Terence Flanagan (Dublin North East, Independent)
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409. To ask the Minister for Health the number of individuals in the various management grades in the Health Service Executive; the changes and recommendations that have been made to him regarding making changes in this area; and if he will make a statement on the matter. [46130/14]

Leo Varadkar (Dublin West, Fine Gael)
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The total numbers employed in management grades in the Health Service Executive stood at 3,031 at the end of October 2014. The vast majority of these (2,183) are employed at middle management level which includes those working in supervisory roles. The numbers of employees working in management grades has reduced by close to 6% since September 2007.

The distinction between the ‘front line’ and management or between ‘front line’ and ‘back office’ hides the realities in the provision of health services to the public. No consultant will operate efficiently without diagnostics or a secretary to schedule care. No hospital can operate without a manager to look after budgets, staff and buildings. No public health department can prepare for emergencies or plan for a flu pandemic, nor can any of our services exist without recruitment or payroll. Staff have to be recruited, managed employed and paid. Patients have not only to be treated but they must also be cared for in clean and maintained surroundings, be fed and transported.