AS the Western Trust reports a deficit of £12.9 million for the first four months of the financial year, the Chairman of its Board has told Directors to “be ready” for tough decisions that lie ahead over cuts to its services.

Speaking during the latest Trust Board meeting in Omagh last week Gerry Guckian told members they were in a frustrating position currently, not knowing what their financial plan was for 2014/15.

In an emergency meeting with Stormont’s health committee recently, Minister Edwin Poots said he needed additional funding from the Executive to stay within his budget and avoid “controversial proposals” that would impact heavily on service delivery.

An Executive meeting was scheduled in the Assembly earlier this week.

But as Trust Board members met last Thursday they acknowledged that the question of what lay ahead for health care delivery in the West was currently out of their control.

“Where does the final decision making lie? At the moment it is not lying with us,” said Mr. Guckian, “We can say lots of good things about how we will protect our services and want them to be maintained, but on this particular day and the particular week that it is in, it is very difficult to be clear about that. We shouldn’t get ahead of the debate.” For the second month in a row the Trust’s Financial Director Lesley Mitchell said a year end deficit of £29.8 million was expected.

Admitting that the Trust was facing one of its biggest financial challenge to date, Mr. Guckian likened their cost cutting efforts to “going down the back of the sofa looking for loose change”.

“At this stage we are ripping open the cushions -- will we have to sell the sofa?” he asked, “I don’t know.” Either way, he told his Directors to prepare themselves for the worst.

“This is an arbitrary discussion until we know what the political decision is,” he said, “If the decision is that the money is just not there, then we will have to have all these difficult discussions.

“It may come back to our control, and when it does we have to be ready for it and protect our services for our population.

“We cannot be found wanting on that,” he told the Directors, “We have to be able to break even.” Mr. Guckian admitted he had not wanted to go into too much detail about the financial pressures during the meeting, given that no direction had been given from the Executive yet.

But Non-Executive Director, Ciaran Mulgrew raised concerns about the Health Minister’s apparent snub towards Transforming Your Care as a means of cutting costs in-year.

“Is he saying that TYC is no longer the answer?” asked Mr. Mulgrew, “That what was apparently the ‘strategic direction’ can be abandoned inside two years to my mind is a huge failure.” Chief Executive Elaine Way was quick to reassure.

“I think what he has been saying is that there are not many areas where he has flexibility to save money in-year,” she explained, “He means that if we have to cut the budget by this amount and in that short space of time these are the mechanisms by which we can do it, but that it is too heavy a hammer for certain services.

“That the Executive needs to make these big decisions because it is too blunt an instrument.” “It is almost a double negative,” Mr. Guckian further explained, “He is saying ‘This is what we could do, but I don’t want to do it’.” The Chairman assured Members that TYC was the way forward for health care delivery, adding that the pressures currently facing the Health Service were the very reason the concept was developed.

“John Compton endorsed TYC for this very reason,” he said, “The tsunami that would hit us is coming -- and it is not as expected.

“Perhaps it is in greater size and has come more quickly than had been anticipated.

“TYC is the answer to all of this, but not immediately.

“If no money is available to help the transition (to TYC) then that is a problem all of its own. We will continue to play our part in ensuring that safe and high quality services will continue. But we have to draw out every efficiency that we can.”