Edwin Poots paper outlines potential cuts to health service
Health Minister Edwin Poots has outlined how the health service will be impacted by potential cuts in a paper seen by the BBC.
The paper shows that cuts could restrain pay for health sector staff, lower the number of agency staff and reduce spending on home care packages.
The cuts could also affect the Transforming Your Care programme of health service reforms.
Mr Poots has said his department faces a £140m shortfall.
In a letter to the chair of the health committee, the minister said the paper highlighted to the executive the significant detrimental impacts of the cuts to the health service.
He added that he wants the public to be fully informed of the seriousness of the position.
In the letter, he said: "Many of the implications are controversial given their magnitude and cross-cutting nature, some of which would represent a reversal of previous executive strategies."
The paper indicates a range of measures that the Department of Health may implement in response to budget restraints from Stormont.
It lists possible savings of nearly £15m under pay restraint of staff, but warns of the potential for industrial action by health care unions.
It also indicates that spending on locum doctors could fall by 50% for six months, saving a possible £9m but requiring changes to rotas across hospitals to ensure enough doctors are on-call.
The Transforming Your Care programme, described as the future road map for health and social care in Northern Ireland, would also lose £9m.
In the paper, the minister notes that the pace of implementing Transforming Your Care would be adversely impacted.
As an example, the paper indicates that only three out of the five health trusts will be able to take forward the appointment of specialist foster carers.
The document also says that standards and targets, such as waiting times, would not be met if the cuts are implemented.
It says that without further funding, the number of people waiting over 15 weeks for assessment will increase by 20,000 and the numbers waiting over 26 weeks for treatment in particular specialities will increase by approximately 7,000.
The paper also shows that millions would be taken away from care packages for the elderly and there would be less money for drug therapies for conditions such as cancer, arthritis and multiple sclerosis (MS).
The cuts would also stop the development of a round-the-clock cardiac unit at Altnagelvin Hospital and significantly affect funding to treat those with sexually transmitted diseases.
A number of hospitals wards would close in specific specialities and permanent staff associated with those beds would be relocated to other specialities to reduce the reliance on temporary staff.
It goes on to describe that outbreaks, such as flu or the winter vomiting bug, are less likely to be contained and could cause a major crisis for the health service.
On Wednesday, the health minister said the paper would outline the cuts required to keep the health department within budget restraints.
He said: "Many of these decisions are so controversial that no single minister could make it."