Some parts of the health service are experiencing difficulties as a result of the dispute over the HSE's hiring of agency nurses at reduced rates.
Meanwhile, the HSE says it is likely to seek sanction for the relaxing of the recuitment freeze on permanent staff replacement in order to reduce reliance on agency work and overtime.
Nursing unions have advised agency members not to work for the new lower pay rates for agency work that came into effect today as part of a HSE cost-cutting drive in its procurement of services.
Agency staff are being used in large numbers to fill in for staff vacancies resulting from the recruitment moratorium, where vacant permanent nursing posts are not being filled.
However, from this week, major cuts in agency nurse pay have been implemented, which have moved pay rates below those of permanent nurses. There is now evidence that some agency nurses are complying with union advice and are not taking up agency posts at lower pay rates.
Dave Hughes, Deputy General Secretary of the Irish Nurses and Midwives Organisation (INMO) said its view was that the HSE intended to continue to increase its reliance on agency nurses employed at lower pay.
Today it has been reported that 14 of the 16 agency midwives due to work at Cork University Maternity Hospital made themselves unavailable for duty and the nursing unions say there has been particular disruption to services in the midlands and north-east, where there is often a heavy reliance on agency nursing.
Cavan Hospital announced today it has had to cancel some non-emergency admissions due to the dispute.
Talks on the dispute are due to take place on Wednesday under the aegis of the implementation body for the Croke Park agreement.
Meanwhile, the HSE has said is is considering whether exceptions can be made to the recruitment moratorium so that agency or overtime hours can be reduced through the employment of additional nurses remunerated at permanent staff entry level.
However, Mr Hughes said if the HSE was serious about circumventing the moratorium in this way and reducing reliance on agency work, it would have implemented this prior to filling vacant posts with agency nurses at lower pay rates.
The HSE, in a PQ reply nearly two weeks ago to Deputy Kathleen Lynch, now a junior health minister, said it was seeking Department of Health and Finance approval to allow for exceptions to be made to the recruitment embargo for the filling of nursing vacancies.
The health executive says it spent €69 million on agency nurses last year. It wants to generate up to €40 million in savings on agency staff in a number of different staff areas this year.
The HSE, in the Dail reply, said the previous agency nursing rates were agreed between the INMO and the agencies and it had no input into pay rates, which, compared to permanent staff rates, had remained unchanged in 2010 despite the pension levy and pay cuts in the public sector.
It said this had meant that the rate of pay for agency nurses was at approximately the 9th to 10th point of the staff nurse salary scale, with hourly rates of up to €28 and all agency nurses paid the same regardless of their experience.
Under the new agency rates, nurses qualified for more than two years get paid at the minimum point of a new reduced pay scale while more experienced staff will get paid at the fifth point of the existing permanent staff pay scale.
In addition, previous premium agency payments for midwives, coronary care staff and other specialist nurses are being removed, as are higher payments for 'twilight shifts'.
So is there a lack of nurse jobs at the moment? Are there any specialties that have more jobs available than others? Hope to get some help on this.