Dr. Eddie Casey:

I thank the Deputy. I will comment on the health staffing targets, which is an excellent box in the report by a colleague, Killian Carroll. He looked at targets for staff increases versus some of the outturns. You can see there are substantial shortfalls there. We see the increases broadly keep place with demographic trends and particularly the older age cohort where there are lot of demands for healthcare provision. However, as the Deputy said, many of the increases were in the areas of management and administration, whereas the front-line staff increases were not seeing the fastest growth. This seems at odds with Sláintecare where community services are really at the core of what it is trying to do, in trying to promote more provisional healthcare through a more community-centred approach. It looks like it could be difficult to achieve the Sláintecare commitments given that, and given that some of the targeted areas are falling short.

I think the broader point we are concerned about, which we have made a few times, is really planning around staffing where the planning in healthcare staffing is done in a really narrow timeframe, so you get plans issued maybe halfway through the year for how many staff are going to be needed for this year. That is quite useless from a planning point of view. You have already started the year and should be monitoring it at this point. It is more or less useless for monitoring. It is not really providing for adequate planning of what the healthcare system needs. What we really need to see are clear plans on a much longer horizon, looking five or ten years ahead to what the system is going to need and making realistic plans.