Northern Ireland

Stormont must ‘accept the consequences’ of underfunding health, official warns

Brigitte Worth, the Department of Health’s director of finance, addressed budget pressures on Thursday

Finance officials addressing Thursday's meeting of the Stormont health committee.
Finance officials addressing Thursday's meeting of the Stormont health committee.

STORMONT will need to “accept the consequences” of failing to fund healthcare in full, a senior official has said.

Brigitte Worth, the Department of Health’s director of finance, made the comments during Thursday’s meeting of the health committee.

It follows warnings from the Health Minister Mike Nesbitt that the Stormont draft budget would amount to a £400m shortfall, despite his department receiving half of the Northern Ireland budget at £8.4bn.

Ms Worth explained the department had been facing a £100m shortfall before the October monitoring round, compared to what was needed to match health worker pay rises in England.

Brigitte Worth, centre, addressing the Health Committee.
Brigitte Worth, centre, addressing the Health Committee.


She added that gap had now been narrowed to £35m through measures like “some additional risk” around end of year underspending.

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She said it was “unlikely” that the upcoming January monitoring would close the £35m gap in full, but said an extra £10m of funding would allow for 11 months of backpay for HSC workers in their March pay packets.

For the 2025/26 budget, she said the draft budget had essentially provided an extra £200m compared to 2024/25.

“You can see from the list of pressures…that £200m only goes so far in covering those inescapable pressures we need to continue to run the health service in its current form.”

She said this included £65m to pay the national living wage, £36m to ensure GPs and other healthcare providers could pay increased National Insurance and £150m for a 2.8% pay rise as recommended by the UK government.

“I’m at £250m already before we even touch on price inflation and the need to address growth and demand for our services,” she said.

She added that the capacity to deliver more savings was reduced, with an unprecedented £200m of savings already secured in 2024/25 across health and social care.

“The reality is that this budget doesn’t provide us with the investment that would be needed to make the kind of difference to our services that we’d all like to see”.

She said the extra funding compared to England was at a 10-year-low at 1.5% - significantly below the 4-7% recommended by the fiscal council to meet additional need.

“We need to be realistic about what can be delivered within the envelope we’ve been given.

“I do accept of course that other departments are struggling to accept the allocations they’ve been given.

“But if we accept that more funding for health can’t be prioritised over the allocations given to other departments, we also have to accept the consequences that has for the delivery of our health and social care services.”