Simon Hamilton
Strangford · Democratic Unionist Party · Northern Ireland
“I have emphasised to the Member and the House before, that, whilst I accept that those are not good enough — that is why we have been developing the plan — there are alternative technologies in place that can present opportunities for those who just cannot get acceptable speeds.”
“I thank the Member for his intervention. There are some initiatives that I believe will help and act as a driver to improve broadband access. One such intervention is the broadband universal service obligation (USO), which is being taken forward by Her Majesty's Government.”
“I thank the Member for his question. However, he is conflating two issues. I wrote to his party leader, and indeed to all Assembly party leaders, before making the announcement that I did last week about wanting to publish the details of the businesses in receipt of the non-domestic RHI scheme. It was my intention to do that tomorrow.”
“<BR /> <BR />The Chancellor, in his autumn statement, made some more funding available for telecommunications, and my Department is studying that and seeking to avail itself of that to the fullest possible extent.”
“In addition, my Department is managing a contract for the delivery of the superfast rollout programme, which, by 31 December, will provide access to superfast broadband with speeds of at least 24 megabits per second to a further 38,000 premises, both business and residential, across Northern Ireland, including in the Newry and Armagh cons…”
“I signalled the intention to do this a few weeks ago. The Member and the House will know that inspections of all installations would have taken place over the 20-year lifetime of the RHI scheme.”
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“A guidance circular was issued in 2013 that requires each new drug to go through technology appraisals and for the board, who are the commissioners of new drugs, to take account of resource issues when they are commissioning those drugs. That also includes —”
“Our GPs, through their various organisations and trade unions, correspond with me on a regular basis. I hope that they will take up the funding that is there to expand and modernise their practices. <BR /> <BR />The Member also asked about drugs and new drugs. He will be well aware of the financial pressures of around £35 million to £40 million facing my Department. I heard the Finance Minister talk in her final answer about welfare reform and the fact that we are losing £9·5 million a month in penalties to pay for welfare reform. That is not helping me or any other Executive Minister with our budgets. There are obviously processes in place to approve drugs through the National Institute for Health and Care Excellence.”
“There are two very different questions there. I will do my best to address as much of both of them as I can in the time that is available to me, which I notice from the clock has only just started. <BR /> <BR />Having spoken with local GPs in our own constituency, I am well aware of the demands on their services. There has been a significant increase in the number of people presenting at GP practices over the last number of years. I accept and acknowledge that there have been difficulties pursuant to that in terms of our GPs and the work that they do. To that end, my predecessor announced a £15 million investment in GP services this year, including some resources targeted at trying to recruit more GPs. A significant portion of that investment was to allow our GPs to modernise and expand their practices.”
“In assessing future demand, the predicted prevalence of diseases such as heart disease, diabetes and cancer is considered, drawing on the findings of national audits and regional and national publications. The development of new technologies has an impact on future demand, and mechanisms are in place to ensure that UK and international developments, emerging research, new technologies and specialist drugs are considered when planning services.”
“There are a number of mechanisms by which future demand for health and social care services is predicted. A demographic model is used to predict the likely growth in demand for services over time, as well as the costs associated with this. This model is based on current population estimates, national population projections and current demand for health and social care services. The model considers a range of service areas including acute care, elderly care, primary health and community care, and general medical services. <BR /> <BR />In addition to this demography model, regular analysis of the demand for a number of specific services is undertaken to identify any gaps in the capacity available to meet this demand and deliver required performance standards.”
“We are right to ensure that it is not just people walking physically into premises that is covered and that we recognise the changing habits of many people who order food via their mobile phone or other online devices. <BR /> <BR />Again, I thank Members and the Committee for the scrutiny that they have given. I hope that Members see fit to support the amendments in the group.”
“<BR /> <BR />Again, it is Mrs Cameron's amendment — if I can call it that, even though it is in my name — that requires the online publication of the rating. As other Members have said, an increasing number of people purchase takeaway food, in particular, online. I have minimal experience of that, of course, Mr Deputy Speaker, as you can tell. There is an increasing volume of people who purchase directly from a takeaway or via what might be described as aggregating websites that sell on behalf of a range of local food establishments. I understand that all will be covered by the legislation. We are right to seek to keep pace with technological advances.”
