When the First Minister and the Deputy First Minister originally announced the establishment of the borrowing facility - the reinvestment and reform initiative that Mr Close mentioned - I said that a large "handle with care" stamp was necessary; that same stamp is necessary for PPPs. That message has been reiterated by all contributions to today's debate.

The public are still confused by pick-and-mix financial policy. They make all sorts of assumptions: that PPPs are confined to the private-finance initiative, which in fact finances only major capital projects, and that PFI offers something for nothing in the context of public expenditure restraint. However, no matter how projects are financed, in the absence of user charges they remain funded by the public purse. Members have made that point repeatedly today. We risk locking the public sector in Northern Ireland into long-term financial commitments that offer poor value for money for the taxpayer. That is the argument of short-term pain versus long-term gain.

It has been recognised today that the infrastructure in Northern Ireland, specifically for regional development, health, and education, is under tremendous pressure and that dependence on public expenditure alone means that the range and the quality of services provided will be insufficient, both now and in future. PPPs may be one way to bridge the gap.

The assertion that the private sector has skills that make it inherently more efficient than the public sector is not always backed up by evidence. If this were the case, far from there being a preference for traditional procurement, there would be a preference for private sector solutions, with no reference to public sector comparators.

Principles and economics must also be considered. Mr Close stated that public money is always the cheapest money, and we should not forget why that is so. Public money should always have the good of the public at heart, which is why it is the best and cheapest way to progress. Some people think that a public service that is funded for profit by the private sector is incompatible, and that Government should provide schools, hospitals, roads, public transport and sewerage systems. Are PPPs and PFIs a legitimate and cost-effective way to increase the pool of money that is available for those services? The dangerous approach of "buy now, pay later" cannot be overstated or ignored.

PPPs should be chosen as a financing option only when they provide better value than conventional long-term public finance. A holistic approach must be adopted, and an assessment of comparative costs must include the social and environmental impact as well as cost-effectiveness considerations.

We urge the Executive to give priority to the identification of long-term and dependable funding streams to sustain the valuable public services that the voluntary and community sector provides.

Patricia Lewsley and others spoke about the guarantees that are required for a level playing field for employees. Trade unions and Members have expressed fears that a two-tier workforce may emerge. Contractors are employing new workers on poorer terms and conditions than workers who have transferred from the public sector. Ms Lewsley also stated that the legislation must be tightened to take that issue on board.

PPPs have not been highly contentious in the Republic of Ireland, so the Executive should consider the Southern experience and take a broader view.

The partnership approach has been highly successful; for example, between local councils and the not-for-profit companies - the voluntary sector. That approach has been important to our communities, because PPPs are at the cutting edge and work successfully in the voluntary sector. Bryson House provides local councils with valuable expertise and information, and its kerbside recycling schemes are at the cutting edge.

Information on the 'Financing Our Future' consultation process and its implementation timetable would be appreciated.

Northern Ireland has a huge infrastructure deficit, and different estimates have been made about its extent, which appears to be more than £7 billion over the next 10 years.

The Committee for Finance and Personnel indicated that the preferred source of finance is public finance, because it is generally provided at lower interest rates than those available through the private sector. We should address that important issue, because there would be no point in passing funding over to the private sector if that were the only consideration. However, it is not the only consideration. No one has claimed that we could finance our deficit of some £7 billion over the next 10 years from within existing public expenditure. We shall have to think outside the box and, increasingly, consider alternatives.

Public-private partnerships can bring benefits. We have heard about improvements in the design of schools, and about the ease of the management of ongoing maintenance arrangements. There are also benefits to be had from encouraging Departments and organisations to think outside the box. For example, Departments could perhaps be encouraged to share facilities with other Departments, and to increase the use of those facilities. That form of funding could increasingly encourage communal use, and a variety of other uses.

There are many ways to finance those activities. We have the traditional route of public expenditure; we have the private finance initiatives and public-private partnerships; and we now have the reinvestment and reform initiative. We should not be tied to any one route. We must consider each means of finance on its merits, and decide which one will best address the urgent community needs that exist. As Members have said, we must also bear in mind that, ultimately, as when someone takes on a mortgage or hire purchase agreement, it must be paid for. Therefore, we must consider the long-term implications of each option.

