Mike Nesbitt
Strangford · Ulster Unionist Party · Northern Ireland
“Think public service, wisdom, generosity and courtesy. Think integrity, insight and curiosity, the lack of which is a key criticism of the two public inquiry reports of recent days.”
“I spoke during Members' statements earlier about the untimely passing of the Western Trust's chair, Dr Tom Frawley CBE. I repeat my condolences to his family, his friends and his many admirers.”
“I absolutely share the Member's ambition to see people living in the community. The trusts provide a range of evidence-informed programmes for individuals who are awaiting assessment. For children and young people, early intervention teams deliver proactive needs-led programmes that are neurodiversity-affirming and trauma-informed.”
“Thank you, Mr Speaker. The Western Trust has assured me that it has undertaken a comprehensive early engagement exercise with stakeholders, involving all political parties, local businesses, service users, community groups, the Patient and Client Council (PCC), local media, community planning partners and Departments, including mine and D…”
“The role played by social workers in delivering safeguarding and family support interventions is complex and challenging. The work frequently pivots on multidisciplinary collaboration, with parents and carers positioned as partners in the formulation and delivery of safeguarding and support plans.”
“I fully recognise the impact of the current delays on individuals and families. The situation has arisen due to a combination of factors, including funding that falls short of objectively assessed need and previously missed opportunities to reform health and social care delivery.”
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“It will require additional investment, and, for that reason, I welcome the establishment of the All-Ireland NCI Cancer Consortium's research and innovation grant scheme, which will provide vital funds to support cancer research and innovation to institutions across the island of Ireland. I also commend the All-Island Cancer Research Institute for the work that it has done to bring together 10 universities across the island in a combined fight against cancer. <BR /> <BR />The way in which healthcare is delivered is continually changing. We must be ready to test and adopt innovative ways to treat and support those who are impacted by cancer. New technologies, new medicines and new techniques provide opportunities to measurably improve cancer survival rates while significantly improving the quality of life for cancer patients.”
“Northern Ireland was the first part of the United Kingdom to commit to implementing an optimal care pathway for pancreatic cancer, and work is progressing well to implement that pathway. Reviews of haematological cancers and cancers affecting adolescents and young adults have also been completed, and recommendations are being implemented. <BR /> <BR />A cancer research strategy, as Mrs Dodds referred to, was a core commitment in the cancer strategy, and I assure the Member that it is under development. It will seek to establish the infrastructure required to support cancer research and innovation and translate that into improved outcomes for patients — a bench-to-bedside approach that focuses on what we need to address the biggest issues facing our cancer services.”
“<BR /> <BR />The cancer strategy published by the Department of Health in 2022 seeks to effect the transformational change that is needed to change how cancer is managed. That includes recognising the opportunities for collaboration across this island, with Great Britain and further afield to deliver better cancer care and better research and innovation. Although the strategy is not fully funded, we are already starting to see the benefits. We have rapid diagnostic centres that now deliver a vague symptom pathway across Northern Ireland. That is available for patients who have vague but worrying symptoms. They are typically patients who would have ended up with a late diagnosis and, consequently, very poor outcomes.”
“Those figures are unacceptable and have been at unacceptable levels for too long. There have been many causes, including rising demand — for example, demand for chemotherapy has increased by 41% over the past five years and the number of first-diagnosis cancer patients treated has increased by 25% in the past 10 years — but we have also been slow to transform and accept new ways of working. <BR /> <BR />I do not underestimate the enormous pressure under which cancer staff and the wider HSC family are working. However, despite their best efforts, many parts of the current system are not ready to deliver the cancer services that we will require in the next five to 10 years, so we must be proactive and ambitious in delivering the equitable and resilient cancer services that the people of Northern Ireland deserve.”
“Research by the institute emphasises the importance of population health and well-being to the economy. It calls for increased investment in oncology research and innovation. Regrettably, though, that comes at a time when my research and development budget is fully committed and I am facing calls to cut core health and social care services. <BR /> <BR />Proposals such as this are timely. As we are all fully aware, cancer services here are under enormous pressure. In the quarter ending in December 2023, 89% started treatment within 31 days of the decision to treat; the target, however, is 98%. Some 30% started treatment within 62 days of a referral, but the target for that is 95%. Of those referred on the breast pathways, 52% were seen within 14 days, but the target is 100%.”
