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Coronary Heart Disease
5. Mr. Simon Coombs: To ask the Secretary of State for Northern Ireland if he will make a statement on progress in reducing the incidence of coronary heart disease in the Province. [15022]
Mr. Moss: Over the past 10 years, premature deaths from coronary heart disease in Northern Ireland have fallen by 33 per cent.
Mr. Coombs: Will my hon. Friend confirm that, between 1985 and 1994, the number of deaths from premature coronary heart disease fell from 1,056 to 703? Does he agree that much of the credit for that should go to the change of heart programme, which was set up in 1986 by my right hon. Friend the Member for Bridgwater (Mr. King)? Nevertheless, does my hon. Friend recognise that the level of heart disease in Northern Ireland remains among the highest in the world? What further plans does he have to research the reasons for that high incidence of heart disease and to promote better dietary and other habits to reduce those figures further still?
Mr. Moss: As my hon. Friend says, that reduction is one of the great achievements of the health service in Northern Ireland over the past decade and more. The change of heart programme was established in 1986 and set a target of a 15 per cent. reduction, which we achieved within five years. We have now set more challenging targets, of about a 40 per cent. reduction by the turn of the century. As for attacking the problem of a regional health strategy for health and social services, we have set a target to increase the number of cardiac operations in Northern Ireland by about 1,200 in the coming years. We have reached that target in the past two years, and we hope to do more in the future.
Rev. Martin Smyth: Does the Minister accept that a change in diet and habits is needed--rather than the change of heart to which he referred in relation to surgical operations--which has been achieved by the Chest, Heart and Stroke Association's campaign? Is it not wrong for advertisers, particularly tobacco advertisers, to try to lure children into that habit, which has an adverse effect on children's hearts?
Mr. Moss: I am grateful for the hon. Gentleman's comments, and I acknowledge the work that has been done by the society that he mentioned. The change of heart programme tackled the main risk factors of smoking, raised blood pressure, cholesterol and physical inactivity. The Health Promotion Agency in Northern Ireland manages the change of heart programme and spends about one third of its £1.3 million budget on resources to tackle the risk factors associated with heart disease. The agency's efforts are complemented locally by the health
promotion work of the health and social services boards and trusts and by general practitioners. New Province-wide strategies on food, nutrition and physical activity are being developed.
Mr. McGrady: Despite the good news about trends that the Minister has delivered to the House, is he aware of the very alarming instruction issued by the director of the Royal Victoria hospital to consultant cardiac surgeons that they should not perform any further cardiac surgery except in cases of extreme emergency or when patients are referred to them by a fundholding general practitioner in the entire area of the Eastern and Northern health board? Is that not very discriminatory, and what action does he intend to take to ensure that my constituents, particularly those with cardiac conditions, get an equal deal in health care?
Mr. Moss: I am not aware of the details of the hon. Gentleman's question, but, if he will write to me, I shall certainly look into the matter for him. I repeat that the regional strategy sets a target for increasing the number of cardiac operations in Northern Ireland from only 700 in 1990 to 1,100 by 1993. That target has since increased. We have appointed two additional cardiac surgeons at the Royal Victoria hospital in the past three years, and we intend to tackle the problem head on in the future.
Mr. Fabricant: Has my hon. Friend seen the research work undertaken by Professor Alan Howard of Cambridge university that states that drinking a glass of red wine a day helps to alleviate heart disease? Will he encourage all the excellent hostelries throughout Northern Ireland--in Belfast and Bangor--many of which I am personally familiar with, to sell not only the excellent stout produced in the island of Ireland but red wine?
Mr. Moss: My hon. Friend will have to wait until the new licensing laws are announced, which I hope to do in the near future.
Elections
7. Mr. Robert McCartney: To ask the Secretary of State for Northern Ireland in what circumstances the Government of the United Kingdom seek the prior consent of the Republic of Ireland to execute decisions relating to elections within the United Kingdom. [15024]
Sir Patrick Mayhew: There are no such circumstances, as the execution of such decisions would fall within the exclusive jurisdiction of Her Majesty's Government.
Mr. McCartney: Does my right hon. and learned Friend accept that the pique expressed by the Government of the Republic about the alleged failure of Her Majesty's Government to consult them on the issue of elections in Northern Ireland seems to reveal a claim to a role in Northern Ireland's affairs under the 1985 agreement that goes well beyond the consultative? Is my right hon. and learned Friend aware that in November 1985, on the day after the Anglo-Irish Agreement was signed, the then Taoiseach of the Republic told Members of the Dail Eireann that the powers granted to the Republic went far
beyond the consultative and stopped short of being full executive powers only because of the notional idea or concept of sovereignty?
Sir Patrick Mayhew: I do not think that I shall follow the hon. and learned Gentleman down the paths that his question took; nor do I think it profitable to explore what was undoubtedly a period of disagreement that arose out of the Government's response to the Mitchell report. Both Governments remain united in seeking to help the people of Northern Ireland to achieve a comprehensive political settlement. They also remain united on the means by which that can be achieved: a process of inclusive all-party negotiations. I would prefer to concentrate on that rather than on the occasional ups and downs that occur in such a close relationship.
