Hospital Staff.

Tuesday, 27 April 2004

Questions (489, 490, 491)

Conor Lenihan

Question:

547 Mr. C. Lenihan asked the Minister for Health and Children the measures he proposes to take in reducing the level of administrative waste within the hospital sector; his timetable for such reductions; and the timeframe within which he hopes to achieve his targeted reductions. [11462/04]

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Conor Lenihan

Question:

548 Mr. C. Lenihan asked the Minister for Health and Children the number of non-medical staff employed in the hospital services; and the way in which this compares to other European countries. [11463/04]

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Conor Lenihan

Question:

549 Mr. C. Lenihan asked the Minister for Health and Children the growth in the number of non-medical staff employed in hospitals here between the years 1990 and 2004; and the figures or breakdown for each year involved. [11464/04]

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Written answers

Minister for Health and Children (Mr. Martin)

I propose to take Questions Nos. 547 to 549, inclusive, together.

I understand that the Deputy is referring to the number of management and administrative staff employed in the health service generally and in the acute hospital sector in particular. The information requested by the Deputy on employment levels for particular categories of health service staff is set out in the following table. It is important to note that caution should be exercised in comparing growth in numbers employed over the period among the different grade categories, as changes in grade classifications have given rise to a lack of continuity in the data series.

As far as the question of administrative economy is concerned, the Deputy may wish to note that almost two-thirds, 64%, of health services personnel formally classified as "management/administrative" are involved in direct service provision to the public. In fact, it is estimated that only 6% of health services personnel are employed in a purely administrative capacity. It is important to emphasise that these administrative staff work in areas that are critical to the effective running of the health services such as payroll, accounts, financial and human resource management, including training, freedom of information and general management. In this regard the report of the commission on financial management and control systems in the health service, chaired by Professor Niamh Brennan, concluded that there was no evidence to support the perception that administrative staff, rather than those providing a direct patient service, have disproportionately absorbed additional resources allocated to the health service over recent years.

While my Department does not hold comparable employment information for other EU countries, recently published UK National Health Service data indicate that the number of staff employed in administrative grades is broadly in line with the Irish figures on a proportionate basis.

With regard to reductions in health service staffing, the Government decided in December 2002 that the contribution of the health service to the overall reduction in public sector employment should be limited to a total of 600 personnel in WTE terms in the period to end-2005 or 200 staff per annum, in view of the high proportion of health service personnel engaged in front line service delivery posts. Given that the health service accounts for in excess of 30% of overall public service employment, a pro rata application of the Government’s targeted reduction in public service employment of 5,000 would have required an aggregate reduction in health service employment of 1,728 staff in wholetime equivalent, WTE, terms.

Total Health Service employment end-1990 to end-2003

Grade Category	1990	1991	1992	1993	1994	1995	1996	1997	1998	1999	2000	2001	2002	2003	Increase 1990-2003
Management/ Administrative1 — Direct Patient Services2	4,433	4,534	4,647	4,849	5,090	5,269	5,449	5,896	6,320	7,066	8,244	9,810	10,460	10,511	6,078
Management/ Administrative1 — Other3	2,216	2,267	2,324	2,425	2,545	2,635	2,724	2,948	3,160	3,533	4,122	4,905	5,230	5,255	3,039
General Support Staff and Other Patient and Client Care	18,385	18,298	18,377	18,577	19,182	19,558	20,065	20,705	21,973	22,928	25,216	28,645	27,242	27,485	9,100
Health and Social Care Professionals	4,180	4,299	4,395	4,628	5,024	5,345	5,576	5,969	6,422	6,836	7,613	9,228	12,577	12,690	8,510
Medical/Dental	3,994	4,100	4,155	4,310	4,417	4,581	4,684	4,976	5,153	5,385	5,698	6,285	6,775	6,792	2,799
Nursing	24,574	25,118	25,771	26,220	26,839	27,267	27,170	27,346	26,611	27,044	29,177	31,429	33,395	33,766	9,192
Total	57,782	58,615	59,669	61,010	63,097	64,655	65,669	67,841	69,640	72,793	80,070	90,302	95,679	96,499	38,717

Source: Department of Health & Children Personnel Census (31 December)

Note 1: The breakdown of the Management/Administrative grade category into Direct Patient Services/Other is based on analysis undertaken by the Regional Health Board's Directors of Human Resources in October 2001 and has been applied retrospectively for comparative purposes.

Note 2: Management/Administrative —Direct Patient Services are staff who are of direct service to the public and include consultant’s secretaries, out-patient departmental personnel, medical records personnel, telephonists and other staff who are engaged in front-line duties.

Note 3: Management/Administrative —Other are staff in the following categories payroll, human resource management (including training), service managers, IT staff, general management support and legislative and information requirements.

Note 4: All figures are expressed in wholetime equivalents.

of which: Acute Hospital employment end-1990 to end-2003

Grade Category	1990	1991	1992	1993	1994	1995	1996	1997	1998	1999	2000	2001	2002	2003	Increase 1990-2003
Management/ Administrative1 — Direct Patient Services2	1,757	1,856	1,926	2,023	2,157	2,223	2,287	2,523	2,870	3,205	3,541	4,280	4,502	4,631	2,874
Management/ Administrative1 — Other3	879	928	963	1,012	1,078	1,112	1,143	1,261	1,435	1,603	1,771	2,140	2,251	2,316	1,437
General Support Staff Other Patient and Client Care	6,568	6,596	6,708	6,764	6,989	7,061	7,137	7,514	8,102	8,318	8,979	9,979	10,080	10,140	3,572
Health and Social Care Professionals	2,344	2,406	2,483	2,573	2,729	2,785	2,926	3,143	3,533	3,825	4,141	4,764	5,127	5,172	2,827
Medical/Dental	2,678	2,742	2,811	2,886	2,978	3,089	3,165	3,450	3,784	3,989	4,252	4,677	5,061	5,076	2,398
Nursing	12,160	12,348	12,679	12,983	13,416	13,683	13,315	13,764	13,932	14,171	15,666	16,603	18,022	18,141	5,981
Total	26,386	26,876	27,570	28,241	29,347	29,954	29,973	31,654	33,657	35,111	38,350	42,443	45,044	45,475	19,090

Source: Department of Health & Children Personnel Census (31 December)

Note 1: The breakdown of the Management Administrative grade category into Direct patient Services/ Other is based on analysis undertaken by the Regional Health Board's Directors of Human Resources in October 2001 and has been applied retrospectively for comparative purposes.

Note 2: Management/ Administrative —Direct Patient Services are staff who are of direct service to the public and include Consultant’s Secretaries, Out-Patient Departmental Personnel, Medical Records Personnel, Telephonists and other staff who are engaged in front-line duties.

Note 3: Management/ Administrative —Other are staff in the following categories Payroll, Human Resource Management (including training), Service Managers, IT Staff, General Management Support and Legislative and Information Requirements.

Note 4: All figures are expressed in wholetime equivalents.