The Health Service Executive has fallen spectacularly short of its target of cutting agency staff costs by 50% this year, as the actual spend is set to top the €219m spent in 2011.
Failure to reduce the “unaffordable reliance” on agency staff, as outlined in the HSE’s 2012 National Service Plan, adds further pressure to a health service running a €399m deficit and in need of a supplementary budget. The average monthly cost of agency staff to September this year was €18.3m.
Yesterday, former junior health minister Róisín Shortall said it made “no sense” to encourage an exodus from the health service under an incentivised early retirement scheme if posts then had to be filled with agency staff.
More than 3,500 staff left the health service earlier this year under the incentivised scheme.
“It is much more expensive to bring in agency staff,” said Ms Shortall.
“The idea of letting several thousand people go in the exit package and then continuing to spend large amounts on agency staff makes no sense. The Programme for Government commits to a lower-cost model for healthcare. The model used at the moment is the most expensive.”
The HSE has forecast spending €220m on agency staff this year, more than double what it intended, and flying in the face of the 50% reduction it described as “critical” in 2012.
Agency spend was highest on nurses. The estimate to the end of the year is €87.6m on nursing staff, €54m on care assistants and porters, €43.9m on doctors, €24.8m on paramedics, and €9m on central support.
Deputy secretary general of the Irish Nurses and Midwives Organisation, Dave Hughes, said agency nurses cost, on average, 33% more than permanent staff, including substantial Vat and commission paid out.
However, the ban on recruiting permanent staff meant agency staff were being used to fill vacancies because the demand was there, said Mr Hughes.
He also said the transposition into Irish law of the Temporary Agency Work Directive last year had cost implications. Under the directive, agency staff have equal pay rights with regular workers.
The HSE said controls had been introduced in an effort to make savings, including “tight management and scrutiny of all types of leave and cover supported by more effective rostering arrangements” and considering all possible staffing prior to the use of agency staff.
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