Health leaders in NI say draft budget is unworkable and call for creative political action to secure three-year financial plan

The Northern Ireland Confederation for Health and Social Care (NICON) has today warned that the proposed funding for Health and Social Care (HSC) in NI could result in service cuts equivalent to the loss of 10,000 staff (1). 

NICON is the only membership body for the whole of the HSC system in NI, representing the leadership of HSC organisations.

In a submission to the draft Budget 2025/26 Consultation, NICON highlights how the proposed health budget is unworkable, counter strategic, and undermines the value of additional funding. Yet with imagination and collective working, a strategic approach could still be possible. 

Neil Guckian, speaking on behalf of NICON, explained: “Our consultation response details how the HSC will need to find £400m savings in 2025/26. Coupled with the increase in demand for health and social care services, this is an untenable ask. Achieving this level of savings in-year will require high-impact cuts on a scale not previously seen, with catastrophic impacts for frontline services. 

“Even if the Minister were to agree to implement such measures, a one-year budget means our senior teams will likely spend 6 months in statutory consultation, leaving little to no time to plausibly deliver this level of savings by the end of the financial year.”

Neil Guckian added: “Additionally, although the Executive’s plan for waiting list investment is very welcome, this funding must not be secured by simply ‘raiding’ the existing budget for the day-to-day running of health and social care. This would be entirely counterproductive, as any investment in waiting lists would be undermined by the curtailment of services and cuts elsewhere, such as domiciliary care packages, leading to further backlogs in care.

“We call on political leaders to urgently agree a more rational, innovative approach to HSC funding that will allow us time to implement the strategic approach that we as leaders are confident we can deliver.”

NICON’s concerns reflect the fact that the proposed funding for Health and Social Care is at a ten-year low relative to NHS England, despite independent experts (2) having identified NI’s additional needs factor as 8-10% above England to deliver the same outcomes. If funded at the level of need, this would not only bridge the shortfall, but help address waiting lists and create capacity in social care to improve flow. 

Concluding his remarks, Neil Guckian said: “While an innovative financial arrangement and Financial Recovery Plan will help us through the next 3 years, we must have a wider societal conversation about how health and care will have to adapt to meet future population needs sustainably. This will require bolder decision-making around additional revenue raising; moving care closer to communities; and prevention, including a rethink on how we support the public to take a more active role in their own health.” 

(1) According to Trust calculations.

(2) See John Appleby, Rapid review of Northern Ireland Health and Social Care funding needs and the productivity challenge (2011).