David Cullinane (Waterford, Sinn Fein)
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1. To ask the Minister for Health when he will end the health service recruitment embargo; when the HSE will publish its pay and numbers strategy; and if he will make a statement on the matter. [19772/24]

David Cullinane (Waterford, Sinn Fein)
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This question relates to the health service recruitment embargo, which, by the way, is a Government-imposed recruitment embargo given that in budget 2024, the health service simply did not get the funding it needed. Will the Minister end that embargo and publish the HSE pay and numbers strategy?

Stephen Donnelly (Wicklow, Fianna Fail)
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I thank the Deputy. On the pay and numbers strategy, that has been authorised, so there should be no issue with it being published. It comes to a little over 1,800 new posts and we are seeking mechanisms to fully roll out safe staffing through agency conversion as well. The net impact will be about 2,300 staff and more staff will be announced as part of the additional €92 million new development funding towards the end of the year. There will be no issue with publishing the pay and numbers strategy.

With regard to the embargo, no more than the Deputy, I have met front-line teams, be they community or hospital teams, and I am very aware the embargo is impacting on them and causing pressure in different ways in teams throughout the country. We have put in place various exceptions, including in emergency care, in intensive care and, on a case-by-case basis, in some other areas. The Deputy will be aware we are also fully honouring our commitments to hiring nursing interns. No embargo has been applied to consultant posts and we are on our way to radically increasing the number of consultants.

Specifically on the embargo, the Deputy will be aware its genesis is not a lack of funding for this year. Rather, last year, a record number of funded posts, about 6,000, were created and the HSE hired well in excess of 8,000 posts, which left more than 2,000 posts that had been either hired or committed to for which there was no funding. Unfortunately, a coarse measure was needed. A graduated approach had been used through the year but it had little effect. I will give more information in my follow-up response.

David Cullinane (Waterford, Sinn Fein)
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We have a growing population and demand in healthcare has increased. When we talked a number of times last year about the deficit that existed in healthcare, the Minister and officials in the Department of Health and the HSE cited two reasons for that, namely, health inflation and increases in demand for services, and the Minister rightly said we were not going to turn away patients. Healthcare demand is what it is, and we have to have the staff and the capacity to deal with that demand. That is the backdrop here. Liam Doran, the former head of the Irish Nurses and Midwives Organisation, INMO, said this week, and he is right, that health service recruitment embargoes never work and cause reputational damage to the HSE.

I have received a number of letters from people over recent weeks. One was from a young pharmacist from my constituency of Waterford, a graduate of a top university who had applied for a role in the health service about which she was extremely enthusiastic and was told she cannot be hired because of the recruitment embargo. Likewise, a student paramedic, who was originally a nurse and went on to train as a paramedic, has been also refused a post because of the recruitment embargo, and when I come back in, I will cite more examples. The embargo does not work and is having an impact on front-line healthcare services.

Stephen Donnelly (Wicklow, Fianna Fail)
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The context for this is important. The Deputy quite rightly referred to the increase in healthcare demand. We have had an unprecedented increase in the number of healthcare workers as well. There has been a pretty extraordinary 24% increase in our health and social care workforce in the lifetime of this Government, or nearly 29,000 more healthcare professionals working in the health services than there were at the start of this Government. It is nearly 10,000 more nurses and midwives, more than 4,000 health and social care professionals and more than 3,000 doctors and dentists. The context for this, therefore, is that there has been a massive increase in the number of staff throughout the country.

Nobody would want to put an embargo in place, but the HSE was hiring so many people and it was not responding to a more graduated approach such that, ultimately, thousands of healthcare workers for whom there was no funding from the Government were being hired by the HSE. Unfortunately, therefore, a coarser measure, the embargo, was required. We do not want it to be in place and I am working with the Government to resolve it as soon as I can.

David Cullinane (Waterford, Sinn Fein)
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It is not a coarse measure; it is the wrong measure. It simply is wrong and I think Deputy Donnelly knows that as Minister for Health. We cannot seek to improve services in the healthcare system if a recruitment embargo is in place. The Minister cited the exemptions, which I accept are in place for final-year graduate nurses and hospital consultants, but all the other posts are not exempt. The HSE sought €20 million for the national cancer strategy for 2024; it got zero. There are a range of posts that need to be filled in that area, such as radiologist and radiation therapy posts, none of which can be filled. There are also many vacancies in mental health care and we have heard from advocate groups in that area, but again the embargo is presenting a challenge there. Approximately 100,000 children are in need of dental screening and, again, they cannot get their appointments because of a lack of staff. The Minister will have seen the letter I received from the HSE, which clearly states the recruitment embargo means it cannot hire the dentists it needs. There are pressures throughout the healthcare service, therefore, but there is now an embargo, wrongly imposed by the Government, that needs to be lifted, and I am asking the Minister to lift it.

Stephen Donnelly (Wicklow, Fianna Fail)
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The embargo is simply a mechanism that was required for an organisation that was hiring staff it had no money or sanction to hire. If a school principal started hiring teachers he or she had no money to hire, the school would be told immediately to stop hiring because it had no sanction to hire the teachers and no funding had been allocated for their salaries. The school would be told it simply needed-----

David Cullinane (Waterford, Sinn Fein)
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We are training these people.

Stephen Donnelly (Wicklow, Fianna Fail)
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-----to stop hiring teachers, and it is the same in this case. Unfortunately, we had a deeply frustrating situation where the HSE had hired thousands of people. The central controls within the HSE failed. The HSE, as soon as it saw it was coming anywhere near its funded target for the year, should have identified that. Had it done that, no such measure would have been required.

I fully acknowledge the frustration for our front-line workers. I meet them every week and hear their frustrations, and we are working to resolve the situation. I would have greatly preferred if the graduated approach had worked but, unfortunately, the HSE continued to hire at a level we had never seen.