‘Explosion of dependency’ on outside consultants needs to be addressed by HSE, says Gloster

New health service chief ‘somewhat surprised’ at levels of care that had ‘tipped over’ into an over reliance on the private sector

The health service has become dependent to an “unacceptable” extent on outside management consultants and similar professional service providers according to Bernard Gloster who said such companies were paid up to €180 million by the HSE in 2022.

The organisation’s new chief executive told delegates to Fórsa’s health and welfare conference in Galway on Thursday that had had been “somewhat surprised” when he took up the role by the extent to which the provision of services had “tipped over” into an over reliance on the private sector.

He said he had no issue with the use of agency staff to address staff shortages and meet acute need, or the involvement of the private sector generally, but suggested an assessment was required to establish whether it was in danger of spiralling out of control.

He singled out what he believed had become an overreliance on external management consultants, saying they certainly had a role to play in advising him and the wider management of the HSE but that the spend on their use had become unsustainable.


“I’ve looked at the crude figures for 2022 expenditure across the HSE, and you have to remember the early part of 2022 was still very much dominated by the impact of the pandemic so there are some unusual features to the year.

“But in looking at those figures when they strip out legal services, and they strip off what we might call professional services and try to distil it back more closely to management consulting, we’re looking at arriving at a position of expenditure in 2022 of between €120 million and €180 million.”

He said he was still establishing for himself the detail of how much was spent, where any why.

He said that in addition to Covid, the cyberattack had also required huge resources and outside expertise to address but that he needed to look “sensibly” at the issue of so much money flowing out of the organisation.

“I have absolutely nothing against commercial activity and I have nothing against outsource providers,” he told delegates. “I have nothing against experts and I have nothing against management consultants but there has been an explosion of dependency and that’s rightly a cause of concern for the public, for the Minister and for you, the staff.

“I have the maturity to stand back and say is that because it’s a very particular job that can be filled in a very particular way for a period of time, and that can happen, it can be a very appropriate thing. Or is that just something that now becomes the new default; and if it becomes a new default, it suddenly grows. And it grows beyond our capability to control it.”

Separately, he said that recruitment to some senior management grades within the HSE was ahead of schedule and that there would be a pause on hiring at these levels except where a specific need was identified. He told delegates that he wanted to see work done on development better career pathways for less senior staff already in the health service to progress into the higher ranks.

Emmet Malone

Emmet Malone

Emmet Malone is Work Correspondent at The Irish Times