Mr. Liam Doran:

It is a critical issue and I want to explain the position to the committee.

The amount of €84 million is the last figure we were given for the agency spend on nursing staff. As an aside, one of the pressures on the HSE this year is that the medical agency spend has increased by more than 100% because of EWTD compliance. That is a further drain on resources and the burden is having to be carried by others. I point out to the Senator and colleagues that we tried to make this point in our initial submission. Our heart is broken by the fact that the agency spend has been targeted by the HSE for a reduction, but then it targets the grades that its argues are incurring the spend. They are only incurring it because local management has decided that while it cannot fill a post directly, it has to fill it to maintain patient care. It is a decision made by local management, not by nurses on a ward, but now they are having to pay the price, as it were, because a budget has to be tackled. It is a flawed policy.