Go raibh maith agat, a LeasCheann Comhairle. I welcome the opportunity to address the House initially as the Chair of the Committee for Health, Social Services and Public Safety, and I thank the Minister for providing the chance for the debate.
Looking at the 2016-17 budget compared with that for 2015-16, we see that the Executive have allocated the Department of Health an additional £128 million. That is, indeed, welcome news. However, even with that increase, the Department will face a difficult year ahead because of budgetary pressures. Officials came before the Committee last week to provide us with some further information on what the financial picture for 2016-17 is looking like. The cost pressures facing the Department continue to increase each year and are roughly running at between 5% and 6% each year. They are typically linked to pay and non-pay inflation; the costs of meeting the healthcare needs of an ageing population; and continued developments in healthcare technologies and treatments. That trend is expected to continue into 2016-17 and beyond.
Of key concern to the Committee is how the Department will allocate its budget for 2016-17 across a range of spending areas. When the officials were before us last week, we asked them directly for information on the Minister's priorities. That information is crucial because, logically, spending decisions should be informed by ministerial priorities. However, officials were only able to provide us with a very broad brush picture of the Minister's priorities. They told us that the Minister’s — I quote —
“overall aim and vision is to build a world-class health and social care service” and that he wants to:
"drive up the quality of health and social care for patients, clients and carers, to improve outcomes, to safeguard the vulnerable, and to ensure that patients, clients and carers have the best possible experience in every aspect of their treatment, care and support".
Nobody would disagree with those high-level objectives. However, they provide us with no detail as to how the £4·88 billion will be spent in 2016-17. The officials advised that further information on the Minister’s priorities would be set out in the commissioning plan direction for 2016-17. However, that document will not be with the Committee for comment until late January or early February, which is obviously too late for the purposes of the debate today.
Members were keen to hear how the Department would approach the significant waiting times for elective care appointments. Again, officials could not advise how much money was going to be allocated to that issue. They said it would depend on what savings could be found in other areas. In the Committee’s eyes, the rationale behind this approach is not clear. Surely, if something is a priority, money should be allocated to it.
Committee members were also concerned that in the areas where savings would be made there may be a tendency to look at quick savings, rather than take a longer-term approach. For example, the Committee was firmly of the view that we would not want to see trusts cutting back on domiciliary care packages as a quick fix to balance the budget for 2016-17. We were also concerned that the Health and Social Care Board and the PHA are charged with scrutinising the trusts’ savings plans, rather than the Department itself, given the recent proposal to dismantle the board.
That then brought us to the issue of how moneys for voluntary exit were being dealt with in 2016-17. The Minister has announced a major reform of health and social care. Obviously, that will have an impact in relation to voluntary redundancy packages for some staff. However, there is no allocation for voluntary exit in the 2016-17 budget; instead, it appears that the issue will be dealt with through June monitoring. This seems unusual, given the scale of the reform agenda proposed by the Department of Health.
Key questions remain unanswered about the spending plans for 2016-17, questions that are of vital interest to Members, healthcare professionals and, indeed, the wider community. They are questions such as these: when will a pay award be found for nurses in the 2016-17 budget and when will additional training places for GPs be found in the 2016-17 budget?
While the Committee welcomes the additional money for Health, we are disappointed at the level of detail available on how the Department’s budget will be spent.
I would now like to make a few comments as a Sinn Féin MLA. Workforce planning has been and continues to be a mess. Three-plus years into the Transforming Your Care process, the Minister still cannot tell us the size of the workforce that we require. Nursing is in crisis. There are 784 vacancies — 3·8% of the workforce population — in the nursing workforce. If that pay situation is not resolved, these people will simply vote with their feet and leave.