NICON submission on the DoH Budget settlement 2025/26

Overview

On 19 December 2024, the NI Executive agreed the draft budget for 2025/26, including the budget settlement for the Department of Health (DoH). A public consultation on the budget ran until 13 March 2025, which NICON responded to on behalf of our members. Our submission sets out our members’ collective response to the draft budget and its implications for the health and social care system in NI.

Key points

• The 2025/26 DoH budget outcome is £8,387.9 million, representing 50.6% of the total NI budget (when wider earmarked funding is included). The stated uplift of 8.7% is misleading – when 2024/25 in-year allocations are taken into account, the real increase on spending is in fact at a maximum of just 2.6%. This falls far below all accepted assessments of additional need (Appleby 2011 +9%).
• The additional £200m general allocation does not even cover the inescapable new cost pressures incurred just to continue running the health service in its current form.
• The HSC level of funding in Northern Ireland relative to NHS England is now at a 10-year low, despite needs Assessment Studies having consistently identified a higher relative need for spending on public services in Northern Ireland and the 24% needs-based funding factor included in the Barnett formula as of 2024/25.
• The funding gap stands at almost £400m after an assumption that Trusts can deliver savings to the level delivered in 2024/25. However, the capacity for real cash-releasing savings is reduced by the efforts in 2024/25 to deliver an unprecedented £200m savings. 
• In response to these challenges, NICON calls on political leaders to urgently agree an innovative financial arrangement and Financial Recovery Plan to help us through the next 3 years. We also ask that additional measures are taken to align funding with need, recognise the nature of the problem, and build on the existing approach.

The full submission can be read here.