Ms Claire Hanna:

I thank our witnesses. This has been a really interesting session. Of course, it is core to the politics of right now. People's living standards should obviously be at the centre of everything elected people do. It is very much at the centre of how people will think about the future of this island, including our constitutional future. There is an opportunity to build something better and new. I have just finished the book by Fintan O'Toole and Sam McBride bringing forward arguments both for and against constitutional change and health features strongly as both an opportunity and a challenge. The book mentions how jurisdictions on both sides of the Border struggle to properly integrate services but it ultimately comes down on the side of there being an opportunity to make something that is better than the sum of its parts.

Last month, my Assembly colleagues brought forward a motion about CAR-T treatment for cancer on the back of the case of a young mother who spent her last six weeks in a hospital in London, away from her three children. She ultimately died of cancer and did not get to spend at time at home when the treatment she needed was available about an hour away as she lived close to the Border. Our system drove her to London, meaning that she and her husband were away from the children as they went through that experience. It makes no sense.

I was struck by Professor Heenan's comment that, where we have made gains, they are in large part as a result of really motivated individuals and really determined campaign groups, people like those families who are trying to fix a problem they have had to face, rather than the result of systemic approaches or politicians on either side of the Border grasping the opportunity. I will ask a few questions. Do we use the existing cross-Border mechanism adequately and appropriately? I hope I will be forgiven for making a political comment but the North South Ministerial Council is like a polite tea ceremony. It seems to meet and go through the motions but I do not think it meaningfully changes politics. The opportunity it presents is not being grasped in the way people thought it would be in 1998. Is there any more low-hanging fruit? Are there gains we could realise quite quickly within the operation of our current models? Are there continuing workforce issues? There is obviously an existential issue in that workers are mobile and understandably feel able to work in systems that give them the chance to practise safely and comfortably rather than the more chaotic system we have North of the Border. Is there fluidity that allows people to transfer between the systems? Are the witnesses aware of any international examples we could take inspiration from, particularly with regard to integrating two health systems in different political jurisdictions? Has anybody done that well? Are the witnesses aware of co-operation happening across borders in other comparable parts of the world?