Dáil debates

Wednesday, 28 November 2007

Adjournment Debate

Health Service Staff.

8:00 pm

Photo of Joe CostelloJoe Costello (Dublin Central, Labour)
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This Adjournment matter is relevant in light of the recent debate on confidence in the Minister for Health and Children. It concerns a former postman who has lived and worked all his life in Sherriff Street and who is now in considerable ill-health. The only relief he had was a couple of sessions every week with a physiotherapist. However, due to the recruitment embargo on the health services these sessions have been taken away. The man, as I said, has multiple and serious ailments such as Parkinson's disease, hypertension, back pain, ulcerated legs, depression, vertigo and an inoperable hernia. He is on 20 tablets a day. He is in pain most of the time and can scarcely walk. He relied heavily on the physiotherapy sessions he received in the Mater Hospital. Some weeks ago he received notice from the patient services department of the hospital to the effect that the service was being discontinued indefinitely. I took up the case on his behalf and spoke to the patient services department. The reply I received was asfollows:

I refer to our telephone conversation on 20th November regarding the above named patient and his enquiry as to why his Physiotherapy sessions have been put on hold.

I have contacted the Physiotherapy Manager who has advised that unfortunately due to the HSE recruitment embargo on staff we have had to redeploy physiotherapist staff assigned to the provision of out patient services to cover for the care of the older person in patient service.

We regret that this has resulted in patients such as [X] being unable to receive out patient rehabilitation at this time.

All patients impacted by this decision have been personally contacted by the therapist responsible for their care and the situation with regard to the recruitment embargo and need to redeploy this therapist explained to them.

I trust this is in order.

This is just the tip of the iceberg in terms of people who are suffering because of the recruitment embargo. Essentially, the HSE has failed to manage its budget and, running out of money towards the end of the year, placed an embargo on recruitment to various front-line services. The Minister for Health and Children is responsible for ensuring that her policy on the HSE is implemented. She should have some sort of monitoring mechanism in place to ensure that patients do not have to suffer towards the end of the year before the following year's budget is put in place. Large-scale recruitment of management and middle-management has created a bloated bureaucracy in the HSE, and now front-line staff can no longer be recruited in the areas in which they are required.

In conclusion, this is a case in which the patient has clearly not been put first. I would like to see the Minister address this. Obviously, the Minister also needs to address a number of other cases, but in this case the person is in dire need of the services which he has been refused indefinitely.

Photo of Máire HoctorMáire Hoctor (Tipperary North, Fianna Fail)
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I will take this Adjournment matter on behalf of my colleague, the Minister for Health and Children, Deputy Mary Harney. I begin by thanking the Deputy for raising this issue and for giving me the opportunity to outline the current position on recruitment in the public health service.

I stress that the HSE must manage within the resources made available to it by Government and voted by this House. Managing the budget in the health sector means managing staff and making the best use of the available resources. Staff costs make up almost 70% of the HSE's overall budget. In a service of this scale, with an employee cohort of this size, it cannot be the case that every vacancy which arises must be filled immediately.

To live within its budget, the HSE must carefully manage the recruitment and deployment of staff. The board of the HSE is committed to ensuring that staff costs are controlled and managed to best effect, that an appropriate balance is achieved between clinical and non-clinical posts, that there is a better skill mix within the clinical areas and that staffing levels provide cost-effective, safe and high-quality care to patients.

The current recruitment pause is a temporary measure initiated as part of the HSE's financial break-even plan and it continues to be monitored by the HSE. In any instance where a critical or essential vacancy arises, it may be filled through redeployment of existing staff by the relevant line manager or re-assignment of responsibilities based on assessment of priority need.

Notwithstanding this, it has been recognised that during the period of this temporary recruitment pause, there are some circumstances where appointment of staff may be necessary in frontline services. Accordingly, the HSE has put a process in place to evaluate, monitor and approve requests for derogation from the general recruitment pause. A small group has been established, including a representative of the HSE's national employment monitoring unit, the National Hospitals Office, PCCC and other directorates, and this group meets regularly to consider such applications. Of the applications received to date, derogations to the value of 520.8 whole-time equivalents have been approved, where posts have been identified as critical to service delivery.

There are close to 130,000 people employed in the delivery of our public health and personal social services, the vast majority of whom provide direct service to patients and clients. The current pause in recruitment must be viewed in this context. As I have previously stated, it is a temporary measure put in place by the HSE to live within its budget.

Since the establishment of the HSE, the number of medical and dental personnel has increased by 1,087 whole-time equivalents, which equates to 15.5%. The number of nursing personnel has increased by 4,652, or 13.6%, to 38,965. The number of health and social care professionals has increased by 2,932, or 22.9%, to 15,762. I draw Deputy Costello's particular attention to the number of physiotherapists, which has increased by 301, or 26.5%, since the establishment of the HSE. In addition, the number of training places for physiotherapists has increased by 81, from 64 in 1997 to 145 in 2007. This represents an increase of over 126% in the past ten years. The House will agree that these changes clearly demonstrate the commitment of my colleague, the Minister for Health and Children, Deputy Mary Harney, the Government and the Health Service Executive to ensuring focus on patient care and the recruitment of frontline personnel.

Photo of Joe CostelloJoe Costello (Dublin Central, Labour)
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In her reply the Minister of State stated a small group has been established to consider such applications where there are special circumstances. Nobody is aware that there is an appeals mechanism.

Photo of Brendan HowlinBrendan Howlin (Wexford, Labour)
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There is no provision for supplementaries, as Deputy Costello will be aware.

Photo of Joe CostelloJoe Costello (Dublin Central, Labour)
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Nobody is informed that there is an appeals mechanism.

Photo of Brendan HowlinBrendan Howlin (Wexford, Labour)
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That would be a useful parliamentary question.

Photo of Joe CostelloJoe Costello (Dublin Central, Labour)
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Would the Minister of State transmit that to the HSE?

Photo of Máire HoctorMáire Hoctor (Tipperary North, Fianna Fail)
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I will.