Ms Fiona Tierney:

I am the CEO of the Public Appointments Service and I am accompanied by my colleague, Ms Margaret McCabe, who is the head of recruitment. I thank the committee for its invitation to attend here today to discuss our role in the recruitment of consultant psychiatrists for the HSE. By way of assisting the committee, I would like to read this opening statement which explains our role as a recruiter for the Civil Service and the public service but I will concentrate very much on what we do for the HSE; the role of recruitment of medical consultants, including consultant psychiatrists; focus on improving the process and outcomes of medical consultant recruitment; and provide some detail on past and current activity levels in the recruitment of psychiatry posts.

I was struck by the number of submissions the committee has received and the detailed volume of information it has collated around the filling of positions and the length of time taken. There is no point going back through all that detail in our submission to the committee today. I take it as read that most of the members will be familiar with the Public Appointments Service. We are an independent office within the Civil Service, set up in 2004, through the amalgamation of the Civil Service Commission and the Local Appointments Commission, for the purpose of providing an independent, merit-based, transparent recruitment process for appointment to Civil Service and public service jobs. As part of that role, and with a history going back to the foundation of the State, the Public Appointments Service has been involved in recruiting medical consultants on behalf of the HSE and its predecessor organisations. It is only one part of what we do.

We conduct more than 400 recruitment campaigns per year, handling more than 100,000 applications, interviewing more than 15,000 people per year and making about 10,000 appointments to different jobs.

I can take any questions about our role subsequently, but I will summarise it to that level. I will talk a little bit about our role in the recruitment of medical consultants. As stated, we work on behalf of the HSE to recruit permanent medical consultants for HSE hospitals and community health organisations, including some academic positions. It is not our role to recruit for section 38 institutions and organisations, voluntary hospitals or any locum consultant posts. We have no role in any of those appointments.

PAS and its predecessor, which, as I said, was the Office of the Civil Service and Local Appointments Commission, have been recruiting medical consultants under the auspices of the Health Act 1970. The function transferred to the HSE in 2005 and the HSE has requested us to continue to carry out recruitment on its behalf. The role of PAS in the recruitment of medical consultants is to undertake the recruitment and selection process as set out under the Commission for Public Service Appointments processes. This includes the advertising of posts; the composition, management and support of interview boards; and all employment checks for successful candidates. We have included a schematic of the activities we undertake as part of that recruitment process at appendix A in order to support the committee in its understanding.

The process is very long and I know that all the members are, at times, very frustrated with the complexity of its overall design. We are a bit player in the middle of a process in which the sanctioning of roles, the design of job descriptions and so on are carried out in the HSE. Once posts are sanctioned they come to us. We advertise and run the selection process, run all of the checks, and then make a recommendation to the HSE which engages in contract negotiations. We currently have 1,618 candidates registered to receive job alerts for medical consultant roles, 260 of whom are registered for the subcategory of psychiatrist.

We want to talk a little bit about the focus on improvement of the process in recruiting medical consultants. PAS is aware that the committee has been briefed previously on the challenges of recruiting medical consultants in Ireland. Full details of activity levels etc. were provided in the submission by Professor Frank Murray to the meeting of the committee on 9 May 2018. Since 2013, PAS has been working with the HSE to improve the overall recruitment process for medical consultants with a view to increasing success rates in the numbers and quality of medical consultants being recruited.

Over the past five years, our focus has been on four areas. The first is improving the overall quality of the recruitment process. Following an in-house review of the end-to-end recruitment and selection process for medical consultants in 2013-2014 using "lean" techniques, it became clear that constitution of the interview boards was taking a significant period of time. In early 2014, PAS began a process of reviewing the number of board members for medical consultant roles and, following a proposal and consultation with the HSE, it reduced the number of interview board members from ten down to five. This proposal was implemented in February 2015. This change has facilitated a more timely scheduling of interview boards and has reduced the overall time taken to complete the selection process.

The second area is that of consultant psychiatrist posts. In reviewing the outcomes of selection processes that took place in 2014, we identified that there was a significant issue in attracting candidates to apply for psychiatrist posts. In the first and second quarters of that year in excess of €35,000 was spent on focused advertising for psychiatrist posts. Posts were advertised in national newspapers weekly over a two-month period and also in international journals in America, New Zealand, Australia, Canada, the United Kingdom and Africa. At the end of the second quarter of 2015, the services of the executive search function in PAS were engaged to try to improve the numbers and quality of candidate pools for consultant psychiatrist positions. The outcome of this work is in appendix B. This information was forwarded to the HSE and discussed at a number of meetings. I would like to bring the committee's attention to appendix B because, having read some of the deliberations of the committee heretofore, it might be worthwhile spending a few moments going through the outcome.