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3.37 pm
The Parliamentary Under-Secretary of State for Northern Ireland (Angela Smith): I congratulate the hon. Member for Strangford (Mrs. Robinson) on securing the debate. The subject is obviously close to her heart and I commend her for the way she made her case; it is one with which I have considerable sympathy. I welcome the support of the hon. Member for Belfast, South (Rev. Martin Smyth).
In the time remaining this afternoon, it may be helpful if I explain the background. I understand the hon. Lady's concerns for her constituents, and I am very much aware of the pressures on individuals and families when a member of the family suffers an injury that leads to acquired brain injury. The hon. Lady outlined the random nature of such an event and the traumatic effect that it can have on the life of the person with the injury and on friends and families, who often bear the brunt of dealing with a very different person, in some cases, and caring responsibilities.
Brain injury is a complex and difficult area of medicine. The Government recognise the seriousness of the issue and the need to find ways to combat the effects of such injury on victims. As the hon. Lady said, brain injury can arise through traumatic events such as accidents, or be acquired through brain damage as a result of tumours or chronic illnesses. Initial treatment usually takes place in hospital neurosurgery or neurology departments. Following hospitalisation, a patient may recover sufficiently to return home, although some may require considerable support.
Investment in the health service in Northern Ireland is central to our Government's policies and is bringing improvement to Northern Ireland for the benefit of patients and their families. This commitment is reflected in the fact that almost 41.5 per cent. of the Northern Ireland departmental expenditure limit for 2003–04 is devoted to health issues. The figure will rise by 7.8 per cent. in the next financial year, amounting to more than £3 billion.
The Department for Employment and Learning, not my Department, is responsible for administering the European social fund for projects such as Reconnect which, as she described, provides rehabilitation for people with head injuries. Eligible projects are those that provide training and skills development for people seeking employment or advancement in employment. Some supported projects seek to meet the employment and training needs of those with health problems or disabilities, as in the case of Reconnect.
The primary focus of the European social fund is to provide individuals with the necessary skills to gain employment. The general rehabilitation of those with health problems or other disabilities is not the primary objective of the European social fund, but, of course, the building of confidence and of the skills required to enter employment are an important contribution to rehabilitation.
There are some misconceptions about the reasons for Reconnect not succeeding this time. There is a substantial but finite amount in the European social fund available to projects for the two years from 1 April 2004 to 31 March 2006. That amount is £22 million. I understand that that is not a reduction, but the reasons for the application's failure have nothing to do with it crossing two Departments. Each application is considered on its merits.
One problem is that there is extensive competition for the funds: 95 applicants sought a total of £36 million, which the fund could not meet. The result was that there were more deserving projects than could be dealt with by the funds available. That is one reason why, on this occasion, Reconnect was not successful.
I understand that Reconnect was supported previously by the European social fund, but that in itself is not a criterion for future support. I am told that that would be unfair to new applicants, which is understandable. However, that causes a problem for organisations on the ground of sustainability, so perhaps we ought to work across Departments and with the organisations that might be involved to see whether more can be done to help to develop exit strategies or alternative funding streams.
Unfortunately, the timing is difficult, because often when organisations are notified that they are to lose their funding there is not always enough time to put
other funding in place. However, the Department for Employment and Learning, as well as my own Department, the Department of Health, Social Services and Public Safety, very much recognise the seriousness of brain injury and its effects on the victims.I understand the disappointment felt by Reconnect at its recent unsuccessful application. It has decided to appeal against that decision—I am told that the review panel is meeting on 4 February—but the difficulty is that Reconnect was not the next organisation on the list for gaining funding. Other organisations, which are also extremely worthy and extremely important, were ahead of it. We await the outcome of that appeal. In the meantime, I can assure the hon. Members for Strangford and for Belfast, South that the discussions are ongoing between the organisation, the South and East Belfast trust and the Eastern board to see whether any interim measures can be taken. I will say more about that later.
In a moment, I will come to the discussions that are taking place and what steps we are considering to see how the Department of Health, Social Services and Public Safety can help. First, I want to talk about the Department's work in this area of health.
Rev. Martin Smyth: I may be coming in too soon on this one and the Minister may be about to answer my question. I understand her reference to the South and East Belfast trust and the Eastern board, but are no folk in other board areas benefiting from Reconnect's work? Has the Department taken that point into consideration?
Angela Smith: Unfortunately, Reconnect's work takes place only in the Eastern board area, not in others. Therefore, it would be difficult to ask other boards to assist in funding activities that do not take place in their areas. There is a problem here—my Department would fund work that happens across all four boards, but this organisation's work does not do that.
Mr. Roy Beggs (East Antrim) (UUP): The point made by my hon. Friend the Member for Belfast, South (Rev. Martin Smyth) is that we have only one centre in Northern Ireland that does not deal exclusively with those who require assistance in the Belfast area. Obviously, others who require support must travel to that centre.
Angela Smith: Perhaps the hon. Gentleman will be patient for a moment. He is not correct because, as I will explain, considerable other work is going on across Northern Ireland to assist people with acquired brain injury. I shall outline some of what my Department is doing.
