The Future of the Mater Hospital

Mr A Maginness:

On 2 July 2002, the McAuley Building was opened at the Mater Hospital. It is a new, state-of-the-art building that will service the hospital. It was called after Mother Catherine McAuley, a Catholic religious sister in the nineteenth century who founded the Sisters of Mercy, an order particularly dedicated to teaching and nursing. She was a sort of nineteenth-century Mother Teresa in Ireland. She and her sisters founded many schools, hospitals and other institutions the length and breadth of Ireland for the Irish people - Catholic and Protestant, from north and south. In many ways, together with other religious orders and people, both Catholic and Protestant, she established the foundations and infrastructure for schools, the education system and the health service in Ireland.

Part of those foundations was the Mater Hospital, which was founded in Belfast in 1883. By 1909, the hospital's status in Ireland was such that it was recognised as a university teaching hospital. The Mater maternity unit was eventually opened in 1945, adding a further service to the hospital. In 1972, the hospital, which had previously been under Catholic control and which had been independent throughout its history, became part of the National Health Service. A deed of arrangement underpinned the transfer of the hospital to the NHS. That was a guarantee from the Government of the time that the hospital's character and ethos would continue. I shall say more about that later.

Until 1972, the hospital was funded by the Young Philanthropists, of which my late father was a member. It was an imaginative and far-sighted group, for it saw that it was important to put moneys necessary for the hospital's future into trust funds. Indeed, the group raised a great deal of money. Over the years, thanks to the financial wizardry of a very distinguished cleric called Monsignor Mullally, the money was transformed into a multimillion-pound fund. The upshot was that the McAuley Building was opened in July 2002. Built at the cost of £17 million, it was virtually a new hospital. None of that money came from the state. It was raised by generations of Belfast people. It was used to build and equip the building. It was, in effect, a gift of £17 million to the public Health Service by a private charitable trust.

The Mater Hospital has, however, been informed, following the Department's document 'Developing Better Services: Modernising Hospitals and Reforming Structures', which was published in June 2002, that it is to be downgraded to a local hospital. It will no longer be an acute hospital. In substance, that means that its acute services will be systematically removed over several years. It will end up as little more than a glorified nursing home.

Despite what the Department says, the hospital will lose many of its services. It will lose its accident and emergency service, which - as those who live in north Belfast know - is crucial to the people of the area. That area has the lowest car ownership in Belfast - indeed, in Northern Ireland - yet the Department is persisting in its views. The Department also insists that intensive care and high dependency units will be removed. Inpatient general medicine, inpatient cardiology and the coronary care unit, inpatient diabetic services, inpatient respiratory medicine, inpatient general surgery, inpatient urology services, inpatient cardiac investigation, inpatient gynaecology, inpatient laboratory services and inpatient anaesthetic services will also go. I contend that there will be nothing left if the Department's proposals are implemented.

The developing better services document takes the form of a White Paper. It not called a White Paper, but that is what it is. It represents the Department's and the Minister's thinking. In fact, the Minister had to be pushed into extending the period of consultation. She said that consultation should end in September 2002. That has now been extended to the end of October 2002. That demonstrates the Department's commitment to the proposals contained in the document. There is no doubt that if the proposals are implemented, it will be the end of the Mater Hospital as an acute service hospital in Belfast.

Furthermore, the continuance of maternity services is also under threat. That threat is not as explicit as the threat to other services. The survival of the service is conditional upon the Mater Hospital's working with the new centralised Belfast Maternity Service. That is code for "If you do not do what you are told, you will lose your maternity services". That is what the Minister and the Department are saying to the Mater Hospital.

The Department says that the Mater Hospital's teaching status will remain. I mentioned that such was the status of the Mater Hospital at the beginning of the century that it was granted university teaching status. The Department says that that status will remain. How credible is that proposal, when the Minister is taking away the acute services that would encourage doctors and nurses to come to the Mater Hospital to train? Its teaching status might remain in name, but in reality it will not remain at all. It does not take a genius or a medical expert to reach that conclusion.

