The HSE has recruited almost three times more administrative and managerial staff than front-line nurses in the past three years.
As the number of people waiting on trolleys hit an all-time record high of 714 earlier this month, it has been revealed that just 892 extra staff nurses have been hired since December 2014.
Concerns have been raised around a “disproportionate increase” in administrative, clerical, and managerial staff, which saw a jump of 2,603 since December 2014.
In the same period, just 54 extra public health nurses were recruited.
The Irish Nurses and Midwives Organisation (INMO) urged the Government and HSE to tackle the issues of recruitment and retention of nurses, which have a knock-on impact on services for patients, as well as working conditions for frontline staff.
Senator Colm Burke said the HSE is lacking the “checks and balances” to ensure the public is getting value for money in health.
“There appears to be an over-emphasis on prioritising the recruitment of staff in the administration area, while the recruitment of staff in the front line is not being given the same sense of urgency,” he said.
While the total number of people employed by the HSE has increased from 99,327 to 110,975 or 11.54% since the end of 2014, the number of administration and managerial staff has risen 17.21% from 15,113 in December 2014 to 17,705 in December 2017.
In the same period, the number of public health nurses increased from 1,460 to 1,514, a 3.69% increase.
Mr Burke said: “Ireland is one of the highest spenders on healthcare across the OECD per head of population. It is essential that we can deliver healthcare in a cost-effective manner.
“I am not satisfied that a 17.21% increase in administration and management will in any way contribute to the delivery of a better health system.”
INMO general secretary Phil Ní Sheaghdha said many nursing graduates are moving to the UK, where pay and working conditions are better, while nurses already in the system are also leaving to work in other countries where the staff-patient ratio is significantly better.
“There is a huge retention issue,” she said. “We are constantly making the argument that until pay improves, that is not going to change.
“There is a solution and that is to stop the cycle; the only way to do that is to pay on a competitive basis with the UK. They are already aggressively recruiting our young graduate nurses.
“Until we get pay right we won’t get the numbers right and until we get the numbers right we won’t be able to tackle the problem of retention.”
She said an agreement had been made last February to increase the number of whole-time equivalent nurses by 1,224 by the end of 2017, but only around 860 have been recruited.
Ms Ní Sheaghdha said there are just 120 training places for public health nurses each year, resulting in a “cap” on the number that can be employed.
“We are barely forward- planning to cover those who are retiring,” she said.
Before the Oireachtas Health Committee last month, HSE CEO Tony O’Brien said many administration staff help nurses and other front-line workers focus on patient care.
“I made a journey around the health system, especially during the period when there was significant reduction in clerical and administrative posts,” he said.
“One of the key points made to me by health professionals, who were often in short supply themselves, was that what they most needed was someone to lift the administrative burden in order that they could focus more on the direct provision of patient care.”
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