The Government has made it clear that a critical part of its strategy to restore the public finances is to achieve sustainability in the cost of delivering public services relative to State revenues. To help achieve this goal, it will be necessary to restructure and reorganise the public service and to reduce public service numbers over the coming years.
The Employment Control Framework for the health sector provides for a net reduction in employment of 6,000 in wholetime equivalent (WTE) terms from March 2009 to the end 2012 and consequential pay roll savings. Based on numbers reductions already achieved in 2009, the net target reduction to end 2012 is 4,560 WTE. Therefore, the net target reduction in numbers in 2010, and in each of the following two years, is 1,520 wholetime equivalents. The Government decision has been modulated to ensure that key services are maintained insofar as possible in the health services, particularly in respect of children at risk, older people, persons with a disability, mental health services, and cancer services. The Framework, accordingly, provides for a number of grades and posts that are exempt from the moratorium on recruitment and promotion.
In addition, the HSE also has some degree of flexibility under the Framework to sanction the filling of certain other posts (both within its own organisation and in voluntary service providers funded by it) on an exceptional basis provided it achieves the overall target reductions in both staffing levels and pay costs. The requirement is that a post or posts of equivalent value must be suppressed in order to meet the cost of the post being filled.
Against the background of reduced budgets and staffing levels in the health sector, a reorganisation and restructuring of work is required not only to maintain the level, quality and safety of services but also to expand the range and accessibility of community services in order to avoid the necessity for hospital attendances. The new Public Service Agreement, which was ratified last week by the Public Services Committee of ICTU, clears the way for the implementation of a major transformation programme for the health sector to commence on a collaborative basis involving unions and employers. The programme is designed to achieve significant cost efficiencies while protecting the quality and effectiveness of services to the public.
The foregoing arrangements apply across the publicly funded health services and there can be no question of exempting voluntary service providers or providing them with additional funding. This would undermine the strategic objectives of Government policy which are to reduce staffing levels and achieve payroll savings in order to bring the public voluntary finances into sustainable balance. Voluntary providers, in common with the HSE, need to identify, and implement under the Public Service Agreement, whatever changes in staffing levels, skill mix and work practices are necessary to protect services within the reduced level of funding now available.