Friday 30 June 2000
Written Answers to Questions (Continued)

Dr Birnie asked the Minister of Health, Social Services and Public Safety to detail the nature of the Department’s participation in the recent public consultation exercise on the future of the National Health Service.

(AQW 631/99)

The Minister of Health, Social Services and Public Safety (Ms de Brún): The exercise referred to was carried out on behalf of the Secretary of State for Health in England in the context of the development of a national plan for England. My Department was not involved.

I will be developing my own proposals for the strategic direction in the health and personal social services and the mechanisms to ensure community participation in shaping these.

Cuireadh an beart seo i bhfeidhm ar son an Stát-Rúnaí Sláinte i Sasain i gcomhair plean forbartha náisiúnta do Shasana. Ní raibh baint ar bith ag an roinn s’agam leis.

Tá mé le mo chuid pleananna féin a fhorbairt don bhealach chun tosaigh don RSSSPS, lena chinntiú go mbíonn an pobal páirteach i gcur i gcrích an plean.

Mrs I Robinson asked the Minister of Health, Social Services and Public Safety what policy will be pursued in relation to the future of small acute hospitals in Northern Ireland, and if she will make a statement.

(AQW 644/99)

Ms de Brún: I am now considering how our hospital services can be developed in a way which ensures high-quality care for all those who need it. I want to look at all the options involved before coming to any conclusions. I am very aware of how important hospital services are to local communities in particular, and before any changes are made I shall want to ensure that decisions about the future of services are based on the fullest possible information.

Anois tá mé ag cuimhneamh ar an dóigh a bhféadfaí ár seirbhísí ospidéil a fhorbairt lena chinntiú go gcuirfí scoth cúraim ar fáil dóibh siúd a bhfuil sé de dhíth orthu. Ba mhaith liom amharc ar na roghanna atá ann sula ndéanfaidh mé cinneadh ar bith. Tuigim go maith a thabhachtaí atá na seirbhísí ospidéal don phobal áitiúil go háirithe, agus sula ndéanfar athruithe ar bith, ba mhaith liom a chinntiú go bhfuil gach cinneadh faoi na seirbhísí sa todhchaí bunaithe ar an eolas is iomláine.

Mr Berry asked the Minister of Health, Social Services and Public Safety what steps have been taken to ensure that pharmaceutical services are strictly monitored with a view to eliminating prescription abuse, and if she will make a statement.

(AQW 647/99)

Ms de Brún: The Department is committed to tackling the abuse of public funds wherever it occurs. Prescription exemption fraud is a major problem here, resulting in some £12 million lost to the health budget in 1998-99. These are funds that would otherwise have been available for the provision of health care.

The Department has been working closely with health and social services boards, the Central Services Agency (CSA) and the pharmaceutical profession, and a range of measures have been introduced to tackle exemption fraud.

With regard to point-of-dispensing checks, since 1 July 1999 patients who claim to be exempt from paying the statutory prescription charge, currently £6, are asked to produce evidence of entitlement when presenting their prescriptions to the community pharmacist for dispensing. Where no evidence is produced, individual scripts are marked accordingly and can be checked subsequently by the CSA.

A dedicated counter-fraud unit is currently being set up. The unit, which will be based in the CSA, will have a dual remit — tackling exemption fraud and undertaking investigations into cases of potential fraud involving practitioners.

On proposed additional counter fraud, proposed new legislation which is to come before the Assembly shortly will include two key provisions for tackling exemption fraud — the introduction of fixed penalty charges, which will be levied on those who are proven to have claimed an exemption to which they are not entitled, and the creation of a specific criminal offence of evading family health service charges. This offence would be brought into operation to tackle serial abuse by individuals.

Then there is the electronic prescribing and eligibility system (EPES). Work is under way to deliver a major IT system, which will produce current prescription data in electronic format. This will greatly enhance the process for validating exemptions claimed by patients.

I look forward to the support of the Assembly and the community at large in our ongoing efforts in this area to safeguard public funds and ensure that the maximum resources are available for the provision of health care.

Tá ceangal ar an Roinn déileáil le mí-úsaid cistí poiblí cibé áit a dtarlaíonn sí. Tá an chalaois diolúine oideas ina fadhb mhór anseo. Cailleadh faoi thuairim £12 milliún ar bhuiséad sláinte 1998/1999 dá barr. Murach sin, bheadh an t-airgead seo ar fáil le cúram sláinte a sholáthar.

Tá an Roinn i ndiaidh bheith ag obair go dlúth i gcomhar leis na Boird Sláinte agus Seirbhísí Sóisialta, le Gníomhaireacht na Lársheirbhísí (GL) agus le poitigéirí agus thángthas ar roinnt seifteanna le déileáil le calaois díolúine:-

Seiceáil Aonaid Dáileacháin: Ón 1 Iúil iarrfar ar othair a deireann go bhfuil siad díolmhaite ar táille reachtúil oidias (a bhfuil £6 anois air) sin a chruthú nuair atá siad ag tabhairt na n-oideas don phoitigéir. Mura bhfuil aon chruthúnas acu, marcáiltear na hoidis aonair dá réir agus féadfaidh an GL iad a scrúdú nios moille.

Aonad Frithchalaoise: Faoi láthair tá Sainaonad Frithchalaoise a bhunú. Beidh an tAonad suite sa GL agus beidh dhá dhualgas air. Beidh sé ag tabhairt faoi chalaois díolúine agus beidh sé ag déanamh fiosrúchán ar chásanna a bhféadfadh calaois a bheith ann a bhaineann le dochtúirí.

