NORTHERN IRELAND ASSEMBLY Tuesday 3 June 2008 Ministerial Statement Executive Committee Business Adjournment The Assembly met at 10.30 am (Mr Speaker in the Chair). Members observed two minutes’ silence. Provisional Out-turn for 2007-2008 Mr Speaker: I have received notice from the Minister of Finance and Personnel that he wishes to make a statement on the provisional out-turn for 2007-08. The Minister of Finance and Personnel (Mr P Robinson): In June 2007, the Assembly voted to approve the spending plans for 2007-08 that were inherited from direct rule Ministers, and which provided for current expenditure of £8,259,000,000 and capital expenditure of £1,409,000,000 in budgetary terms. Today, I will report on the extent to which Departments have spent the money for which they bid and were subsequently allocated. In headline terms, the underspend by Departments was £177 million in respect of current expenditure, and £76 million in respect of capital investment. Members will be well aware that, through the Budget, Estimates and in-year monitoring processes, the Assembly continues to spend a significant amount of time and effort debating the funding that is allocated to Departments. That reflects the importance of prioritising the limited funding that is available to the Executive in order to deliver the best possible public services to the people of Northern Ireland. However, Departments often put too great an emphasis on the size of their budget, rather than on the outcomes that they can achieve. Given that imbalance, and the relative lack of robust and timely information on outcomes, the actual expenditure of Departments against their plans must be considered as a proxy for delivery. There is little point in the best-laid plans being put in place if Departments do not subsequently deliver the planned services, primarily by spending the funds that have been made available to them. Although it is critical that Departments do not overspend, it is equally important to ensure that — to the greatest extent possible, and with due regard to value for money — the amounts that are provided are spent. Significant levels of underspend imply that fewer services have been delivered than had been planned, and that resources have been retained when they should have been redeployed to improve services in other areas. In that context, I shall provide Members with detailed figures of the actual spending levels by Northern Ireland Departments in 2007-08, with particular reference to performance against plans. Details of the provisional out-turns for each Department — covering current expenditure and capital investment — are set out in tables 1 and 2, which are attached to the printed copy of my statement. In my statement of 25 June 2007, I highlighted the fact that the Executive inherited a situation in which, in recent years, Northern Ireland Departments had underperformed when maximising the spend from funds that had been allocated to them. That situation has also been recognised by the Committee for Finance and Personnel, which advocated a 1% target for the maximum underspend rate for current expenditure. The provisional out-turn returns for 2007-08 indicate that the total current expenditure by Departments was £8·2 billion, which represents real terms growth of 4·9% in 2007-08. However, Departments spent £177 million, or 2·1%, less than had been planned. That headline rate is unchanged from 2006-07, and, given the significant efforts over the past year to improve and raise the profile of financial management, it indicates a somewhat disappointing performance by Departments. Members will not be surprised to hear that the overall underspend figures mask significant variations among Departments. The Department for Regional Development (DRD) was the best performer, with a 0·9% underspend, and the Department for Employment and Learning (DEL) was the worst, with a 3·9% underspend. My Department had the fourth-highest underspend at 3·1%; however, that is a significant improvement on the previous year, when it underspent by 10·7%. Although the Department of Finance and Personnel (DFP) clearly has some way to go to be the example to others that it should be, that improvement on past performance demonstrates the extent of change that is possible with a sustained focus on the issue. Other Departments such as the Department of Agriculture and Rural Development (DARD) and the Department of Enterprise, Trade and Investment (DETI) also managed to reduce their underspend rate compared with last year, and I urge them to continue the good work. However, it is disappointing that the Department of Health, Social Services and Public Safety (DHSSPS), DEL and the Department of the Environment (DOE) performed worse in 2007-08 than in the previous year. Although all Departments can rehearse excuses and highlight supposedly extenuating circumstances, the simple fact is that either their planning or their delivery mechanisms were deficient. Although I recognise that some Departments made good progress, in general, Departments are still some way from the ultimate goal of reducing the underspend rate to the Committee of Finance and Personnel’s target of 1% or less, and only one Department — DRD — managed to achieve that benchmark in 2007-08. The challenge for other Departments — including my own — is to match that performance level. In recent years, an area of particular concern has been the spending performances of ring-fenced central funds, which have often experienced substantial levels of underspend. Although the underspend rate for priority funding packages is lower than in previous years, it is still considerably higher than the average for Departments in current expenditure and capital investment. For example, the environment and renewable energy fund underspent by 13·5%, and the children and young people’s fund underspent by 4·3% on current expenditure. Those levels of performance justify the Executive’s decision, as part of the Budget, to mainstream those funds into departmental baselines in order to engender a greater sense of responsibility in Departments for the associated projects. That decision also obliged those Departments to consider how much of their increased allocations should continue to be targeted at areas that were previously funded from central funds. It did not mean — as some Departments appear to have suggested — that they could simply take the additional funding, allocate it to something else and then claim that they had no money left to meet pressures in areas that were previously funded from central funds. Given the greater potential for capital projects to be delayed and their greater propensity to be one-off or innovative in nature, Members will be aware that the percentage underspend on capital projects has traditionally been higher than on current expenditure. The provisional out-turn returns indicate that Northern Ireland Departments have delivered £1·1 billion in 2007-08 in net investment. That is the highest figure on record, representing real-terms growth of 9·3% on the year before. The consequence of that level of actual expenditure is that Departments have spent £76 million — or 6·3% — less than had been planned for. Compared with the performance of Departments under direct rule — when the rate of underspend reached 18·2% in 2005-06 — that outcome represents significant progress on past performance. However, although overall performance is reasonable, that outcome is the consequence of strong performances by two Departments: DHSSPS and DRD. I commend both Departments on their management of capital projects. Notwithstanding, below that high standard lies a great variation in performance between Departments, ranging from an 8% overspend by the Office of the First Minister and deputy First Minister (OFMDFM), to a 34·6% underspend by DARD. In total, five Departments had an underspend of 15% or more. I acknowledge the fact that DFP has performed particularly well as regards capital expenditure, with only DHSSPS and DRD having a lower level of percentage underspend in 2007-08. That is in contrast with the position in 2004-05, when DFP had an underspend of 88·3%, and hence had spent only 12% of its allocated funding. Although the headline performance is one of continued improvement, as with current expenditure, the position needs to be seen in the context of the substantial amounts of reduced requirements and re-profiling requested by Departments during the year. If Departments are serious about delivering on time the infrastructural improvements set out in the investment strategy, that level of performance must not be repeated in the coming years. Although I have focused on the importance of avoiding excessive levels of underspend, it is equally important to emphasise that Departments should ensure that they do not overspend against their approved allocations. Unfortunately, two such cases have arisen this year: the Department for Social Development (DSD) and OFMDFM. Although the Executive will, of course, want a full explanation for the reasons for that overspend and will wish to consider the appropriate response, it is also essential that we ensure that, as has been the case in the past, an unreasonable fear of overspend does not drive higher levels of underspend. I have heard it said many times that one gets shot for overspend, but simply flogged for underspend. However, I believe firmly that we must ensure that there is a proportionate view of those two wrongs. In that context, I ask which is really worse: a small overspend, or a failure to deliver hundreds of millions of pounds of public-service improvements both promised to and paid for by the public, at least in part, through their regional-rate payments? The answer is, of course, that both are to be avoided, but we must recognise that, if we are to reduce substantially the level of underspend, the risk of overspend will increase. I appreciate that that is a difficult issue, as the principle of avoiding overspend at any cost has rightly been at the heart of public-expenditure control for many years. I will want to consider that issue further with my Executive colleagues, but I am clear that, as in other areas, we need to be prepared to challenge accepted practice if we are to secure the sort of improvements that the Executive aspire to achieve. Although I have set out the 2007-08 provisional out-turn position for individual Departments, the Executive as a whole are facing the key emerging issue of equal pay for some grades in the Northern Ireland Civil Service. Although more work is required to establish precisely the level of funding that will be needed to address that problem, it is clear that the costs will be material and will have clear implications for public services here. One option that we are currently considering is whether some of the underspend declared by Departments for 2007-08 should be used to fund part of the equal-pay claim. That will mean that that funding would then not be available for future years, and hence would have a clear cost as regards the future delivery of public services. 10.45 am The Executive must, therefore, take great care in balancing the need to ensure fair and equitable treatment for staff with the imperative of delivering the best possible services for all of the people of Northern Ireland. Work on that is progressing, and the Assembly will be given an update later this month as part of the June monitoring statement. The challenge of financial management manifests itself as not only the level of spend against plans, but as the monthly profile of spend throughout the year. Departments continue to demonstrate a clear profile of steady spend throughout the year, with a significant surge in expenditure towards the year end. Although there may be legitimate reasons for that, it raises concerns whether that expenditure represents value for money or simply reflects a “use it or lose it” mentality in Departments. Despite concerns regarding underspend, and the timing of access to the Executive’s end-year flexibility (EYF) stock, I prefer the adage that “no spend is better than bad spend”. It is important that Departments recognise that, under the Treasury’s existing end-year flexibility arrangements, although the amounts underspent might not be automatically available in subsequent years, they will be available at some point and are not, therefore, lost to the Executive. Furthermore, the skewing of expenditure towards the end of the year implies that spending has been delayed. Although that phenomenon is not recognised in the headline figures, months, weeks or even days of delay can be important with regard to public services, whether new textbooks for schools or the repair of potholes. Although the starting figures on underspend send a strong signal to Departments that they need, substantially, to raise their game with regard to performance in general and financial management in particular, there is an equally compelling message to those Ministers who seek to press for additional funds. Over the past 12 months, I have been subject to subtle, and some not-so-subtle, approaches from Ministers to increase the funding allocated to their Departments. With resources becoming increasingly tighter, I — and, I am sure, my successor — will not countenance the allocation of funding that simply sits unused. That is not acceptable to me, as I am sure that it is not acceptable to Members, or to the general public, who have waited long enough for the return of locally-accountable Government to deliver improved services. Although I commend the progress that has been made by some Departments in reducing underspend, much more can be achieved, individually and collectively. Although ultimate responsibility for that rests with accounting officers in Departments, there is a role for DFP, Ministers and