The Southern Health Trust is grappling with ageing facilities, mounting repair bills and growing levels of underused space across its estate, according to a hard‑hitting report from the Northern Ireland Audit Office (NIAO).
While the report, ‘The Health Estate in Northern Ireland’, looks at the entire health and social care estate, it highlights a series of pressures and risks in the Southern Trust area – including Craigavon Area Hospital – and warns there is no long‑term plan in place to deal with a £1.6 billion Northern Ireland‑wide maintenance backlog.
The health estate covers hospitals, day centres, clinics, offices and other buildings used to deliver health and social care. Across Northern Ireland it is valued at around £3.7 billion, with almost half of all floor space now more than 50 years old.
High‑risk maintenance – work that the Department of Health classifies as likely to result in severe consequences if it is not done – now totals £251 million across the health estate.
The Audit Office says the “remaining £49 million” of that high‑risk backlog is spread “relatively evenly” across the South Eastern, Belfast and Southern Trusts, as well as the ambulance and fire services. Within that figure, an estimated £9 million of high‑risk backlog relates specifically to Craigavon Area Hospital.
Across Northern Ireland, high‑risk backlog covers problems such as roof, guttering and structural defects which carry a risk of leaks, internal damage or falling debris, as well as electrical and mechanical faults, fire safety work and statutory safety issues such as legionella control.
The report notes that since 2020‑21, around £25 million a year has been made available regionally to tackle backlog maintenance, with spending prioritised towards the highest‑risk issues. However, that has not been enough to reduce the overall liability, which has grown to more than £1.6 billion.
Auditor General Dorinnia Carville concludes that there is “no specific long‑term strategy or plan to reduce or eliminate the backlog”, and recommends that the Department of Health and the Trusts develop a clear maintenance strategy, including over what period they intend to bring the backlog under control.
On space utilisation, the Southern Trust has one of the higher numbers of underused properties in Northern Ireland.
Across the health estate as a whole, five percent of space – covering 91 properties – is vacant and 19 percent is underused, while 7 percent is assessed as overcrowded.
Within that picture, the Southern Trust has 16 underused properties, the highest number of underused properties of any Trust.
The Audit Office does not single out the Southern Trust as performing significantly better or worse than its counterparts, but it underlines that the Trust is operating major acute sites – including Craigavon Area Hospital – where high‑risk maintenance liabilities have built up, and that it has a relatively high number of underused properties. The combination of vacant and underused space, alongside overcrowding elsewhere in the system, indicates that the estate “is not being maximised”.
Overall, the report concludes that the Department of Health has not yet developed a long‑term, region‑wide estate strategy, and that progress on rationalising sites, tackling backlog maintenance and making better use of space has been “constrained by limited resources and the absence of a clear, long term strategic estate framework”.
Reacting to the report, Newry and Armagh MLA Gareth Wilson said: “The findings of this report raise important questions about the condition and use of healthcare facilities within the Southern Trust area. I am particularly concerned by the identification of £9 million in high-risk backlog maintenance at Craigavon Area Hospital, one of our region’s most important healthcare facilities.
“The report also highlights that the Southern Trust has 16 underused properties, the highest number of any Trust in Northern Ireland. At a time when health services are under considerable pressure and resources are constrained, it is vital that every available asset is being used as effectively as possible.
“Local people will want assurance that there is a clear plan to address the backlog maintenance issues identified at Craigavon and that opportunities are being explored to bring underused buildings and facilities back into productive use where appropriate.
“The Audit Office report points to the need for more strategic management of the health estate across Northern Ireland. It is important that the Department of Health and the Southern Trust respond positively to these findings and demonstrate how they intend to address the issues identified, particularly where they have implications for frontline service delivery and value for money.
“As a member of the Public Accounts Committee, I look forward to scrutinising these issues more closely and engaging with officials on how best to resolve these serious issues.”