Mr. Bill Walker: Does my right hon. and learned Friend recognise that, whatever the Republic of Ireland's views, they are not important in the sense of what the House will and cannot do? What is important is that the IRA should never get the message that it can intimidate Her Majesty's Government or the House into not holding elections in Northern Ireland.
Sir Patrick Mayhew: I very much agree with my hon. Friend. It has been a matter of great importance that the two Governments should stand side by side in their response to the evil and totally unjustified return to violence that has been carried out by people who have turned their backs on democracy.
Mr. John D. Taylor: As most people in Northern Ireland--with the exception of Sinn Fein--agree with the principle of consent, does the Secretary of State recall that the large majority of people in Northern Ireland oppose the Anglo-Irish Agreement and that all hon. Members on the Ulster Unionist Benches remain implacably opposed to it? Does he therefore understand clearly that any statement by the Government on the future political process in Northern Ireland that implicitly involves the Anglo-Irish Agreement cannot succeed?
Sir Patrick Mayhew: I think that the right hon. Gentleman will recall that part of the purpose of the negotiations, about which we have been talking at length this afternoon, is to see whether a new and more widely accepted agreement between the two Governments can be found. That was part of the process of the three-stranded talks in 1991-92 and it remains something which, by definition, would be desirable.
Mr. John Greenway: Does my right hon. and learned Friend also accept that a great many people in Northern Ireland support political parties that are not represented in the House? Does he agree that elections that would lead directly to all-party talks would enable their concerns and interests to be given a voice in those all-party talks?
Sir Patrick Mayhew: My hon. Friend raises a very important matter. It is important to remember that, as was observed by Senator Mitchell in his report, a process of elections would need to be widely accepted. One of the reasons why it seems to offer a means of carrying forward
the confidence that is needed is that it would enable Northern Ireland's people to make their views known in the new circumstances.
Mr. Mallon: Will the Secretary of State confirm that the only parties that refused to enter all-party negotiations were the two Unionist parties and that the Prime Minister's stated reason for proposing an elective process was to get those parties directly and immediately into all-party negotiations? Is the right hon. and learned Gentleman aware that yesterday the Unionist parties made it clear that, even after an elective process, they would not go directly and immediately into all-party negotiations? Why does the Prime Minister foolishly and stubbornly pursue a policy that cannot achieve his own stated objective?
Sir Patrick Mayhew: I have always found that the Unionist parties, like every other party represented in the House, are well capable of speaking for themselves. On the whole, it is wiser to let them do so--that is true of all parties in the House. Rather than go down a historical road, especially one that is conditioned by the premises of the hon. Gentleman's question, I would prefer to concentrate on what unites parties in the House, particularly those that take a close interest in Northern Ireland affairs: the need to establish an inclusive process of talks, at which are represented all the parties that fulfil the stipulations of paragraph 10 of the Downing Street declaration. That means in particular those that have established that they are wholly committed to democratic principles. That is what unites us all. We must now set much of the past behind us and concentrate on the means by which that objective can be achieved.
Mr. Peter Robinson: Is the Secretary of State aware that, over the past few days, Government spin doctors have been briefing the press to the effect that he and the Prime Minister do not view as mutually exclusive the proposal for an elected convention put forward by my party, the referendum proposal put forward by the hon. Member for Foyle (Mr. Hume) and the proximity talks proposal being put forward by the Government of the Irish Republic? Is that the direction in which the Government are leaning?
Sir Patrick Mayhew: If any spin doctors--I have never met one--have been spinning in the direction of the idea that all these proposals are put forward in good faith as offering a possible way forward and that all are relevant to achieving the objective that we share, I am glad, and I hope that they will go on spinning, because it happens to be true. In the process of the intensive talks that are going on, we must try to rough-hew an agreed way forward. There are good prospects of doing so.
Mr. Worthington: If there is general support for elections, as the Secretary of State said, does he agree that all parties that are committed to exclusively peaceful methods should know at the time of the elections when, where and how all-party talks should take place?
Sir Patrick Mayhew: There is no doubt that nationalists are anxious that all-party negotiations of an inclusive type are started as soon as possible. There is nothing special about them--I think everybody is
concerned about that. We cannot identify a date as being the one with certainty on which negotiations will start. We can, however--this is useful--do what my right hon. Friend the Prime Minister has done: set out a timetable by which it seems likely that the House would approve the necessary legislation and by which thereafter we could, in a short space of time, measured in days rather than weeks, enter the negotiations that we all seek.8. Mr. Simpson: To ask the Secretary of State for Northern Ireland what assessment he has made of the effect of elections on the level of violence in Northern Ireland since 1971. [15025]
The Minister of State, Northern Ireland Office (Sir John Wheeler): There does not appear to be any direct correlation between elections and levels of violence in Northern Ireland.
Mr. Simpson: Is the Minister aware of figures provided for me by the Library, tracing the past 25 years? They show not only that there is no correlation between election years and positive peace-building processes but that election years have invariably produced more deaths, injuries, explosions and firearms caches, which have bucked the trend of decreasing violence. Does the Minister accept that wider evidence suggests that elections follow the conclusion of all-party peace talks rather than their pre-emption? Is that not where the Government should be starting right now?
Sir John Wheeler: I cannot comment on the detail of the figures given by the hon. Gentleman. What I can say is that, in the event of elections, the Royal Ulster Constabulary will produce a plan to protect the public who wish to participate in them.
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