Jim Wells
South Down · Democratic Unionist Party · Northern Ireland
“On a point of order, Mr Deputy Speaker. In November 1982, I made my maiden speech in the Chamber, and, here we are, 40 years later, and I am making my last speech in the Chamber as a DUP MLA. I was the last person in the Public Gallery when the Assembly collapsed in 1976.”
“<BR /> <BR />Mr Deputy Speaker, I thank you for your indulgence and for your patience with me over many years. Unfortunately, Mr McGlone has just left the Chamber; I was about to thank him. I have enjoyed my 27 and a half years in this Building.”
“I wish that I could, but I have only five minutes. <BR /> <BR />That was so that a very small number of Irish language zealots could go in and register their marriage or civil partnership in Irish or in dual language: £261,000. Did anybody stop to think about whether there was a more cost-effective way of doing that?”
“We are all perfectly happy with a genuine expression of people's culture. That is fine. However, when the language is so cynically used by militant republicanism, unionism has difficulties. Why, for instance, is there no translation into Irish of the words, "United Kingdom", "Londonderry", "Northern Ireland" or "Her Majesty The Queen"?”
“The Member has made the point for me. The official who came to the Committee made it absolutely clear that £261,000 had been spent already. It was farcical to bring that before either the Finance Committee or the Assembly, because the money had been spent and the processes had been set up.”
“If they want the unionist community to accept the Irish language as a genuine cultural expression, they should get rid of the political baggage and extremism, and stop using the Irish language as a political weapon to try to subjugate unionism.”
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“I wish that I could, but I am really running short of time.”
“Thank you for your indulgence, Mr Speaker, but the point that she is making is a valid one. We are having great difficulty in the rural hospitals in attracting staff. I will give one recent example. Belfast City Hospital advertised for three consultants. Six people applied, and the hospital took all of them on, because it realised that the supply of consultants for A&E was so finite that if it did not, it would be causing problems down the line. Altnagelvin needed an extra consultant in A&E, but none was any longer available. <BR /> <BR />We are having trouble throughout Northern Ireland, away from the teaching hospitals, in attracting middle-grade doctors and consultants in many fields. Again, that lends itself to the concentration of services into particular specialisms in major hospitals. That does not —”
“<BR /> <BR />Mr Kennedy, Mr Hazzard and several others from the Down district raised the issue of the removal of A&E cover, particularly out-of-hours cover, at Downe Hospital. That was not a cutback. That was simply the reaction to the fact that we did not have the staff to provide it. We were finding it impossible to attract middle-grade doctors to take on those shifts. Legally, you cannot provide that level of service without the expertise.”
“<BR /> <BR />It is now accepted that people will travel from Strabane, Enniskillen, Ballymena, or wherever, to that centre, because they know that there is where they will get the best treatment. If you were to suggest that we dissipate that level of care around the country, there would be uproar. Therefore, it is not rocket science as far as strokes are concerned. <BR /> <BR />Yes, Members are absolutely right: we opened Downe Hospital in 2009 at a cost of £64 million. That was an indication of our commitment to the people of Downpatrick. There have been difficulties referred to in this debate, with the temporary closure of some capacity, but there is still a range of services provided, including acute medicine, cardiology, stroke and fracture rehabilitation. Those continue to be provided in the hospital.”
“The Member is right when he says that the unit does not exist at the moment in Craigavon, and there is no question of any transfer of services until it does. However, if he takes time to read the literature, he will see that it shows that, throughout the world where this has been done and the measurements have been taken, people recover more quickly, live longer and have a higher chance of survival in a centralised unit. <BR /> <BR />This is not rocket science, because it is the same for cancer, for instance, in the City Hospital. We have concentrated services in Northern Ireland for cancer sufferers at the City Hospital, where we can have a large team of expert cancer surgeons and consultants to deal with a full range of conditions.”
“Can I make it absolutely clear that the decision on Daisy Hill is not being taken as a result of Transforming Your Care or the contingency savings? It is being done purely on the clinical assessment of what we need to do and what is best for the stroke patients of the Southern Trust area. <BR /> <BR />The science is absolutely overwhelming. Therefore, you have a choice. You can maintain the present service in Daisy Hill, knowing that that is not the best model for the people of Newry and Mourne or south Armagh, or you can opt for a central model in Craigavon, where the outcomes are quite clearly of a much higher standard. <BR /> <BR />To put it crudely, you have more chance of surviving a stroke if you go into one of the more modern, central units than if you stay at your local hospital.”
