Headlines belie true state of health

By Dot Kirby
BBC NI health correspondent

Cash handouts for health will make a difference but by how much?

"Health is a big winner in budget" and "additional money for health will save lives," screamed the headlines last week.

The justification? Health was doubling the amount of money it had to spend on new services to £300m over the next three years.

In other words, millions of pounds more would be available to spend on heart procedures and cancer screening, as well as extra funds for mental health, learning disability and so on.

Health officials produced a long list of just how the extra money would be spent.

In all but two years since 1992, health got an uplift of more than 6%

It sounded good, but stop a moment and unpick the figures.

What was the promised uplift for health under the draft budget? 3.8% on average over three years.

And what is it now? 3.9%.

Now go back to 1992 and look at all the rises health has had since then - in all but two years, health got an uplift of more than 6%.

So 3.9% is a long way short of that.

Two questions arise: would health have been better off if devolution had never happened? And is it as simple as that?

The answer to both questions is no.

Certainly it is true that health can do more now than it could with the draft budget, but that's not saying much

Firstly, public spending at a national level is being squeezed.

"What is happening is that Northern Ireland as a whole is only getting a 1% uplift in real terms - or 3.7 % if you include inflation, " said a senior source in the Department of Health.

"Health is finishing up with a rise of 3.9% - so in other words it is getting a slightly bigger slice of the Northern Ireland cake than other departments," said the source.

Secondly, the health budget is never simple - and this year is no different.

Health is getting an extra £50m a year than that which was promised under the draft budget.

Ten million pounds a year is hard cash. This is what has raised the increase for health from 3.8% to 3.9%.

But there's another £40m a year which isn't counted in that percentage. Half of that is in-year slippage money from all departments.

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Unspent money goes back into a central pot. Health has been guaranteed to get the first £20m of that.

In addition, health has been told that any money it can save - or any of its money that it doesn't spend - it can keep and plough back into services.

Officials in the Department of Health are confident this will realise at least another £20m a year.

Consequently, the department trumpeted last week's budget settlement as a success.

Certainly it is true that health can do more now than it could with the draft budget, but that's not saying much.

In truth, the next three years will be a significant and sustained period of financial constraint.