Health trusts have unveiled £70m of cost-saving proposals that the public will have the opportunity to respond to in the coming weeks.
The public consultation of saving plans is an unprecedented move for trusts.
The five trusts have been asked to deliver the savings by the Department of Health.
The proposals were unveiled in five meetings across Northern Ireland at 12:00 BST on Thursday.
- Reaction to trusts’ cost-saving plans
- Key points of each trust’s saving proposals
Each trust can act independently and have published their own set of proposals.
Out of the almost £70m overall, the trusts have individually been asked to save:
- £26.3m – Belfast Health Trust
- £13m – Northern Health Trust
- £12.5m – Western Health Trust
- £10.85m – South Eastern Health Trust
- £6.4m Southern Health Trust
While each trust have made their plans independently, some common themes have emerged such as the cutting of agency or locum staff and a reduction of non-urgent elective surgery.
The Belfast Trust proposals could mean the closure of around 100 bed places while the Northern Trust has also suggested closing two wards in Whiteabbey Hospital.
The proposals could be reversed should the Stormont government return and a health minister be appointed.
The power-sharing institutions collapsed in January after a dispute between the DUP and Sinn Féin about a botched green energy scheme. Northern Ireland has been without a devolved government, or a health minister, since.
DUP MLA and former health minister Edwin Poots said some of the proposals were “alarming” while his party colleague, and North Belfast MP, Nigel Dodds said the suggestion to close two wards at Whiteabbey Hospital was “deeply troubling”.
Mr Dodds said the proposals were a direct result of the “intransigence of Sinn Féin and their refusal to restore the Northern Ireland Assembly”.
Sinn Féin MLA Carál Ní Chuilín said the “cynical and divisive” consultation was a “direct result of repeated cuts imposed by the Tory government, which have seen more than £1bn slashed from the north’s finances”.
“These cuts are not the result of the crisis at Stormont – they are the result of austerity policies conceived and implemented by a Tory cabinet in London,” she added.
Analysis: A dire catalogue of proposals
Asking the public to decide where the axe should fall in Health and Social care is as bizarre as it is cruel.
It is also unprecedented.
The local service has been struggling, but this latest measure is further indication of the somewhat precarious position that the system is currently in.
And the plans unveiled by the Belfast Health Trust represent a dire catalogue of proposals.
Read more: ‘Cruel’ public consultation on cuts
Public meetings took place at Knockbracken Healthcare Park in Belfast, Craigavon Hospital, Ulster Hospital, Antrim Area Hospital and Altnagelvin Hospital.
The public will now have the opportunity to comment on the draft savings during a six-week consultation.
The Department of Health said the “financial challenge remains significant due to inflation, an increasing and ageing population and the cost of new treatments and patient expectations”.
“The Health and Social Care service cannot spend money it does not have and savings must be applied to this year’s budget in order to achieve financial balance in 2017/2018,” said the department.
Temporary measures
“In this financial year, trusts are required to generate plans to deliver savings of £70m in order to address the funding gap.”
What remains unclear is what will happen in the eventuality of an executive not being in place by the end of the consultation period.
No executive means no health minister to make decisions, meaning power may lie with the permanent secretary of the Department of Health to implement temporary measures.
Of course, another scenario may include the role of a direct rule minister.
In 2014, the Department of Health attempted to make cuts but the targeting of local services resulted in public protests and the threat of judicial reviews.
Many of the proposals were reversed, with then DUP Health Minister Edwin Poots saying he could not implement the cuts as they threatened patient safety.
The £70m of cuts being sought this time may sound considerable but, as part of an annual budget of £5bn, the figure is conservative.
Nevertheless, health trust executives would prefer to be spending £70m, as opposed to cutting services.
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