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Rev Dr Robert Coulter, the Ulster Unionist Party Assembly member for North Antrim and UUP Stormont Commissioner, has warned the community could suffer because not enough money has been earmarked for health in the recently unveiled Programme for Government spending proposals.

Assemblyman Dr Coulter, who is also UUP Health Spokesman, made his remarks after chairing a health discussion panel at this year’s party conference in Belfast.

He added: “At first reading the full Programme for Government package runs to some £5.6 billion on schools, roads and hospitals – but the contribution for the health department is lower than the other departments in needs terms.

“The Ulster Unionist Party is disappointed with the proposed spending on health. It needed to be much higher given the fact people in Northern Ireland are living much longer.

“We required a radical budget for health; one which had quality as a central theme. Instead, the people of the Province have been allocated a budget which won’t do what those people require.

“The health budget for Northern Ireland is being seriously underfunded. We are between 25 per cent and 30 per cent lower than our counterparts in Great Britain.

“In practical terms, the draft budget will do nothing to drive down the waiting lists. Some £450 million has been allocated to health, when in reality, around £750 million is required because people live longer.

“The cash allocated to health in the Programme for Government is only dabbling with the health service. Being behind in health spending is one of the great injustices of Northern Ireland politics and makes our people second class citizens within the United Kingdom.

“As people live longer, we need to recognise that older people would like to be cared for at home – not in hospitals.

“The Programme for Government also needs to recognise that Northern Ireland will not be able to look after the most vulnerable groups in our society, especially the elderly, by cutting back on nurses.

“At one time, Northern Ireland had some of the worst waiting times in Western Europe. The Programme for Government budget should have addressed the urgent issue of investing in health. You can’t have wealth without health,” said Assemblyman Dr Coulter.

Mr President, Chairman, Ladies and Gentlemen.

Can I say a very big thank you to our panellists here this afternoon who have given us much to think about on the back of their own personal experiences with the National Health Service. To Brian, Patricia, Paula and Mary my sincere thanks and appreciation for giving up your time.

And a special word of thanks to Robert Coulter who chaired the session. Robert is our spokesperson on health matters at Stormont and together with John Mc Callister our Party voice is always heard at the Health committee and in the chamber during the many health related debates. As Minister, I want to thank them for their support.

As we have been hearing the National Health Service has come a long way since its inception in 1948. Sixty years ago times were very different. Our country was emerging from six years of world war and had just elected a new government. The concept of a national health service free at the point of delivery to all may have been viewed as a bold step at the time but one we give thanks for today.

So whilst a Labour Government may have been responsible for one of the greatest political achievements in the twentieth century, let’s not forget that our Party, the Ulster Unionist Party, played a key role in creating the National Health Service in Northern Ireland. It was William Grant MP who was the first Minister for Health in Northern Ireland and over the last sixty years many other people, including William Morgan and William Craig followed in his footsteps. Today, I stand here as the Minister for Health, Social Services and Public Safety – a position I am very honoured to hold. I have greatly enjoyed the last five months in office. There have been many challenges but we are already making a real difference.

In June, I confirmed the siting of the new acute hospital for the South West in Enniskillen which will be open in 2011. I also confirmed that a new enhanced local hospital will be built in Omagh and open in 2012. Now I recognise that there has been concern around Omagh over the future of health services in the town so to avoid any confusion let me reiterate my commitment that there will be a 24 hour Doctor led Urgent Care and Treatment Centre at the Tyrone County Hospital. I am also confident that in the near future further investment will be made in the Ambulance service in the west and I look forward to the conclusion of the consultation on the possibility of a midwife led maternity unit in Omagh.

Both of these hospitals represent a £450m investment in the South West but I am prepared to venture outside of my ministerial health portfolio. While I may not be in charge of roads, I have a vested interest in ensuring that patients have adequate access to both new hospitals so I will be liaising closely with Executive colleagues to ensure much needed improvements in the South West roads.

Mr President, within the first few weeks of taking office a number of issues landed on my desk which had the potential to cause problems.

Following negotiations I was delighted to be able to award the pay uplift to our Nurses and I want to thank those people who worked with me, including the Royal Colleges and the Trade Unions, to deliver this successful outcome. In listening to these bodies I also gave an undertaking that I would look at the Agenda for Change process and today I can state that all grades will be matched by December of this year with all pay uplifts being met by March of next year.

Mr President, Junior Doctors are the backbone of our acute health service and it became clear early on that there were real problems around recruitment issues. Thankfully on 1 August, through appropriate planning we were able to overcome these hurdles and made sure that virtually all places were filled., thus avoiding the predicted crisis within our hospitals.

