There needs to be a greater focus on recruiting frontline healthcare staff rather than management or administrators, Public Expenditure Minister Jack Chambers has said.
He was speaking at a press conference on Thursday about a need for “efficiencies” in how the public sector is staffed.
It comes as the Mid-Year Expenditure Report, published on Thursday, warned that in the health sector, growth in expenditure and staffing “has not always been matched by equivalent growth in activity levels, reinforcing the importance of productivity and reform”.
It also noted that in social protection, targeted interventions “can often deliver greater benefits to lower-income households than broad-based measures”.
“I think there is need for much greater efficiencies in how we deploy public sector staffing,” Mr Chambers said.
“We’ve had significant growth, for example, in management and administrative staff in recent years, but in my view, we need to focus on frontline deployment.
“If you take the health service, for example, the report outlines, in some instances, greater levels of growth in management and admin than frontline capacity.
“For me, that’s not acceptable into the medium term, and we have to have much greater focus on frontline deployment.
“We’re being very clear that growth needs to be aligned with service needs and priorities, not growth everywhere. And that’s why there’ll have to be choices around future staff deployment, around where the greatest service need is.”
He said there had been an 150% increase in agency staff in the last six years, coinciding with a 62% increase in doctors and a 36% increase in nurses being hired, and he said it was “not sustainable” to have an “uplift in both”.
He added: “I think there’s elements of our health system which will need to be much more efficient.
“We know the input costs and the level of expenditure has not been connected to the level of outputs, despite a growth of 10 billion euro in the last number of years, and that speaks to a system that needs reform, improved productivity, and much greater and efficient deployment of staff.
“Endless recruitment everywhere doesn’t improve outcomes for citizens or outputs for people who want a better public health system.”
He also said the Department of Education was “within” its new budgetary allocation, taking into account an extra 646 million euro in 2026, 446 million euro of which has been shared across government for 2027.
The Mid-Year Expenditure Report is a planning an exercise on the “trade-offs” facing government which forms part of the budgetary process.
The Budget is due to be announced in the Dáil on October 6.