The Department says that the developing better services document is in line with the Hayes Report - the acute hospitals review group report. That is untrue. I ask Members to check the document and the Hayes Report. It is not in line with the proposal for partnership with the Whiteabbey Hospital to deliver acute services to north Belfast, Carrickfergus and Newtownabbey. It is not true for the Department to assert that.

There is no proposal to retain acute services at the Mater for the foreseeable future. Some of the acute services that I mentioned will be retained for a few years, but they will be phased out. However, the Hayes Report stated that acute services at the Mater would be retained for the foreseeable future - in other words, for an indefinite period. The Minister's document does not say that; it says that it is merely a transitional arrangement. Further to that, the Hayes Report states that a regional service should be located in the Mater, but that is not mentioned in the Minister's document at all.

The effect in north Belfast will be considerable and significant. The effect on employment alone will be substantial. Around 1,000 people are employed by the Mater Hospital. It is possibly one of the biggest employers in north Belfast. Ancillary, clerical, medical, clinical and nursing staff will be systematically removed. In a few years' time, the number of employees might be down to 500 or 600 staff - and still falling. Think of the effect that that will have on north Belfast.

The latest analysis of north Belfast contained in the North Belfast Community Action Project Report states:

Acute hospital services will be removed from the people who most need them. What sort of madness is this coming from the Department of Health? North Belfast has some of the highest rates of suicide, substance abuse and mental ill health. How can any of these proposals ameliorate that situation?

The Mater Hospital serves the community, and has served it very well. Over 45,000 people have used the accident and emergency service in the Mater Hospital over the past year. There were 6,000 medical or surgical emergencies and 1,000 births. That is a more than creditable performance for any Northern Ireland hospital.

The Minister's proposals are unacceptable and wrong. They are dangerous and will hurt the long-suffering people of north Belfast. They are an offence to good public policy. Is it not ironic that a Minister who is ostensibly committed to the equality agenda is, through her proposals, undermining that agenda and disadvantaging the people of north Belfast, Catholic and Protestant?

The proposals also run contrary to the deed of arrangement, because they undermine the historic character and ethos of the hospital. Not only are the proposals legally questionable, they are undoubtedly politically unacceptable and objectionable to the people of north Belfast. During this little political interlude, let us hope that the Minister will have a change of mind, or that her mind will be changed, by the time we return.

The Chairperson of the Committee for Health, Social Services and Public Safety (Dr Hendron): Wearing my hat as Chairperson of the Committee for Health, Social Services and Public Safety, I wish to express my disappointment that no decisions have been made on the future of not only the Mater Hospital, but of all acute hospitals in Northern Ireland. I want to make it clear that I in no way point the finger at the Minister. Other reports were published long before the Hayes Report, but it is the most recent. It was followed by the Minister's consultation document 'Developing Better Services: Modernising Hospitals and Reforming Structures'. I hope that when the Assembly is reinstated the Minister, or any future Minister, will make decisions on that.

I will now speak not as Chairperson of the Committee but as MLA for West Belfast and as one who has spent many years in west and north Belfast - I sometimes say how many years, but I will decline to do so now. I have long experience of the Mater Hospital, the Royal Victoria Hospital and the City Hospital.

Alban Maginness has already mentioned the new £17 million development at the Mater Hospital. Every hospital has its origins, and people become attached to them. The Mater is in many ways unique, but I will not dwell on that point because it has already been well covered. It seems odd that it has been proposed that the Mater Hospital, with its new £17 million development, is to be stripped of its acute status.

