The Health Service Executive saw its largest-ever surge in staff numbers last year, its chief executive has told the Oireachtas Joint Committee on Health.
The health service workforce is now its largest ever, having risen by over a fifth, 21.8%, since the end of 2019.
Bernard Gloster said: “The highest ever net growth in the health service occurred in 2023.”
“With plus 8,239 WTE (Whole Time Equivalent)” posts, bringing the total numer to 145, 985.”
“The growth is in contrast with an average increase of 4,690 in the previous five years,” he said.
Last year’s increase set a new record as it “well exceeds even the highest most recent year, driven by Covid-19, of 6,361 in 2020”.
“It was clear in the latter part of 2023 that recruitment was running at a rate that was, and is, not sustainable,” Mr Gloster said.
Last December, “even at the height of the pause [in recruitment], employment numbers grew by 933,” Mr Gloster revealed, with that growth having continued into the new year “particularly in nursing”.
He indicated that recruitment this year would be more moderate.
“Notwithstanding control measures and affordability actions, we will this year see recruitment of new development posts at a minimum of 2,268 in our health portfolio, and 683 in disability services,” Mr Gloster said.
He also expressed his determination to ensure that “arbitrary measures at national level such as [the recruitment] pause will not be necessary”.
However, he said fewer staff are leaving the health service, reversing an upward trend in depatures in recent years.
“Turnover has improved, in that it decreased in 2023 by 1.3%,” Mr Gloster said.
Mr Gloster, who took up his post a year ago, acknowledged that the HSE “at times” does “come up short”, leaving many people “challenged in their confidence” in the health service.
However, he insisted that the appointment of new regional executive officers would make decision-making more efficient.
Five are in place, with the sixth due to start on 15 April, he said.
“A further welcome €90m in new health developments is expected to be allocated shortly,” Mr Gloster also told the committee.
He noted a €29.1m investment in GP places, NCHD training, nursing and midwifery, and social care.
A new joint productivity taskforce run by the Department of Health and the HSE will seek to maximise the use of existing resources, he added.
Mr Gloster said that “as long as there’s one person on a trolley, that’s too much”.
However, he pointed to a cut in the number of patients on trollies in the second half of last year “by about 20%” as compared to the same period in 2022.
This was “despite the increased demand”, he said, describing the reduction as one of the “early improvements” of his tenure.
“But we’re gonna have to do a lot more,” Mr Gloster acknowledged, adding that reducing trolley numbers will be “the focus” for 2024.
He also pointed to “very substantial improvements” in reducing the number of people aged over 75 who were waiting on trollies for more than 24 hours.
“We really have moved to a zero-tolerance type of approach,” which did not require any additional resources, Mr Gloster said.
There was a 13% rise in the numbers attending emergency departments in the first ten weeks of this year when compared to the same period in 2023, he added, which is in part a result of an ageing population.
He also revealed it is “increasingly common” for emergency departments to rely on security staff.
Turning away someone who is engaging in “antisocial or unruly behaviour” is not easy, and “could create a different problem”, something he described as “a difficult situation” for staff.
Mr Gloster said such challenging behaviour will not be eradicated.
However, hospital managers asking for additional security measures would get a fair hearing, he said.
“We have to protect the public and we have to protect our staff,” Mr Gloster added.
