Health at the heart of 2016 Budget

The financial pressure on a succession of boards has been enormous, so much so that political members and chief executives have been in and out of the PEH quicker than some patients.

Following last year's thawing of relations with Treasury and Resources and a review of maternity services, HSSD is once again central to the budget narrative.

This time, however, rather than admonishing HSSD, T&R is supportive, accepting that in the current system the department cannot function within the tight budget of the past.

Former department members and chief executives will be lining up to say 'We told you so.'

Treasury's response is to point to a new report by a team of accountants which claims that there are rich pickings within HSSD, if it is taken apart and rebuilt from the bottom up.

In theory, there are £24m. in annual savings to be had, given enough time. That is a huge sum considering the States took five years to identify and recoup almost £29m. in annual savings from the whole of the States.

For the moment, however, HSSD has a comparatively easy time of it with a huge budget of £118m., £7m. more than it spent last year.

If such massive savings are so readily achievable it begs the question of why they have not been identified before. How stringent and forensic was the financial transformation process if it missed such an enormous goal?

And, given that this year's Budget puts the squeeze even more firmly on business and taxpayers, how much more could have been achieved with a more root and branch approach to cuts throughout the States?

Education and Home are the next to come under the microscope. Together with HSSD they account for 70% of States spending. If this new wave of assessment identifies similar opportunities for savings and they are achieved the public can truly start to believe that, belatedly, the States is not only living within its means but doing so frugally.