Stormont budget could inflict ‘irreparable’ damage on health service, Swann says

Stormont’s budget will inflict potentially “irreparable” damage on Northern Ireland’s health service if changes are not made, Robin Swann has warned.

The Health Minister said “drastic” cuts would be required if his department does not receive additional money for this financial year.

Mr Swann appeared before his Assembly scrutiny committee on Thursday one week on from voting against a budget that was approved by all the other ministers in the powersharing administration.

The minister has claimed the additional £515 million he was allocated in the budget agreed by the Executive last Thursday falls well short of what is required to maintain health service provision at current levels.

He voted against the spending plan and has refused to rule out resigning if the budget is approved by the Assembly in its current form.

The minister told members why he voted against the budget.

“If I had voted yes, I would not be able to look patients or health workers in the eye,” he said.

“And I would not be able to look myself in the mirror.”

Mr Swann acknowledged all departments needed more money but he suggested the implications of underfunding the health service carried a greater risk to the public.

“I fully believe an assessment based on the principle of reducing harm would have led to a better budget outcome for health,” he added.

“It is my assessment as Minister for Health that this budget, as presently set, will result in serious and potentially irreparable damage to health and care services. And I don’t say that lightly.”

The health service has been allocated more than half of the Executive’s £14.5 billion resource budget.

The budget process effectively focused on £1 billion of uncommitted funding within that £14.5 billion envelope.

The minister ideally wanted all of that extra £1 billion to be given to his department.

Of that £1 billion, around £300 million would have been spent to maintain a pay award made to health staff at the end of the last financial year as part of the Government’s financial package to restore powersharing.

It also included £150 million to make a further 3% pay award to staff in this financial year. The remaining £550 million requested was described as for inescapable pressures.

Those pressures included £200 million to cover projected overspends by the five main health trusts (the trusts overspent by £150 million last year); £80 million to reduce red flag cancer waiting lists; £70 million to account for inflation; £70 million to cover the costs of new drugs expected to become available in 2024/25; and £80 million to pay for the impact of the UK Government rise in the national minimum wage.

Mr Swann had told Executive colleagues he was prepared to accept an additional £800 million in the budget and would look to make up the £200 million shortfall on the £1 billion with in-year reallocations from central funds and potential cost-saving steps such as limiting the 2024/25 pay award to 2%.

He said the £515 million he has been allocated by the Executive is unsustainable and will have serious consequences for health service delivery in Northern Ireland.

Mr Swann has also been allocated £34 million as part of the UK Government’s restoration financial deal for specific initiatives to tackle the region’s spiralling waiting lists.

However, he said he requires £135 million to address the waiting lists challenge this year.

Officials in Mr Swann’s department are now examining how the almost £300 million hole in their spending estimates can be plugged. As part of that process the five main health trusts have been asked to present cost-saving plans to the minister by the end of May.

During Thursday’s committee hearing, Sinn Fein chairwoman Liz Kimmins insisted Mr Swann should be directing his frustration at his budget allocation at the Treasury, not fellow Stormont ministers.

“The fight isn’t with the Executive, the fight needs to be going to the British Treasury,” she said.

“Because no matter what way, we can go round and round in circles here of where money should go, but every single department (faces pressure) – do we take money out of education? Do we take money out of infrastructure? All very important departments that impact on people’s lives.”

Mr Swann said he would do his “damnedest” to secure more funds for health but said it was outside his remit in the Executive to make direct approaches to the Treasury.

Ms Kimmins also expressed disappointment that a letter Mr Swann sent to the committee outlining his concerns following the budget vote last week was leaked to the media before members had even read it.

She also questioned the appropriateness of Mr Swann holding a party political press conference in the company of his UUP leader Doug Beattie after last week’s Executive.

“I think it would have been more appropriate to see you as Health Minister,” she said.

“So I think going forward, it would be better if we all kind of rise above party politics and work within that trajectory because politics shouldn’t come into health at the end of the day, and we should all be working together to get the best for everyone that we serve.”

DUP committee member Diane Dodds said the manner of the debate on the health budget had been “distasteful” over the last week.

She challenged Mr Swann on whether he would resign if he did vote against the budget when it comes before the Assembly.

“If the budget remains unchanged, will you vote against the budget knowing that that’s in contravention of the ministerial code and potentially a resigning matter?” she asked.

Mr Swann declined to be drawn on whether a no vote would mean he would have to quit but he was clear he would be voting against the spending plan if it was not changed.

“In regard to this budget, if it currently stands coming to the Assembly in this format, I’ve made it very clear, I will vote against it,” he said.