An Cathaoirleach: I thank members for their attendance. Thanks also to the Leas-Chathaoirleach for taking the private session earlier.

On behalf of the committee, I warmly welcome the Minister of Health for Northern Ireland, Mike Nesbitt MLA. He is accompanied by Jim Wilkinson, deputy secretary for health care policy, and Jane Hamill, private secretary. They are all very welcome. Of course, the Minister is no stranger to these Houses, having been here before with this committee and to other events in the Houses of the Oireachtas. He is very welcome. I thank him for taking time out of his busy schedule to be here this morning.

The theme on health on the island of Ireland has been a primary focus for our committee since its formation in May. We welcome the Minister's engagement with our committee this morning. I look forward to strengthening co-operation with his administration. It is safe to say that we have the shared ambition of improving health outcomes for everyone on this island. Members look forward to engaging with the Minister and his officials in achieving that aim.

The format of the meeting is that I will invite the Minister, Mr. Mike Nesbitt, to make his opening remarks. This will be followed by questions from members of the committee. Each member will have between five and seven minutes to ask questions and hear the responses...

...Mr. Mike Nesbitt: I will take the second question first. I have not given consideration to the all-island approach to the Adult Protection Bill.

In terms of its status, it is on its way. I would be very surprised if it does not pass before the end of the mandate in May 2027. The difficulty is the implementation because we do not have the budget to go straight to full implementation of that Bill. We have made clear, frustratingly, that it will be implemented in stages as the funding becomes available. I had the first-day brief and because health is so broad it seemed to last about six weeks. The one that really jolted me and stuck with me was health inequalities. Two babies born today, particularly two females, in one of the maternity units in Belfast could grow up in the city perhaps a mile or less apart, one in the area of the greatest deprivation and one in the least, for example, the Malone Road and Sandy Row, which are less than a mile apart. Their healthy life expectancy currently varies by over 14 years - in a First World country a quarter of the way into the 21st century. I do not even understand how we tolerate that. I have made it an ambition. We picked two areas of deprivation, one in Derry and one in Belfast, which we call demonstration areas because I wanted to demonstrate that we could get results. I will ask Mr. Wilkinson to go through the three lessons we picked out of that.

I want to go back to Executive colleagues because health inequalities are not just about health. In fact, our research suggests it is only 20% health interventions. It is 40% socioeconomic, 10% environment and the remaining 30% is behaviours such as substance use, smoking and vaping. The tobacco and vapes Bill coming through Westminster will be very helpful on that 30%. I would love to see minimum unit pricing on alcohol but I do not have full Executive support and I need it. I am beginning to think I will not get that this mandate. If we can take a lump out of that 14-year difference, what a difference we are going to make to the lives of those people living in areas of deprivation. To Executive colleagues, when I say it is their responsibility - the Ministers of education, housing and environment - I am not saying I want to use their budgets as well as me taking over 50% of the Executive budget. I am also saying that when it comes to educational underachievement, I know healthier children do better at school so it is my problem. It is not just the Minister of Education's problem. As for our rate of economic inactivity, 27% of people of working age are neither in work nor seeking work. The biggest single reason is ill health, mental and physical. It is not just the economy Minister's problem; it is my problem. These are three of the big sticky issues that have been around since before the 1998 agreement. What a difference it would make if, as an Executive, we collectively decided we would target those three issues and make lives better.
An Cathaoirleach
 
I call Mr. Hughes. He has five minutes.

Mr. Dáire Hughes: I genuinely thank the Minister for engaging today and echo the sentiments of my colleagues on this committee in hoping that it can become a regular feature of this committee on health and other forums of North-South collaboration we move forward to explore. The experience of my constituents in Newry and Armagh shows the need for enhanced cross-Border collaboration on health. Our local hospital at Daisy Hill already offers renal and emergency services to citizens in the South but this can be built upon with enhanced capacity.

I have two questions for the Minister. The first is about access to cross-Border cancer services, specifically CAR-T cell therapy. He has heard the example of Catherine Sherry, who passed away in London earlier this year separated from her family after being forced to travel to Britain for that treatment which is available on this island. I know there is an intention to increase CAR-T cell therapy capacity in this State. Will the Minister confirm his support for citizens across the island having access to that treatment? Is he engaging with his opposite number here to prepare for that?

Second, to elaborate on the point of shared data, the Institute of Public Health - the Minister referenced public health challenges with tobacco, vapes and alcohol - and the All-Island Cancer Research Institute, in front of this committee, have bemoaned the lack of all-Ireland data sets being accessible and transferable across the Border. We can all agree that is essential for policy development, strategic planning and workforce planning. I am sure this would be of great benefit to the Minister in his department. I welcome the sentiments in his opening statement about developing that. Will he elaborate on action taken to enable this? In light of his stated intention to introduce legislation on the secondary use of data - that may be the single-clause legislation he referenced earlier - will he provide clarification as to whether this will simplify the existing processes for sharing data on an North-South basis?

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