Breis Reachtaíochta Frithchalaoise: Leagfar ábhar nua reachtaíochta faoi bhráid an Tionóil ar ball ina mbeidh dhá phríomhfhoráil a bhaineann le tabhairt faoi chalaois díolúine, is é sin: táillí pionóis socraithe a thabhairt isteach a ghearrfar orthu siúd ar féidir a chruthú gur iarr siad díolúine nuair nach raibh sí de cheart acu; agus fógairt gur coir ar leith í nuair a sheachnaíonn duine táillí Seirbhíse Sláinte Teaghlach. Cuirfear an fhoráil seo in úsáid le tabhairt fúthu siúd atá ag dul don choir seo go leanúnach.

Ríomhchóras um Soláthar Oideas agus Deimhniú Cáilitheachta: Tá obair ar siúl le córas mór TÉ a chur ar fáil a sholáthróidh sonraí oideas i bhformáid leictreonach. Cuideoidh seo go mór leis an phróiseas a bhaineann le bailíocht a thabhairt do na díolúintí a iarrann othair.

Tá mé ag tnúth go mór le tacaíocht a fháil ón Tionól agus ón phobal go ginearálta sna hiarrachtaí atáimid a dhéanamh sa réimse seo le cistí poiblí a chosaint agus lena chinntiú go mbeidh an oiread acmhainní is féidir ar fáil chun cúram sláinte a sholáthar.

Mrs I Robinson asked the Minister of Health, Social Services and Public Safety what policy will be pursued in relation to replacement of general practitioners’ fundholding, and if she will make a statement.

(AQW 648/99)

Ms de Brún: I propose to introduce a Health and Personal Social Services Bill which, subject to Assembly approval, will include provision to bring to an end to the general practitioners’ fundholding scheme. Before bringing forward proposals on what arrangements should be put in place for the development of primary care following the ending of the scheme, I wish to meet with those most closely involved in the planning and provision of primary care services and other interested parties. I shall also want the Assembly’s Health, Social Services and Public Safety Committee to consider the matter.

Tá sé de rún agam Acht Seirbhísí Sláinte agus Sóisialta Pearsanta a thabhairt isteach, le tacaíocht ón Tionól, a thabharfaidh chun deireadh an scéim fundoireacht doctúirí. Sula gcuirtear chun tosaigh moltaí ar cé na socraithe a nglacfar leo chun aire bunúsach a forbairt i ndiaidh deireadh a chuir leis an scéim fundóireachta, ba mhaith liom cruinniú a bheith agam leis na daoine atá ag pleanáil agus ag cur ar fáil seirbhísí aire bunasach agus páirtithe leasmhara eile. Ba mhaith liom Coiste RSSS&SP an Tionóil plé a dhéanamh ar na moltaí.

Mrs I Robinson asked the Minister of Health, Social Services and Public Safety what steps will be taken to meet the capital needs of the Ulster Hospital, and if she will make a statement.

(AQW 649/99)

Ms de Brún: I recognise that the Ulster Hospital needs significant upgrading to meet modern hospital standards. This has been reinforced by the Eastern Health and Social Services Board proposals aimed at improving the organisation of hospital services, issued recently for consultation. My officials are already working closely with the Ulster Community and Hospitals Trust to meet the most pressing priorities. However, I believe there is a need for strategic development of the hospital, and I have asked my officials to work with the trust over the coming months to determine the overall requirements of the hospital and the best way to meet those requirements.

Aithním go bhfuil feabhsú suntasach de dhíth ar Ospidéal Uladh má tá sé le caighdeáin nua-aimseartha ospidéal a bhaint amach. Tá moltaí Bhord Sláinte agus Seirbhísí Sóisialta an Oirthir ag cur leis seo. Eisíodh iad seo ar na mallaibh, mar chuid de phróiseas comhairliúcháin, le feabhas a chur ar eagrú na seirbhísí ospidéal. Tá feidhmeannaigh de mo chuid ag obair go dlúth cheana i gcomhar le hIontaobhas SSS Phobal agus Ospidéal Uladh leis na tosaíochtaí is práinní a réiteach. Ach creidim gur gá an t-ospidéal a fhorbairt go straitéiseach agus chuige sin tá mé i ndiaidh a iarraidh ar fheidhmeannaigh de mo chuid bheith ag obair i bpáirt leis an Iontaobhas chun riachtanais iomlána an ospidéil a shocrú agus an bealach is fearr le freastal ar na riachtanais sin a réiteach.

Mrs I Robinson asked the Minister of Health, Social Services and Public Safety what policy will be pursued in relation to the future of Downpatrick Hospital, and if she will make a statement.

(AQW 650/99)

Ms de Brún: The Eastern Health and Social Services Board is currently carrying out a consultation exercise with regard to acute services in its area, which will impinge on services at the Downe Hospital, Downpatrick. I am separately arranging to meet a wide range of local interests to hear their views on the issues involved.

I am very aware of how important hospital services are to local communities. I shall want to ensure that decisions about the future of such services are based on the fullest possible information.

In this context, I will be interested in any recommendations emerging from the EHSSB’s consultation process and from my meetings with local interests.

Faoi láthair tá Bord Sláinte agus Seirbhísí Sóisialta an Oirthir i mbun próiseas comhairliúcháin maidir le seirbhísí géarmhíochaine ina a cheantar féin a rachaidh i bhfeidhm ar na seirbhísí in Óspidéal an Dúin, Dún Pádraig. Taobh amuigh de sin tá mé féin ag iarraidh bualadh le cuid mhór de na páirtithe leasmhara áitiúla lena mbarúlacha a fháil ar na nithe atá i gceist.

Tá fhios agam go maith a thábhachtái atá na seirbhísí ospidéil don phobal áitiúil. Ba mhaith liom a chinntiú go mbeidh na socruithe a dhéanfar faoi na seirbhísí sin sa todhchaí bunaithe ar an eolas is iomláine.