However I wanted to ensure that such scenarios would not be repeated locally in the future. I asked Professor Randal Hayes to review the process for Northern Ireland and I am indebted to him and his team for reporting back to me so swiftly with excellent recommendations which I have already set in motion to implement.

Undoubtedly one of the biggest challenges that I have faced has been in the area of mental health. Frankly I have been appalled by the lack of investment over many years but heartened by the dedication of so many people who work at the front face of mental health. I am committed to seeing the full implementation of the Bamford review but if we are serious about meeting the need then we need the money. I am grateful to Executive colleagues for working with me but I say to the Minister for Finance that paltry sums for mental health in the comprehensive spending review are indefensible.

This issue has been forgotten about for too long. I am not prepared to countenance that any longer.

So I have established the board of experts under Professor Roy Mc Clelland who will champion mental health and learning disability issues. One of their first actions has been to look at the area of suicide.

Last year alone there was a 36% increase in the number of people who took their own lives and I know, having met with bereaved families just what an impact suicide can have upon so many families and communities. So I want to see adequate resources being directed towards suicide prevention. Already, through a range of initiatives we have hit the ground running. Numerous engagements and meetings with a range of interested parties have been held including significant engagement with representatives from the internet providers. There will be a region wide telephone helpline across Northern Ireland in addition to a further 350 GP’s undertaking awareness training before January 2008. A public information campaign has been launched and I have commenced an engagement process with the media to ensure sensible reporting continues.

Mr President, no member of the health service should have to endure abuse or the possibility of assault. In July, I launched the Zero Tolerance campaign against staff and I am considering introducing similar legislation to that which exists in Scotland to deter attacks on emergency staff and have asked for assaults on Health Care Workers to be included in the Criminal Justice Bill which is soon to go through Westminster. Let me be clear anyone who assaults a member of staff will be treated within the full rigours of the law.

And in dentistry I announced earlier this month that I was investing £4.4m to help in resourcing overhead costs, purchase new equipment and to assist Boards by plugging the gap through the growth of the salaried dentist sector.

So whilst we’ve hit the ground running there is much more still to be done.

My overriding principle at all times will be ensuring that we put patients first.

And this principle will be at the core of my deliberations around the Review of Public Administration.

On my first day in office, I was presented with a plan for the future of our health service in Northern Ireland that had been dreamt up by Direct Rule Ministers to suit Direct Rule Ministers. Upon initial reading I had concerns and so I have spent the last five months looking at the plans in depth.

As you will be aware I recently wrote to all staff informing them that it was highly unlikely that any further structural changes would be completed before April 2009.

I make no apology for taking a little extra time.

Peter Hain and the direct rule administration took five years to come to a conclusion. I have been in office five months. It is imperative that we get the new structure correct for everyone.

In planning for the future I will be focusing around three core functions; stringent performance management; sound financial control; and commissioning. And I have no hesitation in saying that I want to see much more input in the new structures from local representatives too.

We have to remember that we are a small nation but one that has growing health needs. Whilst spending in Northern Ireland per head is higher on health care, our need is greater compared to Great Britain. This fact has been in my mind over recent days as the budget has been dominating the news.

So let me say a few words regarding health care spending.

Let me be clear I have agreed a draft budget as the basis for consultation with the Assembly and the general public. I have not agreed a final budget.

So despite the spin and hype that has been emanating from Stormont Castle and some naive comments from DUP representatives, the reality is that for health the current proposals represent a standstill budget, particularly in years one and two that barely allows a creep forward in terms of new or improved services. The draft budget proposals as currently presented will do nothing to help in driving down waiting lists further. And frankly, people deserve better.

Yes, it is correct to state that health has received an extra £450m but our inescapable costs such as salaries and the rising costs of drugs have risen to approximately £700m. Our population is growing and we are living longer. Consequently our Health Service is treating more people. So dabbling with the health service budget in a manner akin to Thatcherism is a dangerous step.

We are no different to our fellow citizens in Great Britain. We pay our national insurance contributions and are entitled to the same levels of treatment. Yet healthcare spending in Northern Ireland has been behind England and will be even further behind if the current draft proposals are anything to go by. This is a grave injustice and equality issue. We should not be treated as second class citizens within the Kingdom.

So as we reach the consultation phase, I want to hear the views of those in the front line and on the ground within the health service including the patients. These are the people who face reality on a day and daily basis.

The service has already contributed £140m efficiency savings and we will meet our target of a further £340m in efficiency savings over the next three years.

