Staff issues could hit service safety - HSE

The HSE has admitted that the current recruitment freeze in the public service and other factors could damage its plans to deliver safe services this year.

The health executive, in its service plan report, identifies the recruitment moratorium as a key risk which could scupper its service plan and calls the recruitment freeze "effectively a process of unstructured downsizing."

It also warns of the consequences of the current deteriorating industrial relations situation in the health service and has said it will implement change where necessary without the agreement of the health unions.

In the service plan for 2010, now approved by the Minister for Health and published today, the HSE admits that there were a number of risks which could impact on its delivering planned service levels while trying to live within its budget of €14.07 billion for this year.

The HSE report says the moratorium results in an inability to replace some key staff needed to maintain safe continuity of services.

The HSE says it will address this risk on a site-by-site basis by reconfiguring and redeploying staff.

"However, our capacity to maintain safe services at the 2009 levels in all faciliities will be significantly impacted by firstly the number and type of our staff that have left the organisation and those that choose to retire or leave the organisation in 2010 and cannot be replaced, especially in nursing and care staff, and secondly the practicality of redeploying staff," the report says.

The HSE also warns in the report of the the level of early retirements  on service planning.

It points out that the retirement arrangements made in the recent Budget means that public servants who retire this year will not be affected by the public sector salary cuts and this means more staff than normal may retire in 2010.

The HSE says as it has to pay statutory lump sums to those over 55 who retire and to pay their recurring annual pensions from within its own budget, this may create a higher than expected cost for the organisation.

It warns that service levels may need to be adjusted if a higher number than the target figure of 1,500 retire this year.

The service plan report also warns that 2010 will be challenging and implementing the plan will depend on considerable changes to the way services are delivered and how health sector staff work.

However, it says the current industrial relations environment, in which unions are withdrawing their cooperation with reform, including with redeployment will impact on the pace with which these necessary changes can be introduced during 2010.

"Moreover, unless the industrial relations environment provides for greater, rather than less, flexibility in terms of working hours and rostering, a reduction in service in some locations is inevitable."

The report states that while it will continue to work with the unions, where agreement cannot be achieved, it has a responsibility to implement change where it is clear that the needs of patients and clients require this to happen.

The service plan also states that there are risks to services as a result of the reduction in nursing levels and the requirement that one experienced nurse is required to leave to accommodate two student nurses for most of the year.

The HSE says there are also problems over the requirement to reduce HSE staff by 1,600 futher in 2010.

"How this reduction is achieved in a controlled manner, where no voluntary redundancy scheme is in place, poses significant risks to the delivery of safe and appropriate levels of services.

It says an incentivised early retirement scheme, if introduced, will assist in meeting this target but will not contribute enough in 2010.

The HSE service plan report also warns that trends in medical card and other demand-led schemes are difficult to predict and could pose a risk to the HSE budget if demand grows beyond targeted levels.

The service plan also warns that the requirement under EU law to reduce junior doctor working hours poses risks in terms of the capacity to continue to operate acute services in all existing sites.

It says there is also a question mark over the capacity to provide safe services in hospital sites with low numbers of junior doctors and/of consultants. A growing shortage of junior doctors has been reported recently.

The service plan states that should surpluses arise during the year in one area of spending it will firstly be applied against deficits in other areas.

See also: 'HSE plan to reduce admissions'

[Posted: Mon 08/02/2010]