I concur with the Committee for Finance and Personnel's view that PPPs can be a valuable tool and means of investment, and should not be ruled out. I welcome the First Minister's comments, which reflect the views of the Committee, that value for money has to be demonstrated clearly over the life of a project.

I joined the Committee for Finance and Personnel only this year, and I have already heard favourable comments about public-private partnerships. For example, I heard some during a visit to the Scottish Parliament, and I also heard about positive experiences in the Republic of Ireland. I learnt that, on occasion, even though public finance was available, PPPs were preferred because of other perceived benefits.

Northern Ireland has had limited experience to date of PPPs compared with other UK regions. We need an advisory group that will consider in detail the overarching investment strategy. I expect that to be done by the strategic investment body.

How can we be assured that that body will have the necessary experience and expertise? That will be critical in determining options for funding. I agree with Patricia Lewsley that we should learn lessons from our existing PPPs. There should be a review of our experience to date. Although it is limited, there must be positive lessons to be learnt. I ask the Minister to ensure that any early lessons are built on in future decision-making.

I welcome the reinvestment and reform initiative and the move to establish the strategic investment body. However, further details are needed, and we need to keep the process moving forward. Ultimately, projects must be delivered. For example, the widening of the M1, which is of concern to many commuters, and the new cancer centre will be financed by the initiative. When will more projects be delivered, and when will our constituents begin to see more benefits from these initiatives?

Before I call Mr Byrne, I remind the House that we must break at 2.30 pm for Question Time. Mr Byrne will be allowed to resume after 4.00 pm, if necessary.

It is generally recognised that public investment needs are a major problem in Northern Ireland. That point has been highlighted since the Assembly came into being. Three Departments in particular - Education, Health, and Regional Development - have major capital investment needs, and we have suffered major handicaps in those areas over many years.

Public resources are insufficient to meet those capital investment needs, and that is regrettable. However, that is the reality that the Assembly faces. Most parties would like to see public capital needs provided for through the public purse, but, unfortunately, that is not possible under the limited devolved Budget. The big question is whether private-finance capital sources can be attracted to finance capital budgets or projects in those areas.

There have been several private finance initiative (PFI) projects, and, more recently, public-private partnerships in Britain and, indeed, Northern Ireland that have resulted in new schools, colleges and offices. That has brought welcome development to different localities and communities. However, it is fair to say that there has been some genuine concern and criticism of how some PFIs have worked, including the accumulated cost of servicing the payback on some projects. Many trade unions are greatly concerned about how workers are often asked to pay a price for such projects.

One of the key principles is value for money, which must be crucial in assessing a PFI or public-private partnership project. The rate of return on a private finance initiative must be sufficient, but not excessive. There has been genuine criticism of some of the excessive returns in some projects, and the rate of return should reflect the prevailing safe loan capital environment - the repayment is assured to the public purse, so that risk is limited and controlled.

The reinvestment and reform initiative outlined by the Office of the First Minister and the Deputy First Minister and the Chancellor of the Exchequer in May is a welcome proposal that can be used to get necessary, upfront capital investment money for infrastructure projects. The strategic investment board has obvious merit in facilitating private finance schemes for public investment projects. The public wants to see new schools and hospitals as soon as possible, and there is a great imperative that private finance schemes should be processed in a more efficient and effective way. There is genuine concern that the entire administration of projects is long-winded, cumbersome and leads to excessive costs.

It would be unfair to ask any of the other Members to start a speech for the sake of a few seconds, only to have to interrupt themselves in full flow. The House will take its ease until Question Time, which is in less than one minute.

Oral Answers to Questions

Education

Question 7, in the name of Mrs Eileen Bell, has been withdrawn and will receive a written answer.

1.

asked the Minister of Education to give an assessment of the response to his consultation on the Burns proposals.

(AQO 70/02)

The Minister of Education (Mr M McGuinness): We adopted a multi-stranded approach to the consultation to ensure that all sectors of the community had an opportunity to participate, and I have been encouraged by the response. I held 28 meetings with key interests during the consultation period. More than 650 written submissions were received from education partners, churches, schools, parents, teachers, pupils, political parties and the business community. More than 550 detailed response booklets were received from schools, training organisations and community groups. More than 200,000 adults completed the household response form, and research was conducted into the views of young people. I will publish a summary of the responses to the consultation in early October for everyone to see and consider.

