Colm Burke (Cork North Central, Fine Gael) | Oireachtas source

I thank all the speakers today for contributing their views on this matter. I reiterate what the Minister, Deputy Donnelly, said in respect of the value we place on all the staff working in our health service. These are the people working tirelessly daily to provide care to those most in need right across the country. The Members here went through each of the hospitals in their own local areas. I am very much familiar with the hospitals around the country and the challenges they face.

As highlighted by the Minister, recruitment across the HSE has been incredibly strong over the lifetime of this Government. To suggest otherwise ignores the unprecedented level of investment in recruitment in the health service, which the Minister has set out. In fact, since 2020, we have seen the biggest staff increases since the HSE was established, with 23% growth. Each additional staff member hired has had an impact and contributed to an improvement in the services across the country. The expansion of our workforce in recent years has led to a reduction in waiting lists and in overcrowding in our health service.

While the increase in our workforce has brought benefits for staff and patients, it is important the HSE operates within its budget. The pay and numbers strategy ensures workforce growth is managed in an affordable and sustainable manner, with prudent controls in place to meet our fiscal responsibilities.

Under the new regional structures, the health regions and national services have been provided with their own staffing allocations in which to operate. Each regional executive officer can prioritise recruitment and replacements within their approved numbers, as appropriate. This ensures autonomy is devolved, thus removing any obstacle to normal recruitment and replacement in the workforce. This new operational model enables service areas to prioritise service provision and maintain financial controls within each region. Service areas can also reprioritise, should they wish, and remain adaptive within overall national policy and guidance.

Regarding our cancer services, I acknowledge the incredibly important role radiation therapists play in the provision of cancer services. I am pleased to say that an independent review of radiation therapist profession has recently been finalised. I accept there are radiation therapist vacancies across all radiation and oncology centres. The radiation therapist review was established to help address issues of recruitment and retention. These vacant posts are still available to be recruited for and posts are being advertised. In addition to recruitment and retention, this strategic review considered important issues such as career development and strategic workforce planning for radiation therapists. This important review has published 16 recommendations which aim to help and support radiation therapy provision into the future and overcome the current challenges faced by the service. An oversight group has been established to oversee the progression of these recommendations, driving long-term improvements for the radiation therapist profession and thus enhancing cancer care outcomes.

Another crucial area of growth has been in our National Ambulance Service. Since 2019, investment in National Ambulance Service, NAS, has increased by 37%, or €63 million, with a HSE national service plan, NSP, allocation in 2024 of €231 million. This growth in funding has seen total staff numbers rise to 2,363 as of the end of August 2024. This represents a staff growth of 430 or 22% since the end of 2019. In line with the constant developing healthcare needs of its patients, the National Ambulance Service is in a process of strategic reform to position itself as a dynamic and agile mobile urgent and emergency care service. This process of reform has been supported by a substantial increase in investment in recent years to provide for additional front-line staff and modernised fleet and equipment. In the recent budget announcement, the Government committed to increasing capacity in the NAS with an overall allocation of €280 million for the service in 2025. This includes €8 million for new service development posts, which will further increase the number of staff in the National Ambulance Service.

In budget 2025, funding of €2.841 million was secured for the new development measures for new posts for the children's disability network teams to cover 20 senior grade and 20 staff grade therapists, 20 therapy assistants and 15 psychologist training placements. The funding will also facilitate the continuation of the assessment of need waiting list initiative to enable the procurement of private assessments for long-waiting families. While recruitment and retention of staff is a challenge across the sector overall, a significant priority for the Government is filling vacancies within the 93 CDNTs. The HSE national recruitment service continues to explore a range of options to enhance the recruitment and retention of staff in CDNTs, including sponsoring student training in return for a commitment to work in the HSE; developing an apprenticeship programme for social workers in conjunction with Tusla and UCC, with 12 apprentices commencing in the 2024 academic year and a further 12 in 2025; supporting the grow our own bursary programmes for graduates in health services in the health sciences to train in the UK as health and social care professionals and return to work in the HSE; and launching an international recruitment campaign for health and social care professionals to supplement the national pool.

With regard to recruitment going forward, the Minister, Deputy Donnelly, has set a target of doubling the number of student places across health-related professions to increase the supply of staff needed to meet the demand for health services. There has already been a significant increase in the number of student places in recent years. Last year alone, more than 660 additional student places were provided in the higher education sector on health-related courses. This includes more than 200 student places across nursing, midwifery and allied health professions in Northern Ireland. The Government has also allocated funding in 2024 and 2025 to support the infrastructure for increased availability of clinical placements to match additional student training. That is extremely important with regard to the placements.

Overall, it should be noted that the Government has put significant funding into the health sector, with a budget of €25.8 billion allocated for 2025. The Department of Health's additional allocation in budget 2025 is almost an extra €3 billion. This includes €5.5 million for the roll-out of advanced practitioner nurses in healthcare and social care services, and €2.1 million for additional training places and 209 internship training places for student nurses.

The Government's job is to ensure the significant investment in the health services is responsibly managed and leads to better results for patients through the appropriate recruitment and employment of staff. The new regional structure delegates authority to REOs, allowing them to assess the needs in their respective areas and recruit as required within their budgets. The Government believes that this is the most efficient means of maintaining an adaptable and responsive health service in line with the vision of Sláintecare, a vision that has cross-party support. In summary, I reiterate the pay and numbers strategy is not a recruitment moratorium. In fact, it is an expansionary document and includes 4,210 additional posts for new developments and initiatives in 2024. The Government has provided extensive funding for recruitment, both in this year and next, our healthcare workforce will continue to grow and provide safe staffing and the delivery of quality healthcare.

Going back to the radiation therapists, I was involved in that over the past 18 months as regards increasing their numbers. It is not only about increasing the number of places that are in the hospitals but also increasing the number of places in our universities. Trinity College Dublin, which has a four-year course, has proposed to increase the student intake numbers from 30 to 50. UCC which has a two-year masters course, has proposed to increase the student intake numbers from 12 to 24. I am glad to report that will now progress in 2025. I would like to have got it through in time for the academic year starting in September 2024. It was not possible but that has now been resolved and I hope we will have more people in training. Efforts will be made to make sure all of the posts that are currently vacant are filled within a very short timeframe. That is the target at present.

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