Leo Varadkar (Dublin West, Fine Gael) | Oireachtas source

I welcome the opportunity given by Deputies Billy Kelleher and Sean Fleming to address this matter. At the end of 2014 there will be approximately 97,000 whole-time equivalent, WTE, employees working in the health service. The figure rises to 102,000 when home helps, graduate nurses on the nurse graduate programme, and staff participating on the support staff intern scheme are included.

In March 2009, in response to the financial crisis, the Government of the time decided that the numbers employed across the public service must be reduced in order to meet fiscal and budgetary targets and introduced a moratorium on recruitment and promotion in the public service, which the Minister for Public Expenditure and Reform, Deputy Howlin, has now ended.

In order to mitigate the impact on front-line services of the overall reduction in employment numbers, the priority was and is reform of how health services are delivered in order to ensure a more productive and cost effective health service. The revised working arrangements provided for in the Haddington Road agreement are a pivotal element of that.

I will outline the facts in that regard. There has been a significant reduction of 15,893 employees or 14% of the workforce in the HSE since 2007. The reduction in the number of staff working in management and administration roles was even higher at 18%. In contrast, the number of midwives and doctors has gone up since 2011. The number of nurses has certainly reduced. We have lost far too many of them, but not as many as might appear to be the case, when one includes the graduate nursing programme and the very large number of nurses who are now employed through agencies.

Senior management roles, that is to say, roles at grade 8 and higher, have fallen since September 2007. It is important to say that this group of managers represents just 1% of all health sector staff and approximately 6% of management and administrative staff. Numbers employed in middle management roles in the HSE have also fallen since 2007.

The Haddington Road agreement made provision for the regularisation of long-term acting posts. Under the agreement, employees who had been working in an acting capacity at a higher grade for a period of two years up to 31December 2012 were to be appointed to these posts on a permanent basis as long as certain conditions were met. Close to 400 staff in the management and administration category have been regularised in this process, including the 30 senior managers referred to in the article in The Irish Timesyesterday. What was not said in the article is that applying the exact same principles, an additional 848 nurses and midwives, 248 social and care professionals, and 26 doctors and dentists were regularised in the exact same way. Very many more doctors and nurses had their positions regularised than managers or senior managers.

In return for the Haddington Road agreement, significant change was sought with regard to how posts of a promotional nature would be covered during periods of future absence. With effect from 1 October 2013, no payments are made to staff who take on temporary acting-up appointments to cover annual leave, sick leave, special or other leave, or to allow for the completion of a recruitment process. Instead, staff are expected to take on the role and responsibility of the higher post for such periods without additional pay, provided this period does not exceed three months.

While it is a matter for the HSE to determine the composition of its staffing complement, it is important not to underestimate the significant role that management staff play in the direct support of front-line services.

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