‘Something has to give’ in NI health service, warns top civil servant

The Department of Health’s Permanent Secretary, Richard Pengelly, said health and social care services are moving into the most challenging ever period.

He was speaking at a Healthcare Financial Management Association event at the Dunadry Hotel.

“Yesterday, the organisation NHS Providers in England called for a full, frank and open conversation about the severe pressures facing the health service,” he said.

“It said patients and taxpayers deserve honesty, realism and transparency about the scale of the challenges.

“We are certainly in a defining period for health and social care in N Ireland. Budgets remain under intense pressure. At the same time, demand for care continues to grow.”

Mr Pengelly continued: “Something has to give in that situation. We can see it in our growing waiting lists and the impact these have on public confidence in the system. And it’s also very evident in the rising tide of frustration within our workforce.

“The Department meanwhile has to live within its budget. Despite our well documented financial challenges, we are getting demands on an almost daily basis for additional spending. We simply don’t have the money to do everything we are being asked to do.

“Our constant refrain is that we cannot spend money we don’t have. We need to go further than that, of course, and encourage debate on priorities and how best to use the limited resources we have.”

He said changes will be required.

“Central to this will be progressing the transformation agenda, as mapped out in the Delivering Together and Bengoa reports. The way we organise services is outdated and needs to change for the sake of patients and staff,” he said.

“Change is never easy in health but it is essential. I have no doubt there will be many difficult decisions ahead both on reforming services and on budgetary choices.”

The permanent secretary added: “We can’t duck those decisions. If we did, then we really will be heading over the cliff edge into a full-blown crisis.”