Debate contribution: Budget 2024-25

Debate contribution by Mr Robin Swann on 28 May 2024.

MLA: Mr Robin Swann
Party at the time: Ulster Unionist Party
Date: 28 May 2024
Type: Debate contribution
Business: Executive Committee Business
Heading: Budget 2024-25
Assembly identifier: Official Report component 4492578

Text

I speak as a Back-Bench MLA. I begin with a quote from another Member:
"I am not going to impose cuts which will have such a negative consequence that it will damage the health of the Northern Ireland population ... I will make cuts, but there are certain services that I will not make cuts on, and the consequence of that is, we will break the budget by tens of millions of pounds unless more money is allocated to health".
Those were not my words, Mr Speaker, but yours, when you were Health Minister in 2014. I applaud you for the stand that you took then. You, of course, were correct, but it is worth noting that you were removed as Health Minister a month later. Sadly, funding for health and other public services has continued to be squeezed since then. The repeated stop-start nature of this place, combined with the failure to agree a multi-year Budget for almost a decade, has starved our health and social care system of the certainty and stable leadership that it so badly needs. We all agree, across the Chamber, that Northern Ireland is underfunded. At the same time, there is an onus on us to make the very best use of the resources that we have and to protect the most vulnerable. That is why I and so many patients and health service workers took reassurance from the public statements before and after the restoration of the Executive that the health of our people would be prioritised. Yet, this Budget does not achieve that. Several other Departments, such as Education, Agriculture, Environment and Rural Affairs, Justice and Infrastructure, are all receiving proportionally greater increases to their general allocations than the Department of Health. To those who claim that this is about party politics or elections, I say this: do not judge me by your standards, because this is too important for games. People can debate figures all day long, but the fact is that the Department of Health's budget has been cut by over 2% compared with where it stood a little over a month ago. That fact was recognised in the report published by the Fiscal Council only a number of weeks ago. That is the exact opposite of prioritising healthcare. Let me give an illustration: I received an in-year allocation in the last financial year to pay for the uplift in pay: is anyone seriously suggesting that that uplift is taken off our workers this year? Of course it will not be and cannot be, but that is the implication when people talk in such basic terms. I said at the beginning that I could spend a further £135 million on critical activity to tackle hips, knees, cataracts and many other procedures. If funded, I had also planned to reinstate a reimbursement scheme, following the success of the previous cross-border scheme. It feels as though almost every MLA has either mentioned it or asked me about that over the last number of months. Overall, almost 70,000 people would have benefited. The full details were shared with the Committee a number of weeks ago and were included in the Department of Health's elective care framework document that was published at the end of last week. However, once again, when push came to shove, the only targeted funding for the waiting lists that the Department of Health received was the £34 million that, we already knew, we were getting from the UK Government: not a penny more and not even half of what, I said, I needed to keep up with red-flag and time-critical demand. That is the reality of the Budget. There is little point in demanding maximum action to tackle waiting times and, at the same time, tying the Department of Health's hands behind its back. Likewise, I am sure that some of the very people telling me and the Department to suck it up and accept the Budget will soon be urging the Department of Health to increase spending on a plethora of health issues. In the budget assessment that the Department of Health commissioned following the initial Executive agreement to the Budget last month, it is clear that the remaining £189 million deficit will be resolved only through high and catastrophic impacts to essential services. Again, those are not my words or descriptions but, rather, how our health trusts have described the consequences. I fully accept that every pound given to the Department of Health is a pound less for somewhere else, but, frankly, not all need or level of risk is equal. That reflects the wider concerns with the budgetary process that I have sought to highlight in my discussions with Executive colleagues. The process is fundamentally flawed.
I want to make way. It is based on individual Departments identifying inescapable pressures; yet, Departments use different assessments of what constitutes a pressure. I fully believe that an assessment based on the principle of reducing harm would have led to a different Budget outcome. It is my assessment, as Minister of Health, that the Budget, as presently set, will result in serious and potentially irreparable damage to health and care services. Mr Speaker, I do not say that lightly, nor did you in 2014. In voting against the Budget today, I am conscious that I am not complying with the ministerial code. I do not do that easily, but I have a greater responsibility to defend and protect vital services, to stand up for patients and staff and to oppose cuts that will cause real harm.
I am trying to make progress. As the chair of the BMA GPs committee said only this morning:
"No Health Minister could support this Budget in good conscience".
I agree with that, and that is why I will not do so. The ministerial code requires Ministers to:
"support, and to act in accordance with, all decisions of the Executive Committee and Assembly."
I have to say that I did not always see evidence of that during the pandemic. Collective Executive decisions were publicly undermined within hours, and, of course, Executive COVID restrictions and guidelines were blatantly breached —
— by other Ministers. Mr Speaker, on my final day of office, can I just say that it has been an honour of my political life to twice serve as Minister of Health? I am absolutely certain that Mike Nesbitt will serve with similar commitment and pride.

1,072 words. Text as published by the Northern Ireland Assembly.

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