“It is absolutely right that it should be visible to customers at the establishment that they go to buy food at. <BR /> <BR />The figures show, roughly, that, for the last three years, around 40% of establishments have visibly displayed the sticker on the outside of their premises. Between 50% and 60% have displayed it somewhere. It is interesting that not even close to 100% of those who have a four or five — the highest rating — have chosen to display it, even though, as we have said, it is a useful marketing tool for them. The proportion of those who have had four or five ratings who have displayed their sticker has ranged from 57% to 67% over the last three years. It is right that we should make it mandatory and ensure that it is done.”
“It is something that I would like to see across the House in all legislation that comes forward. Even though we may not be able to precisely predict what technological advances there will be, we should at least try, so far as we can, to ensure that we keep up with the times. <BR /> <BR />It is interesting, though, that, even though we are trying to future-proof the legislation by ensuring publication online, we are not just as sophisticated in ensuring that a sticker is still produced. That is a good old-fashioned way of communicating the message, but a very important one nonetheless. For a significant number of customers, it will be the way in which they see the food hygiene rating. It may not be as sophisticated, but it is absolutely necessary for our customers.”
“Again, I thank all Members for their contributions, and I particularly thank the Chair for summarising the Committee's work on this group of amendments. I concur with all the comments made, particularly around the online publication of ratings. We are absolutely right to change the requirement on the FSA to publish on a website to a requirement to publish online. In so doing, we are future-proofing the legislation and the scheme because of the need to publish the rating on a website selling food or at least to provide a link to the FSA's website. That issue was particularly pursued, most vigorously by Mrs Cameron, during the Committee scrutiny. I congratulate her and thank her for pursuing that. We are right to take account of and try to future-proof our legislation.”
“Amendment No 28 requires that all other regulations be subject to negative resolution. Amendment Nos 30 and 32 add two order-making powers to the list of orders that are required to be laid before, and approved by, a resolution of the Assembly. Amendment No 33 requires that all other orders be subject to negative resolution. Consequential to amendment No 23, amendment No 31 removes the reference to the wide-ranging power at clause 14(8), as noted by the Examiner of Statutory Rules. Amendment Nos 29, 34 and 35 remove a number of subsections as a result of the reordering of clause 18. <BR /> <BR />That concludes my second group of my amendments, which concern communication, reporting and scrutiny issues in the Bill. Again, I hope that the House can support the amendments.”
“Amendment No 22 introduces a requirement on the Department to publish a response to the report indicating whether or not, along with reasons, it intends to exercise certain regulation-making powers. The Examiner of Statutory Rules expressed concern that the order-making power in clause 14(8) is too wide to be an appropriate delegation of legislative power. In response, amendment No 23 removes that power. <BR /> <BR />Amendment Nos 27 to 36 relate to scrutiny functions laid down in clause 18. They are technical amendments to improve the order of drafting of the clause and address consequential matters arising from other amendments earlier in the Bill. Amendment No 27 requires regulations made for online provision of ratings to be subject to the draft affirmative procedure of the Assembly.”
“Amendment No 19 therefore introduces a regulation-making power for the Department to require operators of food business establishments that supply consumers with food through an online facility to provide their rating online in the manner specified. Amendment No 20 provides for an offence where an operator fails to comply with that requirement. Amendment No 24 requires the Food Standards Agency to promote the food hygiene rating scheme. <BR /> <BR />I turn now to the amendments that relate to reporting and scrutiny functions. Clause 14 requires the Food Standards Agency to review the operation of the Act within three years of its commencement and to send the review report to the Department for it to be published.”
“To reflect current practice in the voluntary scheme, where district councils can produce the food hygiene rating sticker showing their council name and logo, amendment Nos 6, 8 and 11 provide for regulations to prescribe more than one form of sticker. In particular, amendment No 6 provides for the regulations to specify whether the cost of producing the prescribed stickers is to be borne by the Food Standards Agency or district councils. <BR /> <BR />The Committee held strong views that, where a food business establishment provides a facility for ordering food online, consumers should be able to have sight of the business's rating on the website or, alternatively, to be provided with a link to the Food Standards Agency's website, where all ratings are available.”
“As you said, Mr Principal Deputy Speaker, the second group of amendments relates to communication, reporting and scrutiny issues. First, I will consider the amendments relating to communication. Amendment Nos 3 and 14 change the requirement on the Food Standards Agency from publishing the rating on its website to doing so "online", the purpose of which is to provide flexibility for future technological developments.”
