Doctors warn new HSE recruitment strategy poses ‘significant risk’ to patient safety

Doctors warn HSE staffing restrictions could threaten services as Cork and Kerry ED visits rise

A new Department of Health recruitment strategy has been criticised by doctors as posing “a clear and significant risk to patient safety”.

Under the new recruitment process, any of the six HSE health regions that exceed their designated pay budget by 2% must explore productivity gains before hiring new staff. The measures require hiring managers to consider whether work can be delivered differently or by using existing staff.

The controls come into effect as the Department of Health seeks to rein in a ballooning HSE overspend. The HSE had overspent by €781m by the end of September, with the figure expected to exceed €1bn by the end of the year.

Matthew Sadlier, president of the Irish Medical Organisation (IMO),  said the recruitment strategy amounted to “a de facto recruitment freeze”.

“Not only does the measure in isolation place unrealistic and prohibitive barriers on doctor recruitment, but it comes against the backdrop of a department setting wholly inappropriate budgets and in a health system that does not have nearly enough doctors to meet ever-growing demand,” Mr Sadlier said.

“Waiting lists will continue to grow until we have a sustainable and funded workforce, which means patients will be denied timely care.

“With this measure, the reality is that there will be no new services and no expansion of capacity, with the current level of services under threat. It is obvious that the Government's aim is to reduce the number of people delivering care, not increase them.”

Pressure on healthcare staffing

The six HSE healthcare regions previously had autonomy to make their own budgeting decisions as part of a move to decentralise Ireland's healthcare system. Four regions — South West, Dublin South East, HSE Dublin and Midlands, and West and North — are now under central management after exceeding their budgets.

Mr Sadlier said the spending controls had been introduced as the health service sought to rebuild its depleted workforce.

He argued that 6,050 consultants were needed to meet the population’s healthcare needs. There are currently 4,945 whole-time equivalents, he said, with 20% of posts not filled on a permanent basis.

“It is wholly unacceptable that, when a consultant leaves or retires, time must now be wasted making an unnecessary case for their replacement,” Mr Sadlier said.

“We need rapid turnover of doctors throughout the system to ensure patients are not adversely affected by natural attrition.” 

Hospitals warn of growing pressure 

Hospital management has also repeatedly called for increased staffing despite the overspend. 

In a widely publicised letter in August, CUH manager Jennifer Kearney said the hospital was “unsafe” amid growing patient demand and warned that the coming winter could put severe strain on the hospital.

A new internal report showed that emergency department presentations in Cork and Kerry had increased by 10% over the previous year.