I am also encouraged by the response. After the recent media speculation that there has been intensive canvassing by grammar schools regarding the survey, how will the Minister ensure that the outcome is totally representative of all opinions?

We had a good response to the household forms; 200,000 people represent a substantial body of opinion in anyone's book. However, we must put that into context - it represents 16% of the adult population. The household form is one strand of a multi-stranded approach to consultation. We adopted that approach to ensure that everyone's views were heard. The public's views are also represented in the responses from schools, parents, pupils, the Churches, community groups, voluntary organisations, the political parties and our education partners. All those views will be taken into account.

Does the Minister recognise that the Burns proposals are particularly controversial? Does he know that more than 1,000 constituents in Strangford have written to me to express their opposition to the proposals? Now that he has confirmed that he will publish his own conclusions in October, he owes it to the public - and I ask him to do it today - to advise us when he is likely to present those proposals to the Committee for Education. Should the Committee reject his recommendations, will he go over its members' heads and bring them before the Assembly?

It is important that everyone, including myself, take time to consider the responses to the consultation exercise in detail. I want to hear the views of key stakeholders in education on the responses to consultation and how best to progress the post-primary review before I make proposals on the way forward. Any new arrangements and their implementation will be shaped by the responses to the consultation and must build on the growing consensus that has emerged during the post-primary review. I will announce details of the timetable for the next stages of the review when I publish a report on the responses to consultation in early October.

I thank the Minister for the way in which he outlined the handling of the consultation process. The proposals that emerge from that process will be of greater importance. Does the Minister plan to bring those proposals to the Assembly before the end of the year?

Through the consultation process and my meetings with key interests and partners, there are strong signs of a growing consensus on the need for change. I want to build on that emerging consensus. I am firmly of the view that we can work together to bring about new arrangements for post-primary education, to the benefit of all.

Decisions on the way forward - which is what Tommy Gallagher is asking about - will depend on the outcome of the consultation, and I intend to consult the Assembly and the Executive about any changes. It may also be necessary to give effect to new legislation, and that will be subject to the approval of the Assembly.

Children are the key focus, and they will continue to be my prime concern throughout the review of post-primary structures. The debate should rise above party-political lines and the interests of individual institutions. Any changes, and the timing of their introduction, will depend on the outcome of the consultation. My Department will maintain the existing arrangements and phase in changes in a planned and orderly manner in order to safeguard the education of children in schools.

Throughout this process the intention is to improve the educational experience of children and to improve standards, and my Department will work with the boards, the Council for Catholic Maintained Schools (CCMS), boards of governors, principals and teachers to achieve that.

The Assembly has a critical role to play, and, given the events of the summer, I have been encouraged by the high level of debate and the important contributions from all the political parties and our education partners. I am pleased how the situation is moving along, and my key object is to continue to build on the consensus that I believe already exists.

2.

asked the Minister of Education whether he intends to urgently review the current school transport strategy in the light of the inequities that it is causing.

(AQO 26/02)

The current transport arrangements were introduced in 1997 to constrain the escalating costs of home-to-school transport and to release resources to safeguard funding for the classroom. The revised arrangements restrict transport provision to pupils who have been unable to gain a place in any suitable school within statutory walking distance of their homes. Suitable schools are defined as the established educational categories of controlled, maintained, integrated and Irish-medium, and, in the grammar sector, denominational and non-denominational. Parents are not obliged to send their children to the nearest suitable school or to any particular school, but, where they do not qualify for assistance, the responsibility to provide transport falls to the parents.

I recognise that some aspects of the current policy concern parents and public representatives. My Department is reviewing the present arrangements and will consult with all relevant bodies in due course.

A similar answer was given the last time that the question was tabled - namely, that the Department was reviewing matters. We need some urgent action, particularly in the light of the earlier question on the Burns review, given that there is such inequality in the current system. For example, a parent on a low income from the Markets area or the Short Strand sending a child up the Ravenhill Road by bus to school - which has to done for safety reasons and because of the sectarian nature of the area that is passed through - has to pay the bus fare. It costs at least 55p a trip. That amounts to over £200 a year, and if there are three children involved it can add up to £600.

On the other hand, a parent of a child living on Malone Road, or in Carryduff, outside the three-mile area, gets such transport for free. That results in an unequal system, where low-income families have to pay more. Likewise, a parent whose child has passed the 11-plus faces the same problem.

