Health Minister warns there is no end in sight to the significant financial pressures on the NHS

Savings within the health service in Northern Ireland mean it is currently operating at the limit of what can be achieved without causing “catastrophic harm”, a budget assessment has said.

Health Minister Mike Nesbitt has further warned that next year’s budget will be “severely challenging” for public services in the region.

The budget assessment produced by his department said that the health service “will not have all the resources to do everything we want to do, or indeed everything that needs to be done”.

Since taking up the health portfolio in May, Mr Nesbitt has consistently warned about acute financial pressures facing health.

Last week he refused to support an Executive funding reallocation exercise, insisting the £350 million given to his department was not enough to cover recommended pay rises for healthcare staff.

Despite receiving 57% of around £700 million shared among departments in the monitoring round, the minister insisted he is still £100 million short of the money he needs to make pay awards of at least 5.5% to all health staff.

Finance Minister Caoimhe Archibald has warned that, despite the funding boost from the Chancellor’s budget, the devolved administration is still overcommitted by around £180 million across all departments this year.

She has made clear that ministers need to find more savings and balance the books.

Mr Nesbitt delivered a written ministerial statement and an updated budget assessment to the Assembly on Thursday.

He said that financial pressures on health services “remain significant”.

Mr Nesbitt added: “As the Assembly will be aware, my department is still short of being able to make full 2024/25 pay settlements in line with those in England and Wales.

“I am continuing to actively seek a viable solution and I have emphasised that a concerted Executive-wide approach is needed to resolve all NI public sector pay issues for 2024/25.

“A joined up Executive approach to public finances will clearly be essential next year too, given the indications that the 2025/26 budget position will also be severely challenging.”

The budget assessment said the health and social care system “has undertaken an intensive programme to identify savings in operational budgets”.

It continued: “We have also received important Executive monitoring round allocations that have reduced but not eliminated our unmet pressures.

“Living within our budget without making reductions that would have catastrophic consequences has proved highly challenging.

“The department accepts the exceptional scale of the savings it has sought and recognises that the HSC (health and social care) system is now at the limit of what can be achieved this year without causing catastrophic harm.”

Turning to next year, the document stated: “It is expected that the budget position for 2025/26 will also be highly challenging for health and all other parts of the NI public sector.

“We will not have all the resources to do everything we want to do, or indeed everything that needs to be done.

“The minister and department will continue to make the case for further investment, while also maintaining a focus on productivity and efficiency gains.”

The budget assessment sets out measures taken by all of the health and social care trusts across Northern Ireland to make savings.

Medics and other health workers in Northern Ireland are demanding parity with colleagues elsewhere in the UK.

There are two health sector pay bodies.

The NHS Pay Review Body, which makes recommendations on the pay of staff on the Agenda for Change terms and conditions in England, Wales and Northern Ireland, has recommended a 5.5% increase for 2024/25.

The review body for pay for doctors and dentists in England, Scotland, Wales and Northern Ireland has recommended a 6% increase.

It is understood the minister has proposed to make the pay award in two stages, with the first award backdated to August, rather than April.

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