My Department does not maintain records on vacancy levels in the health service. The quarterly health service employment returns compiled by my Department are concerned primarily with the numbers employed in the sector.
The responsibility for the management of the workforce in a given region lies exclusively with the chief executive officer of relevant health board-authority. The management of the workforce includes responsibility for the recruitment of all grades of staff employed, in line with service plan priorities, subject to overall employment levels remaining within the authorised ceiling. However, to improve recruitment and retention prospects my Department has put in place a number of important initiatives to meet the human resource needs of the health services. The implementation of these developments is making 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.
Before setting out these initiatives in detail, it is important to emphasise that staffing requirements overall must be viewed in the context of the very substantial increases in employment levels achieved in the health services in recent years. The Deputy may wish to note there has been an overall increase in the level of employment of 28,658 in wholetime equivalence, WTE, terms since 1997, excluding home helps. This represents an increase of 42% over the 1997 levels. In this regard there are, for example, 1,816, up 36%, more medical-dental personnel, 6,720, up 112%, more health and social care professionals and 6,419, up 23%, more nurses. Caution should be exercised in comparing employment growth between grade categories owing to some changes in their composition over the period. This is a considerable achievement which reflects the success of the steps taken to increase the attractiveness of employment in the health services and also the ongoing measures being taken in areas experiencing shortages of fully trained and qualified staff.
The following table sets out employment growth in the grades mentioned by the Deputy. To provide a valid statistical comparison, the employment figures for end year 2003 have been used in answering this query. Employment data for Q2 2004 is available on the Department's website should the Deputy require to access it. It is expected that data in respect of end year 2004 will be available in March 2005.
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. Overseas recruitment by health agencies has, over recent years, also contributed significantly to meeting the workforce needs of the health services, particularly in professions where qualified staff are scarce. As mentioned earlier, specific human resource initiatives are under way in a number of key areas which have expanded considerably over recent years.
With regard to the therapy professions, the report, Current and Future Demand Conditions in the Labour Market for Certain Professional Therapists, commissioned by my Department, concluded that a major expansion was essential in the numbers of therapists. Significant progress has been achieved in boosting the number of therapy training places in line with the recommendations of that report. In the nursing area, the recruitment and retention of adequate numbers of staff has been a concern of this Government for some time and a number of substantial measures have been introduced in recent years. The number of nursing training places has been increased by 70% since 1998 to 1,640 from 2002 onwards. The promotional structure within nursing, including the introduction of a clinical career pathway has been substantially improved on foot of the recommendations of the Commission on Nursing and the 1999 nurses' pay settlement. The National Council for the Professional Development of Nursing and Midwifery has been especially active in this area and, to date, 1,600 clinical nurse specialist and advanced nurse practitioner posts have been created.
My Department gave approval in late 2003 to the rollout, on a national basis, of the health care assistant training programme. This is in fulfilment of a key recommendation of the Commission on Nursing. The main objective of the programme is to upskill health care assistants so that, working under the supervision of nurses, they are enabled to take on a wider range of duties, thereby freeing up nursing resources to concentrate on exclusively nursing tasks.
I am also conscious that, in view of the large numbers of staff employed and the unique nature of the services being delivered, it is 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 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. The issue of skill mix is also of paramount importance in meeting human resource needs. 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. The Health Service Executive will have a central role to play in the development of an integrated workforce planning strategy for the health sector.
I am, however, well aware that, 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. While the record number of staff recruited into the health service in the past number of years shows the progress that has been made in this regard, even more can be achieved. 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 continued implementation of the Action Plan for People Management has a crucial role to play 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.
Public Health Nurses
Region
|
31/12/1997
|
31/12/2003
|
Change end-1997
to end-2003
|
% Change end-1997 to end-2003
|
Eastern
|
440
|
386
|
-54
|
-12
|
Midland
|
100
|
107
|
8
|
8
|
Mid-Western
|
108
|
135
|
28
|
26
|
North-Eastern
|
106
|
121
|
15
|
14
|
North-Western
|
98
|
123
|
26
|
26
|
South-Eastern
|
154
|
158
|
4
|
3
|
Southern
|
163
|
211
|
49
|
30
|
Western
|
167
|
162
|
-5
|
-3
|
Total
|
1,334
|
1,404
|
71
|
5
|
Psychologists (all Grades excluding Students)
Region
|
31/12/1997
|
31/12/2003
|
Change end-1997
to end-2003
|
% Change end-1997 to end-2003
|
Eastern
|
97
|
164
|
67
|
70
|
Midland
|
18
|
31
|
14
|
78
|
Mid-Western
|
28
|
36
|
9
|
32
|
North-Eastern
|
20
|
32
|
12
|
60
|
North-Western
|
24
|
27
|
3
|
14
|
South-Eastern
|
29
|
47
|
18
|
61
|
Southern
|
24
|
57
|
33
|
140
|
Western
|
39
|
47
|
9
|
22
|
Total
|
277
|
441
|
165
|
59
|
Social Workers (all grades)
Region
|
31/12/1997
|
31/12/2003
|
Change end-1997
to end-2003
|
% Change end-1997 to end-2003
|
Eastern
|
612
|
845
|
233
|
38
|
Midland
|
58
|
84
|
27
|
46
|
Mid-Western
|
78
|
149
|
72
|
92
|
North-Eastern
|
63
|
103
|
40
|
63
|
North-Western
|
61
|
125
|
64
|
105
|
South-Eastern
|
86
|
128
|
42
|
49
|
Southern
|
120
|
266
|
145
|
121
|
Western
|
86
|
142
|
56
|
65
|
Total
|
1,164
|
1,843
|
679
|
58
|
Source: Department of Health and Children Personnel Census.