Sa chomthéacs seo cuirfidh mé suim i moltaí ar bith a thagann ón phróiseas comhairliúcháin de chuid BSSSO agus ó na cruinnithe a bheas agam leis na páirtithe leasmhara áitiúla..

Mr Shannon asked the Minister of Health, Social Services and Public Safety to confirm that the recommendations of the Stewart Report will be implemented, to give a timescale for this implementation, and if she will make a statement.

(AQW 651/99)

Ms de Brún: I and my ministerial colleagues are considering the findings and recommendations of this report and will decide in due course what action is necessary.

Tá mise agus mo chomh-Airí ag scrúdú na bhfíoras a aimsíodh agus na moltaí sa tuarascáil seo agus déanfaimid cinneadh faoin bheart a bheas riachtanach in am is i dtráth.

Mr Shannon asked the Minister of Health, Social Services and Public Safety if it is established that fluoride in drinking water can cause non-ulcer dyspeptic complaints.

(AQW 652/99)

Ms de Brún: There is no evidence that, in a temperate climate, drinking water containing fluoride at the levels normally associated with fluoridation schemes, naturally present or adjusted, causes non-ulcer dyspepsia. Reviews of the evidence on fluoridation are currently under way in England and in the South of Ireland, and I will be considering their findings once reports are available.

Níl fianaise ar bith ann go mbíonn dispeipse neamhothrais ar dhaoine in aeráid mheasartha de bharr uisce óil a bhfuil na leibhéil fhluaríde ann, bíodh sí ann go nadúrtha nó curtha isteach san uisce, a bhaineann le gnáthscéimeanna fluairídithe. Táthar ag athbhreithniú na fianaise ar fhluairídiú faoi láthair i Sasana agus i nDeisceart na hÉireann agus scrúdóidh mé na fíorais atá aimsithe a luaithe a bheas tuarascálacha ar fáil.

Mr Shannon asked the Minister of Health, Social Services and Public Safety if only tooth cells are affected by the fluoride ion.

(AQW 654/99)

Ms de Brún: Most fluoride in the body is associated with calcified tissue — the teeth and bone.

Baineann bunús na fluairíde sa chorp leis na fíocháin chailcithe, is é sin, na fiacla agus na cnámha

Mr Shannon asked the Minister of Health, Social Services and Public Safety if the amount of fluoride inhibits enzymes and the individual enzymes inhibited by fluoride, citing supportive references.

(AQW 655/99)

Ms de Brún: Fluoride in high, non-physiological concentrations can inhibit or enhance the action of many enzymes. Detailed information is freely available in many published reviews and scientific papers, which may be consulted in the usual ways.

Féadfaidh fluairíd, más ann di i gcomhchruinnithe móra neamhfhiseolaíocha, gníomhaíocht cuid mhór einsímí a laghdú nó a mhéadú. Tá mioneolas faoi seo ar fáil go saor in a lán irisí agus páipéar eolaíocha is féidir a léamh ar na gnáthdhóigheanna .

Mr McGrady asked the Minister of Health, Social Services and Public Safety what assessment has been made of the documents ‘Regional Strategy for Health and Social Well-Being 1997/2002’ and ‘Well into 2000’ in relation to the provision of acute hospital services in Northern Ireland.

(AQW 664/99)

Ms de Brún: I am now considering how our hospital services can be developed in a way which ensures high-quality care for all those who need it. I want to look at all the options involved, including the approach set out in the ‘Regional Strategy’ and ‘Well into 2000’ before coming to any conclusions. I am very aware of how important hospital services are to local communities in particular, and before any changes are made I shall want to ensure that decisions about the future of services are based on the fullest possible information.

Anois tá mé ag meabhrú ar an dóigh ar féidir na seirbhísí ospidéal s’againn a fhorbairt lena chinntiú go mbeidh scoth cúraim ar fáil dóibh uile a bhfuil sé uathu. Ba mhaith liom amharc ar na roghanna uile atá againn, agus cur chuige na Straitéise Réigiúnaí agus Well into 2000 san áireamh, sula ndéanfaidh mé cinneadh ar bith. Tuigim go maith a thábhachtaí atá seirbhísí ospidéal don mhuintir áitiúil go háirithe, agus sula ndéanfar athruithe ar bith ba mhaith liom a chinntiú go bhfuil na socruithe faoi na seirbhísí sa todhchaí bunaithe ar an eolas is iomláine is féidir a fháil.

Mr Gibson asked the Minister of Health, Social Services and Public Safety what estimate has been made of the cost to the Health Service of treatment for addiction to hard drugs and regarding the effectiveness of drugs action teams supported by the Department.

(AQW 668/99)

Ms de Brún: It is not possible to separate the estimated cost to the Health Service of treatment for (a) drug addiction as distinct from other drug-related health problems and (b) the misuse of different categories of drugs. An independent group of consultants has undertaken an analysis of expenditure on drug misuse here. Their findings, contained in ‘Drug Strategy for Northern Ireland’, published in August 1999, show that £1.025 million was spent on treatment and rehabilitation by health and social services trusts in 1998.

The four drug co-ordination teams make a valuable contribution in tackling the drug problem by ensuring co-ordination and co-operation at local level between the various statutory, voluntary and community bodies with a part to play in implementing the drug strategy.

