NHS needs more cash but current public spend should first be justified

This is vast amount of money, that Mr Swann acknowledges will not be easily found.

We all want limitless money for public services in Northern Ireland, for building roads or rail or school facilities or for increasing employee salaries and so on. But not only is that unrealistic outside of the richest parts of the world’s wealthiest nations, it is all the more unrealistic now, given that the Conservative government is in power until late 2024, and sees the Stormont dispute as resolved and has other priorities.

Instead, local politicians will have to focus on managing existing budgets, and hoping for extra scraps from London.

There are multiple ways in which the wisdom of expenditure in Northern Ireland is open to question. Stormont has a ridiculous number of press officers, for example, and will have eight Spads in the executive office. While that is a small cost in absolute terms, it is symbolically decadent and entirely unacceptable given other demands on the public purse. There is also a debate to be had over whether it is appropriate to continue to offer free prescriptions in all circumstances.

Parties around the executive table, including Mr Swann’s, should outline their view on welfare reform, now that Stormont’s rejection of the spare room subsidy (or ‘bedroom tax’) is going to cost £100 million over four years. Do the parties believe that welfare reform can never happen in NI? If so, why?

Also, given that pay parity for nurses, backed by all parties, is going to cost £170 million it would be helpful to know if they believe there must always be full pay parity in all public sector jobs at all times, and if so the financial cost of that.

Furthermore, it would be helpful to have a forensic financial estimate of the efficiencies and savings that could be achieved by implementing the health and social care reform advocated by Bengoa and multiple preceding expert reports, that the parties have resisted, causing a big financial burden.