Mrs Courtney all said that. Forgive me if I have left anyone out. When will Members say that the time is right? The Bill deals with introducing free care in a way that makes it perfectly appropriate to pass these amendments today. Members may not have read clause 4 subsection (1) closely. It clearly says that

"Sections 1 and 3 (with the Schedule) come into operation on such day or days as the Department may by order appoint."

In other words, if we pass these amendments in my name today, we establish the principle of free personal care as well as free nursing care and follow Scotland and Wales. We acknowledge that free personal care cannot be introduced immediately but say that it is very important.

Passing the amendments would show that we care about this and are taking it seriously. It would also show that Members are not content to sit back and accept bland assurances but are taking a clear stance for the principle of free personal care and calling on the Executive to provide the funds as soon as possible. I urge all Members to vote with their consciences and keep up the pressure that will assist the Minister of Health, Social Services and Public Safety to get the resources needed from the Executive to meet the needs of vulnerable and elderly people.

This twenty-first century Assembly has a wonderful opportunity to give our community a lead and to provide for the needs of our elderly people. We must start somewhere, so let us do it now. Sympathy is simply not enough. I plead for - indeed, I beg - Members to support the amendment.

Question put, That amendment No 1 be made.

The Assembly divided:

Ayes 5; Noes 53

Ayes

Eileen Bell, Seamus Close, David Ford, Kieran McCarthy, Sean Neeson.

Noes

Ian Adamson, Fraser Agnew, Billy Armstrong, Roy Beggs, Billy Bell, Esmond Birnie, P J Bradley, Joe Byrne, Fred Cobain, Robert Coulter, Annie Courtney, John Dallat, Ivan Davis, Bairbre de Brún, Boyd Douglas, Mark Durkan, Reg Empey, Sean Farren, John Fee, Tommy Gallagher, John Gorman, Tom Hamilton, Carmel Hanna, Joe Hendron, David Hilditch, Derek Hussey, Danny Kennedy, Patricia Lewsley, Alex Maskey, Robert McCartney, David McClarty, William McCrea, Alasdair McDonnell, Barry McElduff, Martin McGuinness, Gerry McHugh, Monica McWilliams, Maurice Morrow, Conor Murphy, Mick Murphy, Dara O'Hagan, Eamonn ONeill, Ian Paisley Jnr, Edwin Poots, Iris Robinson, Mark Robinson, Peter Robinson, George Savage, John Tierney, Denis Watson, Peter Weir, Jim Wells, Sammy Wilson.

Question accordingly negatived.

4.45 pm

Mr Deputy Speaker:

Members should be aware that amendments No 2, No 3, No 4 and No 10 are consequential to, and dependent on, amendment No 1. Therefore, as amendment No 1 was not made, those amendments will not be called.

Clause 1 ordered to stand part of the Bill.

Mr Deputy Speaker:

No amendments have been tabled to clauses 2 to 5. Therefore I propose, by leave of the Assembly, to group these clauses.

Clauses 2 to 5 ordered to stand part of the Bill.

Schedule

Mr Deputy Speaker:

We now come to the second group of amendments for debate. It will be convenient to debate amendment No 5 with amendments No 6, No 7, No 8 and No 9.

Ms de Brún:

Molaim leasú 5. Tagraíonn leasuithe 5 go dtí 8 do mhíreanna 4, 5(a) agus 6(1) Sceideal an Bhille agus is é is aidhm dóibh pointe dréachtaithe a cheartú. Ní cheadaíonn na focail sa dréacht-Bhille do phríomhfheidhmeannach chomhairle cleachtais agus oideachais TÉ bheith ina chomhalta den Chomhairle. Tá sé i gceist go mbeadh an príomhfheidhmeannach ina chomhalta fheidhmitheach ar an Chomhairle mar atá amhlaidh ar bhoird comhlachtaí eile de chuid na Seirbhíse Sláinte, mar bhoird agus iontaobhais sláinte agus seirbhísí sóisialta. Déanann na leasuithe seo foráil dó sin agus léiríonn siad go mbeidh an Chomhairle comhdhéanta de Chathaoirleach, comhaltaí neamhfheidhmitheacha eile agus an príomhfheidhmeannach.