Alban Maginness rightly says that 'Developing Better Services: Modernising Hospitals and Reforming Structures' is in effect a White Paper. When asked, the permanent secretary made it clear that it was a White Paper. The odds of the proposals contained in a White Paper being put into effect are at least 50 to one on. Consultation will still take place, and perhaps in special circumstances changes will be made, but as Members will know, generally speaking, the recommendations contained in a White Paper will be carried out. The part of the document that deals with organisation does not have "White Paper status", because it is part of the review of local services.

It is proposed in the document that the Mater Hospital become a local hospital and a key institution in the fields of medical and nurse training and that its links with Queen's University be put on a statutory basis to formalise its role as a teaching hospital. I was taught in the Mater Hospital and also in the Royal. The teaching role of the Mater Hospital is well known in this country and far beyond. No formality or legal standing is needed in that regard. It is an outstanding teaching hospital. I find the suggestion that somebody from Queen's University should be on the hospital's board of management condescending. It is as if the hospital is being given some sort of important status when, in fact, it is being slowly destroyed by the removal of its acute services.

The Mater Hospital has been outstanding in its diagnosis and treatment of chronic obstructive pulmonary disease (COPD), which is associated with emphysema, smoking and dust in the air. North Belfast has twice as many cases of that terrible condition as other parts of Northern Ireland. It seems odd that, although the Mater Hospital is so well established and recognised for its treatment of chest disease, it may lose its acute services over the next 10 years. The hospital has piloted a multidisciplinary approach to treating patients with COPD, and it is the only hospital in the North with a specialist COPD clinic. Only two years ago, a young nurse there was named UK Respiratory Nurse of the Year.

The McAuley Building houses facilities to provide the most advanced acute services for the benefit not only of its catchment area, but of a much wider community through regional and outreach services and clinics.

I speak not only from my own years of experience, but as someone who has visited the accident and emergency (A&E) departments in all the major hospitals, including the Mater Hospital. Let me take those of the Royal Victoria Hospital and Belfast City Hospital as examples. I have nothing but respect for the nurses, doctors and other staff who work there, but they cannot cope, and not only in winter. I shall not go into the whole matter of trolleys and people waiting, but acute services, especially A&E, are not coping.

I emphasise that the picture is the same in Belfast City Hospital and in Antrim Area Hospital. I have visited all those hospitals. I suppose that no matter what Maurice Hayes and his people said about hospitals, they could not possibly satisfy everyone. However, with regard to overall principles, I have no difficulty in accepting the Hayes Report, and I am aware of what it said about the Mater Hospital.

I understand that every politician will make a case for the hospital in his or her area. However, in respect of the Minister's points, there is something about the Mater Hospital that is not fully realised. The Antrim Area Hospital and the Royal Victoria Hospital could not cope with north Belfast. It has nothing to do with sentiment, although that is involved in all hospitals. It comes down to the direct clinical issues that affect north Belfast, which Members will accept is the most impoverished area in these islands. To remove acute services - even in a few years' time - is the beginning of the end of that hospital. It must be borne in mind that the other hospitals cannot cope.

I appreciate and understand that it was not easy for the Minister to make the decisions in her White Paper. Were someone to ask me what I recommended, I should not find it easy, taking account of the picture across Northern Ireland. However, the sums have either been done incorrectly or wrongly interpreted. I should like the Minister and her Department to examine those figures again. They must realise that the people of north Belfast - Catholic and Protestant alike - could not cope without the Mater Hospital. Its proud tradition extends to the Shankill Road, the Antrim Road, Glengormley and the ever-increasing population of Newtownabbey and beyond. As I said earlier, Antrim Area Hospital could not cope either.

The Business Committee set a maximum of 60 minutes aside for this debate. Ten of those minutes will be allocated to the Minister. I simply ask Members who speak from this point on to bear that in mind. I have five or perhaps six Members on the list.

I shall endeavour to bear that in mind to allow others to make a contribution.

I thank Alban Maginness for raising this matter. He has very ably set out the case that must be made for the retention of services at the Mater Hospital. Most Members should be able to agree with that, and I concur with many of the remarks made by the Chairperson of the Health Committee, Dr Joe Hendron. He knows from his personal, professional experience how the Mater Hospital has met the needs of the people of north and west Belfast.

