CUH staffing tensions persist amid calls for 'honest conversation' on health funding 

Health minister pushes back after Cork University Hospital staff and management unite to press for reform — while Ifac highlights its earlier article about 'bad budgeting' of health spending

Anomalies in the way CUH staffing levels are calculated — with some personnel double counted and others recorded as on duty when working elsewhere — are among the issues staff and management have raise with the HSE. File picture: Denis Minihane

Tensions over staffing levels at Cork University Hospital (CUH) continue this week despite the health minister trying to talk down the problems. Amid the furore, the Irish Fiscal Advisory Council (Ifac) has indicated that “bad budgeting” could be part of national health overrun issues.

In Cork, anyone who attended the hospital over the summer will have noticed the pressures. Staff raised alarms and, last week, chief executive Jennifer Kearney wrote to her bosses in HSE South West again.

The Tipperary woman was appointed last year, coming from over 20 years in the health services. She is believed to be well-respected by staff at all levels.

“We should not wait for a patient safety incident to demonstrate that the current position is unsafe,” she wrote bluntly.

It is probably no surprise to hear unions calling for more workers, but less common to see managers and staff singing from the same hymn sheet.

People will see an echo of the unity shown at University Hospital Limerick (UHL) when staff at all levels came together to press for reforms there.

In her letter, Ms Kearney questioned staffing limits and hiring processes.

She questioned how the absence of over 200 people on maternity leave or long-term sickness leave is recorded at national level.

Leave and cover staff both 'on duty'

It is understood that if ‘Nurse A’ is on maternity leave and ‘Nurse B’ is hired as cover, both are recorded as actively working.

Staff working at UCC 'on duty' at CUH

In other cases, consultants work hours at other HSE hospitals but are recorded as full-time in CUH. Some consultants teach at University College Cork but their hours are recorded as all CUH.

Doctors hired some months back will only start work next Monday, according to the CUH consultant staff committee. Shortages are also understood to affect non-medical staff, including switchboard operators.

HSE rebuffs claims

However, HSE South West management is not buying the concerns. They argued instead that the hospital has the equivalent of 258.67 people over limits.

Funding rose to €626m this year, up from €377m in 2021. However, it is understood to face an overall year-end deficit of €69m.

HSE regional executive officer Dr Andy Phillips answers to HSE chief executive Anne O’Connor.

This region, like others now under Tier 3 financial restrictions, must clear spends of over €10,000 with her.

Minister defends HSE approach

Health minister Jennifer Carroll MacNeill defended the HSE’s approach on RTÉ yesterday.

“Should every hospital be given every resource that it ever asks for?” she asked.

“How can I say yes to that and also answer the charge of the Ifac that health must stay within its pay budget in particular? We have to manage.”

Ifac comment on health spending

This week, Ifac (the Irish Fiscal Advisory Council) said: “Health spending is higher than budgeted in the first seven months of the year. This is largely predictable.”

It estimated a likely overrun in health of €600m in its pre-budget statement.

It noted that this year’s budget was set at “almost exactly the same level” as 2025.

“This is despite a growing and ageing population, which means more demand for health services,” it said.

Ifac 'bad budgeting' article

The statement highlighted an article it published in May by senior economist Killian Carroll which suggested failures to control spending are only part of the story.

“In health, and especially in hospitals, budgets have repeatedly been set as if the previous year’s actual level of spending did not happen,” he said.

Mr Carroll said of recent hospital overrun data: “Part of this reflects bad budgeting.”

People working in health and disability sectors have called for multi-annual funding to better funnel money to the public.

However, Labour Party health spokeswoman Marie Sherlock said this is debated every year with little sign of change.

“We’ve had at least three or four years where there’s been a failure to properly budget for health,” Ms Sherlock said.

“There are huge issues around the capital budget, and there’s the reality — there’s been a failure to factor in rising demand for our health services.”

She said there is a “particular sensitivity” to these issues being raised for Cork and Kerry in light of safety concerns much debated at UHL.

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She acknowledged increases in staffing at CUH, but said key posts have been open for some time.

“A hospital will always look for more, and of course the minister has finite finances,” she said.

She called for “an honest conversation” around health funding in the run-up to the budget in October.