Short-term health approaches could cause lasting damage to services, body warns

Short-term approaches to dealing with budget pressures in the health system in Northern Ireland could result in “significant and lasting damage to services”, a national body of NHS finance professionals has warned.

In its submission to the public consultation on the 2025/26 draft budget for the region, the Healthcare Financial Management Association (HFMA) encouraged the powersharing Executive “to ensure there is a thorough understanding of the consequences” of the allocation for health.

The Executive agreed a draft budget for 2025-26 in December.

Health Minister Mike Nesbitt has already warned it could leave him facing a £400 million funding shortfall.

This week, the Northern Ireland Confederation for Health and Social Care warned in its budget submission that the allocation could result in service cuts equivalent to the loss of 10,000 health staff.

In its response, the HFMA “expresses concern that the real resource growth rate provided by the draft budget falls significantly short of inflation with no real-terms growth”.

It added: “While the response recognises the challenging economic position and the prioritisation of infrastructure investment to support growth, the Northern Ireland health system operates below the expenditure per head of population level of England when adjusted for need.”

The HFMA pointed out a blueprint for transforming health services in Northern Ireland was delivered in 2016.

It said: “The proposed budget settlement will be very much counter to these transformation objectives.

“We would encourage the Executive to ensure there is a thorough understanding of the consequences to health and social care in Northern Ireland under this draft budget settlement for 2025/26.

“This short-term approach to addressing the deficit could result in significant and lasting damage to services which will be difficult to recover from and negatively impact on the lives of those living in Northern Ireland.”

The body said there are “significant variations” between different regions in the UK on charging for services such as dental, prescriptions, domiciliary and care home service costs.

The submission added: “Although charges would undoubtedly prove unpopular, in the absence of a budgetary settlement that addresses the health needs of the population, the HFMA considers that there may be some merit in establishing a process to introduce charging to create greater alignment and equity between the nations except where (as in Scotland) that is not specifically funded by the use of devolved tax raising powers.

“Any arrangement should be means tested to ensure that cost does not become a barrier to accessing services.

“However, it again seems unlikely that such a process could be completed to a timescale that could meaningfully contribute to addressing the significant financial gap that the proposed budget settlement for health and social care will create.”