Ní féidir na costais mheasta seo ar an tSeirbhís Sláinte a dhéalú óna cheile: (a) cóireáil andúil i ndrugaí; (b) cóireáil fadhbanna sláinte eile a bhaineann le drugaí; agus (c) cóireáil mí-úsáid drugaí de chineálacha éagsúla. Tá anailís déanta ag grúpa neamhspleách de chomhairligh ar an chaiteachas ar mhí-úsáid drugaí anseo. Taispeánann na fíorais, a d’aimsigh siad agus a foilsíodh in "Drug Strategy for Northern Ireland" i Lúnasa 1999, gur chaith na hIontaobhais Sláinte agus Seirbhísí Sóisialta £1.025m ar chóiréail agus ar athshlánú i 1998.

Tá na ceithre Fhoireann Comhordaithe Straitéise Drugaí ag cuidiú go mór linn tabhairt faoi fhadhb na ndrugaí agus iad ag cinntiú go bhfuil comhordú agus comhoibriú ann ag an leibhéal áitiúil idir na comhlachtaí reachtúla, deonacha agus pobail a bhfuil pairt acu i gcur i bhfeidhm na Straitéise Drugaí.

Mr Berry asked the Minister of Health, Social Services and Public Safety what services have been transferred from the South Tyrone Hospital to Craigavon Hospital.

(AQW 676/99)

Ms de Brún: Obstetrics and gynaecology in-patient services were transferred from South Tyrone Hospital to Craigavon Area Hospital in February 1999; accident and emergency services were transferred in September 1999; and acute and emergency surgery services were transferred in November 1999. All the transfers are temporary measures, pending a decision on the long-term future of South Tyrone Hospital.

Aistríodh na seirbhísí Cnáimhseachais agus Gínéiceolaíochta d’othair chónaitheacha ó Ospidéal Dheisceart Thír Eoghain chuig Ospidéal Cheantair Craigavon i bhFeabhra 1999. Aistríodh na Seirbhísí Taisme agus Éigeandála i Meán Fómhair 1999, agus aistríodh na Seirbhísí Géarmháinliachta agus Máinliachta Éigeandála i Samhain 1999. Níl iontu seo uile ach bearta sealadacha go dtí go ndéanfar cinneadh ar stádas Ospidéal Dheisceart Thír Eoghain sa todhchaí.

Mr Berry asked the Minister of Health, Social Services and Public Safety what steps have been taken to alleviate the increasing waiting times at the Casualty Department of Craigavon Hospital.

(AQW 677/99)

Ms de Brún: The Southern Health and Social services Board recently received an additional £3·895 million to improve hospital services. It is a matter for the board to determine how best to use this additional funding, taking into account the competing pressures on resources.

Fuair Bord Sláinte agus Seirbhísí Sóisialta an Deiscirt £3.895m ar na mallaibh le feabhas a chur ar sheirbhísí ospidéal. Caithfidh an Bord a shocrú cad é an dóigh is fearr leis an mhaoiniú breise seo a úsáid agus é ag cur na mbrúnna san áireamh atá i gcomórtas lena chéile.

Mr Berry asked the Minister of Health, Social Services and Public Safety if there has been an increase in staff at Craigavon Hospital since services were transferred there from South Tyrone Hospital.

(AQW 678/99)

Ms de Brún: An additional 161.52 whole-time- equivalent staff across the full range of disciplines have been employed by Craigavon Area Hospital Group Trust to accommodate the transfer of services from South Tyrone Hospital. This figure includes 69.09 whole-time-equivalent staff who transferred on a secondment basis from South Tyrone Hospital. These staff remain employees of Armagh and Dungannon Health and Social Services Trust pending final decisions on the future role of South Tyrone Hospital.

D’fhostaigh Iontaobhas Grúpa Ospidéal Cheantar Craigavon coibhéis 161.52 ball foirne lánaimseartha breise thar an speictream iomlán de dhisciplíní le freastal ar na seirbhísí a aistríodh ó Ospidéal Dheisceart Thír Eoghain. Bhí coibhéis 69.09 ball foirne lánaimseartha san áireamh a d’aistrigh ar iasacht ó ospídéal Dheisceart Thír Eoghain. Is fostaithe de chuid Seirbhísí Sláinte agus Sóisialta Ard Mhacha agus Dhún Geanainn na baill foirne seo go dtí ndéanfar na socruithe deireanacha faoi ról Ospidéal Dheisceart Thír Eoghain sa todhchaí.

Mrs E Bell asked the Minister of Health, Social Services and Public Safety whether the issue of the provision of care for children with mental health and trauma problems has been included in the general review of the Northern Ireland Health Service.

(AQO 353/99)

Ms de Brún: The provision of care for children with mental health problems has already been reviewed. A departmental policy statement on child and adolescent mental health services was issued in January 1999. As required by the statement, boards have reviewed existing provision and identified unmet need.

An additional £1 million has been earmarked this year, towards the development of child and adolescent mental health services, in meeting these needs.

Rinneadh athbhreithniú cheana ar sholáthar cúraim do pháistí a bhfuil fadhbanna sláinte meabhrach agus tráma acu. Eisíodh Ráiteas Roinne ar Sheirbhísí Sláinte Meabhrach do Pháistí agus d’Ógánaigh in Eanáir 1999. Mar a iarradh orthu sa Ráiteas, rinne na Boird athbhreithniú ar an soláthar a bhí ann agus d’aimsigh siad riachtanais nach ndearnadh freastal orthu.

Chun freastal ar na riachtanais seo tá £1 mhilliún breise curtha i leataobh i mbliana i leith forbairt na seirbhísí sláinte meabhrach do pháistí agus d’ógánaigh.

Mr Shannon asked the Minister of Health, Social Services and Public Safety if there are plans to reinstate the service of painting and decorating of pensioners’ houses lost with the end of the Action for Community Employment scheme.

