Health funding shortfall leaves department ‘unable to resolve pay dispute’

Stormont’s Department of Health is facing a funding shortfall of £470 million that will leave it unable it resolve the current pay dispute with healthcare workers.

A briefing given to political parties by the department said a budget set by Northern Ireland Secretary Chris Heaton-Harris will need it to make cuts that will be “very damaging for service delivery with long-term impacts”.

The parties were told no decisions have been made on savings options yet.

In the absence of a devolved executive, Mr Heaton-Harris last week set a budget for Northern Ireland. The Department of Health received £7.3 billion for 2023/24, a similar funding level to the previous year.

The department briefing document said: “Even with a sustained productivity and efficiency drive the 23/24 budget will be around £470m short of estimated funding requirements.

“Most significant of the pressures faced is the estimated pay inflation pressure at c£375m which includes the cost of implementing the English pay offer in full for Agenda for Change Staff.”

The document said trusts and Health and Social Care (HSC) organisations have already been instructed to implement low and medium impact savings.

It continued: “A funding gap of this size will require the implementation of high impact savings with adverse consequences for an already highly pressurised health and care system.

“This would be very damaging for service delivery with long-term impacts.

“The 2023/24 budget will exacerbate the gap between capacity and health care need in Northern Ireland, meaning reduced service levels and more patients waiting excessive periods for care.”

The document said actions already taken were possible under the Northern Ireland Executive Formation Act 2022 but further steps will need to be “assessed against the current legal framework”.

It added: “Under the budget settlement, it will not be possible to resolve the current pay dispute.”

Health unions in Northern Ireland have taken industrial action, including strike action, in recent months.

On Tuesday, after health unions backed the deal, it was announced that more than one million NHS staff in England will get a 5% pay rise.

The department briefing document set out a number of options to bridge the funding shortfall in Northern Ireland.

These include reductions in payments for support services provided by the community and voluntary sector as well as reductions in education and training places.

Options also include reducing initiatives to cut waiting lists, a reduction in nursing and residential care placements and domiciliary care packages

The document said: “As a system we are actively considering whether there are alternative measures that could mitigate the above.”

It continued: “In this context, 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 to fully bridge this gap.”