Catherine Byrne (Dublin South Central, Fine Gael) | Oireachtas source

On behalf of the Minister for Health, Deputy Harris, I thank the Deputy for raising this issue. I will read the response I have been given.

I would like to first clarify that it is not the case that budgets are being cut. This issue can be accurately described as individual hospital groups and CHOs across the HSE needing to live within their allocated budget. Where individual hospital groups or CHOs have not demonstrated their ability to do this the HSE have quite rightly introduced certain measures and controls across these locations.

By way of background, in recent months, officials from the Department of Health have been engaging intensively with the HSE in reaching agreement on a pay and numbers strategy for 2019. The key focus in developing the strategy is to ensure that affordable and appropriate recruitment decisions are made by the HSE and that they need to operate within its pay allocations.

By the end of 2018, agency staff overtime and pay costs had reached unaffordable levels. In light of this, the HSE decided to introduce interim control measures for a consolidation period of three months to the end of June, until it received clarity on plans and financial performance for quarter 1 of 2019 from hospital groups and CHOs. The intention is for these measures to be in place for a short period, and the overriding requirement for the HSE is to prioritise the delivery of safe services within the available resources.

With regard specifically to CHO 2, I understand that this location has an agreed affordable funding whole-time equivalents, WTE, limit, inclusive of an affordable level of agency staffing. The current WTE levels in CHO 2 are in excess of this arising from significant growth during 2018 and plans been put in place to bring back this growth to within affordable levels. This includes a plan for agency conversion which is a priority across the HSE. Agency conversion provides for the direct employment of staff resulting in a corresponding decrease in agency staffing while maintaining the level of service provided in 2018. These measures include temporary recruitment restrictions and the capping of agency and overtime expenditure. The HSE’s decision to introduce these measures is based on the high levels of recruitment in 2018 and the consequential impact in 2019. It is also based on the need for the HSE to live within the resources provided to them as set out in the national service plan for 2019.

As part of this process, the HSE directorate has made it clear that these recruitment restrictions will only be necessary for hospital groups or CHOs until such time as there is clarity on plans for 2019.

On receipt and acceptance of balanced plans, these additional controls can be reviewed and removed where appropriate. The earlier that costs begin to reduce towards affordable levels, the less impact it will have on staff and services over the remainder of the year.

Responding adequately within available funding to support the delivery of all key services whilst also responding to increasing levels of demand may result in waiting lists for particular services. However, as far as possible, the CHO has confirmed that it will continue to respond to the most pressing patient and service user needs using resources as efficiently as possible.

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