(AQW 683/99)

Ms de Brún: The painting and decorating of pensioners’ houses does not come within the statutory responsibilities of health and social services boards or trusts. There are no plans for boards and trusts to assume responsibility for this service.

Ní cuid de fhreagrachtaí reachtúla na mBord ná na nIontaobhas Sláinte agus Seirbhísí Sóisialta tithe pinsinéirí a phéinteáil agus a mhaisiú. Níl pleananna ar bith ann go nglacfaidh na Boird agus na hIontaobhais freagracht na seirbhíse seo orthu féin.

Mr Shannon asked the Minister of Health, Social Services and Public Safety if there is any medical evidence to suggest a link between aluminium and Alzheimer’s disease, Down’s syndrome and Parkinson’s disease, with respect to the chemical content of drinking water.

(AQW 684/99)

Ms de Brún: The results of some of the many studies of the biological effects of aluminium have led some scientists to suggest that it may play a part in the development or progress of Alzheimer’s disease and possibly Parkinson’s disease.

However, the evidence is inconsistent, and there is no persuasive evidence to support a primary causative role for aluminium in either Alzheimer’s disease or Parkinson’s disease. People with Down’s syndrome invariably develop the brain changes of Alzheimer’s disease in their 30s or 40s, but there is no evidence that aluminium is a cause of Down’s syndrome.

Mar gheall ar thorthaí cuid den iomad staidéar ar éifeachtaí bitheolaíocha alúmanaim tá roinnt eolaithe ag maíomh go bhféadfadh sé tionchar éigin a imirt ar fhorbairt nó ar fhás ghalar Alzheimer, nó ghalar Parkinson b’fhéidir.

Ach níl an fhianaise comhsheasmhach agus níl fianaise áititheach ann a thaispeánann go bhfuil an t-alúmanam ar na príomhchúiseanna taobh thiar de ghalar Alzheimer nó de ghalar Parkinson. Is fíor go dtarlaíonn sé gan teip go dtagann athruithe inchinne ghalar Alzheimer ar lucht siondróm Down nuair atá siad sna 30í nó sna 40í, ach níl fianaise ar bith ann gur alúmanam is cúis le siondróm Down.

Mr Davis asked the Minister of Health, Social Services and Public Safety to detail plans to initiate a screening programme to establish the total number of patients in Northern Ireland with diabetes.

(AQW 687/99)

Ms de Brún: The National Screening Committee, which advises Health Ministers on all aspects of screening policy, is assessing the case for a targeted screening programme for people at high risk of type 2 diabetes. I expect to receive further advice from the Committee this winter.

Tá an Coiste Náisiúnta Scátha ag déanamh meastúchán le fáil amach an féidir scéim scatha a thoiseacht do dhaoine a bhfuil an chontúirt ann go dtógfaidh siad diabaetas a 2, tugann an Coiste comhairle don Aire Sláinte maidir le ceisteanna scátha. Tá mé ag súil le tuilleadh comhairle a fháil ón Choiste an geimhreadh seo atá ag teacht.

Mr Gibson asked the Minister of Health, Social Services and Public Safety what proportion of the additional resources allocated to the National Health Service has been devoted to the accumulated deficits and debts of health trusts.

(AQW 700/99)

Ms de Brún: None of the additional £53 million made available for the health and personal social services as a result of the Budget announcement has been devoted to the accumulated deficits and debts of health trusts. In April, George Howarth proposed that £38 million of the £53 million be allocated to the four health and social services boards for specific services. Boards’ proposals on how these resources are to be applied are currently being scrutinised by the Department.

Níor baineadh úsáid ar bith as na £53 milliún breise a cuireadh ar fáil de bharr ar fógraíodh sa cháinaisnéis leis na heasnaimh agus na fiacha carntha de chuid na nIontaobhas Sláinte a laghdú . In Aibreán mhol George Howarth gur cheart £38 milliún den £53 milliún a tabhairt do na ceithre Bhord Sláinte agus Seirbhísí i leith seirbhísí áirithe. Faoi láthair tá an Roinn ag iniúchadh na moltaí a fuarthas ó na Boird faoi na dóigheanna ar cheart na hacmhainní seo a úsáid.

Mrs I Robinson asked the Minister of Health, Social Services and Public Safety to detail the rate of cancellation of appointments for cardiac surgery at the Royal Victoria Hospital, Belfast.

(AQW 708/99)

Ms de Brún: In the last two quarters of 1999-2000 cardiac operations at the Royal Victoria Hospital were cancelled as follows:

In the period 1 October to 31 December 1999, 109 operations were cancelled — a cancellation rate of approximately 39%.

In the period 1 January to 31 March 2000, 84 operations were cancelled — a rate of 26%.

Sa dá cheathrú dheireanach de 1999 / 2000 cuireadh obráid mháinliacht chroí ar ceal san Ospidéal Ríoga Victoria mar a leanas:

Sa tréimhse 1 Deireadh Fómhair go dtí 31 Mí na Nollag 1999, cuireadh 109 obráid ar ceal, a léiríonn ráta cealaithe de 39% a bheag nó a mhór.

Sa tréimhse 1 Eanáir go dtí 31 Márta 2000, cuireadh 84 obráid ar ceal, i.e. ráta de 26%.

Mrs I Robinson asked the Minister of Health, Social Services and Public Safety what are the current waiting times for cardiac surgery in Northern Ireland Hospitals and what steps have been taken to reduce waiting times.

(AQW 709/99)

Ms de Brún: The waiting times for cardiac surgery at 31 March 2000 are set out in the table below.

It is not acceptable to me that so many people are waiting more than 12 months for heart operations. There have been particular problems in the past year at the Royal Victoria Hospital, where all the cardiac surgery is performed, and the health and social services boards are working with the Royal Victoria to find ways of overcoming the present difficulties.