“It might make a good headline, but you will still have your first point of contact at Daisy Hill. You will then be taken to the more intensive facilities that are available in Craigavon Area, and that is exactly what is being done in every other part of Northern Ireland and throughout the United Kingdom and western Europe. All the evidence says that that is the best way to do it.”
“Remember, also, that we are asking the Dungannon people to make the same difficult decision. Their patients will also be going to Craigavon. <BR /> <BR />Let us nail this absolutely: when you have a stroke in the Newry area, you will go to Daisy Hill Hospital. You will be taken by ambulance to Daisy Hill, and, if you require the clot-busting drugs, as they are known, for thrombolysis, you will receive that treatment immediately in Daisy Hill Hospital. The phrase is "door to needle within an hour", and that will almost certainly be achieved by that process. If you require more intensive care, you will be taken for 16 days to Craigavon Area Hospital. After that, you will be brought back to convalesce in Daisy Hill. The message that is going out that they are removing stroke services from Daisy Hill Hospital is simply not true.”
“The honourable Member will find that all the trusts are moving to one centre of excellence for stroke services in each of their areas. It is not possible to provide the full range of skills and facilities at every hospital. <BR /> <BR />I will go off-message a bit here and say that I read with great interest what Mairead told Newry and Mourne District Council about this important issue. Councillor John McArdle was there. There is absolutely no doubt that all the empirical and scientific evidence says that what the Southern Trust is doing is absolutely right for patient outcomes. I know that this is a very difficult argument for the folk who live in the Newry area, but the reality is that, in terms of survival and outcome, the best option is to have the highest quality in one centralised unit, in this case Craigavon.”
“This may mean that they are centralised as part of a wider clinical network in order that they can deliver up-to-date, modern services. That is something not to be feared but rather to be welcomed because it provides the opportunity to deliver safer, better and more sustainable services up to the standard that we would like to see for all our constituents. <BR /> <BR />I will now move on to the two hospitals because I know that those are the main interests here.”
“I also understand how difficult it is for local communities and their representatives to see the reduction or removal of highly valued services that have provided excellent care to local people for many years. I understand those concerns because I questioned similar decisions when in another role. However, faced with the evidence and the pressures that I have outlined, significant change in the way we deliver services is required. We simply cannot continue as we are. <BR /> <BR />We should and do continue to deliver as many services as close to patients as possible, and that is consistent with the direction of travel of Transforming Your Care. However, there will be occasions, whether for reasons of sustainability or safety, that some acute services will need to be changed.”
“Thirdly — this is a legitimate concern — it allows services to be provided more efficiently and more cost-effectively. That is particularly important, given the scale of the financial difficulties that we face and to which many of you have already referred. <BR /> <BR />The out-turn of this process and the need to ensure stability has been that there has been some reduction in the number of services that can be sustained in smaller hospitals. I fully understand Members' concerns. Of all the people in this Building, I have maybe been around South Down and the Daisy Hill Hospital longer than most, and I perfectly understand where Members are coming from.”
“We also have an environment of fast-growing opportunities in technology and medical interventions. That latter development is having an important effect on how we provide services. As knowledge of treatments and interventions grows, it has become obvious — this is backed by all the statistical and clinical evidence — that many of the treatments delivered in the acute sector achieve better results for patients if they are delivered in larger and better-resourced hospitals. That means that we have seen a centralisation of services across a range of specialities. This has had a number of benefits. First, it means that, in clinical terms, patients are being treated by specialists. Secondly, those teams are larger and therefore more resilient and sustainable in terms of recruiting and retaining staff.”
“<BR /> <BR />It is important that we should not confuse the current financial context with the need for strategic change in how we deliver health and social care in Northern Ireland in order to further improve the quality of services provided and to use the available resources with maximum efficiency. The strategic change has been set out in 'Transforming Your Care', and it will affect local hospitals such as Daisy Hill and the Downe, bringing challenges and opportunities. <BR /> <BR />The greatest challenge we face — you are all aware of this — is increasing demand. We have an increasingly elderly population, which, obviously, leads to a rise in demand for services and an over-reliance on those services. Added to that, we have a population that has growing expectations of the quality and accessibility of service.”