“It has not been so well used by those who did not do well, but, of course, their absence from the scheme has been noted and will no longer be possible. The scheme has also made it somewhat easier for those in the councils who carry out this work. Instead of having to inspect every business regularly, they can have a degree of confidence in those that get a five-star rating, so they do not need to deploy as many resources to them. Obviously, they have to check them regularly, but they do not have to go back and check with the same scrutiny or as frequently as a business that has scored a much lower rating would require. It has, hopefully, helped councils to deploy their resources more smartly. <BR /> <BR />Again, I thank Members for their contributions and look forward to their support for this group of amendments.”
“I want to make a brief contribution at this stage and thank Members for their contributions. All were positive about the amendments in this group, so I thank everyone for their broad support. Specifically, I thank the Chair and members of the Committee for their diligent scrutiny of the Bill, including this group of amendments. <BR /> <BR />Some Members talked about the food hygiene rating scheme and welcomed its success. Whilst, as Mr McKinney pointed out, it has been voluntary, it clearly has been well received right across the hospitality sector. It has not just provided good information to allow customers to make informed decisions but has been used almost as a marketing tool by businesses to highlight those doing exceptionally well in food hygiene.”
“Amendment No 12 provides a power for the Department to amend subsection 5 to clause 4 to limit the number of occasions on which the right to request a review of each food hygiene rating may be exercised. Amendment No 25 also provides a power for the Department to amend time periods specified in the Bill. Both of those powers would be exercised following a review of the scheme as required by clause 14 only if necessary. <BR /> <BR />That concludes my comments on the first group of amendments regarding timings, operational and technical issues. I hope that the House can support them.”
“The definition remains unchanged, and amendment No 26 refers the definition of the "end of the appeal period" in the interpretation section of the Bill to the definition to be laid out at clause 2. Amendment No 10 is a technical amendment to ensure that the appeal mechanism in clause 3 also applies when a food hygiene rating is produced following a request for a rerating in clause 4. Amendment No 16 corrects an incorrect reference in subsection 4 to clause 5. Amendment No 36 is a technical amendment providing that, where an order is made under clause 1(7) to amend the definition of "food business establishment", consequential provision in such an order can amend clauses 7, 10 and 11.”
“<BR /> <BR />Within the Bill, the operator of an establishment is afforded the opportunity to make written representations on their establishment's food hygiene rating to the district council, and the Food Standards Agency is required to publish online written representations it receives from district councils alongside the rating to which the representation relates. Amendment Nos 13, 15 and 17 require the Food Standards Agency to do this either within seven days of receiving the representation or within seven days of publication of the rating to which the representation relates. <BR /> <BR />I turn now to the amendments that relate to operational and technical issues. Amendment Nos 5 and 18 simply move the definition of the "end of the appeal period" from clause 6 to clause 2.”
“It also extends certain time-bound requirements by seven days over the Christmas period to take account of office closures. <BR /> <BR />Amendment Nos 2 and 9 place a new requirement on district councils either to notify the Food Standards Agency of an establishment's rating or that it is not appropriate to publish the rating within 34 days of carrying out an inspection. Amendment No 7 also requires the district council to notify the Food Standards Agency of the determination of an appeal before the end of the appeal period. Amendment Nos 4, 7 and 9 require the Food Standards Agency, having received food hygiene ratings from district councils, to publish those ratings online, unless it is not appropriate to do so, within seven days of receiving them.”
“<BR /> <BR />The Bill requires district councils to provide specified information about the food hygiene rating scheme to operators of food business establishments within set time frames. Amendments Nos 1 and 21 introduce flexibility for district councils in that the specified information does not have to accompany the rating or be issued to new food business establishments within the set times where it has already been provided. Amendment No 25 also provides flexibility for district councils and the Food Standards Agency to comply with certain time-bound requirements as soon as is reasonably practicable, where, due to exceptional circumstances, they have been unable to do so within the required period; for example, a major outbreak of food poisoning that requires deployment of resources.”
