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Choices will have to be made on funding priorities in health and social care, the Department of Health's top civil servant has said.

Permanent Health Secretary Richard Pengelly said his department does not have enough money.

Mr Pengelly was speaking at a Chartered Institute of Public Finance and Accountancy conference.

He said that the health and social care trusts are facing a projected deficit of £20m this financial year.

He said that represented only a small part of escalating pressures.

"Currently these are presented to me with frustration - the argument being that because I don't do something, it means I don't want to do it. That is certainly not the case," he said.

"Why wouldn't I want to reduce waiting lists, increase pay for hard-pressed staff and reduce the pressure on those staff by recruiting and training more colleagues?

"Why wouldn't I want to improve mental health provision and focus on suicide prevention, commission new drugs for patients with cancer and other serious conditions?

"The truth is I simply can't afford to do all these things. In fact, I can't afford to do all the things we currently do."

Mr Pengelly called for a wider conversation on budgetary priorities and how limited resources are used.

It is not the first time the department has warned about increasing pressures and projected deficits, money is often found in monitoring rounds.

Sources have also told 91�ȱ� News NI that a projected £20m deficit across five health trusts is not unusual.