The cost of hiring agency staff for the country’s hospitals increased by almost 50 per cent between 2021 and 2024, newly released HSE figures show, with some hospitals showing much greater increases.
At Temple Street Children’s Hospital and the Mater, both in Dublin, there were four- and five-fold increases respectively.
The hospital-by-hospital breakdown of costs provided to Sinn Féin’s David Cullinane by the HSE shows a nationwide spend of €379.7 million on the hiring of agency workers, including nurses, other health professionals and administrators, across the country’s network of more than 50 statutory and Section 38 hospitals last year. The latter are facilities run by voluntary organisations on behalf of the HSE.
Recently published HSE accounts covering just statutory services suggest a little over half of the total spend would be on clinical workers.
READ MORE
The overall cost to hospitals of agency staff, the figures show, was up 47.7 per cent between 2021 and 2024, with the preliminary €170 million spend for the first five months of 2025 suggesting the annual spend is set to increase despite ongoing efforts to rein it in.
The highest spend overall in 2024 was the €26.2 million outlay at Mullingar General, while the bills at Limerick University Hospital and the Midlands Regional Hospital Portlaoise exceeded €21 million in both instances.
The greatest percentage increases over the period, meanwhile, were at the Children’s Health Ireland-run Temple Street Hospital, where the spend went from €1.93 million in 2021 to €8.53m in 2024, and the Mater – where the corresponding figures were €3 million and €15.726 million respectively.
There are substantial variations in the scale of and changes to agency spend over the four years across the 54 hospitals for which detail is provided, with Covid, service and facility development all said to be factors.
However, the figures at some of the country’s largest acute general hospitals – St James’, Tallaght, Beaumont and St Vincent’s – all remained relatively stable.
[ HSE to cut travel expenses and agency staff to tackle €218m overspendOpens in new window ]
In a letter to Mr Cullinane that accompanied the figures, the HSE says the “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”.
It says the need can arise for a wide variety of reasons, including absences due to illness and covering vacancies, and that the spend on agency staff arises in many instances despite extensive efforts to recruit staff.
Unions say a freeze on hiring across many roles in recent years has contributed to the increased reliance on temporary workers.
As the HSE comes under continued pressure to keep total spending within budgets, however, it told Mr Cullinane: “There remains work still to do to achieve the level of agency and overtime savings required.”
Commenting on the figures, Mr Cullinane said, “It is completely unacceptable that HSE spending on outsourced staffing is continuing to rise. It is staggering that more than €725 million was spent on agency staffing in 2024, and has not slowed down in 2025.”
The €725 million figure, contained in the HSE accounts, relates to the organisation’s own spend on agency workers across all areas of its operations including non-hospital settings, but does not include Section 38 hospitals.
With more than €2.5 billion spent since 2021 on private agency staffing, Mr Cullinane said it was “incredible that the HSE could consider this wasteful spending to be sustainable”.
“It is no coincidence that agency spending skyrocketed in 2024 after the Government imposed an arbitrary recruitment embargo.
“The Government must mandate real cuts to agency spending. Spending should be converted into directly hired HSE jobs. The HSE has said that savings are possible in this area but it seems that is no political will to achieve it.”
