Draft Budget: Health leaders warn of cuts worth 10,000 staff

Northern Ireland’s draft budget could result in health service cuts equivalent to the loss of 10,000 staff, according to health leaders.

The figure has been calculated by the six health and social care trusts, who say they measure cuts in terms of potential job losses – ranging from nurses to domiciliary care providers.

The draft budget has been described as “unworkable” by the Northern Ireland Confederation for Health and Social Care (NICON), which represents leaders of HSC organisations.

A spokesperson for the Department of Health said the minister has made his very serious concerns known about the draft budget and its potential implications for health and social care services.

NICON have called for “creative political action” to secure a three year financial plan.

It said the proposed budget is “unworkable, counter strategic and undermines the value of additional funding”.

NICON spokesperson Neil Guckian said the HSCNI will need to find £400m in savings in 2025-26.

“Coupled with the increase in demand for health and social care services, this is an untenable task,” Mr Guckian said.

“Achieving this level of savings in-year will require high-impact cuts on a scale not previously seen, with catastrophic impacts for frontline services.”

According to NICON, even if the health minister were to agree to implement such measures, “a one-year budget means our senior teams will likely spend six months in statutory consultation, leaving little to no time to plausibly deliver this level of savings by the end of the financial year”.

Health received £8.4 billion in the 2025-26 budget settlement, which was described by the Department of Health as an increase of only 2.6% – the finance minister, however, described it as an 8.7% increase by comparing the allocation to the opening budget for this financial year and excluding funds that had already been set aside for specific projects.

According to Northern Ireland’s budget watchdog, the difference between the two figures is largely because health has been allocated an additional £471.9 million this year since the 2024-25 budget.

Additional costs facing the Department of Health include £65 million to meet the National Living Wage increase, £36 million to cover employer NICs increases, and £150 million to cover the 2.8% pay rise that the UK Government has recommended to the pay review body.

According to NICON, to keep within budget, health and social care would remain still with little or no change in direction or funding allocation – if anything allocation could worsen.

The impact might include multi-million-pound budget cuts; little improvement on hospital waiting lists; and the health minister not being able to move as he describes “shift left”, which means prioritising resources into social care and general practice.

At the start of March, there had been concerns the Programme for Government (PfG) did not confirm the required £215m to tackle hospital waiting lists would be made available to the Department of Health or if it would be recurrent for five years.

Nesbitt acknowledged the PfG said funding “up to that amount” would be available and on that basis would move forward with trusts on a plan to address waiting lists.

The minister said there will be a “cocktail of delivery” to begin tackling the lists, including using the independent sector.

The NICON statement said it welcomes that investment but stresses the funding mustn’t be secured by “raiding” the existing budget for the day-to-day running of HSC.

Neil Guckian added that would be “entirely counterintuitive as any investment in waiting lists would be undermined by the curtailment of services and cuts elsewhere, such as domiciliary care packages”.

A fiscal assessment of the budget also pointed out that there wasn’t clarity around this amount, including where the funding will come from.