Mr. Paul Reid:

I will make some general comments, then I might refer to some members of my team to comment on the specifics. First of all, I want to acknowledge that there have been huge failings in communications and the consistency of communications, in engagement, in levels of empathy, and in consistency across different community healthcare organisations, CHOs, and areas. I can see the inconsistencies. I know what good looks like and I know where it has worked well. I can also see where it has not worked well. In response to the points raised by Senator McGreehan, I wish to state that everybody working in the service cares a lot. People who are directly engaged with service users and those sitting alongside me today care. They work night and day to make people's lives and the lives of families better. We do care. I want to put that on the record. I am not trying to be defensive, but I wish to restate that we care a lot. I also acknowledge that the transition has not gone well. There are major gaps in policy that we are trying to close to get to where we want to be.

On the points raised on the Disability Act, I appeared before an Oireachtas committee alongside the Ombudsman for Children. At that meeting, we made the point that there are inconsistencies and challenges around the Act, particularly in terms of our own roles and responsibilities and the roles and responsibilities of education. The ombudsman has produced a report that recommends certain changes be made to the Act. We agree with many of the recommendations that he has made. We are not criticising a policy or an Act, but we are highlighting where we believe it can be made better. We will be making submissions - and we have made submissions - to strengthen the Act and to make people's lives better. I will refer to members of my team to respond to the points made on the workshop that we held.

In response to the points raised by Senator Seery Kearney, I will not comment on the individual case she referenced. I know the Senator is not asking me to do that. We have to be compliant with procurement procedures. There have been occasions when we have gone to procurement for suppliers. We have to find that balance of pragmatism and compliance with procurement procedures where we have to fill a gap in between. The case to which the Senator referred highlights the need for a level of pragmatism in between compliance with procurement processes. We have experienced and know for a fact that there are recruitment challenges not just for the HSE, but also for service providers. A large part of the model of delivery of major disability services in particular is driven through section 39 organisations. We know that there are gaps in funding models at Government policy level. There are fundamental issues that the sector has to address. Today, I will concentrate on what the HSE has to address. However, gaps have been identified at a Government policy level.

Specifically on the issue of recruitment, as we have discussed with the Minister, we are probably going to have to look at different ways of recruiting staff. I am not just referring to recruitment in the market. We are going to have to look at what levels we are bringing people in at, and what qualifications are required to being people in at a particular level. We will have to look at that differently. There are some examples of other healthcare providers bringing people in with different qualifications, enabling them to get experience and then upscale. That is something that we are discussing with the Minister and some of the third level education providers. We want to increase the pipeline of people coming through to the service. The Minister has engaged with our colleagues in the other relevant Departments, including the Department of Education and the Department of Further and Higher Education, Research, Innovation and Science. I will refer to members of the team to comment on specifics, but generally, we have committed to filling the 28% gap that exists in respect of vacant positions. Looking at recruitment to the HSE over the past two years, we have recruited a total of 35,000 people. That is a net increase of 14,800. We need to recruit 9,500 people every year just to stand still due to the turnover of staff. That is just natural turnover from people leaving on pensions and people leaving the service. The net increase of 14,800 staff represents the biggest recruitment in the history of the HSE since its establishment. However, it is still not enough for the service demands that we have. Recruitment is a real challenge for the disability services sector, in particular. We are going to have to look at it differently and look relentlessly at the numbers being recruited.