Dáil debates

Tuesday, 3 November 2020

Ceisteanna Eile - Other Questions

HSE Staff

7:50 pm

Photo of Bernard DurkanBernard Durkan (Kildare North, Fine Gael)
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85. To ask the Minister for Health the extent to which he remains satisfied regarding the adequacy of staff at all levels throughout the health services; the degree to which he has identified staff shortages at consultancy, nursing, general practitioner or other levels; his plans to address these issues in the short and medium term; and if he will make a statement on the matter. [33482/20]

Photo of Bernard DurkanBernard Durkan (Kildare North, Fine Gael)
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This question relates to the extent to which the Minister has examined the need for vacancies to be filled at various levels throughout the HSE, with particular reference to the need for adequate permanent staff to deal with all exigencies that arise in the future.

Photo of Stephen DonnellyStephen Donnelly (Wicklow, Fianna Fail)
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I thank the Deputy. Covid-19 has greatly increased pressures on the health service and staff have shown incredible strength and care in their duties. Several initiatives were undertaken to staff the necessary expansion of the workforce and these have facilitated an expansion of 4,292 whole-time equivalents from the end of February to the end of September of this year.

While this increase was necessary to deal with the pandemic immediately, a larger and more permanent expansion of the workforce is necessary and is under way. This expansion will support the resilience of the services but also ensure our healthcare system is resourced to meet the longer-term healthcare needs of the population.

Shortages exist across disciplines, including at consultant, nursing, midwifery and allied health professional levels.

Budget 2021 has provided funding for up to 15,738 additional posts in the HSE, above what was funded for 2020. That is inclusive of the posts identified in the winter plan. The funding will provide for a permanent increase in the size of the public health workforce, with a focus on front-line staff. The Government is committed to the ongoing roll-out of the framework on safe staffing and skill mix for nursing by the HSE in hospitals and has committed to further funding for the initiative in 2021. Specific increases in supports for general practitioners in rural practices and practices in urban areas of deprivation will help make general practice more sustainable and a more attractive career option for doctors.

This level of recruitment is ambitious, as Deputy Kelly pointed out to me previously in the Chamber, and there will be challenges faced by the HSE. Irish graduates are attractive in the global market. They are very well trained and highly sought after. The HSE is working to develop a recruitment plan that will ensure the Irish public health service is recognised as one of the places in which people wish to work. However, there are always challenges in recruitment. I am committed to supporting the HSE to find solutions to these challenges and to ensure our health service is adequately staffed to manage the pressures we will face in the coming months and years.

8:00 pm

Photo of Bernard DurkanBernard Durkan (Kildare North, Fine Gael)
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I thank the Minister for his comprehensive reply. Is he satisfied that progress to date is sufficient to reassure him that there will be adequate resources available to his Department to meet future challenges, including the normal challenges as well as the Covid challenges? Is he satisfied that the recruitments sought already have been taken up by the HSE to the extent necessary?

Photo of Stephen DonnellyStephen Donnelly (Wicklow, Fianna Fail)
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As to whether the resources are enough, the budget provided for the biggest increase in health spending we have ever had. That would hold true even if one stripped out the Covid funding. What we are funding next year is very ambitious. We are funding the biggest increase in acute beds, ICU beds, community beds and workforce in a single year. I think we are pushing the limits of implementation, to be honest. We have sufficient resources in terms of funding in the budget. The real challenge now is that I, the Government, the Department of Health and the HSE work together on implementation. What has been laid out in the budget is very ambitious but, given the waiting lists and the needs of patients, we must be ambitious and try to push the implementation as far as we can. Step 1 was the formulation of the plan, much of which was informed by Sláintecare. Step 2 was to get the budget in place and step 3 will be implementation.

Photo of Bernard DurkanBernard Durkan (Kildare North, Fine Gael)
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Comment has been made regarding the availability of staff who answered the Be on Call for Ireland initiative and are available and ready to take up duties but have encountered delays. I understand there are logistical issues. Will the Minister assure the House that these offers will be taken up at the earliest possible date? In the event of there being an inability in the early stages to appoint people to full-time positions, will they be appointed to part-time positions while awaiting approval for the posts in question? Has the Minister examined the extent to which such a measure could and would augment the staffing levels in the first instance and, second, prepare for any challenges in the future?

Photo of Stephen DonnellyStephen Donnelly (Wicklow, Fianna Fail)
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In terms of the figures in respect of the Be on Call for Ireland initiative, when one narrows down the number who applied to the number deemed to have the relevant qualification, then to those who answered the follow-up, then to those who went through the interview process and finally to those who successfully interviewed, one moves very quickly from a very large number to a far smaller number. I have discussed the matter with the HSE and heard its chief executive explaining on the record that when it moved through all of those steps in the process, it ended up with a far smaller number than all Deputies had hoped for, given the very high number of people who applied.

On the recruitment process, I do not think the current recruitment process works. It is too centralised, bureaucratic and slow. It is probably too expensive as well. It means that people who are ready, willing and able to take up some of these 16,000 jobs are being asked to jump through too many hoops. Some of them walk away because they get better offers. One of the things I wish to do is to work with the HSE to improve and speed up that process while maintaining the quality controls because it is clear that we need a better and more responsive recruitment process.