I remember that, a few years ago, a public meeting was called in Newtownabbey in relation to the proposals that had been announced for the Whiteabbey Hospital. Hundreds of people attended, including trade unionists, staff, doctors, people in the medical profession, people whose relatives had been treated at Whiteabbey Hospital and members of the public. The common cry at that meeting was that if, at some stage, as part of a devolved Government, there was a Minister from Northern Ireland, no locally based Minister could possibly take such a decision. Unfortunately, as a result of the Department of Health, Social Services and Public Safety's 'Developing Better Services: Modernising Hospitals and Reforming Structures' document, we are now faced with proposals that not only confirm the bad news about Whiteabbey Hospital, but deliver a bolt out of the blue for the Mater Hospital.

As was rightly stated by Mr Maginness and Dr Hendron, Dr Hayes did not suggest the sweeping, radical downgrading of the Mater Hospital that the Minister of Health, Social Services and Public Safety has proposed. That must be emphasised, and, as demonstrated at a recent meeting of Belfast City Council, any attempt to pin the blame on the Hayes Report must be stopped.

The proposals are resisted and opposed across the community in north and west Belfast. I met recently with Lady McCollum and Patricia Gordon, community workers and medical staff. I visited the Mater Hospital and toured the McAuley Building. There is unanimous dismay and bewilderment at the decision to implement the proposals now, especially, as other Members stated, given that £17 million of investment was privately raised - with not a penny of that coming from the public purse. The suggestion is that the Mater Hospital should be downgraded to the same status as a local hospital.

Aside from the impact that that will have on the delivery of medical services in the most deprived and needy area of our Province, we must remember that the Mater Hospital, which serves both communities, is perhaps the biggest employer in the area. It is situated in Crumlin, which is the most deprived ward in Northern Ireland. When I toured the hospital, I was struck by the number of people from both sides of the community divide who work in it and who receive treatment in it. Both sets of people, regardless of their background, are devastated that the Mater Hospital is to be downgraded from its current status to nothing more than a local hospital.

It has been argued that some provision, such as maternity services, will be retained. However, if specialists such as anaesthetists are not retained, the long-term outlook for maternity services is poor, because it would not provide value for money to pay for those services simply to cover maternity provision. That the Mater Hospital could be retained as a major teaching hospital without the throughput of specialised services is not tenable and will not happen in practice.

The Minister is delivering a death knell to the Mater Hospital, unless she changes her mind; is forced to change her mind; or her successor reverses the disastrous course along which she seeks to set the hospital.

At a recent meeting of Belfast City Council, the political parties unanimously supported the retention of the Mater Hospital's status. There is unanimous support in the communities, and it is to be hoped that there is unanimous support among political representatives. I appeal to the Department and to those civil servants who will guide and advise the person who succeeds the current Minister.

Perhaps the Minister and her party have decided that this attack on a vital service in the most needy community - north Belfast - will go ahead. However, I hope that the new Minister will be advised that the House has united in opposition to the proposal and that the clear message will go out that there should be no interference with, and no downgrading of, the services that the Mater Hospital provides. If anything, we should recognise the valuable contribution that the hospital has made over many years, and we should work to retain and strengthen it.

Although I accept the general thrust of 'Developing Better Services: Modernising Hospitals and Reforming Structures', issues such as the Mater Hospital must be sorted out. Given the needs of the local community and the standards that the hospital sets, its proposed services are insufficient.

I am very concerned about the proposal to remove accident and emergency (A&E) services from the hospital, bearing in mind what that would mean for the provision of acute services, particularly A&E services themselves. My worries about the removal of full casualty services from the Mater Hospital are not merely a matter of defending a facility in my constituency - although you may note, Mr Deputy Speaker, that all the Members from North Belfast agree on a lot of what is being said today, simply because of the hospital's location.