the Assembly. The steps that have so far been taken to improve financial management skills and raise the priority given to financial issues may not yet have had sufficient time to bed in, and will, therefore, have an impact on the level of underspend for 2008-09 and beyond. That on its own, however, may not be enough, and other options must be considered to provide a stronger incentive for improved performance. Those include setting targets and sanctions at organisational and individual levels, and taking greater account of a Department’s underspend performance when prioritising funding, or even revisiting the Budget allocations. Moreover, Assembly Committees have a role to play, and I look forward to reports of the challenges from Committees to their respective Departments on their underspend performance. The Executive has set out a challenging programme of work to improve the lives of people in Northern Ireland over the next three years. We must not fall at the first hurdle as a result of an inability by Departments to carry out the fundamental act of spending the funds that have been allocated to them, thereby delivering the planned level of services. Spending plans will be informed by the ability of Departments to spend what they have been allocated, or to make that money available to others as early as possible in the process. The Chairperson of the Committee for Finance and Personnel (Mr McLaughlin): Go raibh maith agat, a Cheann Comhairle. I welcome the Minister’s statement, and support its robust criticisms about underperforming Departments. The figure of 2.1%, or £177 million, underspent in current expenditure is disappointing, and is the highest rate of underspend in the past four years. That performance is especially disappointing given the tight public expenditure environment and the need to maximise the impact of available resources. The Minister referred to the target that the Committee for Finance and Personnel proposed in its report on the draft Budget for 2008-2011, which advocated a maximum rate of underspend of 1% for current expenditure. The Committee arrived at that conclusion following analysis of previous patterns of underspend here and in other jurisdictions. Experience and practice elsewhere have demonstrated that that target is achievable. Therefore, given the emphasis that the Department and the Committee have placed on robust financial management in Departments, what additional steps can be taken to address the culture of underspend in Departments, which has been inherited by the Executive? Will the Minister also state how the underspend in his Department has affected delivery of services in 2007-08? The Minister of Finance and Personnel: I thank the Chairperson and members of the Committee for Finance and Personnel for taking a great interest in the performance and underspend of each Department. Additional steps could be taken, but some of those might be considered to be too revolutionary to be accepted by the Executive. For example, at one point, I asked officials to rework mechanisms in the Civil Service so that the Department of Finance and Personnel could have a presence in the finance sections of each Department. That would have enabled DFP to obtain a better level of information, because it is only after a financial year is over that DFP obtains a clear picture of each Department’s final position. As has been seen, Departments hold on to money unnecessarily, rather than give it up at an earlier stage to enable it to be spent elsewhere. At an individual level, accounting officers could be made more accountable with respect to underspends — for instance, it could be one of the factors taken into account in relation to bonuses earned in the senior levels of the Civil Service. However, one option that is open to us all — and which I would consider seriously — is that where there is a pattern of underspending by a Department, it should be taken into account when determining that Department’s future year allocations. Indeed, a case could be made for reviewing the allocations for the remaining years in this comprehensive spending review period to take into account the inability of Departments to spend their money. Therefore, there are several sanctions that we need to consider, because we simply cannot continue to have a situation whereby £177 million that could have been spent in Northern Ireland in the last financial year was not spent. Mr Storey: I thank the Minister for his statement. What implications will the out-turn have on the Executive’s access to its stock of end-year flexibility? Have any negotiations taken place? If so, what was the outcome? The Minister also pointed out the important role of Statutory Committees, and he will be aware that those Committees are facing difficulties in receiving departmental submissions on monitoring rounds. What can be done to ensure that that situation does not continue? As a member of the Committee for Education, I ask the Minister for Finance and Personnel to comment on an accusation that was made by the Minister of Education on 20 May during a debate on the extended schools funding programme, when she said that funding for that programme had been cut because DFP had not provided sufficient funds for it. The Minister of Finance and Personnel: The Deputy Chairperson of the Committee for Finance and Personnel raised three issues. First, with regard to end-year flexibility, I said that although a substantial part of my statement focuses on the provisional out-turns of each Department, one pressing issue for the Executive relates to equal pay for some grades in the Civil Service. A significant amount of money will be required to deal with the six years’ back pay to which those members of staff are entitled under the law. We have already begun discussions with the Treasury about receiving an allocation from our underspend for that purpose. If successful, we would retain those funds, which would not be placed into the normal end-year flexibility stock. I emphasise that Members and, in particular, Ministers must be aware that, in the past, we were allowed to keep any underspend automatically, whereas we must now bid, negotiate and argue with the Treasury to receive that funding. It is conceivable that, because UK finances are tight, the Treasury could restrict future allocations if we do not use our allocations fully. Therefore, it is imperative that we improve financial management. It is a Committee’s responsibility to ensure that any papers that it requires are delivered. Committees have a statutory right to receive papers and to summon people to appear before them, and they must be more robust in demanding that information. If Members want me to investigate specific cases, I would be pleased to do so. Mr Storey mentioned education; I understand that a particular Department of Education programme required funding of approximately £4 million, and the Minister of Education decided — according to the headline in ‘The Irish News’ — to blame me for allocating insufficient funds. My answer to that is: just look at the Department of Education’s underspend of £50 million. With better financial management, the Department of Education could have conducted more than a dozen of those programmes. Mr McCallister: Does the Minister accept that the Department of Health, Social Services and Public Safety was much closer to achieving targets in the two spending areas than most Departments and, in particular, his own Department? Furthermore, does he agree that, because revenue reflects a pattern of need whereas capital is a planned process, tackling capital underspend should be easier and, therefore, is a more disappointing result? The Minister of Finance and Personnel: The figures show that the Department of Health, Social Services and Public Safety had the highest underspend of £54·8 million, whereas my Department had an underspend of £6·1 million. However, that outlines the amount only, and the Member’s reliance on percentages illustrates the Department of Health, Social Services and Public Safety’s massive allocation. I recall a debate during which I was told that the Department of Health, Social Services and Public Safety needed to receive an extra £300 million a year; it is difficult to swallow that point if the Department returns £55 million at the end of the year. However, I commend the Department of Health, Social Services and Public Safety for its record on capital allocation, which, as the Member said, is more difficult to control because legal planning and other issues can make it difficult to achieve the appropriate out-turn. Therefore, the Department of Health, Social Services and Public Safety shows mixed results — a large underspend of its resource but a good capital expenditure out-turn. Mr O’Loan: Given the demand and support for renewable energies, the environment and renewable energy fund’s underspend of 13·5% will cause disappointment. However, the public will welcome the news that the Northern Ireland Assembly’s allocation was underspent by £3·4 million, which is 7·6% of its budget. 11.00 am I commend certain Departments for their very good results. I wonder whether it is easier for some than others. For example, one can envisage that DRD can spend rapidly on roads maintenance; we all accept the great need for that, and that is an area in which spending can get going quickly. I accept the Minister’s comment that no spending is better than bad spending. Nevertheless, is there a model that Departments can replicate — namely, have in readiness meaningful schemes to use up budgeted funds — or can he say anything else about best practice that would prevent underspend and overspend? The Minister of Finance and Personnel: Let me start where the Member finished. The expenditure should all be planned; it should not be about holding things back that can be pulled out suddenly at the last minute if there is a bit of money left over. Departments should have plans in place to spend the money that is allocated to them. They should not keep money in reserve that can be pulled out of the hat at the last minute. The whole idea of a budgetary process is for Departments to look forward to what they want to accomplish during the following years and to utilise the funds that are necessary to achieve their targets. There should be plans for the expenditure of all that money. If a Department discovers that it is falling behind, as can happen in the case of capital funding and in resource funding, it must free up the money as early as possible in the financial year so that other Departments can use it — or, indeed, it can bid to use the money for another purpose. That is a matter of financial planning; it is not simply a case of having something in a back pocket that can be pulled out if there is a bit of money left over. I share the Member’s disappointment at some of the high levels of underspend on renewable energy. I hope that mainstreaming those funds, rather than having them in the Executive priority funds, will help us to deliver better. Although some departmental underspend levels are bad, they are all better than the priority funds had been, which are somewhat detached from the Departments. The Member also asked whether it was easier for some Departments to reach their targets than others. He is right; we all see roadworks staring to appear more frequently in the last few months of the year as DRD uses up its allocation. That is no bad thing, however, because that work must be done. In that case, I am not so worried about the upgrade and the curve, because it is not simply a case of taking on work that would not otherwise be done. That work should be done, although the money for it is being used up at the end of the year. DRD’s record is exceptionally good, both in revenue and capital terms, and it has been able to plan its programmes well on both accounts. I hope that, to some extent, on the capital front, that is down to the assistance that was provided by a previous Minister, who introduced a preparation pool so that schemes would be prepared and ready to move as soon as funding was available for them. Some Members: Hear, hear. (Mr Deputy Speaker [Mr Dallat] in the Chair) Dr Farry: First, in what may be his last appearance at the Dispatch Box as Minister of Finance and Personnel, I acknowledge, on behalf of the opposition, the Minister’s contribution in that role. Although we may not have agreed with every decision that was taken, I certainly respect his mastery of his brief. Does the Minister see any correlation between the levels of current underspend and the Departments that are making bids under the monitoring rounds? Does he see the monitoring rounds as a means of enforcing a greater degree of discipline on Departments? How does Northern Ireland compare with the latest figures from our counterparts in Scotland and Wales, and the UK as a whole? Mr Deputy Speaker: I am not sure whether I should refer to the Minister as “the Government Minister”. The Minister of Finance and Personnel: Thank you, Mr Deputy Speaker. I thank the Member for his kind remarks. I, at least, am one of those who recognises the importance of the role of an opposition. I know that many of the Member’s criticisms are merely synthetic because of the role that he has in opposition, and that he feels that he has to make those comments. [Laughter.] The Member is right to draw attention not just to the issue of underspend at the end of the year, but to link it to the in-year monitoring rounds. Let us not forget that money that is given up during the course of the year, as well as money that is left over at the end of the year, is money that is not going towards expenditure that was planned at the beginning of the year. If one adds the amount that was given up during the in-year monitoring rounds to the end-year flexibility figure, one