Joan Collins (Dublin South Central, People Before Profit Alliance)
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To ask the Minister for Health if he will confirm that all agency workers in hospital are being paid the agreed rates; and if he will make a statement on the matter. [41010/12]

Gerry Adams (Louth, Sinn Fein)
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To ask the Minister for Health if his Department and the Health Service Executive have carried out an impact assessment of the effect on patient care of the further restrictions on overtime and use of agency staff; and if he will make a statement on the matter. [40998/12]

Bernard Durkan (Kildare North, Fine Gael)
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To ask the Minister for Health the extent to which agency nursing or other staff are now employed throughout the health services; the extent to which such positions could be filled by part-time or whole-time temporary staff; the extent to which cost comparisons have been made in such circumstances; and if he will make a statement on the matter. [41173/12]

Bernard Durkan (Kildare North, Fine Gael)
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To ask the Minister for Health the extent to which school medical examinations remain on target; if any particular health issues have emerged which may require attention in terms of follow up procedures; and if he will make a statement on the matter. [41177/12]

James Reilly (Dublin North, Fine Gael)
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I propose to take Questions Nos. 54, 59, 201 and 215 together.

The cumulative impact of staff reductions from this year and previous years presents a significant challenge for the health system in delivering services. The priority is to reform how health services are delivered in order to ensure a more productive and cost effective health system. The health service faces challenges this year, both in terms of reduced staffing levels and a reduced budget. The 2012 National Service Plan sets out what actions will be taken to address these challenges and to mitigate the impact of the reductions in overall staffing numbers on front line services. These actions include a target for reductions in agency costs.

Agency staff may be used only in the most exceptional of circumstances and when all alternative avenues have been exhausted. Such staff may only be engaged when signed off by identified senior management. In the light of the current serious budgetary situation in the HSE, further instructions concerning reductions on the use of agency staffing were issued by senior management in August this year.

The HSE has provided the following information, as at the end of July 2012, on the average number of staff engaged each week from contracted agencies. This does not included agency staff who are engaged other than through national contracts.

Nursing - 711 WTE

Health Care Assistants - 486 WTE

Doctors 138 WTE

Allied Health Professionals - 261 WTE

Social Care Workers - 115 WTE

Following the enactment of the Protection of Employees (Temporary Agency Work) Act this year, the HSE provided guidance to public service employers on the Act, including the fact that the equal pay provisions of the Act have retrospective effect to 5th December 2011. All agency staff employed through agencies contracted by the HSE have now had their basic pay adjusted in accordance with the Act. The HSE and the contracted agencies are currently making arrangements for the calculation and payment of back money due to agency staff.

The health service must operate with the employment targets set by Government, in line with the Government's commitment to reduce public expenditure. The HSE has also implemented a general pause on recruitment in order to deal with the serious budgetary situation. Decisions on the filling of positions, including whether posts should be filled by directly recruited staff or by agency will be made by the HSE in the context of the need to meet employment reduction targets and cost containment targets. This would include the cost effectiveness of the direct recruited staff compared to agency staff. However, such cost comparisons will depend on the individual grade and the differing costs of using agency staff in that grade, such as the fee to be paid to the contracting agency and VAT.