Martin Daly: End third‑party agency fees in HSE staffing

I just want to reflect that in relation to the public only contract, it was the Minister and the Government that took the strongest stance in relation to the Rotunda and that is borne out by all the commentary around it. The Minister and the Government took the strongest stance in defending the public only contract in relation to the issues at the Rotunda Hospital and I commend her for that because it would have unravelled slaunter care and just in relation to, I suppose, whilst you have pushed it down to the REOs, I would say this Minister, you have shown leadership in a lot of areas, insourcing, outsourcing, CHI and POC and I just would say that it will take your leadership and the Department's direction to set policy in relation to this because it does seem inexplicable to the average person that when we know a post is coming up in the HSE, a consultant, a nurse, a midwife, admin staff, the day they start looking appears to be the day that that person leaves the job and there's a gap left and I just can't understand that. I don't think any right minded person can understand how that, the inefficiency of that system and that's just a reflection of the situation. Thank you. Just to note the issue on public only contracts come up under Amendment 3 so we might discuss it on that. If you don't mind, thank you. A couple of different things. I totally agree the word control is the wrong word, it is of course my responsibility and I know what you're saying, it's just that I think this committee has such a strong role because you can bring people in and spend time speaking in a public way that I don't necessarily have the facility to do and it's more that sort of partnership that I mean. It is of course my responsibility. One of the things that I have required is that I get a week by week update of how this is going, region by region and the reason, obviously the regions are so important because the detailed conversation is there. So for example, if I can say, and I'll show you this, of the different regions, my most recent update, the week ending the 12th of June on agency conversion, deliver on target to convert maximum agency conversion, all of the regions are red except the west and north west, which is doing quite well. On the agency off framework reduction, this is going to be crucial, elimination of all framework agency use on a phased basis by September, all of the regions are red. But when it comes to September and I say right, that's it, you were given three months notice to get yourself off framework, you're off framework, that's when I will need your help to back this change. Flexible contracting, the establishment of a staff bank, the deputy is so right, this is not for, I don't, if private hospitals want to recruit agency through private companies, that's a matter for them, that is not my business. But the HSE, recruiting agency, we do need a measure of it, but I want them to recruit it from themselves. I do not want the idea that there is somebody working in the HSE who is also employed in the HSE but through a third party agent. It doesn't make any sense to me. This is the question I asked last September, tell me the number of people that are working in the HSE that are also working in the HSE except through a third party agency and we're paying fees for that and a heightened price for it. Please explain it to me. We have our own HSE agency, so I've required that this agency be set up. Of that, the progress so far is that four regions are in red and two regions, Dublin South East and the South West are seeing some progress in relation to that. In terms of absence management, again, all of the six regions are in red. But the point is, we do have a week by week rolling update of this over the summer period. That's the only way I can see to really implement this. It's that level of granularity I think that is necessary, rather than just coming in and saying yes, that's what we want to do and I've tasked the HSE CEO with it. This is a detailed week by week plan to try to do that. That's why I suggest it would be augmented by your role in that and engaging with the regions on the actual, not just how they're doing it and the way in which they're engaging with it, but the real challenges that there are for them in different ways that are tangible, site by site challenges that are meaningful. You could draw that out a great deal as well. Of course, what we want is people working in permanent positions. That's our goal. We have far too many permanent positions that are funded that are not filled. I want them hired permanently and I want people to be working in the HSE on a public basis. The Deputy Sherlock, you mentioned about the Model 2s. Actually, sorry, excuse me, where we see the real difficulties is the Model 3s. What it needs as well is this cultural shift to make sure that people who are consultants in particular working in a Model 4 hospital, that they regard the Model 3 role as just as important as the Model 4 role. That's our structure. There's a question of whether they want to work in Model 3s or not. There is a reasonable structure between working in a Model 4 and a Model 3. It gives very good cover. It gives the opportunity to still do some of the more specialist work in the Model 4 and bring that specialist experience to the Model 3. It does actually have to happen. It does actually have to happen. That relationship, it has to happen every week. It has to happen culturally in a totally integrated way. We're seeing our biggest challenge with the Model 3s as such. That redeployment between the Model 3 and Model 4, that balance is really, really important. Thank you for flagging it.