Professor Deirdre Heenan:

As we have already said, health is an established area of North-South co-operation. One might have imagined the North South Ministerial Council would have grasped that nettle and moved the issue forward. I was interested in Ms Hanna's description of it. It does sometimes feel like an afternoon tea party. In terms of serious public policy, it is a missed opportunity. We are told ad nauseam that health is an established area of co-operation. We have to interrogate that statement and ask exactly what it means. Does co-operation mean that I tell you what I am doing, you tell me what you are doing and we have a nice cup of tea while we discuss it? That is not good enough any more. We do not have a committee to drive this forward. Looking back on our record in the area of health, including public health, you find that, if there is no strategic leadership, these things are talked about and then fall off the agenda until they are talked about again. That is very difficult.

I did a scoping study for the shared island unit. I spoke to consultants and others at the coalface to ask them what they thought. What really struck me was that no one said more co-operation would be a bad thing. There was universal agreement that there are many areas in which we can co-operate to achieve better outcomes. However, they were also concerned that, if you say this to the people in charge, you will be told the data systems are different, the information is different, the systems cannot speak to each other and there is no way to know whether outcomes are better North or South. We have been using that as an excuse for almost three decades. It is not beyond our wit to produce data sets to give us a robust understanding of outcomes North and South.

Of course, the world and his wife are talking about AI so I will have to introduce it into this conversation. Could AI be the mechanism whereby we make it possible to use data North and South? Then we need a way of sharing information. Quite frankly, on an island this size, it is bizarre that things are going on across the island that people working in the same area have no knowledge of. They may accidentally run into someone who works in the same area. This is not just an issue in clinical practice but also in research projects. We find people saying they heard about someone or read about their work and asking to collaborate because the information we have is invariably out of date and the websites we have are not maintained because project money has run out.

This is a really serious issue. If we are going to have change in this area, where is the leadership going to come from? Both healthcare systems are under stress. We are realistic. Who is going to put their head above the parapet and say that, while people are knocking at their door demanding to know what is happening about health in their area, they believe we should prioritise North-South collaboration? It is just not going to happen unless an external person comes along and says this should be a priority, that we need to agree it is a priority and that we need to agree what that priority looks like. I do not know where that is going to come from. There has been an awful lot of talk about it. After the Covid-19 pandemic, we were told that we had learned lessons and that we understood the importance of better collaboration. The key word here is "leadership". Where does the leadership in this area come from if both our health Ministers are working frantically to deal with difficulties in their own systems? As it is not realistic to expect that they will suddenly offer their services, it has to start at a joint governmental level. I would have thought the North South Ministerial Council would have been the ideal vehicle. We have a road and we have a vehicle. I do not know how we get the two together.