New health survey applauds Trust's fiscal management

The report focused on the results of the 2008/09 financial audits of Health and Social Care bodies across Northern Ireland and highlighted number of successes and challenges.

The audit report found that all trusts experienced a significant increase in expenditure on health care provided by the private sector largely as a result of the drive to meet waiting list access targets whilst at the same time responding to increasing demand for services.

Equally, the costs of utilities (gas, oil, electricity) also rose to a peak during the early part of the 2008/9.

A considerable decline in income from interest on bank deposits was also experienced in 2008-09 as new arrangements, to ensure the more timely draw down of cash, were introduced by the Department of Health in compliance with Department of Finance and Personnel (DfP) treasury management requirements.

The report also notes the impact of the Review of Public Administration (RPA) and how trusts have been set a target of achieving 38m in reduced costs across their entire operations as a result of reorganisation by 2010/11.

Against an interim target in 2008-9 of 38m in efficiency savings, trusts achieved 19m. The interim cumulative target for 2009-10 is 37m, that is, trusts will need to achieve a further 18m.

Overall, the HSC sector plans to deliver efficiency savings of 53m as a result of RPA by 2010-11. The savings to be delivered by the trusts are: Belfast 13.4m, South Eastern 6.4m, Western 5.7m and Northern 7.2m.

Mr Donnelly concluded that there had been a “step change” improvement in the health sector over the past five years but that evidence of the contribution of the RPA to progress is limited.

He concluded: “It is becoming apparent that, in the context of delivering health and social care, the sector's performance has undergone a step change improvement in recent years.

“On measures such as waiting times, prevention of and mortality from heart disease and cancer, the HSC sector is delivering a markedly better service than five years ago.

“With the implementation of revised structures under the RPA, new pay regimes for health and social care professionals and staff and a considerable capital investment in the health estate, the building blocks for making and sustaining further progress are being established.”

Mr Donnelly did point to a number of challenges faced by the trusts including swine flu and the need to hold back money to offset outstanding deficits.

“The financial stability of trusts is coming under increased pressure and this has the potential to affect the HSC sector's performance on some key targets.

“In addition, the required HSC response to swine 'flu and the need to hold back funding to offset outstanding deficits may also adversely impact upon progress to date and the ongoing achievement of its objectives.

“For example, a range of service developments have been necessarily delayed in the short term (including bowel cancer screening and some services for people with long-term health conditions such as stroke and heart disease).

“The Minister has also highlighted that further progress in reducing waiting times in Accident and Emergency and incidences of health care related infections is necessary.

The challenge of embedding good governance - in all aspects if the HSC sector's work - remains ever present,” he continued.

He also pointed out that realising the benefits of major change programmes of recent years is an important challenge for the health and social care sector.

“Progress has been achieve, undoubtedly, but direct evidence of the contribution made to this by, for example RPA and the Agenda for Change (AfC), is limited,” he said.