Undoubtedly there have been significant improvements in healthcare in Northern Ireland over the last five years but such advances will not continue if we are not prepared to invest.

I want to see further investment in screening for Bowel Cancer and Cervical Cancer. We are fortunate to have leading cancer specialists such as Professor Paddy Johnston working within the NHS in Northern Ireland and their work must be supported. Funding for screening, in essence, means saving lives.

Tackling the growing problem of obesity is one which I want to see being taken much more seriously. So I will work with colleagues across the Executive to identify a more effective focus on this issue.

Children play an important role in our society. Currently spending in Northern Ireland on children’s issues is nearly a third behind what is spent in England. This must change going forward.

Alcohol accounts for upwards of 40% of admissions to the average accident and emergency unit on every Friday night in Northern Ireland. Too many people are being referred to mental health specialists as a result of alcohol and too many young people are experimenting with binge drinking. I am prepared to look at a local tax but taxation alone will not solve this problem. Supermarkets and off licences have a role as well and I will be engaging with them to see what measures they are prepared to adopt. The days of the blue bag syndrome must be over.

In social policy I look forward to the speech and language task force report which is expected in December and I am indebted to Lord Maginnis for investing so much time in leading the panel of experts around Autism. But to see real change in these important areas further investment will be required.

I have already stated that I intend to strengthen the process to identify victims of domestic violence so that anyone who attends an A&E unit or doctors surgery with a physical injury is asked about domestic violence.

Under infection control, I am determined to crack down on the high levels of MRSA and C-difficile. This is an issue that I am not prepared to compromise on. Patients demand clean hospitals and I agree with them. So whilst there has been some progress in recent years much more is required. I will be looking at all options including screening patients for MRSA and the regulation of visiting and movement of the public within hospitals. If necessary I will introduce independent, unannounced inspections to ensure standards are met and maintained.

So fellow Unionists, my half term report can be summarised as much done but much more still to be achieved. But for real change to be effective further investment is required.

I know that many people within the Health Service are up for the challenge and together I know that we can make a real difference. I want to see a local health service for a local community.

Mr President, putting patients first is my priority. So as we embark on delivering this task, I ask you to join me in standing firm for patients. Standing firm for health workers and standing firm for our health service.

Together I know that we can deliver.

Thank You

Following today’s publication of the Draft Budget, Ulster Unionist Finance Spokesperson Roy Beggs MLA has questioned the Finance Minister’s decision to give a much greater increase to the budget of the DUP-Sinn Fein Office of the First Minister and Deputy First Minister than that given to the Department of Health.

Mr. Beggs said, “Today’s Draft Budget follows the Finance Minister’s recent statement in which he warned of the need to take ‘difficult and challenging decisions’. Now we know what he meant by difficult and challenging decisions – increasing the budget for OFMDFM by 5.9% over the next 3 years, while giving the Department of Health a mere 3.8% increase. It is staggering to think that the DUP-Sinn Fein Office of the First Minister and Deputy First Minister is receiving greater priority than our National Health Service. That this is occurring at a time when health expenditure in the rest of the UK is rising at a significantly greater level will only increase the unacceptable disparity between health care in Northern Ireland and elsewhere in the UK.

“It is also puzzling that the Draft Programme for Government says that it is giving priority to ‘personal health and well-being’ and goes on to recognise that a ‘strong economy requires a healthy … population’. If this is so, why has OFMDFM received a much greater budget increase than our National Health Service? If the First Minister and Deputy First Minister, and the Finance Minister, had a genuine commitment to our National Health Service it is obvious that they would not have made the choice to pass by the NHS and increase the budget of their favoured department – OFMDFM.

“Under the last Devolved Administration, the OFMDFM budget was £32m – now, under this Draft Budget, it has become £73.9m. Quite clearly, the Finance Minister has judged that the ‘difficult and challenging decisions’ do not apply to OFMDFM – and that it is much more appropriate for the consequences of difficult decisions to be experienced by the NHS.

“Over the coming weeks both in the Assembly and in its Committees, the Ulster Unionist Party will continue to subject this Draft Budget to careful scrutiny. A budget that gives priority to OFMDFM over the National Health Service is not a budget that puts the needs of Northern Ireland first”.

Following today’s debate on the requirement handed down by the Courts to the Department of Health to issue guidelines on the legal termination of pregnancy, Ulster Unionist MLAs John McCallister and Danny Kennedy have welcomed Health Minister Michael McGimpsey’s statement that he is not seeking and will not seek to change Northern Ireland’s abortion law.