“I thank the members of the Health Committee for their detailed consideration of the Bill. As always, the Bill has got to this stage only due to partnership between the Department and the Committee. <BR /> <BR />In total, there are 36 amendments that, I believe, strengthen the Bill and reflect the detailed work carried out by the Committee, the Office of the Legislative Counsel and officials in my Department and the Food Standards Agency (FSA). I put on record my thanks to everybody who has been involved in this process for the efforts that they have made. <BR /> <BR />The first group of amendments relate to timings and operational and technical issues. I will consider first those amendments that relate to timings.”
“I would not proceed with the legislation if I did not think that there was a good practical purpose to it. I believe that stringent safeguards are in place; if they were not, I would not proceed. <BR /> <BR />I welcome the general support for the purpose of sharing information to help people to improve standards of care and enhance the health and social care of people in Northern Ireland.”
“<BR /> <BR />I hope that the Bill, with the House's support this evening, can move to what is probably one of the most critical stages in testing any legislation: the Committee Stage. I look to the Committee to do its job rigorously to test the legislation and examine the concerns. Hopefully, some concerns have been clarified and assuaged today. If not, I hope they can be assuaged through the Committee process. I have to say that I am very open to the input of the Committee, and I have already taken on board some of the concerns on some of the language. The Committee will see that reflected, I hope, in amendments that will be brought forward throughout Committee Stage. The concerns expressed are concerns that I understand.”
“<BR /> <BR />The 2009 Health and Social Care (Reform) Act placed a general duty on my Department to design an integrated system of social care to secure improvement in the social well-being of people in Northern Ireland without having a very specific definition of social well-being. The Bill, therefore, merely reflects the statutory duty on my Department to advance social well-being and makes an attempt to define, in some cases, the areas in which social well-being might happen. I would be happy to listen to any feedback from the Committee around whether to have a list of things, an incomplete list or no list or whether another option of having a better definition may be a better way to proceed.”
“Clause 1(11)(b) talks about social well-being and has quite a long, but not exhaustive, list of what social well-being is. Again, I understand the points that Members raised. Generally, I do not like legislation that has long lists and examples because, invariably, you will include lots of things about which you can say, "Yes, that's fine, I agree with all those", but you will exclude some things that you think should be there. You may even sometimes include stuff that you are not entirely sure should be there. As a rule, we should seek to avoid being too prescriptive, but there are really only those two choices available to us. Either we make an attempt or we do not put anything there at all and have it quite broad. I appreciate the point made around the words "or any", in that it could be other stuff as well.”
“In many cases, it may be only minimum information that is shared with applicants; for example, the contact details of somebody so that they might be contacted by an organisation to ask for their consent to participate in a study. Rather than being about information on their specific circumstances, their health and their social care, it may be about the ability of an organisation to contact somebody to ask their permission to take part in a study.”
“The Bill provides more checks and balances around public interest than the current test via common law, because of the safeguards that I have already gone into. In making a decision, the committee will weigh the potential benefits to society of disclosure against the risks of any negative impact of disclosure. <BR /> <BR />It is also worth saying that, without the public interest test in the Bill, the opportunity for greater scrutiny of public interest will be missed and the current common law consideration will remain. It has been a common thread throughout the debate that there is dissatisfaction with the current common law situation and how it may allow information to be shared without the statutory framework that the Bill will put in place. Again, I make the point that the Bill only permits sharing; it does not require it to be done.”
“On the issue of public interest, which exercised most contributors to the debate, I understand, again, where people are coming from. It is worth pointing it out that public interest in this case is for medical or social care purposes and not broad public interest. Under the common law duty of confidentiality, the public interest test is already a consideration. Public interest is not defined, because it is, as you would expect, specific to each application. Public interest in one application may be different from that in another, and, again, you get into the difficult situation of defining what public interest may or may not be. It would take up much more lines in the legislation than it currently takes up in the Bill if you were to get into specifically defining public interest.”
“It would seek guidance and support from the Department, and it would be made clear that it did not have to release that information. There are safeguards built upon safeguards. It would have to be made very clear in a research application why the information is required, the purpose of getting it, who would be using it, what it would be used for and so on. If the information was to be passed to somebody else for work to be done on it, that would have to be made very clear in any application. Of course, the research would have to be ethical and be tested through the relevant authorities for that. There are safeguards and measures put in place to ensure that those scenarios, about which I share concerns with Members, do not come to pass.”