I beg to move amendment No 5: In page 3, line 21, leave out from "a chairman" to end of line 22 and insert

"(a) a chairman appointed by the Department in accordance with regulations under paragraph 5;

(b) the person for the time being appointed under paragraph 7 to be the chief executive of the Council; and

(c) other members appointed by the Department in accordance with regulations under paragraph 5.

(2) In the following provisions of this Schedule the members appointed under sub-paragraph (1)(a) and (c) are referred to as the non-executive members of the Council."

The following amendments stood on the Marshalled List:

No 6: In page 3, line 25, leave out "chairman and other" and insert "non-executive". - [The Minister of Health, Social Services and Public Safety (Ms de Brún).]

No 7: In page 3, line 28, leave out "chairman and other" and insert "non-executive". - [The Minister of Health, Social Services and Public Safety (Ms de Brún).]

No 8: In page 4, line 2, leave out

"its chairman, to any other member"

and insert

"the non-executive members". - [The Minister of Health, Social Services and Public Safety (Ms de Brún).]

No 9 : In page 4, line 14, leave out

"a member of the staff of the Council and shall be" - [The Minister of Health, Social Services and Public Safety (Ms de Brún).]

Ms de Brún:

Amendments No 5 to No 8 refer to paragraphs 4, 5(a), 5(b) and 6(1) of the schedule to the Bill, and their purpose is to correct a drafting point. The wording in the draft Bill does not provide for the chief executive of the Northern Ireland practice and education council for nursing and midwifery to be a member of that council. It is the intention that the chief executive should be an executive member on the council, as is the case on the boards of other HPSS bodies, such as health and social services boards and trusts. The amendments will provide for that and will clarify that the council will comprise a chairperson, other non-executive members, and a chief executive.

Amendment 9 corrects a drafting point in paragraph 7(1) with regard to a chief executive being stated as a member of staff of the council. That is already implicit from the remaining details within the paragraph.

(Madam Deputy Speaker [Ms Morrice] in the Chair)

Dr Hendron:

The Committee welcomes the proposed creation of the new council. It will help to ensure consistently high standards and best practice, education and performance in nursing and midwifery in Northern Ireland.

The Committee considered it important to have a local body working in partnership with nurses and midwives to ensure that clinical training and development meet the highest standards in Northern Ireland. Members were satisfied that it would not involve additional costs. Transferring the existing budget for the old national board to the new body will cover the expenditure involved. However, the council should be subject to rigorous audit to ensure that it spends its money wisely. The Committee advocates that the proposals be considered in conjunction with those published for consultation in the document 'Best Practice - Best Care'.

The new council can be expected to play an important role in working closely with the new local health and social care groups to examine the role of nurses and explore ways in which to develop their specialist skills. Spreading good practice across the nursing profession will ultimately benefit all service users by developing consistently high standards of health care.

The Committee supports clause 2, the schedule and the amendments tabled by the Minister. The Minister has explained that the amendments are needed to bring the Bill into line with standard practice for all health and social services bodies.

Ms McWilliams:

Amendments 5 to 8, tabled by the Minister and her Department, came to us very recently; therefore, we have not had an opportunity to look at them in detail. My concern is that the schedule, as amended, no longer makes sense. For example, amendment 5 asks us to leave out from "a chairman" at page 3, line 21, and insert

"(a) a chairman appointed by the Department in accordance with regulations under paragraph 5;"

Amendment 6, which deletes part of paragraph 5, means that there will no longer be any reference to a chairman. Whose job will it be to appoint a chairman? Paragraph 5, as amended, will refer only to non-executive members. The Minister has explained that the amendments are required to keep the practice and education council in line with other bodies, and make the chief executive a member of the council.

As the Minister has explained, I can understand why - in line with other bodies - the chief executive will now be a member of the council. However, the amendments leave no provision for a chairperson, or "chairman", as is referred to in the legislation. Therefore, I want some explanation as to whose job it is to appoint the chairman.

Ms de Brún:

I thank those Members who participated in the discussion. Indeed, I recently announced new arrangements to improve the quality of service, which are based on 'Best Practice - Best Care'.

The Northern Ireland practice and education council for nursing and midwifery (NIPEC) will have an important role in contributing to those arrangements by supporting organisations, delivering services and enhancing the quality of nursing and midwifery care provided to service users. For example, it will provide advice and guidance, on a co-ordinated regional basis, on best practice, and by supporting the professional development of nurses and midwives in quality-assuring their education and training.

