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Budget uncertainty threatens health services with major cuts

Marie-Louise Connolly,Health correspondent, BBC News NIand
Niall Blaney,BBC News NI
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The Department of Health has said it's facing a fresh projected deficit of between of up to £1bn

The failure of the Stormont Executive to deliver a three-year budget could cause significant cuts to health services, according to the Department of Health (DoH).

Permanent Secretary Mike Farrar said that having another one-year budget would make it "almost impossible" to deliver necessary savings as well as jeopardising the vision to transform Northern Ireland's health care system.

Despite a £600m deficit expected to have been cleared, the DoH has said it's facing a fresh projected deficit of between £800m-£1bn for the new financial year.

The department came in for significant criticism after it announced it would not be extending the Real Living Wage (RLW) to social care workers.

Farrar had previously told BBC News NI that he and Health Minister Mike Nesbitt had committed to extending the RLW as soon as possible and that it was "morally" right to do so.

He said it would have been "wonderful to have had more certainty on our budget position as it helps us plan and it would allow us to understand how quickly we can improve services".

"We have had to make some assumptions that a budget would be agreed, and as the accounting officer, in the event that it isn't agreed, it is my responsibility, so it's been quite difficult to do that," he said.

"The department has been working on the basis of assumptions, so hopefully the executive will agree the budget and that will cover the next three years."

The permanent secretary said those assumptions included making further efficiencies but also making improvements to the healthcare system to ensure better outcomes for patients.

This included a greater emphasis on getting people to stay out of hospitals and be treated and cared for closer to home.

Farrar said things could not continue to stay the same and the department would have to begin its reset programme regardless of the budget.

Department of Health A man with grey hair in a grey suit. Under his jacket is a navy jumper over a pale blue shirt and tieDepartment of Health
A former senior leader in the NHS in England, Mr Farrar took up the role in April

When Farrar took up the post one year ago, he said he believed that Northern Ireland could be among the best in the world.

Farrar said that negotiating a new contract with General Practice has helped improve relations and he is confident GPs will be at the heart of a new community health care system.

"I said that I believe we could have one of the best health and social care systems in the world and I still believe that," he said.

"But I think to get there, we have to be prepared to take some tough decisions and to move our services closer to home, to look at efficiencies, to challenge our clinicians to be the best they can be, to reduce that variability of care that you often see in Northern Ireland.

"To balance our expenditure, we need to spend more money in community along with general practice balance, mental health and social care those are the areas we need to shift the balance of our expenditure towards."