James Reilly (Dublin North, Fine Gael)
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Question 4: To ask the Minister for Health and Children the steps she has taken to ensure administrative staffing levels within the Health Service Executive will be reduced so that resources will be devoted to front line services; and if she will make a statement on the matter. [22488/08]

Mary Harney (Dublin Mid West, Progressive Democrats)
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I have previously made it clear that I want to see appropriate staffing structures in place throughout our public health service. This includes management structures and front line service delivery. My main aim in management structures is to ensure clarity of roles, responsibilities and reporting relationships to improve the overall governance and management of our health services. The board and management of the HSE have been considering possible improvements in their existing management structures which would optimise their operational or service delivery capacity. These proposals are still being finalised and will be considered by me in the near future.

Separately, the HSE has commissioned a review of its administrative staffing. I understand this review indicates that the HSE is not over-resourced in clerical, administrative and managerial staff compared to Scotland, England, Wales and Northern Ireland. Between December 2004 and March 2008, direct front line service staff in both the HSE national hospitals area and primary and community care have increased by approximately 10% while HSE corporate staff levels have reduced by a similar proportion. A properly planned and managed voluntary redundancy scheme could have an important role in helping to streamline management within the HSE and, as a result, in improving the delivery of health services to patients. Such a scheme would need to be built upon a clearly delineated organisational structure and the associated human resource requirements. It would also need to demonstrate that it will deliver value for money, having regard to other options such as natural wastage and the scope for re-deployment.

Discussions about a possible redundancy scheme are still at an exploratory stage. In accordance with established practice in the public service, any such scheme would operate on a voluntary basis and would require the approval of the Minister for Finance. There would also need to be discussions with the relevant staff associations. This option requires further work but could help deliver significant benefits in terms of a much more streamlined and integrated management structure.

Charlie O'Connor (Dublin South West, Fianna Fail)
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I ask Deputy Reilly to try to stay within his time.

James Reilly (Dublin North, Fine Gael)
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I will do my best. I remind the Minister that she did not read out the full paragraph of the report, as follows: "The external report found that while the number of clerical, administrative and managerial staff compared favourably with those in similarly public owned health services in Northern Ireland, Scotland and Wales, there were too many staff at senior level." These are our famous grade eights of which there were six in 2000 and the last time I asked the Minister there were 714; perhaps it is gone up since then. When the Minister has the information she might tell us the current figure.

The report also said the proportionate number of managers within the overall clerical, administrative and managerial ranks was slightly higher than the UK National Health Service. Would the Minister not agree that at the formation of the HSE she and her Government failed to bite the bullet? They merged 11 companies and promised everybody they would not have to move job and that nobody would lose their job. This was an impossible starting place. As her Government failed to bite the bullet, patients are choking and dying on that bullet.

In the past the Minister has said it would be premature to speculate about the appropriate staffing levels, yet we have report after report after report. How many reports does the Minister need before she takes action? Will she indicate when this much-needed re-balancing in the HSE away from administration and to the front line will take place? Will it be done as a matter of urgency? Has she any time lines by which she can measure it or will it be more fudge and fuddle?

Mary Harney (Dublin Mid West, Progressive Democrats)
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Since I became Minister, 423 fewer people are working in the corporate headquarters of the HSE, 6,000 more people are working in hospitals and 5,600 more in primary care. I could give Deputy Reilly all the percentages across all the professions. One cannot decide in advance of establishing an organisation who should be made redundant. Deputy Reilly knows that.

James Reilly (Dublin North, Fine Gael)
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It can be negotiated beforehand.

Mary Harney (Dublin Mid West, Progressive Democrats)
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The appropriate action is to establish an organisation on a statutory basis, which happened in January 2005, and charge the management and board of that organisation with making decisions on appropriate staffing levels. I repeat that nothing on this scale has ever been embarked on in the public or private sector in Ireland by way of reorganisation and transformation. We are in active discussion. I have had no report on appropriate staffing levels.

Deputy Reilly asked me how many reports I need. The HSE commissioned two reports, one by McKinsey examining the management structure and one examining the clerical and administrative areas. The first report is to hand. The second is being completed with the board of the HSE. I am in discussions with the chairman of the HSE, whom I will meet later with Professor Drumm, around some of these issues to ensure we have the appropriate management structure down the line. At that point we will be able to decide where we need to redeploy people. There are major disparities. That is a hangover from the former health boards.

Many of these famous grade eights were in acting positions under the former health boards. Many are nurses and other professionals who became managers through industrial relations agreements, for example. It is not correct of Deputy Reilly to suggest that a plethora of new people have come in as managers. That is not correct. Many of them have resulted from industrial relations agreements.

The Deputy asked recently at the Committee on Health and Children how many additional ones we had approved in the past year. I understand the answer is one and that the remainder were replacements for those who were moving on, retiring or otherwise. We have approved one additional post in the area of child care. There has been full scrutiny of all these positions in the Department of Health and Children for the past 12 months.

James Reilly (Dublin North, Fine Gael)
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How many have we got? It is playing semantics to say they are not new posts. They are new posts. That has been the whole problem. People are being progressed up through the system into these senior management positions and they have not got——

Mary Harney (Dublin Mid West, Progressive Democrats)
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Some of them are working on the primary care teams——

James Reilly (Dublin North, Fine Gael)
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Where is the——

Mary Harney (Dublin Mid West, Progressive Democrats)
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——or as physio managers, for example.

James Reilly (Dublin North, Fine Gael)
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The Minister's own report referred to an ethos of administration and no ethos of management. She is perpetuating this and refusing to address the issue. Will she tell us how many grade eights there are now?

Charlie O'Connor (Dublin South West, Fianna Fail)
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I will allow the Minister to reply if she can be brief.

Mary Harney (Dublin Mid West, Progressive Democrats)
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I understand there are 700 grade eights

James Reilly (Dublin North, Fine Gael)
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There were 714 the last time we asked the Minister.

Mary Harney (Dublin Mid West, Progressive Democrats)
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That is the same. There has not been any increase. There are actually 710.