“<BR /> <BR />Of course, those proposals to bring together the major players in industry, academia and the public sector are not new. We have city deals that seek to deliver exactly that, and it is important that we seek to use the leverage of those deals to bring about the greatest benefit for Northern Ireland. I know that my ministerial colleague Conor Murphy is fully aware of the potential economic benefits of having a thriving health industry operating in Northern Ireland. Organisations such as Invest NI and the Health Innovation Research Alliance Northern Ireland are working hard to develop the sector. <BR /> <BR />The economic benefits are, of course, important and of interest to everyone here. However, my priority is to deliver the best health and social care outcomes for the citizens of this place.”
“Its proposed oncology innovation clusters would help to bring together all the key cancer research bodies in Northern Ireland and the Republic to consolidate knowledge, resources and infrastructure, with the combined goal of finding innovative approaches to gain better outcomes for patients here in Northern Ireland, on the island of Ireland and globally through their research. <BR /> <BR />The All-Island Cancer Research Institute states that the global oncology market is expected to reach $690·4 billion by the year 2032. Its advice is that research stakeholders in Northern Ireland and the Republic should work together, alongside public bodies and industry, to be a part of that growth. The institute has conducted comprehensive research, identifying all the key stakeholders in both jurisdictions.”
“There is also ongoing collaboration between the Northern Ireland Cancer Trials Network and Cancer Trials Ireland to increase the number of cancer trials available across the island. <BR /> <BR />Cancer research is another key element on which cross-border collaboration is vital. The Health Research Board in Ireland is partnering with the Health and Social Care research and development division and the US National Institutes of Health to provide funding to support cancer research. The All-Island Cancer Research Institute's recent paper, 'Landscape Review and Economic Potential of the Oncology and Allied Digital Health Sector on the Island of Ireland', calls for us to go further on North/South collaboration.”
“That partnership commits us to working together to reduce cancer incidents and mortality across the island of Ireland through cross-border and transatlantic collaborations in cancer research and education. It has been pivotal in many of the positive steps that we have taken against cancer on this island over the past 20 years. Collaborative cancer research has doubled, delivering cancer clinic trials to over 35,000 patients, North and South. <BR /> <BR />We have the All-Ireland NCI Cancer Consortium, which has established clinical trials infrastructure on this island; an all-island cancer atlas; and the training of some 500 clinicians, healthcare professionals and scientists. The consortium has funded fellowship programmes in cancer prevention and in health economics.”
“It provides outpatient systemic anti-cancer therapy and radiotherapy services to approximately half a million people, including patients from County Donegal, with the centre treating approximately 250 people from the Republic every year. In June last year, Stephen Donnelly, the Minister for Health, announced funding for a new Daisy Lodge short-break centre in Cong, County Mayo, for children with cancer and their families. The centre will welcome 30% of its visitors from Northern Ireland, just as our centre in County Down welcomes 30% of its visitors from the Republic. <BR /> <BR />Cancer care should not be about politics. Decisions should be made on the basis of what is best for patients. We have a tripartite partnership between the Governments of Ireland and Northern Ireland and the National Cancer Institute in the United States.”
“It published in recent months, calling for greater cooperation across the island on cancer research, innovation and care. One of my first meetings as Minister was with Professor Lawler as we celebrated 30 years of the Cancer Registry. I am pleased to be able to advise that my Department is already working closely with the Department of Health in the Republic to look at ways in which we can cooperate to deliver cancer services. The North West Cancer Centre, as was mentioned, is a key example of that, with patients from the Republic accessing services there. Likewise, we have patients travelling to Dublin for specialist treatment. <BR /> <BR />We opened the North West Cancer Centre, at Altnagelvin Hospital, in 2016.”
“"For better outcomes": those three words will be my mantra, my test and my yardstick to judge everything that I do. It is clear that Northern Ireland must find new and innovative treatments and care pathways if it is to improve outcomes for cancer patients. I am also clear that we cannot work in isolation if we want to achieve that aim. Collaboration is essential, and that includes collaboration with our neighbours, North/South, as well as east and west. For the avoidance of doubt, I have no political or ideological objection to North/South cooperation. As the Committee Chair said, we have to take politics out of healthcare, and I am determined to do that. <BR /> <BR />I am becoming familiar with the work of the All-Island Cancer Research Institute.”
