Ms Bairbre Nic Aongusa:

I thank the committee for inviting the Department to outline and discuss North-South co-operation in the area of health. Co-operation in this area makes sense because 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, resources and exchanging good practice. The Department of Health is committed to strengthening and growing North-South co-operation in this area. Members will also be aware that both Ministers for health meet under the auspices of the North-South Ministerial Council, NSMC, to discuss and share experiences on a wide range of issues. This spirit of co-operation is in evidence through the work of Co-operation and Working Together, commonly known as CAWT, which is delivering a number of cross-Border health and social care projects in association with the health and social care services in both jurisdictions and also with the support of EU INTERREG funding.

The HSE, as the key agency with responsibility for the delivery of health services, is proactively involved in the development of linkages between the services here and in Northern Ireland. The executive has a small number of personnel designated to lead on this work and to assist with establishing contacts between individual services in both jurisdictions. This work is greatly supported though the HSE's active participation as a leading partner in the CAWT organisation. The HSE and CAWT, with the involvement of the Department of Health, Social Services and Public Safety in Northern Ireland and the Department of Health work closely with the North-South Ministerial Council on matters of mutual interest to both jurisdictions.

I would like to briefly outline some areas of specific co-operation in health. There is continued engagement between the Department of Health and the Department of Health, Social Services and Public Safety on progressing co-operation in respect of acute hospital services. A clear example of that co-operation was evident in the instant and comprehensive assistance afforded to the HSE and to patients of the north west during the catastrophic flooding of Letterkenny General Hospital at the end of July 2013. The Department of Health has placed on record with the authorities and service providers in the North, in particular Altnagelvin Hospital, its sincere gratitude for that assistance.

The needs assessment of congenital cardiac services on an all-island basis, which is currently being initialised, is a pragmatic example of co-operation across both jurisdictions that seeks to create an effective integrated service for the benefit of patients.

In addition, a working group established by the Department of Health to determine how best to provide emergency aeromedical support to the ambulance service on a permanent basis has, as part of its membership, representatives from the Department of Health, Social Services and Public Safety of Northern Ireland and the Northern Ireland Ambulance Service.

The terms of reference of the group include giving consideration, in the medium term, to the potential for an all-island approach to emergency air medical support.
The committee will also be aware of the proposed new radiotherapy facilities at Altnagelvin Area Hospital in Derry. The Government has committed capital funding for the unit which will offer huge benefits for cancer patients from both jurisdictions requiring radiation oncology services when it opens in 2016. It will improve geographic access to radiation oncology services for over 500,000 people living in the north west of the island. It will also considerably reduce travel times for patients in Donegal and surrounding areas. The project is an excellent example of cross Border co-operation and great progress that has been made to date to ensure the delivery of the new unit. Officials from both jurisdictions are working together on the service level agreement for the operation of the unit.
On alcohol and tobacco, the promotion of health and well-being is very important for all our citizens. There is important and ongoing co-operation between the two jurisdictions on health promotion issues including that of alcohol, which is one of very serious concern. The North-South alcohol policy advisory group, supported by the Institute of Public Health, was set up to undertake work on the issues relating to alcohol availability. This work contemplates examining product, price, promotion, and place, as well as hidden harm, which includes the need to support children with substance-misusing parents or carers. Last October, the Government approved an extensive package of measures to deal with alcohol misuse to be incorporated in a public health (alcohol) Bill. Work is progressing on the development of this legislation which will provide, inter alia, for a minimum unit price in respect of alcohol. This is a mechanism of imposing a statutory floor in price levels per gramme of alcohol that must be legally observed by retailers in both the on and off-trade sectors.
Concrete steps are being taken jointly with Northern Ireland to prepare for the development and implementation of policy on minimum unit pricing. A health impact assessment, HIA, has been commissioned in conjunction with our counterparts in Northern Ireland as part of the process of developing a legislative basis for minimum unit pricing. The assessment will study the impact of different minimum prices on a range of areas such as health, crime and likely economic effects. It is expected that the findings from the HIA will be available by the end of quarter 2 of this year. Minimum unit pricing is key to reducing the harm of alcohol in adolescents and problem drinkers. Collaboration with our colleagues in Northern Ireland on the HIA sets a good example of progress which we can make together in tackling the issue of alcohol abuse. The Minister for Health and his Northern Ireland counterpart are in agreement on the need to act simultaneously to allay concerns regarding negative impacts on cross-Border shopping.
An inaugural North-South tobacco conference was held in Belfast in November last. It provided a platform for speakers, both local and international, to share their experiences and expertise in respect of tobacco control research and policy. Good progress has also been made in respect of standardised packaging and the general scheme of the relevant Bill has been published and has been referred to the Joint Oireachtas Committee on Health and Children. The joint committee called for submissions on the general scheme and the first in its series of public hearings on the matter was held on 23 January. I understand the committee is discussing this matter again today.
There has been significant co-operation between the Public Health Agency in Northern Ireland and the National Office for Suicide Prevention, NOSP, in respect of suicide prevention measures and the implementation of the all-island action plan is ongoing. Particular actions arising from this approach have included understanding risk issues - particularly for young men - the roll-out of applied suicide intervention skills training, ASIST, and the sharing of training resources. As part of its programme of work over the next three years and in partnership with the Department of Health and the health authorities in Northern Ireland, the NOSP will further develop and implement the all-island action plan, focused on knowledge transfer, sharing of resources and information on programmes that are exemplars of good practice. Suicide is a complex issue and there is no single or easy interventions that will guarantee success. However, by promoting cross-organisation collaboration and the development of networks and partnerships we can maximise the impact of our suicide prevention initiatives.
As members are no doubt aware, the Food Safety Promotion Board, or safefood, is one of the six North-South implementation bodies established under the Good Friday Agreement in 1999. It is principally charged with tasks involving food safety awareness, supporting North-South scientific co-operation and fostering links between institutions working in the field of food safety. It has been engaged in a wide variety of projects and campaigns including continuing to support the all-island obesity action forum, the purpose of which is to support the implementation of obesity policies; the "Stop the Spread" public awareness campaign, which was launched in May 2011 to raise awareness that excess weight has become the norm in Ireland and to encourage people to take action; and an independent television production "Operation Transformation", which has been sponsored by Food Safety Promotion Board since 2011.
I am pleased to report that e-health is an area in which we are developing very positive and meaningful relationships with colleagues in Northern Ireland. As part of the Irish Presidency of the Council of the European Union there was very useful co-operation during e-health week in May 2013. The Northern Ireland Minister for Health, Social Services and Public Security, Mr. Edwin Poots, MLA, and his officials were welcome guests at the three-day conference on e-health we hosted in Dublin at that time. The e-health strategy approved by Government and published on 13 of December. It highlights the benefits of e-health from both a jobs and patient-care perspective. We are interested in working more closely with our colleagues in Northern Ireland in this area and we believe there may be potential for an all island approach to e-health. This would have benefits for patients and providers on both sides of the Border.
I am of the view that this short presentation has demonstrated the depth and breadth of co-operation between the two jurisdictions in the area of health. We in the Department of Health will continue to foster that co-operation. While I have attempted to give members a flavour of progress on issues of co-operation, it is not been possible to cover all areas in the time available. My colleagues and I are happy to answer any questions members may wish to pose.