Northern Ireland Assembly Monday 17 September 2007 Ministerial Statement: Committee Business: Private Members’ Business: Oral Answers to Questions: Private Members’ Business: The Assembly met at 12.00 noon (Mr Speaker in the Chair). Members observed two minutes’ silence. Mr Campbell: On a point of order, Mr Speaker. I ask that you review the Hansard report of last Tuesday’s debate on attacks on Orange Halls. There has been an omission from page 276, column 2. I understand that it can be difficult for Hansard staff to pick up all interventions, especially if a debate becomes heated; however, although my intervention was clearly audible on this side and was definitely heard on the other side of the Chamber, it was omitted. Speaking at 2.30 pm, junior Minister Mr Kelly said: “that is why attacks on homes, businesses, Orange Halls, other buildings belonging to the Loyal Orders, GAA premises, and all other cultural and religious premises must be condemned.” — [Official Report, Bound Volume 23, p276, col 2]. At that point, I asked, “And the Old Bailey?” Perhaps you would review that exchange, Mr Speaker. Mr Speaker: Thank you for your point of order. I shall speak to the Editor of Debates. I will then either write to you directly, or bring the matter back to the House. Additional Dentistry Funding Mr Speaker: I have received notice from the Minister of Health, Social Services and Public Safety that he wishes to make a statement on additional dentistry funding. The Minister of Health, Social Services and Public Safety (Mr McGimpsey): Access to Health Service dentistry has been one of the first — and most pressing — issues that, as Minister, I have had to address. I believe strongly that people who want Health Service dentistry should be able to get it. As Members are aware, that is far from the case in too many parts of Northern Ireland. Members will recall that during the debate on dentistry on 2 July 2007, a question was asked about what could be done to address the drift of dentists from the Health Service into private practice. At that time, I explained that after representations from the British Dental Association, an additional recurrent investment of £2 million had been agreed, effective from April 2007. That additional £2 million was to assist dentists who continue to provide care for Health Service patients with the costs of running their practices. It was hoped that that additional funding would encourage dentists to remain in the Health Service and slow the drift into private practice. However, I have listened carefully to representations made by Members and their constituents across Northern Ireland; I am also aware of the issues that have been raised by the British Dental Association. It is now clear to me that previous Administrations have not done enough to address the issue effectively. Although that additional £2 million is undoubtedly a significant investment in our 361 dental practices, it has become clear to me that it has not proved sufficient to stop the movement of dentists out of the Health Service. We need to take further measures not only to retain dentists in the Health Service but to address the problems of access to Health Service treatment in areas where dentists have opted for private practice. We also need to keep an adequate supply of dentists in Northern Ireland practices in the first place. I am pleased to be able to announce to the House a substantial package of additional measures. First, I am making an additional injection of £2 million recurrent funding, over and above that already announced in this financial year, into practice allowances. That is specifically to address the profession’s main concern with the current dental contract — increasing overhead costs. Secondly, in recognition of the increasing costs of meeting cross-infection control standards, I am making a further £1·5 million available to help dentists with the costs of necessary new equipment and procedures for sterilisation and disinfection, thus improving patient safety in the surgeries. Thirdly, to help to ensure an adequate supply of new dentists into Health Service dentistry in Northern Ireland, I am making available £500,000 to increase significantly the vocational training allowances for trainers who are willing to take on new graduates. Finally, I am determined to address the problem of equity of access to Health Service dentistry by allocating up to £400,000 to health boards to enable them to start to grow the salaried dental sector in order to plug the gaps in Health Service provision. I have already said that the additional £2 million recurrent funding, which was announced earlier this year, is insufficient to address the profession’s concerns about the increasing costs of running a dental practice. There is evidence that those costs are rising at a much higher rate than inflation. Therefore, I have decided to approve a further £2 million funding of the practice allowance. That increase will be targeted at those dental practices that are defined as “Health Service-committed” — in other words, they must provide a minimum level of Health Service treatment, which must include those adults who pay for their Health Service treatment. It is my intention that that increase to the practice allowance will incentivise dentists not only to remain in the Health Service but to continue to provide care and treatment to paying adults. For those practices, that will mean that the practice allowance is, in effect, being raised from 8% of practice Health Service income to 11%. On average, Health Service-committed practices will now receive an annual practice allowance of £29,600 compared with £21,500 under previous arrangements. If the additional funding that I am announcing today is included, the Department of Health, Social Services and Public Safety, over the past two years, will have invested some £7·7 million into this scheme and the 361 practices involved. Most importantly, it means that I am responding to the main concern expressed by the British Dental Association, which is its assertion that, in the past, Health Service funding has not adequately covered the costs of running a dental practice. I am also aware that the regulations around infection control procedures, and the continuing raising of standards in that area, have had significant resource implications for the profession. For example, higher specification sterilisers and other equipment are now required. Patient safety is paramount to me, and it is imperative that our dental practices offer the best possible standard of cross-infection control to their patients. Therefore I am pleased to be able to release a further £1·5 million to assist Health Service dentists to improve their sterilisation and infection-control procedures. The additional funding will permit dentists to equip their practices to meet the highest infection-control standards and assure patient safety. As with the practice allowance, the additional funding will be allocated to those dental practices with the most Health Service patients, although a proportion will be available to all Health Service practices. As regards vocational training allowances, Members will be aware that all aspiring dentists, on graduation, must undergo a vocational training year in a dental practice before they are qualified to practice on their own. In recent years, there have been difficulties in attracting sufficient numbers of high-street dentists who are willing to train our new graduates in the Health Service. That has meant that many new graduates must leave the country to undertake their mandatory vocational training year. In fact, 10 graduates had to leave Northern Ireland this year, which is an expensive loss as it cost the taxpayer £1·75 million to train that particular group. Dental students are expensive to train: the figure is £178,000 per student over the five-year undergraduate course. My Department directly funds more than 50% of that amount, and the balance is funded by the Department for Employment and Learning. Therefore, it is important that we are in a position to offer training places to all our graduates, not only to provide a sustainable base for the Health Service dental sector, but to ensure a return on the substantial investment that is being made in the students. I recognise that taking on a graduate for the vocational training year is an expensive undertaking for a dental practice. In addition to requiring supervision from the dental practitioner, each graduate needs to have hands-on experience with patients, which requires the full facilities of a dedicated dental surgery. In response to the shortage of trainers, I have sanctioned an increase to the vocational training allowances paid to dental practitioners to encourage them to become trainers. That will provide additional funding of approximately £0·5 million. I am confident that that additional funding will help incentivise sufficient trainers to provide enough training places for all our graduates and stem the flow of graduates to Scotland and elsewhere to complete their vocational training. I hope that the significant investments that I have outlined will encourage dentists not only to come into, and stay in, the Health Service but to come back to it where they have currently opted for private practice. Where dentists do not return to the Health Service, I cannot accept the situation in which there are geographical pockets in Northern Ireland where dentists have stopped providing Health Service dentistry, or are providing treatment only to patients who are exempt from charges. I want to move quickly to address that problem. I mentioned during the course of the Assembly debate on NHS dental treatment on 2 July 2007 that I am encouraging the dental directors of the four boards to seek to commission salaried dentists in areas where there are problems with access to dental services. The Northern Health and Social Services Board has already commissioned a salaried dentist working out of the Dalriada Urgent Care centre in Ballymena. That is a very welcome development, and the board is looking at other possibilities for employing salaried dentists. The Western Health and Social Services Board has identified the need to recruit six salaried dentists to address access problems in its area. Both boards are actively considering where, and how best, to recruit salaried dentists, bearing in mind the comparative lack of new dentists in the local labour market. I confirm today that I have made funding of up to £400,000 available to resource those new posts, and I want to see similar proposals from the other two boards as soon as possible to address the identified shortfalls in Health Service dentistry in their areas. In summary, the measures that I am announcing today represent an investment of £4·4 million into Health Service dentistry to address the immediate issues around access pending the introduction of the new dental contract in the next few years, which I intend will address those issues on a more permanent basis. 12.15 pm Together with the increase in practice allowances that was announced earlier this year, we are investing a total of £6·4 million in Health Service dentistry this year alone, £4·5 million of which will be recurrent. That represents a substantial package of additional funding for dentists who are committed to the Health Service. I hope that Members will see that package as being my commitment to tackling inequities of access to Health Service dentistry and to making such services available to everyone who wants them. Some Members: Hear, hear. Mr McGimpsey: I am confident that those measures will help to persuade dental practices across the country, and the general public, that I am determined to provide fair and equitable recompense for Health Service treatment of patients in Northern Ireland. I trust that the profession will respond positively to this generous dental investment package. The Chairperson of the Committee for Health, Social Services and Public Safety (Mrs I Robinson): I welcome the Minister’s statement, and I thank him for allowing me sight of it before the sitting. During the Assembly debate on NHS dental treatment on 2 July 2007, to which the Minister referred, I acknowledged that, despite improvement in oral health in children and adults in Northern Ireland in recent years, we still have much higher levels of dental disease than our counterparts in Great Britain or the Republic of Ireland. Tackling that problem, therefore, must be a priority, and any measures that address the particular issue of access to Health Service dentistry must be welcomed. Just last week, a lady wrote a letter to the Committee for Health, Social Services and Public Safety to point out that there are no longer any dentists operating in County Fermanagh who provide Health Service dentistry, and that all of them are now in private practice. That is a problem, however, not only for the people of County Fermanagh but for people across Northern Ireland, as the Minister will be aware. My question to the Minister concerns the Health (Miscellaneous Provisions) Bill, which the Committee is currently considering. One of the Bill’s provisions seeks to provide a legislative base to allow health and social services boards to enter into a contract with dental practices and individual dentists. The Minister said in his statement that he is allocating up to £400,000 in an effort: “to start to grow the salaried dental sector”. How far can that approach progress before the legislative provision is in place? Mr McGimpsey: Members will know that dentists run independent businesses: they can set up where they want, and it is a matter for them whether they take Health Service patients. That is the situation with which we must deal, and therein lies the raison d’être for the measures in the Health (Miscellaneous Provisions) Bill