Staffing requirements overall in the health service must be viewed in the context of the substantial increases in employment levels achieved in the health services over recent years. In this regard, the Deputy may note the increase of almost 28,000, 41%, in the approved employment level for the health service between end-1997 to end-2003, bringing the national employment ceiling to 95,800 in whole time equivalent, WTE, terms, excluding home helps. This significant increase in the human resources deployed in the health service has supported substantial increases in the volume of health and social care services provided to the public over the period.
Within the total increase, large increases in employment have been achieved for key health and social care professional staff, including growth of 22.2%, +6,063 WTEs, in nursing personnel, 36.8% more medical-dental personnel, +1,832 WTEs, and over double, 112%, the number of health and social care professionals, +6,971, now employed in the health services. This considerable achievement reflects the success of the steps taken to increase the attractiveness of employment in the health services and the ongoing measures being taken in areas experiencing shortages of fully trained and qualified staff.
Developments such as pay increases, improvements in career structure and enhanced opportunities for professional and career development have all played a part in increasing staffing levels through recruitment and improved retention. The full implementation of the pay recommendations of the public service benchmarking body is expected to reinforce this process. Overseas recruitment by health agencies in specific instances over recent years also contributed significantly to meeting the workforce needs of the health services. The ongoing implementation of these and similar developments will make an important contribution to strengthening the capacity of the health services to recruit and retain the high calibre professionals required in all disciplines to fill challenging and demanding roles central to the delivery of quality health and social care services to the public.
As far as speech and language therapists in particular are concerned, the initiatives outlined in the previous reply referred to by the Deputy have contributed to the increase of 83 WTEs from 399 WTEs at the end of 2001 to 482 WTEs at the end of September 2003. This represents an increase of in excess of 17% over the period, complementing the increase of 13.5%, 345 WTEs to 399 WTEs, which took place over the two year period from end-1999 to end-2001. The continued implementation of the recommendations of the report of the expert group on various health professions, which included new pay scales and career structures, the availability of the fast track working visa scheme and the streamlining of procedures for the validation of overseas qualifications are designed to help sustain the improvements in staffing levels achieved for speech and language therapy services, both at local and national level.
In addition, three new speech and language therapy courses commenced in the 2003-04 academic year in UCC, NUIG and UL. In total, these courses will provide an additional 75 training places in speech and language therapy. This expansion in training numbers was identified in the Bacon report as necessary to meet the long-term demand and supply balance for speech and language therapists in Ireland.
In view of the large numbers of staff employed and the unique nature of the services being delivered in the health service, it is clearly imperative that a coherent, strategic approach to workforce and human resource planning be developed further and aligned closely with strategic objectives and the service planning process. Planning for the development of new and existing health and social services in the future must be soundly based on a robust and realistic assessment of the skill and human resource needs to deliver these services. As highlighted in the social partnership agreement, Sustaining Progress, better skill mix is also of paramount importance in meeting the human resource needs of the health service. Enhanced skills mix by matching skills to service needs benefits patients and empowers health personnel to reach their full potential and optimise their contribution to quality care.
In addition to effective planning to ensure the continued availability of a qualified, competent workforce, it is also necessary for the health service to become an employer of choice to further improve potential for recruitment and retention. The record number of staff recruited into the health service in the past number of years illustrates the progress that has been made in this regard.
Having recruited and developed such a large number of staff over recent years, it is a priority to retain them by offering a challenging and rewarding career path. In the human capital and skills intensive health sector, retention has been identified as a key issue in better people management. The continuing implementation of the "Action Plan for People Management" is playing a crucial role in improving retention and reducing turnover of skilled staff, while providing the opportunity for each member of the workforce in the health sector to maximise their contribution to the creation of a quality and patient centred health service in line with the objectives of the health strategy.
In conclusion, the chief executive officer of each individual health board has responsibility for the management of the workforce, including the appropriate staffing mix and the precise grades of staff employed within that board, in line with service plan priorities, subject to overall employment levels remaining within the authorised ceiling. Hence, the recruitment of health service staff in 2004 will take place in the context of the implementation of each health board's service plan.
