Louise O'Reilly (Dublin Fingal, Sinn Fein)
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2. To ask the Minister for Health the reason there has been a persistence with a recruitment embargo in the midst of a recruitment and retention crisis in the health service; and if his attention has been drawn to the fact that persons who were offered jobs are now being told that the positions are no longer available [20932/19]

Louise O'Reilly (Dublin Fingal, Sinn Fein)
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The question hardly needs explaining because it is quite simple. In the context of a recruitment and retention crisis, ever-escalating waiting lists and a seemingly endless budget for agency staff and the national children's hospital, why has an embargo been placed on the hiring of staff in the health service? It was wrong when such an embargo was implemented by the then Fianna Fáil Government - I fought the move at that time - and it is equally wrong now in light of the ongoing recruitment and retention crisis.

Simon Harris (Wicklow, Fine Gael)
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I thank the Deputy for this important question. To clarify, I would not describe what is happening as a recruitment embargo in the health service, nor did the new director general of the HSE do so in his first memorandum to his HSE leadership team, which I read about this morning. The issue can be accurately described as individual hospital groups and community health organisations across the HSE needing to live within their allocated budget. It should not be seen as a radical concept that when the House passes a budget which allows for the hiring of a certain number of additional staff, hospital managers and others are expected to live within those budgets. Where individual hospital groups or CHOs have not submitted staffing plans in line with their budgets, certain measures and controls regarding recruitment have been put in place. If a hospital or CHO puts a plan in place that is in line with its budget and the plan is approved, it can conduct recruitment but if it has not bothered to produce a plan it cannot simply make up its recruitment plans willy-nilly.

The HSE will proceed with filling approximately 2,000 additional approved and funded development posts. These are posts that Members of the House voted to fill through the service plan. It will mean extra nurses, doctors and therapists. However, the reason the HSE decided to introduce these measures relates to the high level of unfunded recruitment in 2018. Many Members were rightly critical of significant cost overruns in the health service in previous years and of the impact overruns have on other things we may wish to do. The director general has pointed out that this is for a period of three months, which ends next month. Posts that have been approved in line with development posts for which there is funding are being filled, but one cannot have a situation - and it would not occur in any other Department or agency - where people are hiring staff with no relationship to the budgetary reality which Members of this House have given them.

Louise O'Reilly (Dublin Fingal, Sinn Fein)
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It is like déjà vuall over again. The Minister's predecessor when Fianna Fáil was in government did not call it an embargo either, but we all know that is what it was. I am little shocked. The Minister will state that he pays hospital managers very well, but they simply have not bothered to submit a plan. They are his words, not mine. He is happy that there are people at a very high level in the health service, earning very high wages, who are not bothered to do parts of their job. That is wholly unsatisfactory. We are spending €300 million per annum on agency staff, so staff are still coming in but via the most precarious and expensive route. They are not being employed permanently. Nobody is suggesting that there is no need to have sensible and controlled budgets. However, the budget that is out of control is that relating to agency staff. Clearly, these staff are needed. The managers who cannot be bothered to do some parts of their jobs, as the Minister indicated, are hiring staff and doing it in an ineffective and expensive way. The Minister must make a decision at some point. Will services be cut back? Will he be honest and tell people the services that will have to be cut or will we be in a position to offer people full-time, permanent jobs when there are full-time permanent vacancies being filled by expensive agency staff?

Simon Harris (Wicklow, Fine Gael)
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I agree with the Deputy on the need to tackle agency staff. That is why in the new deal we have with nurses and the new nurses contract both I and the Irish Nurses and Midwives Organisation, INMO, believe that the new measures will help reduce a dependency on agency staff and help to recruit and retain more nurses in full-time, permanent posts. That is the view of the union that has just accepted the new nurses contract. We are hiring additional staff and will hire approximately 2,000. My record on increasing front-line staff in the health service should not be misrepresented. When I was appointed Minister for Health, 109,124 people worked in the health service. Last March, the figure was 118,984. That included 346 additional consultants, 501 additional registrars, 1,124 additional nurses and midwives, 188 additional personnel in the ambulance service, 110 additional psychologists and 599 additional therapists. We are increasing the number of staff every year. However, when the House provides a budget and when we tell a hospital or a CHO that it has a particular staffing budget for the year, there must be a situation where there is a plan within that budget, not with figures that do not match the budget. Otherwise we will get into a very difficult situation.

Louise O'Reilly (Dublin Fingal, Sinn Fein)
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The Minister is putting words in the INMO's mouth. He knows well that what it stated-----

Simon Harris (Wicklow, Fine Gael)
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I was at its conference.

Louise O'Reilly (Dublin Fingal, Sinn Fein)
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-----was in the context of hiring full-time staff to replace agency staff, but that is not happening. I can give the Minister examples - I have engaged with the HSE on this - of young nurses who were living in England who came home and want to work here. After receiving letters of offer, they spent weeks waiting and they are now considering returning to England because they cannot get permanent contracts. There is a need for these nurses and the hospital managers are bothered to recognise that need, but in the meantime they are paying agency staff to fulfil that role. There is a recruitment embargo in place and its result will be an escalating spend. The Minister cited his record of increasing staff. What is increasing, in fact, is the spend on agency staff. That is not decreasing and the reason is that the staff are not being converted from agency staff to full-time, permanent staff. It is costing more money per hour. The Minister and I know that, yet a young woman will return to England next week. She had a letter of offer but she will return to her job in England. Quite frankly, she feels the NHS wants her to work there and does not feel that the HSE wants her here.

Simon Harris (Wicklow, Fine Gael)
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One cannot describe a situation where we will hire 2,000 additional staff this year as a recruitment embargo. An embargo suggests that we are not hiring any more people. In other words, that we are stopping recruitment. We are not doing that; we are going to hire 2,000 more people. However, what we are expecting hospital groups and CHOs to do is something that every other public service agency, every Department and certainly every other business and private sector employer does, which is live within their budget. The House votes on the budget and debates and passes the service plan. When it leaves this House it must be delivered across the country. We are offering full-time jobs. At the INMO conference last week, I was able to offer, for a third year, every graduate nurse in the country a full-time, permanent job in the health services. That will help, with the new conditions, to reduce the number of agency staff. That is what happens over time. We were unable to do that when I was appointed Minister, but we have been able to do it now.

The measures that have been put in place by the HSE, which I believe are sensible, will end at the end of next month. It is an important period if we are to ensure we have more resources to spend on the delivery of more public services this year, which we all want.