The Department recognises that people with a brain injury require a continuum of care—this was also acknowledged by the hon. Members for Strangford and for Belfast, South—in respect of acute care, which is followed by community care and support. As a result, we are establishing a new regional acquired brain injury unit on the Musgrave Park hospital site. That will provide state-of-the-art in-patient rehabilitation
services, and is due to open in 2006. I am sure that that will be welcomed across Northern Ireland and by all in the Chamber. The £8.5 million cost of that represents a considerable investment in brain injury rehabilitation services.The development of community brain injury services to complement the new unit is also essential. These will provide rehabilitation and support for those with brain injury already living in the community and provide a "step down" service for the new unit, the importance of which both hon. Members specified. It is envisaged that community services will be provided by teams comprising psychiatry, psychology, therapy, nursing and social work input. In 2004–05, an additional £500,000 will be provided for that purpose.
The third aspect of support for people with brain injuries and their carers is also provided by voluntary organisations. Currently, my Department provides funds amounting to £120,000 to the Cedar Foundation, which provides rehabilitation and vocational training. Cedar provides socio-vocational brain injury services at six centres across Northern Ireland—Belfast, Ballymena, Lisburn, Londonderry, Newry and Enniskillen. The Cedar Foundation was successful in its recent application for funding from the European social fund, and it plans to expand its brain injury services. Headway also provides support and services for people with brain injury and their families. That organisation received project funding until March 2003.
A new organisation, the Northern Ireland traumatic brain injury forum, was established in 2002 to bring together people with a brain injury, their carers and professionals in the field to lobby for better services. My Department provided funding for the organisation's inaugural conference in 2002 and an application for recurrent funding is currently being considered. The forum also organised a seminar in November 2002 on the needs of children with a head injury, which my Department funded. A report of the recommendations of the seminar is awaited, and that will assist in planning for future service development. In addition, an inspection of services for disabled children is being undertaken by the social services inspectorate, which will advise my Department of any current gaps in service provision.
Work is also being undertaken by the Department for Employment and Learning through its disablement advisory service, which provides advice, guidance, training and a placing service for people with disabilities and health issues. The service is available for those who wish to obtain or retain employment and can be accessed through a specialist team of disablement employment advisers across Northern Ireland.
The disablement advisory service also offers a range of practical and financial support to employers recruiting and retaining disabled employees, as well as a professional assessment system. The disablement advisory service administers four main employment programmes to help people with disabilities enter or remain in work: the job introduction scheme, access to work, employment support and the new deal for disabled people. The job introduction scheme is a job trial facility, which offers both the employer and the disabled jobseeker an excellent opportunity to find out if the job and the person match. The disablement advisory service helps the employer with a contribution towards
employment costs for the first few weeks, and the trial period usually lasts for about six weeks. Employment support gives people with more severe disabilities the opportunity of working alongside non-disabled employees in a wide variety of jobs. That enables people who cannot reach standard output levels, because of their disability, to work in real jobs and earn the full rate of pay for the job that they are doing. I have mentioned the work of the new deal for disabled people.Projects such as Reconnect, which were already receiving European social fund assistance, were aware that further assistance, as previously, is subject to competition with other organisations. That, however, does not lessen the threat to Reconnect's services. Clearly, health is a priority for Northern Ireland and is central to Government policies. As I indicated earlier, the priority is reflected in the high proportion of expenditure devoted to health issues in Northern Ireland, and I have outlined some of the important work that is going on to assist people who have disabilities and acquired brain injuries. We do as much of that work as we can, as this is a very complex and distressing area of medicine, and patients, carers and their families need support, as I outlined at the beginning of my speech. However, I have to recognise that, within the budget limits that apply, we cannot meet every need in medicine.
I want to comment on the specific action that we are taking to try to help Reconnect. I apologise to the hon. Member for Belfast, South if he has not had a response about meeting me. I understand that my right hon. Friend the Member for Liverpool, Wavertree (Jane Kennedy) is the Minister with responsibility for
employment and learning. If the funding falls under that Department, the request would not have come to me at this stage.I understand that 33 people are currently using Reconnect services and I am most concerned that they continue to receive the care and support that they need. I am sure that the hon. Lady appreciates that it is quite difficult for the Health Department and health boards to pick up the drop in expenditure from the Department for Employment and Learning. I can say that the trusts that use Reconnect services have advised the board that they have contingency plans to absorb current users into alternative provision if the need arises. For those currently accessing the services of Reconnect, every effort has been made to ensure that there is no lack of provision of service for them.
The Eastern health and social services board and the four community trusts are working together to find a means of supporting Reconnect beyond 31 March 2004. What we would like to do then is collectively to review the longer-term funding of the organisation to establish how it can be supported. I am pretty confident that we will be able to achieve that. There will be further formal discussions with Reconnect in the very near future, but its longer-term future must be viewed in the context of other services being provided across Northern Ireland for people with brain injury. The commitment to building community services for people is also important.
I assure the hon. Lady that I take a personal interest in this matter and I have asked to be kept informed of what happens in future. I hope that I have dealt with the points that she raised and I thank her for the way in which she raised them today. I hope that we can find a way to continue these services, which are so important.
- Adjourned accordingly at nine minutes to Four o'clock.
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