David Cullinane (Waterford, Sinn Fein) | Oireachtas source

I move:

That Dáil Éireann:

notes:

— that the Government's mismanagement of the health budget has led to a disastrous embargo on recruitment into frontline posts; and

— the memorandums sent by the Chief Executive Officer of the Health Service Executive (HSE), which directed a severe escalation in the recruitment embargo across the health service, and which noted that the embargo "will create difficulties" in the face of "an enormous increase in demand";

further notes that the disastrous decision of this Government to underfund the health service has:

— resulted in the loss of more than 7,000 essential posts from the HSE workforce;

— caused the removal of vital frontline vacant posts which were needed for the winter ahead;

— caused the withdrawal of job offers from prospective health service workers;

— sent a message to Irish workers abroad not to come home;

— sent a message to workers frustrated with the health service in Ireland to emigrate;

— sent a message to foreign health services to come and take our healthcare workers; and

— seriously impacted the ability of the health service to deliver safe, quality care and expand provision to meet rising demand across almost all services, including mental health, older people, home care, community services, and acute hospitals;

condemns this Government for throwing in the towel on health and causing significant reputational damage to the health service through their disastrous recruitment embargo, as a result of the underfunding of the health service; and calls on the Government to:

— immediately end the recruitment embargo on essential HSE posts;

— urgently bring forward revised estimates for 2023, to properly fund the health service to year end; and

— reverse its disastrous decision to deliberately underfund the health service in 2024.

It is extraordinary that we are having a debate about a recruitment embargo on many key front-line posts in healthcare when we consider that almost 1 million people are on some form of health waiting list, the pressure many hospitals and emergency departments are under and that far too many people are not getting the right care in the right place at the right time. Despite advances that have been made in the enhanced community care programme, many of the teams that are needed are not fully staffed. Yet, we now have a recruitment freeze under which 7,000 posts have just vanished. The rug was pulled out from under many people who went through a lengthy recruitment process and were offered jobs, only to be told that because no contracts had been signed and the posts were not approved, the posts were gone. Nurses, doctors, healthcare assistants and allied healthcare professionals who emigrated to Australia, Canada, New Zealand, Britain and elsewhere have essentially been told to stay in those countries and not to come home to work in the public system. It is extraordinary, it beggars belief, that the Government has put in place this type of recruitment embargo. I put it to the Minister that the reputational damage this causes to the health service when we have such a real difficulty in recruiting and retaining staff, getting the numbers we need, is breathtaking.

I also put to the Minister that this is a chaotic way to fund the health service. It is unprecedented that the head of the HSE will have to essentially write a national service plan for next year with a built-in deficit. The Government announced today a Supplementary Estimate for healthcare of €1 billion, that is €500 million short of what the head of the HSE has said is the deficit for this year. The Minister knows the deficit will be €1.5 billion. Only €1 billion has been given so the difference now has to be carried over into next year, on top of the hole that is already there because the Government has not properly funded the health service. The mess that was created this year will be even worse next year. That is on the Minister.

The three requests in our motion today were reasonable. The first was that the Government end the recruitment embargo and that will not happen, certainly not anytime soon. The second was to bring forward revised Estimates to properly fund the health service for 2023; the Minister has brought forward a Supplementary Estimate that leaves the health service again short €500 million and lumps the deficit onto next year. The third was to reverse its disastrous decision to deliberately underfund the health service for next year. That certainly has not been done because, perhaps I am wrong, the €1 billion that was announced today will not be recurring expenditure that will go onto the base but yet, that all will have to be funded again next year. The Government has made a complete mockery of funding the health service. At the same time, as I said, 7,000 posts have been scrapped. Vital front-line posts are now gone, with the withdrawal of job offers from people who acted in good faith, and there are consequences for patients because what I am hearing right across the health services from chief officers to hospital managers is that they are making difficult choices.

There is confusion on the one hand as to what these memos actually mean. Many people are struggling to understand what to do. They are continuing to hold job interviews but with no sense of when those jobs can be offered and contracts signed. Some of them are saying they may have to ignore elements of the memo because they simply cannot do without the staff. The Minister's amendment to the motion talks about agency staff. One of the objectives was to cut down on agency staff and management consultancy. It is not possible to cut down on agency staff unless replacement staff are available to work in the public system. The head of the HSE talked about the conversion of agency staff into permanent public servants working for the HSE. That cannot happen now because of the recruitment embargo. There is a lot more in the Minister's amendment to the motion, which I will go through later.

We talk about the reductions in waiting lists. There has been a 1% reduction across all waiting lists. I am not sure whether the Minister is looking for a pat on the back for a 1% reduction but he certainly will not get it from me or from the nearly 1 million people who are on community waiting lists, diagnostic waiting lists and acute hospital waiting lists. On the other elements of the Minister's amendment, particularly the enhanced community piece and the care programme for older people, there is still no statutory home care scheme. Home care services will be affected by this recruitment embargo. If the Minister talks to any chief officer in community services, he or she will tell him that. The Minister and the Government have made a complete mess of funding the health service and a direct consequence of that is this recruitment embargo that will impact on patient care. Unfortunately, that is on the Minister and the Government.

I commend the motion to the House.

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