ends up, effectively, with underspend of £400 million. The original budgets that were set out at the beginning of the financial year have been underspent by about 4% or 5%. The figures are worse for capital spend, because only about 60% of the planned capital expenditure actually took place. Mrs I Robinson: As has been said, table 1, attached to the printed copy of the Minister’s statement, indicates that the underspend in the Department of Health was £55 million. The Minister has already confirmed that that money has been lost to Northern Ireland’s public expenditure. How can that underspend be reconciled with the Health Minister’s claim, during the Budget process, that his Department was underfunded by £300 million? Bearing in mind that those who work in the mental-health sector — the Cinderella sector — are crying out for resources, particularly in the areas of suicide and self-harm and units and beds for children and adolescents, does the Minister agree that that is an abysmal showing on the part of the Health Minister? The Minister of Finance and Personnel: There are two issues. First, let me make it clear that the funds are not lost to Northern Ireland plc, as things stand. We can seek the return of those funds, and they should be returned to Northern Ireland. It will be up to the Executive to determine how they distribute end-year flexibility when they get it. Secondly, the Department of Health is a massive Department. It receives half of the overall Budget for Northern Ireland, and it must filter money to a series of organisations. Therefore, it faces massive financial-planning issues. However, many people are waiting for hip replacements or heart bypasses, for example, and they may have been told by the professionals that the money is not available for their treatment. If they hear today that there is a £55 million underspend in the Health Department, they will ask questions. It is the job of the financial planners in the Health Department to ensure that they plan better to ensure that they use the money that is allocated to them. Simply asking for more money achieves nothing if they cannot use the money that has already been allocated. Ms J McCann: Go raibh maith agat, a LeasCheann Comhairle. All Members will share the concerns that the Minister has just outlined about departmental underspending and the effects that that has on essential front-line services. I was glad to hear his comments about Assembly Committees exercising a more proactive role in scrutinising their respective Departments’ budgets, especially in the run-up to monitoring rounds, where they can have an impact. Will the Minister comment on any direct effect on front-line services to the public that resulted from underspending in the Department of Finance and Personnel? The Minister of Finance and Personnel: By asking PEDU to examine one particular area of the Department of Finance and Personnel’s responsibility, I have indicated an area in which I think that there can be improvements. It is probably unnecessary for me to say more than that. As the Member will know, she and I could identify areas in which improvements could be made in any Department. If Departments are handing back money at the end of a financial year, we must ask why that money was not used to improve the services that we give to the community. These are very large sums. I recognise the difficulties that accounting officers and others face in ensuring that the plans that are set out at the beginning of the year — or, in some cases, three years in advance — are implemented. If our plans cannot be fulfilled, we must do better to ensure that funds are reallocated to where they will be of use. I accept the Member’s point about the Committee for Finance and Personnel. The target for the general level of underspend is about right — Departments should aim for an underspend in the region of 1%. Other Governments have achieved such levels of underspend; the Scottish Government, for example, reached a 0·1% underspend. I would be nervous about such a tight position, but the example shows that underspend targets can be achieved, with proper planning. We must raise our game to ensure that the public get a return for the money that they hand over in payment of their rates bill. Mr Weir: The Finance Minister indicated that underspend figures are set against February’s final-plan position. Will he advise how Departments have performed against what they were allocated at the start of the year? The Minister of Finance and Personnel: I will be happy to provide the Member with a table showing detailed figures for each Department. As I indicated to Dr Farry — Mr Weir’s fellow Member for North Down — overall, Departments fulfilled only 60% of their intended capital expenditure, and about 95% of their resource or revenue expenditure. If we have had to reallocate funds within departmental in-year monitoring rounds, the underspend figure is really 5%, rather than 2%. Mr McClarty: In light of the Minister’s response to Mr McCallister’s question, does he not accept that it is much more difficult to forecast revenue spend? For example, DEL’s expenditure on programmes is dependent on the decisions of individuals. The Minister rightly draws attention to his Department’s 3·1% underspend — the fourth highest of all the Departments. The Minister conceded that his Department has some way to go before it can set an example that others should follow. Will the Minister provide the House with some detail on how — and when — his Department aims to achieve the Committee for Finance and Personnel’s target of 1% underspend? The Minister of Finance and Personnel: I am not sure whether I have misinterpreted Mr McCallister or whether the Member misspoke during his initial remarks. It is more difficult to get close to zero underspend for capital than for revenue. Capital expenditure is very difficult to predict because it is subject to so many variables. Capital schemes are innovative by nature and, therefore, it is more difficult to develop a curve showing the trajectory of capital expenditure. Capital spend is often subject to the Planning Service, and the process is not always as prompt as we would like. Capital expenditure can also be subject to legal, roads and tendering issues. For example, tenders are often not within what we are prepared to pay, and there has to be a re-tender. Lots of things can go wrong in capital spend; revenue spend is much more predictable. Therefore, we should be able to get closer to our underspend target for revenue expenditure. That is not simply my general belief — statistics prove that to be the case. Underspend figures for past years show that capital underspend is significantly higher than revenue underspend. The Member’s second question referred directly to the Department of Finance and Personnel. The trajectory under direct rule indicated a worsening situation in the Department of Finance and Personnel. The level of underpsend increased from 7·1% in 2004-05, to 9·1% in 2005-06, to 10·7% in 2006-07. The trajectory is going in the other direction and has been reduced to 3·1%. With hard work, the position has been turned round. Far from being critical of my officials, I recognise that they have reversed the trend in my Department and been able to reduce the underspend. Those figures relate only to current expenditure. With respect to the capital budget, the underspend in 2004-05 was 88·3%; in the following year, it was 73·4%; the year after that, it was 18·3%; and now I have reduced it to 4·6%. Therefore, I take the applause from the Ulster Unionist Benches for transforming the situation in the Department of Finance and Personnel. 11.15 am Ms S Ramsey: Go raibh maith agat, a LeasCheann Comhairle. I agree with the other Members who have spoken. The public will not care about the reasons for the £177 million underspend, come the back of numerous debates in the Assembly. In answer to a previous question, the Minister said that the money would not be lost to the Executive with the passing of time. Can he explain that to us? I believe that the money will be lost to Departments, for it will be transferred to the central fund. Does the Minister believe that senior civil servants in all Departments take their talents and experience with them when they move from one Department to another? The permanent secretary of the Department of Health previously worked for the Department of Finance and Personnel. Where did that all go wrong? The Minister of Finance and Personnel: We could have a long debate about that last point. The Member is absolutely correct that as soon as there is an underspend in any Department, the money is lost to it. The £55 million underspent in the Department of Health is lost to that Department. It will stay in the Treasury. The Executive will have to bid for the return of all the money underspent in this financial year from the Treasury. If we cannot persuade the Treasury to release that money to settle the equal pay issue, I suspect that the Treasury will want to spread the return of the money over a number of years. As the money comes back to Northern Ireland, the Executive can allocate it. The Executive will receive bids from the Department of Health and from other Departments. If a Department has an underspend, there is no guarantee that it will get that money back. It will have to bid for it, as will every other Department. Mr Hamilton: After encouraging indications earlier in the year, and in the monitoring rounds, of improved financial management in Departments, there has been a deeply disappointing out-turn from some Departments. That makes a compelling case for application of some of the sanctions described in the Minister’s statement. Will the Minister confirm to the House that he will consider making senior civil servants ineligible for bonuses if their Departments continue to underspend so badly? The Minister of Finance and Personnel: I hinted earlier that the award of a bonus must reflect good value given by an individual in his public service. If ensuring that the public service fulfils the plans laid by the Executive is a key objective, then it must be a factor in how well that person has performed. The Member’s suggestion that it should be the only factor and the whole bonus should depend on it is draconian, but it is certainly one factor and, therefore, the bonus should reflect to some extent the ability of the accounting officer to meet the targets that have been set. Mr McQuillan: I thank the Minister for his statement. Has the impact of the Northern Ireland Civil Service equal pay policy been factored into the underspend figures? The Minister of Finance and Personnel: It has not. The figures that I have outlined are the provisional out-turns for the Departments based upon the allocations made to them. The underspend of £177 million leaves us with two arguments that might be deployed against the Treasury. The first is that direct rule left us with the problem of equal pay, and therefore, the United Kingdom Government should stump up to remedy that. Secondly, if they are not prepared to do that then we should be able to use some of the funds that were not spent to deal with the costs that we will incur in back payments to meet equal pay requirements. Mr B McCrea: There appears to be a significant difference of opinion between the Minister of Finance and Personnel and others about whether capital expenditure or revenue is the most difficult to forecast. I ask the Minister to demonstrate his command of the detail and explain how in the Department for Employment and Learning — which he mentioned — more than two-thirds of the original £733 million produced an underspend of less than three-quarters of one per cent. That position is highly acceptable. Does he agree that the underspend occurred in demand-led areas, which are difficult to forecast? Does he also accept that planned overspend was reduced to try and meet the budget? Does he consider that that reduction had an adverse effect on the profile, which, I see from the chart, peaks at the end of the financial year? Does he think that the party-political-bickering that we see, in which one Department plays off another, is helpful as regards collective responsibility? Will he explain to the people of Northern Ireland why the Minister of Education appears to have a £50 million underspend but cannot find money for extended schools? That inconsistency can be applied to any Department. Why is that being allowed to happen under our financial regulations? The Minister of Finance and Personnel: Let me settle the issue, because it is not merely about the Member’s opinion or mine. There is statistical evidence, and the statistics are fairly stubborn. The Member can put whatever excuses he wants into the ether, but the figures show the reality. There are significantly higher amounts of underspend in capital expenditure than there are in resource expenditure. Mr B McCrea: Why is that? The Minister of Finance and Personnel: I will inform the Member of the reasons again, because I suspect that he needs to be told three times before he understands. First, it is more difficult to predict capital expenditure because the projects involved are often novel, one-off experiences. Departments are unable, therefore, to benefit from a learning curve or by drawing on the knowledge of previous capital expenditure projects. Secondly, capital expenditure relies on planning, tendering, legal issues and a Department’s ability to get workmen on and off site in a given time. In the 2007-08 financial year, there was an underspend of 2·1% in resource expenditure and 6·3% in capital expenditure. That should tell the Member something — it should tell him that since the underspend of capital expenditure is greater, it is more difficult for Departments to spend their full capital expenditure