The north’s five health trusts face an uncertain financial future unless there’s a fundamental overhaul of how they’re run, a new report warns.

The Stormont Public Affairs Committee also had strong criticisms of the failure to hit waiting time targets and in particular the time it’s taking for cancer patients to be seen. None of the trusts met the target of 95 per cent of cancer patients starting their first treatment with 62 days of diagnosis. The number of women being seen within the key 14-day window after referral has also fallen away, the report says.

While four of the five trusts here broke even, the PAC report highlights an underlying funding gap of £131 million in the total budget of £4 million and it says if this is not faced up to, will make it hard for the trusts to provide the level of service required.

There’s also a warning about the difficulties presented to the trusts by their struggle to recruit and keep permanent staff and the report recommends that trusts be allowed to offer special incentives to key staff or the implementation of a new requirement that specialist medical staff be required to fill vacancies where needed for a limited time after qualification.

Heavy expenditure on locum doctors – that is, doctors brought in as cover for maternity, holidays and illness – was also pointed to as a major cause for concern and more and better strategic planning is needed.

PAC Chairman, Sinn Féin’s Michaela Boyle MLA, said: "The committee believes strongly that it is crucial for the Health Service to redesign the way it provides services. If this does not take place, the trusts will find it difficult to provide the health and social care services needed, within their budgets.”

Ms Boyle said the trumpeted Transforming Your Care initiative has been too slow to effect the urgent changes needed.

“Putting the HSC trusts on a sustainable footing is a major challenge unless there is a significant change in funding or transformation of services,” she said. “Transforming Your Care has been heralded as the great transformational saviour for health and social care, but the pace of change has been at best mediocre. Without serious review and change the committee believes that the trusts are likely to struggle to maintain their performance. We believe these issues must be dealt with urgently.”