The question from the hon Lady is clear.

Could we please have a date for the end of this review and some free school transport in the future -

Order.

Mr M McGuinness: I appreciate the concerns articulated by Ms Monica McWilliams and, indeed, by other elected representatives. It is an important issue. There will be a wide-ranging review, which will consider the impact of the 1997 policy change, along with other issues that have emerged since then. Ms McWilliams is correct in saying that the review will need to have regard to the report of the review body on post-primary education; it will also need to take account of the recommendations of the Committee for the Environment's report on home-to-school transport.

I am concerned, as is Ms McWilliams, that we are hearing words rather than having action. Does the Minister intend to take any action to address the situation in which students over 16 years of age in full-time education and financially dependent on their parents must pay adult fares? Is that not unfair and discriminatory? Their situation has not changed; only their age has.

The review provides an opportunity for everyone to raise his or her constituents' concerns, and this matter can also be considered during it. However, at the same time, there will be widespread appreciation that it is sensible, when dealing with such issues, for us to recognise that the review must also have regard to the report on post-primary education and the Committee for the Environment's report on home-to-school transport, on which we have had several debates.

I tabled a similar question some months ago, and the answer too was quite similar: there will be a review. I share the other Members' concerns that we still have no date for that review. My worries are about primary schoolchildren and also about 16- to 18-year-olds. I understand that a review is under way involving the Department for Regional Development and the Department for Employment and Learning. Will the Minister consult those Departments when proposing any changes? It is very relevant. I believe that he is proposing a reduction of at least 50%, and for some primary schools that would be of great help.

We shall gladly consult those Departments.

3.

asked the Minister of Education to make a statement on the development of nursery education.

(AQO 92/02)

In 1997, there were funded places for 45% of children in their immediate pre-school year in statutory settings. As a result of my Department's pre-school education expansion programme, that rose to 85% in the 2002-03 school year in both statutory and voluntary settings. In the 2003-04 school year the programme aims to provide a place for every child whose parents wish it.

The overall growth in places is obviously to be welcomed. How many places are in existing controlled or maintained primary schools as opposed to in facilities which are seen to be completely open to all sections of the community? Is there not a danger that we have lost a major opportunity to promote integrated education for the under-fives?

I shall write to Mr Ford with the figures that he seeks. It is also important to point out that in the present provision there are undoubtedly many integrated settings in which children from all sections of the community enjoy a year's pre-school education together. Growth in pre-school education for children in the year before formal education begins has mushroomed over the last few years. We have made tremendous strides, and we must constantly review how we continue that in the light of our having quite a strong integrated education sector. Parents increasingly choose to have their children educated together; I am conscious of and sympathetic to that trend.

When can Moorfields Primary School have its nursery unit?

He is stumped.

No, I am not stumped; not yet. My Department has been in contact with the North Eastern Pre-School Education Advisory Group on the subject, and I shall write to the Member about it.

Why has the Minister not taken the opportunity afforded by the Education and Library Bill to close the legislative loophole that allows two-year-olds a funded voluntary- or private-sector nursery place while many four-year-olds do not receive one? Would it not be better if he enabled educationalists to ensure that every child in his or her pre-school year received a funded place? The Minister could do that by moving an amendment, rather than simply hoping that those places will become available. The Minister might be able to give an assurance based on the assumption that a percentage of parents will not take up places, but there will undoubtedly be a spread in different areas.

Order. The Member's question is clear, and I am sure that the Minister is aware of the arguments.

Since the early 1970s, places in the statutory sector have been open to children from two years old to the lower limit of compulsory school age. It is, however, my intention to amend the legislation so that very young children, who gain little benefit from attending nursery schools or classes, will no longer be admitted. Such an amendment was not made to the current Bill because of the nature of the legislation. The main purpose of the Bill is to introduce the local management of schools common funding formula.

I am aware, however, that the Committee for Education has raised that issue, and that departmental officials met the Committee last week. I want to await the outcome of the Committee's report.

4.

asked the Minister of Education to give an update on the progress of the centre for autism.