that primarily seek a new contract between the Health Service and dentists in order to fulfil our stated aim of providing Health Service dentistry for all patients in Northern Ireland. The Member mentioned salaried dentists. There are general practice dentists, who are those whom I talked about when I mentioned independent businesses. There are also community dentists, who work directly for health and social services boards, and who primarily provide a service to those who have learning disabilities or to those who require general anaesthetic for their dental work. There is also a third category, which we must see grow; namely, salaried dentists who are employed directly by boards to fill the gaps in provision that are identified. As I said, I cannot simply direct dentists to an area where there are gaps and tell them to set up a practice there, any more than I can tell them that they must take on more Health Service patients because they are not taking on enough. My intention is to create an incentive and a new contract for Health Service dentists, and, in the interim, to employ salaried dentists. There are clear needs for salaried dentists in various areas. Mrs Robinson asked what the limit to growth is in the salaried dentist sector. Resources set that limit, but, as far as I am concerned, where need exists, we must address that need, and that is what I have asked the health and social services boards to do. Mr McHugh: Go raibh maith agat, a Cheann Comhairle. I thank the Minister for his statement, which comes on the back of the resolution passed in this House on 2 July 2007. Iris Robinson raised the issue of access, and I want to raise the same matter with reference to Fermanagh. Pain clinics are supposed to be available in all areas. However, if people in Fermanagh are in pain at the weekend, or, indeed, at any other time, they have to use the out-of-hours service, which, I am told, is totally unsatisfactory. People have to pay immediately, and sometimes there is great difficulty in claiming that money back. People, who are often very much in need, cannot afford the large amounts of money required. A lot of money is put into training dentists — they train for five years — and none of that is put back into the public sector after that training is finished. It costs more than £200,000 to train each dentist. Then they go into the private sector, so the NHS gets no return on the money invested. Can something more, other than what we have been told, be done to give people, and the people of Fermanagh in particular, proper access to pain-relief clinics when they need it? Can that be done as soon as possible? Mr McGimpsey: The areas that have been referred to are the responsibility of the Western Health and Social Care Trust, which is responsible for provision. It has identified a need for six salaried dentists, and it is actively recruiting those in order to deal with the demand for services that the Member has highlighted. Where a need exists, my Department attempts to meet that need. We are currently plugging the gaps with salaried dentists. Ideally, we are moving towards a new contract with dentists, and I hope to be able to negotiate that over the next two years. That will enable dentists, and traditional dental practices, to deal primarily with the needs of the people, and to do so through the Health Service, so that free cradle-to-grave healthcare is available for all of the people of Northern Ireland. That is the guiding principle; it is very much my guiding principle. That is what those contracts are about. As I said, measures must be taken in the meantime. The measures that I have outlined today are targeted primarily at dedicated Health Service practices that treat 500 or more patients. That is where the money is being directed. I accept the point about investment and return. It is a poor return to invest large sums of money in training young people to be dentists — we badly need them — only for them to be forced to go and work in Scotland, for example. Once they do, there is a possibility that they will not come back. That is why I am also considering increasing allowances for vocational training so that we hold onto our graduates. Rev Dr Robert Coulter: I welcome the Minister’s announcement, which follows the personal commitment that he gave in the debate in the House earlier this year to address the issues of dental services. The Minister is aware of the chronic shortage of NHS salaried dentists in the Northern Health and Social Services Board area. Although this statement will help in some way to address the issue, will the Minister take a personal interest in ensuring that resources in the Northern board area are increased as soon as possible in order to meet the demand? Mr McGimpsey: I have probably largely answered that question in so far as it relates to plugging the gaps through the employment of salaried dentists. For example, I know that in the Northern board area, the need for a salaried dentist has been identified, and it has already employed one. If it needs to employ more, I have no doubt that it will take the necessary step to do so. The appointments of salaried dentists in the Dalriada Urgent Care centre and in Cushendall have been approved. One of those dentists has already been employed. Further business cases from the Northern board will be given full and prompt consideration when my Department receives them. Mrs Hanna: As one of the Members who proposed tomorrow’s motion on the National Health Service, I welcome the Minister’s promise of additional funding and the assurances he has given on increased funding for running practices and increased training opportunities for new dentists, so that we get a better return on the £178,000 which it costs to train each dentist. As the Minister knows, the Health (Miscellaneous Provisions) Bill is now at Consideration Stage. Will there be a facility in that Bill for pilot schemes, to ensure the broadest access to the full range of dental services for the whole community? Mr McGimpsey: Mrs Hanna makes an important point about access. There must be access to all types of dental treatment in all areas of Northern Ireland. However, 92% of Health Service dentists accepted new Health Service patients last year. We have to look at the context. We have by no means slipped into the situation that pertains in England. My Department is determined to ensure that we do not get that far down the line. We are concerned to ensure access to appropriate treatment, and to have sufficient numbers of dentists in place to provide whatever category of treatment is required. Mr McCarthy: I also welcome this morning’s announcement. I am delighted to hear that the Minister has listened to the voices of the community and of the Assembly. I recall that on 2 July, questions were asked about the benefit of debating dental practices in Northern Ireland. I am pleased that the Minister is here as a result of that debate. Clearly, he listened to what everyone said. I remind Members that, on that day, I questioned the wisdom of the Executive’s spending huge amounts of money on the multi-sports stadium, the Irish language and other policies which, noble causes as they may be, are not priorities. I said then that we should get our priorities right. This morning, the Minister has listened to what Members have said and has got his priorities right. As Assembly Members, we do not want to have to answer telephone calls daily from people who cannot get access to dentists. How soon will this be rolled out for the community, so that our constituents may have access to a dentist when they need one? Mr McGimpsey: As I have just said, 92% of Health Service dentists accepted new Health Service patients last year, so overwhelmingly the profession is responding. The measures that I have announced this morning are to plug gaps and fill deficits. They are active immediately. The money is immediately available. Health and social services boards are actively recruiting for salaried dentists, and the vocational training money is now available. Other moneys — £1·5 million for infection control and £2 million for practice allowances, on top of the £2 million already announced — are all in place. Mr Easton: Will the Minister clarify a few points? Will any of the new money be available for children’s dental health? As he knows, children in Northern Ireland have the worst dental health in the United Kingdom, and it must be addressed urgently. Indeed, is this new money, or has money been withdrawn from other areas of the Health Service? 12.30 pm Mr McGimpsey: The funds that I have announced today are designated for the area of dental health and will not affect any other service. The money in question has become available because a number of dentists, whose services the Department had anticipated having to pay for, withdrew their services. I am, therefore, redeploying the resources that have been made available in the budget rather than waiting and returning the money at the end of the year. It is important that that happens, as the money in question was voted by the House to be used for dental provision. In relation to children’s oral health — Northern Ireland has the worst record of oral health in the United Kingdom. It is extremely poor, and it is one of the worst oral health situations in Europe. The rate of decay, teeth extractions and fillings for the under-12s is much higher, sometimes double or treble, than that of other European countries. It is therefore an important area. In the Health Service, children are provided for by exemption from charges. Everybody under 18 is exempt from Health Service dental treatment charges. Ms Ní Chuilín: Go raibh maith agat, a Cheann Comhairle. I also welcome the Minster’s statement. Like Alex Easton, my concern was that the money for dental provision was going to be removed from another budget, and the cynical part of me was asking whether it would result in another strain on the budget for mental health or for other areas. I, therefore, welcome the fact that additional money is being made available from within the dentistry budget. Does the Minister agree that the other concerns that have been raised in relation to his announcement today can be addressed in the Health (Miscellaneous Provisions) Bill; for example, the issue raised by my colleague, Gerry McHugh, regarding the cost of training, investing in and retaining dental practitioners? During the Assembly debate on training for junior doctors, similar points were raised about training costs, and ensuring that investment was not being displaced to another country or another region of this country. Those concerns also apply to dental practitioners. Is there room in the Health (Miscellaneous Provisions) Bill to ask for a clawback on investment? It is only fair that our taxes, rates and other investments should be tracked. Thank you. Go raibh maith agat. Mr McGimpsey: Dentists are the most expensive students to train; for example, costs run at almost double that of training a doctor. The investment is substantial and, therefore, we would expect to retain the services of the dentists we train in Northern Ireland. One of the problems in doing that lies in vocational training, where it has not been cost effective for dental practices to take on dental graduates for a year’s vocational training. I have announced an investment to try to persuade practices to take on young graduates. Last year, I believe Northern Ireland had 40 graduates, and 10 had to leave. It is a substantial investment to lose if they do not return, and, sadly, that is one of the things that is liable to happen. Northern Ireland is more or less in balance as regards the number of dentists trained, and the need is approximately met each year. Each year, the Department aims to put 45 students into the workforce. This year, 40 students are being trained, but the target is 45, so we are approximately on target. In relation to the Health (Miscellaneous Provisions) Bill, I am not clear about getting a return on investment, as that could be construed as students repaying fees. That is a difficult area. The Health (Miscellaneous Provisions) Bill focuses on giving trusts and boards the power to commission the dental services that their areas require. They will be able to commission those services through a contract, which will be the normal procedure, or, if necessary, through salaried dentists if further commission is required. That approach, and not the English method, should be followed. I understand that the English approach is unpopular with dentists, is more concerned about setting targets, and is more of a “drill-and-fill” method. Ms Ní Chuilín: My point was not about retaining money. I want to be clear that the last thing that I want to do is put pressure on those who are studying for any profession, given that there is enough pressure on them already. My point, which has been discussed with regard to other professionals, such as junior doctors, and to which Gerry McHugh referred, is that if the NHS has invested a lot of money so that individuals can train to become dentists, it may be possible to retrieve some of those NHS hours. It is reasonable to ask whether a way could be found to work that out while ensuring that the process were transparent and that equality and equity were enshrined throughout. The Health (Miscellaneous Provisions) Bill offers an opportunity to provide that. I want to clarify my point; I was not saying that any further pressure be put on students of any profession. Mr McGimpsey: The Member has explained her point to an extent. However, what she suggests is a form of clawback. One must be careful when getting into such an area. Therefore, I must consider it carefully. As I have said, the Health (Miscellaneous Provisions) Bill focuses on another area. The work in the types of professions about which