Over £300m spent by NI health trusts on private providers in the last five years is “draining capacity” from the health service, a trade union has warned.
UNISON, the largest trade union in the health service, said that £302m was paid out to private providers between April 2020 and April 2025, even as waiting lists remained among the worst in the UK.
Describing the private sector as “a major feature” of the Executive’s efforts to reduce waiting times in Northern Ireland, UNISON claimed that private providers were “cherry-picking” lower-risk, healthier, and often wealthier patients.
Calling for an end to “short-term private workarounds” that divert “scarce public funding,” the union said it was time for a “decisive shift” to rebuild capacity in the health service – pointing to efforts in Scotland as an example.
Regional Secretary Patricia McKeown also questioned the lack of transparency around health service decision making.
“Vested interests that see healthcare as an opportunity for profit have a different agenda,” she said.
“One of the big questions for us is which agenda is winning out and who is really taking the decisions?
“We will continue to oppose privatisation and profiteering with all the means at our disposal. So too should the people we elect.
“Many opportunities to get it right have been missed and bad decisions have been imposed on us, mostly because of Stormont’s failure to agree, stay in government and work collectively.”
She continued: “As a union, we have consistently demonstrated that we know how to establish and work in meaningful partnerships to deliver quality healthcare and justice for the workers.
“It’s time for our government to do the same.”
The Department of Health has been contacted for a response.
Last week, the Health Minister Mike Nesbitt spoke of progress in reducing waiting times for hip and knee replacement surgery in the South West Acute Hospital.
UNISON Regional Secretary, Patricia McKeown. PICTURE: UNISON
He said this was achieved by “utilising independent sector capacity” alongside the improvements in theatre efficiency.
“By improving the way theatres are used and making full use of available capacity, including the independent sector, we are reducing long waits and helping people regain mobility and quality of life,” he said.
Last year, further use of the private sector included extending a cross-border treatment scheme across Europe – where NI patients on waiting lists can claim back the cost of procedures from the Department of Health.