Mary Butler (Waterford, Fianna Fail) | Oireachtas source

I thank all those who spoke on the motion for their views. First, I reiterate what the Minister, Deputy Donnelly, said regarding the value we must place on all staff working in the health service. They are the people working tirelessly on a daily basis to provide care to those most in need, whether in their own home or in an acute or residential setting.

As highlighted by the Minister, recruitment across the HSE has been incredibly strong in 2023. The HSE workforce is at its highest level. To give some perspective on the level of growth seen in recent years, I can advise that 23,263 additional staff have been recruited since 2020. That is an increase of 19.5%. It is 6,808 nurses and midwives, 3,388 health and social care professionals, 2,633 doctors and dentists and 3,334 staff in patient and client care. In fact, the years 2020, 2021 and 2022 saw the biggest staff increases since the HSE was established and 2023 has continued on that trajectory. Each additional staff member hired has had an impact and contributed to an improvement in services throughout the country. The expansion of our workforce in recent years is a very positive thing for the public who use our services and for our staff working in them.

Ireland now has the highest life expectancy in the EU, as determined by the World Health Organization. We were also formally recognised as the first age-friendly country in the world in 2019. These are remarkable achievements and they are to be celebrated. We know Ireland has a rapidly ageing population. The Government’s priority is to support people to age in their own home and communities for as long as possible. To enable this, we continue to invest heavily in community-based services and deliver what I think of as the important triangle of supports, namely, day centres, meals on wheels and home care. Of our vital day centres, 323 have reopened following Covid. Earlier this year, I announced increased funding for day centres and to expand the meals on wheels network, which provided approximately 2.5 million meals to more than 54,000 people throughout the country last year. I also secured increased funding for these in budget 2024.

Improving access to dementia supports continues to be a key priority for me. Every day, there are at least 30 new cases of dementia, each of which has a direct effect on the families involved. I am proud to say we recently saw our 50th dementia-specific day care centre open following the pandemic, working with the Alzheimer Society of Ireland. Day care is an important support for many people with dementia and their families. Since 2021, vital funding is in place for in-home dementia day care for people who, for a variety of reasons, cannot attend a day care centre. Some 18% of all new home support hours are now ring-fenced for people with dementia.

As well as increased clinical services, we now have 29 dementia advisers throughout the country to provide crucial support around a diagnosis and to help people to continue to live well with dementia. In the budget this year, I also secured new funding for weekend activity clubs for people with young onset dementia. This is just a sample of what delivery on the ground looks like. Regardless of the temporary pause in recruitment, there is no service cut despite recent budget challenges. There is no intention to cut services.

However, it is important to state the health sector must operate within a budget each year and all services must be carried out within this allocation. This ensures that although the health service continues to function effectively, it must be managed in a measured and sustainable way in the context of spending. We must ensure we continue to operate an effectively managed health service into the future and that the funding provided is used in as appropriate and efficient manner as possible. All contracts offered will be honoured. People are still coming on board every day because these contracts have been going through the system. There is a cap but this is not a cut.

For context, I will outline examples across the HSE where recruitment targets have been exceeded. For example, the HSE has gone over its recruitment target for the management or administrative staff category by 343 staff this year. In the medical and dental staff category, 792 staff have been recruited but it was funded to 500. It has exceeded its target by 292 staff already this year. Acute services, for example, had a year-end recruitment target of 3,400 staff. By September 2023, it had hired 3,751 staff. This means it has exceeded its year-end target by at least 351 staff this year. It is clear from these numbers that, in reality, many areas of the HSE have been recruiting far more staff than they are funded for, and this simply cannot be allowed to continue uncontrolled. We are criticised for having a runaway budget but when the chief executive of the HSE tries to roll in the budget, we still get criticised. It is important to note, however, that if a contract was offered, accepted and issued, the individual who accepted the post will be in a position to take up the job. There are also a number of exemptions relating to disability front-line and residential posts, as the Minister of State, Deputy Rabbitte, outlined. These exemptions have been set out to the relevant chief officers. The measures are only in place until the end of 2023. The Government has made a further commitment to an additional net workforce growth of approximately 2,268 whole-time equivalents in 2024, which includes mental health.

It should be noted the Government has put significant funding into the health sector, with €22.5 billion having been allocated to the health budget for 2024. The additional allocation to the Department of Health in budget 2024 is nearly €2 billion. This includes an increase of €808 million in core current funding, slightly more than €1 billion in non-core current funding and an additional €120 million in capital funding.

The Government’s job is to ensure the significant investment in recruitment in the health sector in recent years is being consolidated and that staff are now being deployed appropriately to the most impactful areas of the health service to benefit patient needs.

See this speech in context