The amendments to the legislation that will establish NIPEC are required to enable the chief executive to be an executive member of the council. Although that was always the intention, it was identified only at a late stage that the wording of the draft Bill would not allow that. The required amendments were made available to the Committee as soon as was practicable. Amendment No 5 to paragraph 4 states that the schedule will refer to the chairperson and other members as non-executive members of the council. Paragraph 5 will be amended to refer to non-executive members, which includes the chairperson and others. The Department will, therefore, appoint the chairperson.

Amendment No 5 agreed to.

Amendment No 6 made: In page 3, line 25, leave out "chairman and other" and insert "non-executive". - [Minister of Health, Social Services and Public Safety (Ms de Brún).]

Amendment No 7 made: In page 3, line 28, leave out "chairman and other" and insert "non-executive". - [Minister of Health, Social Services and Public Safety (Ms de Brún).]

Amendment No 8 made: In page 4, line 2, leave out

"its chairman, to any other member"

and insert

"the non-executive members". - [Minister of Health, Social Services and Public Safety (Ms de Brún).]

Amendment No 9 made: In page 4, line 14, leave out

"a member of the staff of the Council and shall be". - [Minister of Health, Social Services and Public Safety (Ms de Brún).]

Schedule, as amended, agreed to.

Long title agreed to.

Madam Deputy Speaker:

That concludes the Consideration Stage of the Health and Personal Social Services Bill. The Bill stands referred to the Speaker.

5.00 pm

Railway Safety Bill: Further Consideration Stage

TOP

Madam Deputy Speaker:

I remind Members that the Assembly agreed in April to amend Standing Order 35, which now allows debate and votes at Further Consideration Stage only when amendments have been tabled. There will no longer be votes on clauses or schedules stand part at Further Consideration Stage.

No amendments to the Bill have been tabled. The Further Consideration Stage of the Railway Safety Bill is therefore concluded. The Bill stands referred to the Speaker.

Budget (No.2) Bill: Further Consideration Stage

TOP

Madam Deputy Speaker:

No amendments to the Bill have been tabled. The Further Consideration Stage of the Budget (No.2) Bill is therefore concluded. The Bill stands referred to the Speaker.

Review of Public Administration

TOP

The Deputy First Minister (Mr Durkan):

I beg to move

That this Assembly endorses the terms of reference for the Review of Public Administration.

In February, the First Minister and I outlined the challenges presented by this review and initiated a pre-consultation exercise on the draft terms of reference. I will explain the steps that have been taken since February and the changes made to the terms of reference as a result. As well as considering the terms of reference, we should also begin to look ahead to the review itself.

Endorsement of the terms of reference by the Assembly today will signal the start of the review. There is a great desire to move ahead quickly and to start to tackle the many difficult issues that fall within the review's remit. Before doing so, I will explain the steps taken over the past four months.

The extensive debate on 25 February 2002 was a helpful start to the consultation on the terms of reference. Since then, we have also received comments from several Committees. The First Minister and I met the Committee of the Centre on 8 May 2002 in a lengthy and constructive meeting that went into some detail on several of the issues.

What I found most notable in that meeting was the desire to get on with the review itself, rather than to continue to pick over the specific text of the terms of reference. That reinforced the need to move on. The Committee of the Centre will have an important role in overseeing the review. I welcome that and look forward to further engagements.

In addition to considering the views expressed by the Assembly and its Committees, we consulted a range of umbrella organisations. We sought views on the terms of reference from groups which can effectively represent key sectors. Among the groups consulted were those representing local government, the trade unions, business and the community and voluntary sectors. We received a range of comments and suggestions for changes to the terms of reference. A significant number of those have been taken on board and are reflected in the revised text.

In our debate in February, several Members asked whether the review would be sufficiently independent. The Executive want a strong, independent element to this review. We have appointed a panel of experts to fulfil this role, and the calibre and experience of the individuals appointed are testament to our determination to ensure that strong, independent element. The appointment of Tom Frawley, the Northern Ireland Ombudsman, to chair the panel specifically recognises the need to ensure that the experts have a strong voice.

The panel, which will have a direct line to Ministers, consists of six people with a broad range of skills, experience and backgrounds. They will bring a robust, inquiring, quality input to the review. Working with a team of officials, the panel will be engaged in all its key elements. It will be able to suggest ideas, challenge the way things are done now and quality-assure the results.

