David Cullinane (Waterford, Sinn Fein) | Oireachtas source

That recruitment embargo was put in place by the head of the HSE. I did not interrupt the Minister. I have my time. The Minister can dispute what I am saying but it is indisputable. The HSE said there was a need to contain costs. He sent communications to the health service that he was putting in place a recruitment embargo with very limited exceptions relating to final-year nurses and hospital consultants, but across a whole range of other grades, we had a recruitment embargo. The Minister will also know that the Irish Nurses and Midwives Organisation has said that because 2,000 nursing posts were vacant at the end of 2023, on 31 December, those posts are now vanished and gone. We are hearing the same across a range of other grades too. The Minister talked about radiation therapists. SIPTU told us last week that there is a 30% shortage in these grades. That has been the case for some time. There is equipment in cardiac services that is not being properly utilised because they do not have the staff.

This is an example of the inefficiencies in healthcare that we talk about. We cannot and are not recruiting the staff needed to make the best use of expensive equipment that exists in the healthcare system because of either an embargo on the one hand, or limited and curtailed recruitment on the other. I will get to what the Minister said about additional staff who have come into the health service in a moment. The Irish Cardiac Society was before the health committee today. It referred to significant workforce issues, including an embargo on filling vacant positions since October 2023. It gave one recent example where novel services to manage patients in the community were partially suspended because of the embargo. It also gave examples of where cardiac physiologist posts are only at two thirds of where they were four years ago. There are vacancies in these posts in hospitals up and down the State. The Irish Cardiac Society made the point that we have cardiac equipment that is not being properly utilised because we do not have the staff. It specifically mentioned the recruitment embargo but also a suppression of posts.

It strikes me that we have the Irish Cardiac Society, the Irish Nurses and Midwives Organisation, SIPTU, Fórsa, which will be before the Oireachtas committee today, and front-line healthcare staff who want to come and work in the public system all telling us that there is a problem with recruitment, that the embargo is wrong, and about the consequences of this, including in community services, where it is important that we have the staff. The only person who does not accept any of that is the Minister for Health, who keeps talking about all the additional staff who have been recruited. Additional staff have been recruited. I recognise that. Nobody is disputing the fact that the health service has grown but one cannot dispute that an embargo was put in place which caused reputational damage to the HSE, and that thousands of needed posts were suppressed. Funding for those posts is needed to equip the healthcare system for the increased demand.

Today, I got a reply to a parliamentary question to the Minister on agency spending. There was €650 million in agency spending in 2023, up from €300 million in 2019. The figure so far this year, up to the end of August, is €470 million, despite all the Minister's talk about productivity, savings, task forces, and how we would save money and clamp down on waste. Last year, €650 million was spent on agencies and over €150 million of that was on nursing. People look at that and say we are spending hundreds of millions on agency spending which is going up and up every year, yet we have nursing posts that were scrapped, vanished and gone. That is inefficient. It is the Minister's responsibility, which he has to accept. I accept all of the recommendations and proposals in this Private Members' motion from the Labour Party.

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