A temporary halt on offering fertility treatment to couples in Northern Ireland is among a raft of cost-cutting proposals aimed at delivering a £70 million saving by March.
Access to the Regional Fertility Centre for an estimated 320 new patients would be deferred until next April under the plan detailed by the Belfast Health Trust.
They would then join a waiting list that is already up to nine months long for certain treatments.
Belfast is one of five trusts in the region.
They have been instructed by Stormont’s Department of Health to collectively save £70 million to ensure the books balance at the end of the financial year.
The trusts are set to reduce reliance on agency staff and locum doctors, while the number of hospital beds available are also due to be cut in some trust areas.
The level of domiciliary care provided, such as home visits, will also be reduced under the plans, with limits also put on new residential care places.
The five sets of proposals were unveiled at a series of public meetings on Thursday afternoon.
A public consultation exercise will now run for the next six weeks.
Many of the proposals focus on measures that will not impact front line services, such as administrative efficiencies.
But all five trusts also put forward a number of proposals that will impact patients.
While Stormont ministers did divert extra funding to the region’s health service on a number of occasions prior to the collapse of the devolved government earlier this year, that investment has not kept pace with inflationary pressures.
A major reform agenda to deliver better value for money service provision is also stuck in the starting blocks due to the Stormont impasse.
If powersharing was restored in the near future, elected ministers could intervene and pour more cash into the struggling system to avert the £70 million savings.
But, as it stands, civil servants at the Department of Health have to work within the budget available.
The region’s health service has an annual budget of more than £5 billion, however the sector remains under enormous strain.
The Belfast Trust’s plan aims to contribute £23.6 million of the required £70 million savings.
As well as the limit on NHS funded fertility treatments, waiting lists for elective care could rise by another six months under the trust’s proposals.
It also aims to reduce the number patients offered residential home placements.
This will delay hospital discharge of many older patients - a move which, in turn, will extend waiting times in accident and emergency for those needing a ward bed.
The trust is also planning to defer a number of high cost drug treatments.
The Northern Trust, which is searching for £13 million in savings, is planning to reduce the number of acute hospital beds by 16 to 20 and the number of rehabilitation beds by 44.
It will also reduce some day surgery procedures, rise prices at hospital car parks and end meals on wheels deliveries.
The Western Trust’s share of the £70 million is £12.5 million.
It is seeking to reduce routine elective activity by 50% for day cases.
A remodelling of how neo-natal care is provided across the trust area has also been proposed.
The South Eastern Trust is aiming to save £10.85 million.
Its proposals consist of a £1 million reduction in locum doctor spend and a similar saving by cutting agency staff.
The Southern Trust, which has to save almost £7 million, has also proposed cut backs on agency and locum workers.
Public sector union Nipsa branded the consultation exercise a “sham”.
The Department of Health has warned the impact of some of the trust’s proposals if implemented “is likely to have a considerable adverse effect on the delivery of services.”
It said there are “significant challenges” to the health service due to inflation, an increasing and ageing population and the cost of new treatments.
A spokeswoman said the health and social care sector “cannot spend money it does not have”.
“Savings must be applied to this year’s budget in order to achieve financial balance in 2017/18,” she said.
“In this financial year, trusts are required to generate plans to deliver savings of £70 million in order to address the funding gap.”