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Tighter watch to be kept on health service spending as budget unveiled

By Rebecca Black

The head of the Civil Service is to be tasked with scrutinising how the mushrooming health budget is being spent.

The Department of Health receives over twice as much money as any other Stormont department - and yet is still having to make cuts to stay afloat.

In the draft budget agreed last Thursday and set to be unveiled today, Finance Minister Simon Hamilton is expected to order an oversight mechanism to monitor how Health Minister Jim Wells spends his budget.

An independent longer term strategic review is also set to be ordered.

Last month the Belfast Telegraph revealed that our health system was top-heavy with administrative staff.

Northern Ireland has 42% more non-clinical staff - including senior managers and administrators - than England, proportionate to our population.

At the same time we have fewer clinical staff, such as doctors, nurses and midwives, per capita than Scotland and Wales.

An extra £75 is spent on health per person here compared to England.

The health service has also been hit with several crises at emergency departments across Northern Ireland, as hospitals struggle to cope with demand.

The Department of Health is one of only two departments, along with the Department of Enterprise, Trade and Investment, to receive an increase in today's budget - the toughest since devolution in 1998. It is set to receive an additional £200m, bringing its total allocation to £4,693.1m.

The next biggest allocation to a Stormont department is less than half of this -Education (£1,849.3m).

In the third draft of the budget - seen by the Belfast Telegraph - Mr Hamilton specifies that this additional £200m must go to "direct health services".

But he states in return the department "must demonstrate it is taking the necessary actions to ensure efficient service delivery and the address any residual pressures in order to remain within its budgetary control totals".

"The Executive will establish an oversight mechanism to monitor health spending. The oversight would involve immediate scrutiny of the current pressures and priorities to ensure that the additional funding goes to front line services. The Executive should ask the head of the Civil Service to bring forward urgent proposals for this scrutiny mechanism with an independent element; and "an independent, longer term strategic review of the health service and its current direction and priorities."

Mr Hamilton will present the budget to the Assembly today.

More detailed plans on how these savings will be made are due to be presented in two weeks.

It will go out to public consultation with revised proposals planned to be presented to the Executive by January.

Meanwhile, Mr Hamilton told the BBC yesterday that he was hopeful the Executive can find a solution to the political deadlock over welfare reform.

The issue is set to be discussed at inter-party talks which are currently ongoing.

All the parties are yet to meet around the table in a plenary session yet.

Last week they met newly appointed US envoy Gary Hart.

"We have set aside £70m for a package of measures which will ameliorate the worst effects of welfare reform in Northern Ireland," Mr Hamilton told Inside Politics.

"We think that is the best option for moving forward, so that we can continue to have welfare payments here in Northern Ireland, but we don't have in the negative way that it's been impacting on people in Great Britain.

"We're very keen to work on it in the talks process, and we think that there is a solution that can be found."

Speaking for Sinn Fein, Upper Bann MLA John O'Dowd said the current Welfare Reform Bill was "totally unacceptable" to his party.

"A new Bill, brought to the floor of the Assembly, is open to amendments, it is open to persuasion," he said.

"There is a role here also to play for civic society - the trade unions, the business sector and all - in relation to how we format our own welfare system.

"So, if a Bill comes on the floor of the Assembly, we will play our part in reshaping that Bill."

Story so far

Finance Minister Simon Hamilton will today unveil the toughest budget since devolution. All departments - with the exception of Health and Enterprise, Trade and Investment - are facing cuts. The Department of the Environment has been hit hardest. The Executive agreed the draft budget last Thursday, but the SDLP voted against it while Alliance and the UUP abstained.

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