“In order to achieve financial break-even, each trust has produced a range of contingency plans for this year — 2014-15 — and each trust has provided assurances that its services will remain safe and effective. That includes the Southern Trust and the South Eastern Trust. I have, therefore, had to make difficult choices in allocating resources and determining the measures needed to secure break-even this year, and the same will be required of me for 2015-16. I have no doubt that we will return to this important matter in the House in the weeks and months ahead. That is guaranteed.”
“Following that, I will make a few general observations about the necessary beneficial, strategic change that, we know, is needed in all our smaller hospitals. Then I will move on to the specific issue of the two hospitals. <BR /> <BR />As I have stated previously, given the financial challenge I face, it is simply not possible to maintain current levels of service provision in the absence of all the required funding. Members will certainly hear more of that in the incoming weeks. My priorities are to ensure that the services provided are safe and effective and that my Department achieves financial balance, as is required of all Ministers.”
“When you respect someone and their judgement as much as we do with Mairead, it is interesting that you then say that she, her management board and her senior clinicians have got it wrong when it comes to Daisy Hill. You have to bear that in context. <BR /> <BR />I thank — well, I do not know about that. I note that Members have proposed the Adjournment debate tonight, and I hope to respond to as many of the points raised during the debate as time allows. <BR /> <BR />This debate is slightly unusual in that we are debating the future of services at two hospitals that are administered by two different trusts, against the background of the current financial pressures. I need to set the context and begin by commenting on the financial pressures faced by the health and social care system.”
“At the outset, I concur with all that has been said about Mairead McAlinden. The honourable Member for Newry and Armagh Mr Kennedy made a slip of the tongue when he said that she had been appointed the new chief executive of the "South Down" health trust. If only. If that was possible, I would be producing the contract document now. She has made an outstanding contribution to health in Northern Ireland over the last 29 years, and she will be sorely missed. However, I say to all those who paid such glowing and deserved testimony to Mairead that she went to Newry and Mourne District Council and made a very strong and articulate case for the changes to the Daisy Hill that they oppose.”
“I thank the Member for giving way. In the entire Southern Trust area, there was only one cancellation out of the 179 in Northern Ireland. Such a magnificent performance is a credit to the staff in the Southern Trust.”
“Before this line goes any further, I want to point out that nothing will change in that respect under the proposals. The person from Newry and Mourne will still be taken to Daisy Hill and will still have the clot-busting drugs within eight minutes or within the quickest time possible. He or she will then move on to Craigavon for more intensive care. The Member is tilting at windmills. That is not going to happen.”
“It makes commercial sense to ensure that patients from Donegal — be it in the cath labs or the radiotherapy unit — are there, because they keep that capacity going more efficiently.”
“I am confident that my officials will make certain that we will not be out of pocket for having treated patients not only from the Irish Republic but from anywhere else where we can have full-cost recovery, and that will add significantly to our income. <BR /> <BR />There is also another aspect. If you spend vast amounts of money, as we are doing in the Western Trust — woe betide anyone who comes to me in the next 18 months and says that Altnagelvin is being neglected, because that simply is not true — it is absolutely vital that you use those assets to the maximum. There really is no sense in spending millions of pounds on a new facility to have it lying empty for several hours a day or at weekends.”
“I had suspected that, given the dreadful difficulties that the Health Department in the Irish Republic was under during the recession, there would have been problems getting the money out, but that has not occurred. I am confident that, if there are any problems with getting full-cost recovery, the problem is ours because we have not assessed the bill correctly; it is not that the Republic is not paying. <BR /> <BR />As to whether the Irish Republic has come up with the money for the capital aspect of the budget — absolutely, on the nail, no problem. Every time we asked for the money that was committed by the Irish Republic, we got it.”
“It is quite a simple issue: the board and the trust decide what is full-cost recovery for each procedure carried out. The patient comes from the Irish Republic — from Donegal, Cavan or wherever — and the procedure is carried out. We are then very quick to send the bill to the Irish Republic, and my experience is that it pays quickly and does not haggle or negotiate. A reasonably solid income is produced for the Department. The Newry experience is that there have not been any difficulties. I am always very quick to check and double-check, because, if something is too good to be true, it sometimes is. However, I have spoken to the Southern Board about it and visited the renal unit to see how smoothly the system operates, and we do not seem to be experiencing any problems.”
