The Government decision to put a ceiling on the number of staff that can be employed in the health sector has been sharply criticised by the new chief executive of the Health Service Executive, Prof Brendan Drumm, who said the measure was actually driving up costs.
He said the "crude measure" had to be challenged by all within the service.
"There is no doubt that all of us in the health service see the staff ceiling as being a remarkable structure or control to put in place. We accept 100 per cent within the HSE that it is actually driving costs within the system rather than controlling costs," he said.
It made no sense, he added, as it resulted in costly agency staff being employed instead of full time staff being recruited. This was putting up costs in a service for which he now controlled the purse strings, and he believed if he balanced his books even with 5,000 extra staff, it should not be a concern for Government.
"It was a crude measure I suspect put in place that nobody had thought through. It's one that is being challenged by me and has to be and I think everybody in system has to challenge it, not on the basis that it's there but on the basis that it's costing more," he said.
Prof Drumm was speaking at the annual conference of the Irish Association of Directors of Nursing and Midwifery (IADNAM) in Tullamore, Co Offaly, yesterday. The issue had been raised by IADNAM's president, Barbara FitzGerald, in her address to delegates.
"The negative impact of clinical staff ceilings on service delivery and the quality of patient care is evident across all services and is the single greatest deterrent to service development and the delivery of safe patient care. There is an over-reliance on agency staff to fill vacancies wiped out by the introduction of the staff ceiling in 2002, and to provide cover for staff taking statutory entitlements such as maternity leave," she said.
She urged Prof Drumm to give the issue urgent attention.
Meanwhile, Prof Drumm told the conference he believed the State was "massively equipped with hospital beds". He said the Republic was over-equipped with hospital beds by international standards and the focus needed to be on treating people in the community rather than in hospital beds.
"The focus in this country on hospital beds is quite an amazing thing but let me tell you this country is massively equipped with hospital beds. By any measure this country is actually over-equipped with acute hospital beds by international comparisons. We have more acute hospital beds than Britain has. Britain has 17 per cent of its population over 65, we have 11 per cent of our population over 65 and 60 per cent of your beds are taken by over 65-year-olds," he said.
"Quoting to me the need for beds without controlling it for the age of the population is bizarre," he said.
Prof Drumm also gave some further details of his reform plans. He plans to have four rather than 10 hospital networks and, in addition, plans to have a range of "national care groups" to look after issues such as cancer care, child health, maternity services and so on.
The groups will be representative of doctors, nurses, other professionals and patients in each area and they rather than "outside consultants" would define policy for the HSE, he said. In addition, if there was a problem in one area they would go in and sort it out.