What's going on with HSE agency spend?

Goldengirl

Maybe they are expecting the patient's to get off their trolleys and fo a bit of work ? Or the relatives?

Like people are just getting too uppity asking for trained staff to look after them and a bed in a ward !

Floppybits

https://www.boards.ie/discussion/comment/121243907#Comment_121243907

That wouldn't surprise me. I remember my dad was dying and all they wanted to do was get him out of the hospital promising my mother the sun, moon and stars if she would take him home. Only when I went in with her and started asking questions did they admit that my mam who is in 80's would be doing most of the caring with someone coming in maybe once a day to check on my dad and then they asked me whether the family could take a leave of absence from work to help my mam out. Stood firm and said no and luckily got a place in St Francis Hospice. I think if we had taken him home we would have been burying my mother as well. So much for a caring profession all they wanted was him out from under them.

monty_python

I do agency work as a chef in various healthcare facilities, some of which are HSE

I get 23.50 per hour and the HSE employed chefs get 16

I also get double on Sundays or bank holidays

MegamanBoo

https://www.boards.ie/discussion/comment/121246485#Comment_121246485

Thanks for that, I'm trying to figure out too what the agency gets. Have you any idea in your case?

Back when I worked in healthcare I'm pretty sure it was the hourly rate again. If that's the case the HSE would be paying 47/hr for you, against 16/hr + prsi etc for HSE staff.

monty_python

They pay holiday pay and insurance on top. I'm not sure but I think they pay another 10 or 15 per hour on top of that again but I'm not sure

bigroad

It would be interesting to see who owns these agencies and have they any friend/family connections to HSE top brass or political people.

and how do they win these contracts.

monty_python

https://www.boards.ie/discussion/comment/121246566#Comment_121246566

The one I work for doesn't have any connections in the HSE. They supply chefs, catering assistants, nurses barmen and waitress to healthcare and hospitality facilities. They are very big and act as a kind of union for staff aswell

AndrewJRenko

https://www.boards.ie/discussion/comment/121246566#Comment_121246566

They win these contracts by submitting the Most Economically Advantageous Tender in response to the HSE invitation. Check out etenders.gov.ie for all the details.

MegamanBoo

https://www.boards.ie/discussion/comment/121247089#Comment_121247089

Are you sure? For agency staff?

I wouldn't have thought that very practical in my experience, but I could be wrong.

It certainly wasn't the case when I worked for one of the HSE funded services, which is where a lot of the 22 billion budget goes.

MegamanBoo

https://www.boards.ie/discussion/comment/121247162#Comment_121247162

It turns out I'm partially incorrect.

There is a tender process but multiple agencies, at least 14, have been approved.

And that would only be for within the HSE itself, not the various outsourced services.

AndrewJRenko

https://www.boards.ie/discussion/comment/121247162#Comment_121247162

Yes, that's how contracts are awarded. A tender will go out detailing the type of services, the approximate quantity expected, the locations, the skill mix and the relevant time period. Agency businesses will respond with quotes, best MEAT responses wins the contract. HSE sets up a framework with one or more providers, and hospitals drawdown services under that framework.

Here's a current example specifically for OT services; https://www.etenders.gov.ie/epps/cft/prepareViewCfTWS.do?resourceId=2291176

How else would it work, if not through procurement?

MegamanBoo

https://www.boards.ie/discussion/comment/121247205#Comment_121247205

When I worked in services we'd just ring around a list of agencies if stuck.

And how much do they pay the agencies?

This article says 66% higher in some cases.

https://www.breakingnews.ie/ireland/hse-costs-up-to-66-higher-in-cork-kerry-region-for-using-agency-staff-instead-of-direct-recruitment-1531129.html

Whether that's tendered or not it's still terribly wasteful.

AndrewJRenko

https://www.boards.ie/discussion/comment/121247369#Comment_121247369

The list of agencies was probably the list of those within the framework agreement.

ADHD and Me

This is a bit off topic but maybe someone can answer.

When looking at the job vacancies on the HSE website, The roles are listed as Internal / External.

Does anyone know what is ment by this?

Goldengirl

https://www.boards.ie/discussion/comment/121244477#Comment_121244477

Sorry for your loss .

Some people do want their loved ones at home but this should never be forced on people .

Those bad experiences which are a direct result of lack of beds and resources are not going to get much better unfortunately.

crusd

https://www.boards.ie/discussion/comment/121247418#Comment_121247418

They can hire for the position either internally from employees in another role or externally from the market.

mariaalice

FG wins the PR on this one, I don't know fully the ins and outs of this, no organisation can hire staff whenever they like there have to be cost controls and a business case for hiring staff. The management in the HSE does seem very poor for some reason.

keeah91

As an agency nurse I can tell you I make € 45-60 per hour, no paid holidays or pension contributions!

