Senior Economist: 'Patients will die if we don't manage budgets correctly'
Warning health resources must be 'sustainable' as crisis rumbles on
Last updated 20th Dec 2019
A leading Northern Ireland economist has warned 'premature mortality rates will go up' if the Department of Health's budget is not managed more effectively.
Dr Esmond Birnie was speaking to Downtown Cool FM as part of our focus on health special.
Earlier this year, the then Secretary of State Karen Bradley announced a Stormont budget of £11.2 billion for 2019/2020.
Dr Birnie told us over one and a half billion of that goes towards the Department of Health.
"The level of public spending on healthcare in Northern Ireland is enormous.
"It's about five and a half thousand million pounds, £1.6 billion.
"It's got a dominant share of the total of public spending within Northern Ireland and indeed over time, the share of health within all the public spending in Northern Ireland-spending on schools, on roads, on railways and industrial development, health share has been growing steadily as part of the total."
But Dr Birnie told us that is not reflected in outcomes for patients:
"There is evidence that even though the amount of healthcare spending in Northern Ireland per head of the population per person, is about the same or even slightly higher than in England, we have far higher waiting lists."
And he warned the long-term impact of that could be fatal:
"To put it in very euphemistic terms its premature mortality but in practical terms it means that people's conditions worsen more than they should do.
"In the worst cases it means people will die prematurely.
"There's a sad inevitably about that."
Despite healthcare services getting a 3.8% increase in its budget for 2019/20, many commentators have expressed concerns that will not be enough.
Dr Birnie said we need almost 2% more than that to maintain current services but to improve, me must manage budgets more effectively:
"A figure of up to 6% has been quoted which is an incredibly high growth rate of spending and I think that illustrates the level of challenge.
"Fundamentally what we need to do over the long-term isn't just to allocate more money but to look at how healthcare operates in Northern Ireland."
A large body of work has been done in a bid to reform health and social care, most recently the Bengoa report which set out a ten year transformation plan.
This is being gradually rolled out across Northern Ireland.
Some of the recommendations in the 2026 Delivering Together review have been met with public outcry.
Protests took place earlier this year when plans to consolidate and centralise breast assessment and stroke services in order to provide more specialist care were put out for consultation.
Dr Birnie explained the financial reasons behind the decisions that may not be popular with the public:
"For historical reasons, we've spent too much on bricks and mortar, we've a lot of hospital buildings the whole estate of the health system is immensely expensive.
"When people hear the phrase 'we are going to centralise,' people say 'oh dear this is terrible.'
"Northern Ireland is a small place so we cannot afford to have physical outlets for healthcare in every County Town."
And he urged patients to take into account the bigger picture:
"We won't have general hospitals on everybody's doorstep.
"That is simply not financially viable and it's diverting cash which should be better spent."