allocation. I do not look at out-turns as being a case of comparing one Department with another, because I acknowledge what a Member for North Antrim Mr O’Loan said. Some Departments find it easier than others to use up money at the end of the year, and the Department for Regional Development is such a Department. Contrary to being party political, I commended the Department of Health, Social Services and Public Safety on its capital expenditure. It was able to return a low level of underspend. It is not right for Basil McCrea to point the finger at the Minister of Education and accuse her of being a terrible Minister because £4 million could not be found for a project although she had an underspend of £50 million, while saying that his Minister had an underspend of £55 million, which is all right. [Interruption.] Mr Deputy Speaker: Order. Please allow the Minister to respond. The Minister of Finance and Personnel: I have been fair in distributing criticism where it is due, and that criticism must be directed at departmental financial planners. It is not the Minister of Education or the Minister of Health, Social Services and Public Safety who carry out departmental financial planning — they crack the whip and ask what the out-turn figures will be, and whether the Department will meet its requirements. We have to be even-handed. No Department, with the exception of DRD, has done well in its current expenditure underspend — I did not notice that the Minister for Regional Development had just arrived. [Laughter.] The Department for Regional Development was the only Department that managed to get its spending within the target figures that were set by the Department of Finance and Personnel. Mr Ross: Several Members mentioned the debate on extended schools that took place in the House. During that debate, the Minister of Education indicated that, on numerous occasions, she had written to the Minister of Finance and Personnel to request additional funding. Will the Minister of Finance and Personnel state whether he responded to those requests? The Minister of Finance and Personnel: I believe that, on four occasions, I responded to requests that were made during the Executive-level discussions — I was going to call them negotiations — that take place between Ministers. I met the Minister of Education on many occasions, and she indicated the needs of, and her aspirations for, the Department of Education. The money that was allocated to that Department was increased as a result of each of our discussions. Indeed, the Minister can point out that her Department had one of the highest levels of increase in its budget. It seems that the Department of Education has more money than it can use and will therefore have to reduce its underspend in the next financial year or it will be one of the Departments whose future spending patterns will have to be reviewed. Mr O’Dowd: Go raibh maith agat, a LeasCheann Comhairle. The Minister of Finance and Personnel has made much of his call for efficiency, for funds to be directed towards front-line services, and for an end to bureaucracy in our system. I support that fully, as does my party. Does the Minister agree, therefore, that if we are to curb the underspend in the Department of Education, we must achieve all the aforementioned goals? Does he also agree that one way of doing that is to establish the education and skills authority, as proposed by the Minister of Education? Furthermore, does the Minister agree that if that authority were introduced, there would be a more-refined, leaner, keener machine that would ensure that money is spent? That would also allow for capital-build programmes to progress. I am aware of one of capital-build programme with an allocated budget of £21 million that has been delayed because of the bureaucratic system within which we operate. Therefore, does the Minister of Finance and Personnel agree that we must establish the education and skills authority and start making changes in education? The Minister of Finance and Personnel: I do not intend to get too involved in the policy issue, but I remind the Member that, although there are always ways of doing things cheaply, we must do things to the highest level in order to get the best return. For instance, if there were three bodies rather than one education and skills authority, it could be argued that that would allow a closer on-the-ground scrutiny of what was going on, resulting in savings being made. However, the financial outcome of such an undertaking is the kind of issue that we can leave the economists and others to argue about. We must recognise that every Department provides services, that those services must be provided in a way that offers the best value for money and that, often, that way is not the cheapest option. We must get the best value for money and cut out waste. It rattles me significantly that, at the end of a financial year, we find ourselves with £177 million unspent, while members of the public want improved services and have been denied the services that they desperately want and need. That is not a satisfactory situation, but it should not provoke an argument among Members, because the only issue that we should be concerned with is how to get a better return at the end of the next financial year. Rather than worrying about how much has been spent by any one Department, we should be concerned about ensuring that the underspend is reduced and that the ratepayers and taxpayers of Northern Ireland get the best value for money. North/South Ministerial Council — Transport Sectoral Meeting Mr Deputy Speaker: I have received notice from the Minister for Regional Development that he wishes to make a statement regarding the North/South Ministerial Council transport sectoral meeting. The Minister for Regional Development (Mr Murphy): Go raibh maith agat, a LeasCheann Comhairle. In compliance with section 52 of the Northern Ireland Act 1998, I wish to make the following report about the fifth meeting of the North/South Ministerial Council (NMSC) in the transport sectoral format, which was held at the Tí Chulainn conference centre in Mullaghbane, County Armagh on Wednesday 21 May 2008. The Executive were represented by Arlene Foster MLA and I, and the Irish Government were represented by Noel Dempsey TD. The Environment Minister, Arlene Foster, has approved the report, and I make it on her behalf. 11.30 am The Council noted and welcomed the progress that had been made since the last meeting in December 2007 and the chance to meet to discuss opportunities for cross-border co-operation on strategic transport planning and road safety. The Council discussed the positions of the A5 north-west gateway to Aughnacloy and A8 Belfast to Larne road projects, and noted the progress that has been made. I advised the Council that the A5 project is on target to achieve its first significant milestone — preliminary route corridor assessment — by late 2008. It is anticipated that the preferred route will be selected by mid-2009, and the draft statutory Orders published by late 2010. Beyond that, it is anticipated that a public inquiry will be necessary. Subject to satisfactory progress through the statutory procedures, construction could commence by 2012 and be completed by 2015. The Council also noted that several key milestones have been agreed, which can be aligned with the timing of payments from the Irish Government. On the A8 project, I advised the Council that development work is in progress on the proposal to provide 14 km of dual carriageway between Belfast and Larne. I confirmed that that project is also on target to achieve the first significant milestone of preliminary route corridor assessment later this year. Overall delivery is anticipated on a similar timescale to the A5 project. The Council noted and welcomed the continuing progress on the Irish Government’s proposals to replace the two cross-border bridges at Annaghroe and Knocknaginny on the Tyrone/Monaghan border. Monaghan County Council has appointed consultants to develop the design, and information evenings for the public were held in County Tyrone and County Monaghan in March. The issue of full community consultation on the proposals before the bridges open was raised by the Environment Minister and discussed. A further opportunity for public consultation will arise when the bridge design proposals are submitted for planning approval. The Council welcomed that progress and commended the excellent cross-border co-operation to date at official level. The Council noted that Louth County Council has appointed consultants who have begun a technical study on the construction of a bridge at Narrow Water — public consultation took place recently in Louth and Warrenpoint. The technical study, environmental impact statement and preliminary design work will be completed by the end of 2008. I reminded the Council that Roads Service has employed consultants who have undertaken a feasibility study for a Newry southern relief road, which would link the A2 Warrenpoint Road to the A1 just south of Newry. That study is also due to be completed later this year, and further reports on both projects will be presented to future NSMC transport sectoral meetings. The Council welcomed the close co-operation between officials on those projects, which it looked forward to continuing as the work on both studies progresses. The Council reviewed the progress since the last meeting on proposals for improving the Belfast to Dublin rail service. It noted that the two railway companies have considered options for redeploying additional existing rolling stock on the Belfast to Dublin line, which could improve the frequency of the service. Both railway companies are finalising proposals in the form of a costed business case, which will be presented prior to the next NSMC meeting in transport sectoral format. The Council welcomed the commitment from the Department for Regional Development to improve the railway line from Belfast to Derry. Ministers noted that the Department for Regional Development has agreed to undertake a study to consider the long-term social, physical and economic redevelopment of the railway throughout the north-west. Once the study is complete, its findings will be brought to a meeting of the NSMC in transport sectoral format, at which stage consideration will be given to a study of improved public-transport links with Donegal. The Council noted that City of Derry Airport had begun work on the runway safety improvement scheme, which is supported by £14 million of funding from the two Governments. Already, over £3 million of grants has been paid to Derry City Council. As a precondition of the grant scheme, Derry City Council is required to commit to a programme of reform for the governance of the airport. The Council noted that a commitment had been given to incorporate the airport into a company wholly owned by the local authority, followed, within an 18-month period, by the sale of the company, either outright or with Derry City Council retaining control of the airport land through a long-term lease. The Council noted that, in addition to the grant aid scheme, Derry City Council has funded the construction of a new taxiway and extended the aircraft parking apron. The Council noted the progress that is being made in reducing road deaths by the authorities on both sides of the border. It welcomed the continuing co-operation between the authorities on advertising, publicity and road safety in border areas and noted the potential for further liaison on key road-safety issues, such as drink-driving limits, road-safety strategies and cross-border enforcement. Ministers also requested an intensification in the work on a bilateral agreement on the EU Convention on Driving Disqualifications to ensure that it is brought into effect by late 2008 or early 2009. The Council noted that preparations are under way for a cross-border rural community transport project, which is expected to commence before the end of 2008. That project will involve community transport groups in the Fermanagh and Cavan border region. A report on the evaluation of the pilot scheme will be presented to a future NSMC meeting in transport sectoral format. The Council discussed sustainable transport, and noted that the Department of Transport has launched a paper entitled ‘2020 Vision — Sustainable Travel and Transport’ for public consultation. The Council also noted that a number of initiatives on sustainable transport are being progressed by the Department for Regional Development. The Council noted that officials met to share information and experience and to explore measures to promote sustainable transport. It looked forward to receiving specific cross-border pilot projects on sustainable transport for consideration at future NSMC meetings in transport sectoral format. The Council noted the ongoing work and studies being undertaken on rapid transit in Belfast, Cork, Limerick, Waterford and Galway. It welcomed the ongoing discussions among officials about sharing information and co-operation on that issue. Ministers welcomed the presentation from the Confederation of British Industry/Irish Business and Employers Confederation Joint Business Council on the findings of the report ‘Freight Transport Report for the Island of Ireland’. Ministers agreed that officials should consider the recommendations of the study that are relevant to the NSMC transport area and should report to a future meeting. The Council agreed to meet again in October or November 2008. Go raibh maith agat, a LeasCheann Comhairle. The Chairperson of the Committee for Regional Development (Mr Cobain): I thank the Minister for his statement. Is the real problem with the Belfast to Dublin rail service not related to the trackbed, rather than rolling stock? Unless