David Cullinane, Sinn Féin’s spokesperson for health, brought to the Dáil’s attention last Thursday a case involving a nurse who, despite undergoing training to become a paramedic, found herself unemployed due to hiring limitations within the health service. He also mentioned a young pharmacist who fell victim to the same employment freeze. Cullinane, serving as TD for Waterford, pointed out that while there are individuals eager to contribute their skills, the health service faces an enormous backlog in patient treatment due to insufficient staffing.
Cullinane also emphasised the numerous roles, including radiology and radiation therapy positions, that remain vacant. He noted how the current employment embargo is curbing the ability to staff the mental healthcare sector adequately. He also highlighted that approximately 100,000 children in need of dental screening are unable to secure appointments due to the shortage of medical personnel.
Health Minister Stephen Donnelly displayed great frustration at the ongoing staffing issue. Despite record health budget allocations, and the addition of around 30,000 more health care providers since the Coalition government took office in 2020, staffing limitations continue to cause disputes. These disputes are reminiscent of the austerity period more than ten years ago.
Donnelly countered criticisms by stating that the number of employed nurses and midwives has increased by approximately 10,000 since his time in office. However, the annual nurses’ conference this week is expected to feature harsh criticisms of hiring restrictions and how they are negatively impacting patient care.
The Minister has approved over 1,800 new roles for the current year. However, several replacement hires are being hindered due to what is being labelled a “standoff” between his department and the Health Service Executive. This standoff primarily arises from the ripple effects of the previous year’s recruitment decisions.
Donnelly acknowledged that last year saw the creation of a “record number of funded posts”—around 6,000—in the health service. Nevertheless, he insisted that the HSE overstepped and hired over 8,000 individuals, resulting in more than 2,000 posts that were either filled or pledged without proper funding.
Donnelly claimed that the HSE’s internal control mechanisms had “failed”. The Health Service Executive, antagonised by these allegations, appears to feel the sting of such accusations.
It is known that earlier in the past year, the department prompted the Health Service Executive (HSE) to hasten its hiring process. It was estimated that about 13,300 new staff would be required when accounting for different health service plans from the past few years.
During the previous autumn, it came to light that the department instituted an official limit of approximately 6000 on the number of new appointments for the annum, a figure that the Health Service Executive regarded in its 2023 service plan as the utmost number that could be supplied by the labour market.
Despite this limit, certain sectors within the health service are of the belief that the hiring efforts earlier in the year resulted in much greater personnel being added than initially planned. As a tactical response to the controversy, the HSE purportedly broadcasted that there would be no ambiguities for the current year. Apart from some exceptions, replacement jobs or positions unrelated to new developments would not be fulfilled unless they fall under the “employment top line number” approved by the Minister, as stated in an annual report referred to as the pay and numbers strategy.
However, this strategy still hasn’t received approval due to ongoing dialogues between The Department of Health, HSE and presumably the Department of Public Expenditure, about the future of approximately 2,000 jobs filled last year without funding approval. In the light of no agreement reached, it is believed that a proposal paper has been submitted to the leaders of the three coalition parties.
The current administration has seen a 24 per cent surge in health and social care staff numbers, but the Health Service Executive is unable to appoint large numbers without proper financial backing or approval.
Ministers will likely have to consider whether to provide retrospective funding for an additional 2,000 positions from last year or to uphold a hiring freeze until the officially authorised HSE workforce aligns with the actual number of employees. Alternatively, they could opt for a gradual resumption of recruitment.
In the interim, trade unions will continue to denounce the hiring ban, and competent healthcare professionals waiting for employment, as brought up by Cullinane last week, will have to remain patient.