Mr. Dodds: I am interested in the amount of money that the Under-Secretary is talking about saving and putting into front-line services. We are all in favour of that. When is that money likely to find its way to front-line services?
Mr. Woodward: As the hon. Gentleman knows, the proposals that my right hon. Friend the Secretary of State set out in the review of public administration could take three to four years to be implemented. Although the proposals that I announced this week are related to the RPA, they are not dependent on it. I intend to change the number of trusts from 19 to five plus one and to start work on it in January 2006, with a view to the five new trusts being up and running for April 2007. There will be redundancy costs and I anticipate that the substantial savings will probably not start for the best part of 18 to 24 months. However, I am ensuring that, for the long-term future of people in Northern Ireland, we make the decisions now and tackle the issues. That means that we can deal with the outrageous, intolerable and almost immoral waiting lists for the drugs that we are considering.
We will therefore be relentless in driving through the reforms to pay for the drugs. Again, I wish to add a cautionary note. Despite additional investment in the next two years, the changes that I am making in the efficiency structures of the health service of Northern Ireland, the Appleby report and the savings that will derive from the RPA, demand will continue to grow.
Matching resources to that demand will always involve making difficult choices and selecting priorities. The emergence of new specialist medicines has provided an opportunity to treat diseases that were considered untreatable until recently. Patients have the right to expect to be able to access those medicines when they need them.
The hon. Lady mentioned the National Institute for Health and Clinical Excellence. Its guidelines currently have no formal status in Northern Ireland. The Department is finalising links with NICE which will give its guidance formal status in Northern Ireland. I expect the new arrangements with NICE will be in place by spring 2006.
I would prefer to deal with the hon. Lady's specific points in writing. They are very specific and they should be given the proper consideration that they deserve. The current waiting lists for some specialist medicines are a serious priority for the health service in Northern Ireland. We will make improvements as quickly as we possibly can. The hon. Lady made her case strongly this afternoon and I shall do everything I can to improve access to the drugs that she mentioned and ensure that the new treatments and new drugs that people want in Northern Ireland are made available as quickly and as effectively andcriticallyas safely as possible.