Jennifer Carroll MacNeill: Deepening North-South Health Cooperation

Thank you Mr Fairlock and having been a member of this committee for some years it's wonderful to join you again. As the committee will be aware there is a long history of cooperation between the Department of Health and the Department of Health in Northern Ireland and between the HSE and the six health and care trusts in Northern Ireland. And at the outset I really do want to acknowledge the strength of my relationship with my counterpart Minister Nesbitt who has already addressed this committee. Minister Nesbitt and I have had an immediately warm relationship and are very productive to date and I want to thank him for his engagement. I also know that in attending this committee, as I understand it, he was the first unionist member to address any meeting in the houses of the Oireachtas and I think it's important that he be recognised as such, which I think was really, really important. So our collaboration has grown into a really warm and constructive partnership and we've quite a lot of work to do and have been able to progress some things together. Senior officials and clinicians do meet regularly and they work together to improve health and social care provision for the benefit of patients across the island. The newly appointed Secretary General at my department, Derek Tierney, has met with his counterpart in Northern Ireland, Permanent Secretary for R in recent weeks, which I think continues to strengthen the relationship between the jurisdictions and a further meeting is planned for June. There is wide-ranging existing North-South collaboration on health through bilateral agreements, through cross-border initiatives, such as the North-South Ministerial Council, the Shared Island Initiative and the cross-border EU funding initiative, Peace Plus. 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, the All-Ireland Congenital Heart Disease Network, where 1,880 procedures have been completed since its establishment and the North-West Cancer Centre at Altena Glelven, where over 4,200 patients have received radiotherapy treatment locally. Both are based on agreements and they are underpinned by service-level agreements between our respective health services, North and South. And I do know that the committee has already heard from some of the stakeholders working in these very valuable initiatives. And as part of a broader commitment to deeper cooperation in 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. It's a very, very sensitive area. It's not perhaps the area that you might like to start with, of course, but it is an area of great need and closer cooperation does have the potential to reduce distress for families and improve how we respond to a very highly specialist service needed on this island. Encouragingly, the HSE has also been engaging with colleagues in Northern Ireland on discussions to further enhance cooperation across 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. That reflects a broader shared focus on identifying practical areas where cooperation can improve patient access, make better available use of 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, very importantly, on the construction of the new Daisy Lodge Centre in Kong in 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 cooperation projects under the Shared Island Initiative are being explored and they're considered on an ongoing basis in cooperation with our counterparts in the Northern Ireland Executive. We want to deepen collaboration between healthcare services on the island and also stakeholders are working across border to continue on the cross-border EU funded programmes. Peace Plus, which you know is a programme valued at €1.1 billion overall, includes a substantial investment of €97 million in projects focused on healthy and inclusive communities and on collaborative health and social care. And I'm really pleased that the 11 health-related projects selected are beginning to move into the delivery phase. Peace Plus builds on earlier programmes that supported large volumes of cross-border care and helped establish trusted networks of providers working collaboratively between the jurisdictions. Of course, one of the main vehicles through which we cooperate with Northern Ireland on health is of course the North-South Ministerial Council, which is something that I take very, very seriously and make sure I don't think I have missed an opportunity to attend or to work with my counterpart. At the most recent sectoral meeting in January, Minister Nesbitt and I formally approved a revised health work programme and that work programme identifies key areas of health cooperation that could be mutually beneficial and have significant impacts. And we intend it, though, as a living document. The priority is to convert all of this goodwill, but what's the practical enablers of cooperation? So the areas of cooperation are organised into 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, secure data sharing and interoperability so that patients who access care can have a more joined-up service across border, which I think is quite important. There's also huge scope to explore cooperation in areas such as genomics, clinical research, clinical trials and other specialist pathways where shared expertise and population scale can really achieve better outcomes for patients in both areas. Our cooperation is not just about service delivery. It's also about addressing inequalities that are often, as we see it, most acute in some border communities and also about supporting prevention, early intervention and resilience. That is particularly important where some communities continue to live with long-term intergenerational impacts of trauma, disadvantage or social exclusion. And I'm hopeful that the work programme will provide a useful framework for engagement and will drive health collaboration between the two areas for years to come. And I look forward to reporting progress on that, Chair. Very important to mention Safe Food, which is one of the North-South implementation bodies under the North-South Ministerial Council. And that really does play an important role in the promotion of food safety and healthy eating on the island of Ireland. It is a trusted source of information. It is well known. The public learn about food safety and build on practical skills and knowledge. And we have an excellent new CEO of that who came from the Department of Health, Joannie Cleric, which is a very welcome appointment. Minister Nesbitt and I are very keen to remove barriers to cooperation. And at the January North-South sectoral meeting, we instructed our officials and departments to examine some of the issues that we had come across relating to divergence in professional regulations between our jurisdictions so that it would be easier for therapists and other professionals to be able to work in either jurisdiction and that that wouldn't be a barrier to expanding workforce. It wouldn't be a barrier to expanding care. So the intent is to produce a joint paper for the autumn sectoral. And that work is important because goodwill is all well and good, Chair, but practical and regulatory issues can slow the delivery of care, and that's not what we want. So we've committed to working to ensure that professional regulations and all other areas of possible divergence are a, understood, and b, pragmatically managed so that we can deepen our cooperation. So in conclusion, let me thank committee members for the opportunity, and we're very excited to be able to hear, to answer questions. We do welcome your feedback. We welcome your ideas. North-South cooperation is a priority for our department, and I'm delighted to be here with my senior officials and the chief medical officer who will be delighted to take questions as well and explore ideas that you may have. There are, I will say to members, there are some practical barriers to advancing the scale of ambition that we would wish, and we recognize that there is perhaps a different funding situation in different areas in the two jurisdictions, which is important to be aware of, but we really are trying to work as practically as we can to achieve the most harmony between the two jurisdictions as possible.