THE LOCAL healthcare system is facing its biggest challenges in its modern history, with wide reaching and severe cuts on the cards that could have consequences for years to come.
That was the message from the Western Trust at its June board meeting last week, where the £732 million shortfall in the North’s health budget – as a result of the Stormont impasse – and what it will mean for local services was outlined in stark terms, with tens of millions in savings required in the local service.
While the Trust is still awaiting confirmation on what its exact budget allocation will be for the coming year, already the situation is looking dire, with chief Executive Neil Guckian stating the year ahead will be “an extremely challenging financial environment.”
Mr Guckian added the cost reduction requirements are coming at a time when demand for services has never been higher.
“The health and social care system is facing some of its biggest challenges since the establishment of the NHS,” he said.
“Patients are living longer, often with more complex clinical needs.
“The system is finding it more difficult to attract and retain staff, GP practices are reporting severe pressures on their staff, and there are ongoing concerns for a number of practices that have highlighted sustainability difficulties.
“We’ve the highest waiting lists on these islands and we need to find a way reduce demand on our fragile services.”
In her address to the board, Trust director of finance, Eimear McCauley, outlined some of the key elements of the equality impact assessment recently published by the Department of Health, noting it had identified £260 million in “savings and efficiency opportunities which are potentially achievable without long term or irrecoverable damage to services.”
Ms McCauley said the Trust had developed a “low to medium risk savings plan” to make reductions of £12 million, towards its target savings of £25 million.
Some of the areas where reductions are being made across the North are in the slashing of the planned increase in nurse training places, while other savings are to be made regarding “other staffing related issues” such as reducing the use of agency staff, as well as a reduction in funding for waiting list initiatives.
Other potential cuts may be made to “community aids and adaptations” and to community care provision.
Mr Guckian said the local Trust had already been making savings by reducing its agency reliance, and by no longer needing to supply masks to those attending its hospitals. He noted the Trust may not be able to make other planned savings measures at such short notice, however.
“The lateness of the budget, and the time needed to safely implement decisions and actions, inevitably mean that the first quarter will see insufficient progress in our reductions,” he said.
“I want to reassure the Trust board the Trust has a plan in place, and we are working through the various actions.”
Trust chairman Dr Tom Fawley said more would be known when the Trust’s final budget allocation was confirmed, but warned, “We’re already in that difficult space, but it would be unrealistic of us not to realise this could get much more difficult before it’s concluded.
“It’s a very difficult time for us, and I don’t want in any way to underplay or under state that.”
Noting political representatives had “voices to make this improve or worsen”, he added, “If we can’t see improvements by the end of the summer I think we will have huge difficulties.”
Board member Ruth Laird warned the regional cuts could have consequences well into the future and were “short sighted” in a “political context.”
“I find it very difficult, as I know everybody does, to sit back and watch things like nursing places actually taking us backwards, and worse than that, will have a historic legacy which we will then be picking up in years to come,” she said.
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