we are talking is done, in effect, by volunteers rather than by conscripts. Volunteers give a much better return than conscripts. Rather than be forced, volunteers are able to enter into contracts in which they receive a proper wage and are rewarded for their work. Mr Buchanan: I welcome the Minister’s announcement about the provision of additional funding for dentistry. The west of the Province has been mentioned. At present, it is difficult to access a National Health Service dentist in that area because they are all going into private practice. What measures will the Minister put in place to ensure that that additional funding is distributed equally in all the boards? Mr McGimpsey: Decisions about Health Service provision, including whether to allocate money to an area such as the west or to provide services in another area, are driven by need. Funding will be concentrated in areas where there is most need. The Western Health and Social Services Board has identified a need for six salaried dentists to plug the gaps in provision in its area, and it is currently recruiting. The Northern Health and Social Services Board has identified a need for two salaried dentists. At present, it is also recruiting. However, money will flow into areas where the need is strongest. The bulk of the money will cover the practice allowance and will be targeted at dedicated Health Service practices — those practices that treat over 500 patients per annum. The Department aims to reinforce provision of its own Health Service dentists and to plug the gaps in provision. By definition, gaps indicate need. Therefore, plugging those gaps will tackle need. Mr Kennedy: I warmly congratulate the Minister on his statement. I welcome the fact that he has addressed the urgent and great concerns of many people throughout Northern Ireland on the increasing problem of availability of NHS dentists. Will he tell the House how he will ensure that people in rural areas — including parts of my constituency of Newry and Armagh — will continue to receive adequate NHS dental treatment at the point of need? Will the Minister encourage all the health and social services boards — not only the Northern Health and Social Services Board and the Western Health and Social Services Board — to commission salaried Health Service dentists in areas where people have difficulty in accessing dental services? Mr McGimpsey: Mr Kennedy’s points go to the crux of the matter. Under current Health Service dental services arrangements, we cannot tell dentists where to set up their practices. Dentists can set up their practices wherever they wish, and they can treat whomever they choose. In the future, the new contracts that we envisage will address those problems. New legislation will make it a duty on the health and social services boards to commission Health Service dental services for their respective areas. That is the future. In the meantime, we are beginning to employ salaried dentists to plug the gap — that is the point that I made about the Western Health and Social Services Board and the Northern Health and Social Services Board. I accept the point that Mr Kennedy has made about the Southern Health and Social Services Board and the Eastern Health and Social Services Board. I shall raise the issue of plugging the gaps in dental services provision with those boards to see how far they have gone in addressing that matter. Mr Gallagher: I remember a similar debate — probably more than most, because I proposed the motion. The Minister was present for that debate and made a constructive contribution. Despite that, some Members from his party — the Ulster Unionist Party — argued that day that there was no need for the motion. Those comments were also forthcoming from the DUP Benches. The Minister’s statement shows how badly that motion was needed, and I commend him for returning to the House in a short space of time having made some concrete steps to alleviate the problems of dental services provision. Besides increases in salaries, other matters such as infection control and vocational training have been mentioned. My question concerns the issue of salaried dentists. The Western Health and Social Services Board and the Northern Health and Social Services Board have been identified as having a problem in dental services provision. The previous Member who spoke mentioned the Southern Health and Social Services Board, which covers an area that includes my constituency. That is important too. However, the delay in addressing the shortage of Health Service dental services is, in part, a result of the Department of Health, Social Services and Public Safety’s assessing the business cases provided by the health boards. In welcoming what he has said, I ask the Minister whether he will investigate that matter as the programme for salaried dentists progresses. We must ensure that progress does not get bogged down in the Department for an undue length of time. Mr McGimpsey: I understand Mr Gallagher’s point. I have been in the situation, as we all have, of working with various groups and running into business case and approval scenarios. It should give the Member some comfort to know that the required money is in the current budget and is available now. I assure the Member that there will be no delay in spending that money — it needs to be spent now and there are no excuses for not doing so. Ms Anderson: I too welcome the Minister’s statement. The Minister has addressed some of my concerns during the debate. The scandalous lack of dental services provision in the north-west needs immediate resolution. Although I welcome the announcement on salaried dentists, I am keen to know how soon Health Service dentists will be available to people who live in the north-west, particularly those who live in the Derry area. Mr McGimpsey: As I have said, the package is for immediate action this year. Putting that in context, 92% of Health Service dentists accepted new patients last year. However, there is a problem, and I am concerned that that problem does not grow and overwhelm us. In that context, the gap in dental services provision is around 10%. The new measures are designed to address that gap quickly. I have already said that six salaried dentists have been identified in the Western Health and Social Services Board area. Further recruitment is under way. 12.45 pm If the Western board needs more, representatives can come and tell me, and that will also be considered. I am as anxious as the Member is to ensure that all parts of the country receive an equitable service — the service that is required under the principle of cradle-to-the-grave care for everybody. Taxis Bill: Extension of Committee Stage The Chairperson of the Committee for the Environment (Mr McGlone): I beg to move That, in accordance with Standing Order 31(4), the period referred to in Standing Order 31(2) be extended to 7 December 2007, in relation to the Committee Stage of the Taxis Bill (NIA Bill 4/07). Go raibh maith agat, a Cheann Comhairle. The Taxis Bill was given its Second Stage on 26 June 2007, and it was referred to the Committee for the Environment on 27 June 2007. As Members will appreciate, that was just before the summer recess, and the Committee was unable to begin to scrutinise the Bill until its first meeting after recess, which was held on 6 September 2007. The Taxis Bill is a comprehensive piece of legislation that consists of 56 clauses and three schedules. It will make provision to regulate taxi operators; introduce new requirements and duties relating to the operation of a taxi service at separate fares; provide for the regulation of vehicles used to provide taxi services; make further provisions to regulate the drivers of taxis; and deal with other issues such as enforcement. The Committee wishes to give adequate time to scrutinise this important Bill. It has received 21 submissions from 16 interested parties, and it has just begun to take oral evidence from those individuals and organisations. Members will appreciate that that takes time. The Committee will, therefore, need a time extension in order to consider their views, and the Department of the Environment’s responses, before completing a clause-by-clause scrutiny and compiling its report on the Bill. The Committee faces a heavy workload in the coming weeks, which includes consideration of the Budget, Planning Policy Statement 14 (PPS 14), environmental governance, the review of public administration and statutory rules I, therefore, seek an extension of the deadline to 7 December 2007 to allow sufficient time for the Committee to consider the Bill and report on its findings, and I ask Members for their support. Go raibh maith agat. Question put and agreed to. Resolved: That, in accordance with Standing Order 31(4), the period referred to in Standing Order 31(2) be extended to 7 December 2007, in relation to the Committee Stage of the Taxis Bill (NIA Bill 4/07). Ad Hoc Committee on Suicide Mr Speaker: The Business Committee has agreed to allow up to one hour and 30 minutes for this debate. The proposer of the motion will have 10 minutes to propose and 10 minutes for the winding-up speech. All other Members will have five minutes to speak. One amendment has been selected and published on the Marshalled List. The proposer of the amendment will have 10 minutes to propose and five minutes for the winding-up speech. Mr Adams: I beg to move That this Assembly shares the growing concern about the level of suicide, particularly among our young people, and, pursuant to Standing Order 48(7), appoints an Ad Hoc Committee, to — Examine the delivery of services and support to people who may be at risk from suicide; make recommendations to the Executive; and present its report to the Assembly by 10 December 2007. Composition: DUP 4 SF 3 UUP 2 SDLP 1 Other Parties 1 Quorum: The quorum shall be five. Procedure: The procedures of the Committee shall be such as the Committee shall determine. Go raibh maith agat, a Cheann Comhairle. Tá mé buíoch díot, nó is ábhar an-tábhachtach é seo. This motion was first introduced by Sinn Féin in July to raise awareness of suicide. The motion came on the back of more reported suicides in west and north Belfast, as well as in County Tyrone and Craigavon. A report published in June into the death of Danny McCartan found that there had been serious failures of care by the Health Service. Another report identified people over 60 years of age as a group at serious risk of suicide. For legitimate reasons, the motion could not be debated until now, but in the course of the summer, more people committed suicide. The statistics are frightening. In 2006, 291 people died by suicide in the North and close to 500 died in the South. That means that nearly 800 people took their lives last year on this island. Yet, suicide is preventable; all of us can play a part in reducing it. That is especially true of those of us elected to this Assembly. Ba chóir do na húdaráis ceannasaíocht láidir a thaispeáint san ábhar seo. The bereaved families have demonstrated remarkable courage. Many of them have been to the fore in helping to prevent the same tragedy engulfing others. They deserve our respect and praise, but they also deserve practical assistance and public investment. A lot of burnout has occurred at the grass roots; support groups and family networks are still not properly resourced. It is a source of concern that much of the money ring-fenced for suicide prevention is recycled through the Health Promotion Agency. It is also a concern that there are still insufficient community-based services, too few psychiatric nurses, psychiatrists and psychologists, and most GPs still do not receive dedicated training in suicide awareness and prevention. Sinn Féin believes that civic society must be mobilised to respond. A conference will take place here on Monday 24 September to discuss this. I have spoken to the Minister of Health, Social Services and Public Safety, the Minister of Education and the Chairperson of the Committee for Health, Social Services and Public Safety as well as to representatives of other parties in the Assembly. Ba chóir dúinn a bheith ag obair le chéile. The Health Minister, Iris Robinson, proposed that the Health Committee would take up — Mr Kennedy: We did not hear about that. Mrs I Robinson: I am the Health Committee Chairperson. Mr Speaker: Order. Mr Adams: I am sorry, Michael. Gabh mo leithscéal. The Chairperson of the Committee for Health, Social Services and Public Safety, Iris Robinson, proposed that the Health Committee would take up suicide prevention as a priority and would hold a statutory Committee investigation into the matter. I commend that approach; we believe that it is a positive and constructive proposal, which has the potential to deliver significant improvements to suicide prevention strategies. Dá thairbhe sin, ba mhaith liom rún s’againne a tharraingt siar. For that reason, Carál Ní Chuilín and I would be pleased to withdraw our motion in the light of such a positive development. Mr Speaker: As the Member made a significant speech when moving the motion, I intend to carry on with the debate. I call Mrs Iris Robinson to move the amendment. Ms Ní Chuilín: On a point of order. Is Mr Adams not entitled to the rest of his time? If you are moving into a full debate, does he not have the rest of his 10 minutes? Mr Speaker: Yes. It is the normal procedure to allow the Member moving the motion and the Member moving the amendment each to speak for 10 minutes. Mr Adams: Thank you, a Cheann Comhairle. I welcome the fact that, even though it is a bit unorthodox, you have decided to proceed with the debate, because the important thing is to focus in on the scourge of suicide. We got to the point of considering withdrawing the motion simply by dint of a lot of good tick-tacking between ourselves to