“Thank you very much, Mr Deputy Speaker. I thank all those who contributed to the debate. As many Members made clear, everybody knows somebody who has been affected — a friend, sibling, loved one, child, parent. I have spoken previously of my paternal grandmother and her slow, painful and, frankly, undignified death from bowel cancer. It impacts, as Mr McGrath hinted, on mental health, finances and life choices. It impacts on oh-so many others: family members who become carers; and parents who have to tell their six-year-old that their mother passed away in the night. To Mr Sheehan, I extend my total sympathy. <BR /> <BR />As Health Minister, I am committed to doing everything that is within my power to ensure that we can improve outcomes for those who are impacted on by cancer.”
“I would like every job in Health and Social Care to be a good job. Pay is very important, as are terms and conditions. However, I see a good job as a job that people get out of bed for because they look forward to their shift and because it is a valued role that they think is important, and, importantly, because we all value the work that Health and Social Care does. Unfortunately, I can only repeat that there would be a potential shortfall of £150 million were we to talk about a 3% increase in pay this year.”
“I am pleased that my ministerial colleague the Minister for the Economy, Conor Murphy, has charged Dr Lisa Wilson from the Nevin Economic Research Institute to look at the definition of a good job. The Economy Committee is looking at that.”
“I thank the Member for his question. The short answer is this: it is simply not good. The budget that I have gives me, frankly, zero ability to deliver a pay award for this year. Members will know that we are largely informed by the recommendations of various independent pay review bodies. While those panels are yet to publish their recommendations, they are likely to come in just a few weeks' time. A pay award here of 3% would cost approximately £150 million. While there was an additional resource allocation in the most recent budgetary outcome, not a single penny of that, I am afraid to report, was for pay. <BR /> <BR />If I may broaden that out: I consider pay to be part of the definition of a good job.”
“The conclusion seemed to be that aviation was way ahead of the health service because of the black box and the fact that, when a catastrophic event occurs and passengers die, every effort is made to analyse what went wrong through the black box etc, with no particular concern for the effect on the individual. Of course, the point is that if there is a catastrophic impact in aviation, the pilot and crew tend to die, whereas, in the health service, it is the patients who suffer rather than those who work in it. Your concern has to be this: which system do you put in place to most motivate an individual to come forward and be honest about the mistakes that they have made? You could put a punitive system in place that actually discourages openness and candour.”
“I thank the Member for his question, but I do not agree with his description of copping out. What I am interested in is how best we encourage individuals who work in Health and Social Care to be absolutely honest about what happens when things go wrong. Is that by placing a statutory duty of candour on an individual? I am not sure that it is. It is the outcome that I am focused on; I am not yet clear about the mechanism by which to get there. <BR /> <BR />I remind the Member that DHSC in England is reviewing the duty of candour because it is clearly not delivering exactly as it was. Not too long ago, I studied a comparative report on candour in aviation and in health.”
“I thank the Member for his question. I have been discussing that with officials during my first two weeks in office. The Member will be aware that, in 2022, there was a public consultation on a duty of candour. My officials are developing proposals for a regional "being open" framework. That includes plans for further consultations in the months ahead. That is a key contributing piece of work to help to further support an open, just and learning culture in Health and Social Care. I am aware that the Department of Health and Social Care (DHSC) is reviewing the implementation of the duty of candour in England. We will, of course, consider the learning that emerges from that exercise.”
“Thinking back to my experience as a victims' commissioner in the Commission for Victims and Survivors, we had maybe 100 groups that were set up to help some of the most vulnerable — people who had been hurt in the conflict, both physically and mentally. The people who were running those groups did not set them up to be chief executives, accountants or human resource managers, yet they seemed to spend a lot of the time doing those things. They spent a very significant amount of their time chasing funds on an annual basis to keep their bodies running. I am very interested in how better we support the voluntary and community sector and effectively free it up to do what it set itself up to do, which is to help vulnerable people.”
“I thank the Member. I must add this caution: there are so many all-party groups that I am not sure that it will be logistically possible for Ministers to start engaging across that whole sector. I sat on a number of all-party groups, so I very much recognise their importance. It is also important that the right officials from Departments attend all-party groups when it is relevant. For example, back in the day, I was very fond of sitting on the all-party group on social enterprise, and the then permanent secretary of the Department of Finance, Sue Gray, was a regular attender at those meetings. There is a way of better coordinating engagement between all-party groups and Departments at a very senior level. <BR /> <BR />I also say this to the Member.”
