Controls introduced by HSE were not effective in managing growth in employment numbers, say auditors

Measures put in place by health service management last year were ineffective at controlling the growth in employment numbers in the HSE, internal auditors have found.
A report, released on Monday, said there was a time lag between senior management issuing directives and rules on recruitment and the impact of the controls and restrictions in the system.
It said there was also evidence of “inconsistent interpretation” across different service areas of the provisions contained in various memos issued by the HSE chief executive or the human resources unit such as on when a valid contractual obligation of employment existed.
The internal audit report said that the HSE in its national service plan for 2023 – its agreement with the Government on services to be provided in return for its exchequer funding – set a target of increasing the workforce by 6,010 personnel. The report said it was evident early in 2023 that there was a “significant risk” that this target would be exceeded. Eventually by December 2023 the health service had taken on about 2,230 staff more than the official figure set out in the national service plan.
Auditors said that acute hospitals accounted for about 95 per cent of the additional staff recruited.
The report said that to mitigate the risk of breaching the target for recruitment for the year the HSE chief executive and its national human resources unit had implemented a number of temporary employment controls during 2023 in May, July and on two occasions in October.
It said in November 2023 the South/South West Hospital Group had 537 staff above its target level, while the Ireland East Hospital Group was 452 above its ceiling.
Auditors examined a sample of 66 appointments in November 2023 across a number of hospital groups, community health areas and at the HSE Centre. It said there were four instances of noncompliance identified, and these related to management and administrative posts at clerical officer and grade IV level in the HSE.
The report said the main reasons that the controls put in place were not effective in controlling employment growth included that recruitment processes “can take significant time from offer/acceptance to finalisation of employment”.
Auditors maintained the HSE’s conditional job offer letter said that a contract of employment was only valid when received in writing and signed by both parties. “However, national HR issued guidance stating that recruitment could progress if there had been an offer and acceptance of a position.”
It said that 40 per cent of the sample tested had progressed on this basis. “If the clause contained in the HSE’s conditional job offer letter/email was applied as stated, reduced numbers would have went through the system.”