THE district’s most senior health chief has warned that additional money which is being made available for health and social care is not a cause for celebration.
Addressing an extraordinary meeting of the South Eastern Trust’s management board in Downpatrick last week to discuss implementing savings ordered by the Department of Health, chief executive Hugh McCaughey said there remains a need for a major discussion around how public services are funded.
Last August, the Province’s five health trusts were ordered to find savings totalling £70m, with the South Eastern Trust asked to make a saving of almost £11m. Plans were subsequently drawn up to meet this target, with the most controversial of these a £1m reduction on locum doctor spend across the organisation and a £1.05m reduction in agency staff.
The Department of Health last week confirmed that £40m was being made available to help all five trusts reduce the savings they had to make.
While the extra cash has allowed the South Eastern Trust to shelve its most controversial savings proposals, it still has to make savings of £8.75m, and the organisation says the underlying financial challenge it faces has not gone away.
These savings include slowing or deferring the use of money for service development or new initiatives, replacing agency and locum staff with in-house staff, savings in administrative and management areas, introduction of parking charges at the Ards Hospital site and the non-implementation of an uplift in community care contracts.
Mr McCaughey said while additional money has been made available which will ease pressure on staff moving into the winter and prevent any planned reduction in elective procedures, he does not view this as a cause for celebration. He said while controversial savings of £2m will now not need to be implemented, things “could have been much worse” had it not been for the extra cash made available by the Department of Health.
“The reason I believe there is no cause for celebration is I think the bigger challenge for us is looking at the bigger picture. We talked a lot at our public meetings [to discuss proposed savings] about the health system being driven harder and harder with funding which falls well short of what is needed.
“We know there are signs of strain on the system and on our staff; we are seeing lengthening waiting lists and other signs of that strain. While there is this temporary relief, we will start the new financial year with significant financial challenges and for me that is the bigger issue. The story is not about the extra £40m this year.”
Mr McCaughey said there needs to be a major discussion around how public services are funded, what is the correct level of funding and how services are delivered into the future. He said the case has been made for people to fight for the NHS, making it clear he is certainly up for that.
“I have spent 30 years working for the health and social care system and believe passionately in it and always will fight and stand up it. If, however, we want to succeed, if we want a model into the future based on the values and principles the vast majority of us hold passionately, then we need to accept there will be change and that we change the model of how we deliver.
“We need to accept transformation, accept we need to change, not just keep driving this system harder because that is only going to put more strain and eventually the system will break. For me, there is a challenge, its’ how we do that. If we are going to save the health and social care system then it’s about fighting for change and we accept that change needs to happen.”
Mr McCaughey said too often, people oppose change and refuse to have any change, suggesting that to do this “penalises” the health and care system, driving it harder until it breaks.
He continued: “It is absolutely essential that we move forward with the transformation of our health and social care system as outlined by Professor Bengoa. We must use the months ahead to discuss publicly how we better use the significant levels of funding already available and develop a model of healthcare which is sustainable and affordable.”