About 100,000 staff across large parts of the health service face restrictions on promotions as part of incoming controls on filling new posts and vacancies. <\/p>\n
The move has been described by doctors as a \u201cde facto recruitment freeze which presents clear and significant risks to patients\u201d. Nurses said staff and patient safety have been \u201cthrown out the window\u201d.<\/p>\n
A new four-stage recruitment authorisation process has been introduced which culminates in each individual position now having to be approved by the Department of Health<\/a> \u2013 even in cases where posts had previously been authorised within the Health Service Executive<\/a>.<\/p>\n [\u00a0Health budget no longer based on evidence, consultants\u2019 conference toldOpens in new window<\/a>\u00a0]<\/p>\n \u201cThe above sanction requirement applies to all recruitment, replacement, promotion and conversion posts without exception, including graduate appointments, agency conversions and any other category of appointment or internal progression that would impact the overall pay bill,\u201d a directive to top-level HSE management, which came into effect in recent days, states.<\/p>\n The new measures, which have no specified end date, come as the latest HSE forecasts to Government maintain it will face a \u20ac1 billion cash deficit by the end of the year. The projections suggest the health service will overspend its official pay budget by \u20ac142 million. <\/p>\n HSE regions which overspent on staffing this year are now expected to have to make cuts to recruitment in 2027. <\/p>\n The new enhanced control measures will apply to four HSE regions which have gone 2 per cent or more above their official pay bill. These are HSE South West, HSE Dublin South East, HSE Dublin and Midlands and HSE West and North West.<\/p>\n While the new controls stipulate that the department will make the decisions on sanctioning recruitment and promotions, they also indicate \u201cthe HSE remains responsible for managing the identified clinical and service risk at all times, including while an application is prepared or considered\u201d. <\/p>\n \u201cSubmission does not transfer risk to the Minister [for Health] or department and does not relieve the HSE of its obligation to implement safe interim arrangements,\u201d notes the Government document on the revised recruitment\/promotion financial sanction process \u2013 which is quoted in the memo to senior management.<\/p>\n The president of the Irish Medical Organisation, Dr Matthew Sadlier, on Friday warned that \u201cwith this measure, the reality is there will be no new services or expansion of capacity while those currently in place could be under threat. It is obvious that the Government\u2019s aim is to reduce the number of people delivering care, not increase them.<\/p>\n \u201cWhere will accountability lie for the introduction of this measure when it inevitably has a negative effect on doctor numbers, waiting lists and patient outcomes?\u201d <\/p>\n