Leo Varadkar (Dublin West, Fine Gael) | Oireachtas source

I thank the committee for inviting me here this morning to discuss opportunities to enhance health service provision through North-South co-operation. At the North-South Ministerial Council, NSMC, health and food safety sectoral meeting in Altnagelvin last month, I said that cross-Border co-operation on health was one of the unsung successes of the Good Friday Agreement. There are several very good examples of co-operation in health, such as in radiotherapy services in Derry for all of west Ulster, the paediatric congenital cardiac service for the island, which will be based in Our Lady’s Children's Hospital in Crumlin, health promotion, e-health and food safety. We are an island of just over 6 million people and it makes sense to pool our resources to provide better health care for all our citizens, regardless of politics.

In Ireland, North and South, there is a growing interest in cross-Border all-island health and social care services co-operation where mutual advantage can be demonstrated. That was not always the case in the past, but I am very glad that it is now. That reflected the complexity of health and social care services and the many barriers which may be encountered in attempting to put cross-jurisdictional arrangements in place, including a lack of development funding, different systems for assessing eligibility and a situation in which each jurisdiction is Exchequer-funded only to provide for its own population catchment. There have been several significant cross-Border and all-island initiatives over the past 20 years, with the early experience gained through local and regional pilot projects in the Border area building the confidence to put more permanent collaborative arrangements in place. Today, there are many examples which illustrate that co-operation between North and South in health makes sense. The challenges facing health and social care providers, planners and policy makers on both parts of the island are similar. There is no doubt that patient benefits will accrue from pooling expertise and resources and exchanging good practice. I am committed to strengthening and increasing North-South health co-operation.

North-South co-operation on health matters takes place through the NSMC as well as joint departmental projects. Taking its place within the broad spectrum of public agencies involved in facilitating North-South co-operation is the Co-operation and Working Together, CAWT, partnership, which has played a significant role over the past 20 years in promoting cross-Border health and social care co-operation, particularly in the Border area. CAWT is delivering the health element of the EU initiative for inter-regional co-operation, INTERREG IV, programme, comprising 12 projects with a strong focus on improving access to services, promoting health and well-being, reducing health inequalities and promoting social inclusion. The numbers of patients and clients who have benefited from services is in excess of 53,000 as of March 2015. The new INTERREG V programme has been agreed and I understand a call in the health area will issue in the coming months. There is an increase in the funding available for the new programme, which will continue to deliver tangible benefits to citizens in both jurisdictions.

I will outline some areas of specific co-operation in health. The committee is aware of the development of new radiotherapy facilities at Altnagelvin Hospital in Derry. I recently had the opportunity to see at first hand the progress in the development of the new radiotherapy unit. The previous Minister for Health, Social Services and Public Safety in Northern Ireland, Jim Wells, and I visited the site where construction of the radiotherapy unit started in July of last year. I was impressed and enthused by the dedication of the people I met. This is an exciting cross-Border project that will significantly improve access to radiation oncology services right across the west Ulster region, on both sides of the Border. Among the beneficiaries are people living in County Donegal and surrounding areas. It will provide high-quality services on their doorstep on a par with those provided in the Northern Ireland Cancer Centre in Belfast and in our special centres in Dublin and Galway. The Government has committed capital funding of €19 million towards construction costs, and the HSE will also provide funding for the provision of services to patients per year, of which 385 will be from the Republic. Donegal on its own does not have the population to justify or support a specialist centre for radiotherapy, and nor do Derry, Tyrone and Fermanagh, but taking the four counties together, they have sufficient population and critical mass to justify and safely staff a specialist centre. That is what has been done there. It is a good example of work that could be done in the future in Derry, Dublin and Belfast.

There is continued engagement between the Department of Health here and the Department of Health, Social Services and Public Safety in Northern Ireland on progressing co-operation and finding a solution for paediatric cardiology services on an all-island basis. The expert international working group report on an all-island service for cardiology and cardiac surgery for congenital heart disease was published in October 2014. This report is a pragmatic example of co-operation across both jurisdictions which seeks to create an effective, integrated service for the benefit of patients. It makes clear and explicit recommendations on the development of a single congenital cardiac service for Northern Ireland and the Republic of Ireland. One of the recommendations was that paediatric surgery and interventional cardiology should cease in Belfast and that all services should be provided in Dublin, giving us the critical mass of a population of approximately 6 million, which is needed for such a centre. This development will ensure that a very vulnerable group of sick children and young people get the best level of care no matter where they come from on the island. Other benefits of the service will include an expanded database for research into congenital heart disease and an expanded range of medical services.