(AQO 90/02)

Work on the centre for autism is progressing well. A project manager has been appointed to co-ordinate the work of all the agencies involved, prior to the appointment of a chief executive. A steering group has been established, including representatives from the Department of Education and the Department of Health, Social Services and Public Safety in the North, and the Department of Education and Science and the Department of Health and Children in the South.

In particular, the steering group will consider legal issues such as purchase, ownership, governance and management of the centre, professional issues, access and health and safety issues, and ways of including parents and other interests in the planning process.

What is the current state of financing for the project? Have any resources been forthcoming from the Government of the Republic of Ireland?

We were given some £1·7 million from the Executive programme funds, which will contribute to the purchase of the site at the former St Joseph's adolescent training centre in Middletown. I am confident that the Government in Dublin will make their contribution. I do not have any difficulties about achieving that. Our objective is to have the centre up and running in autumn 2003. Some months ago, people thought that that was an ambitious target, but I am confident that we will meet it. There is still work to be done, and many appointments to be made, but the work is well in hand. We will have to consider funding as we progress.

Go raibh maith agat, a Cheann Comhairle. What other work has the Minister initiated to address autism?

I recently reported to the House on the outcome of the previous North/South Ministerial Council meeting. A joint working group on special education was set up under its auspices, which will focus initially on autism and dyslexia. Northern task groups on autism and dyslexia were established, and I launched the reports produced by those groups earlier this year. I welcome their challenging recommendations to all of us with responsibilities for the education of children with autism and dyslexia.

My Department has also organised separate conferences, to be held in September and November, which will progress the recommendations from the reports on autism and dyslexia. Those major events will involve relevant education and health professionals working together with parents of children with autism and dyslexia and representatives of voluntary organisations to help plan for provision. Those events will provide focal points for discussion on how best to take forward the recommendations from each report.

My Department and the Department of Education and Science are supporting a bid made to the Peace II funds by the Centre of Cross-border Studies, which will, if successful, provide cross-border exchange opportunities for teachers, principals, educational psychologists and inspectors working in special educational needs. The programme intends to promote dialogue and the exchange of good practice for professionals working with children with special educational needs.

I have recently become aware of the difficulties that many young people face in accessing appropriate day care or employment when they leave special schools. I therefore met the Minister of Health, Social Services and Public Safety, the Minister for Employment and Learning and relevant officials to consider what could be done. Officials from the three Departments will consider the matter fully, and they will put forward proposals on how best to improve the transition planning process and the options available to the young people.

5.

asked the Minister of Education to comment on the series of attacks on schools that occurred over the summer.

(AQO 76/02)

My Department is aware of seven arson attacks on schools since the beginning of June. During other attacks on schools windows were broken - in one case in north Belfast there was a disgraceful attack in which hundreds of windows were broken in a controlled school. I deplore attacks on all schools. Schools must remain sanctuaries and should not be dragged into community conflict. Acts of vandalism serve no purpose and divert financial resources from the classroom, where they are needed most.

All children are entitled to the best possible education in good, modern, safe schools. Vandals try to deny them that right, and it is everyone's responsibility to make it clear that attacks are unacceptable.

I agree that such attacks are reprehensible. Approximately how much funding is being diverted from the delivery of education?

I appeal to everyone in society to do his or her best to help to create a proper environment in and around schools to ensure that such attacks are stopped. I call for an immediate halt to attacks on all schools.

My Department does not have details of the cost of repairs to the schools affected, but such attacks put further pressure on funds, given the increased need for security measures in schools. For the five years until March 2002, additional resources of £5 million were made available to address basic security measures in schools, and a further £1 million has been made available this year. That money could be put to better use.

I note the Minister's comments regarding pressure and the diversion of funding. Will he assure the House that the schools affected will not suffer financial difficulties because of the attacks, and that additional funding will be provided to address the damage so that resources meant for the classroom will not be diverted from where they are most needed.

There is a responsibility on Members to ensure that the limited funding available goes directly where it is needed - into the classroom. Undoubtedly, the disgraceful behaviour by a tiny minority in society has a detrimental effect on our children's education. There is a responsibility on me, the Executive and every Member to ensure that we do everything in our power to get as many resources as possible for the education of our children. That is problematic considering the difficulties that many Departments are enduring as a result of the legacy of neglect and underfunding across all Departments over the past decades.

At the same time, the Department will do its best with its limited budget, and I will fight for more resources for the education and library boards, the CCMS and other education partners.

