WHY I VOTED AGAINST THE BUDGET?
My fundamental objection to the Budget is the allocation for Health.
I welcome the additional funding but this will do little to redress the long-term structural underfunding of the service. As I pointed out previously, I have no political axe to grind with anyone on this issue. I speak as someone who has had a long interest in health economics since my appointment to the Eastern Health Board in 1981. My concerns about health spending are long-standing and began with the previous Budget, in which our Health Department received an increase of 2·6% in money terms, while the NHS inEnglandwas given a 4% increase in real terms. Our 2·6% increase did not meet inflation, was the lowest for many years and compared badly with the average of around 8% during the previous five years of direct rule.
Unlike in 2007, when I was one of the few MLAs to highlight underfunding in the Health Service, NHS funding has, unfortunately, become a major political debate. We need a rational, objective debate on the present state of the Health Service. However, it has now become just a political football.
The 2007 Programme for Government included new programmes to reduce the suicide rate, promote healthier ways of living, halt the rise in obesity and implement the long-delayed Bamford report. However, the Budget did not provide any additional resources to fund those programmes. The Appleby report compared the standard of care in Northern Ireland with that in England and identified a shortfall of £500 million over the CSR period. Therefore, not only do we have lower standards of care, but the gap between entitlements and expectations, compared with those inEngland, continues to widen.
Appleby concluded that, at funding levels then, access targets and waiting times would not match English levels in the foreseeable future. When I voted against that Budget, I warned that it would mean NHS cuts, job losses and longer waiting lists. Those have all come about and will be accelerated if we accept the current Budget. I accept the Minister’s assertion that health has received the biggest increase of any Department and that it consumes over 40% of the Budget. However, that does not address the funding of previous years. Funding should be based on need and not on what proportion of the Northern Ireland Budget it makes up. It has to meet increasing demand.
There have been demographic changes. Compared to the rest of theUnited Kingdom, we have more elderly people. We have more young people and more children. We have a much higher incidence of disease and much higher rates of cancer and heart disease. We have more smokers and more obesity. The differential in health expenditure betweenNorthern IrelandandEnglandhas reduced significantly in recent years. A recent study shows that, taking account of age profile and deprivation levels, the Health Service inNorthern Irelandrequires 10% more resources per head thanEngland, owing to the higher levels of need. In 2007, the differential was 4%. We now hear that the differential has actually swung the other way and that expenditure per head inEnglandis more than inNorthern Ireland.
On that basis, I certainly cannot accept the Budget. The Health Service should be taken off the political agenda. Let us try to sort the thing out. There is a definite need. Anyone who looks at it seriously will see that need is increasing because of demand. Demand, of course, is insatiable, but we have to provide more.