Mr. Bernard Gloster:

Good morning Chairman and members of the committee. Thanks for the invitation to meet with the committee today and to join with colleagues from the Department of Health in providing an update on our work arising from the Sláintecare policy framework. I am joined today by my colleagues Mr. Liam Woods, national director for regional health area, RHA, implementation, Ms Sheila McGuinness, national lead on the waiting list action plan for acute hospitals, Ms Anne Marie Hoey, national director of human resources, HR, Dr. Colm Henry, chief clinical officer and Mr. Dean Sullivan, chief strategy officer. I am supported by senior staff Ms Sara Maxwell and Mr. Ray Mitchell.

Previous briefings to this committee have demonstrated strong progress on aspects of Sláintecare and on overall health reforms. While access remains a challenge and is our central focus, our activity and performance has grown considerably this year. Unprecedented growth in demand for services, also experienced in other jurisdictions, is believed to be associated with pent-up demand post the pandemic. It is for this reason that access is challenged at a number of points but also showing signs of some improvements in the right direction.

I want to briefly address two matters central to the current implementation of Sláintecare. The first of these is organisational reform. The HSE, with the approval of the Minister for Health and Government, has now moved to recruit six regional executive officers to lead the implementation of health regions. These senior post holders will report directly to me. I have also issued a draft new design for the HSE centre and national services. It is my intention to finalise that by year end then move to implementation in parallel to the establishment of the health regions in the period up to September 2024. This is a radical redefinition of the HSE centre and, together with the direct reporting of six regional executive officers to me, represents the most significant de-layering of the HSE since its establishment in 2005.

The second matter is that of the workforce, which is of specific interest to the committee today and which will also be addressed by the Secretary General of the Department in his opening statement. At the end of August 2023, the HSE and section 38 agencies employed 161,634 people equating to 142,468 whole-time equivalents, WTEs. That is a net growth of 4,722 WTEs, with four months of the year still to be counted. This is a significant growth of 18.9% since December 2019. All staff categories in the current year are ahead of recruitment target, reflecting changes to our recruitment practices and processes. As we approach 2024, the HSE has a critical task to undertake in consolidating an overall approach to pay and numbers. There are currently several categories of allocating and tracking employment such as agency, overtime, Covid, new developments, routine replacement and so on. All of these need to be combined together in one strategy for the purposes of both planning and control.

The public-only consultant contract, POCC, continues to attract both new applicants, numbering 146 at the time of writing, and conversions of existing post holders, numbering 379. That total of 525 has increased since the data were last collected and the amended number is now 622. I have previously referenced to the committee the need for extended services over seven days and I have commenced engagement with staff representative organisations on an approach to that. I expect this will be of some assistance in the coming months in the short term, and more dependably so in 2024. That concludes my opening statement.