Mr. McCallister said, “today’s debate on abortion clearly shows that opinion in the Assembly remains resolutely opposed to any attempt to extend the 1967 Act to Northern Ireland. Both the motion and the amendment reaffirmed and reasserted the existing legal position – that abortion is unlawful except when necessary to save the mother’s life or to prevent her physical or mental harm. As I stated in my speech, I oppose the extension of the 1967 Act to Northern Ireland and any attempt to undermine the existing law in this part of the United Kingdom. It is of fundamental importance that the Department of Health, in discharging its legal obligation to bring forward guidelines on the lawful termination of pregnancy, ensures that the guidelines are entirely consistent with the existing law. It is therefore to be welcomed that the Minister has said that the proposed guidelines are being reviewed to ensure that this is so”.

Mr. Kennedy also emphasized the strong support within the Assembly for maintaining Northern Ireland’s present abortion law. He said, “as a member of the Assembly’s All-Party Pro-Life Group, I – like my colleague John McCallister – am firmly opposed to any attempt to undermine Northern Ireland’s existing abortion law. The 1967 Act which applies in the rest of the UK has resulted in more than 1 in 5 pregnancies in GB ending in an abortion. No right-thinking person can accept such a situation as desirable. This is why the amendment moved by myself and my colleague explicitly stated that the guidelines to be brought forward by the Department must be consistent with the existing law. I welcome the Minister’s clear and unambiguous declaration that he is not seeking and will not seek to change Northern Ireland’s abortion law”.

Sam Gardiner MLA, the Ulster Unionist Assemblyman for Upper Bann, spoke today of his delight at the news that Ulster Unionist Health Minister Michael McGimpsey had announced a £15.2 million investment for Craigavon Area Hospital.

“This is the sort of financial injection which makes a real difference, “said Mr Gardiner, “and I am delighted that it was an Ulster Unionist Health Minister who was able to deliver for the people of Craigavon and Upper Bann in general.”

“This money will provide a new Trauma and Orthopaedics unit costing £9.4 million and this will include two new theatres and a total of 33 beds.”

“An additional investment of £5.8 million will provide infrastructure improvements at the hospital.”

“Investment in the Trauma and Orthopaedics unit is part of a strategy which aims to cut waiting times for fractures and orthopaedic services.”

“This is a local Ulster Unionist Health Minister delivering for the people. What is more Michael has said that he will expect to see improvements in waiting times by March 2008, including fractures being treated within 48 hours and people who require orthopaedic surgery being treated as an inpatient or day case within 21 weeks.”

Sam Gardiner MLA, Ulster Unionist Assemblyman for Upper Bann, today called for a new look at the grading of medical secretaries in Northern Ireland.

“I am concerned that, after three years medical secretaries across Northern Ireland have been told that they have been banded across the board as band 3 entry grade medical secretaries. Considering that some of the people have been in post for 30 years, I have to ask the question – what exactly does it take to be raised to the standard band 4 medical secretary grade ?”

“It would appear that the Northern Ireland health trusts have gone out on their own in this instead of waiting for other parts of the country involved in the agenda for change programme. This sends out a terrible message to staff of just how the Trusts view them and value them.”

“I am also led to believe that information on this decision under the freedom of information legislation has been blocked. This is a completely unacceptable way for the trusts as employers to behave.”

“I will be raising the matter with Health Minister Michael McGimpsey, who I know values the work of health professionals to see if anything can be done.”

Danny Kennedy MLA, Deputy Leader of the Ulster Unionist Party, has addressed a group of National Health Service senior managers from across the UK at Parliament Buildings in Stormont on the theme of leadership.

The NHS managers were delegates at an event organised by the King’s Fund, an independent charitable foundation working to promote better health through developing policy and fostering innovation and leadership in the health service.

Mr Kennedy told the delegates :

“Leadership, in my experience, is as much about behaviour as it is about skills. Skills can be taught. Behaviour is more difficult. It is often intrinsic to the individual and, to this extent, leaders are often born and not made.”

“Leadership is also about style. The style that may suit one situation or set of circumstances may be wholly inappropriate in another. What is good one day can be bad on the next. A leader, for instance, can appear resolute on one occasion and, on another, dictatorial. Mrs Thatcher’s leadership is a case in point. It was suited to the Falklands War and to addressing the nation’s economic malaise in the early 1980’s. It appeared resolute in those contexts. When it came to Europe, it appeared, on the other hand, as intransigent. The enabling war leader became the obstacle in the way of progress a few years later.”

The Ulster Unionist Deputy Leader continued :

“That is why we need to be careful about the cult of leadership. Such a raising of the leader to almost venerated status, can cause massive political angst when they have outlived their usefulness and their political time. People eventually become exhausted by the demands of an authoritarian leadership. Such a leadership is also highly personal and few successors can replicate it.”

