Dáil Éireann Debate, Tuesday - 21 April 2026
158. Deputy David Cullinane asked the Minister for Health the targets she has set for the reduction in agency spending; her plans to reduce the over-reliance on agency and temporary workers in the health service; and if she will make a statement on the matter. [28499/26]
Amharc ar fhreagraThe HSE’s 2026 National Service Plan sets out its commitment to reducing agency costs for Department of Health funded services to €720m in 2026, which is a 12% reduction on 2025 full year agency costs. This figure is consistent with agency costs agreed between the Department of Health and the Department of Public Expenditure, Infrastructure, Public Service Reform and Digitalisation as part of the 2026 budgetary estimate process.
To meet this commitment the HSE’s CEO required that Regional Executive Officers submit detailed plans for managing agency costs in their respective Regional Health Areas. These plans include:
• the conversion of agency staff to permanent employees
• improved absence management, targeting a 1% reduction in absenteeism
• accelerated recruitment and workforce planning in line with the Workplace Relations Commission’s agreement between the HSE and the health-sector unions of the 31/03/2025
• expansion of staff banks and e-rostering
• strict escalation and enforcement mechanisms.
Additionally, the HSE issued an emergency directive on March 20th, iterating the contents of the Agency Control Framework that accompanied HSE’s CEO Memorandum 15687 of the 9th of December 2025. The framework seeks to reduce reliance on agency staffing, whilst simultaneously managing quality services through a more balanced use of direct, overtime and agency staffing. To that end the framework sets out specific actions on:
• the exercise of authority and delegation controls on the use of staff from agencies that are included on service framework agreements.
• the imposition of controls on the use of staff from agencies that are not on service framework agreements.
• the management of agency approval in emergency situations.
• the development of tools for monitoring agency costs.
• the necessity for recruitment and workforce planning.
• the need of the regions and services to align with the national commitment to savings in agency costs.
Subsequently, on the 5th May, the CEO of the HSE activated the escalation provisions of the Performance and Accountability Framework placing Dublin & North-East, Mid-West, West & North-West on Tier 1 of the framework and Dublin & Midlands, Dublin & South-East and South-West Health Care Regions on Tier 3. The tiered approach to escalating allows for differentiated approaches to managing cost overruns across Regional Health Areas. Under this approach regions on higher levels of escalation (Tier 3) will use additional measures, such as more comprehensive business cases for the use of agency staff, and caps on total agency spend to control agency costs.
The Department of Health continuously examine the relationship between funded staffing levels, vacancies and agency expenditure as part of the health service’s workforce planning, financial oversight and agency expenditure cost reduction arrangements. This ongoing analysis informs the work of the Productivity & Savings Taskforce, the Health Budget Oversight Group (HBOG) and numerous regular engagements between the Department and the HSE.