A report on north-west cardiology provided to the board of the Saolta hospital group in October 2013 was positively received and its recommendations accepted. The adoption of the recommendations of the report can build and support a robust cross-Border relationship that has the potential to deliver a high-quality service for the benefit of all of the population of the region. In particular, the recommendation to establish a joint cardiology department between Letterkenny and Altnagelvin is very exciting, not solely because of the benefits to service provision for the people of the north-west but also because it will be the first ever joint cross-Border department in medicine or surgery.

The promotion of health and well-being is deemed important for all important for all our citizens. There is important co-operation continuing between the two jurisdictions. There is broad agreement on the need for significant and innovative action to protect the health and well-being of the wider public, and especially children, from alcohol abuse. The two health Departments have co-operated closely here through the work of the North-South alcohol policy advisory group. One such area of co-operation is the introduction of minimum unit pricing. This is an important measure to tackle the harm caused by alcohol in adolescents and problem drinkers. The University of Sheffield reports, which were jointly commissioned by the two Departments, studied the potential impact of minimum unit pricing in both jurisdictions. The two Departments have agreed to work together as far as possible to ensure a co-ordinated approach to minimum unit pricing in terms of timing and rates to ensure health impacts are maximised and the impact on cross-Border trade minimised.

Since the inaugural North-South tobacco conference was held in Belfast in November 2013, which allowed for the sharing of innovative ideas to benefit the health of people from both jurisdictions, there has been significant progress on tobacco control measures. The Public Health (Standardised Packaging of Tobacco) Act 2015 was signed into law by the President on 10 March 2015. This has made Ireland the first country in Europe and the second in the world to pass such legislation. Legislation to introduce standardised packaging of tobacco products has now been enacted in both Ireland and the United Kingdom, and the provisions will come into force in Ireland in May 2016.

Rare diseases have also been discussed at NSMC level. There is broad agreement in principle for future collaboration in this area. The national rare disease plan in Ireland was published in July 2014. The foreword to the plan referred to the policy framework on rare diseases, envisaging a combined approach with EU partners and Northern Ireland to diagnose and treat people with rare diseases.

Dealing with the current high levels of suicide and deliberate self-harm is a priority for the Irish Government. Much has been achieved under our Reach Out suicide prevention strategy and the Protect Life strategy in the North. However, more needs to be done. The development of a range of all-island actions on suicide prevention, together with the long-standing co-operation between the National Office for Suicide Prevention and the Public Health Agency in Northern Ireland, has resulted in several excellent initiatives, including the media monitoring service, the registry of deliberate self-harm, information campaigns and the all-island men’s health forum.

The Department of Health and the National Office for Suicide Prevention are currently finalising a new strategic framework for suicide prevention for the period 2015 to 2020 to follow on from Reach Out. A new suicide prevention strategy is also under development in Northern Ireland. The publication of these two new strategies will present opportunities for further co-operation on suicide prevention initiatives.

The food safety promotion board, safefood, is one of the six North-South bodies established under the Good Friday Agreement in 1999. Members will be familiar with the work of safefood as its representatives attended this committee last month and a detailed discussion took place on North-South co-operation in food safety initiatives to promote healthy eating and combat obesity. safefood is principally charged with tasks involving food safety awareness through public campaigns, conferences, training and advising professionals and the general public. It is also involved in supporting North-South scientific co-operation and links between institutions working in the field of food safety, including laboratories, statutory food safety enforcement agencies and international and domestic research bodies. It has run a number of successful campaigns in recent years. These include the "Operation Transformation" television programme, the Community Food initiative, which aims to promote greater access and availability of healthy and safe food in low-income areas, and eatright.eu, a new website with a focus on healthy eating, food safety and physical activity. safefood's knowledge networks continue to enhance linkages across the island among food safety professionals working in the food production and processing sectors, research and academia and the wider public sectors. Digital engagement is an important feature of campaigns as it allows safefood to engage with customers in a cost-effective manner. safefood can build on this success by continuing to increase public awareness through these channels.

To conclude, some of the best examples of practical public sector cross-Border co-operation are in the fields of health and social care. I acknowledge, therefore, the great work of all those involved in cross-Border health co-operation and the difference they are making to people's lives. The health services in both jurisdictions have evolved in different ways but there has always been enthusiasm about collaboration where it is mutually beneficial. I look forward to continuing and developing this work in the coming years.