Ms Bairbre Nic Aongusa:

I am the senior person in the Department of Health with overall responsibility for North-South co-operation. As is evident from the discussion, the areas of co-operation span many parts of the Department. Therefore, in a few minutes I will ask my colleague, Charlie Hardy, a principal officer in the acute hospital division, to deal with some of the issues committee members have raised about emergency and hospital services. Issues were raised also about GP cross-Border services, and my colleague, Paul Barron, will deal with those. He will also cover the various issues relating to the cross-Border directive.

I will take a few minutes to deal with some of the other issues. A general question raised by a number of members, including the Chairman, concerns the fact that while there is significant good work under way in cross-Border co-operation on health, there is much more that could be done. The Department of Health would agree with that. There is very close co-operation at official level between our Department and our colleagues in the North. The Secretary General of the Department meets his counterpart in the North, Andrew McCormick, regularly - several times a year. There are also regular meetings at official level across the spectrum of North-South issues.

A question arose as to whether there is a process by which new areas of co-operation can be explored, other than through the usual liaison between officials. Deputy Crowe mentioned conferences and special events. We have done that in the past and would consider doing it again. I mentioned the successful cross-Border conference on tobacco. We also had one on e-health in Dublin during our EU Presidency, on which we had very active engagement from Minister Poots and his officials. Under the formal mechanisms, the parties involved are in regular contact to decide on priorities. At the most recent North-South Ministerial Council plenary session, it was agreed there would be an exploration in each sectoral area to establish whether there were additional priorities that could be progressed. That exploration will take place in the health area and we will certainly take into consideration the various issues raised here in this discussion.

The issue of alcohol was raised and there were questions and concerns about minimum unit pricing. We have a North-South alcohol policy advisory group in the Department, which was set up by the chief medical officers of both jurisdictions in 2012. This group has been doing significant work on assessing the evidence for the alcohol policy that has been agreed. The Government has approved an extensive package of measures to deal with alcohol misuse, including the drafting of the public health (alcohol) Bill which will include provisions for minimum pricing. Concrete steps are being taken to address concerns about minimum pricing.

I mentioned research that has been commissioned, in conjunction with the Department of Health and Public Services in Northern Ireland, to model the impact of the minimum unit pricing on alcohol consumption in both jurisdictions. As well as looking at the health impacts of alcohol consumption, the impact assessment is being required to look specifically at the likely effects of different minimum prices on a range of areas, such as crime and the economy North and South. A Sheffield university has been awarded the contract to carry out the wide-ranging impact assessment, and it is anticipated the research will be ready by the end of quarter two of this year. I expect the study will address some of the concerns people have had about the economic effect and, possibly, the effect on levels of crime in Border areas.

Minimum pricing is a tool which addresses the issue of alcohol that is cheap relative to its strength, and all the evidence has shown that its use is more effective in terms of targeting at-risk drinkers, particularly young people. Some committee members mentioned the recent controversy concerning the so-called Neknomination. Young people are attracted to buying cheap alcohol at very low prices, and minimum unit pricing has been shown to be the most effective way to deal with that. It is more effective than increasing excise duty across the board in terms of addressing this issue.

Senator White asked about the cancer radiotherapy centre in Altnagelvin. That unit is due to open in 2016 and the Irish Government has committed once-off capital funding of a ceiling of one third of the cost for radiotherapy facilities at the centre. The unit will provide access to radiotherapy services to more than 500,000 people. Approximately 10% of patients from the Republic will continue to receive more specialist treatment in Galway or Dublin. Republic of Ireland patients receiving radiotherapy in Altnagelvin will continue to have their diagnosis, surgery and other treatment planning in either Letterkenny or Galway. Agreement was reached with the Northern Ireland authorities on the revenue costs, and discussions are under way for a service level agreement which will finalise the agreement between the two jurisdictions for the radiotherapy services to be provided in Altnagelvin. This is very much a success story in terms of North-South co-operation.