Northern Ireland health minister Bairbre de Brun has secured an extra £154m for next year's health and social services budget. But she says the 7.2 per cent increase is not enough - and the chief executive of the province's biggest acute trust has warned that there is still 'a mountain to climb'.

The spending plans for 2001-02, announced last week, the first to be set by the Assembly's Executive, were welcomed with some relief by the service, which is already experiencing early winter pressures and is braced for another difficult year.

Ms de Brun has made getting more funding for health and social services her top priority, and is regarded as having done well to secure a total of£2.3bn funding for next year, despite expressing her disappointment.

Ms de Brun said the funding would enable planned initiatives to be taken forward and go some way to reducing the historic funding deficit in Northern Ireland's health service. But she added: 'I have to confess it falls short of the sum I believe is needed to transform the service.' The minister had argued for an extra£247m.

Health got a slightly higher increase than education, which got a 7.1 per cent rise, but the Department of Environment got a 14 per cent increase and there was a 9.6 per cent increase for agriculture and rural development.

William McKee, chief executive of the Royal Group of Hospitals trust in Belfast, said the budget showed the benefits of devolved government: 'People in health and social services in Northern Ireland will acknowledge that it is much better that Northern Irish politicians are making decisions and priorities about Northern Ireland.'

But Mr McKee emphasised that the settlement for health could only 'arrest the slide': 'We'll not slip over the edge this year. Even with this increase our funding still lags behind England's.

We still have a mountain to climb.

'It's accepted that we need a 3 per cent real increase in funding to just stand still.The 7.2 per cent increase includes 2.4 per cent notional inflation - so real growth is just under 5 per cent. And that's an underestimate of what inflation is likely to be next year - I don't imagine that nurses will settle for 2.4 per cent pay increases. It's going to be tight.'

The Royal Group of Hospitals is having to find£5m in efficiency savings over the next three years to clear its long-standing deficit.

The British Medical Association in Northern Ireland called on Ms de Brun to follow her budget success with immediate action to counter the premature winter crisis in the province's hospitals. The service received£52m earlier this year to prepare for winter pressures. But the additional funding has not made enough difference, said a BMA spokeswoman: 'We would like to know where that money has gone - has it been used to clear trust balance sheets? We want some answers.'

Mr McKee said the Royal hospitals had experienced an increase in trolley waits, despite very thorough advance preparation: 'Winter pressures money hasn't gone to address our deficit. We are finding true efficiency savings.'

A spokesman for Eastern health and social services board confirmed that most hospitals in the area had some trolley waits, despite the best ever winter planning.