try to find the best way forward. Everybody was sincerely engaged in trying to find the best way to get preventative measures brought forward. All of us have felt the impact of suicide. Every time someone loses his or her life through suicide, shock waves are felt far beyond the immediate family. That is because three out of four people on this island have said that they knew someone who took his life. It is also important to note that a huge number of people have attempted to take their lives, or have survived suicide attempts, or are self-harming. That amounts to a huge degree of trauma. Over the past 10 years, reported suicides in Ireland have risen by more than 20%. North and west Belfast have been particularly affected, as have other areas. No community, whether rural or urban, no class, and no religious grouping are free from this great tragedy. Suicide has convulsed many local communities. I have experienced the sense of powerlessness that people feel when a loved one has taken his or her life. Particularly in families in which a young person has taken his or her own life, parents and grandparents are living in great fear, watching and waiting to see who will be next. The biggest killer of the next generation will be suicide. We, as the legislators, together with the Governments, must show leadership on suicide prevention. We must have the power to prioritise, to develop strategies and to allocate resources. The number of recorded deaths by suicide on this island outstrips the number of deaths in road-traffic accidents. Everyone will agree that there is a necessary urgency about road safety, because so many deaths are preventable. We all agree that there should be safety training for drivers, safety devices in cars, technology on the roads, road-safety advice for schoolchildren, road-safety research, and penalties for those who create road hazards. Millions are spent on public-awareness advertising. There is an increased integrated approach by statutory agencies and Government bodies on an all-Ireland basis. Why should death by suicide not be afforded the same degree of intense effort and resources? In the past, I have written to the commissions on human rights and on children’s rights in the North and South to ask them to forge a common way forward. I am now also writing to cultural and sporting organisations to explore how suicide awareness can become mainstream. Suicide prevention must be integrated into all walks of life. Consequently, Sinn Féin wants suicide prevention to be prioritised across the island, under the institutions of the North/South Ministerial Council. If road safety, drug trafficking and foot-and-mouth disease are all rightly designated as issues for that type of action, the same can, and must, be done for suicide prevention. Specific action must be developed and implemented that is targeted at individuals who have been identified as being at risk of suicide. Actions must be developed to assist people who have been bereaved through suicide and to promote greater targeting of mental-health resources for schools, youth services, workplaces and the media. Action must be taken to address the serious shortage of counselling services for adolescents and young adults. Urgent action is required to ensure that the health system can deal appropriately with people who present themselves at accident and emergency units, having taken either drugs or alcohol. The role of the Internet, and its influence, must be addressed. Although I do not know how true they are, stories have mentioned suicide pacts and discussions about methods of suicide on the Internet. All of that means that we must work together, around agreed common goals and objectives. To repeat what I said earlier, I have spoken with the Minister of Health, Social Services and Public Safety, the Minister of Education, and the Chairperson of the Committee for Health, Social Services and Public Safety, as well as with representatives of the other parties. When we were drafting the original motion, we agreed that every party would have two representatives on an Ad Hoc Committee, and, because of the time lost over the summer recess, we wanted the Committee’s report date put back until January or February 2008. However, the proposal from the Chairperson of the Health Committee to adopt suicide prevention as a priority issue and to hold a Statutory Committee investigation into it is a welcome step. Once again, I commend that approach. It is a positive and constructive proposal, which has the potential to deliver significant improvement to suicide-prevention strategies. Go raibh míle maith agat. Mrs I Robinson: I beg to move the following amendment: Leave out all after “people” and insert “and refers this issue to the Health, Social Services and Public Safety Committee to examine, as a matter of urgency, the delivery of services and support to people who may be at risk from suicide; make recommendations to the Executive; and present its report to the Assembly at the earliest opportunity, but not later than 12 February 2008.” I am pleased that the Sinn Féin Member for West Belfast is now appreciative of the fact that the proper course of action is for the Health Committee, which has the remit to hold a public inquiry, to take responsibility for the issue of suicide prevention. The Committee should set up a subcommittee to deal with that. That the Health Committee is to do so offers nothing but good for the wider community. We stand at a moment in the history of Northern Ireland at which people will look back and judge us on what we do now for the sake of our young people. Society is demanding that something be done about the current plague of suicide, and, if we are to make a difference, all of us must play our part. In recent times, Hillary Clinton has made popular the African proverb: “It takes a whole village to raise a child.” That principle holds the key to our society’s helping to decrease the numbers of people of all ages dying by their own hands. 1.00 pm Society will never effectively deal with suicide by expecting mental-health professionals alone to solve the challenge. However, by accepting that suicide is a social, biological, spiritual and mental-health problem, all those areas can be examined to find a solution. Understanding suicide requires investment in gathering appropriate useful information and avoiding the mistake of collecting what is easy. There must be wide consultation with all stakeholders and experts in the field. As policy-makers and politicians, we must first listen. When dealing with such a painful subject, there is a temptation to act hastily and risk investment that may not be very effective. The motto of the Royal College of Psychiatrists is “Let Wisdom Guide” and, in considering such a complex subject, wisdom is required. Any group that is constituted to examine suicide must, therefore, involve the necessary experts — by which I do not mean only professionals: expertise resides in many parts of the community. The family unit is the main element that holds together a healthy society. Effective policies that support the family are important in the healthy development and maturation of a child. However, more important still is that the healthy strong family acknowledges the role of the older individual. In aboriginal culture, the older person does not retire and become perceived as valueless. The best translation of how they are regarded is “the manual”. The older individual is someone from whom others seek advice and guidance. The young and the old may be at risk from suicide because they feel useless and worthless. They have no purpose in their lives and, worst of all, they have no hope that that will change. Research has consistently shown that hopelessness puts a person who is contemplating suicide at high risk. Suicide has been described as a permanent solution to a temporary problem. As communities, we must show people that help and support is available when required and that there are always options. Investment in community infrastructures is important, and pragmatism, not platitudes, is required. The young mother who is geographically isolated from her family and who cannot access affordable childcare needs a practical solution. Although those aspects of social care seem distant from the topic of suicide, they are not, and we neglect them at our peril. Although suicide is considered to be a problem of the mind, the mind cannot be divorced from the body. Issues that impact the body and have a significant role in suicide include alcohol misuse and addiction to other substances. Many people impulsively take their own lives when under the influence of drugs or alcohol. It is important that, in a society that has been historically divided on spirituality, that aspect of a person’s life is not ignored. People may not be religious, but they are, generally, spiritual. Christian mental-health professionals have been holding seminars at educational conferences for clergy that focus on the interface between faith and mental health, and that should be encouraged and supported. The 2006 response from the Royal College of Psychiatrists to the five-year report of the National Confidential Inquiry into Suicide and Homicide by People with Mental Illness concluded that: “it is up to commentators outside clinical practice to give up the culture of blame.” If the Assembly is to make a difference in dealing with suicide, all areas of society — the state, the voluntary sector, clinicians and families who have lost loved ones to suicide — must put aside their differences and work together. Suicides are a tragedy for victims, their families, their society and the professional staff involved. It is important to take steps at all stages to improve mental health and to minimise risks. There is a need for robust systems, such as a better physical environment for inpatient services, with fully trained staff in all disciplines, and there must be joined-up working. Professionals agree that every attendance at hospital following an incident of self-harm: “should lead to a specialist psychosocial assessment.” This should aim to: “identify motives for the act and associated problems which are potentially amenable to intervention, such as psychological or social problems, mental disorder, alcohol and substance misuse.” That information has come from the University of York NHS Centre for Reviews and Disseminations, 1998. There are teams being developed to work in the area of self-harm, such as that at the Mater Hospital, Belfast, and lessons must be leaned from the experiences of such teams. I will list some practical goals that emerged from American research into suicide prevention. These were published on the US Governments National Library of Medicine web pages as a report of the Surgeon General, ‘National Strategy for Suicide Prevention: Goals and Objectives for Action’. “Goal 1: promote awareness that suicide is a public health problem that is preventable.” For example, one could work with local media to develop and disseminate public service announcements describing a safe and effective message about suicide and its prevention. “Goal 2: develop broad-based support for suicide prevention.” For example, one could encourage organisations to consider ways that they could integrate suicide prevention into their ongoing work. “Goal 3: develop and implement strategies to reduce the stigma associated with being a consumer of mental health, substance abuse, and suicide prevention services.” For example, one could review — and modify, where indicated — school health curricula to ensure that mental health and substance abuse is appropriately addressed. “Goal 4: develop and implement community-based suicide prevention programmes.” For example, one could develop and test natural- or peer-helper programmes for use with young people, and implement and evaluate a programme that trains educationalists with a pastoral role in the principles of suicide risk identification, crisis intervention and referral. One could also develop and implement a training programme for employees of local programs, working with older persons to assist these workers and volunteers in identifying persons at risk of suicide. “Goal 5: promote efforts to reduce access to lethal means and methods of self-harm.” For example, one could develop an emergency department screening tool to assess the presence of lethal means in the home, and develop standardised practices for law enforcement response to domestic emergencies that assess for the presence of lethal means and advocate their removal or safe storage. “Goal 6: implement training for recognition of at-risk behaviour and delivery of effective treatment.” There should be training for the key gatekeepers: teachers and school staff; school health personnel; clergy; police officers; correctional personnel; supervisors in occupational settings; natural community helpers; hospice and nursing home volunteers; primary health care providers; mental-health care and substance abuse treatment providers, and emergency healthcare personnel. “Goal 7: develop and promote effective clinical and professional practices.” For example, one could develop guidelines for hospitals and health delivery systems that ensure adequate resources to implement confirmation of mental-health follow-up appointments. One could also collaborate locally to establish processes that increase the proportion of patients who keep follow-up mental-health appoint_ments after discharge from the emergency department, and develop standardised suicide assessment guidelines for primary care physicians when assessing elderly patients. “Goal 8: improve access to and community linkages with mental health and substance abuse services.” For example, one could develop and offer peer leadership training for facilitators of suicide survivors support groups. “Goal 9: improve reporting and portrayals of suicidal behaviour, mental illness, and substance abuse in the entertainment and news media.” One could develop and provide press information kits that provide a resource for reporting on suicide and contact information for local spokespersons who may provide additional information. Mr Speaker: The Member’s time is almost up. Mrs I Robinson: Also there is: “Goal 10: promote and support research on suicide and suicide prevention.” For example, one could tie priorities for training grants to the inclusion of “suicidology” in curriculums. “Goal 11: improve and expand surveillance systems.” Mr Speaker: The Member’s time is up. Rev Dr Robert Coulter: I was intrigued by the previous speech and think that it is great that we can have an analysis of a problem that goes to the very heart of our society. In my work, I have had to pastor and counsel those who have suffered trauma in the aftermath of suicide in the family. Only those who sit with them and share their tears will realise the extent of the problem. In our country, too many families have been beset by such grief and by the sense of guilt that follows. Some people may feel a sense of failure as they were unable to recognise what was going on in the young person’s mind, and older people may feel that they have let the young person down. Perhaps we should take those issues on board and use the media, and incorporate training into the media so that people who are faced with this problem and with its aftermath will have somewhere to turn and know exactly what to do in that situation. I was amazed to learn recently of a chat room that actually promotes suicide. I was horrified when I read that someone who was suicidal said in the chat room that they were going to commit suicide, and they were actively encouraged to take their own life, which they did. That suicide was photographed as it happened, so that others could take delight in seeing a life being taken. It is incumbent on all of us regardless of religion, as Mrs Robinson said, and regardless of our political beliefs, backgrounds and aspirations, to take this problem to heart. I am glad that this motion has been tabled today. It is a great loss to society when young people who have spent years in primary school, high school or grammar school and then, perhaps, further education, suddenly take their lives. Their future is lost not only to them and to their families, but to society. The cost of education and training has been mentioned. What is the cost when someone’s life is suddenly cut off after they have been trained to commit their talents to society? The Health Committee should take this issue forward, so that it can return to the House and inform Members of the progress that has been made. Not only politicians and health professionals, but churches, mental-health charities, teachers and anyone who is involved with young people in any way should be involved and contribute. In my constituency of North Antrim, a young boy who lived near my home was bullied at school and took his own life. The impact of that on the family and on the community was disastrous. The family have never gotten over it, and they never will. If only the teachers had been aware of the bullying, perhaps that great young talent could have been saved. The training of doctors and health workers must be addressed, and the Health Minister is also concerned about that. If we work together to tackle this issue, we can move forward. I hope that the Health Committee will provide a platform from which benefits can be brought to many young people and to the community. 1.15 pm Mrs Hanna: Suicide is at the heart of mental-health issues. Parents, siblings, and loved ones trying to understand and come to terms with their awful loss need every possible support. They also need to know that we, as politicians, are doing all we can to address those issues. Why do people commit suicide? Sometimes there are no obvious answers. In the first instance we must promote good mental health and try to ensure that everyone has a stake in our society. As a matter of urgency, the recommendations of the Bamford Review must be implemented. A bottom-up approach is absolutely essential; there must be support at community level. There should be awareness training, counselling, and training for teachers, parents and others — particularly GPs. I am aware that there is an opportunity for training for GPs, which should be taken up and made available to all health professionals. Although sometimes there are no signs before a suicide, there should be training for teachers to look out for them. We need to train more personnel to work in the mental-health sector, which is a major point of the Bamford Review. It is up to the Health Committee to ensure that the recommendations of the Bamford Review are fully implemented and that there is a bottom-up — and top-down — approach to ensure that there is sufficient detail. Every possible ounce of support must be given to the parents, relatives and loved ones of anyone who is suicidal or has, sadly, already taken their life. Mrs Long: I welcome the motion, because it has brought an issue to the House that is important to the wider community, as well as the Assembly. The suicide of a young person has to be one of the greatest tragedies that can confront any family. All Members will feel a great sensitivity in dealing with the issue. Suicide has devastating consequences, not just for the young person involved, but also for their family, friends and local community, who are left behind to come to terms with their loss. It is testament to the level of despair, isolation and hopelessness in modern society that suicide is so prevalent. All Members in the Chamber will recognise the importance and sensitivity of the issue, and the role that we can play — however limited — in trying to address it. Although the overall rate of suicide in the UK and Ireland is among the lowest in Europe, that masks a disturbing and rapid increase in the rate of suicide among young people, particularly young men from deprived communities. That increase has been largely masked by a fall in the rate of suicide among older people. Suicide is now estimated to be one of the three main killers of people in the 15-44 age group, and is therefore an issue that Members must give serious consideration to. When the Order Paper was published, the Alliance Party gave long and detailed consideration to whether the proposal for an Ad Hoc Committee was the right approach for the Assembly to take in response to the issue. The Alliance Party is not opposed to Ad Hoc Committees in principle, if they work to a fixed timescale with clear objectives. Ad Hoc Committees also have the benefit of being able to deal with cross-cutting issues, for example by addressing health and education issues together. However, after weighing up the motion and the amendment, the Alliance Party was convinced that the Health Committee was the best place to effectively deal with the issue. Regarding the effectiveness of a response, departmental Committees have the weight of statutory powers behind them, as well as a formal scrutiny role. Therefore, as well as developing a report and a strategy, they have the ability to scrutinise the progress and implementation of promises that have been made. The Alliance Party also feels that where there are cross-cutting issues, for example where the Department of Education and youth services both have a role to play, Ministers can liaise with other departmental Committees. I am glad that the Members who moved the motion and the amendment have reached agreement, and I hope that the House can move forward on this without division. As other Members have said, suicide must be examined in the context of other mental-health issues. The Bamford Review acknowledged the deficits in mental-health facilities, particularly for adolescents, and it realised that that deficit would take a long time to redress owing to the length of time required to train a psychiatrist to deal with adolescents specifically. That is a huge problem that must be addressed sensitively. The Assembly must recognise that suicide is at the end of a spectrum of mental-health disorders which often go undiagnosed and untreated in the community, and the Health Committee is well placed to examine that shortcoming. Whatever strategy is set up to deal with suicides should also deal with other related issues such as mental-health problems and, in particular, the promotion of good mental health. One of the main aspects of any future strategy should be to remove the stigma of mental-health disorders so that people feel free not only to discuss treatment with their doctors but also to discuss their problems with their friends and family without feeling that they are being judged on their illness. We need improved counselling facilities for young people and greater awareness in the community. Several Members have mentioned the roles played by teachers, parents and GPs, but the people who volunteer to work with young people through youth organisations and youth clubs should also be acknowledged. They may feel ill-equipped to deal with a young person who is contemplating suicide, and they should be given support and guidance on how to address the needs of those young people. The Assembly must also consider the need for support for families who have been affected by suicide — not only those who have been bereaved by suicide, but those who have felt the devastation that a family member’s attempted suicide can also cause. There must be proper support and counselling for the family circles and friends of young people who have made failed suicide attempts to help them come to terms with what has happened. As a community, we need to deal with isolation and hopelessness, and although the Assembly has a role to play, this will best be driven forward through the Health Committee. Mr Easton: We are confronted, daily, with newspaper and television reports giving dreadful accounts of the pain and suffering caused to families and communities by the loss of loved ones through suicide. All Members can recall the recent nightmare scenario in Armagh when, following closely on the death of a young adult, three pupils from the same high school took their lives in what appeared to have been a series of related suicides. In the past five weeks, nine young people in west Belfast have taken their lives. At times like this, we do not think of politics, race, colour, creed or religion: we only see and feel the pain of the families and wonder how we would respond if we were in that position. We want to reach out and help, but we feel a sense of helplessness in the face of the intense grief and devastation that parents suffer when they have lost a child. Northern Ireland is in the grip of what has all the hallmarks of a suicide epidemic. Suicide is almost becoming part of daily life here, and few people have not been directly affected by it, such is the scale and prevalence of the problem across the Province. The suicide rate has doubled in the past decade from 143 to 291 last year. We are indebted to local newspapers for the magnificent ‘Newspapers Against Suicide’ campaign that they conducted last week to bring to our attention the need for concerted action and for us to do all in our power to deal with this scourge. That campaign followed on from the various events organised on last Sunday’s World Suicide Prevention Day, which helped us to realise that suicide is a serious international problem. However, we are also informed by the various editorials and articles that the suicide rate in Northern Ireland is one of the highest in Europe, and that warns us against being less than resolute in our response. The Department of Health, Social Services and Public Safety has promised to give a suicide prevention strategy the attention and commitment it deserves, and its publication last year of ‘Protect Life: A Shared Vision’ was welcomed by all. Suicide is no longer the taboo subject that it was in the past. Everyone recognises that suicide is a multi-dimensional community health problem, and any strategy — to be effective — will have to involve the co-ordinated approach of the widest possible range of statutory, voluntary and community agencies. At the forefront of our minds must be the importance of conducting appropriate research. We must also ensure that critical people, particularly medical practitioners, have the appropriate training and that the entire community has the information that it needs to assist in tackling all aspects of suicide prevention and dealing with the consequences. Many of the risk factors are known, including: unemployment; forced retirement; changes in social or financial status; alcohol; drugs; bullying; peer pressure; dangerous influences in society, on the Internet and on television. We must take a determined stand against any individuals, gangs or social groups who direct social policies that actively undermine personal and community well-being. We all need to understand and know how to deal with friends, co-workers and family members who show signs of depression. We need early information about and sensitive medical treatment for those at risk. People must be prepared to reach out to others when they see problems of any kind. Some parts of the solution include: the teaching of life skills; health, educational, personal and social development; education; the identifying of high-risk groups or individuals; school-based screening; community crisis centres; the provision of telephone and Internet helplines; and charitable groups that involve parents who have experienced such tragedy. There must be a determined strategy of preventative activity at different levels directed towards complementary goals and a comprehensive, multi-level approach involving a wide range of