James Reilly (Dublin North, Fine Gael)

I propose to take Questions Nos. 1 and 2 together.

The most recent information available to me indicates that approximately 4,200 individuals will have left the health service between September 2011 and the end of this month. The corresponding wholetime equivalent figure is about 3,700. These figures are subject to change for various reasons, one being the time lags involved in collating data at national level. However, management at local and regional levels have full details of the staff who have already left or will leave by 29 February. Over 2,000 individuals had already left by the end of January. The figures are subject to further change because those who have indicated their intention to leave can change their minds right up to 29 February. Others may choose to leave who have not indicated this to date.

Planning for the impact of the end of the grace period began last autumn and a formal transition team for the health service, chaired by an assistant secretary from my Department, is in place. It comprises key HSE national and regional directors. Contingency plans have been developed locally for hospital and community services, reflecting risk assessments undertaken by each hospital or community manager. These have been reviewed at regional and national levels to ensure appropriate contingency measures are in place across all services.

I am satisfied that suitable arrangements are in place at national, regional and service-specific levels to manage proactively the impact of staff exits on front line services. The focus is on protecting and maintaining critical front line services such as emergency department, maternity, critical care and neonatal services.

The recently approved HSE National Service Plan 2012 acknowledged that there will be an inevitable and unavoidable reduction in services this year because of the scale of the financial and staffing challenges facing the health service. Obviously, I would prefer to have more funding available for our health services but the reality is that this is not possible right now. There is, therefore, an onus on all of us working in the health services to be as innovative and flexible as possible in order to mitigate against the impact on services of reduced budgets and staffing.

The mitigation measures in place include the backfilling of certain critical posts. However, the main focus is on reform and achieving greater productivity. The national clinical programmes are already delivering improvements in day-of-surgery admission rates, increases in the proportion of care that can be delivered on a day-case basis and other productivity improvements designed to provide a better quality service to patients at less cost. I very much welcome the clinical leadership that is being provided in this regard. I acknowledge and welcome the improvements in productivity that are being delivered by staff at local level through the Croke Park agreement. Examples pertain to staff redeployment, streamlining of management structures, including clinical management roles, changes in skill mix and more cost-effective rosters.

The national service plan has already been published and the regional service plans are in the process of being finalised and published. However, the need for dynamic and proactive management of the impact of reduced budgets and staff will remain and will continue beyond 29 February.

See this speech in context