“Where there are gaps, I need to know about them and need to react to them, so I thank the Member for putting that on my radar. I will take it away and ask questions about why you remain unsatisfied and why we cannot satisfy your desire.”
“I thank the Member. I am disappointed that she is not satisfied with the response that she got. As a broad point, when you include the voluntary and community sector and charities, the health and social care system is a vast and very complex set of institutions and bodies, and there are an awful lot of moving parts. I am aware that, sometimes, when a Member asks a question for written answer of me, I have to say that the information is held by the health and social care trusts rather than by the Department. Sometimes, the health and social care trusts are able to provide the information, and, sometimes, they come back and say that they do not hold the information. <BR /> <BR />As I have already said on a couple of occasions in this session, data will be very important to me in how we improve and max out the capacity of the entire system.”
“I will look at it and promise that, once again, I will study it, reflect on it, make a decision and get back to you in due course.”
“I thank the Member. Perhaps we should be swapping places for this one, because you have a level of detail that I am afraid that I cannot match on my first day of topical questions. However, cancer is one of the four areas that I identified, as well as mental health, waiting lists and health inequalities, as something that I really want to focus on in the remaining three years of the mandate. <BR /> <BR />In being the Minister and having a leadership role, it is very important to surround yourself with people who know the things that you do not. Clearly, for example, you have expertise and an interest in this particular area, which I will take back to the relevant staff in the Department of Health, the arm's-length bodies and other stakeholders, as required.”
“Yes: awareness, education and early detection are absolutely critical.”
“I certainly do. I think that, first of all, awareness and education and then early detection and prevention — these things all go together. Social prescribing is something that is relatively new in health and social care, and that is very important. I do puzzles and crosswords to try to keep myself mentally fit. My dear late mother, when she was in her eighties, liked to do things like Wordle. In fact, when the Glider came on stream in east Belfast, she used to get the Glider into town to go for a cup of coffee. She felt that it kept her active and mentally stimulated. There are a lot of things besides pills and tablets that we have to look at to address these issues — I was going to say "tackle these issues", but it is not going to go away. It is a question of handling it to the best effect.”
“I thank the Member for his question. Dementia is an issue that is so broad and impacts so deeply on so many people. I am sure that the Member popped in to the Parkinson's UK event earlier today in the Long Gallery. I know that his colleague sitting behind him, Mr McGlone, was there. If I may divert for a second, I put on record, as I did upstairs, my thanks to the thousands and thousands of carers, particularly unpaid carers, who provide such fantastic work to us. <BR /> <BR />In breaking down numbers across the various geographic health trusts, I am not sure whether that has been done, to be frank with the Member. I will certainly make it my business to find out. As I have said previously, data is absolutely key to maximising the resources and the capacity of the health and social care system to deliver for patients.”
“I am thinking about it, and I hope to be able to return to the House, if not before recess, certainly early in the autumn, with an idea of how we go about rebooting Bengoa and actually delivering it in a practical sense and delivering the principles in a real-time sense.”
“I thank the Deputy Chair of the Committee for his question. What we perhaps need, given that we are so far away from the publication of the Bengoa report, is to get back to day zero and reboot. We should almost return to factory settings, to use that cliché. I have been discussing with senior officials in the Department how we might reboot. It seems to me that Bengoa has perhaps been misinterpreted in part of the public consciousness and is now viewed as some sort of road map or blueprint for how we get from where we are to the best 21st-century health and social care service that we can devise. Of course, it was not that; it was a set of principles. We could, perhaps, call it a "framework". It is up to us and to stakeholders to populate that framework and make it work in the best possible way.”
“I hope, sooner rather than later, to speak to the House about how we better view each hospital as part of a network rather than as an institution operating in isolation. Not every hospital will provide every service. Again, as I said last Monday, if I were to need a procedure and the choice was between going to the nearest facility, where the procedure is done, say, once a week, and travelling a bit further to somewhere where it is done seven times a day, five days a week, I know which one I would choose. It is a question of reorganising and reforming; it is not a question of saying, "I am closing a hospital". I have no intention, over the next three years, of going anywhere near the idea of closing a hospital or reducing that square metreage or square yardage.”