Government Departments, peoples and agencies. The health, education and social-development sectors and voluntary agencies require the help of teachers, police, youth and community workers. Public knowledge and awareness must be improved, and there must be acceptance of crisis services. All possible support must be given to families that are dealing with children or family members who are in danger. I welcome the recognition today that Members share a growing concern about suicide rates, particularly among young people, and believe that it is in the best interests of those people if that matter is dealt with by the Committee for Health, Social Services and Public Safety rather than an Ad Hoc Committee. I am pleased that the Member is withdrawing his motion. Ms Anderson: Last Monday, 10 September, was World Suicide Prevention Day, one day institutionalised in the calendar to mark the death and unimaginable suffering of friends and relatives whose children felt that life was not worth living. In my city, Derry, families and the wider community have recently experienced unbearable pain and anguish because so many people have taken their own lives. In the past year, almost 300, mostly young, people in the North ended their lives. That is nearly one a day. Members must examine what they are doing for the generations of young people to come. What world will we leave them with? After the publication of excellent junior certificate results, what world faced that Dublin child who took her own life last week? What world faced Louise Meenan, the beautiful young Derry woman who had the potential to gain a university degree? We know for sure that it is a world of cut-throat, competitive pursuit, a world based on inequality and marginalisation, in which communities are plagued by drug pushers who peddle poisonous substances to young people. When faced with suicide, we must be careful not to fall into the trap of reducing those circumstances to the individual trauma. We must be sure that we do not dislocate the relationship between individual suffering and the societal context that gives rise to it. In his report on suicide prevention, Mike Tomlinson of Queen’s University suggested that more must be done to encourage empowerment, which: “is not limited to developing more positive feelings about oneself and gaining insight into one’s situation. It also means doing something about it.” All Members must do something about it, and I wish to commend my colleague Caitríona Ruane, the Minister of Education, who took action by placing counsellors in every post-primary school. Hopefully, that will address some of the concerns about bullying that were expressed earlier. 1.30 pm There is a serious problem of under-provision of psychiatric and community services for children, adolescents and young people in the North. There is a clear need for help and support for children and for those who live with someone who is struggling and may be contemplating taking his or her life or self-harming, or who is suffering from a mental illness. As many Members know, it is heartbreaking to see so many families devastated in the aftermath of a relative’s suicide. We must ensure that we find the advice, help and support that those families need and that more backup services are made available for bereaved families. I do not believe that all those who ended their lives wanted to die; some simply did not know how to live at that moment. I appeal to anyone who is struggling today to talk to someone. I want them to know that all Members are here to support them and that their friends and relatives care. People want action from the Assembly, dedicated ring-fenced resources and care that goes some way towards redressing the unbearable individual circumstances that give rise to these deaths. The onus is on Members. When we are moved by each tragedy, it can be difficult to remain rational. However, the Assembly has a responsibility to take action, and power sharing has given us the responsibility to share and shape a new society that has confidence in itself and where it is possible for everyone to realise hopeful dreams and have plenty to live for. Go raibh maith agat. Mr Speaker: I remind Members that the motion has not been withdrawn. The motion has been proposed, and the amendment was proposed by Mrs Robinson. Members who wish to speak must remember that the motion has not been withdrawn. Lord Morrow: Thank you, Mr Speaker, for clarifying that. The motion is still up for debate, as is the amendment, which I support. I am glad that most Members, with hindsight, seem to support the amendment. I am getting a pleasing vibe that perhaps the House will not divide on the issue, but that remains to be seen. It is important that the House does not divide on the amendment. Some of us tried to impress that point on the Business Committee, but no one was prepared to listen. With hindsight, only good can come out of this useful debate. The subject matter does not touch only one section of the community; it goes across the spectrum of society in Northern Ireland. Therefore, it is most important that the House unites and sends out a clear message that the Assembly is concerned about what is happening, albeit being so powerless to do anything about the matter. However, I trust that, as a result of today’s debate, minds will be focused, attention will be drawn to the issue and resources will be directed to tackling an acute problem that exists across Northern Ireland. I listened to all the contributions, and I was struck by some of the things that were said. However, I was also struck by something that was not said. Some Members have tried to guess — rightly so — the reasons behind the situation. I suspect that one reason is that our society has emerged from 35 traumatic years. Society has felt the charge and dynamism that peace has brought as well as the pressures that extend to all households in the Province, no matter the background from whence they come. I have little doubt that, as a result, and in some significant way, that played into the situation in which we find ourselves. It is difficult to explain or to ascertain why young people are under such pressure. They have not yet lived their lives, which are still in front of them, and their future should be bright. It has been mentioned that many young people who have taken their own lives were doing well at school or at university. In my constituency, one young man, who was at the peak of his educational career and was ready to step out into society with a well-earned degree of a high class, could not face society and took his own life. That is a great tragedy. That message must come across, and I know that all of us struggle to find out why someone would do that. This issue presents a challenge, not only for the Minister and his Department, but for society as a whole, because we all play into it, and all of us impact on it in some way. There is a challenge for us, as an Assembly, to show whether we are really concerned at what happens around us. Why do so many people, from age groups across the spectrum, take their own lives? No matter what political group any of us comes from, all of us struggle to provide the answer to that question. We can all point to people in our communities or in society who put up a facade of not having a care in the world and that everything is going for them. Yet, often, we find that those are the very people that, tragically, we learn have taken their own lives. The Assembly must tackle this issue in the days ahead. Teachers and leaders of the community become concerned, blame themselves, and ask whether they missed the signs or the vibes. However, such tragedies are not attributable to them. I hope that the Assembly will send a united message that it sees this matter as important, and that it directs the Committee for Health, Social Services and Public Safety to take its concerns on board and produce a report that will get to the heart of the problem. Mr McCallister: I am pleased to be involved in, and to contribute to, this debate. The Rev Dr Coulter spoke eloquently about his role in providing pastoral care. There is no one in the Chamber without knowledge of someone — perhaps someone very close — who has attempted suicide. As the proposer of the motion mentioned, the issue, therefore, cuts across all divides of class and religion. This issue knows no boundary, and, as Lord Morrow pointed out, it affects those at the very height of educational attainment, as much as those from a deprived social background. The Assembly must tackle this sad issue. Lord Morrow further pointed out that there must be some link between this problem and our situation in the last 35 to 40 years. In my brief time as a member of the Committee for Health, Social Services and Public Safety since devolution was restored, we have been given excellent and useful briefings. From the diversity of witnesses to the Committee, it is clear just how cross-cutting the issue is, and how cross-cutting some of the answers must be from the Minister of Health, Social Services and Public Safety, and the Committee, the Department of Education, and, particularly, the Department for Social Development. There must be a big involvement and input from the community and voluntary sectors. I have been at meetings with various groups, and have taken various briefings from them, which have been very useful in enabling me to share information with the Committee for Health, Social Services and Public Safety. It is important to consider how to get the first-aid plan for mental health rolled out as early as possible into schools, universities, workplaces, sports clubs, youth clubs, and so on. I am aware of the great work on this issue that is done by many voluntary groups, and I pay tribute to that. In the brief time that the Minister has been in office, I am aware of the huge amount of work, time and interest that he has invested in this matter. Of course, owing to the timing of his assuming office, the issues raised in Bamford Review have been prevalent both in his work as Minister, and for members of the Committee for Health, Social Services and Public Safety. I would like the Minister to attend the meeting of the Committee for Health, Social Services and Public Safety when we discuss this issue. Most people want action, not a duplication of work. It would be very useful if the Minister were available to give Members a briefing on what work that the Department has done to date, so that there is no duplication of that work. Answers to this huge problem must be found, and they must be found quickly so that no other families have to go through the awful pain and loss that far too many have suffered so far. I support the amendment. Mr Savage: I commend the Members who brought this most important matter before the House. It is certain that Members are united in the view that this is an issue on which urgent action must be taken. Young people — and those who are not so young — cannot be allowed to be left isolated, vulnerable and bereft of help. Suicide in Northern Ireland is at an all-time high. In 1996, as was said earlier, there were 143 suicides, yet last year that figure had more than doubled to 291. Since I wrote this speech on Friday, that number has increased again. In my constituency of Upper Bann in June this year, five teenagers in and around the Craigavon area tragically took their own lives, and left empty seats in the classroom, empty places at the dinner table, and an ever deepening void in the hearts and lives of those who knew and loved them. Statistics, sadly, are only that. They do not show the character that people possessed, or their skills, talents and abilities — they become only a number. Sadly, the true extent of this tragic problem in our society remains unknown. Currently, it is believed that one person a day in Northern Ireland takes his or her own life, and that is one person too many. How do we end this? How do we protect our young people, and those who are in a different age bracket? How do we protect those who are most vulnerable? I welcome the initiatives that my colleague the Minister of Health, Social Services and Public Safety has taken recently. I commend him for doing so, and I believe that they will make a difference. However, the following points were raised in the Bamford Review, which, I believe, if implemented, would reap the benefits in the future: suicide prevention must be made a public health priority; a suicide-prevention strategy must be developed with an identified action plan that will target dates and responsibilities; suicide prevention must be properly resourced; and a regional mental-health promotion directorate should be created to ensure the implementation of the proposed suicide-prevention strategy. 