6.

asked the Minister of Education how many postcode areas had not received the Burns questionnaire by the beginning of June 2002, and to explain the reasons for the delay.

(AQO 88/02)

The household response form was distributed to more than 670,000 households. Distribution took longer than anticipated due to the massive scale of the exercise, and, unfortunately, a few postcode areas did not receive their forms by the beginning of June. Those areas were BT1, BT2 and BT3 in Belfast; BT24, which is Ballynahinch; BT25, which is Dromore; and BT40, which is Larne. However, those areas received their forms by the week commencing 24 June 2002. The deadline for responses was 28 June 2002, but, in the light of the distribution difficulties, my Department considered all responses received up until the end of July 2002.

Does the Minister accept that many people found the personal questions on the back of the form intrusive and offensive, and does he accept that this will have affected the response rate? Will he give an assurance that the results of the consultation will take account of all responses regardless of whether these questions were answered?

I received no information to the effect that society had revolted over the quite legitimate questions that were posed in the household response form. All the responses will receive the important consideration that they deserve given that some 200,000 households saw fit, and were bothered enough, to return the forms. The Department is very pleased with how the exercise has gone, and people should consider that we are evaluating not only the household response form exercise, but the many other strands of the consultation. As a result of the exercise, we have given society a unique opportunity to contribute to the shaping of our future education system. Good work has been done. Let us try to build consensus to ensure that the key people in all of this, the children, receive the best possible education.

Does the Minister accept that a response from 200,000 households out of a circulation of more than 600,000, which is 33%, is a response of over 100%, if we take into account the number of families with children in education? Why has he sought to downplay the responses that he has received and introduce yet another layer of consultation by asking the key stakeholders to respond to a consultation on the consultation? The Minister is ducking and diving because he knows that the people have hampered his drive towards comprehensive education in Northern Ireland. Will he assure the House that when he finally comes up with some proposals, he will seek the cross-community consensus of the House rather than try to drive it through by ministerial decree?

We have had a good response to the household form. A response by 200,000 people represents a substantial body of opinion, though still that constitutes only 60% of the adult population, and that is why the five strands of the consultation were so important to ensure that everyone's views are represented. The views of the public are also represented in the responses from schools, community groups, churches and education partners. I find it a bit rich that the Member takes it upon himself to speak for the education partners.

I have had 28 positive and constructive meetings with everyone who is involved in the process. Much good work was done over the summer, and I am confident that in bringing about the essential change that everyone knows must take place, I will do so with the full good heart and co-operation of those people.

They are genuine people; they are good people. They may be on different sides of the argument, but they all want to do everything in their power to ensure that our education system grows stronger no matter what changes are made. No one in the House can speak for the education partners. They are good, decent people, who will work in partnership with me to ensure that change takes place sensibly.

I regret that other Members who wish to raise questions will find that we have run out of time.

Health, Social Services and Public Safety

I wish to inform the House that question 14, standing in the name of Mrs Eileen Bell, has been withdrawn and will receive a written answer.

1.

asked the Minister of Health, Social Services and Public Safety whether the casualty unit at Antrim Area Hospital is being used as a makeshift ward, and, if so, what plans she has to improve the bed-blocking system there.

(AQO 3/02)

Go raibh maith agat, a Cheann Comhairle. Bhí sé riachtanach ar roinnt ócáidí d'othair in Ospidéal Ceantair Aontroma fanacht sa roinn taisme agus éigeandála i ndiaidh na cóireála tosaigh go dtí gurbh fhéidir iad a ligean isteach i mbarda. Ba í an phríomhchúis leis sin ná an mhoill i ligean amach othar nach raibh cúram de dhíth orthu a thuilleadh in ospidéal, mar aon leis an líon méadaithe iontrálacha éigeandála.

I mí Iúil 2002, chuir mé maoiniú ar fáil do bharda breise 24 leaba, agus le trí bliana anuas méadaíodh an bhunáit altranais mhaoinithe i roinn taisme agus éigeandála an ospidéil. Ag tabhairt aitheantais don bhrú a chruthaíonn moill a bheith ar ligean amach, fuair mé £19·1 milliún breise do sheirbhísí cúraim phobail anseo sa bhliain reatha.

