HSE blames Covid and staff retention for spending an extra €70m on agency workers

HSE figures show that up to October, the latest month for which figures are available, spending on agency staff stood at €460m, up from €390m for the whole of 2020. In 2017, the figure was €300m.

The HSE's spending on agency staff has risen by more than €70m so far this year, with the executive blaming the increase on covering staffing shortfalls due to the Covid-19 pandemic.

HSE figures show that up to October, the latest month for which figures are available, spending on agency staff stood at €460m, up from €390m for the whole of 2020. In 2017, the figure was €300m.

The figures were released to Sinn Féin's health spokesperson David Cullinane, who described the sharp increase as "worrying".

Up to October, an additional €11m was spent in acute hospitals, €33m on primary care, and €36m extra on contact tracing, while older persons and mental health services saw spending cuts of €4m and €9m.

In response to Mr Cullinane, the executive said the figures are for HSE statutory services only and are subject to change due to end-of-year audits. At the current rate of spending up to October, the figure will likely surpass half a billion euro by year end.

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The HSE said much of the spend was because of the need to plug gaps created by the Covid-19 pandemic.

"In 2020 and 2021 the HSE sourced additional agency staff primarily to support the expansion of the workforce in response to the Covid-19 pandemic and also to support service delivery and Covid-19 response due to increased staff absence due to Covid-19.

"Due to the immediate nature of the unprecedented emergency, coupled with the additional strain already being felt by the HSE recruitment services, it was necessary to engage outside agencies to assist in this work. Agency contracts are in place for contact tracing staff within the HSE National Contact Management Programme."

The figures show a €14m increase in the cost of agency supports, which the HSE puts largely down to IT and systems. In total, the cost has gone from €6m in 2019 to €20m this year. The HSE says that support agency teams were "engaged within the Office of the Chief Information Officer (OoCIO) primarily to commission the technology for new centres for both testing and tracing and also to support" those staff running the HSELive system.

The HSE said agency expenditure is "under constant review and the reduction and control of agency costs continues to be a particular focus for the Health Service".

However, it pointed out that "in addition to the specific critical response to the Covid-19 pandemic there are a variety of reasons driving agency demand" and said staff retention is a key issue.

"Recruitment and retention of clinical, nursing and other key staff is a constant challenge and impacts adversely on the ability to maintain safe and effective services. The balance between high cost and high risk to service quality and safety is struck through agency and overtime use to provide/maintain necessary services. 

"Agency staffing is also used for the replacement of short-term illness and maternity leave and allows for flexible services designed to meet specific Service User needs, variation in activity and as required where there is a short-term critical service need."

Mr Cullinane told The Irish Examiner that while he accepts the need to quickly employ staff in the pandemic, the ongoing reliance on agency staff was something that must be addressed.

"Obviously Covid means more staff being employed quickly, but the sharp increase is worrying.

"When you look at the outsourcing of healthcare between agencies and other measures, close to a billion euro is gone and that's a huge part of the HSE budget.

"The HSE needs to wean itself off this outsourcing and come back to Sláintecare and public healthcare rather than the short-term solution of outsourcing. We need more investment in the HSE's own facilities and staffing to ensure that this can be done."