work to the trackbed is conducted, there is little point in spending money on faster trains, which will not be able to run at full speed. That has been a problem with the Belfast to Derry/Londonderry line. I am sure that, like us, the Minister does not want to see such problems repeated on the Belfast to Dublin line. The Minister for Regional Development: The Chairman is correct to say that we need to improve the service and the system of rail network across the North and across the island generally. Of course we want to improve the Belfast to Dublin railway line. That not only involves investment in the rolling stock, but investment in the track itself. There are a number of problems with the track between Belfast and Dublin that cause the service to be slower than we would like. The general objectives are to provide more a frequent, faster and more comfortable service. In doing so, we hope to improve the usage of the service. One study that we considered recently estimated that, within 30 years, 40% of the population of Ireland will live on the eastern corridor between Belfast and Dublin. Such a statistic could be used to argue for investment in the rail network along that corridor, both locally and on the intercity network. Iarnród Éireann and NIR (Northern Ireland Railways) are preparing a business case to present to a NSMC meeting that will outline a range of options and associated costings about how to improve across a range of areas, including frequency, speed and comfort. We have asked for that report to be delivered to us in advance of the next NSMC meeting, which will enable us to consider and discuss the options, rather than simply receive them at that meeting. I look forward to receiving that, and to the continued support for increased investment in rail from the Committee for Regional Development and the Assembly generally. Mr Wells: Does the Minister recall that, just before he took high office, he, I and all the Assembly Members for South Down and Newry and Armagh signed a document in Newry stating that a southern relief road was essential to relieve congestion in that city? If so, does he believe that that is still the case? The Minister stated that negotiations are ongoing for a bridge at Narrow Water, near Warrenpoint. Will he offer an assurance that, should that project proceed, it will in no way prejudice the prospect of having a southern relief road that is required for South Down and Newry and Armagh? Such a road will relieve the chronic congestion that is currently strangling Newry. The Minister for Regional Development: I have no difficulty in standing over what I signed up to. I believe that there is an urgent need for a connection between the port of Warrenpoint and the M1 motorway between Belfast and Dublin. Such a connection is essential for the port and its continued expansion, and for the southern part of Newry into South Down to relieve traffic congestion. Despite what the Member might like, I will not fall into the trap of saying that those projects are in competition with each other. Even before I assumed what he referred to as “high office”, I always avoided the notion that the Narrow Water bridge project was competing with the southern relief road project. Louth County Council is currently conducting a study in relation to the Narrow Water bridge project, and the Roads Service is conducting one in relation to the southern relief road. Officials from both of those projects are sharing information with one another, and both studies are expected to be completed by the end of this year. They will then be put before the next NSMC meeting, and we will see where that takes us. I am committed to trying to reduce the traffic congestion on the southern side of Newry. I am also committed to improving the access to Warrenpoint port because that is an essential economic driver for that region. I have also expressed my support for the idea of a bridge linking the communities in County Louth and County Down. We will consider what the two studies produce, and we will see where that takes us. Mr W Clarke: Go raibh maith agat, a LeasCheann Comhairle. Will the Minister outline what progress has been made in relation to sustainable transport on an all-island basis? Will he also outline what initiatives are being progressed by the Department regarding sustainable transport? With your indulgence, a LeasCheann Comhairle, I also ask the Minister whether the issue of public transport using biofuels was discussed at the NSMC meeting. The Minister for Regional Development: I will answer the Member’s final question first — it was not. However, that is not to say that that issue could not feature on the agenda of a future NSMC meeting. Sustainable transport is something that is very important to us. I strongly feel that there is an all-Ireland dimension to travel, and I support the need to deepen cross-border co-operation to address sustainability issues and meet the challenges that lie ahead. At a time when the amount of traffic on roads continues to increase, we need to work together and contribute to CO2 reductions by seeking opportunities to address congestion and encourage more environmentally friendly travel. Officials, North and South, have met to share information and experience, and to explore measures to promote sustainable transport. I am keen that behavioural-change projects that are already in place in the North — such as the promotion of walking, cycling, public transport, car sharing and park-and-ride facilities — could assist the South in the development of its sustainable travel and transport action plan. The meeting noted plans to jointly undertake pilot demonstration projects and studies that will lead to more sustainable travel on both sides of the border. At a future meeting, we look forward to hearing the results of how those projects could be expanded further for the mutual benefit of both North and South. Mr P J Bradley: I welcome the Minister’s statement this morning. I also welcome the report on the ongoing efforts to improve the Dublin to Belfast rail link. Both Governments must continue the work to upgrade that very important track, because, until we receive a fully recognised Euro rail link, that is a target that both Governments should aim for. I imagine that the Minister expects me to raise a question about Narrow Water, so I will not disappoint him. I welcome the fact that the project was profiled at the meeting on 21 May 2008. The report gives me encouragement, and I welcome the response that the Minister gave to Mr Wells. At the last meeting that I had with officials in the Republic, I was given nine indicative dates. As the Minister mentioned, two of those have already passed. However, the dates that I was given included 28 February 2010, which is the date for the tendering process; and August 2011, which is the date for the completion of the work. Will the Minister assure me — and others who will benefit greatly from the provision of the bridge — that he will work to achieve those stages by those dates, or even advance them if possible? The Minister for Regional Development: Due to his keen interest in that project, the Member will be aware that the study was undertaken by Louth County Council; it was not done by the Department for Regional Development. The dates that he mentioned were shared with him by those who conducted the study on behalf of Louth County Council. I have read further press announcements in relation to that project. I often think that Narrow Water bridge would have been built a long time ago if it were built on press releases. Nonetheless, we are where we are with that project. In one of the Member’s press releases, I also note that he said that DRD was not doing enough to assist that project. DRD has not been asked to do anything by the people conducting the study. I asked Roads Service officials to share information with the people conducting the study on behalf of Louth County Council. My answer remains the same as it was to Mr Wells; let the studies be completed and then we will see what propositions are put to us. We will certainly respond as positively as we possibly can. Mr Neeson: I am delighted that the issue of the A8 Larne to Belfast road was discussed at the meeting, and the fact that public consultations are ongoing currently. Will the Minister indicate what the estimated timescale is for the completion of that project? 11.45 am The Minister for Regional Development: As I said in my statement, the first milestone will be to identify the route corridor, which will happen shortly. As the Member knows, that will go out for consultation, and we will then have to identify the preferred route option. Unfortunately, those processes take time, because a proper assessment of, and consultation on, all the routes is required. Whatever route is suggested, as with any significant road project, a public inquiry will be inevitable, because people will object to some aspect, be it their access to the road or the impact that that will have on people’s property or land; that will take time. However, the process is expected to follow the same timescale as the A5 Derry to Aughnacloy route, with commencement by 2012 and completion by 2015. Mr Moutray: Given that journey times on the Belfast to Dublin rail link are often more than two and a half hours and, indeed, in the past, have taken as long as five hours, what analysis has been undertaken to assess the effectiveness of the Minister’s efforts to improve the efficiency of the service? The Minister for Regional Development: We strive constantly to improve efficiency. However, bad experiences are heard more often than good, normal, run-of-the-mill experiences. Several parts of the line have been identified that slow down the journey, one of which is between Lurgan and Lisburn. Access into Connolly station on the Dublin side is an issue because of congestion with the local intercity service. Several issues have been identified. At the previous NSMC meeting, we had a presentation from Iarnród Éireann and Northern Ireland Railways. We had hoped that the business case that we had requested would be presented at the Mullaghbawn meeting, but that did not happen because it required more work. However, we have asked for the business case to be presented to us in advance of the next NSMC meeting so that some analysis can be conducted, and we can respond at that meeting. We want to improve the service — frequency, speed and comfort — and thereby increase the number of passengers who use the service. It is hoped that the business case will identify a range of options and the attendant costings, and we will then have to find the resources. However, the business case will identify what must be done, and at what level, to improve the service. The improvement of the service is the constant goal of the Department and NIR. Mr Brady: Go raibh maith agat, a LeasCheann Comhairle. Given the fact that there will be a report on the community-based rural transport pilot scheme in the Fermanagh/Cavan area, have there been any discussions to extend that scheme, if successful, into other border areas? The Minister for Regional Development: The fact that community-based rural transport is considered a pilot scheme suggests that we anticipate and hope that it will be successful. A range of issues has been identified about difficulties in the provision of cross-border rural transport. The pilot scheme is focusing on identifying the potential demands and barriers, which include logistic, legislative and procedural issues, for the provision of cross-border rural transport. We hope that the operation of the scheme between Fermanagh and Cavan will identify the obstacles. We are reasonably sure of some of the obstacles, but pilot schemes are effective in examining how schemes work and what inhibits their full and proper working. We intend to address whatever difficulties are thrown up as a result of the pilot scheme and to use that experience to introduce other schemes that will benefit from learning about the obstacles that were faced and overcome in the pilot scheme. The intention is to use that experience to roll out schemes in other cross-border areas. Mr G Robinson: In his statement, the Minister referred to the bridges on the Tyrone/Monagahan border. Although they are not in my constituency, will the Minister assure the Assembly that full public consultation will be undertaken at every stage of the process, particularly on the design of the bridges at Annaghroe and Knocknaginney? The Minister for Regional Development: Yes, the bridges were discussed at the meeting, and the Minister of the Environment raised the specific concerns of the local community on the re-opening of the roads. Undoubtedly, when roads have been closed for a lengthy period, their re-opening will create some disturbance in that area. Minister Foster asked Minister Dempsey to talk to Monaghan County Council to ensure that whatever further consultation the communities in that border area deem necessary will be fully undertaken. A quantity of information has been distributed, but some people felt that they did not have a full opportunity to examine, and express their views on, the proposals. However, Minister Dempsey assured us that Monaghan County Council will ensure full consultation with local people at each stage of the process and, if people want additional information, the council will accommodate them. Mr McCallister: This morning, I am reassured that, should the projects for a bridge at Narrow Water and a southern relief road end up competing on budgetary terms, at least the Minister has signed up to the latter and has pledged to honour that commitment. The Minister accepts that there has been widespread local opposition, on both sides of the border, to the bridges linking Tyrone and Monaghan. Will he do everything