It has been necessary, on some occasions, for patients at Antrim Area Hospital to remain in the accident and emergency department after initial treatment until it is possible to admit them to a ward. The principal reason for that is the delayed discharge of patients who no longer need hospital care, combined with an increased number of emergency medical admissions.

In July 2002, I made funding available for an additional 24-bed ward, and the funded nursing establishment in the accident and emergency department of the hospital has been increased in the past three years. I acknowledged the pressures created by delayed discharges, and I secured an additional £19·1 million for community care services here in the current year. That sum will enable boards to increase care home payments, implement free nursing care from next month and support 1,000 more people in community settings.

Does the Minister agree with Dr Brian Patterson's comments on behalf of the British Medical Association (BMA)? He said:

If she accepts that opinion, will she coherently - not using the gobbledygook that we have heard to date - outline her strategic plan for the Antrim Area Hospital and say how she will provide beds and staff to tackle the bed-blocking and waiting crises? None of the measures that she mentioned in her answer has, to date, solved the problems or fulfilled her promises.

I shall continue to make the problem of delayed discharges a priority, together with the restoration of domiciliary care as a cost-effective alternative to institutional care. Studies have shown that that is a fundamental measure in any strategy for dealing with the issue to which the Member referred.

Moreover, each board is committed to examining good practice and innovative schemes. The boards have identified schemes that are specifically designed to reduce admissions to long-term care, prevent inappropriate admissions to hospitals and facilitate early discharge. The Northern Board, in meeting its targets of 1,000 additional people to be treated in community settings, indicated that 75% of the additional support will be made available to elderly people, and that will have an impact on the problem.

There are no easy answers. I have made the case for substantial additional funding, some of which has now been secured and is finding its way into the service. Developing better services will provide a framework in which significant improvements can be made to the provision of acute services here. Significantly, I announced in the summer that Antrim Area Hospital will gain 24 additional medical beds at a cost of £3·47 million, a new chemotherapy unit costing £1·58 million, a new CT scanner costing £0·65 million, and four additional dialysis stations costing £0·35 million.

We must put capacity back into community services and hospitals to ensure that equipment is up to date and that staff are available. Since I became Minister, I have addressed in a sustained and strategic manner issues that had not received significant investment during direct rule.

Go raibh maith agat, a Cheann Comhairle. Will the Minister outline what she is doing to improve community care services, so that people who are able to use such services can do so rather than availing themselves of hospital care, thereby easing bed blocking?

I have made a provision of £19·1 million. Each board has suggested ways in which community care can be improved. I carried out a review of community care, which has led to information on good practice being collated. Boards have been asked to take that into account when examining the implementation of the work to ensure that an additional 1,000 people in community settings are supported. That will help to address problems in the community, prevent inappropriate admissions to hospital and facilitate early dismissal.

The Minister has advised that some £19 million of additional money has been directed towards the easement of bed blocking. However, does she acknowledge that there is a problem in the Homefirst Community Trust area, which serves United Hospitals, in that it receives less funding for community care per capita? The inability to move patients from hospitals into the community and provide care packages adds to the waiting lists.

The £19·1 million is for community settings and will include funding for nursing homes and free nursing care. However, the bulk of the money will be used to ease bed blocking. There are difficulties with delayed discharge in United Hospitals, which, according to provisional figures for the end of June 2002, have the highest number of patients awaiting discharge. I allocate funding to boards, and the boards decide on the allocation of funding to the trusts based on population needs.

2.

asked the Minister of Health, Social Services and Public Safety how many cancer operations were cancelled last year due to lack of available intensive care unit beds.

(AQO 25/02)

Níl teacht furasta ar an eolas seo san fhoirm inar iarradh é agus níorbh fhéidir é a fháil ach ar chostas díréireach.

That information is not readily available in the form requested and could be obtained only at a disproportionate cost.

I am disappointed by the Minister's answer. That information should be available because cancer patients are being told to prepare for operations that require intensive care beds, only to be told that their operation has been cancelled.

My question is based on the case of an elderly woman who was admitted to the Ulster Hospital. On four occasions she prepared for an operation by fasting so that pre-operative medication could be administered, and on four occasions her operation was cancelled. She was sent home, told to fast, and to wait for a telephone call. A message cannot be sent out that the Health Service will tolerate such practice. Members must be told how many operations were cancelled in the past year because no intensive care beds were available.

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