Sa tábla seo thios tá na tréimhsí feithimh le haghaidh obráidí croí leagtha amach mar a bhí siad ar an 31 Márta 2000.

Nil sé inghlactha agam go bhfuil an oiread sin daoine ag fanacht breis agus 12 mhí le hobráidí croí a fháil. I rith na bliana seo caite bhí fadhbanna áirithe in Ospidéal Ríoga Victoria áit a ndéantar na hobráidí croí uile agus tá na Boird Sláinte agus Seirbhísí Sóisialta ag obair i gcomhar le hOspidéal Ríoga Victora le teacht ar réiteach na ndeacrachtaí atá anois ann.

Mr Paisley Jnr asked the Minister of Health, Social Services and Public Safety to detail for the period since devolution (i) the district councils she has visited; (ii) the dates of the visits; (iii) the subjects discussed.

(AQW 714/99)

Ms de Brún: I have not visited any district councils since devolution. However, I have visited a number of organisations governed by the various trusts and boards.

Ní dheachaigh mé ar cuairt ar chomhairle cheantair ar bith ó cineachadh cumhacht orainn. Ach thug mé cuairt ar roinnt eagraíochtaí atá á rialú ag Iontaobhais agus ag Boird éagsúla.

Mrs Carson asked the Minister of Health, Social Services and Public Safety to confirm that any funding allocated to the Sure Start programme will be ring-fenced.

(AQW 739/99)

Ms de Brún: I can confirm that the funding allocated to the Sure Start programme is earmarked for that purpose. The funding will be shared across the four childcare partnerships, which will allocate it to the Sure Start projects operating in their areas.

Is féidir liom cinntiú go caithfear an maoiniú a tugadh don chlár ‘Sure Start’ ar an chlár sin amháin. Beidh an maoiniú roinnte thar na 4 Pháirtíocht Chúram Leanaí a dháileoidh an t-airgead ar na tionscadail ‘Sure Start’ ag feidhmniú ina gceantar.

Mr Beggs asked the Minister of Health, Social Services and Public Safety to detail the number of nursing vacancies in Northern Ireland hospitals, and indicate whether additional students are being trained to meet current demand.

(AQW 746/99)

Ms de Brún: Health and social services trusts recently reported that at 31 January 2000 there were a total of 141 unfilled vacancies (equivalent to 105 whole-time posts) for qualified nursing staff in hospitals. This represents a vacancy level of 2% of the permanent nursing establishment in adult acute nursing.

A total of 350 student nurses are expected to qualify and become available for employment in September this year. The composition is expected to be as follows:

Adult nursing 266
Mental health nursing 41
Learning disability 16
Children’s nursing 27

The Department is currently reviewing the number of nurse training places.

Ar an 31 Eanair 2000 d’fhógair na hIontaobhais SSS go raibh 141 jabanna do bhanaltraí cailithe gan lionadh sna otharlanna (ionann agus 105 postanna lánaimseartha). Seo 2% den fhoireann bhanaltrachta buan atá i ngéarbhanaltracht aosach.

Tá 350 ábhar banaltraí le beith cáilithe agus réidh le hobair a dhéanamh ó Mheán Fómhair na bliana seo. Seo a leanas mar a bheas:

Banaltracht aosach 266
Banaltracht mheabhairghalar 41
Fadhbanna foghlam 16
Banaltracht pháistí 27

Tá athbhreithniú á dhéanamh ag an Roinn ar líon na n-áiteanna traenála do bhanaltraí.

Mr Poots asked the Minister of Health, Social Services and Public Safety what plans the Department has to increase accessibility for disabled people.

(AQO 337/99)

Ms de Brún: The Department has issued guidance for the health and personal social services on implementing section 21 of the Disability Discrimination Act 1995, which imposes a duty on service providers to take reasonable steps to make their services accessible to disabled people. It has also issued ‘Access to Health Service Premises Audit Checklist’, a tool to help service providers to audit premises for accessibility to disabled people. For its part, the Department will be assessing over the next 12 months its arrangements for providing information, taking account of the statutory requirements of the Act.

Tá an Roinn i ndiaidh treoir a eisiúint do na seirbhísí sláinte agus sóisialta faoi fheidhmiú Alt 21 den Acht um Leithcheal ar bhonn Míchumais 1995, rud a leagann dualgas ar sholáthróirí seirbhísí céimeanna réasúnta a ghlacadh lena chinntiú gur féidir le daoine faoi mhíchumas teacht ar na seirbhísí. Fosta tá sí i ndiaidh "Access to Health Services Audit Checklist" a eisiúint. Is gléas é seo le cuidiú le solathróirí seirbhísí foirgnimh a iniúchadh lena chinntiú go bhfuil sé furasta ag daoine faoi mhíchumas teacht isteach iontu. Thar 12 mí beidh an Roinn ag déanamh staidéir ar na na socraithe atá ann le eolais a cuir ar fáil, ag glacadh san áimhreadh an Aict.

Mr McClelland asked the Minister of Health, Social Services and Public Safety how many persons aged 16 or under have been treated for alcohol or drug abuse in the Northern Board area this year.

(AQO 359/99)

Ms de Brún: During the period January-December 1999

• there were 17 acute hospital admissions related to alcohol misuse;
• there were fewer than five psychiatric hospital admissions due to either alcohol or drug misuse;
• there were 14 referrals to child and adolescent mental health services as a direct result of alcohol and/or drug misuse (five of them for solvent misuse).

These figures do not include all young people who receive treatment as a result of drug or alcohol misuse. For example, those reporting to accident and emergency units but who are not subsequently admitted for further treatment will not be included.

