Health service faces £300m gap in ‘best case’ budget scenario, MLAs told

Stormont’s under-pressure health service is facing a minimum £300 million black hole in the coming year, MLAs have been warned.

The £300 million shortfall is dependent on the Department of Health receiving the most generous budget settlement of those currently being proposed for the coming financial year, the main Stormont parties were told.

Health officials considering how to bridge the funding gap have outlined a range of short-term potential actions, including halting initiatives to tackle spiralling waiting lists; reducing nursing and residential care placements; reducing use of services provided by the community and voluntary sector; restricting domiciliary care packages; and closing some community facilities.

Medium-term options outlined to generate income include the introduction of prescription charges and charging for domiciliary care.

The department is actually facing a £550 million funding gap under the best-case scenario for 2023/24, but health officials have identified £250 million worth of internal efficiencies and savings for the coming year.

Efficiencies proposed include scaling back waiting list reduction initiatives for certain specialisms; restricting capacity on some demand-led services; and cutting back use of agency and locum staff.

The stark budgetary picture facing the local health service was outlined to representatives of the main Stormont parties at a briefing organised by Department of Health permanent secretary Peter May on Wednesday.

A presentation shown to MLAs stated: “In the absence of significant additional funding the HSC will be required to make high impact cuts that will be counter strategic to long term service sustainability”.

Responsibility for setting the 2023/34 Stormont budget rests with Northern Ireland Secretary of State Chris Heaton-Harris in the ongoing absence of a devolved executive.

The Northern Ireland Office has been working with Department of Finance officials on how Stormont’s block grant from the Treasury could potentially be allocated among the departments.

MLAs were told that the best-case scenario proposed for the Department of Health was an allocation on par with the £7.31 billion it received in the current financial year.

The department has estimated that it will require £7.86 billion to deliver services in the coming year, when inflation around pay and operating costs are factored in along with continued increasing demand for treatment.

The parties were told that even with the best-case scenario allocation health spending in Northern Ireland would still fall further behind the level in England.

The flat cash scenario could only be delivered if other Stormont departments absorb “significant” cuts to their allocations, the parties were told at the briefing in Belfast.

“As health currently takes c50% of the funding it is hard to provide protection without significant impacts on other departments,” the presentation stated.