“Leaders,” he said,” should never be afraid to be courageous.

Quoting British Prime Minister Lloyd George he said :

“Don’t be afraid to take a big step when one is indicated. You can’t cross a chasm in two small steps.”

Sam Gardiner MLA, the Ulster Unionist Assemblyman for Upper Bann, is to seek a meeting with the Chief Executive of the Craigavon Area Hospitals Groups HSS Trust, and with Health Minister Michael McGimpsey, following the disclosure in the Assembly that Craigavon Area Hospitals have the worst record for MRSA in the Province over the past 5 years.

“I am disturbed by the figures made available by Health Minister Michael McGimpsey and I intend to discuss these figures with both him and with the Chief Executive of the Craigavon Area Hospitals Groups HSS Trust.”

“Craigavon Area Hospital Group HSS Trust has had 35 deaths from MRSA in the past five years. This compares to 20 in the Royal Group of Hospitals, 17 in Altnagelvin, 24 in the Ulster Hospital, 11 in the Sperrin Lakeland Trust, 6 in the Causeway Trust and only 1 in the Green Park trust. I am shocked by Craigavon’s position at the top of the table – well clear of Belfast City Hospital in second place with 27 deaths.”

“This is not the kind of table Craigavon wants to be at the head of. It is a table of death.”

“The vast bulk of these deaths occurred in Craigavon and not in Lurgan or South Tyrone. Craigavon accounts for 15% of all MRSA deaths in the Province. There are questions that need an answer.”

The announcement that the Dentistry service in Northern Ireland is to receive a 6.4 million pounds boost has been greeted with delight by local Ulster Unionist MLA, Tom Elliott.

Mr Elliott said: “This is great news for the local area as many people in Fermanagh and South Tyrone are struggling to find a dentist that caters for NHS users or to afford the rates of private dentistry services.

“Within Fermanagh, many people have to spend months attempting to find a dentist but with the new incentives laid out by Health Minister Michael McGimpsey I am hopeful that we will see more dentists providing NHS treatment in Fermanagh and South Tyrone and indeed across Northern Ireland.

“The number of dentists in Northern Ireland has never been the problem, and indeed we have the highest ratio of dentists per head of the population in the United Kingdom. The problem has been that many of these dentists have gone private in recent years and it was vital that there was a move like this to encourage them to become available once more for the majority of citizens in Northern Ireland who use the NHS.”

The announcements include financial packages concerning four main areas of dentistry treatment. 2 million pounds will be used to help with continuing price rises in the operational costs of running a dental practise. 1.5 million will go towards helping increase the standards of sterilisation and disinfecting practises. £500,000 will go towards training allowances with a further £400,000 to be used as subsidy for current dentists and to encourage dentists that have left the NHS service to return. Of the 6.4 million pounds that will be injected into the service this year, 4.5 million pounds of investment will be recurrent, an increase of over 50% in funding for the service.

The Ulster Unionist MLA concluded: “Within the United Kingdom, Northern Ireland has the worst dental health. For example, in comparison to the rest of the UK our 12-year-olds have almost three times the level of dental decay. With these new investments I firmly believe that inadequacies such as this will improve dramatically or disappear completely within the coming years. As more dentists return to providing NHS care this will make it easier to receive the dental health provision that we all deserve without having to pay large amounts of money to private practises.”

Speaking at the launch of Breast Cancer Awareness Month at Stormont today, UUP South Down MLA John McCallister said,

“I welcome today’s launch of the Annual Breast Cancer Awareness Month for October. Breast cancer is the most common form of cancer amongst women in Northern Ireland. Every year around 900 women are diagnosed with the disease and one in twelve women will develop the cancer during their life time. These large numbers mean that many families in our society will, either directly or indirectly, have their lives affected by breast cancer.

“I am pleased that because of recent developments in awareness and early detection, recovery rates are showing signs of improvement. Today in Northern Ireland there are 6,000 women living with a diagnosis of Breast Cancer. To ensure that we continue to see an improvement in these figures all women should be entitled to a detection service which is easily accessible and does not require excessive waiting times.

“I urge everyone to get involved in Breast Cancer Awareness Month, both by increasing awareness of the signs and symptoms of the disease and by raising much needed financial support. It is essential that adequate funding is available to allow research to continue, so that hopefully one day this will be a thing of the past. It is also crucial that those who are experiencing the reality of breast cancer are treated with dignity and are provided with the support they deserve.”