Northern Ireland’s health trusts spent almost £22m in a single year on restricted procedures which should only be carried out in very specific circumstances, according to the auditor general.

Dorinnia Carville said about 12,000 operations, which include tummy tucks and tonsillectomies, were carried out in 2023-24 without any assurance they complied with government policy.

Ms Carville described the lack of oversight by the Department of Health and the trusts as “very disappointing”.

The Department of Health and the five health trusts acknowledged the concerns raised in the Audit Office report and accepted that oversight arrangements must be strengthened.

Health trusts must adhere to the Effective Use of Resources (EUR) policy which restricts 29 medical procedures, with six of these not permitted at all.

The Audit Office report found 40 restricted procedures were carried out each day during that year.

Other restricted procedures include liposuction, breast reduction, removal of breast implants, carpal tunnel and tattoo removal.

About £6m was spent in a single year on removing patients’ tonsils.

Procedures such as the repair of split ear lobes, fixing simple snoring and the reversal of male and female sterilisation are not permitted.

The auditor general found the EUR policy was “not resulting in good value for money being achieved”.

She said: “Trusts have not put in place arrangements to verify that medical staff are complying with the policy.”

“At a time when our health service is facing increased demands and significant financial pressures, measures introduced to ensure the effective use of resources are vital.

“However, these can only be successful if they are properly implemented and monitored.”

While some of the thousands of procedures performed may have been permissible under the policy, the report found health trusts had not put any arrangements in place to verify this.

No such assurances were provided by trusts during 2023-24, and none was sought by the department, said the auditor general.

The report recommends that trusts introduce arrangements for monitoring and complying with the rules, and for the Department of Health to ensure they are doing so.

It is also calling on the department to review the rules policy every two years.

The Department of Health said it was committed to working collaboratively over the next 12 months to implement the recommendations.

“It must be emphasised that the EUR commissioning position is there to guide clinicians who must continue to exercise their professional judgment in providing appropriate, timely care,” a spokesperson added.

“While there is an onus to take account of the position, other factors must also be taken into account, including patient safety.”