However, as one of the most deprived areas of Ireland, North Belfast relies greatly on the Mater Hospital, which contributes to the health of the population. Mr Alban Maginness mentioned the number of patients who are treated, but he did so in a different context than I. There is no justification for the closure of the Mater Hospital's A&E department. According to the figures that the Department of Health, Social Services and Public Safety published last month, the Mater Hospital's A&E department treats over 10,000 more patients each year than Daisy Hill Hospital and over 20,000 more than either the Causeway Hospital or the Downe Hospital, yet all those hospitals are earmarked for A&E services while the Mater Hospital is not.

I fully accept that A&E units require a certain throughput to maintain effectiveness and efficiency, but I cannot see any justification for failing the Mater on those grounds. Indeed, although we are all aware of the debates about the site of the acute hospital west of the Bann, the Mater's A&E department treats more people than the Enniskillen and Omagh hospitals together. Even in Belfast, the Mater's A&E department treats over 90% of the volume of patients who are treated at the City Hospital's A&E department, and apparently treats them more efficiently.

We have two hospitals in the same city that treat roughly the same volume of people every year. One of those hospitals is located within a few hundred metres of the main trauma unit in the Six Counties, while the other is in another part of the city. What justification is there for favouring the hospital that is so close to the Royal Victoria Hospital? Considering the differences in the performances of those two units, the argument in favour of maintaining the Mater's A&E department as part of the provision of casualty services in Belfast becomes stronger.

In developing better services, it is conceded that the proposed change in the role of the Mater Hospital will take some considerable time: it will be at least 10 years before anything is done with casualty provision there. A week in politics is a long time, and a decade is simply beyond reasonable foresight. How can anyone tell with any accuracy what the healthcare needs of the people of Belfast and, in particular those of north Belfast, will be in 2013?

That being so, is there any rationale for making decisions now about what should happen so far in the future? I urge the Department of Health, Social Services and Public Safety to take that on board and guarantee to maintain the Mater Hospital indefinitely. That is not to say that with the properly funded development of reasonable trauma services in Belfast, there may not be a need in future to review the Mater's A&E department, but we can have that debate when it comes.

Other Members have given reasons for maintaining and assisting the Mater. There have been 30 years of conflict, and north Belfast has seen a disproportionate amount of death, injury, imprisonment and militarisation. Its condition today is a consequence of decades of statutory neglect, and Mr Alban Maginness said that the amount of money that the North and West Belfast Health and Social Services Trust, as opposed to the Executive, gives to the area speaks volumes. The Mater Hospital is an important local employer, and removing the A&E department will have a detrimental effect on the cohesion and morale of the hospital staff as a whole.

The staff of the Mater Hospital, whom I have also met, and the unions both fear that the removal of the A&E department will in turn undermine the hospital as a whole, compromising job security and the ability to attract doctors, nurses, and so forth. Some of the reductions in health services make no sense when political representatives from all parties are arguing for more resources in north Belfast for education, youth provision, job creation, leisure provision, and so forth. Go raibh maith agat.

Other Members have covered many of the issues. However, the only way the problems of health and acute hospitals will be solved is through the restructuring of the Health Service. When that time arrives we will have to consider the Mater Hospital's position.

There are two issues involved. First, someone gave the Mater Hospital permission to build the fabulous McAuley Building, because it was felt that more beds were needed. Why did that happen? The money did not come from the Government; the community raised it, and it could have been better spent elsewhere. Everyone knows that in north Belfast health issues such as mental health and the levels of suicide have been neglected. Unfortunately, the Government gave the Mater Hospital that permission and, in many ways, gave it a vision for the future.