I am pleased to say that the panel of experts and the review team had an informal first meeting with the Committee of the Centre this afternoon to make introductions and begin building a relationship. There will be many formal meetings in the future, but this was a helpful start.

It was always the intention to seek the views of independent experts on the draft before seeking the endorsement of the Executive and the Assembly for its terms of reference. The revised draft takes account of suggestions made by the experts. Specifically, they proposed keeping the terms relatively short and putting the commentary on the characteristics and parameters, or questions that might inform the review, into an annex. Their view, which the Executive endorsed, was that too much material in the terms of reference would be unwieldy and potentially confusing when explaining the starting point for the review at public meetings and other forms of consultation that the team will undertake. It is sensible to keep them brief and to the point.

We listened to views from the Assembly, from its Committees, from wider civic society and from the independent experts, and the terms of reference have been significantly amended to reflect that. One change is the preface, which is intended to answer many of the questions posed in February.

We have set the review panel a challenging timetable. We hope that it will produce a report by the end of 2003, and we have asked for an interim report by March 2003. The panel of experts has said that the timetable is challenging, particularly in view of the level of consultation believed to be necessary if the review is to be conducted successfully. The interim report next March will set out the progress made on the consultation exercise and the conduct of the review. It is a stepping stone to developing the key propositions and recommendations for the review. It will not, however, outline a draft report or emerging findings. We must be realistic about what can be achieved.

In only a few areas, we have not accepted the suggested changes. Primarily, they relate to the review's ability to examine the 11 Departments and to calls from a few quarters to draw in the North/South bodies and other institutions of the agreement. The review is not a means by which to renegotiate the agreement by the back door. It is considering a system of public administration that was established 30 years ago, to decide what changes are needed, not least because of the creation of the Assembly and the devolution of powers to it. We considered carefully whether to review the distribution of functions between the 11 Departments and concluded that that would detract from the main focus of the review. Energy would be channelled into turf wars rather than better services. The remit of Departments is not, of course, set in stone, but that is not the task of the review.

There are no illusions about the difficulty and scale of the task that is to be faced. An undertaking of that nature challenges us to think radically, to examine the problems and to decide better ways to do things. The Executive are determined to lead that exercise, which reflects our determination to take responsibility for the task. To assist in that process, we have established an Executive subcommittee to lead the review. That subcommittee met the panel of experts, and the senior official who is the review's chief operating officer, for the first time this morning. The subcommittee will advise the review team and develop its approach and thinking. The Executive will take the final decisions.

However, the success of the review depends on what the review team can learn from those who experience the services and structures of public administration. To listen to those who receive the services, to those who deliver them and to those who can tell us about good practice further afield is an essential part of the review.

The listening and learning process will highlight the proposals and recommendations to be tested. The review team made it clear to Ministers that the process will be highly consultative. Everyone will have the chance to have their say. We want a system of public administration that meets the needs and expectations of all the people of Northern Ireland. To achieve that, people must contribute their views. Some people feel over-consulted and others doubt whether their views are taken into account.

For such a consultation to succeed, two things must happen: the review team must imaginatively provide people with opportunities to contribute; and those with views must make them known. The review is a major exercise for the Executive, the Assembly and all the citizens of Northern Ireland. I hope that we have shown that we have listened to Members' comments on the terms of reference. We have a sound basis on which to initiate the review.

The Chairperson of the Committee of the Centre (Mr Poots):

The Committee of the Centre welcomes the publication of the terms of reference and the opportunity for today's debate. It is leading the scrutiny of the review and is keen that the review should begin without any further delay. In undertaking that scrutiny, the Committee will co-ordinate responses from all Committees, and it will take that role seriously. I assure the Assembly that the Committee's scrutiny will be thorough and robust.

Since the first debate on the terms of reference on 25 February 2002, the Committee has undertaken some preliminary work to identify the main issues that must be considered. As part of that, the Committee heard evidence from three leading academics. It also heard proposals from the First Minister and the Deputy First Minister. Several main points came out of those sessions.

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First, the need for a review is not in doubt. There is widespread agreement that we are over-governed. It was put to the Committee by Prof Knox of the University of Ulster that

"the prevailing argument in Northern Ireland is that we have moved from a position of democratic deficit to a surfeit, with 18 MPs, 108 MLAs, 582 councillors and three MEPs, all for a population of 1·6 million."

That is not to mention the numerous quangos.