I rith na tréimhse Eanáir – Nollaig 1999:

• Glacadh isteach sna hospidéil 17 agus iad in an-drochdhóigh de bharr mí-úsáid alcóil
• Glacadh níos lú ná 5 chás síciatrach isteach sna hospidéil de bharr mí-úsáid alcóil nó mí-úsáid drugaí
• Atreoraíodh 14 chuig seirbhísí sláinte intinne do pháistí agus d’ógánaigh go díreach de bharr mí-úsáid alcóil agus/nó mí-úsáid drugaí – atreoraíodh 5 dóibh de bharr mí-úsáid tuaslagán

Ní uimhir iomlán é seo de na daoine óga atá ag fáil cuidithe de dheasca mí-úsaid drugaí agus dí. Mar shampla níl na daoine atá ag freastal ar rannóg A&E, ach nach bhfuil ag fáil tuilleadh cuidithe san aimhriu .

Mr McHugh asked the Minister of Health, Social Services and Public Safety what steps will be taken to upgrade services at the Erne and Omagh Hospitals and other Health Service facilities in Fermanagh and South Tyrone, and if she will make a statement.

(AQO 350/99)

Ms de Brún: I am very aware of the importance that local communities in Fermanagh and the Omagh area attach to their acute hospital services. I want to be as open-minded as possible about how hospitals such as the Erne and the Tyrone County should be developed in future, taking on board the concerns of local people as well as the issues of clinical standards. The future of hospital services is one of my top priorities.

Tuigim go fíormhaith gur tábhachtach le muintir áitiuil Fhear Manach agus na hÓmaí na seirbhísí géarmhíochaine ospidéil atá acu. Ba mhaith liom a bheith chomh saorbhreathach agus is féidir maidir leis an dóigh ar cheart ospidéil cosúil le hOspidéal na hÉirne agus Ospidéal Chontae Thír Eoghain a fhorbairt sa todhchaí, agus mé ag cur imní na ndaoine áitiúla san áireamh chomh maith leis na ceisteanna faoi chaighdeáin chliniciúla. Is é todhchaí seirbhísí na n-ospidéal ceann de na hardtosaíochtaí atá agam.

Mr Byrne asked the Minister of Health, Social Services and Public Safety to endorse the Western Health and Social Services Board’s recommendation to establish a new hospital in the south-west, to maintain acute-services provision in the area at their present level in the interim, and if she will make a statement.

(AQO 315/99)

Ms de Brún: It would not be appropriate for me to offer any comment on the Western Board’s recommendation for a new acute hospital as this matter is currently the subject of judicial review. I can, however, give an assurance that decisions will be taken as necessary to ensure the provision of safe and effective hospital services pending long-term decisions on the future of hospital services. The future of hospital services is one of my top priorities.

Ní bheadh sé cuí agam tuairim a thabhairt ar mholadh Bhord an Iarthair faoi ospidéal nua géarmhíochaine mar tá an t-ábhar seo faoi athbhreithniú breithiúnach faoi láthair. Mar sin féin, thig liom a dhearbhú duit go ndéanfar cinntí mar is gá lena dheimhniú go mbeidh seirbhísí sábháilte éifeachtacha ospidéil á soláthar go dtí go ndéanfar cinntí fadtéarmacha faoi sheirbhísí ospidéal sa todhchaí. Is é todhchaí seirbhísí na n-ospidéal ceann de na hardtosaíochtaí atá agam.

Mr Berry asked the Minister of Health, Social Services and Public Safety to detail all expenditures on services for cancer patients in Northern Ireland, and if she will make a statement.

(AQO 333/99)

Ms de Brún: It is not possible to disaggregate all expenditure related to the care and treatment of cancer patients. I can, however, say that an extra £8 million has been provided for cancer services this year, on top of the additional £7 million allocated last year. This new funding will make a substantial contribution to improving our cancer services.

I should say also that funding is not the only factor in developing services. The availability of key specialist staff will dictate how fast we can make those improvements. It takes time to put in place suitably qualified specialist staff, such as clinical oncologists and specialist nurses, particularly when these are in short supply in the NHS and elsewhere.

Ní féidir gach costas maidir le cúram agus cóireáil othar le hailse a dhealú ón iomlán. Ach thig liom a rá gur cuireadh £8 milliún breise ar fáil do sheirbhísí ailse i mbliana ar bharr na £7 milliún a cuireadh ar fáil anuraidh. Cuideoidh an maoiniú nua seo go substaintiúil le feabhas a chur ar ár seirbhísí ailse.

Ba mhaith liom a rá nach é an maoiniú an t-aon fhachtóir amháin i bhforbairt seirbhísí. Beidh luas feabhsaithe na seirbhísí ag brath ar bhaill áirithe sainfhoirne a bheith ar fáil. Bainfidh sé tamall asainn na baill sainfhoirne, mar oinceolaithe cliniciúla agus sainbhanaltraí a bhfuil na cáilíochtaí cearta acu, a fháil – go háirithe nuair atá siad gann sa SSN agus in áiteanna eile.

Mr Gibson asked the Minister of Health, Social Services and Public Safety what steps have been taken towards the provision of a new acute services hospital in the south-west of Northern Ireland, whether an announcement can be expected before the summer recess, and if she will make a statement.

(AQO 320/99)

Ms de Brún: It would not be appropriate for me to offer any comment on the Western Board’s recommendation for a new acute hospital as this matter is currently the subject of judicial review. I can, however, give an assurance that decisions will be taken as necessary to ensure the provision of safe and effective hospital services pending long-term decisions on the future of hospital services. The future of hospital services is one of my top priorities.