“The concept that the world ends at Glengormley does not apply here, because the leading players are in places like Newry, Crumlin, Portadown and Craigavon. I was in Cuba two years ago with the then Health Committee Chair, Sue Ramsey, and it was very interesting to note that a lot of diagnostics in Cuba were being carried out by Randox in Crumlin. With great pleasure, I explained where Crumlin was. I remember that company starting with four men in a farm building at the lough shore near where my grandparents lived, and now it is a world leader. This has my full commitment, as well as that of the ETI Minister and the previous Minister, Edwin Poots, not only to benefit our patients but to develop our economy. I am totally committed to pursuing every possible way of maximising the returns from this partnership.”
“Not only does it provide opportunities for clients and patients in Northern Ireland to obtain better care, but Northern Ireland is quite good at taking those technologies and using them to promote employment. It has been quite remarkable that, during the last five years, all our major companies in that field have increased their employment and have not laid anybody off. Indeed, one of the major companies doubled its workforce between 2008 and 2014. So, that indicates that the outcomes of that tri-nation partnership could lead to significant employment opportunities throughout Northern Ireland, and not always in the greater Belfast area.”
“As the Member knows, the US-Ireland R&D Partnership promotes innovative research projects to deliver major advances in healthcare and to the economy. The projects involve academic and clinical research collaborations from the USA, Ireland and Northern Ireland. Project proposals relevant to health care are submitted to the US National Institutes of Health, where they undergo rigorous evaluation. If they are deemed to be of sufficient scientific merit, they are recommended for funding. Funding is provided by each of the three jurisdictions to meet the research costs that they will incur. <BR /> <BR />I am very excited about that proposal, because the US is obviously a leading world authority on medical research.”
“The first decision that Edwin Poots made as Health Minister was that the radiotherapy centre in Londonderry would go ahead, and we have delivered on that promise.”
“From my experience with Daisy Hill Hospital, where a high percentage of the users of the renal unit are from Louth and north Monaghan, I know that there have been no difficulties whatsoever with that arrangement. The bill is sent, it is paid and the unit is used to its maximum capacity. That has to be a good thing. <BR /> <BR />I know that the honourable Member for East Londonderry is very concerned about his constituents in places like Limavady and Ballykelly. They can be absolutely certain that, as things stand, that unit will open on time and will be used to alleviate the problems that so many cancer patients face in the north-west. <BR /> <BR />Four years ago, we were told that it would never happen and that the money was not there to build that new facility. Indeed, it was very controversial at the time.”
“I suppose that I am going to disappoint some Members, because all the news from the meeting was very positive. You always look for the complexities, difficulties and problems, but we came out of that meeting feeling that it had gone very well. <BR /> <BR />I am glad to say that the authority in the Irish Republic — the HSE — has come up to the mark and has been paying the capital bills that we have sent for the work on the new radiotherapy unit. There have been no difficulties whatsoever with that, and that is commendable given the fact that the Republic is coming through very difficult financial times. No; there have been absolutely no problems. <BR /> <BR />I am told that the discussions on the agreement to reimburse patients when they eventually arrive from the Republic are also going very well.”
“We are still working very closely together on the cancer strategy and hope to use the joint research between the two jurisdictions to improve cancer care. Again, I think that there is a lot to be said for joint cooperation and sharing of information. Northern Ireland and the Irish Republic are quite good at cancer care, and the stats show that we are making huge progress. Therefore, as with all jurisdictions, we are very keen to share the knowledge and experiences of the two jurisdictions to better the treatment of all our communities.”
“His condition was quickly spotted, he was in the cath lab within 55 minutes, totally conscious throughout his procedure and out within three days. I am glad to say that he told the entire city of his very pleasant experience. Why should that not be made available on a full-cost-recovery basis to the residents of Donegal? That makes common sense to me. Maybe some people can see a problem with it, but I cannot.”
“It does not seem to make much sense that they almost drive past the front door of Altnagelvin on their way to Dublin. When I asked the authorities up there recently what happens to those patients, they told me that some of them die. It is very sad that people are forced to drive for two hours when there is a brand new state-of-the-art facility in Altnagelvin that they could use and that the clinicians there are very keen to make available because we have sufficient spare capacity. I hope to talk to the Minister in the Republic when he comes up to Altnagelvin about the potential to use that spare capacity . <BR /> <BR />We have all heard of a chap called Christie O'Donnell, the famous taxi driver in the Bogside who had a heart attack and drove himself to Altnagelvin.”