in his power to address the issues that have been raised on each side of the border? Will he agree to review whether the project should even proceed? The Minister for Regional Development: The Southern Government would fund the project for a bridge at Narrow Water, and it would be up to the Assembly to fund the southern relief road project, if it were to go ahead. The only chance of the projects competing for a budgetary allocation would be in a united Ireland, in which everyone would share the same Budget. I look forward to the day when such projects compete for funding from the same pool of money. The bridges were discussed at the meeting, and it was accepted that the re-opening of roads after a lengthy closure would cause some disruption and alter the pattern of people’s lives that has been established over the past 30 years, or for however long the bridges have been closed. The Minister of the Environment raised the issue, and it was acknowledged that people — certainly on the Northern side — want more consultation. They want to examine the proposals more fully and be given an opportunity to comment on them. The Southern representatives undertook to speak to Monaghan County Council about facilitating that. Mr P Ramsey: I, too, welcome the Minister’s statement, particularly on road safety. Members are constantly concerned about the continued carnage on the roads, such as occurred in Donegal, only last weekend. A move to a metric system would be of particular benefit to tourists travelling in the border regions. Does the Minister foresee a time of greater harmonisation of road signage? The Minister has committed to improving the Derry to Belfast railway line. An independent study by the Northern Corridor Railways Group clearly demonstrates that the sustainability of the line is crucial to the long-term economic, social and environmental stability of the area. When will the Minister introduce definitive proposals on the future of the line from Derry to Belfast? The Minister referred to a study on a rail link in the north-west. Is that time-bound? Will he use the proposals by the Northern Corridor Railways Group, in conjunction with the Irish Government’s study on Donegal, as a template for going forward? The Minister for Regional Development: The Northern Corridors Railways Group produced its study. It then asked my Department to initiate a study into the social and economic benefits of developing the railway line between Belfast and Derry, and links to the north-west in general. We have agreed to do that, and we will undertake that study as soon as is possible. The Member will be aware that significant investment is already being made between Coleraine and Derry. More work is about to begin, and work has been proposed for the coming years. I identified, and bid for, a £64 million improvement to the track between Coleraine and Derry. That all augurs well for the future of that line. The study will undoubtedly help, because, as was the case with the Belfast to Dublin line, and our railways in general, we must increasingly make stronger arguments for investment in rail infrastructure, as the population, congestion and pressure on our roads grows. We must return to a system of investing more in our railways. I look forward to the completion of the study to which we have committed. We have also committed to bringing that study to the NSMC, and to using it to kick-start and influence a study into public transport in Donegal that examines how both systems might link up. We are committed to doing that at future NSMC meetings. The Member asked about road signage. An examination of each and every area in which road safety can be improved will take place. The objective is to try to reduce the number of deaths on our roads. Particular problems exist in border areas, but whether accidents occur because of road signs or because of driver behaviour, which, unfortunately, most deaths on the road are as a result of, is another matter. The Minister of the Environment takes lead responsibility for developing the road safety policy. My Department will contribute to that policy, and we will happily consider improved signage if it were identified as something that would help. Mr Boylan: Go raibh maith agat, a LeasCheann Comhairle. I thank the Minister for his statement. Does he agree that there has been substantial progress on North to South road infrastructure, in particular the M1 from Dublin to Belfast and the M2 from Belfast to Derry? Given its congestion and traffic problems, did any discussion take place on the third main arterial route, which, in part, connects Castleblayney, Keady and Armagh? Given that 70% of road fatalities happen on rural roads, and in the border counties, will the Minister update us on any relevant new measures to reduce that statistic? Go raibh maith agat. The Minister for Regional Development: Other Members may dispute whether the road through Keady is the third main route. Quite a few people have suggested that the Sligo to Belfast route — the N4 — is one of the main routes, North and South. To answer the Member’s question directly, the matter was not discussed. However, roads projects that cross the border are issues that feature on NSMC agendas. If a particular issue arises, or a case is made for improving that road, I am sure that it will appear on our agenda at some stage. A range of road safety issues was discussed, one of which concerned mutual recognition. There was a sense that the urgency in dealing with mutual recognition of disqualifications, and in sharing information across the border, should be stepped up. Of course, a range of measures to deal with road safety is already in place. At the previous NSMC meeting, we saw a presentation of the Southern Government’s road safety policy. I know that the Minister of the Environment is intending to review the road safety policy here, and to make known her findings in 2010. That, of course, does not prevent the introduction of interim road safety measures, such as advertising, road improvements, education measures, detection, disqualification, and harsher penalties for people who are caught speeding or driving irresponsibly. All those measures are being undertaken as it is, but a review of the road safety strategy will also take place. A strategy is currently being introduced in the South. That will provide opportunities, particularly in border areas, where it is recognised that there is a particular problem. Statistics show that there is disproportionate number of accidents and deaths compared with some of the other counties across the island. Sharing information on both strategies will help Ministers to devise further strategies on top of those that already work in order to reduce the carnage further. Bearing in mind that serious accidents have occurred during the past few weeks, with bank holidays in the North and South — which, tragically, always seems to be the case — generally speaking, statistics for the time of year are down, both North and South, compared with previous years. We hope that that remains the case and that those figures can be driven down further. 12.00 noon Mr Shannon: I thank the Minister for his statement. He referred to improvements that have been made to the southern relief road. As regards tourist traffic, 100,000 extra tourists have come to Northern Ireland in the past year, and it is quite clear that a large number of them are from the Republic of Ireland. Are steps being taken, not only to improve the southern relief road at Warrenpoint, but to provide a bypass or similar road improvements at Ballynahinch and, indeed, at Downpatrick, which will, ultimately, open the door towards Strangford? That is my idea. I am sure that the Minister would be disappointed if I were not to mention Strangford at some stage. My other question relates to the bilateral agreement on driving disqualifications. Has any progress been made between the Republic of Ireland and Northern Ireland on the issue of disqualified drivers? Many in the Chamber believe that it is important that, when someone is disqualified from driving in the Republic of Ireland or Northern Ireland, the same rule applies in the other jurisdiction. I want confirmation on whether progress is ongoing on that issue. The Minister for Regional Development: The Ballynahinch bypass is identified in Roads Service’s forward planning schedule. I am not sure about a bypass for Downpatrick. I met some of Downpatrick’s councillors to discuss the traffic through the town and improvements that could be made, and we identified some options by which the flow of traffic through Downpatrick could be assisted. Of course, increased tourism brings increased traffic. On one hand, increased tourism is a welcome development. However, it brings associated problems. I am sure that many tourists who come to the North will want to visit Strangford Lough and to see the beauty of that area. So, a bypass for Ballynahinch has been identified. The Department will continue to work to improve road networks away from major, key roads, on which there is already a high degree of focus. As regards the mutual recognition of driving disqualifications, there was, as I have said, a sense during the discussion that the matter is largely between the Minister of the Environment and Minister Dempsey. Certainly, there was a sense that both Ministers wanted some urgency to be injected into discussion on the issue and that they felt that progress has not been made as quickly as, perhaps, it could be. The matter has been the subject of constraints that are associated with the normal processes of policy development and implementation, including public consultation in both jurisdictions. I understand that several technical and legal difficulties have also been encountered. Mutual recognition of penalty points has also proven to be a complex and difficult issue. It is expected to be some time yet before all the obstacles to implementation can be overcome. A trilateral meeting on mutual recognition between the Environment Minister and her counterparts in London and Dublin is scheduled to take place in Belfast in June. Certainly, the sense that I got from the meeting was that both Minister Foster and Minister Dempsey wanted some urgency to be injected into the issue. Technical and legal difficulties always occur with cross-border issues. However, my sense of the discussion is that those difficulties are not insurmountable. Ministers want to move ahead and close that loophole as early as possible. A trilateral discussion is scheduled to take place in Belfast later in the month to try to make progress on the issue. London’s input is a key element in that discussion. Mr McCartney: Go raibh maith agat, a LeasCheann Comhairle. I thank the Minister for his statement and the answers that he has already given. I note that the meeting took place in Tí Chulainn. I hope that the Minister showed a good example to the Environment Minister by, at least, cycling, if not walking, to Tí Chulainn on that particular day. Mrs Foster: Does the Member suggest that I should have walked to Tí Chulainn from Fermanagh? [Laughter.] Mr McCartney: No, I meant that the Minister for Regional Development should have shown the Environment Minister such a good example. I welcome the study that has been carried out on the redevelopment of railways in the north-west. What discussion on rapid transit has the Minister had with his counterpart in the South? What discussions have taken place between officials in both Departments? Mr Deputy Speaker: Minister, did you cycle? The Minister for Regional Development: I have to confess, a LeasCheann Comhairle, that I did not. Anyone who knows Sturgan Brae, which comes out of Camlough, heading towards Crossmaglen, will understand that it would require more than my legs to get up it on a bicycle. I take on board the Member’s point about sustainable transport. Dublin has experienced the Luas rapid transit system, and several other cities across the South, including Waterford, Limerick and Galway, are considering rapid transit propositions. We were able to share with, and hand over to, Minister Dempsey the outcome of the feasibility study that was carried out on Belfast. We provided the highlights of that study, which was welcome to his Department, given that those other cities are being considered. On 15 May 2008, my officials made a presentation on the findings and recommendations of our feasibility report to colleagues in Dublin, and they agreed to continue the discussions as the project progresses. I understand that the Southern Government are considering the feasibility of bus-based rapid transport systems for Cork, Limerick, Galway and Waterford. Mr D Bradley: Go raibh míle maith agat, a LeasCheann Comhairle. Fáiltím roimh ráiteas an Aire, agus gabhaim buíochas leis as. Is maith liom go raibh an cruinniú ar siúl i dTí Chulainn, nó tá mé féin ar dhuine dá bhunaitheoirí. Is maith go bhfuil an Chomhairle Aireachta Thuaidh/Theas ag baint úsáide as áiseanna pobail. Ba mhaith liom fosta tagairt áirithe a dhéanamh don bhóthar faoisimh ó dheas ó Iúr Cinn Trá, nó beidh ról tábhachtach ag an bhóthar sin ag fuascailt fadhbanna tráchta an Iúir. I thank the Minister for his statement, and I welcome it. I welcome the fact that the meeting was held in Tí Chulainn, as I am one of the founders of that centre. I am glad that the NSMC is making use of community facilities. The southern relief road in Newry will have an important role in solving the traffic chaos in Newry. The Minister said that further reports on the feasibility of the southern relief road will be presented to the NSMC later this year. Will he ensure that the study, in addition to examining the benefit to Newry city and south Down, will consider the potential benefit to both jurisdictions in that the road will