Health service recruitment targets missed despite ‘unprecedented’ increases in staff, PAC to be told

The health service had “unprecedented” increases in staff but still fell short of recruitment targets in 2021, the Dáil’s Public Accounts Committee (PAC) will be told.

Department of Health secretary general Robert Watt will blame the Covid-19 pandemic and a shortage of health workers around the world for the situation.

He is due to appear before the PAC on Thursday where he is expected to be asked about the controversy over the legal strategy of successive governments for handling claims related to nursing home charges.

Mr Watt is also to face questions about the implementation of the cross-party Sláintecare plan for reforming the health service as well as emergency care and waiting lists in hospitals and the 2021 cyber attack on the health service.

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In his opening statement he is to outline how extra funding in 2021 was provided to recruit “significant extra staff” across the health system.

He will say that 2020 and 2021 saw the “largest annual increases in the workforce since the foundation of the HSE” with a total of 12,506 whole-time equivalents (WTE) hired across those years.

Mr Watt will outline how the total number of HSE staff was 132,323 WTE at the end of 2021, an annual net increase of 6,149.

His statement says: “While these increases in staff numbers were unprecedented, they still fell short of meeting the ambitious recruitment targets for the year, with difficulties experienced, due to Covid-19 and an international shortage of healthcare workers.”

The HSE’s National Service Plan for 2021 projected that there would be 135,655 WTE staff by the end of that year and this target was missed by 3,332.

The PAC will be told that increases were seen across all categories of staff including 1,660 WTE nursing and midwifery roles; health and social care professionals up 1,192 and medical and dental staff up 352, with 150 of these WTE roles at consultant level.

Mr Watt will say that recruitment underspends particularly affected community settings and the savings realised by not reaching recruitment targets were used to offset the overruns on Covid-19 expenditure.

His statement outlines how €1.666 billion was originally provided for Covid-19 expenditure in 2021 but extra costs including an earlier than anticipated roll-out of the vaccine programme saw pandemic-related measures totalling €2.193 billion, some €527 million extra.

Mr Watt’s statement says that increased funding for the health service in 2021 was not just for the Covid-19 response but were also designed to develop extra, permanent capacity.

Funding of €426 million was provided to pay for additional beds including 1,146 acute hospital beds; 66 critical care beds and 1,250 community beds.

Mr Watt says that “while Covid had an impact on some expansion during 2021, most of the planned targets have been met by end 2022, with the plan to deliver on any remaining funded additional bed capacity in 2023.”

On the cyber attack on the health service, the PAC will be told that the HSE incurred costs of €51 million in its immediate response.

He said the impact on the Department of Health was minimised due to the security measures already in place.

A review of ICT controls and countermeasures led to expenditure of just under €1 million.