Free prescriptions in Northern Ireland could be scrapped to help health bosses cover the cost of life-saving cancer drugs, the Health Minister has said.

Edwin Poots — who has revealed his department is facing an £80m budget black hole this year — said he may also cut the drugs currently available on prescription to ease the suffering of people with cancer, Cystic Fibrosis, arthritis, Crohn’s disease and colitis.

In a frank interview with the Belfast Telegraph, the minister outlined his vision for the future of the health service and said he is considering a range of controversial proposals to help save money and improve patient care.

Free prescriptions were introduced by the previous Health Minister last April but Mr Poots said the system has been “abused”.

He said: “I want to look at the types of drugs on prescription, painkillers can be bought for a few pence and we are paying pharmacists to dispense those on prescription. It does not stack up.

“I have a challenge in terms of drugs in that we are currently short of funding to buy NICE approved drugs, such as anti TNF drugs that are good at treating people with arthritis.”

The health service budget is high on the agenda and Mr Poots said he is working hard to find efficiencies but warned thousands of jobs could be axed as he struggles to balance the books.

He said: “We have about a £177m shortfall this year and we have identified about £100m of savings that will probably not be overly painful to bear and we are working on the other £80m.

“In terms of job losses, we will have less jobs in the the department and that will probably run into thousands but we will not be having thousands of compulsory redundancies.”

Mr Poots stressed laying off frontline staff, such as doctors, nurses and physiotherapists, would be a last resort but would not rule out the possibility of breaking away from UK-wide pay deals as a way to save money.

During his five weeks as Health Minister, Mr Poots has not shied away from controversy and in his interview with the Belfast Telegraph, he reiterated the possibility that the number of acute hospitals here could be cut.

Asked whether he understood the concerns of the public over such proposals, he said: “If I have a major stroke I would much prefer to get to the hospital that can identify whether I am suitable for thrombolisis and actually have that thrombolisis treatment and walk out of that hospital, which may be 40 miles from my home, the following week as oppose to being wheeled out of the local hospital in a wheelchair three months later.

“We cannot have that facility in every hospital, there are not enough consultants to be able to do that, so we are going to have specialist services across a range of hospitals and they can deliver much better outcomes.”

Mr Poots said he would consider the introduction of an air ambulance scheme but said it would have to be run by charitable donations.

He revealed he has axed a review of acute services which was to be carried out by the former chief executive of the Belfast Trust, William McKee, and has replaced it with a review headed up by the chief executive of the Health & Social Care Board, John Compton.

He said he also wants to look at fining the 50,000 people who do not turn up for hospital appointments each year.

“This happens when you don’t turn up at the dentists so for example if someone doesn’t turn up for an appointment we institute a fine and they will not get their next appointment until they pay that,” said Mr Poots

He ruled out charging for GP appointments as he believes this would stop people from going to their family doctor and result in conditions going undiagnosed and ultimately costing the health service more money.