facilitate better links between Warrenpoint port and Dublin port? Will he ensure that the study considers the fact that Warrenpoint handles a considerable volume of port traffic that Dublin port cannot presently handle? Go raibh maith agat. The Minister for Regional Development: I was delighted to host the meeting in Tí Chulainn, and it is beneficial that, where possible, Government business, particularly North/South meetings, makes use of community facilities, which rely on that business more than some of the other venues that have been used. It is a good venue, and all who came to it got a real sense of the beauty of the south Armagh area and were made welcome, which was also beneficial. I notice that the Member’s namesake and colleague Mr P J Bradley has left the Chamber. It is similar to a Punch-and-Judy act; one Member supports the southern relief road and the other tries to harangue me over the southern relief road and supports the construction of a bridge at Narrow Water. Nonetheless, all politics is local, and even parties are able to divide along local lines on such projects. The idea of a southern relief road is important not only for the port of Warrenpoint and for the southern side of Newry but for the connection onto the A1/M1 north, which will make a connection towards Dublin and the other ports. Warrenpoint has a key role, and we have one eye on the issues of port traffic generally on the eastern side of the island. Dublin has capacity issues, and there are, perhaps, development plans for the ports at Greenore and Braemore. The ports at Warrenpoint, Belfast and Larne are all well placed to try to enhance, and share, business with other ports. From my attendance at a couple of ports conferences, I have noticed an increase in co-operation among the ports across the island, and I am encouraged by that co-operation. Warrenpoint port is important strategically to the region that the Member and I represent and to the eastern seaboard generally, and I am fully aware that a link road between the Warrenpoint-to-Newry dual carriageway and the main Belfast-to-Dublin road would be hugely important to the port and its ability to do business both North and South. Mr McCarthy: Go raibh maith agat, a LeasCheann Comhairle. [Interruption.] Last week, members of the Committee for Culture, Arts and Leisure were presented with a beautiful orange badge on which the word “Tá” was written. I understand that tá means “yes”, and, therefore, I am doing my bit to promote the Irish language. I welcome the Minister’s detailed report, but I am disappointed that, as yet, there has been no mention of the anomaly between North and South on concessionary fares for people aged 60 and over. As usual, the North led the way for people aged 60 and over. Given that we have friends and relatives over the border, will the Minister pursue equality for everyone on the island, so that everyone aged 60 and over — rather than over 66, as it is across the border — can avail themselves of free public transport as soon as possible? The Minister for Regional Development: I thank the Member for his commentary and use of Irish. He raised several issues. First, there was an anomaly anyway — even when the concessionary fares applied to people aged 65 and over — because the South’s concessionary fares applied to people aged 66 and over. Therefore, there was already a one-year anomaly. Given our intention to reduce the concessionary-fare age limit to 60 in the autumn, an even greater gap will be created between here and the South. I must point out that the policy in the South is the responsibility of the Department of Social and Family Affairs and not the Department of Transport. Therefore, the North/South Ministerial Council transport sectoral meeting was not the occasion on which to discuss such a matter. Obviously, although reducing the age for eligibility to the concessionary-fares scheme from 66 to 60 would have financial implications for the Government in Dublin, I, and people aged 60 and over throughout the island, would welcome such a policy. However, in the first instance, it is a matter for the Irish Government. Nevertheless, I am content to raise the matter in order to achieve some degree of harmonisation. As I said, there are budgetary implications for the South, and, in the final analysis, it will be a matter for them to decide. Progress Report on the Independent Review into the Outbreak of Clostridium Difficile at Antrim Area Hospital Mr Deputy Speaker: I have received notice from the Minister of Health, Social Services and Public Safety that he wishes to give a progress report on the independent review into the outbreak of clostridium difficile at Antrim Area Hospital. The Minister of Health, Social Services and Public Safety (Mr McGimpsey): I shall update the Assembly on the independent review’s progress on the outbreak of clostridium difficile in the Northern Health and Social Care Trust. During the debate on 4 March 2008, I said that the situation required an urgent response and immediate action. My first priority was to ensure that the outbreak was contained and that other health and social care trusts were taking all possible steps to minimise the risk of clostridium difficile outbreaks in their hospitals. I announced that I had asked the Regulation and Quality Improvement Authority (RQIA) not just to carry out an independent review into the circumstances of the outbreak in the Northern Health and Social Care Trust but to examine the measures being taken by all trusts to reduce healthcare-associated infections. I set terms of reference to ensure that the review would be rigorous and would have all the powers and expertise necessary to investigate the outbreak thoroughly and examine all five trusts’ management of, and clinical response to, clostridium difficile infections. It was important for the review to be conducted quickly, and I asked the independent review team to report to me on its findings by the end of May. I have now received the review team’s interim report. The report is, of necessity, interim because the outbreak has not been declared over. From the outset, I have made it clear that the review will be conducted in such a way as not to hamper staff’s efforts to contain the outbreak. 12.15 am Over the past 12 weeks, the RQIA team has made substantial progress on its independent review. On 30 May, members of the review team reported to me in person, and I received the team’s written report on 1 June. To date, the team has completed its investigation into the other four trusts’ actions to reduce clostridium difficile rates. The team has also gathered substantial documentary evidence from the Northern Health and Social Care Trust, and it carried out a validation visit on 30 May. Further important work must be carried out before the RQIA can deliver its final report, and I will return to that matter. I met members of the review team on 30 May, and they commented on the tremendous dedication of all staff in the Northern Health and Social Care Trust and their efforts to contain the outbreak. They acknowledge the immense pressure that staff have been under. I witnessed that dedication when I visited the trust, and I want to take this opportunity to pay tribute to the staff. They have worked tirelessly, under extremely demanding conditions, to bring the outbreak to an end. Members should also be reassured to hear that the management of the outbreak is being taken very seriously by everyone in the trust, from the chairperson and the chief executive right down to the cleaners who work on the wards. People at all levels are working hard to ensure that infection control is given the highest priority. The RQIA team has also commented that the chief executive and the medical director of the trust — indeed all the staff — have been very open. I am pleased to report that there is evidence of progress in containing the outbreak. The month of May saw the lowest number of cases of any month this year, and the severity of the illness has eased. It is still too early to say that the outbreak is over; that improvement must be sustained. To that end, a team is being set up to ensure that policies, procedures and practices for healthcare-associated infections are fully embedded across the trust area. We will continue to monitor the position until we are sure that the measures being taken by the trust are really working and that the outbreak is over. The independent review team’s report is wide-ranging and important. It makes 36 recommendations that cover four key areas: governance; infection control; laboratories; and pharmacy. Overall, the team has reported that all health and social care trusts have made good progress towards the implementation of effective control measures to reduce the risk of clostridium difficile infections. The team has given the reassurance that all five health and social care trusts recognise the need to prioritise actions to minimise healthcare-associated infections in general and clostridium difficile in particular. It has further reassured that all the trusts are working to achieve the target that I set last year of an overall reduction of 20% in the number of clostridium difficile cases in hospital patients aged 65 and over by March 2009, and to introduce a programme of action to ensure that plans and procedures are in place, in line with recommended guidance, to reduce the rate of clostridium difficile. In addition, the team points to the skilled and committed staff who are working in infection-control teams in laboratories and pharmacies. The team also highlighted many examples of creative local initiatives to prevent and control infection, and good working relationships between all those involved in infection-control measures across the trusts and boards. As one would expect, there are challenges for the trusts. In particular, the RQIA recognises that the five trusts were established recently, and, as is normal when dealing with the merging of any complex organisation, they are busy managing the detail of the mergers, including the harmonisation of policies, procedures and practices. The review team identified shortfalls in staffing levels in key professional groups, such as microbiologists, antibiotic pharmacists and infection-control nurses. The team also commented on a wide variation in the quality and condition of hospital facilities, which reflects the age of some of the buildings. In addition, it recommended improvements in the IT systems that support infection prevention and control, especially for surveillance and antimicrobial resistance. The review team comprises leading experts in the fields of clostridium difficile and healthcare-associated infections. I will now consider the report in more depth, and will take seriously its recommendations and findings. Some issues will need to be addressed more urgently than others, and my Department, and health and social care organisations, will give those priority. We have not been standing still while awaiting the report. The Department has worked with the Northern Health and Social Care Trust at every step in order to support its efforts. We agreed recently that there would be value in bringing in more external expertise. To that end, we have enlisted the support of the National Health Service’s cleaner hospitals team. The team visited the Northern Health and Social Care Trust on 7 May 2008 and set about identifying areas for improvement, and making recommendations to help to bring the situation under control. The trust has established an action plan in order to address the issues that have been raised, and the cleaner hospitals team will return to the trust on 4 June 2008 to see how well the plan is working. A member of the team will join my Department’s service delivery unit for two days a week for the next few months. Their role will be further to assist the Northern Health and Social Care Trust to end the outbreak, and to work with other trusts to improve infection prevention and control. We will never be able to eradicate healthcare-associated infections. However, there must be sufficient controls and systems to minimise the risk to patients. That is why I announced in January an extensive range of measures to tackle the so-called hospital superbugs. An additional £9 million will be invested over the next three years to improve patient safety and to reduce the spread of infections such as MRSA and clostridium difficile. New initiatives to tackle healthcare-associated infections include single rooms for new hospitals in order to improve hygiene and privacy; a rolling programme, which is under way, of unannounced hygiene inspections of all hospitals; restrictions on hospital visits, which I announced this morning; a dress code for healthcare staff, which is being introduced; a regional hand-hygiene campaign to encourage healthcare staff and visitors to wash their hands; MRSA screening for high-risk patients; additional funding to set up rapid-response cleaning teams at all hospitals; and funding for a pharmacist in each trust area to work with clinical staff to promote safer prescribing of antibiotics. There are policies already in place to tackle healthcare-associated infections including the Changing the Culture action plan and the ward sister’s charter, which aim to reduce infections and to give nurses the power to create a cleanliness culture in their wards. My Department is also convening a committee to tackle the problem of antimicrobial resistance. In addition, last September, I announced new targets to reduce MRSA by 10% and clostridium difficile by 20%. New leaflets for the public on hand hygiene have been distributed to hospitals. Enhanced staff training on infection reduction is ongoing, and extra funding was provided for the appointment of five infection-control nurses for trusts. Those measures are