The second issue relates to the contradictions in the acute hospitals review group report with regard to what is being said now. Those contradictions have been well rehearsed. There was a proposal for the partnership of the Mater Hospital with the Whiteabbey Hospital for the provision of services for north Belfast, Newtownabbey and Carrickfergus. Where has that proposal gone? It was included in the recommendations of the review group. We were also told that a regional service would be provided at the Mater Hospital. That has now gone.

I would like to hear from the Minister why permission was given to build the McAuley Building when the situation was to change. Also, why are there contradictions between the two reports?

As a former medical registrar at the Mater Infirmorum Hospital, I add my support to the retention of this great and unique hospital. Following a visit to Lourdes, I wrote my second book, 'Bangor: Light of the World', which told how Bangor became the focus of a religious life of great depth and power in the early medieval period of Europe. With the fall of the Roman Empire, Irish and British monks were left to salvage what was left of Christian civilisation and share in its traditions the secrets of wisdom, justice and mercy for all mankind. That is what the Mater Hospital means to me.

There are many who believe that we have reached a stage of nothingness and have invented the philosophy of the void. The wisdom that makes the Mater Hospital what it is is not irrelevant today, especially in our present circumstances. It is not just an embodiment of what is or even what will be; it is a temple built with living stones, with doctors, nurses and auxiliaries from both the active and contemplative life from both religious traditions, dedicated to the rights and duties of the person, imbued with a sense of honour, justice, mercy and self-sacrifice and of holy hope and high humility. Their patients are from the Shankill and the New Lodge roads. They are all asking, as one, for entry to their own sanctuary. They are the secret suffering poor of north Belfast, but they are all pilgrims on the road to paradise.

I support the comments of Mr Maginness. Perhaps no one in the House knows, but in the dying days of the old Stormont Parliament, I was Leader of the Opposition, which consisted of the Member of Parliament for the Shankill Road, Mr Desmond Boal; the Member of Parliament for Woodvale, Mr Johnny McQuade; and my Colleague from South Antrim, Rev William Beattie. If Members care to read that Hansard, they will find that the four of us supported, and gave unanimous approval for, the Mater Hospital to be given grants by the Government and to be rightly treated. Some people like to paint us as anti-Catholic, anti-Roman Catholic, and so on, but if Members read that debate, they will realise just where we stand.

The Mater Hospital has a right to exist, and it needs to exist. As I have seen in my area, once acute services are taken away from a hospital, its position is destroyed, and it ceases to be a real hospital. I am glad to see that Dr Hendron agrees with that. It is a fact.

If ever the Mater Hospital was needed as an acute services hospital, it is today; there is a crying need for its services. It is located in an area of dense housing and intense poverty. If there was ever a time when we should maintain the hospital, it is now. What grieves me is that, while many hospitals such as the Mater Hospital have been supported and maintained by the voluntary contributions of charitable groups, the Department has stolen the money that those charities gave.

In my area, we helped to lead actions to raise large sums of money for a special heart treatment service in Ballymena Hospital. The Department stole that money and took it away to Antrim. No harm to the people of Antrim - including the Deputy Speaker - but they did not raise that money. It was raised for my area, and those benefits should have remained in that area. As was rightly said by one Member, planners tell people to give their money to ensure that hospital extensions are possible, but at the end of the day, the benefit may be taken away from them.

I want to end on a good note. Although I would not cross every "t" and dot every "i" of what Dr Adamson said, he is my friend. He used to give me jags, and every time I left for a Third-World country, he came to my home and jagged me with great relish, as an Official Unionist would want to jag Democratic Unionist flesh, but I never held that against him.

The hospital that has done this work; the people who backed the hospital with their gifts and all its workers from both sides of the community deserve to be supported. I trust that, if it is the last thing that this Assembly does, it will save the Mater Hospital from being demoralised and reduced to being a glorified nursing home. The Mater Hospital should be maintained as a thoroughgoing acute hospital, giving the people of that area all the services that they deserve and need.

Dr Paisley, you have tremendous trust in your doctor. [Laughter].

