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Chapter 1: What is the main topic discussed in this episode?
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Good afternoon. You are very welcome to LiveLine. 51551 is the text number. You can reach me on email, LiveLine at rte.ie. Or as always, give me a call on 0818 715 815. I suspect it was by email that Anne O'Connor, the CEO of the HSE... Contact us. Senior managers earlier this week to tell them that they have to rein in their spending.
They need to control it when it comes to overtime and agency staff and recruitment and what have you. Why? Because to the end of March, three months into the year, they are a quarter of a billion quid.
over budget and anne o'connor was on the news at one speaking to rachel english about this about the overspend about the implications of it and she talked a little bit as well about how much frontline staff and any clinicians they are hiring and the active recruitment that's ongoing in that regard and brenda hartnett was listening to the news at one and she got in touch with us here on live line brenda what's the issue
Hi, Ciarán. My issue is that we've sort of heard all of this before and, unfortunately, nothing really changes in the agency. I am myself an ex... a retired speech and language therapy manager who would have worked across disability and primary care services. And during my tenure there, all I saw was a consistent...
disproportionate increase in the recruitment of non-front-facing managerial and administrative staff, while numbers across the medical, dental, nursing, midwifery and allied health and social care professionals simply either stood still or actually declined. So I do get very cross when you hear about
The fact that they are so over budget, that's because the spend is in the wrong places, categorically and absolutely.
How long did you work with the HSE?
I would have been there 30 years.
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Chapter 2: What recent changes have been made to HSE spending?
And what was the response? You were basically told it was none of your concern and you were accused of being... unprofessional for speaking out about it. I mean, I wrote to Bernard Gloucester, I wrote to all of the ministers or the parliamentarians who had some responsibility for health. And it was just, it was almost accepted that this is the way things are. And, you know, it was...
You said... Yeah, dispiriting is the word you used a moment ago as well.
Chapter 3: Why is there a call to rein in spending within the HSE?
Tell me more about that, how it felt to work in that environment then.
Well, it was... I feel a disrespect for clinicians. I mean, after all, clinicians and medical and nursing professions, we are the ones who are responsible for healthcare delivery. You know, we're the ones who the patient needs to see. Um... And yet, there was no workforce planning, for instance.
There was never any desire by so-called... I mean, the concept of senior management, I actually struggle with that because it's quite hard to see how they have reached these lofty roles because there's very little evidence of their managerial skills or their leadership skills.
but anyway I'm sure they were hired on merit like anybody is well I would yes yes I'm pleased to say that but anyway that's just my cynicism and Sorry, I've sort of lost track of what the question was.
Well, it was more about that sense of... How did you describe it? That it was dispiriting to work there. You know, particularly, I suppose, in the area you worked in, disability services and speech and language therapy. And we all know how profound... the shortages there of frontline staff and what a profound effect that has on the most vulnerable children in society.
Absolutely. Absolutely. Yeah.
Yeah. Go on.
You know, to try to explain that to managers, it was almost like our voices, you know, weren't being heard. And there was sort of an acceptance that if your waiting lists were... under 12 months or once they didn't stray over 12 months, no one actually really cared. And yet, as everybody knows, we talk about early intervention across all disciplines and in all spheres.
You know, that was totally disregarded.
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Chapter 4: What concerns does a retired speech and language therapy manager raise about HSE management?
or their inability to access services. You know, and as clinicians, we know we have the skills to make a difference. And it's just, it feels off, you know, it's amoral, it's unethical to be almost prevented from doing that.
How often did you find yourself having to explain the lack of services to those parents?
Well, I mean, all the time, you know.
Yeah.
And, you know, that became... I mean, I spoke for parents of children, you know, with an obvious disability. They begin to take on the language of a war and we have to fight. You know, their right to health care, to adequate, high-quality health care... It's a human right. It's not a privilege.
It's not something they should have to fight for or feel grateful for having a service that's substandard.
Yeah. Were there times, and I'm sure there were given how emotionally fraught all this is for the parents, where they would have taken it out on you, but maybe misdirected their anger at the person in front of them?
Well, they would, you know, and that becomes very difficult because as clinicians, you do take on that burden because you know you're failing these parents and you're having really to stand over a service that you know is substandard and isn't of adequate quality.
But that must be so hard, Brenda, to be in there doing your best and to obviously be in this job. I think people go into those types of jobs out of a sense of vocation. It's that type of work. You're not becoming a speech and language therapist with the HSE to be a millionaire. It's a sense of vocation. And then to have a parent...
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Chapter 5: How has the recruitment of non-clinical staff affected frontline services?
Well, now management, I think, again, they would say they never deny those problems and they just say, listen, we're working hard to solve them.
No, they do deny those problems.
So I was looking at the numbers as well, Brenda, after you got in touch when you were listening to Anne O'Connor. The Irish Independent, actually, they were pretty startling. It was last year they had a couple of articles on this. So overall admin staff numbers over 10 years rose by 50%. And grade 5 to 8 middle managers went up 134%.
Absolutely, absolutely. And in the same period, Ciarán, those, their so-called, they had reached and exceeded their targets by June of that year, whereas medical and allied health and social care, we were at about, we'd reached 30% of our target. And then, ironically, the recruitment calls happened. And who did that affect? Clinical staff. Because
Thankfully, the other roles had all been stuffed together.
Yeah.
So sometimes, I think sometimes as well, I've heard, you know, some of these middle managers or senior managers say, and it's often off the record, they say, because they don't want to stick the boot into politicians, their paymasters, but they say, you know, they're kind of forced into some of this expansion that you've got sláinte care reforms, that you've got all this kind of compliance and legal reporting obligations, that you've got the introduction of more digital health systems.
And this is stuff that's that's from the outside imposed on the system, as it were, particularly, say, compliance and reporting obligations, and they just have to hire middle managers to manage all of that. They have to meet those obligations.
But the problem is, Ciarán, that these middle managers simply delegate all those responsibilities back to the therapy manager.
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