HSE director jobs increase at 20 times rate of public health nurse positions

Health service audits other agencies ‘but who controls the controllers and audits HSE?’

Senator Colm Burke said Ireland was one of the top three countries in the OECD for spending on health, yet had only 2.8 hospital beds per 1,000 people.  Photograph: Alan Betson

Senator Colm Burke said Ireland was one of the top three countries in the OECD for spending on health, yet had only 2.8 hospital beds per 1,000 people. Photograph: Alan Betson

 

The number of jobs at the most senior management level in the HSE has risen at more than 20 times the rate of some front-line positions, it has emerged.

A total of 88 additional executive managers or directors were employed by the HSE between December 2014 and April this year, an increase of 43.5 per cent. There are now 289 people at the most senior director level in the HSE, up from 201.

In contrast, the number of public health nurses rose by just 29, or just 2 per cent, in the same period.

There were significant increases too at other levels of management, including a 23.5 per cent rise in the number of executive manager positions, with 231 extra jobs created in the last 2½ years.

The number of jobs at the next grade down, categorised as senior managers, increased by 319 or 26.9 per cent with 1,186 positions at this level.

Concerns have been raised about the lack of long-term planning for high-level administrative positions in the wake of the release of figures to Fine Gael Senator Colm Burke.

Mr Burke accused the HSE of “camouflaging” the number of staff it has at senior levels. He said the figures initially issued earlier this year excluded grade six and grade seven managers, such as assistant hospital managers and, as a result, it looked like the numbers of managers had dropped.

He said, however, that a closer analysis of the data showed the HSE had categorised them as administrative staff, when previously they were listed as management.

In its response, the HSE said it was undertaking “arguably the largest public sector-reform programme in the country’s history”.

Devolved model

The system was moving from a centralised to a devolved decision-making model with the creation of seven hospital groups and nine community healthcare organisations, as well as a greater focus on mental health, care of the elderly and disability services by divisions within the HSE.

“Any one of these would in their own right be amongst the largest organisations in the State in terms of staff and budget,” the HSE said.

However, Mr Burke said his concern was “that there is no long-term planning for the numbers of senior administrative staff. What is the plan for the next 12 months for management growth? Is there a plan for the next two years, the next five years?”

The Cork-based Senator said that 2,500 organisations received funding from the health budget and the HSE had properly sent in auditors to look at the pay levels of managers such as those in agencies such as Rehab.

“But who is controlling the controllers?” he said. “Who is sending in the auditors to the HSE?”

Mr Burke said Ireland was one of the top three countries in the OECD for spending on health, yet had only 2.8 hospital beds per 1,000 people, compared to an OECD average of 4.3 per 1,000.