Ní bheadh sé cuí agam tuairim a thabhairt ar mholadh Bhord an Iarthair faoi ospidéal nua géarmhíochaine mar tá an t-ábhar seo faoi athbhreithniú breithiúnach faoi láthair. Mar sin féin, thig liom a dhearbhú duit go ndéanfar cinntí mar is gá lena dheimhniú go mbeidh seirbhísí sábháilte éifeachtacha ospidéil á soláthar go dtí go ndéanfar cinntí fadtéarmacha faoi sheirbhísí ospidéal sa todhchaí. Is é todhchaí seirbhísí na n-ospidéal ceann de na hardtosaíochtaí atá agam.

Mr Leslie asked the Minister of Health, Social Services and Public Safety to indicate the number of people deemed to have died in Northern Ireland as a result of drug abuse over the last four years.

(AQO 332/99)

Ms de Brún: The available figures relate to deaths due to poisoning by drugs, medicaments and biological substances and will include deaths caused by abuse of both legal and illegal drugs. During the years 1995-98, 166 deaths were recorded here.

Is bais nimhiú drugaí, míochaine agus substaint bitheolais atá i gceist san uimhreacha atá ar fáil, chomh maith le bais ó drugaí dleathach agus mí-dleathach. Bhí cuntas ar 166 bais san blianta 1995-1998.

Mr Neeson asked the Minister of Health, Social Services and Public Safety what steps will be taken to ensure that acute hospital services do not break down next winter.

(AQO 355/99)

Ms de Brún: Health and social services came under severe pressure last winter as a result of an unprecedented number of hospital admissions due to flu and flu-related illnesses. A comprehensive programme of action is under way at the moment to build on the lessons learned. This includes providing extra intensive-care and high-dependency beds, extending flu vaccinations to the over-65s and reviewing the effectiveness of existing winter pressures schemes. The additional £53 million allocated to the services this year will also directly contribute to improving health and social services capacity to deal effectively with pressures of that sort that arise during the winter period.

Bhí brú iontach ar na seirbhísí sláinte agus sóisialta sa gheimhreadh seo caite mar gheall ar an uimhir mór daoine sna hotharlanna le fliú agus tinnis eile a bhaineas leis. Faoi láthair tá clár cuimsitheach gníomhaíochta ar siúl le buntáiste a bhaint as na ceachtanna tá foghlamtha againn. Mar chuid de sin tá leapacha breise géarchúraim agus ardspleáchais a soláthar; tá an vacsaíniú in éadan fliú á thabhairt feasta do dhaoine thar 65 bliana d’aois agus táthar ag athbhreithniú éifeacht na scéimeanna reatha a bheas ag déileáil le brúnna an gheimhridh. Fosta cuideoidh an £53 milliún breise a bheas ar fáil ag na seirbhísí go díreach le feabhas a chuir ar chumas na seirbhísí sláinte agus sóisialta le déileáil go héifeachtach leis na brúnna a d’fhéadfadh teacht i rith an gheimhridh.

Mr Molloy asked the Minister of Health, Social Services and Public Safety to detail how clinical waste is disposed of at present, and if she will make a statement.

(AQO 316/99)

Ms de Brún: A joint waste management board representing the then Department of Health and Social Services and the Department of Health and Children, Dublin, signed a 10-year principal agreement with Sterile Technologies Ireland Limited on 4 August 1998 for the disposal of all clinical waste in the island.

An interim service commenced here on 29 March 2000.

At present, while the new disposal plant is being installed and commissioned on the Antrim Hospital site, the majority of the clinical waste generated by the health and personal social services (HPSS) is being incinerated at HPSS incinerators here, with the surplus being transported to Scotland for incineration.

Ar an 4 Lúnasa 1998 shínigh Bord Comhbhainistíochta Dramhaíola, a bhí ag feidhmiú ar son na sean-Roinne Sláinte agus Seirbhísí Sóisialta agus na Roinne Sláinte agus Leanaí, Baile Átha Cliath, Príomhchomhaontú le Sterile Technologies Ireland Limited faoi dhiúscairt na dramhaíola cliniciúla uile atá ar an oileán.

Thosaigh seirbhís shealadach anseo ar an 29 Márta 2000.

Faoi láthar tá fearais nua dhiúscartha á suiteáil agus á gcoimisiúnú ar shuíomh Ospidéal Aontroma. Tá bunús na dramhaíola cliniciúla atá á cruthú ag na SSSP á loscadh ag loisceoirí de chuid na SSSP anseo agus seoltar an fuílleach go hAlbain lena loscadh ansin.

Mr McCarthy asked the Minister of Health, Social Services and Public Safety what assessment she has made in relation to the acute hospitals review, and if she will make a statement.

(AQO 354/99)

Ms de Brún: I am now considering how our hospital services can be developed in a way which ensures high-quality care for all those who need it. I want to look at all the options involved before coming to any conclusions. I am very aware of how important hospital services are to local communities in particular, and before any changes are made I shall want to ensure that decisions about the future of services are based on the fullest possible information.

Anois tá mé ag cuimhneamh ar an dóigh a bhféadfaí ár seirbhísí ospidéal a fhorbairt lena chinntiú go gcuirfí scoth cúraim ar fáil dóibh siúd a bhfuil sé de dhíth orthu. Ba mhaith liom amharc ar na roghanna atá ann sula ndéanfaidh mé cinneadh ar bith. Tuigim go maith a thabhachtaí atá na seirbhísí ospidéal don phobal áitiúil go háirithe, agus sula ndéanfar athruithe ar bith, ba mhaith liom a chinntiú go bhfuil gach cinneadh faoi na seirbhísí sa todhchaí bunaithe ar an eolas is iomláine.

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