Mr. Hugh Mills, speaking at the Trust Board’s monthly meeting in Enniskillen on Thursday, said that while there has been recognition by the Western Health and Social Services Board about the financial problems, some of which have been caused by the additional number of patients treated here, he was saying to the Western Board that they were getting good value for money.

    This week, the Sperrin Lakeland Trust has been meeting with the Western Board’s Administrative Services Committee in an attempt to establish how much additional resources can be pumped into providing health care in the south-west of the province.

    The Trust, already under pressure from meeting its budget from its routine work, is facing further financial shortfalls as a result of dealing with additional patients who are coming to hospitals in Enniskillen and Omagh because of the of closure of hospital services in Dungannon.

    The complex financial situation was outlined by the Trust’s financial director, Mr. Michael MacCrossan, who said there had been increased pressures in a number of areas with special difficulties regarding providing radiology, the working hours of junior doctors and the costs of running the CT scanner.

    Mr. Eugene Fee, Director of Acute Services, also referred to the new pressures of contract arrangements with the Southern Health Board arising from the closure of services at the South Tyrone Hospital in Dungannon.

    He said that despite the forecasts of likely numbers requiring admissions to hospital, the Sperrin Lakeland Trust was anticipating an increase in emergency admissions “over and above contract.”

    Another challenge for them is to meet the one per cent productivity gain.

    Dr. Jim Kelly, medical director, said they would face further pressures on the working arrangements of junior doctors.

    Mr. MacCrossan, looking at projections for the remainder of the year, referred to over £500,000 for salaries and wages and over £900,000 overspend for services to the end of this financial year.

    Mr. Kevin Martin, one of the non-executive directors, wondered if the Trust’s officers could get a steer where the next six months or year was leading them. He said it appeared to him that they were receiving information after the event and were unable to accurately predict what the financial implications were in the future. He said it would be helpful if the Western Board could give some indication what they might pay for in terms of increased workload.

    Mr. McCrossan said the Board had indicated they would let them know as early as possible.

    Mr. David Bolton, director of community care, said his concern was that the Trust was accumulating debts in areas where they had no confidence the Board would fund and he felt the recovery plan was becoming an obstacle to what was happening on the ground .

    Mr. Bolton, speaking for those in the community who depended on aids, pointed out that any cutbacks in community care would have a severe impact on that level of service. If they cannot buy, for example, special mattresses, then family care was at risk and he described this as a “pivotal” service which cut across other services. Cutbacks would have significant consequences for other areas of their work, he suggested.

    Mr. Hugh Mills, chief executive, said they had confirmation of a two and a half per cent rise in budget due to inflation but there were other areas where they did not want to cut back such as the CT scanner.

    “We are three months into the financial year and this level of uncertainty continues,” said Mr. Mills, revealing he had written formally to the Western Board’s general manager, Mr. Tom Frawley asking him to release more information. He hoped that by next month, they would have a clearer picture of the financial situation and where the Trust stood.

    He revealed that the allocation of £536,000 for recurrent expenditure would help them with financing the CT scanner, junior doctors hours, the endoscopy service and increasing pharmacy costs and the Western Board’s contribution of £250,000 per year over three years would assist with their clawback of overspend.

    However he did not have the up-to-date information to assist them to make a decision.

    He said the difficulty for the Trust to find £250,000 in the first year arose from a current shortfall in income of £100,000, as well as less income predicted. Add to that the fact they were three months into the current financial year and they had problems.

    “I have grave concerns that we cannot make those savings without a reduction in services,” said Mr. Mills.

    A further problem has been the increase in contract cases of general surgery. The Western Board paid for this increase in the first year but had not paid the money to continue that level of activity, he explained.

    “I am saying to the Western Board, they are getting good value for money,” said Mr. Mills.

    He told the Trust Board members that he could not ask them to sign up to agree to find all these savings within the Trust as there were so many pressures on the system.

    “I would not like to sign up to a plan which requires us to save up to £500,000 in nine months on top of other pressures,” he added.

    Mr. Kevin Martin said they needed a contingency plan to roll out at times like this.