There are close to 6,000 fewer nurses, doctors and other staff employed in the health service than officially allowed by the Government.
Under its national service plan agreed with the Minister for Health, the Health Service Executive (HSE) can employ a maximum of 136,605 personnel to run State-funded services this year.
However, in a report to the HSE board, its chief executive, Anne O’Connor, said the organisation was “under our current recruitment level by almost 6,000 at the end of May”.
The HSE said on Thursday this gap would close in the months ahead as trainee staff including nurses and midwives moved into regular employment after graduation.
The figures in O’Connor’s report to the HSE board in June emerged this week as management at Cork University Hospital as well as nurses and doctors expressed concern at delays in approving posts and restrictions on recruitment.
The HSE said at the end of June its workforce stood at about 5,600 below the maximum permitted level of 136,605 whole-time equivalent personnel.
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However, it said this variance excluded certain trainee cohorts who were “expected to transition into the workforce upon graduation and, when included, materially reduce the apparent gap”.
The HSE said the workforce limit of 136,605 was never intended to operate as a stand-alone target. “Rather, it reflects the level of staffing that can be supported within the approved financial resources,” it said.
“The primary control mechanism is the total pay budget available, thereby establishing a direct link between workforce capacity and affordability.”
The HSE said workforce numbers represented only one element of overall pay expenditure with “regions and services accountable for managing total pay costs across direct employment, agency staffing and overtime”.
O’Connor told her board that while recruitment was about 6,000 posts below the maximum level, “our workforce expenditure challenges remain in agency [staff provided through employment agencies] and overtime”.
Overall, the HSE recorded an overrun of about €400 million in the first five months of the year although the pace of spending is understood to have reduced since then.
O’Connor told the HSE board she had “centralised control” across recruitment and non-pay expenditure until the system demonstrates it is “well advanced” towards meeting national service plan budgetary targets.
She said clear goals had been set, while “strengthened and more centralised” pay and workforce controls have been introduced “with immediate effect”.
“Overtime reliance will be reduced through improved rostering, workforce planning, attendance and absence management,” she said.
O’Connor added her approval was required for all posts, while all new and replacement positions in the HSE had to be reviewed and prioritised weekly by regional executive officers.
She said there was no automatic replacement of staff who left or were absent.