Drastic spending cuts in the healthcare service would still leave a £189 million budget deficit, Robin Swann has warned.
The Health Minister has told Executive ministers and members of the health committee that “deep dive” cuts to health spending would not avoid a multimillion-pound overspend in the department.
Mr Swann sent the letter and cost-saving analysis by the health trusts in Northern Ireland, seen by the PA news agency, on the eve of a key Assembly debate on the budget.
The budget has already been approved by the wider Executive and is expected to be approved by the Assembly.
The health service has been allocated more than half of the Executive’s £14.5 billion resource budget.
Mr Swann had bid for an additional £1 billion for health – an amount that represented the entirety of the uncommitted funding available for distribution among all Stormont departments.
Instead, an additional £500 million was allocated by the Stormont Executive in late April.
Health trusts in Northern Ireland had been asked to work up cost-saving plans as part of efforts to bridge the gap, but Mr Swann has said these spending projections had confirmed “my worst fears about the consequences of the budget”.
He warned that no Ulster Unionist Party health minister would approve cost-saving measures “with such catastrophic impacts”.
UUP deputy leader Robbie Butler has said the party would not quit the Executive, but Mr Swann’s warning on Monday raises the possibility of the health minister overspending his budget in the current financial year.
Former UUP leader Mike Nesbitt will likely be left to grapple with these issues as Mr Swann is stepping down imminently to contest a Westminster seat in South Antrim.
Mr Swann wrote to his fellow Executive ministers: “The assessment details that even after extensive deep dive savings measures, a remaining deficit of £189m is anticipated.
“That estimated deficit is in addition to the fact that no funding is provided in the Executive’s budget for staff pay increases, meaning further industrial action is all but inevitable in the year ahead.”
The analysis by trusts said possible “contingency” savings measures included recruitment freezes for “non-frontline” staff and further reductions in agency and locum costs, but the analysis states that such savings “will be challenging in a single year and may not be achievable in their entirety”.
“This leaves a remaining and significant deficit of £189m (assuming no pay increase in 2024/25),” it said, but warned that this level of savings “cannot be achieved without high/catastrophic impact measures”.
It said that all trusts had expressed “grave concerns” about the impact on health and social care services at both local and regional level if such savings measures were to be requested.
Some of the “projected” requirements include a reduction of around 400 acute hospital beds across Northern Ireland, a reduction of around 1,200 staff; an estimated reduction of 1,100,000 hours of homecare/domiciliary care type support over a year; and an estimated reduction of around 500 care home beds.
It said that a more detailed assessment will be needed on contingency plans and ministerial approval would be needed for high/catastrophic impact measures.
Mr Swann called the analysis both “hugely concerning” and “fair and balanced”.
“It is the most alarming advice I have received in my time as Minister, outside of the Covid-19 pandemic.”
Urging his Stormont colleagues to reconsider the vote on the budget, Mr Swann added: “Both before and after the latest restoration of the local institutions, promises were made and commitments were given that the health of our people would be prioritised. This budget does not do that.
“Even without implementing the most damaging cost saving measures, this budget will make the challenges in our health worse instead of better.”
