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Reforms needed to ease financial pressure on health trusts, says committee

Published 20/01/2016

The five regional health and social care trusts account for the bulk of expenditure within the health and social care sector
The five regional health and social care trusts account for the bulk of expenditure within the health and social care sector

Radical reforms are required to ease the financial pressures facing Northern Ireland's health trusts, a Stormont scrutiny committee has warned.

Although just one trust failed to break even last year, this masks an underlying funding gap estimated to be about £131 million, according to findings from the Assembly's public accounts committee (PAC).

The PAC chairman, Sinn Fein MLA Michaela Boyle, said: "The committee believes strongly that it is crucial for the health service to redesign the way it provides services.

"If this does not take place, the trusts will find it difficult to provide the health and social care services needed, within their budgets."

The five regional health and social care trusts account for the bulk of expenditure within the health and social care sector - £4 billion during 2014-15.

In a new report, MLAs have highlighted a lack of strategic planning and expenditure on locum doctors as major causes of concern.

They have called for a more flexible system, similar to the Scottish model, with the introduction of a three-year budget to avoid annual constraints and the reliance on in-year monitoring round bailouts.

Urgent action is also needed to deal with the shortage of consultants, particularly in the Western Trust area which has experienced difficulties in recruiting and retaining permanent staff, the report said.

Recommendations include allowing trusts to award incentives to attract doctors to some geographical areas or specialities; the possibility of recruitment on a Northern Ireland regional basis; or to insist that, for a limited period after qualification, consultants would be expected to fill a vacancy where their specialism met the need.

"Putting the HSC trusts on a sustainable footing is a major challenge unless there is a significant change in funding or transformation of services," said Ms Boyle.

Concerns were also raised about spiralling waiting times, with no hospital able to ensure that 95% of patients began their first treatment of cancer within the 62-day standard.

There has also been a drop in the number of urgent breast cancer referrals being seen within the recommended 14 days.

Ms Boyle said: "It is hard to see how the Department for Health, Social Services and Public Safety can sustain the current service model as efficiency savings start to dry up.

"Transforming Your Care has been heralded as the great transformational saviour for health and social care, but the pace of change has been at best mediocre.

"Without serious review and change, the committee believes that the trusts are likely to struggle to maintain their performance. We believe these issues must be dealt with urgently."

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