An increase to the maximum number of people employed by the Health Service Executive, outlined by Stephen Donnelly to the organisation’s board late last year, would not be enough to head off proposed industrial action by more 80,000 staff, according to a senior union official.
The outgoing Minister for Health, in a letter to HSE chairman Ciaran Devane, said the budget for current expenditure at the organisation in 2025 would be €23.7 billion, with an additional €1.44 billion to be provided for capital spending.
He said almost half of the current expenditure – €11.666 billion – would be earmarked for pay costs. The number of whole-time equivalent (WTE) staff the HSE would be permitted to employ would be capped at 133,257, an increase of about 3,500 on the limit set out last July in the executive’s pay and numbers strategy.
The limits in that document were based on the headcount on December 31st, 2023. The “census” carried out had provided a WTE number of 125,420, on top of which provision was made for the addition of about 4,300 posts intended to facilitate new services and the integration of hospice staff from the voluntary sector.
Teenage heroin addict ‘dying before the eyes’ of those seeking to care for him, court told
Enoch Burke’s lonely vigil at the school gate has not been entirely pointless
‘The minute I sat down on the train, I knew I’d been scammed’: Are the Irish susceptible to con artists?
What Ronan O’Gara has done at La Rochelle is exceptional. What comes next will be fascinating
The move prompted an angry response from unions, which said the approach taken had resulted in thousands of jobs which happened to be vacant on that day being “suppressed” or lost.
They also argued the system adopted under the strategy for allocating resources did not necessarily prioritise the most urgent patient needs. The HSE denied this.
The memberships of five unions, including Fórsa and the Irish Nurses and Midwives Organisation (INMO), subsequently voted for industrial action. Those two unions are due to meet next Wednesday to consider how they might proceed given the government formation talks.
In the letter to Mr Devane, sent in November and seen by The Irish Times, Mr Donnelly said the ceiling on pay could be altered only with the prior agreement of the department.
[ HSE told to shift staff working patternsOpens in new window ]
The €11.666 billion figure comprised €8.722 billion for basic pay, €1.048 billion for employer PRSI and €988 million for staff allowances which include weekend, bank holiday and overnight premiums.
In addition, €493 million is provided for staff overtime and €415 million for agency and locum staff. The corresponding agency spend for 2023 was €647.3 million but the target for that year had been €293.9 million.
In his letter to the board Mr Donnelly said that with regard to the agency and overtime allocations “all reasonable efforts should be made, without compromising patient safety, to ensure that the spend in these areas is lower than the above ceiling amount”.
The instructions provided are intended to feed into the HSE’s service plan for 2025, which is due to published this month.
The proposed increase of just over 3,500 to staff numbers is intended to cater for new services and so, the unions say, will not address the issues behind their decision to take industrial action.
“What happened with the pay and numbers strategy had the effect of wiping clear at least 2,000 existing nursing posts,” said senior INMO official and chair of the HSE group of unions Albert Murphy on Friday. “That’s core to the dispute we’re having.”
He said the meeting next week would be to assess the situation with regard to the dispute but “at the moment we have nobody to negotiate with because we have no government”.
- Sign up for push alerts and have the best news, analysis and comment delivered directly to your phone
- Join The Irish Times on WhatsApp and stay up to date
- Listen to our Inside Politics podcast for the best political chat and analysis
