Written answers
Tuesday, 11 November 2014
Department of Health
Health Services Staff
Bernard Durkan (Kildare North, Fine Gael)
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426. To ask the Minister for Health if he is satisfied that adequate staffing levels are being maintained at all levels throughout the public health sector, with particular reference to employment at consultant, medical and nursing levels; and if he will make a statement on the matter. [43255/14]
Bernard Durkan (Kildare North, Fine Gael)
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428. To ask the Minister for Health the extent to which he remains satisfied that adequate staffing levels are maintained to meet requirements in public hospitals throughout all disciplines; and if he will make a statement on the matter. [43257/14]
Leo Varadkar (Dublin West, Fine Gael)
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I propose to take Questions Nos. 426 and 428 together.
Given the budgetary position it was essential that the numbers employed across the public service be reduced in recent years in order to meet fiscal and budgetary targets. However, given the need to ensure delivery of essential services, arrangements have been in place in the HSE to allow the recruitment of staff where it has been established that there is an urgent service requirement. In addition the moratorium did not extend to consultant recruitment and more recently NCHD recruitment was facilitated given the need to progress EWTD compliance. This policy has resulted in overall medical/dental numbers increasing by 700 since the end of 2007. In the current calendar year the fall in nursing numbers has been reversed with an increase of about 150 nurses in the period to from January to the end of September.
In order to mitigate the impact on frontline services of the overall reduction in employment numbers, the priority was and is reform of how health services are delivered in order to ensure a more productive and cost effective health system. The revised working arrangements provided for in the Haddington Road Agreement are a pivotal element in this regard. In addition, while it is necessary to continue to control public sector employment, the focus in 2015 will be on budgetary control,enabling the health services to appoint staff where more efficient and economical delivery of services can be achieved.
Bernard Durkan (Kildare North, Fine Gael)
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427. To ask the Minister for Health the extent to which he remains satisfied regarding the availbility of adequate staffing at primary care level throughout the country; and if he will make a statement on the matter. [43256/14]
Kathleen Lynch (Cork North Central, Labour)
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At the end of June 2014, 4,362 staff were assigned to Primary Care Teams and Health and Social Care Networks. In line with the commitment in the Programme for Government to a significant strengthening of primary care services, the HSE's National Service Plan 2013 provided for additional funding of €20m to support the recruitment of prioritised front-line primary care team posts and enhance the capacity of the primary care sector (€18.525m for 264.5 front-line Primary Care posts and €1.475m to support Community Intervention Team development).
The breakdown of the 264.5 posts by Region is as follows:
| HSE REGION | Public Health Nurses | Registered General Nurses | Physiotherapists | Occupational Therapists | Speech and Language Therapists | TOTAL |
|---|---|---|---|---|---|---|
| Dublin Mid-Leinster | 38.5 | 8.5 | 24 | 12.5 | 23 | 106.5 |
| Dublin North East | 12 | 9.5 | 14.5 | 9 | 14.5 | 59.5 |
| South | 12 | 8.5 | 7 | 18 | 6.5 | 52 |
| West | 9.5 | 14 | 2 | 13 | 8 | 46.5 |
| TOTAL | 72 | 40.5 | 47.5 | 52.5 | 52 | 264.5 |
At the end of October 2014, a total of 232.5 posts (88%) have been filled. A further 4 posts have start dates agreed and the remaining 28 posts are still going through the recruitment process. In addition, 17 WTE Primary Care based Clinical Diabetes Nurse Specialists posts have been recruited, enabling better support and integration of diabetic patients in the community and supporting General Practitioners in the delivery of diabetic care. In 2014, more than half of the total health expenditure on operational services is in the community healthcare sector. The 2014 gross current Budget Day Estimate for the Health Service (including Children and Families) is €13.120bn. Based on the above, the proportion of the health budget aligned to primary care in 2014 is approximately 25%.
The HSE recently published the report, ‘Community Healthcare Organisations – Report and Recommendations of the Integrated Service Area Review Group’, which sets out how health services, outside of acute hospitals, will be organised and managed. Community healthcare services include primary care, social care (involving services for older persons and for persons with a disability), mental health and health & well-being. The establishment of nine Community Healthcare Organisations (CHOs) and 90 Primary Care Networks will see the further reconfiguration of staff to front line integrated services.
I am confident that the resources outlined above along with the implementation of the CHO Report will facilitate the delivery of the Government's commitment to refocus health care away from the hospital setting and into the community, which is an essential component of the health service reform process.
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