I will not take a moment. I just want to say that I have some experience of the Mater Hospital. My mother, who suffered acutely from a serious problem before the war, went there in an emergency and recovered. I had many friends in the RUC - now the PSNI - who were very happy to be taken there as a result of bombings and shootings, and so on, because they believed that they would receive the best of attention, irrespective of what the political slant might be.

It strikes me as particularly wrong that £17 million collected by people years ago - which is probably worth about £80 million in today's terms - should be now seen as simply a resource to be absorbed. The attitude seems to be: "Never mind where it came from or what the motives were for collecting it". That is quite wrong. I beg the Minister in her last few hours to reconsider the matter to see whether some of the phrases used in Dr Hayes's report in relation to the Mater Hospital might be given rather more favourable connotations. I do not doubt that, being the man he is, he was probably keen not to show favouritism to a hospital of which he was chairman for so many years.

Possibly, he was almost too fair. I ask the Minister to re-examine the issue to see if, at least, the Mater's teaching and accident and emergency roles can be retained. It would be to the benefit of the entire country to see in the Chamber, where so many antipathetic remarks have been made among parties, unanimity from every party in order to save the Mater Hospital.

Go raibh maith agat, a LeasCheann Comhairle. Tá mo chuid moltaí do thodhchaí Ospidéal an Mater leagtha amach i mo cháipéis chomhairliúcháin 'Seirbhísí Níos Fearr a Fhorbairt: Ospidéil a Nuachóiriú agus Struchtúir a Leasú'. An chéad rud is mian liom a rá is é nach raibh sé riamh i gceist go dtarlódh na hathruithe atá molta agam thar oíche. Leanfaidh an Mater de bheith ina ospidéal géarchúraim go ceann i bhfad ina mbeidh raon iomlán de ghéarsheirbhísí ar fáil. Tiocfaidh an comhairliúchán chun críche ar 31 Deireadh Fómhair agus is mian liom béim a leagan air nach ndéanfar aon chinneadh ar aon cheann de mo chuid moltaí go dtí go mbeidh faill agam mo mhachnamh a dhéanamh ar iomlán na fianaise agus an eolais dá bhfuil ar fáil.

Aithním, áfach, gur ábhar imní do fhoireann an Mater agus do mhuintir thuaisceart Bhéal Feirste mo mholadh gur chóir go ndéanfaí ospidéal áitiúil nua-aimseartha den Mater, agus is maith liom an deis seo a bheith agam tabhairt faoin imní sin.

Proposals for the future of the Mater Hospital are set out in the consultation document 'Developing Better Services: Modernising Hospitals and Reforming Structures'. The changes proposed were never planned to happen overnight. The Mater Hospital will continue as an acute hospital for the foreseeable future, providing a full range of acute services. The consultation will end on 31 October, and I stress that no decisions will be made on any of the proposals until there has been an opportunity to consider fully all the evidence and information available.

However, I recognise that the proposal that the Mater Hospital should become a modern local hospital has caused concern, both to its staff and to the people of north Belfast. I welcome this opportunity to address their concerns.

My objective is to provide high-quality modern hospital services to the population here. It is clear that hospitals in future will need to collaborate as part of clinical networks. Proposals for the Mater Hospital are that it should become a modern local hospital with strong clinical links to the acute hospitals network, both at the Royal Group of Hospitals and Belfast City Hospital. I would expect the Mater, as a local hospital, to make full use of its modern facilities to provide increasingly sophisticated methods of investigation, diagnosis and day procedures.

In relation to the recent £17 million investment and the tremendous work done by people in the community to bring that about, we must in future ensure that the investment in the Mater is used to its fullest in serving the population of the area. That must be given careful consideration before coming to any final decisions.

Under these proposals, the Mater Hospital will also provide a base for a range of expert clinicians, specialist nurses and other health professionals, who will relate to the hospital needs of the population it serves, making a distinctive contribution to the overall provision of modern, high-quality services in the heart of the local community. Developing local hospitals in this way will require considerable and continuing investment in modern equipment and staff training.

