17 October 2013
Question (Deputy Jerry Buttimer)
To ask the Minister for Health and the HSE to provide details of the number of administrative staff employed by the HSE, the changes in numbers each year since 2002, if a review has been conducted on the role and function of all administration positions.
Prior to the establishment of the Health Service Executive in 2004, the public health service comprised health boards and a large number of agencies funded directly by the Department of Health or the Eastern Regional Health Authority.
The number of management / administrative staff employed in the public health service (now the Health Service Executive and HSE-funded agencies) was 14,471 WTE (whole time equivalent) in December 2001. The number rose to 18,421 WTE in June 2007 before decreasing by 15.7% to 15,513 WTE in June 2013.
Of the total staff coded under the staff category of management/administration, close to 79% are at grades lower than Grade V and include grades IV, Clerical Officers, telephonists, supply officers etc, most of whom are operating in front-line services, directly engaging with the general public, e.g. Outpatient departments, Emergency Departments, Primary Care Centres, or in direct support of clinicians in their service delivery.
86.60% or 13,434 WTEs of the total 15,513 WTEs are in Acute Services, Primary & Community Services, Children & Family Services, Ambulance Services and Health & Wellbeing.
The remaining 13.40% or 2,079 WTEs are in functions without which front-line services could not operate, e.g. Payroll, Corporate Finance, Corporate HR, National Shared Services across the range of corporate services, including ICT, Estates, Procurement, and national planning and management
The attached graph Appendix 1 (included) and table 1 Appendix 2 (included) illustrate the reduction in management / administrative staff as the number of employees in other disciplines increases.
When the various disciplines of employees in the public health service are compared, it should be emphasised that any distinction between the ‘front line’ and management / administrative staff or between ‘front line’ and ‘back office’ hides the realities in the provision of health services to the public. No Consultant can operate efficiently without diagnostics or a secretary to schedule care. No hospital can operate without a manager to look after budgets, staff and buildings. No Public Health Department can prepare for emergencies or plan for a flu pandemic nor can any of our services exist without recruitment or payroll. These staff are critical for the functioning of these services and the organisation.
Taking that into account, total employment levels across the health services have reduced by 11,877 WTEs since they peaked in September 2007 to a recorded level at the end of July 2013 of 100,894 WTEs. This brings employment levels back to those last seen in early 2005, despite significant new service developments and a range of formerly independent agencies being subsumed into the HSE. These agencies – with their WTE impact – are listed below:
- Post Graduate Medical/Dental Board – 8.80 WTEs
- National Crisis Pregnancy Agency – 14 WTEs,
- National Cancer Screening Service – 258 WTEs
- IBTS – MUH – 5 WTEs
- Office of Tobacco Control – 3 WTEs
- HRB/RCSI – 25 WTEs
- National Council for Nursing & Midwifery – 7 WTEs
- Former ‘Subsidiary Companies’ (ECW, EVE Holdings, Tolco, APT) – 341 WTEs
- Children’s Advisory Board – 4 WTEs.
- Total – 665.8 WTEs
During the period since 2007, permanent approved Medical Consultant posts have grown by over 30%. Targeted grades within the staff category of Health & Social Care Professionals have all recorded significant increases during this time, albeit in some cases from relatively low bases; Occupational Therapists increased by 92.8%, Physiotherapists by 59.75%, Speech & Language Therapists by 69.9%, Social Workers by 48.3% and Psychologists and Counsellors by 46.9%.
In 2007 a review was commenced of management / administrative levels however it was superseded by controls on staffing arising from the Government moratorium on recruitment. Since 2007, a combination of the four staff categories of Medical/Dental, Nursing, Health & Social Care Professionals and Other Patients & Client Care moved from a combined 71.8% of the workforce to 74.8% as recorded at July 2013. This reflects a shift in the public health service workforce as the proportion of staff focused on patient and client care increases. In parallel, the two categories of Management / Administrative staff and Support Staff have reduced from 28.2% to 25.2% of health sector employment. Over 40% of overall health service staff reductions since 2007 have been from these two categories of staff.
Annex 1: A Graph of the numbers of management and administrative staff employed in the HSE, 2001 – 2013
Annex 2: Employment levels – 2004* to July 2013 – By main staff category
* Establishment of the HSE on 1st January 2005