Stormont Health Minister Robin Swann has warned that he is “looking down the barrel of an inadequate budget” while also facing growing need.
He warned that the “risks of service breakdown are real and growing in a range of areas”, and said his department needs an addition billion pounds for 2024/25 based on what it received last year.
Mr Swann described an “insidious position” of just two weeks before the end of the financial year “with a budget process that hasn’t started” following the resurrection of devolved government at the end of January.
He said the reality is that the year ahead “will largely be about damage limitation”.
The minister was speaking during his first appearance before the Assembly’s health scrutiny committee since resuming the role in January.
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He paid tribute to health service workers “doing amazing work every day”.
But he said the system is in “deep trouble”, saying he is “not going to sugarcoat that”, adding: “I owe it to patients and staff to be honest and frank”.
Mr Swann said healthcare systems in other jurisdictions are under pressure, with the “double whammy of budgetary constraints on the one hand and growing demand for care from an ageing population on the other”.
However, he said the health service in Northern Ireland has its own “specific and deep-seated problems as well”, with political instability, a lack of multi-year budgets and growing waiting lists.
“In common with other Executive Ministers, I am looking down the barrel of an inadequate budget for 2024/25 – while also facing growing need and demand,” he told MLAs.
“The risks of service breakdown are real and growing in a range of areas.
“By that, I don’t mean we will wake up one morning and the health service will have simply toppled over.
“It will be more gradual, more insidious than yet – a slow motion slide that in reality has already been at play.”
The minister said productivity and efficiency savings alone will not be enough to bridge the funding gap, and said there will be “unavoidable real-life consequences for patients, staff and services if health is left with an entirely inadequate budget”.
He said turning the ship around is “doable”, with the “right combination of ambition, funding and joined-up political leadership”.
Turning to his approach he said prioritising primary care and social care is needed, route maps including cancer, mental health, and urgent and emergency care strategies and reform.
He stressed they are already starting to see an impact with some waiting list reductions and increasing staff numbers.
Mr Swann also said that making sure that Northern Ireland is covered by the terms of the UK Government’s Tobacco and Vapes Bill is an early priority for him.
The proposed legislation will make it illegal to sell tobacco products to anyone born on or after January 1, 2009 and will also provide powers to allow for further regulatory measures to address youth vaping.
“I believe it offers a significant opportunity to tackle a public health scourge in our society and I do not want Northern Ireland to be left behind,” he added.