1.45 pm If we are to achieve anything from this debate, it must be that all of us begin to help bring about a major culture change in society; where seeking help is seen as a sign of strength, not as one of weakness. Together, we must bring an end to the silent hopelessness that haunts thousands of people in our cities, towns, villages and remote rural areas. In doing so, we will help them to feel that there is hope, that help is available and that things can change and improve. We have heard much talk of a phone-in helpline. That should be in place, and when someone rings for help there should be someone on the end of the line. A problem shared can be a problem solved; and sharing problems can go a long way to saving lives. I support the motion. The Minister of Health, Social Services and Public Safety (Mr McGimpsey): Like everyone else, I am deeply concerned about the increasing numbers of people who are dying through suicide, and I reaffirm my commitment to do all in my power to improve mental health services for those who are in crisis and at risk. Suicide is recognised worldwide as the third biggest cause of years of life lost, after cardiovascular disease and cancer. An estimated one million lives are lost annually to suicide. That is not only a tragic loss of life, but also leaves a difficult legacy for families and local communities. The problem is complex and many-faceted, and there are no clear short-term solutions. Some individuals show signs of risk and can be targeted for additional support and services. In others, warning signs may be absent or less obvious, and therefore they are much more difficult to reach and support. There is no easy answer; there is no quick fix. If we are to turn the tide and have a reduction in the rate of suicide in Northern Ireland, we will all have to work together — statutory bodies, communities, voluntary organisations, the media and local churches — and take a long-term view. Reducing the rate of suicide is a big challenge. We have only to look at the recent significant increases in the suicide rate to realise that. The media has an important role to play in helping to prevent suicide and in promoting positive mental health and well-being. I therefore welcome the commitment made recently by local editors on World Suicide Day. The issue requires very careful handling by the media because it is possible to worsen the situation through excessive or inappropriate reporting. Sometimes, when we are attempting to play things down or calm a situation, we inadvertently talk it up. We are all obliged to act responsibly and maturely on the issue. Lives are at stake through contagion, especially among our young people. We must monitor the situation most carefully right now; the issue is seldom out of the news. It is estimated that Northern Ireland’s mental-health needs are at least 25% greater than those of England. Suicide is one manifestation of poor mental health in our population. Many factors affect mental health and well-being, and a range of policies relating to alcohol and drugs, sexual health and abuse or violence can contribute to a reduction in suicide. It is difficult to tackle suicide in isolation and outside the context of a wider strategy to improve mental health and well-being. I therefore urge the Assembly to continue to address the issue in an integrated way. I accept that mental-health services are not good enough. We all know that those services have been underfunded for years and that we are now trying to redress the balance. The Bamford Review, which has recently been finalised, has shown that there is a clear need to reform and modernise mental-health services to bring about improvements. Prevention is a key element in improving services; and I am fully committed to that. I have recently established the Mental Health and Learning Disability Board, which has already had its first meeting. I expect that board to champion the cause of those with mental-health and learning disabilities and to be a driving force delivering the Bamford reforms. I intend to meet the Chairperson and the board regularly. My Department has already taken on board recommendations from the Bamford Review; however, I emphasise that all relevant Departments and statutory bodies must be involved in developing a joined-up response, and in reshaping services. The Northern Ireland suicide prevention strategy, ‘Protect Life: A Shared Vision’, published in October 2006, provides a comprehensive route map for tackling this tragic issue. I take the opportunity to acknowledge the key roles played by many bereaved families, their local communities and support networks in the development and ongoing implementation of the strategy. Their commitment has been matched by the dedication of many health professionals. This year, over £3 million has been allocated to support the implementation of the Northern Ireland suicide prevention strategy. A substantial amount has been allocated to support local communities in the development of initiatives to tackle the rising suicide rate. Several pilot schemes operate locally that were established to assist with the implementation of the strategy, including a telephone helpline and mentoring services for those in crisis. In addition, having listened to feedback from local communities, and in response to the rising levels of local suicides, I recently announced the establishment of a Northern Ireland telephone helpline for suicide prevention, with associated counselling and mentoring support services. I anticipate that the service will come on stream by the end of this year. The pilot scheme in north and west Belfast has proved to be seriously overused, which demonstrates its value. Research suggests that GP training in depression recognition and treatment can have a positive impact on the level of suicide. Therefore, a new depression-awareness training programme has been developed and is being rolled out across Northern Ireland. To date, 161 GPs, and 71 practice managers and nurses have participated in the programme, and I anticipate that a further 200 GPs will have done so before December 2007. I am looking at ways to encourage greater uptake of the training among GPs, and will continue to work proactively with the British Medical Association’s (BMA) Northern Ireland General Practitioners Committee (NIGPC) on the issue. Much other work is under way, including research into the underlying causes of suicide and the development of a public information campaign. A crisis intervention service is now available in all areas. Furthermore, a service specifically for under-18s is now operational in the Eastern and Southern Board areas, and is being put in place in the northern and western areas, where recruitment is under way. That has been achieved despite delays caused by difficulties in recruiting appropriate staff. I am increasingly concerned about the impact that the internet can have on vulnerable people, especially in times of crisis. In London, in July, I met internet industry stakeholders, including Bebo, Google and Vodafone, to highlight my concerns in some detail. Those involved in the meeting have responded positively. In particular, they have highlighted their intention to continue to promote positive mental health, and to encourage people to seek help and support in times of crisis. I intend to meet the stakeholders again in the near future. I am also concerned about the correlation between drug and alcohol misuse and suicide among young people. Alcohol and drugs decrease inhibitions, and increase the likelihood of suicide attempt by a depressed young person. American research suggests that one in three adolescents were intoxicated at the time of their suicide attempt. Therefore, I intend to focus on prevention and intervention in drug and alcohol misuse, as I believe that that will impact on adolescent suicide rates. Suicide respects no borders, and many of the issues we face will also be challenges for colleagues in England, Scotland, Wales and the Irish Republic. It is vital that we share learning and best practice among our close neighbours. A group on suicide prevention has been established, which includes key representatives from England, Scotland, Wales, the Republic and Northern Ireland. The group is due to hold its next meeting in Northern Ireland in November 2007. The parallel implementation of the Reach Out strategy in the Republic is of particular relevance to Northern Ireland, as is the strategy in Scotland. The Department has developed an all-Ireland action plan in conjunction with the health service in the Republic. Soon, I will meet with Dr Jimmy Devins, a Minister of State at the Department of Health and Children, who has special responsibility for mental-health and learning disability, in order to discuss ongoing co-operation on that issue. The Health Service alone cannot successfully reduce suicide levels in Northern Ireland. Other sectors and Departments must play their part. The Executive established the ministerial co-ordination group on suicide prevention in order that they could do their part by co-ordinating action and by ensuring that suicide prevention remains a priority for all relevant Departments. The group, which includes the Minister of Education, Caitríona Ruane, and the two junior Ministers, Gerry Kelly and Ian Paisley Jnr, works together and has brought added focus to the issue. Several issues have been identified. Officials are examining how those can be taken forward. The Ministers will consider the issues further at its next meeting in October 2007. The co-ordination group has the potential to provide Ministers with the wider context and support that will allow us to work in an integrated and joined-up manner in order to deal with the devastating effect that suicide and self-harm has on all our communities. I have already stated my willingness and eagerness to work and engage with fellow MLAs in order to find out what input can be brought to bear by the Assembly. I also welcome the support that I have received from the Committee for Health, Social Services and Public Safety, which has already met with representatives from families bereaved by suicide from across Northern Ireland in order to listen to their concerns about the services that are provided and the available support. I accept that more must be done to develop mental-health services and to provide a better service for people, particularly those who are at risk of suicide in Northern Ireland. I welcome any input that can be brought to bear. Mr Buchanan: I support the amendment. Suicide is a complex issue that affects constituents throughout Northern Ireland. Indeed, I am sure that every Member in the House knows of a family that has suffered the loss of a loved one through suicide. When a suicide occurs, it not only brings grief and sorrow to the family concerned but leaves behind a stigma and raises questions among the family members about whether they could have done more to recognise the signs that led to the suicide. Although those families cry out for help, there appears to be little assistance available to them. In recent years, Northern Ireland has witnessed an increase in the number of people who die from suicide and acts of self-harm. Statistics show that Northern Ireland has more suicides per 100,000 people than England and Wales, although that figure is less than levels in Scotland and the Republic of Ireland. When they are taken in isolation, suicide statistics indicate a substantial public-health issue that generates tremendous public concern. However, media reporting of individual cases highlights the human tragedy that is associated with suicidal behaviour. The statistics also suggest failings in existing prevention strategies and resources that have been put in place to tackle suicide, as well as inherent limitations in mental-health services for children and adolescents throughout Northern Ireland. In addition to the costs that are associated with suicide — the lives that have been lost and the trauma that bereaved families in local communities experience — it has been widely acknowledged that suicide and self-harm can generate significant economic costs. According to ‘Protect Life: A Shared Vision — The Northern Ireland Suicide Prevention Strategy and Action Plan 2006-2011’, there were 146 suicides in Northern Ireland in 2004. That figure equates to 4,350 potential years of life lost for that year. Associated with each suicide are the direct costs of a post-mortem and a funeral, as well as the indirect costs, such as the value of potential earnings lost. Subsequently, the total estimated cost of suicide in Northern Ireland in 2004 was in the region of £202 million. That figure represents £1·4 million for each suicide. Those figures, combined with the significant human tragedy of suicide, imply that the development of successful prevention strategies may generate significant economic returns. Moreover, there are the obvious benefits of saved lives and the avoidance of emotional trauma. 