“I agree wholeheartedly with the Member. As my predecessor said, we need every square metre, or was it square inch? I am not sure whether he was being European, but we need every "amount" that we have in those buildings. What I want to do, however, is put a focus on the people who populate them. As I said last Monday, the two primary reasons that we have a health service are to keep the healthy healthy and to cure the sick. No matter how much resource we have to keep people healthy, we will find that people become sick and will still need to go to places where they will find specialists who are dedicated to curing whatever ailment they present with. <BR /> <BR />Yes, we will look at our entire estate of hospitals.”
“One of the pressures is the inability to deliver the roll-out of multidisciplinary teams in as timely a manner as I would wish.”
“The irony is not lost on me that the Member criticises me for giving a history of events in 2016 but then gives the House a history of her party's confidence-and-supply arrangements. <BR /> <BR />I repeat that the multidisciplinary teams are, on an evidence base, working well and delivering what I want. Everything that I focus on is for better outcomes, which the MDTs are delivering. The roll-out was a multi-year plan. Unfortunately, under the current Budget, that plan will not be speeded up but will slow down. <BR /> <BR />I look forward to meeting Executive colleagues to try to impress on them some of the issues that are related to the current Department of Health budget and seeing what we can do. I want to do what I can with the money that we have. It is a lot of money, but the pressures remain.”
“My Department has published a number of Delivering Together update reports, highlighting the progress that has been made on various reform projects. The Delivering Together 2024 progress report, which summaries all the current Health and Social Care reform strategies and plans, will shortly be available for publication.”
“For example, in primary care, we have rolled out the multidisciplinary team model, which is not only providing a better service for patients but helping to stabilise GP practices. In elective care, we have established day procedure centres at the Lagan Valley and Omagh hospitals and overnight stay centres at the Mater Hospital, Daisy Hill Hospital and the South West Acute Hospital. That is beginning to deliver some welcome results: the latest inpatient and day case stats show a reduction for the seventh successive quarter, which is the longest sustained reduction since at least 2008. I offer that as a fact, not to show complacency. <BR /> <BR />There are important examples of reform in action. Reform continues to be progressed through co-production and collaborative working with a wide range of stakeholders.”
“I thank the Member for her question. The reform of our Health and Social Care service is one of my key concerns. I made it clear in my opening statement last Monday that it was an area that I would be focusing on along with health inequalities, cancer, mental health and waiting lists. There is an existing overarching plan for reforming our health service: the 'Health and Wellbeing 2026: Delivering Together' report. That was launched in 2016 as the Department's 10-year plan in response to the recommendations of the Bengoa report, 'Systems, Not Structures: Changing Health and Social Care'. Of course, we need to continue to review and refine that 10-year Delivering Together plan. <BR /> <BR />Progress has been made across a broad range of critical areas, including social care, mental health, acute care, elective care and primary care.”
“I thank the Member for her question. Unfortunately, as I said, being just under two weeks into the role, there are some areas that I have not yet had the opportunity to have a detailed briefing on from senior officials in the Department of Health or, indeed, from arm's-length bodies, some of the royal colleges or the British Medical Association. I am not in a position to make a definitive statement to the Member on that issue, but she has put it on my radar. I will consult, reflect and decide in due course.”
“I assure the Member that, as is the case with all abortion publications in England, Wales and Scotland, the forthcoming publication for abortions in Northern Ireland will provide a breakdown of abortions by age; by health and social care trust; by the statutory grounds for abortion, which will be based on the Abortion (Northern Ireland) (No. 2) Regulations 2020; by gestation; and by method of abortion.”
“<BR /> <BR />The issue arose because the methodology in place prior to the law change was set up to capture only those procedures involving hospital admissions. However, since the introduction of the 2020 abortion regulations, the majority of abortions in Northern Ireland are early medical abortions and take place in an outpatient setting. <BR /> <BR />Following an instruction from the Secretary of State for Northern Ireland to the Department on 2 December 2022 to formally commission abortion services, a process has been under way to verify up-to-date statistics from the date of the law change in Northern Ireland. Those are the statistics that will be published later this month.”
“I thank the Member for his question. The Department will publish comprehensive data relating to abortions in Northern Ireland on 20 June this year. It will cover the three-year period from the introduction of the Abortion (Northern Ireland) (No. 2) Regulations on 31 March 2020 to 31 March 2023. <BR /> <BR />My understanding is that the Department's annual publications had under-reported the number of abortions in Northern Ireland since the law was changed in 2020. That is recognised, and, although the accurate totals have been disclosed regularly through Assembly questions for written answer, I assure the Member that they will be corrected in the forthcoming publication for each of the three reporting years.”
