Recruitment of vital healthcare staff such as hospital consultants, speech and language therapists and physiotherapists may now grind to a halt as a result of the HSE's latest hiring ban.
In addition, patient groups are concerned about the prospect of hospital services running out of money this year as their deficits spiral, with further bed cuts and service closures looming.
The new HSE jobs ban will lead to serious concerns about the maintenance of frontline care in hospitals.
The HSE, in a bid to deal with a potential financial meltdown this year, has announced that it is to pause recruitment to all but critical vacancies only.
As first revealed on irishhealth.com yesterday, the health executive is currently €170 million in the red, with the deficit set to grow considerably unless corrective action is taken.
It has stated bluntly that while it would be allowed within its agreed employment levels to recruit replacement grades exempt from the 2009 recruitment moratorium, 'these posts are not affordable.'
Under the 2009 recruitment freeze, grades such as consultants, therapists, psychologists and emergency medical technicians (EMTs) were exempt from the hiring ban.
Subject to certain conditions and restrictions, these posts could be sanctioned where they became vacant or where additional frontline posts needed to be created.
The creation of additional consultants was regarded as important in light of the policy to change to a consultant-provided hospital service,
Hiring EMTs was regarded as necessary to support future hospital reconfiguration, where it was planned to move emergency department services from smaller to larger hospitals, as in the the recent move of services from Roscommon to Galway.
There will now be considerable doubt about these initiatives and about the future provision of frontline care as a result of what is now an almost complete ban on hiring.
The HSE, which buried the announcement of the new recruitment ban on a relatively obscure section of its website yesterday, has yet to clarify which critical posts may be exempt from the latest ban and under what circumstances.
It has yet to be clarified whether the new ban will just apply to vacant posts formerly exempt from the moratorium or whether in future only a limited number of newly-created posts can be filled.
Services were already reported to be stretched very thinly as a result of the non-filling of staff vacancies, such as in nursing, that were not exempt from the 2009 moratorium. Health unions had said frontline care was already being affected by the existing moratorium.
Concern will also be expressed about the future provision of services currently being reorganised, such as cancer care.
Stephen McMahon of the Irish Patients Association said what is now facing the healthcare system makes former Minister Harney’s declaration of a state of emergency in our EDs look 'more like a tea party compated to what faces us in the coming months.'
"The stark reality is, if a hospital runs out of cash, it cannot pay staff, pay suppliers and of crucial importance, it will cease treating patients.”
Mr McMahon said patient impact statements must be conducted by all budget management teams who are considering cutback options, in order to to minimize effects on any patients.
Red more on the HSE's financial crisis here
Cut down all those management staff and their high spend on transport, meetings.
There seems to be no end to that, you can never save money as long as you are top heavy