Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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Question 4: To ask the Minister for Health the way he is monitoring the effects on front-line services of the departure of some 4,200 staff from the health services up to the end of February 2012; the additional numbers expected to leave the health services during the remainder of 2012; the criteria for the lifting of the recruitment embargo in certain circumstances; and if he will make a statement on the matter. [16564/12]

James Reilly (Dublin North, Fine Gael)
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My Department continues to work closely with the Health Service Executive, HSE, to ensure the contingency plans put in place for both hospital and community services are operating satisfactorily and that all critical front line services continue to be delivered. It is necessary to be as innovative and flexible as possible to mitigate the impact of reduced budgets and staffing. The Government's priority is to reform how health services are delivered to ensure a more productive and cost-effective health system.

Between September 2011 and February 2012, approximately 4,500 members of staff retired from the health service. This figure includes some 800 staff who were not in active service when they retired, for example, staff who had retired on preserved benefits or staff retiring because of permanent infirmity. Since the precise date of retirement is a matter for personal decision by each staff member, it is not possible to indicate the number of staff who will retire during the remainder of 2012. The HSE will be monitoring the level of retirements as part of ongoing management of its resources.

Health sector employment numbers must be reduced to approximately 102,100 whole-time equivalents, WTEs, by the end of this year. Based on the end-2011 outturn of 104,400 WTEs, this requires a net reduction of 2,300 staff. Subject to the achievement of this target and to budgetary constraints, the service may make appointments which are necessary to ensure critical services are maintained and in line with the developmental priorities set out in the national service plan.

I want to take this opportunity to thank all those who work in the health service for ensuring a continuing safe service in our hospitals and elsewhere despite the serious challenges they face.

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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Since I tabled this question we have become aware that the number who left by 29 February had increased to 4,515. That is the figure provided by the chief executive officer of the HSE last week at the health committee meeting. It must not be forgotten that this is on top of the estimate by the Irish Nurses and Midwives Organisation, INMO, that 8,700 personnel have left the health services since 2007 and have not been replaced. Of this figure, 3,500 were nurses and midwives. Of the figure that left up to 29 February on the early retirement scheme, over 2,000 were nurses. That compares with the order of some 400 management and administration personnel. It is significantly kinked towards front line service deliverers.

When the Minister stated in his reply that he is not in a position to indicate or speculate what number may leave the service over the course of the remainder of 2012, I must remind him that one of the service area plans for 2012 actually states a number and uses the language "required to leave the service by the end of this year". This is for the service plans for my area - the north east - and the Minister's as well, Dublin.

Michael Kitt (Galway East, Fianna Fail)
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Could the Deputy frame a question, please?

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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Is the Minister aware that a further 561 departures have been signalled as required in the service plans for the area in which both and I and the Minister live?

While the Minister was very bullish at the health committee meeting last week regarding this, stating everything is fine and everyone has coped wonderfully, there are clear signs that this is not sustainable. Despite the indications of the numbers that will be recruited by special arrangement, the fact remains that we are looking at a serious situation with front line health services.

Michael Kitt (Galway East, Fianna Fail)
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This is a very long question, Deputy.

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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This is my final point which I believe is the core issue. Will the Minister set a date for the lifting of the recruitment embargo? Will he make a clear statement on the floor of the House today that he will lift the recruitment embargo and allow for normal personnel replacements to recommence in the health services?

James Reilly (Dublin North, Fine Gael)
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Not for the first time Deputy Ó Caoláin attempts to confuse the issue. The service plan was written before all the retirements had actually taken place. For him to state now that another 550 odd people will leave Dublin and north-east health services is utterly inaccurate. We have to see how many have already left from that number. As we know, 4,500 - 4,515 to be absolutely precise and the figure I used at the committee – have already left. I am not in a position to say how many of the 550 count among the 4,515, but many do. To suggest that 550 are still required to leave would be misleading.

I have no intention of setting a date for the lifting of the embargo. When considering how many people have left the health service since 2007, one must bear in mind how many joined in the preceding five years, some 25,000 plus or perhaps even more. I do not have the figures before me. At a time when we quadrupled our spend on health and increased the number of personnel working in the sector, we did not reform the service in the manner necessary to deliver care to our citizens.

