Hospital spends €550,000 per quarter filling consultant posts

The Health Service Executive is paying private agencies €110,000 every 13 weeks to fill a single consultant post at Letterkenny General Hospital. In total, five consultant posts at the hospital are being filled on hourly-rate contracts, with the cost for three months equivalent to the normal pay of a full-time consultant for an entire year, the HSE has told the Dáil's Public Accounts Committee.

The executive says it has encountered significant challenges in filling medical posts at the hospital. Seven out of 54 consultant posts are vacant and “in the recruitment process at various stages”. Nationally, it spent almost €200 million on agency staff in the first seven months of this year, up almost 50 per cent on last year.

Minister for Health Leo Varadkar, who is seeking an extra €500 million in next month’s budget, argues that money can be saved on agency costs by employing more staff full time.

Difficulties in filling posts at smaller regional hospitals have greatly increased since the Government cut starting salaries for consultants by 30 per cent two years ago. This is likely to be largely reversed soon.

The five vacant posts filled by hourly-rate consultants in Letterkenny are in the emergency department, radiology, general medicine and oncology. Two paediatric posts are filled by locum consultants on payroll.

According to the HSE, consultants are recruited on hourly-rate contracts “only when absolutely required, when all other approaches have not resulted in successful recruitment and where service continuity must be guaranteed”.

Paying a locum consultant through an agency for 13 weeks at an hourly rate costs €80,849, it says. In addition, the agency is paid a 10 per cent fee and VAT is levied at 23 per cent, bringing the cost to €110,328. A new consultant directly employed by the HSE is paid between €109,381 and €110,328 per year.

“Recruitment of consultant posts in this way is actioned only when options become very limited and timing is a key factor,” the HSE said in a written response to questions from the committee.

Earlier this year, it was reported that 117 out of 122 non-consultant hospital doctor posts in Letterkenny were filled on a contract or locum basis. Nationally, at least one in eight consultant posts is unfilled.

Asked about delays in building the new emergency department at University Hospital Limerick, the HSE has told the committee the programme for development of the building, due in June 2016, is “in line with” the programme originally advised.

Construction of a €6 million building shell has been completed, but the fit-out for the emergency department is not due to start until next January, prompting complaints from local TDs. The HSE says the fit-out is a complex project which will take 18 months to complete.

The HSE has also told the committee that almost 1,500 staff have been, or are in the process of being, “regularised” on higher salaries.

In these cases, the staff were required to act up for colleagues on a short-term basis but, because of the recruitment embargo, the arrangements have remained in place longer term. It says because the staff were already receiving higher pay, there should be no additional costs association with regularisation.