Mr. Kevin Figgis:

I will make one or two brief points in response to the two questions Deputy Durkan asked together. He asked whether there is a co-ordinated or integrated approach to the filling of vacancies, employment, etc. The last time there was a co-ordinated and integrated approach was when the opposite was being done, that is, when there were incentivised schemes such as those relating to early retirement, voluntary redundancy, etc. However, there was no correlation at all regarding the effects this would have on the service. It was really just a case of getting as many out as possible. It was the classic sledgehammer approach. What we have not seen since then is a rebuilding of the health service.

We recently carried out, by joint agreement with the HSE, an independent review of the radiology department in University Hospital Kerry, which has had its own challenges. I refer to this purely as an example. We implemented a review and agreed terms of reference. We also appointed independent people to come down, and it was to be chaired independently as well. They prepared their report based on the existing safe staff guidelines published by the professional body. That report stated that that department had 60% of the staffing it should have had. The HSE and the hospital group in the summer of last year accepted that report and all its recommendations. I met with them about ten days ago under the auspices of the WRC because it was impossible to get any progress made. Their current plan is such that they have no approval to go any further and that the department will remain 30% down on recommended staffing levels. They have no plan whatsoever to fill the vacancies they accept are there. Everything is overheating because there is such a small staff complement. In this example, 60% of staff every day of the week are trying to deal with what 100% of staff should be doing. That is just one example among, I would imagine, most departments in most locations throughout the country.

The difficulty we have in the model of recruitment is, as we have said in our paper, that it is about frustrating matters. There are not only so many layers that people must go through but also the layers even outside of the health service in that these things ultimately go to the Department of Health or the Department of Public Expenditure and Reform. As we said, line managers are asked what they need to provide for the safe level of service in their departments and to meet the demands made of them. They come up with those plans, they base them on safe staffing guidelines and, by the time they go through the rigmarole of the bureaucracy, they either get back something that looks nothing like what they asked for or just do not get back anything at all. At a meeting I was at two weeks ago a person said to me, "I am at the stage now where I just keep submitting every two weeks. I do not change anything; I just keep submitting the plan." One wonders to whom such people are submitting their plans. Clearly, they are just landing on someone's doorstep and they just do not open that post.