Mr. Stephen Mulvany:

The most marked increase has been in medical posts, meaning doctors. Given that the moratorium on recruitment largely did not apply to medical posts, the issue is not typically approval but availability, the capacity to find suitable people, particularly for smaller, more rural places and those with more challenging rosters. It is about being able to attract and retain staff, and the fact that in some hospitals we are under significant pressure consistently to field a team of directly employed medics, which is our preference. While it is not all down to salary, we hope the recent changes in consultant salaries should assist us in recruiting consultants, and there will be an obvious knock-on to NCHDs. This is our single most challenging area, and it is not related to funding availability, approval or the moratorium, but to the market and our ability to attract and retain medical staff. We are competing in an international market.

The other large areas are agency and support staff, which are subject to moratorium and approvals and the permission to recruit under the previous employment control framework. When it hits grades at which we are providing essential, often 24-7 residential services, there is a growth in agency costs, albeit overall pay costs, including agency, have decreased during the period. This includes nursing and support staff, such as porters, cleaners, domestics and health care assistants.