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Civil servant feels wrath of Gildernew over NHS budget

By Lisa Smyth

The top civil servant in the NHS has been hauled over the coals by the Stormont body set up to scrutinise the Department of Health.

Permanent secretary Andrew McCormick came under fire from Michelle Gildernew, chair of the health committee, as she demanded action to address the black hole in the NHS budget.

She said: “There is a real need to take the system and shake it, but it doesn’t seem to be happening. It’s frustrating. We are hearing people who have ideas and suggestions to save money and it isn’t happening. Why not?”

The civil servant, who earns more than £100,000 a year, said: “This needs done.”

Ms Gildernew then told him: “Then do it. You are permanent secretary. There are hundreds of good ideas every week and they are not being acted upon.” To which Mr McCormick admitted: “We need to be better at this.”

The exchange at Stormont yesterday came as waiting lists continue to soar and thousands of jobs across the health service remain under threat.

In particular, MLAs told Mr McCormick they wanted the DHSSPS to address the amount of money being spent on prescription drugs.

Deputy chair of the committee, Jim Wells, said millions of pounds could be saved quickly if doctors were made to prescribe generic drugs instead of branded drugs. However, family doctors have argued they are doing the best they can with the drugs available to the health service.

Mr McCormick was called in front of the health committee to talk about the current financial situation and also provide details about the department’s capital priorities.

He said there are five potential strategies which could be used to address the budget shortfall in the long-term:

  • Further efficiency savings — he said this is becoming increasingly difficult as many efficiency measures have already been put in place.
  • Service reconfiguration — in particular the way hospital and social services are delivered in line with recommendations from medical professionals. This could mean the closure of a number of acute hospitals.
  • Introducing charges — the Health Minister has hinted he may consider car park charges and charging patients for missing appointments, but Mr McCormick went further and said such an initiative could include “modest, reasonable charges for people who can afford to pay”.
  • Policy changes regarding parity of pay for health professionals in line with the rest of the UK — he said this must be considered carefully. “It is on the list and we will deal with that,” he added.
  • Additional cash from the Department of Finance — Mr McCormick said this would be difficult given the current financial climate.

He stressed that any changes to the way the health service is run must only be implemented if they improve patient outcome.

Earlier in the meeting, Mr McCormick was forced to apologise to the committee when Ms Gildernew said she was disappointed over a lack of detail in a report it received from the DHSSPS on the areas being discussed.

“It’s not really good enough,” she said.

Profile

Andrew McCormick has been permanent secretary at the Department of Health, Social Services and Public Safety (DHSSPS) since August 2005. He read geology at University College, Oxford, and has a doctorate in geochemistry from Queen’s University in Belfast. He joined the Northern Ireland Civil Service in 1980, and has worked in the departments of Finance & Personnel (DFP) and Education.





Our annual drug bill of £400m is money well spent

By Dr Tom Black

More than £400m is spent by the NHS in Northern Ireland each year on prescription drugs. This is money well spent as it controls serious conditions such as heart disease, asthma, diabetes and high blood pressure.

This stops patients becoming more seriously ill with complications and keeps them out of hospital. The average spend on drugs per head of population per year in Northern Ireland is £220, which is slightly higher than the other three home countries but much lower than other developed countries such as France, Germany and the USA, where between £300 and £600 per year is spent.

GPs in Northern Ireland have worked hard with their patients to cut spending on drugs by increasing the use of generic prescriptions and have achieved a rate of 62% out of a maximum possible of 64%. The reason that 64% is the maximum possible is because the other 36% are new drugs still on patent and have to be prescribed by their brand name.

Readers will appreciate that this means that GPs have achieved 97% of the target set for them for generic prescriptions.

Further progress would not only cost more money but would confuse the few elderly patients who have been left with a choice of their drug brand for safety reasons.

If our politicians want to reduce the drug bill further then we will have to reduce the number of prescriptions issued, or bring back a prescription charge. I'm not in favour of either choice and neither should they be.

Dr Tom Black is deputy chair of the British Medical Association’s Northern Ireland GP committee

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