The attempt to set out principles - or characteristics, as they are referred to in the revised terms of reference - to inform the process of the review was welcomed, but it was recognised that a difficulty arose in that there was no attempt to rank or prioritise those principles. The principles are laudable, and few could disagree with them. However, they are potentially conflicting, and trade-offs in how they are applied will be necessary. As Prof Knox put it:

"the often conflicting imperatives of efficiency, which point to larger units, often at the pan-Northern Ireland level, could conflict with democratic issues, which might suggest smaller units, conceivably at the town or district level."

The validity of excluding the 11 Departments from the review's remit has been raised with the Committee, and will doubtless be raised again during the debate. There were calls for greater clarity in setting the review's parameters, and while the Committee welcomes the indicative list of bodies that will fall within its remit, the inclusion of the 11 Departments would have made it a more encompassing exercise.

In the first debate, I pointed out that the review must address the need for joined-up government and examine the scope for the electronic delivery of services and for one-stop shops to improve the delivery of services to the public. Prof Skelcher of the University of Birmingham reinforced that point in his evidence to the Committee:

"The impact of e-government and new technology enables us to think in different ways about how we organise public administration systems."

Although the terms of reference make passing references to the need to address opportunities for new technologies, I am concerned that those could be missed. Advances in electronic government have enormous potential to revolutionise how services are organised and delivered. There are many examples of how services can now be built around and delivered to meet life events, rather than remaining in the silo mentality of the past. It is insufficient to consider how e-government can be used to deliver services after new structures have been agreed. It is not an add-on; it can fundamentally influence how the structures are developed. In Northern Ireland we have a unique opportunity to re-engineer our processes and to exploit that potential. Perhaps the First and the Deputy First Ministers could tell the House whether someone on the panel of experts has significant expertise in e-government, and how that potential will be explored and maximised.

It is recognised that the review must take account of developments and best practice elsewhere. The Committee welcomes that, as it does the appointment of the eminent experts who will bring an international perspective to the review.

I said earlier that the Committee had already heard evidence about developments in other parts of the United Kingdom and the Republic of Ireland. For example, the Committee heard from Prof Skelcher about the international move away from the public management model towards a system that questions how public administration can operate effectively as part of a democratic society. We learnt that there is still a highly centralised approach to public management in England, whereas in Wales and Scotland, as Prof Skelcher put it:

"there is more consensual discussion between different tiers of Government and between politicians in those tiers."

Mr John Stapleton of the University of Limerick gave evidence to the Committee about how the structure of public administration has evolved in the Republic of Ireland. The Committee heard about the dramatic rise and subsequent decline in the number of state-sponsored bodies, para-governmental organisations and quangos, and the reasons for that effect. The Committee also learned of the emergence of a regional administrative dimension in the Irish Republic, but that it did not amount to regional government as it has in the United Kingdom.

The Committee also visited Washington DC and Boston, and while there we had several opportunities to explore some issues relating to the review. The Committee had a meeting with the directors of the National Academy of Public Administration in Washington. That organisation is dedicated to improving the performance of government systems to make them work for everyone. In Boston, we heard about the system of public administration in the state of Massachusetts and had valuable discussions with the director of the Shamie Centre in Boston, a think tank on state and local government issues, and leading academics from Boston College.

In the previous debate on the subject, I mentioned the lack of information on the structure and methodology of the review. The Committee would welcome the inclusion of the terms of reference in the preamble, because that would give a clearer picture of how the review will be carried out. I also questioned the validity of restricting the examination of Northern Ireland's needs to those that are forecast to exist in five or 10 years' time. The revised terms of reference still give that timescale. Surely a system that results from such a comprehensive and strategic review must be capable of lasting for a generation, while retaining the scope to adapt to change.

I recently attended a seminar in Belfast to discuss the review of public administration. There was unanimous agreement on the need for the review, and for it to be carried out quickly. The need to improve the delivery of services to the public was made clear. People care whether they receive good services efficiently and at the right time.

We must always remember that as public representatives we serve the public. It is our duty to ensure that the administration exists to serve the public, rather than us in the guise of political masters. We need to focus on what is best for the public. The review provides a unique opportunity to do that, and we must ensure that its outcome is a better, more efficient system that saves money on administration and delivers better core services. That needs to be carried out soon.

I wish the review team well and look forward to working with them. The review must be fundamental and must bring about real change; otherwise we will have wasted more public money.

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