Mary Harney (Dublin Mid West, Progressive Democrats)

I propose to take Questions Nos. 74 and 75 together.

There are close to 130,000 people employed in the delivery of our public health and personal social services, the vast majority of whom provide direct service to patients and clients. The current pause in recruitment must be viewed in this context. It is a temporary measure put in place by the HSE to live within its budget. It will be reviewed at the end of October and it is being monitored by the HSE on a week by week basis.

The HSE must be able to manage within the resources made available to it by the Government and voted by the Dáil. It should not come as a surprise to anyone that managing the budget in the health sector means managing staff. Staff costs make up almost 70% of the HSE's overall budget. It is unreasonable to suggest that in a service of this scale and with an employee cohort of this size, every vacancy which arises must be filled immediately and, if not, dire consequences will result. Living within budget and making the best use of the available resources is an essential task of any sound organisation. Reforming our health system is not just about extra funding and extra posts, it is about ensuring that the extra money which has already been invested by the Government on behalf of the Irish people is being used wisely and efficiently.

The gradeeight title was first introduced in 2000 as a result of an industrial relations agreement. Staff would previously have held other titles such as hospital managers, disability service managers, accountants, industrial relations officers and IT personnel. This explains why the numbers of posts categorised as grade eight was very low in 2000. However, I share the concerns about the growth in posts at grade eightfrom 521 to 713 between late 2005 to June 2007. As part of a new employment control framework introduced in December 2006, the HSE is now required to get my Department's approval for the filling of posts at grade eight or above. Despite the controls that are in place now, the numbers are running ahead of expectations. I am awaiting a report from the HSE on this.

Many of the actions taken by the HSE to control its rate of spending in the last three months of this year have demonstrably no effect on frontline services. Some of the claims made about alleged effects on services are without justification. For example, the cancellation of foreign travel and the release of temporary summer holiday cover staff cannot mean a reduction of services. Claims of this nature should be assessed in the context of the HSE's overall activity levels. For each of the last three months of this year, there will be more than 100,000 patients treated as inpatients or on a day case basis in publicly-funded acute hospitals. That will continue to be the case.

However, the HSE recognises the importance of staying within annual budgets and staffing levels, as well as managing activity throughout the year so that planned annual service increases are achieved in an orderly manner over the whole year. It is ultimately no service to patients if hospitals or any other cost centres overrun budgets and staffing levels in the early part of the year, causing a slowdown of activity in their own service or in any other service later on. Any postponement of an operation or service arising is naturally very disappointing to individual patients and clients.

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