Ms Rosarii Mannion:

I thank the Deputy for her questions.

The grades with which we have difficulties are predominantly in mental health nursing, radiography, psychology, paramedics, consultants, psychiatry, and, in some cases, non-consultant hospital doctors, NCHDs, all of which are set out in chapter 6 of the report of the Public Service Pay Commission - Recruitment and Retention in the Public Service. We are engaging with the commission on the next steps regarding that report.

The black spots depend very much on the grade. It is broader than mental health, but, for instance, in public health nursing, we have a specific problem in the east because many people choose to relocate there. There is variation in respect of living conditions, accommodation and education facilities. These factor into the dynamic when people choose to work in specific locations. For public health nursing, the problems are outside of Dublin. There are difficulties with some of the consultant posts in model 2 and model 3 hospitals as well. We have heard from the Chairman about Wexford and Waterford. However, it is important to understand that we are making attempts to address these specific areas. The point I was making to the Deputy Browne is that, as a result of that specific report, we have a group that is looking at designing a better model for recruitment. I am confident that this will deliver options such as more local autonomy within what is a funded workforce plan for each area certainly by July or so of this year. That will then have to be implemented, but we are working towards that.

Regarding the 25 layers and the signatories, recruitment is handled through HBS. This is all determined by the relevant chief officer within the given area. We have had issues with nursing, particularly in the past two years, and arrangements have been put in place whereby delegated authority has been given to the directors of nursing. This has been enabled across the system as far as practicable to give that delegated authority to nursing in particular. Where this is working, it will be supported. Each chief officer has his or her own budget, and he or she works to a workforce plan. The decisions as to what the layer of delegation is and who signs what are determined locally within the operational system. Centrally, within HR, I specifically do not have involvement in that.

I am chair of the group that is going to bring forward a better model but I do not have responsibility for the determination of levels or signatories in regard to operational funding.