“in the interests of improving health and social care or in the public interest. <BR /> <BR />This is a hypothetical situation, but, if an insurance company were to make an application for what appeared to be commercial purposes, we all might say that that should not get through, and I expect that the committee would stop that. However, if, for some reason, the committee did not do so, there is a further backstop in that health and social care organisations do not have to give up the information. An application could get through the process — I do not expect that it would — and the request could come before a trust, for example. The trust, you would hope, would say, "Hang on a minute, this is not what the legislation is intended for".”
“That is quite broad. I do not think — I will get onto this on some other issues — that we should get into the habit of defining who can apply and who cannot. As soon as you start doing that, you remove flexibility, and you can shut down the possibility of having very good research done. I do not think that we want to be very specific about it. Obviously, safeguards are in place in that the application will be made to the committee, and it will judge whether it is:”
“The safeguards will apply to any application. There is nothing to prevent anyone from applying. The Bill is not as prescriptive as that, because the test is:”
“That makes it clear that sharing the information with insurance companies or other financial institutions is not the intention. <BR /> <BR />There is another safeguard in that respect. Say an application were to come from an insurance or a pharmaceutical company for what appeared to be commercial purposes. Of course, a pharmaceutical company could request such information for medical or social care purposes, and that could actually benefit patients and people in Northern Ireland, so we must decouple them from insurance companies.”
“I do not see how it could be gained for insurance purposes. Again, it must be:”
“Members appreciate that I have almost inherited this legislation, so, in studying it completely afresh, this was one of the concerns that I had: who might get their hands on this information? You would be surprised if I said anything other than that it is not the intention for insurance or pharmaceutical companies to get such information. However, it goes further than it not being our intention; there is enough in the Bill to make it clear that it is not for those purposes. Clause 1 makes it clear that it is:”
“We want to have the ability to participate in studies in the UK or further afield that increase our understanding of certain diseases, how people respond to certain treatments and, above all, raise the standard of care that people in Northern Ireland receive. I think we would want to participate in such studies and play our part. We would want to gain the benefit for Northern Ireland of the information that would be derived from the conclusions and recommendations that come out of such studies. However, we cannot do that, clearly, if people in the health and social care sector are fearful of releasing their information for legal reasons. <BR /> <BR />Some Members, particularly Mr McKinney, raised concerns around the release of information to insurance or pharmaceutical companies. I certainly share that concern.”
“I do not think that we want to put any medical practitioner in the position where they are concerned about legal challenge to the releasing of information for good purposes, for trying to improve our understanding of cancer and other diseases. There is an existing desire among many health professionals to participate in studies. Some of them are UK-wide, and some of them are just for Northern Ireland. In fact, there was a recent cancer satisfaction survey that we were unable to participate in because of the fear of legal challenge on releasing the information. If we were to cast our net around for other examples, I am sure there would be many. We do not want that to be the case.”
“Within that registry, it will allow the removal of duplicate information. People can appear in several different environments within the health and social care system and are, perhaps, being double-, triple- or quadruple-counted. It will allow that to be taken out; it will facilitate genetic requests; and it will have the ability to link patient data with a death certificate. It will also enable Northern Ireland participation in many UK-wide epidemiology studies. It will allow us to participate in our own and other clinical audits, health monitoring and research studies, with the other safeguard that any research must be shown to be ethical. <BR /> <BR />As Members are aware, there are concerns about legal challenge to releasing information via the common law. Dr Paul Darragh of the BMA is quoted as having said:”
“Having that information and the ability to share it and use new technology like the electronic care record ensures that people get a high standard of care no matter what health and social care establishment they go into. <BR /> <BR />Of course, there is a practical purpose. In debating the definition of social well-being or the definition of public interest, we can sometimes forget the very good practical purpose that there is in the Bill in taking the legislation forward. There are already examples of where the legislation, when passed, will enhance the sharing of information for good, sound, solid, medical and social care purposes. For example, it will underpin the operation of the already successful Northern Ireland cancer registry, and many Members referenced and acknowledged the good work that that is doing.”
“We will be in a far better position if we have the robust safeguards of a committee and a code of practice in place to ensure that this is done in a more robust and safer way than has hitherto been the case. <BR /> <BR />Some Members alluded to the fact that there has been broad support for the legislation. Our inboxes have been populated today by some people from various sectors who support it. Some 96% of respondents to the consultation supported the legislation. I could not quite work out Mrs Dobson's comments about how she thought that, if more people knew about the Bill, they would be shocked that their private information was being kept. I would have thought that most people were quite content that their private information was being kept within the health and social care system.”