2.00 pm A phrase that is often used about suicide is that it is a permanent solution to a temporary problem. While that comment can be applied to anyone who has been affected by suicide, it has frequently been associated with the education of adolescents and young adults in addressing their concerns about suicide and self-harm. The point is often made to young people who are considering taking their own lives that, whatever the nature and source of the emotional stress and pressure that is influencing them, advice and support can be given that can lessen that burden. The difficulty in getting that message across to young people — particularly to young adult men — is reflected in recent findings that 41% of young males under the age of 35 who took own lives were in contact with their GPs during the year before their deaths. Members have heard how suicide has affected so many families. I commend the Chairperson of the Health Committee, who proposed the amendment to the motion. I was intrigued by the list of goals and guidelines that she outlined. Families across the Province are being torn apart because of suicides. Suicide is an issue that must be tackled by the Health Committee — that is the proper vehicle and the proper way in which to deal with the matter. During the course of the debate, Robert Coulter mentioned awareness training for teachers, ministers of religion and others working with young people. That must be given consideration. Carmel Hanna spoke about training for GPs and the full implementation of the Bamford Review. Again, that must be considered by the Health Committee so that all the measures that are recommended in that report are put in place. Naomi Long spoke about the removal of the stigma associated with mental-health issues. That too is a big issue; there are many people who do not want it to be known that they have mental-health problems. If the stigma of mental-health issues can be overcome, that may help to solve some of our current problems. Undoubtedly, the issue will be raised in a future meeting of the Health Committee. We believe that that is the proper vehicle in which to deal with the issue. Ms Ní Chuilín: Go raibh maith agat, a Cheann Comhairle. Much has been said during the debate, and everyone who has spoken has made a valuable contribution to the debate. I ask that the Official Report of the debate be made available to the Health Committee, because we will consider it as a source of reference. Members’ valuable contributions must not be overlooked. Equally, while the contributions are valuable, they must be translated into actions. The Statutory Committee’s inquiry will be one way of achieving that outcome. I was delighted to hear Mr McGimpsey, the Minister of Health, Social Services and Public Safety, outline all of the actions that have been undertaken since May 2007. There has been much ongoing work. He also conceded that, while we are all doing good work, we need to do more. The Health Committee will add to that body of work. At the start of the debate, my colleague Gerry Adams said — and every other Member has also mentioned — that the number of people who are ending their lives or harming themselves is increasing. To take the issue of road safety, for example: when we see youngsters playing football in a street full of parked cars, our instinct is to look out for them. We need to develop a similar instinct for looking out for each other, because very often we do not know that people are vulnerable until it is too late. I pay tribute to the bereaved families and those who are caring for people with mental-health problems, because they have a mighty fight. We need to support them up that hill. Many people ask why, and that question was woven throughout the debate today. We ask what we can do, and what we can do together. It is very clear from the debate that by listening to one another, talking together and working together, we can make a difference and help those who are often trying to help themselves in very difficult circumstances. We heard from some groups that we met this morning that some of the difficulties are around burnout. The funding for community groups is very sporadic, and the Minister has recognised that. Even the funding for the Protect Life strategy and other strategies that fall within the remit of this House is piecemeal. The strategies are often cross-cutting, but they are also often piecemeal. So, in a sense, the ability to plan and sustain and retain what services there are is often threatened. We must consider that issue as well. The Committee Chairperson, Iris Robinson, and Thomas Buchanan both said that suicide is a: “permanent solution to a temporary problem”. That really had an impact on me. We have all had difficulties, and it is really a matter of how we deal with those difficulties and of whether we have the support to deal with them. What do we do within Government, schools, churches and the community? We must listen to those who are working in the field and those who have had experience of suicide. We need to promote awareness of suicide and self-harm, and we need broad-based support for suicide prevention. That is the minimum that is required. We must also be realistic and honest. From time to time, the money that has been allocated for suicide prevention or mental-health issues has gone elsewhere. Action must be taken to address that. The Minister outlined the role of the media, and Alex Easton talked about the campaign in some of the papers. From young kids I hear about Bebo, YouTube and other technologies that mean nothing to me, but I recognise that the Internet is a very powerful tool. We must commend the fact that steps have been taken to outline the responsibility that Internet and other telecommunication providers have. Lord Morrow mentioned the effects of the conflict, and Martina Anderson spoke about the need to remain connected to each other. In terms of our empowerment, what happened in the past cannot be divorced from this process. The indelible marks of the conflict are on us all, and they have been proven to have been passed down to our kids, so they go from one generation to another. The last thing that any of us wants is to be in the situation that the Rev Robert Coulter has been in. Perhaps not as ministers, but as politicians, neighbours, brothers, sisters or partners, we have all sat in too many wake houses where people have ended their lives. It is very frustrating. The Bamford Review is about mental-health and learning difficulties. There is the Protect Life strategy, and there will be this Committee investigation. We need to mop up all the evidence and look at the issue again. Even when the investigation ends, we will still need to review the situation. Things change, and, unfortunately, they change at a pace. More people are ending their lives and harming themselves, and more carers are being put under pressure. We cannot resolve this matter ourselves, but we can start by having a good look at the issue. Daniel McCartan was a constituent of mine. A report in June found that there were serious flaws and failures at the core of the mental-health services. We must learn lessons from what happened to the McCartan family, and we must do everything that we can to ensure that it does not happen again. However, I imagine that that will be considered in the inquiry. I commend all the Members who have spoken today — and previously — on the matter. The Minister of Health, Social Services and Public Safety said that he and the Minister of Education, Caitríona Ruane, and the junior Ministers, Gerry Kelly and Ian Paisley Jnr, are also part of a team. Given that we need to hear what our young people are saying, I am delighted to hear — as are other Members — that counselling services will be available in primary schools. We cannot wait until it is too late. We cannot wait until those people are young adults, or even until they get to our ages — a variety of ages is represented in the Chamber. It is hard to ask for help; therefore, we must make getting it easier. We must also ensure that every step that can be taken is taken so and that the people who are so often let down can get the help that they so frequently ask for. I accept Lord Morrow’s view that the House should not divide. Therefore, I beg to ask leave to withdraw the motion. Go raibh maith agat. Motion, by leave, withdrawn. Mr Speaker: The next item of business will be questions to the Minister of Education. The Assembly is suspended until 2.30 pm. The sitting was suspended at 2.11 pm. On resuming (Mr Deputy Speaker [Mr McClarty] in the Chair) — 2.30 pm Education Youth Outreach Expenditure 1. Ms S Ramsey asked the Minister of Education to give a breakdown of departmental expenditure on youth outreach work. (AQO 92/08) The Minister of Education (Ms Ruane): The Department allocates an overall budget of approximately £32 million for youth services. Of that, £1·82 million has been allocated in 2007-08 for outreach and detached youth workers. The youth outreach initiative, specifically funded through the children and young people funding package, was allocated as follows: £205,000 to each of the four education and library boards outside Belfast, focused on rural areas and small conurbations near rural areas; £205,000 for YouthNet, focusing on dealing with young people who are isolated because of their gender, disability, because they are from an ethnic minority community, or from a lesbian, gay, bisexual or transgender group. The Department also allocated £437,000 for detached outreach youth workers in Belfast; £250,000 for detached youth workers, under the renewing community initiative in Belfast; and £108,000 for peer educators carrying out similar work, focused in south and east Belfast. It is essential that those limited resources are prioritised according to need. Therefore, I have asked departmental officials to re-examine, with colleagues in the education and library boards, especially in the Belfast and South Eastern Board areas, the deployment of outreach workers in areas of objective need. Ms S Ramsey: Go raibh maith agat. I thank the Minister for her detailed response to my question and I also welcome her commitment to re-examining because it is my understanding that Belfast was left out of the funding bid under the children and young people funding package. Can the Minister give an assurance to people in my constituency of West Belfast that outreach workers will be provided in what is clearly an area of need? Ms Ruane: The roles of outreach and detached youth workers are important because those workers try to reach young people to encourage them off the streets. They are skilled at engaging with young people and, having made some contact and established a degree of understanding and trust, they work to determine what young people’s needs are, how they can be met, whether they can be helped by existing services. They then work with other agencies to develop strategies. It is difficult work and it should not be underestimated. The statutory providers, who deploy and support those workers, are experienced in that approach to meet urgent and critical needs. The youth sector is only one of a number of agencies and services involved in helping to address issues affecting young people. In the West Belfast constituency, there are wards covered by Belfast Board workers and wards covered by South Eastern Board workers. In the Belfast Board, there are four qualified, detached, outreach workers and there are four trainee, detached, outreach workers in west Belfast. There are four outreach workers funded through renewing communities. In the South Eastern Board, there are five outreach workers, funded under the children and young people funding package. That outreach work is focused on rural areas and their communities groups of interest, under section 75 of the Northern Ireland Act 1998. I am aware that the focus on rural areas restricts the ability of the board to deploy outreach workers in urban areas, but there are questions for the Department on that. The Department has made a bid to secure the funding currently available for outreach workers through the comprehensive spending review and, if successful, the deployment of those workers can be reviewed. It is essential that the limited resources are prioritised according to greatest need and, as I said earlier, I have asked my officials to examine, with colleagues in the South Eastern Education and Library Board, the need for outreach workers in Poleglass and Twinbrook. Twinbrook is the 20th most deprived ward in the North under multiple deprivation and the 17th most deprived ward under education statistics. Mr Elliott: I thank the Minister for some of those answers. Does the Minister have any thought or plans to change any of the responsibilities or roles of Sure Start when it comes under the remit of the Department of Education this year? Ms Ruane: I thank the Member for his question. Previously, the Assembly had a good debate on the importance of early-years education, and that is an area that must be further developed. If the Assembly is serious about tackling disadvantage and giving young people a start in life, particularly those from the most disadvantaged areas, the early-years strategy must be right. I will engage with the Committee for Education to develop the Department’s existing strategy, and we will work together to devise the best possible programme. Mr Durkan: I thank the Minister for her earlier answer in which she highlighted the current budget for youth services. In the context of the review of public administration (RPA) and the establishment of the new education and skills authority, will the Minister assure the House that the resources, role and reach of youth services will be developed in the future? Ms Ruane: I am a passionate supporter of youth services. It is important to reach out to all young people, particularly those living in disadvantaged areas across the North. Members have seen what can happen when youth is marginalised. Many young people play a tremendous role in society, but there are others whom we are failing to reach. Recently, I visited young people in the young offenders’ centre at Hydebank Wood. While I was talking to them, I felt a real sense of sadness. They came from all communities, though mainly from working-class disadvantaged areas, and there were both Catholics and Protestants. Politicians have failed those young people by failing to provide resources to support them. Even when young people are in Hydebank, they do not receive the support that they should. It is essential to provide resources to young people across the board, but it must be done strategically. Members know that finding the money will be difficult given the comprehensive spending review (CSR). The Department must consider many issues, such as early-years education, youth provision, and finding more money for primary schools, and Members have been lobbying me on all of them. I am doing my utmost to ensure that the maximum amount of money possible is invested in youth services. As the process is not complete, I am not at liberty to say how much will be available. Indeed, I do not know the amount, but the Department has made some strong bids. Academic Selection 2. Mr P Ramsey asked the Minister of Education what the final date is for assuring the public that academic selection will end in 2008. (AQO 23/08) Ms Ruane: I assure the public that the transfer test will operate for the final time in 2008. My position on academic selection is well known. However, in the search for agreement on workable new arrangements for the transfer of children from primary to post-primary education, I am conscious of the continuing need to engage with those who hold different views. In attempting to find the best |