Northern Ireland health service facing £600m budget shortfall
Northern Ireland's health service is expected to face a £600 million budget shortfall.
Stormont Health Minister Mike Nesbitt described financial plans being finalised which will be "unprecedented in their scale and ambition" and involve "extremely difficult and painful savings measures".
In a written statement to the Assembly, Mr Nesbitt said the projected £600 million is the "scale of the gap between existing funding and what's needed to maintain services".
He told MLAs he will play his part and "do everything I can to achieve a breakeven budget", but also urged the Executive and the Assembly to support him.
"My permanent secretary is finalising financial plans that will be unprecedented in their scale and ambition," he said.
"They will involve an extremely difficult and indeed painful series of savings measures for HSC trusts.
"I can assure the Assembly that I will drive forward savings to reduce the projected shortfall."
"To repeat, I will play my part and do everything I can to achieve a breakeven budget.
"But I will need Executive and Assembly support."
Mr Nesbitt also confirmed he is ordering the paying of £200 million recommended pay increases despite not having the budget to cover it.
It includes 3.6% for nurses and staff under Agenda for Change, 4% for doctors, and 4% plus £750 for resident doctors - formerly known as junior doctors.
That requires a ministerial directive to be made to the department's permanent secretary to proceed despite not having the necessary budget.
It will go to the Finance Minister, John O'Dowd, and potentially be passed to the Executive for approval.
Mr Nesbitt told MLAs the move involves the risk of an overspend for the department, but that not paying the pay increases also involves risks.
"There is an undeniable risk that the department could be on a path towards a potential overspend," he said.
"I have also concluded that there are also substantial risks in not proceeding with the pay increases - the biggest risk is failing to deliver on my promise to deliver 'better outcomes'.
"I do not want health service staff to be demoralised by inaction and another year of uncertainty on pay. They deserve better than that. This is about treating with respect the people who keep us healthy, fix us when we are broken and keep us alive when death becomes a potential outcome.
"Falling behind pay levels across the water will also exacerbate challenges with recruitment and retention of health service staff."
He added that pay parity with England for Agenda for Change staff is a "well-established and hard-fought principle" that he intends to maintain.
"Failure to do so would undoubtedly lead to industrial action with all the disruption to patient care that will involve," he said.
"Not to mention the negative impact on the focus to reduce waiting lists, or the overdue need to reform healthcare delivery.
"In short, the risk of a potential budget overspend must be balanced against the significant risk to service provision."
Potential for NI to have 'one fo the best health systems in the world'
The new leader of Northern Ireland's Department of Health says there is potential for the region to have one of the best health systems in the world.
Mike Farrar took up the position of permanent secretary in mid April, having previously held senior positions within the NHS in England.
Mr Farrar emphasised while there are several big immediate challenges in the health service, he is optimistic about the future for the health service.
He said around half of the £600m budget shortfall is in the health trusts where they have been running deficits, while £200m is to meet recommended pay increases for health workers and £66m for increased national insurance contributions.
"That's come about largely because the budget that was voted for health this year really didn't have an allowance at the scale of the pay awards we're facing, and we haven't in the past I think, really pushed as hard as we are now pushing to get real efficiency out of the system," he said.
"On my watch, we're going to take a stand and we're going to try to live within our means but that takes a while to do.
"In the short term I need some support."
He said they hope to reduce costs and improve services in some areas and said cuts which will impact services will be kept as a "last resort".
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