Worrying financial times for healthcare

The recruitment embargo within the HSE has cast a huge shadow over the healthcare initiates to be funded under Budget 2024

The week before the Budget was announced, news broke that the Executive was to pause all applications for new and replacement manageial/administrative positions due to financial overruns.

At a briefing following Budget 2024, the Minister for Health Stephen Donnelly intimated the embargo would be extended.

This was confirmed two days later, on Friday 13 October, when the details of a memo sent by HSE Chief Executive Mr Bernard Gloster were revealed.

According to the memo, no new staff will be recruited next year except for approximately 2,000 posts where pre-existing commitments have been made. Plans to recruit an additional 7,000 staff will not proceed, Mr Gloster stated.

While consultants and GP trainees are exempt from the embargo, it will apply to NCHDs.

The IMO issued a release shortly after the revelations were made, stating it was “appalled” by the decision.

Dr Rachel McNamara, Chair of the IMO NCHD committee, said: “This recruitment freeze flies in the face of safe staffing levels. It will add to the chaos in a system which already does not have enough doctors to deliver safe patient care, where many teams across the country are not fully staffed and where NCHDs are still working illegal and unsafe hours.”

“It is astounding that this decision could be made at this point in time. Even in the depths of austerity there was no recruitment freeze on medical professionals as it was recognised that delivery services had to be prioritised.”

According to IMO President Dr John Cannon, the HSE previously acknowledged

to the Organisation that a further 800 posts were required so that working hours could be reduced in line with the NCHD agreement reached in December 2022.

“They are now quite simply abandoning their own legal obligations as an employer,” Dr Cannon said.

The financial difficulties facing the HSE were not a secret. At the joint Oireachtas health committee meeting at the end of last month, Mr Gloster confirmed the Executive would likely have a deficit of approximately €1.1 billion at the end of 2023. It has also been reported that the HSE is frustrated with next year’s Budget allocation of €22.5 billion. Following the Budget 2024 announcement, the IHCA drew attention to the fact that this figure is €916 million below the opening allocation for 2023.

The HSE was already suffering a recruitment and capacity crisis before these developments. And the news of the embargo is especially troubling as the health service braces itself for the difficult months of winter. How did this situation come to pass? Questions need to be asked about financial oversight within the HSE and the Department of Health. But they also need to be asked of the Government. Given the plans to build capacity under Sláintecare, the hope was growing that the Government had finally accepted healthcare in Ireland has suffered historically from a lack of adequate funding. However, if Budget 2024 is any indication, this hope has been misplaced.