Trust close to break even despite continuing locum and vulnerable children pressures

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The Western Trust is close to breaking-even in 2017/18 despite starting the year with a projected deficit of £59m and continuing to grapple with a chronic over reliance on locum doctors and rising numbers of vulnerable children.

Lesley Mitchell, Director of Finance at the Western Trust told the health authority’s January board meeting that the dramatic reduction was realised partly through its own internal savings programme.

However, she said there was now a recognition by both Richard Pengelly, the Permanent Secretary at the Department of Health (DoH), and Valerie Watts, the Chief Executive of the Health and Social Care Board (HSCB) of the unique pressures in the west.

Back in November when DoH received £40m from the Department of Finance to reduce a £70m savings target across all health authorities, the Western Trust was allowed to write £22.1m off its deficit due to a structural dependence on expensive locums and rising numbers of ‘looked after children’.

Mrs. Mitchell said this has allowed the Trust to report a projected year-end deficit of just £2.2m. She has written to DoH asking it to recognise this £2.2m as an ‘authorised deficit’ and was hopeful this would be approved.

Major contributory factors to the exceptional financial pressures facing the Trust are the large number of ‘looked after children’ and the relatively remote health authority’s dependency on locums.

For example, the projected cost of locums is £16.4m this year, which is only marginally down on the £17m bill incurred in 2016/17.

Mrs. Mitchell said the central health authorities in Belfast recognised these ‘exceptional pressures’ and that’s why they allocated £22.1m to the Trust in November.

Dr. George McIlroy, Non-Executive Director, said that while the locum bill had not reduced dramatically the fact that the Trust has stopped what had been incremental year-on-year increases was ‘a major achievement’.