“First, I welcome the progress of the new radiotherapy centre in Londonderry. I was up at it recently. I do not know not whether it was the topping-up or what particular stage it was, but it was certainly making excellent progress. <BR /> <BR />It is unfortunate that the Chair is not here because I think that she would be very interested in my next point, which I think I should raise as a result of this question. There is considerable capacity in the cath lab in Altnagelvin, which is brand new state-of-the-art provision for those who have had heart attacks or have heart conditions. There is a proposal, which I hope to pursue, that we make available that cath lab to patients from Donegal, where between 130 and 150 people a year have cardiac arrests.”
“So, in the interim, let us have a debate and see what we think about making alcohol less readily available to all in our community.”
“This is a big problem, particularly when you remember that 27% of the population, including me, never touch it. Therefore, that indicates that the prevalence amongst the rest of the community is extremely high. <BR /> <BR />We will all be put under enormous pressure on this issue by the large drink companies. Be very aware that companies with a bigger budget than the Northern Ireland Executive will lobby you — be ready for that. It is important that, before that starts, we hear the initial views of all MLAs. If you have problems with it, let me know, because I am very keen to have that discussion. We have a hiatus caused by the fact that big distillers in Scotland have referred the Scottish Executive's decision to the European Court of Justice, and there can be no legislation until that case is reported upon.”
“<BR /> <BR />There are so many indicators that this is the right thing to do: alcohol is 60% cheaper than it was 30 years ago; we treat 3,100 individuals in hospitals as a result of alcohol abuse; and, at midnight on a Saturday or Sunday, the vast majority of those who report to A&E are under the influence of alcohol or are there because of alcohol. I am very keen that all the parties and all the elected representatives in the Chamber let me know what they feel about the concept of minimum unit pricing, because there is not much sense in all of us working hard on the issue to find that some parties have such huge difficulties with it that it gets no further. <BR /> <BR />We have found that 31% of our population are binge drinkers: 35% of males and 27% of females.”
“I am very keen to start a public debate on alcohol abuse in Northern Ireland. We know, for instance, that it costs the health service in Northern Ireland £240 million a year. If I had had that £240 million, my first three months in office would have been so much easier because we would not have had to have any contingency plans and cause the pain that occurred in various communities. We would have been able to roll out new and additional services. We would not have had, for instance, the 130 deaths that occurred in Northern Ireland as a result of alcohol abuse.”
“<BR /> <BR />Remember, of course, that this is much more than just a Department of Health issue. The Public Health Agency (PHA) jointly funds an active school travel programme for 180 schools. DCAL and Sport Northern Ireland continue to invest in the Active Communities programme, in which approximately 106,000 people participated approximately 1 million times in 2013-14. <BR /> <BR />He is absolutely right: if we do not solve this problem of childhood obesity, it will lead to a long-term rise in type 2 diabetes and other conditions that could swamp the health service in 20 or 30 years' time. Whilst we have concentrated today on many of the tangible issues such as the radiology centre in Altnagelvin and minimum unit prices, there is no doubt that this is one of the priorities that we have to tackle in the coming few years.”
“Actions undertaken in these areas in Northern Ireland include supporting a healthy start to life and promoting healthier environments, especially in schools and preschools. <BR /> <BR />The former Minister wrote to the Secretary of State for Health at Westminster in support of a 9.00 pm watershed ban on the advertising of certain foods. However, this issue remains a reserved matter. Again, there might be a role for cooperation here between the two jurisdictions. I understand that some Members and some members of the public in Northern Ireland watch an overseas — sorry, another — TV station known as RTÉ. If RTÉ continues to advertise foods before the 9.00 pm watershed, it really would not make much sense for us to put a ban on that. However, that is not an issue that we, as an Assembly, can deal with.”
“First of all, I am glad that the honourable Member for Strangford missed me over Christmas. I cannot win. If I am constantly on the airwaves, he complains that he is fed up hearing my voice. Then, when I give him a bit of relief, he says that he has missed me greatly. However, I suspect that he will be pretty annoyed about the number of times that he will hear me in 2015. <BR /> <BR />As he knows, the overarching goal of the action plan on childhood obesity is to contribute to halting the rise in the number of overweight and obese children and young people, 0-18 years. We want to achieve that by 2020. To achieve this goal, the action plan specifies a set of operational objectives that have been designed to guide the actions of stakeholders across eight priority areas.”
“I would be surprised if it were not possible to continue to ensure, on a cross-border basis, the highest possible standards within a reduced budget, though it may not be as reduced as the early indications suggest.”