January 2011 saw the highest number of people, some 569, lying on trolleys since counts began by the Irish Nurses and Midwives Organisation, INMO. I gave an undertaking at the time that the situation would not recur. Thanks to the hard work of front line staff, the special delivery unit, SDU, and the clinical programmes, this has been achieved right through March and in the teeth of extraordinary challenges, for example, the €2.5 billion removed from the health budget in the past three years, the moratorium and the 4,515 personnel who left last month. This situation has not been helped by Deputy Ó Caoláin in this Chamber talking about doom and gloom and the catastrophe and disaster about to befall people, and upsetting those awaiting cancer treatment or the birth of their children. Childbirth should be a joyous event. A certain degree of anxiety is always associated with it but additional anxieties should never be added to it by scaremongering, something that the Deputy has engaged in more than once in the House.

Finian McGrath (Dublin North Central, Independent)
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The Minister is also engaged in scaremongering.

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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It is quite appropriate to say that I am sick of the Minister's balderdash. That is all that he ever employs. He is a big bombast.

Michael Kitt (Galway East, Fianna Fail)
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Could we have a question, please?

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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He was a big bombast on this side of the House and he is no different over there.

James Reilly (Dublin North, Fine Gael)
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Does that make the Deputy a little bombast?

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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The fact of the matter is that the Minister concluded his contribution at last week's meeting of the health committee by stating that he would always be accountable and was quite open to accepting Opposition voices.

James Reilly (Dublin North, Fine Gael)
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That is right.

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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The one thing that he is not able to take is what he was quite prepared to give during his years in opposition. He is a double-sided individual.

James Reilly (Dublin North, Fine Gael)
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What does that make Sinn Féin? It has double standards.

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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The Minister can take any interpretation he likes but the figures I cited came from the HSE's service plan. They clearly indicate what will be further required this year. The Minister is indicating that he is not in a position to project what might happen in terms of a further staff exodus before the end of this year. That is a statement of acceptance of his failure to oversee the health services.

Michael Kitt (Galway East, Fianna Fail)
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Does the Deputy have a question?

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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I will close with this. At times, trying to get any straight answer from the Minister is futile. What methodology is he employing to monitor the impact of the departure of 4,515 personnel? Is it being done on a day-by-day or week-by-week basis? Is the Minister receiving reports? Almost one month later, does he know the impact on the health services of the departure of 4,515 people?

Michael Kitt (Galway East, Fianna Fail)
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The question has been asked. I call on the Minister to reply.

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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Will the Minister give the House a clear indication and explain why he will not set a date for the lifting of the recruitment embargo?

Michael Kitt (Galway East, Fianna Fail)
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Deputy Ó Caoláin, please. The Minister to reply.

Finian McGrath (Dublin North Central, Independent)
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Answer the question.

James Reilly (Dublin North, Fine Gael)
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Unlike the bombast opposite, I take responsibility. I made it my business to travel around the majority of hospitals during the latter weeks of February to ensure that contingency plans were in place and that a safe service could be continued. I am happy to report that during the course of my tour, front line personnel engaged in a major way with the clinical programmes and the SDU in changing their practices. I commend them in this regard. When I met 120 personnel last Friday, I told them that were they to be called anything, it would be "the Impossibles". They make the impossible possible despite all of the challenges they face. More work needs to be done because additional reforms are necessary to fix our health service. It was dysfunctional and grossly unfair and must be turned into a fair and equitable system that delivers for patients on time. It must be somewhere that patients can feel safe and of which everyone working in it can feel proud. This is the Government's goal and it will be done.

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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Is the Minister receiving reports on the impact?

James Reilly (Dublin North, Fine Gael)
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We are constantly monitoring what is occurring in hospitals. We have real-time information, which we never had before. We can now predict problems and take action, which we were previously unable to do.

Michael Kitt (Galway East, Fianna Fail)
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We will now return to Question No. 3 in the name of Deputy Kelleher.