Jennifer Carroll MacNeill (Dún Laoghaire, Fine Gael) | Oireachtas source

Having been a member of this committee for some years, it is wonderful to join members again. As the committee will be aware, there is a long history of co-operation between the Departments of Health in Ireland and Northern Ireland and between the HSE and the six health and care trusts in Northern Ireland. At the outset, I acknowledge the strength of my relationship with my counterpart, the Minister for Health, Mr. Nesbitt, who has already addressed this committee. He and I have had an immediately warm and very productive relationship to date and I thank him for his engagement. As I understand it, in attending this committee he was the first unionist member to address any meeting in the Houses of the Oireachtas and it is important that he be recognised for that. Our collaboration has grown into a really warm and constructive partnership. We have quite a lot of work to do and have been able to progress some things together. Senior officials and clinicians meet regularly and work together to improve health and social care provision for the benefit of patients across the island. The newly appointed Secretary General of my Department, Mr. Derek Tierney, has met with his counterpart in Northern Ireland, Permanent Secretary Farrar, in recent weeks and continues to strengthen the relationship between the jurisdictions. A further meeting is planned for June.

There is wide-ranging existing North-South collaboration on health through bilateral agreements and cross-Border initiatives, such as the North-South Ministerial Council, NSMC, the shared island initiative, and the cross-Border EU funding initiative, PEACEPLUS. There are quite a number of agreements in place covering specific specialist cross-Border initiatives that ensure patients can receive a range of medical services as close to home as possible. For example, there is the all-island congenital heart disease network, where 1,880 procedures have been completed since its establishment, and the north-west cancer centre at Altnagelvin, where over 4,200 patients have received radiotherapy treatment locally. Both are based on agreements and underpinned by service level agreements between our respective health services North and South. The committee has already heard from some of the stakeholders working on these valuable initiatives.

As part of a broader commitment to deeper co-operation on specialist paediatric care, agreement has also been reached to work together on perinatal and paediatric pathology. I welcome the fact that detailed discussions on the potential for an all-island service in this area are progressing. This is a very sensitive area and perhaps not one we would like to start with but it is an area of great need. Closer co-operation has the potential to reduce distress for families and improve how we respond to a highly specialised service needed on this island.

Encouragingly, the HSE have also been engaging with colleagues in Northern Ireland on discussions to further enhance co-operation on cross-Border and all-island specialist services in recent months. For instance, an acute services scoping exercise has commenced to examine opportunities for deeper collaboration in both scheduled and unscheduled care, the aim of which is to build on existing cross-Border pathways and identify areas where joined-up planning could further improve access and resilience. This reflects a broader shared focus on identifying practical areas where co-operation can improve patient access, make better use of available capacity and support more sustainable service delivery in Border regions, such as collaboration between the National Ambulance Service and the Northern Ireland Ambulance Service in emergency response and planning for cross-Border urgent or emergency ambulance calls or urgent incidents.

Work has also been commissioned in related areas. Under the shared island initiative, for example, work is continuing on the construction of the new Daisy Lodge centre in Cong, County Mayo, which is due to open to the public in spring 2027. This shared island funded project will double the capacity for families affected by childhood cancer to benefit from short therapeutic breaks. Proposals for other health related all-island investment or co-operation projects under the shared island initiative are being explored. They are considered on an ongoing basis in co-operation with our counterparts in the Northern Ireland Executive. We want to deepen collaboration between healthcare services on the island. Stakeholders are also continuing to work together on cross-Border EU funded programmes.

PEACEPLUS, a programme valued at €1.1 billion overall, includes substantial investment of €97 million in projects focused on healthy and inclusive communities and on collaborative health and social care. I am really pleased that the 11 health-related projects selected are beginning to move into the delivery phase. PEACEPLUS builds on earlier programmes that supported large volumes of cross-Border care and helped establish trusted networks of providers working collaboratively between the jurisdictions.

One of the main vehicles through which we co-operate with Northern Ireland on health is the North-South Ministerial Council, which is something that I take very seriously. I have not missed an opportunity to attend or to work with my counterpart. At the most recent sectoral meeting in January the Minister, Mr. Nesbitt, and I formally approved a revised health work programme. That work programme identifies key areas of health co-operation that could be mutually beneficial and have significant impacts. We intend it to be a living document. The priority is to convert all of this goodwill into practical enablers of co-operation.

Future areas of cooperation have been organised under three broad themes: acute services; health inequalities and population health; and the future of healthcare, which includes, among other things, closer work on digital systems and secure data sharing and interoperability, so that patients who access care can have a more joined-up service cross-Border. There is also huge scope to explore co-operation in areas such as genomics, clinical research, clinical trials and other specialist pathways where shared expertise and population scale can achieve better outcomes for patients in both areas.

Our co-operation is not just about service delivery. It is also about addressing inequalities that are often most acute in some Border communities and about supporting prevention, early intervention and resilience. That is particularly important where some communities continue to live with the long-term, intergenerational impacts of trauma, disadvantage or social exclusion. I am hopeful that the work programme will provide a useful framework for engagement and will drive health collaboration between Ireland and Northern Ireland for years to come. I look forward to reporting progress on that.

It is very important to mention Safefood, which is one of the North-South implementation bodies under the NSMC that plays an important role in the promotion of food safety and healthy eating on the island of Ireland. It is a trusted and well-known source of information for the public on food safety and it builds practical skills and knowledge. Safefood has an excellent new CEO who came from the Department of Health, Dr. Joanne Uí Chrualaoich, which is a very welcome appointment.

The Minister, Mr. Nesbitt, and I are very keen to remove any potential barriers to co-operation. At the January NSMC sectoral meeting, we instructed officials in our Departments to examine some of the issues we had come across relating to divergence in professional regulations between our jurisdictions. The aim is to make it easier for therapists and other professionals to work in either jurisdiction and to ensure that it would not be a barrier to expanding the workforce or expanding care. The intention is to produce a joint paper before the autumn sectoral meeting. This work is important because while goodwill is all well and good, practical and regulatory issues can slow the delivery of care and that is not what we want. We have committed to working to ensure that professional regulations and all other areas of possible divergence are understood and pragmatically managed so that we can deepen our co-operation.

I thank committee members for the opportunity to be here. We are very excited to answer questions. We welcome the committee's feedback and ideas. North-South co-operation is a priority for our Department. I am delighted to be here with my senior officials and the Chief Medical Officer who will be delighted to take questions and explore ideas that members may have. There are some practical barriers to advancing the scale of ambition that we would wish for. We recognise that there are different funding situations in the two jurisdictions. but we really are trying to work as practically as we can to achieve the most harmony between the two jurisdictions as possible.