“There is only a small area that we can target for budget reduction, and this is one of those bodies that is not seen as being front line. Therefore, we have asked all such groups to come up with options for a 5%, 10% and 15% reduction in funding. When all those come back, I will look very carefully at them and see what the impact will be. <BR /> <BR />I suspect that, with the FSA, we could reduce to some extent the amount of red tape and bureaucracy at meat plants to reduce the costs involved. Well done to the quality assurance scheme and our farmers for producing food to the highest standard. That is showing in the abattoirs, where it is quite unusual to find issues of concern, which means that all the tests that are being carried out are not producing much. <BR /> <BR />A range of different agencies have responsibility for food safety.”
“I have had representations from the Food Standards Agency on that particular issue and I can understand its concerns about the reduction in funding. A very high proportion of its expenditure is on fees for vets to inspect meat plants. I am pleased to say that that work is generally showing that our standards are extremely high in Northern Ireland and, indeed, in the Irish Republic. Some of what is being undertaken at the moment is very routine and is not producing much in the way of new information. <BR /> <BR />The agency has asked us to have another look at the reduction in funding, and I have agreed to do that. It is like so many other issues in my budget and in the Northern Ireland block grant generally: we have to find savings somewhere.”
“<BR /> <BR />The overall goal of INTERREG V is to extend to those networks in Northern Ireland and build corresponding linked infrastructure of that kind in the Republic of Ireland. That is important, but it is on a very small scale in the overall scheme of things. We have a £5 billion budget and, in the Republic, the budget is something like €9 billion. Therefore, whilst it is important in areas of mutual concern to encourage joint provision and cooperation, it does not come anywhere near what we need to fund our own health service, for which we are short by about £70 million this year. Therefore, I welcome it and think it has potential, but it will not, in my opinion, provide a significant input to our future funding in the hundreds of millions that we require.”
“The honourable Member, from his huge experiences, will know that, for health, EU funding is not the pot of gold that it is perhaps for other Departments. If only we could access additional funding from Europe to cover pressures on A&E and domiciliary care etc, but we cannot. Therefore, we are really tied to INTERREG V and Horizon 2020. <BR /> <BR />In Northern Ireland, we have three health-care intervention networks established in cancer, public health and through the Northern Ireland Clinical Research Network, which cover 11 areas of health and social care. Within that existing portfolio, there are interventional trials running in Northern Ireland, of which 30% are commercial.”
“<BR /> <BR />In Northern Ireland, however, different issues from those in the Irish Republic are causing the worrying trend. For instance, the Irish Republic does not have the legacy of the Troubles that we have or the sectarian interfaces. Therefore, it is important that we have our own distinct strategies but that they complement each other rather than conflict. <BR /> <BR />What slightly worries me about this statement is that, on every issue that we brought up, there seemed to be unanimity and agreement on the ways forward. There were no differences or difficulties expressed whatsoever. Again, they are very keen to let us have access to their research and study, and we are equally keen to make our research available to the authorities in the Republic in this instance.”
“As the Member knows, the issue has come up frequently at sectoral meetings. Indeed, there have been joint events between the two jurisdictions. We are hoping that our suicide prevention strategy will go out to consultation in early 2015, so that is only a few weeks away. I have not got a date from my colleagues in the Irish Republic, but there will be a read-across in the two strategies as to the most efficient way of dealing with the issue. <BR /> <BR />We have huge experience of dealing with this desperately difficult problem. Remember that, in 2013, we lost 303 lives to suicide in Northern Ireland. It is a growing and very difficult problem. Therefore, we will have to learn from each other. I suspect that the issue will be on the agenda for future sectoral meetings, and I want to work closely with our colleagues in the Irish Republic.”
“I think therefore that we are moving forward in tandem, and I really do welcome that cooperation.”
“There would be the mass importation of cheaper alcohol from the Republic into Northern Ireland. <BR /> <BR />The island of Ireland has history when it comes to this issue. There has been a long tradition of alcohol moving from one side of the border to the other, depending on price. Therefore, because we are dealing with two currencies, it is vital that we work together. As such, we are going to have to pitch our minimum price at a level that means that people buying alcohol in the supermarket are paying basically the same, North or South. <BR /> <BR />My clear view from the meeting was that exactly the same problems that we have, and the £900 million that they are costing us, are evident in the Republic. It also accepts the University of Sheffield study.”