THE Health Minister Mike Nesbitt has said waiting lists will not improve in the next year as his department faces a “deeply concerning” £400m funding shortfall.
In a written statement to the Assembly, he said the health and social care system would be expected to deliver £200m of savings for the second year running.
The department of health will get £8.4 billion this financial year, more than half the Executive budget, but Mr Nesbitt said it’s not enough
An Equality Impact Assessment from his department on the Executive’s draft budget for 2025/26 said it would amount to a 2.6% spending increase, when in-year allocations were included.
Mr Nesbitt said this was not enough to counter factors like growing demand, increased pay, inflation, increased National Insurance contributions for GPs, pharmacists and social care providers.
Even if £200m of savings were achieved, he said “significant in-year monitoring round allocations were needed to achieve a breakeven position” and that it would bring “considerable risk” for services, including already stretched waiting lists.
Despite waiting lists being identified as a priority in the Executive’s Programme for Government, Mr Nesbitt said this was now the second year in a row where no additional money was provided to address them.
“It will not be possible to reduce our lengthy waiting lists within the funding currently available,” he said
Stating that the predicted health spend would amount toa 10-year low compared to England, he said the actual increased spend would amount to 1.5% which was “significantly out of sync” with growing demands on services.
The Health Minister has thanked Emergency Department staff across Northern Ireland as they continue to deal with winter pressures on services.
— Department of Health (@healthdpt) January 10, 2025
Minister Nesbitt visited six EDs in the past few weeks to hear directly from staff and patients.
➡️More info: https://t.co/J8eklCeubY pic.twitter.com/um57VJs4hX
He quoted a 2022 NI Fiscal Council report, which suggested 4-7% more health spending may be required compared to England.
An earlier Appleby report put the combined figure needed for health and social care at an extra 9%.
“To be clear, that means we cannot match the standard of service delivered in England unless the Department of Health receives up to £109 for every £100 provided in England,” Mr Nesbitt said.
Referencing his three-year plan, he said breaking the current pattern of struggling services required “substantial” investment in primary care, social care and public health to ensure more people were treated close to their home rather than in hospitals.
He said the proposed budget would instead “leave us again fighting to identify sufficient savings to meet the pay expectations of our workforce and protect the services that we currently have.”
Mr Nesbitt quoted a UK Government report from last year, stating that successive governments had promised to shift care away from hospitals into the community – but between 2006-22, spend on hospitals actually increased from 47 to 58%.
He also criticised Assembly Members repeating “vague mantras about transformation” while also opposing any planned changes to hospital services.
“Unfortunately, the draft budget threatens to consign our health service to ‘more of the same,’ he said.
This included maintaining the current “inadequate levels of provision,” firefighting service pressures and surviving from “last-minute in-year allocations.”
Praising health trusts for the cost-saving efforts, he said the limit had been reached in what could be achieved by efficiency and productivity.
Acknowledging budget pressures on other departments, he said the Executive and Assembly now faced a moral choice.
“If you are told that the budget is entirely inadequate to meet the needs of the HSC service, and yet vote for it, despite the warning, and then complain about the consequences of your decision, are you comfortable taking that position? When I say comfortable, I do not mean politically; I mean morally.”