intended to ensure that all staff have the skills, training and equipment that they need to reduce the spread of healthcare-associated infections. More importantly, they should also help to restore public confidence in the health and social care service. I said that this is an interim report, because the review team cannot have full access to the affected wards until we are sure that the outbreak is over. I have, therefore, given the review team an extension for delivering its final report. That extension does not mean that anyone is less committed to ending the outbreak or to improving infection control across Northern Ireland — quite the opposite. We are determined to get to the root causes of the outbreak. I have asked the review team to produce its final report as soon as possible after the outbreak is over, and it is expected to deliver the report by the end of July. The review team is determined that the best way to discover the cause of the outbreak is by a root-cause analysis, which is a retrospective inquiry to identify how and why an incident happened. The purpose of that approach is not to apportion blame but to identify preventable factors and the lessons that must be learned. Once the team has completed that review, it will review the Changing the Culture action plan, and it is aiming to complete that job by the end of October. I acknowledge the work of the review team and the fact that it has delivered such a substantial and important report in a short space of time. During discussions on the clostridium difficile outbreak at the end of last year, there were calls for a public inquiry. At that time, I said that I was minded to hold such an inquiry. However, my first priority was to ensure that the outbreak was contained and that other health trusts were taking every possible step to prevent clostridium difficile outbreaks from occurring in hospitals. I did not take that step lightly, nor did I take it without the expert advice of the Chief Medical Officer for Northern Ireland, Dr Michael McBride. The situation required an urgent response and immediate action, and I believed that a public inquiry could not deliver that. In fact, a public inquiry at that time would have served only to deflect staff from their vital work in trying to reduce and control infections, such as clostridium difficile and MRSA. That would have put patients at risk, and I cannot and will not do that. Furthermore, a public inquiry could not have delivered so much in such a compressed period. As I have said before, it is not possible to eliminate healthcare-associated infections completely, but we can and must adopt a zero-tolerance approach to them. That means that no case of infection is regarded as acceptable, and the response to each new case is immediate and urgent. Healthcare-associated infections cause pain and distress to patients, and the outbreak has led to a loss of public confidence in our health and social care service. It is clear from the RQIA’s interim report that healthcare staff at all levels take the matter very seriously and are working extremely hard, often under severe pressure, to reduce the spread of such infections. My Department is considering the interim report carefully, and its recommendations, in particular, which require a region-wide response. Infection, prevention and control are everyone’s business, and the inquiry shows the value of co-operation in making healthcare safer and restoring people’s confidence in their healthcare system. The Deputy Chairperson of the Committee for Health, Social Services and Public Safety (Mrs O’Neill): Go raibh maith agat, a LeasCheann Comhairle. I wish that I could welcome the Minister’s statement, but, unfortunately, it is lacking in detail and substance. At the heart of this issue is the fact that more than 40 people have died from hospital-acquired infections. Families of the deceased and others who have contracted hospital-acquired infections want and deserve answers. People have cancelled their surgeries and hospital visits because of fears of acquiring such infections, yet the Minister is discussing an incomplete inquiry. According to the Minister, the report makes 36 recommendations to improve current standards and practices in hospitals. However, neither I, as Deputy Chairperson of the Health Committee, nor any other Member have received a copy of that report. When will we receive a copy of it, and when will the 36 recommendations be implemented? If we want to restore public confidence in the Health Service, we must see action, and we must see those recommendations implemented. It has been six months since the first outbreak was discussed in the House, and we still do not have answers for people. When will those people get answers? The Minister of Health, Social Services and Public Safety: As I explained to the Chairperson and Deputy Chairperson of the Committee this morning, I have only just received the report. I will share the report with all Members later today, and Mrs O’Neill will be able to examine it more closely then. There are key messages in that report, which we are considering. One of the key messages concerns the state of our hospital buildings. It is very difficult to keep old buildings up to the levels of cleanliness of new ones. There is a shortage of pharmacists who are skilled in the application of specific types of antibiotics to deal with particular infections. Furthermore, there is a shortage of microbiologists and a need for infection-control nurses. With the benefit of hindsight, those people should have been in place. However, this is a recent phenomenon, and we are working and moving quickly to try to deal with it. I have already put some measures in place, such as the Changing the Culture action plan. I also announced further measures, to which I referred in my speech, including restrictions on hospital visiting, a dress code for staff, a regional hand-hygiene campaign and MRSA screening for high-risk patients, among other measures. Those measures are working effectively, as is the raft of other measures, such as single rooms and newbuilds. As I reported to the House previously, environmental cleanliness audits and unannounced inspections are now in place. After consideration, the review team did not disagree with the introduction of those measures. However, as its role requires, the team has identified gaps. Mrs O’Neill is correct; we must increase public confidence, which has been knocked since the incidences of healthcare-associated infections. We understand — or at least accept — that we can never eliminate those infections; we can, however, restrict them to the absolute minimum level. 12.30 pm Mr Easton: Will the Minister outline how many new cases of clostridium difficile were identified at Antrim Area Hospital last month? Is sufficient funding in place to implement the 36 recommendations to reduce clostridium difficile levels? What measures are in place to screen hospital staff who might carry the infection? The Minister of Health, Social Services and Public Safety: Expert advice suggests that screening for clostridium difficile is not helpful. For example, a large proportion of over 65s — approximately 30% — carry clostridium difficile. When symptoms emerge, we must react, instigate isolation and control the infection. At Antrim Area Hospital, the number of deaths has decreased from February’s peak of 14, to three in March, two in April and two in May. If we can restrict deaths to that level, the outbreak can be declared over. However, we must reach a point at which no new cases are emerging. The number of new cases has decreased from 20 in January 2008 to 10 in February, 17 in March, 18 in April and three in May. Therefore, the numbers are tailing off, but it takes time to reach the point at which we can declare the outbreak over. The problem is that the review team cannot complete its inquiry until the outbreak is over. We cannot remove staff from isolation wards to deal with the inquiry team’s queries until we are confident that the outbreak is over — otherwise lives will be at risk. Rev Dr Robert Coulter: On behalf of my constituents, I congratulate the Minister on introducing initiatives to contain and eliminate the clostridium difficile outbreak. I pay tribute to the staff — particularly in the Northern Health and Social Care Trust — who have worked hard to combat clostridium difficile. During my numerous visits, I witnessed the work conducted by the chief executive of that trust, Norma Evans, and her team. Does the Minister agree that staff must not be deflected from their duties? Will he commit to offer the future support that is necessary to eliminate the problem of clostridium difficile? The Minister of Health, Social Services and Public Safety: I assure Rev Coulter that I will leave no stone unturned in my quest to tackle that problem. The Northern Health and Social Care Trust has worked hard and adopted a dedicated approach. I have visited the isolation ward and talked to staff; one could not fail to be impressed with their serious approach to their work. There is a shortage of the skilled infection-control nurses, antibiotic pharmacists and microbiologists that are required. I will consider a human resources strategy to determine how to deal with that situation. The more serious consequences in the Northern Trust area, particularly in Antrim Area Hospital, as the Member is aware, have been caused by the new and virulent clostridium difficile 027 strain. Mrs Hanna: I welcome the Minister’s update. I have met the review team, and I appreciate the time that it spent in informing me of its work. Although progress has been made, and we are aware that the lowest number of deaths as a result of the infection was recorded in May, we are still concerned that the infection is ongoing. The Minister mentioned that the RQIA process highlighted the staffing shortfall. Is that being addressed? Are infection reductions and ward inspections being recorded in order to ensure that the maintenance of high standards is continued? The Minister of Health, Social Services and Public Safety: Several unannounced inspections have taken place already. They have been recorded, and reports have been issued. The consequences of and responses to those reports will also be issued. Unannounced inspections have taken place at Craigavon Area Hospital, Belfast City Hospital, Downe Hospital and Altnagelvin Area Hospital. That work will continue. We must address the staffing situation, and I am putting resources in place as necessary. For example, there will be a pharmacist in each trust area to work on this particular area. Microbiologists also play a key role. The microbiologist in Antrim Area Hospital impressed me strongly when she spoke to me about the need for a microbiological approach to the identification of both the infection and the correct antibiotic to deal with it. We must move away from the broad-spectrum antibiotics that are the root cause of so many problems. When infection breaks out, we must control it. In order to do so, we must have skilled infection-control nurses, but we must also change the infection-control culture, from the cleaners through to the chief executives and the chairmen. We must have the right culture at the root of everything that we do. Mr McCarthy: I thank the Minister for his report. However, it will not be of much comfort to people who, over the past while, have lost loved ones as a result of this outbreak. The report contains 36 recommendations, and another Member asked whether the Minister would have the funding to put those recommendations into practice as quickly as possible. In the report, the review team identified the shortfall in staffing levels. I am concerned about the Department’s policy to achieve 3% efficiency savings over the next three years under the RPA. That will commit the Department to further staff reductions. If the Minister goes down that road, will that complicate matters further and make it more difficult to overcome clostridium difficile? The Minister of Health, Social Services and Public Safety: I have no choice but to go down the road of the 3% efficiency savings. Over and over again, Members have reinforced to me the need for efficiency. I heard a discussion this morning between the Minister of Finance and Personnel and the Chairperson of the Committee for Health, Social Services and Public Safety on that issue. It is important to point out, for example, that the Department’s underspend last year rose above 1% precisely because of its efficiency. The Department overachieved in savings on the drugs budget to the tune of £20 million more than was anticipated. That skewed our figures over that 1% underspend, so instead of being the best-performing Department as usual, it was the second-best. That information is contained in a letter to Mrs Robinson, which I will circulate to all Members of the Committee for Health, Social Services and Public Safety; I know that they will be interested in that. Although we have been successful in achieving efficiencies, not all efficiencies have to come at the expense of staff. We anticipate achieving reasonable efficiencies in our drug budget, because it runs to about £400 million a year through chemists’ shops and pharmacies. As for staffing, we need staff with the right skills, and there are gaps that we must fill. The phenomenon of healthcare-associated infections appeared suddenly. Although clostridium difficile and MRSA have always existed, the sudden rise in their incidence has taken the system by surprise in recent years. We must get on top of that, because patient confidence is everything. Anything that detracts from patients’ confidence in the Health Service is very damaging to the healthcare of the entire population. We have a first-class Health Service, manned by first-class staff, an |