Clo-Clo

https://www.boards.ie/discussion/comment/121247369#Comment_121247369

Government can't just ring around. They have to tender and as part of the tender process would get a list of companies approved to get contracts from and would have agreed rates

The HSE uses contractors because they don't have the staffing number to take on full time staff. A contractor doesn't have to be paid pension etc. Plus they are only hired for a short period and if let go the HSE wouldn't have to pay redundancy.

The question in most cases comes down to would it be cheaper to hire these people full time including pension payment etc, or is it better to pay contractors so they can let them go. Of course a contractor could be working in one hospital one day and another hospital the next day. A full time HSE employee like a nurse would be in a set hospital as far as I am aware and wouldn't be jumping from one to another.

MegamanBoo

https://www.boards.ie/discussion/comment/121391625#Comment_121391625

Thanks for that.

For me the relevant questions are...

1) Is the HSE overusing agency staff, because of failures to recruit enough permanent or contract staff, at great cost to the taxpayer.

2) If such a volume of agency staff is required, why doesn't the HSE operate it's own agency function. Why all the middlemen?

Clo-Clo

https://www.boards.ie/discussion/comment/121392754#Comment_121392754

1. Would need to ask the HSE, as mentioned with a contractor they move from one hospital to another so if they work 200 days a year that could be across 10 hospitals, so 20 days in each hospital. The hospital might not need a nurse the entire time
2. The HSE can't set up an agency because then they will have to provide them with government contract....

I don't know enough to suggest a way it could be resolved to use, or should the HSE look at hiring nurses not assigned to a single hospital but they would probably have to pay through the nose to have that option....

AndrewJRenko

https://www.boards.ie/discussion/comment/121392754#Comment_121392754

'Failure to recruit staff'? Would you like them to magic up doctors and nurses out of fairy dust? The staff don't exist, and the HSE aren't in control of the salary scales to recruit them. What more would you like them to do?

https://www.boards.ie/discussion/comment/121392888#Comment_121392888

Oh but they do exist

its just the HSE pays them so poorly they go elsewhere to work. My cousin is a midwife, she works in Australia now.

She worked in St Vincent’s for a few years and was paid less than I am as a chef, so she fecked off.

Don’t cod yourself. UCD medicine isn’t bloody empty every year.

AndrewJRenko

https://www.boards.ie/discussion/comment/121397298#Comment_121397298

Did you miss the bit about "HSE aren't in control of the salary scales to recruit them"?

MegamanBoo

https://www.boards.ie/discussion/comment/121399410#Comment_121399410

Well anecdotally at least it's not just hiring staff is the problem, it's also retaining those they have due in part to culture and work conditions.

And is it the salary that's the problem or the cost of housing, thanks to years of FFG failures.

MegamanBoo

https://www.boards.ie/discussion/comment/121392790#Comment_121392790

I appreciate the need in some cases for temporary staff to fill in, but are they being used, at great expense, to fill gaps in recruitment and not for day-to-day needs such as covering sick leave.

I think other government bodies can work directly with temporary staff, I'm pretty sure the dept of education does it with substitute teachers, an Post at Christmas, the CSO during census etc. So why can't the HSE do it too and not waste so much on middlemen?

Clo-Clo

https://www.boards.ie/discussion/comment/121401350#Comment_121401350

But they are working with temp staff. They can work directly with them and some do. As far as I know, can be corrected, most nurses don't want to work directly with the HSE because it is then left up to them to manage their contracts/tax etc and this would put a huge overhead on them. Especially when the point of been a contractor is to jump in and out of different hospitals.

So you would need to have terms agreed with each hospitals.

Most teachers go in for a longer period than just a day. An post at Christmas I have no idea about and neither on the CSO,

But really putting an envelope into a box is a small bit different than looking after someone life. I don't see how you could compare,

MegamanBoo

https://www.boards.ie/discussion/comment/121401486#Comment_121401486

So if I understand what you're saying correctly...

Rather than make it easier for staff to work temporarily with the HSE, we spend hundreds of millions on recruitment agencies as a workaround?

Scary.

MegamanBoo

https://www.boards.ie/discussion/comment/121401486#Comment_121401486

And as for comparing postal work to 'saving lives', nobody's doing that other than to say that one state agency can, it seems, successfully manage temporary staff while another can't.

A daft thing to come out with, unless you're desperate to defend the national disgrace that is our health service management.

feelings

Not surprising. Very lucrative contracts being dished out. The family connections in the companies winning contracts is phenomenal.