Northern Ireland faces pressure from rising demand

In speeches in October – to the HFMA Northern Ireland Branch and at a CIPFA event – Department of Health permanent secretary Richard Pengelly (pictured) warned that services had to be transformed and that rising demand was making it difficult for local health and personal social services to remain within budget.

The forecast £20m deficit in the current financial year was ‘only a small part of the escalating pressures and demands’ local services will face, Mr Pengelly told a CIPFA conference.

Intensive work to balance trusts’ books would continue, but the service could not afford to do all the things it currently offers, never mind reduce waiting lists, increase pay and recruit more staff. ‘In the next year alone, the competing demands and pressures could between them add hundreds of millions to an already very stretched health budget.’

Mr Pengelly told the HFMA Northern Ireland Branch: ‘Despite our financial challenges, we are getting demands on an almost daily basis for additional spending. Our constant refrain is we cannot spend money we don’t have. We need to go further than that, and encourage debate on priorities and how best to use the limited resources we have.’

Transformation was key, he said. ‘We can’t duck those decisions. If we do, we will be heading over the cliff edge into a full-blown crisis.’