5% of health staff should go

An Bord Snip Nua has recommended that 6,168 staff in the health service should be axed in order to make savings of €1,230 million a year. This amounts to more than 5 per cent of the entire workforce.
With health service employees currently at the record level of 111,800 — an increase of 18,804, or 20 per cent, over the past eight years — initial reductions on this scale are the ‘minimum that must be achieved’, Colm McCarthy’s group has stated.

Compulsory redeployment and, if necessary, redundancy must also be considered.
The Group has also recommended that staffing at the Department of Health, currently at 526, should be reduced by 10 per cent a year for the next three years as demand allows. This could save €11 million a year.
The Report of the Special Group on Public Service Numbers and Expenditure Programmes welcomed recent efforts to reduce the spiraling public service pay bill, including the Incentivised Scheme for Early Retirement, the Special Incentive Career Break Scheme and the Shorter Working Year Scheme.
However, it will be necessary to go further than this if the numbers issue is to be addressed effectively, the report stressed.
“Critically, while work efficiencies and redeployment should allow for broad continuity in the delivery of key public services, in other cases full savings will only be delivered where there is a political and public acceptance that the State can no longer afford to continue some services at previous levels, or at all.”
Furthermore, the Group has recommends that staff flexibility and redeployment should be on a ‘compulsory basis’ if necessary, in the best interest of patients. Redundancies would have to be considered to facilitate outsourcing of non-routine services, where these could be delivered on a more cost-effective basis.
Staff representatives did not escape criticism either. The report claimed that ‘restrictive agreements and work practices’ involving trade unions and staff organisations had been a major inhibitor to staffing and pay efficiencies in the health sector, and a ‘block to good quality patient-focused care’.
“The Group considers that such practices have no place in an efficient, modern health system that is operating under severe budgetary constraints, and in which the needs of patients should be a paramount consideration.”
In relation to changed working patterns, the report has recommended that all staff should be required to work 8am to 8pm on a five-day over seven-day basis (i.e. where Saturday and Sunday form part of the normal working week), and that no premium payment should be made to hours worked within that span.
Straying into the clinical arena, the report went on to recommend that the ‘unnecessary demarcation’ between grades that prevents nurses from carrying out routine medical procedures performed by NCHDs and healthcare assistants carrying out routine nursing duties should be removed.
Various semi-state bodies – and even one entire Government Department – were singled out for either the chop or merger. In Health, it is recommended that the Ombudsman for Children be merged with the Office of the Ombudsman, the Health Research Board be integrated into a single stream of science funding and that the Health Insurance Authority merge into the Financial Regulator.