“I thank the Member for his question. A variety of factors impacts on the growth of type 2 diabetes. We all need to be focused on it because its implications for not only the health of individuals and communities but the resourcing and funding of the health service cannot be overestimated. Factors include age and ethnicity. Above all, however, there are manageable issues, and the biggest of all, of course, is diet. One of the issues that I have been discussing with colleagues and officials in the Department of Health — the discussion is at an early stage and relates to my desire to bring forward an initiative on health inequalities — is diet and the role that dieticians can play if we are to get ourselves out of the building, as we call GP surgeries and hospitals, and take services into the community.”
“<BR /> <BR />The Member may be interested to note that NHS England has developed a phased implementation strategy in response to the guidance. Owing to the scale and scope of the recommendation, implementation will be over a five-year period, and it will include a process of prioritisation for eligibility, in line with NICE guidelines. <BR /> <BR />Significant additional investment will be required to support the implementation of the hybrid closed-loop system for people living with type 1 diabetes who would be eligible. The Northern Ireland Diabetics Network will communicate with all stakeholders following decision-making in relation to the hybrid closed-loop system and its implementation in Northern Ireland.”
“I thank the Member for her question. I am not entirely sure how it relates to the original question. I can say, however, that the strategic planning and performance group has received formal notification of endorsement from the Department of Health. That followed the review of the National Institute for Health and Care Excellence (NICE) final guidance on hybrid closed-loop systems for managing blood glucose levels in type 1 diabetes, which was published in December 2023. Work is being undertaken to understand the implications of that decision for overall provision, consideration of priority groups, system costs, workforce and the communication requirements to enable and support. That will inform final decision-making and commissioning arrangements for Northern Ireland.”
“I agree with the Member: this is a critical issue. Public health is so important. We spend a lot on it, but we think about the savings. I believe very much in data as a way forward, but I am also conscious that all data ultimately equates to human beings, and it is the human cost of things such as obesity that we have to tackle.”
“I absolutely agree with the Member. Take, for example, treatments for obesity and the cost of treatments for obesity. I had my Department give further consideration to the potential to use such resources as this levy, and the mechanisms to do so, through the development of priorities and actions arising from the strategic framework. Officials are in contact with the Department of Finance. A consultation summary report will be published soon.”
“My Department recently consulted on a new co-produced obesity strategy framework, Healthy Futures. The public consultation commenced on 24 November 2023 and closed on 1 March of this year. A consultation summary report is being developed. The Department will give further consideration to the potential to use such resources as the soft drinks industry levy, and the mechanisms to do so, as work on the new strategic framework progresses.”
“Using population measure, and assuming that the production of soft drinks is representative across the UK, we could estimate that £10·6 million was raised in Northern Ireland in the 2022-23 financial year. <BR />The levy is not formally linked by the UK Government to any specific spending, so it is not known how much the Executive receive as a result of the levy. My Department previously explored the potential to use funds equivalent to those likely to have been raised through the levy in Northern Ireland for tackling obesity and other public health-related issues, but, given that there was no budget line, that did not prove to be possible. It is still my preference that the revenue raised through the levy be targeted at obesity-related purposes.”
“I thank the Member. The soft drinks industry levy is a UK-wide tariff that applies to drinks that contain added sugar. It seeks to contribute to strategies to reduce obesity by reducing or removing added sugar from soft drinks and encouraging producers and importers to reformulate their products to reduce the sugar content and/or portion sizes of added-sugar drinks. Given the nature of the market, and the fact that the levy applies to producers and importers, the relevant businesses report once for all receipts raised across the UK. Therefore, HMRC does not report receipts below the UK-wide level, or regionally. However, in 2022-23, the levy raised £355 million across the UK.”
“I thank the Member for his question. I have been discussing the public health Bill in my early days. We are currently governed by an Act dating from 1967. It seems to me that that Act is all well and good if the issue is noted on the face of the Bill, but that, if it is not, there is a problem. I am in the early stages of taking briefings, with colleagues, about introducing a new Bill that will, effectively, cover all hazards, so that we can be much more fleet of foot. That will, obviously, require cross-departmental agreement at Executive level. I am keen that any regulations that may be contained in such a Bill will be subject to affirmative action — in other words, the Assembly would very much have its place in making the final decisions.”