“Similarly, on a code of practice, which is part of the safeguard that is there, the legislation as currently drafted says to "have regard to" the code of practice. Again, I would be content to look at strengthening that by way of an amendment. <BR /> <BR />Other safeguards in place include the Human Rights Act, particularly in respect of the right to private and family life, and the Data Processing Act, especially around fair and lawful processing so that information is only what is absolutely needed and only those who are entitled to have that information have it. The Human Rights Act and the Data Processing Act and how they apply to this are still applicable. Those safeguards are not in place at present in respect of the way information is shared via the common law.”
“Even in that situation, which is not a perfect system, since 2001, about two thirds of applications have been approved and one third has not been approved. That is an indication that not every application coming forward to their committee is getting through and that a robust test is being applied. Although not the majority, a significant number — around one third, which is 300 out of 900 — of applications since 2001 have been turned down and have not proceeded. <BR /> <BR />I know that the Committee has a concern about the committee in that the Bill as currently drafted permits rather than requires the establishment of the committee. I am happy to look at that, perhaps by way of an amendment at a later stage, because I understand the point that the Committee has made in its deliberations so far.”
“Obviously, we have regulations, including the limited circumstances in which information can be shared, that will have to be put through. Many Members touched on the creation of a committee that will look at each application. I think that that is a robust safeguard to have in place. An onerous task will be placed on that committee. Mr McKinney shared some not-so-good experiences from England. I will come back to them, but I agree with him on the points that he raised.”
“<BR /> <BR />The primary purpose of the Bill is to place that sharing of information, which can and does identify individuals, on a clear statutory framework. That is something that does not currently exist — a fact that was identified by many Members in their contributions. At this minute in time, we have a situation in which information is already being shared via the common-law parameters. It is my view, and, I think, the view of other Members, that information can be shared, and is being shared, via common-law tests, that it is better for us to have a statutory framework, and that it is far better for us to have a Bill passing that has robust safeguards to ensure that that information is shared appropriately. <BR /> <BR />The safeguards are extensive.”
“That has been a debating point during Second Stage, and I will return to it before the end. As we go through all these issues and concerns, it is worth bearing in mind, as the Bill proceeds through its various stages in the House, that it is for medical "or" social-care purposes, to pick up on Mr McKinney's point that this goes much further than the equivalent legislation across Great Britain. That is simply because we have the benefit of an integrated health and social-care system. It is not some great conspiracy; it is actually a benefit of the system that we have in Northern Ireland. The release or sharing of information, within certain parameters, which I will come on to momentarily, is for medical or social-care purposes.”
“I thank all Members who contributed to the Second Stage debate. There has been commonality in issues raised by Members from all sides around some concerns, if I can put it as strongly as that, with aspects of the Bill. I will seek to address, as far as I can, some of those as I go through the comments. <BR /> <BR />I do not think that there was much disagreement on the purpose of the Bill and support for the purpose of the Bill. The purpose is laid out very clearly early in clause 1. Clause 1(1) states that the release of information that identifies individuals will be for "medical or social care purposes". Clause 1(1)(a) and clause 1(1)(b) go further and talk about information not being released:”
“They will further have to prove that similar results could not be obtained by using anonymised information and that it is either impossible or impracticable to obtain consent from every individual whose information may be used. If an application is approved, the approval will allow the organisations to release the information. It will not compel the organisations to release it. <BR /> <BR />In bringing forward the Bill, I am seeking to remove the ambiguity that currently surrounds the use of information for purposes other than direct care and, in so doing, safeguard the patient, their information, the health and social care sector and the information user.”
“<BR /> <BR />The purpose of the Bill is not to open the floodgates for sharing confidential information without adherence to existing law or due regard to an individual’s right to privacy. In fact, it is quite the opposite. The Bill would enable my Department to establish a robust, transparent and open process that will ensure that information is shared in very limited and strictly controlled circumstances for medical or social care purposes that will clearly benefit health and social care or be in the public interest. Any use of information must still comply with the requirements of the Data Protection Act and the Human Rights Act. <BR /> <BR />Applicants will have to clearly demonstrate to the committee that the use of information that identifies individuals is absolutely essential to the successful outcome of their work.”