I have proposed that maternity services at the Mater Hospital should be retained, but the hospital has been experiencing increasing difficulties in maintaining those services. Therefore, I have proposed that it should exploit its close proximity to the new centralised maternity hospital on either the Royal Group of Hospitals or Belfast City Hospital site to open up new opportunities for supporting maternity services at the Mater Hospital on a close partnership basis. I expect that the new centralised maternity hospital and the Mater Hospital will develop those opportunities to the full.

I also realise the concerns of the staff who live in north Belfast, where the Mater Hospital is a significant employer. They fear that their jobs might be lost in the hospital's transformation to a modern local hospital. The Mater Hospital will continue to be a large and busy hospital, and it will continue to provide much-needed employment for the area.

It is not possible to be specific about how staff might be affected at this stage, and detailed work will need to be undertaken with the health and personal social services organisations and other key interested parties to identify long-term staffing needs. During the consultation process, I was aware of the growing cross-party and cross-community support for retaining acute services at the Mater Hospital, as well as the strong lobby from the Mater Hospital Trust and staff at the hospital. I am sure that that will continue to be reflected in the responses to my consultation up until its close on 31 October, as it has been in Members' contributions today.

I assure Members that, as stated in the report 'Developing Better Services: Modernising Hospitals and Reforming Structures', the importance of making full use of the modern facilities at the Mater Hospital is fully accepted. The hospital has an excellent range of facilities, and in any future configuration of hospital services we must ensure that those facilities are used to their best advantage through clinical networking and building on new achievements in medical treatment and technology.

Members raised points about the phasing out of services. Acute services will continue for the foreseeable future and will be reviewed according to levels of capacity and deprivation as those are assessed. There is no question of phasing out acute services over the years in the way that has been suggested. Any decisions will look at the needs assessed at a particular time and the overall capacity of the service to deliver those services to people in the area.

Teaching status will remain as part of a clinical network of acute and local hospitals, and opportunities for more rounded training for medical staff will be available.

Before coming to any decision on the chronic obstructive pulmonary disease (COPD) clinic, we must look very carefully at the services provided in any area where such a disease is a feature of deprivation and associated ill health. A final decision has not been made, and the information referred to in this debate will be reflected in the responses to the consultation.

Will the Minister accept an intervention?

It is up to the Minister if she feels like giving way.

I have been told that I have very limited time, and, therefore, I do not think it is possible.

A very quick -

Order. Does the Minister want to give way?

I have had signals that my time is almost up, so, unfortunately, that will not be possible.

The points raised during the period of consultation, and those raised today, will be taken on board when considering the outcome of the consultation process. This is a real consultation process, as I have said in debates about other aspects of the consultation proposals. I have stressed that people's views will be listened to and taken on board. The terminology used today should not suggest that the consultation process is just about going through the motions.

I thank Members for their contributions today and for the contact they had with me during the consultation period. I shall ask the Department to consider carefully the Mater Hospital's future profile in the light of the deeply held cross-community and cross-party concerns expressed in the debate and elsewhere.

I stress that, in common with all my proposals to develop better services, no decisions have yet been taken. All the responses to the consultation, including any new evidence or information that arises from it, will be carefully considered before any final decisions are made on the Mater Hospital's future.

I take this opportunity to add my voice to those that have paid tribute to the sterling work that has been carried out over the years by the staff, and those who support them, at the Mater Hospital. I pay tribute to those who have ensured that its services have been delivered. I thank Members for their kind words, and I shall ensure that they are passed on to the staff.

On a point of order, Mr Deputy Speaker.

Order. Ample opportunity was given this morning, and ample opportunity was taken this morning, to raise points of order.

It is on a totally different matter.

I am taking no further points of order.

Adjourned at 4.57 pm.