To ask the Minister of Health, Social Services and Public Safety, further to his recent meeting with the Ulster Farmers' Union, for his assessment of current health care provision in rural communities.

Mr Wells

With your permission, Mr Deputy Speaker, I will respond to questions 3 and 8 together. I am committed to improving the health and well-being of the rural population and to taking forward the commitment for health in the rural White Paper action plan. My Department and the Public Health Agency are committed to working jointly with the Department of Agriculture and Rural Development on initiatives such as the maximising access in rural areas (MARA) project and the farm families health checks programme. I also want to ensure that high-quality care continues to be provided to people with palliative and end-of-life care needs, irrespective of where they live or where their care is delivered. The Health and Social Care Board and the Public Health Agency, in conjunction with Marie Curie, are taking forward the Transforming Your Palliative and End-of-life Care programme. The programme aims to improve the design and delivery of coordinated services and ensure equity of access to services for urban and rural communities. It will do that through the development of person-centred care so that people with palliative and end-of-life care needs will have, as far as possible, choice in how and where their care is provided.

Mr McMullan

Go raibh maith agat. I thank the Minister for that partial answer, but he has still not answered the question. When will rural dwellers see the investment in community and palliative care that the all-singing and all-dancing Transforming Your Care promised when it came out and all its plans were announced to the public? Will the Minister guarantee the House and the wider public today that any decision that he takes through Transforming Your Care for the rural community will first be rural-proofed?

Mr Wells

As I already mentioned to the Member, the Executive have adopted the rural White Paper action plan for Northern Ireland. That followed extensive engagement with stakeholders and Departments. It was agreed by the Executive in May 2012. That demonstrates the Executive's commitment to improving the quality of life of those who live in rural areas. The plan was developed to provide a strategic framework for rural policy for the next 10 years. It provides a framework for a more integrated approach by the Executive to seek to address the challenges facing rural communities and to help ensure the future sustainability of rural areas. It contains commitments on rural issues by all Departments, including mine.

Mr Wells

As the honourable Member for East Londonderry will know, rural transport is outwith the control of the Department of Health. However, I realise that it is an important factor in people getting access to essential services. She raised the particular issue of the Blind Centre in Coleraine. I am more than happy to take up that issue with Minister Kennedy to see what is happening. In my area, the Down Armagh Rural Transport Partnership (DART) is having huge difficulties with funding at the moment. Essential services are being withdrawn because the cash is not being made available to enable an extensive service to remain available to the community. I am therefore more than happy to pursue the issue. Coleraine is not the area that I would be in most often, so I am not across the particular issue raised. I know that the Member is raising it on behalf of her constituents, and I am more than happy to follow up on that with Minister Kennedy.

Mr G Robinson

Will the Minister provide an update on the paediatric palliative care strategy?

Mr Wells

The Department's review of paediatric services — Sorry, I did not quite hear the Member. Was it paediatric or palliative care?

Mr G Robinson

Palliative care.

Mr Wells

The Department places huge store on protecting and enhancing palliative care services. Indeed, we have an agreement with Marie Curie, which organises visits to those in rural areas who have end-of-life care needs. Indeed, I was also up at the Northern Ireland Children's Hospice, and I noticed that it has a team of nurses who go to every county in Northern Ireland to provide care to people who look after young children who have end-of-life care needs. I was very impressed with the quality of the care that I saw, and I am committed to ensuring that the review of palliative care continues to reach out to rural communities. I want to continue to work with the charitable NGO sector in this respect. We also provide domiciliary care to 25,000 people in Northern Ireland, many of whom, of course, are elderly people, and some of whom have palliative care needs. So, there is a commitment throughout Northern Ireland to ensure that we do our best for people who wish to remain in their community in their last days. We know how difficult a period this is in their lives and the lives of their families, and I would like to think that the Department, through the five trusts, is working to ensure that people, in even the most remote areas, are getting the care they require.

Mrs Overend

Care in the community is especially important in rural areas, yet each of the trusts is cutting support for domiciliary care. Can the Minister detail how this is justifiable?

Mr Wells

The overall level of domiciliary care is actually continuing to increase. I think that she is referring to the fact that, under the contingency plans to save money in the last four months of this financial year, some trusts have been adopting a policy of providing only two out of three non-urgent packages to slow down demand and restrict growth in the budget. This does not mean that there is not an overall growth in the programme, and it continues to be a major component of the social care budget. This will be reviewed, of course, in the context of Budget 2015-16. I have not yet had direction from the trusts on what they intend to do, but, if anyone needs a domiciliary care package urgently, they are still getting it. I emphasise that. It is only the non-essential packages that are being restricted and, even then, it is two out of three, and that policy does not apply to all trusts. This is a rapidly growing part of our budget, and, indeed, as part of Transforming Your Care, one of the main focuses of that document is to transfer funding from further up the healthcare ladder down to domiciliary care.

Dr McDonnell

Mr Deputy Speaker, can I take this opportunity to congratulate the Minister on his earlier warm comments about GPs? They are outstanding people dedicated to serving the community at a level that is far beyond the norm that is expected. [Laughter.]

Mr Deputy Speaker (Mr Beggs)

Can we have a question, please?

Dr McDonnell

Minister, your comments will be noted and remembered. We started off by talking about Transforming Your Care in this question. Minister, to what extent are the health trusts involved in the decision-making to close nursing homes such as Orchard House in Belfast? What assurances can be given to residents affected by those decisions that they will be provided with suitable alternative accommodation or provision in the community?

Mr Wells

Orchard is a private facility. The Department has no direct control over private nursing homes. We have had situations where they have announced closure, and, of course, they have to consult before doing so. It then becomes the trust's role, in this case the Belfast Trust, to provide alternative accommodation for the residents of a private home. We had a similar situation in Bangor. You will understand that, as a privately owned facility, it is a matter between the Belfast Trust and the RQIA that, during the period of notice, they meet all the relevant registration and contractual requirements and that the residents are appropriately and successfully relocated. From experience, I have found that it is always possible to relocate residents in this situation. I understand, of course, that, if someone has lived a large portion at the end of their life in a private residential or nursing home, the trauma and upheaval of having to be moved out and be split from friends is very difficult. You will understand that the Department could not get into the situation of moving in and bailing out, or rescuing, private residential nursing homes, because, when there is alternative provision, we have to make use of it. There have been some isolated incidents of this happening, but, on all occasions, the residents have been relocated to other facilities in a reasonably short period.