New Executive would face ‘tough decisions’ such as water charges
former head of the Civil Service has said a reformed Executive faces making unpopular decisions including the potential introduction of water charges and fees for missed hospital and GP appointments.
Sir Malcolm McKibbin, who now works with Deloitte, was speaking at the launch of a report by the business advisory firm advocating major policy proposals in face of what it calls the unsustainability of Northern Ireland’s current finance spend.
As well as reconfiguring the health service and schools estate, the options listed by Deloitte include introducing tolls to fund road repairs, charging non-vulnerable people for water and charging for missed GP appointments in certain circumstances.
Northern Ireland has the highest level of public spend per person in the UK at £13,954 per head, compared with the UK average of £11,742 per person.
“The Department of Finance has said that the current pattern of spend is unsustainable,” said Sir Malcolm (right). “The idea is to improve the sustainability of public services and help people live within budgets.”
The report has been backed by a new IPOS/MORI poll, which indicated that 61% of people in Northern Ireland would be prepared to pay more taxes for extended government services.
It also stated that 78% of respondents in Northern Ireland said their family had not been affected by austerity.
Sir Malcolm, who retired as Northern Ireland’s most senior civil servant last year, said: “While you may have to pay more for some services, the services will be better. This is not a no gain event. You are going to get improved public services if there is more revenue available to deliver those services.”
He pointed to a series of case studies in the report, showing how new technologies had been used in other parts of the world to improve services. However, he said care would have to be taken.
“If you charge people to go to their GP and they decide that they don’t want to spend that money and they don’t present, they could end up with a much more serious condition for not having presented, and at a greater cost to the public purse,” he said.
“There was a greater appetite shown in the IPOS/MORI poll for people to be charged if they missed appointments, but that should not be targeted at the most vulnerable in society.”
The former mandarin, who up until June 2017 was the principal adviser to the First Minister and Deputy First Ministers, said there were many cases for Northern Ireland to draw example from, including across the border.
“Where people have had the courageous and determined leadership and willingness to adopt new technologies, they have achieved some fantastic results,” he said.
“Look across the border at the Republic. A few years ago they were facing into an economic black hole and they’re now the fastest growing economy in EuTHE rope. There are things that can be done. They took a very structured approach, got their budgets back under control and they saved €30bn over eight years.
“There were some very hard decisions made down south and decisions like that may have to be made here. A lot of them were not particularly publicly or politically acceptable.”
Asked whether there is political will for such hard choices, Sir Malcolm said: “Time will tell. I do think that if the Executive comes back it’s going to have to act more strategically and collaboratively than it did before.”