Mr. Paul Reid:

I will make a few general comments in response to Deputy Costello and summarise some of the figures on recruitment. Thirty-five thousand is the total number of people we will have had to bring into the system. I say that figure because it has never been achieved in the history of the HSE. We have had to put in place a whole new set of recruitment processes in place nationally, locally and internationally. There are recruitment processes, particularly for nursing, in India, the Philippines and the Middle East. We have targeted about 1,800 nursing midwife professionals to come in from international campaigns. That is along with the 1,500 nursing midwife graduates this year to whom we want to give placements. We have never achieved any figures like that. We can forward a breakdown of figures for this year to date to reassure the Deputy. We are at a total staffing level of just over 137,000 whole-time equivalents. That is about 150,000 staff.

The vast majority of this year's recruitment has been primarily focused on front-line services. In primary care services, for example, 80% of recruitment has been to front-line professions. We recruit management and administrative staff because we need people to manage and oversee services and to provide services of a safe quality. We are recruiting in a different way. It is a strategic recruitment plan that we have never had before, with us recruiting on a three- to five-year basis. We want to ensure that we are targeting the gaps.

Regarding the churn, approximately 4,000 of the 35,000 people were recruited for testing, tracing and vaccination. They were people who wanted to return to the workforce, and thankfully did, and now want to return to retirement or whatever other roles they play in society. The 9,500 churn within the health service involves people retiring - a significant number will retire over the next three years - as well as others leaving the service. We have a large, young and mobile workforce and people will emigrate again, particularly now that this opportunity has been restored. This churn is not completely out of kilter with what I have seen in the private sector or across the public service, but it is a large churn just to stand still. I was making that point to provide some context.

The recruitment breakdown is approximately 4,800 nurses and midwives, 470 consultants, 2,000 healthcare assistants and a further 4,000 client and patient care staff. These are people working in front-line services. This is significant recruitment. To restate what my colleague, Ms Crehan-Roche, mentioned, we are seeing some people returning through the international recruitment campaigns. We have done the early stage of a study of people, in particular doctors, who did not go away for reasons of pay, but for good quality conditions and healthcare that they did not view us as having. A significant proportion of those people return within three years. There are benefits that we can take from people going away, getting experience and returning. That will happen in the health service.

The retention of people in whose training and education a significant investment has been made is a major policy issue. We are seeing some of the impacts of people leaving. Some countries employ a period of a sustainable number of years where someone must stay in the service. I do not see that working, but this is a significant issue. In recent years, though, our graduates have generally been staying. Of course, people can now travel more.

We have discussed pay disparity issues.

Deputy O’Dowd asked about the NIRP process and the Brandon report. As I stated publicly at the time, there were a couple of reasons for producing that report. First, the NIRP report process is one that facilitates people coming forward to contribute on a confidential basis. They are given that commitment so that we may extract from them information on where harm occurred. That was the approach recommended by the NIRP and its chairperson, and remains so to this day in terms of our publication of the executive summary.