HSE controls not effective in managing workforce growth, auditors say – The Irish Times

Internal auditors have found that measures implemented by the health service board last year were ineffective in controlling the growth in the HSE workforce.

A report published on Monday found there was a lag between when management issued directives and policies on recruitment and when controls and restrictions had an impact on the system.

The document also found evidence of “inconsistent interpretation” of provisions in different memoranda issued by the HSE Chief Executive or the Human Resources Unit, for example relating to when a valid contractual obligation to employ existed, in different service areas.

The internal audit report found that the HSE had set a target of 6,010 more staff in its National Service Plan 2023 – an agreement with the government on services to be provided in return for funding from its Treasury. The report said that by early 2023 it was clear there was a “significant risk” that this target would be exceeded. Ultimately, by December 2023, the health service had recruited around 2,230 more staff than the official figure set out in the National Service Plan.

The auditors found that about 95 per cent of the extra staff were hired in acute care hospitals.

The report found that to minimise the risk of exceeding the recruitment target for the year, the HSE Director-General and his national HR Unit implemented a series of agency work audits in May, July and twice in October 2023.

In November 2023, employment in the South/South West Hospital Group exceeded target levels by 537 people, while employment in the Ireland East Hospital Group exceeded target levels by 452 people.

Auditors examined a sample of 66 appointments in November 2023 across several hospital groups, community health areas and the HSE Centre. They found four non-compliances were identified, relating to management and administrative positions at clerical and grade IV levels within the HSE.

The report found that the main reasons why the controls implemented were not effective in controlling employment growth included the fact that recruitment processes “can take a long time from offer/acceptance to finalisation of employment”.

The auditors said the HSE’s conditional offer letter stated that an employment contract was only valid if it was received in writing and signed by both parties. “However, the national HR department issued guidance stating that recruitment could proceed if an offer was made and the position was accepted.”

It found that 40 per cent of the sample were promoted on this basis. “Had the clause in the HSE conditional job offer letter/email been applied as described, fewer people would have come through the system.”