The Public Service Stability Agreement 2018 to 2020 provides that management will engage with the Parties with a view to minimising the use of agency as far as possible and practicable over the lifetime of the Agreement.
The level of spending on agency staff in the health sector is under constant review. Agency staff are utilised by the sector where there is a difficulty in recruiting and employing hospital staff and where there is a short-term critical service need. Agency staff are also used for flexibility to allow for variations in activity and to meet patient demand.
The level of health sector agency expenditure is influenced by a range of factors including increasing demand for services; ongoing challenges in recruiting and retaining clinical staff; and the need to comply with the European Working Time Directive.
However, despite these issues it is clear that in certain services, the level of reliance on agency staffing is high, or has increased. As a result, the HSE has assured the Minister for Health that the reduction and minimisation of agency costs remains an area of focus.
Generally, progress achieved by the HSE in agency expenditure reduction last year was disappointing. However, in the Acute Hospitals Division, agency spending reduced from over €202m in 2017 to under €200m in 2018. Within the Medical/Dental staff category, there was a reduction of over 10% between 2017 and 2018 representing an average monthly saving of over €1m.
The HSE National Service Plan 2019 provides for a number of initiatives to address the overall financial challenges being faced by the HSE this year. A target to reduce agency/overtime spend by €17.5m has been identified and this has been subject to ongoing engagement with HSE service areas as part of operational planning for 2019. The HSE have advised that this process is nearing completion.