1. 1 Impact of ‘grace period’ retirements in the HSE Update for Joint Committee on Health and Children Laverne McGuinness National Director, Integrated Services Directorate 23 rd February 2012

2. 2 Retirement Numbers  4,326 notified retirements as at 16 th Feb (3,822 WTEs approx)  Of the 4,326 approximately  2,300 (53%) aged over 60 years  730 (17%) retiring on other grounds  1,052 are early retirees under the Cost Neutral Early Retirement scheme  Numbers who have left  At end December 20111,759 (41%)  At end January 2,176 (51%)  At 16th February 2,347 (54%)  Balance to leave1,979 (46%) Please note that the figures contained in this report are ‘point in time’ information and are liable to change as more information becomes available.

3. 3 Retirements by Region Region Dublin Mid Leinster Dublin North East SouthWestNationalTotal Grand Total 99888812171194294326 % of Total23%21%28%27%1%100%

4. 4 Retirements by Care Group and staff type Acute Hospitals 1,490 Ambulance Services 38 Children and Families 66 Corporate Functions 101 Disability Services 478 Elderly Care 572 Mental Health 586 Primary Care 676 Other 319 Grand Total 4,326 General Support Staff 468 Health & Social Care 419 Management/ Admin 400 Medical/ Dental 170 Nursing 1,994 Other Patient & Client Care 821 To be Determined 54 Total 4,326 Total health service staff (WTE as at 31/12/11) 104,392

5. 5 Planning Process  Planning commenced in Autumn 2011  National and Regional Service plans reflect retirements.  Regional plans reflect both the HSE’s budget reduction of €750m and retirements in 2012.  The National Service Plan assume 3,313 exits yielding pay bill reduction of €160m  Refined contingency plans have been developed locally  Hospital and community services  Risk assessment undertaken by each hospital CEO/ community manager.  Priority is on maintaining essential critical frontline services  e.g. Maternity, Emergency Departments, Critical Care, Neonatal etc

6. 6 Planning process: Assurance  Individual Contingency Plan Review meetings  Held between the National Director, Integrated Services and RDOs, Hospital CEOs, Area Managers to review individual plans  Review of replacement for critical posts  Staff redeployment/ reorganisation/ work practice changes are first contingency option.  Short term transition measures (increased hours/agency/ postponed leave)  Where critical roles cannot be filled through redeployment or other changes a limited number of posts have been identified for replacement  Signed assurance statements  Formal written assurance provided by each RDO, hospital CEO and service managers, that appropriate contingency measures are in place across all services

7. 7 National levers  Public Service Agreement  Maximising staff flexibility and productivity  National Clinical Programmes  Greater productivity (€23.4m)  Strategic allocations in the National Service Plan 2012  Mental health €35m, Primary Care €20m  Targeted recruitment  €16 million

8. 8 Hospitals: Key risks South  General  326 retirees, 57 replacements  Consultant posts  19 Consultants will be retiring and 14 critical posts will be replaced.  In addition over 20 new Consultant Posts being filled as part of the Clinical Programmes.  Maternity services  32 midwives will retiring and 23 replacements have been agreed.  Nursing  For the transition period to the end of March graduate nurses have been maintained on a 3 month contract in the two regional hospitals / cancer centres Cork University and Waterford Regional.  In addition a number of these posts have also being maintained in the mental health service in Waterford / Wexford & the Cork Area.

9. 9 Hospitals South Numbers of staff retiring and being replaced HospitalTo be replaced Bantry General Hospital4 Mallow General Hospital3 Mercy Hospital Cork2 South Infirmary3 Cork University Hospital (Including Maternity)11 St. Luke's, Kilkenny13 South Tipp General Hospital3 Kerry General Hospital4 Waterford Regional Hospital9 Wexford General Hospital5 Total 57 ( 17.48%) Total retirees326

10. 10 Consultant Posts South Numbers of consultants retiring and being replaced Acute HospitalNo. retiringNo. being replaced Specialties Bantry General 22 Surgical Registrarx1; Radiologist x1 Cork University 52 Ophthalmology (0.5 replacement), Neuropathology (0.5 replacement) Mallow General 11 Radiology - reduced hours plus additional ultrasonographer recruited Mercy Hospital 22 Anaesthetics, Microbiology Kerry General 33 Radiology South Tipperary 31 General Medicine, St. Luke's, Kilkenny 11 Surgery Waterford 22 Nephrology, Gastroenterology Total HSE South 1914

11. 11 Maternity Services South Numbers of staff retiring and being replaced Hospitals No. retiringNo. being replaced Cork University Hospital 148 Kerry General 10 Waterford Regional 42 Wexford General 32 St. Luke's Kilkenny 1011 Total HSE South 3223

12. 12 Community services: Key risks South  General  891 retiring, 31 to be replaced  Figures do not include the new investment in mental health/ primary care  Nursing in the community  266 nurses including 21 Public Health Nurses to retire. 28 additional nurses to be recruited.  Nurse management posts to be reorganised.  A number of PHNs to be replaced with Registered General Nurse community nurses

13. 13 Hospitals: Key risks Dublin North East  General  357 retirees, 71 replacements  Consultant posts  10 Consultants will be retiring and 8 critical posts will be replaced  Maternity services  21midwives retiring and 20 critical posts to be replaced

14. 14 Hospitals Dublin North East Numbers of staff retiring and being replaced HospitalTo be replaced Connolly Hospital, Blanchardstown6 Cappagh Orthopaedic Hospital3 Our Ladys Hospital, Navan2 Louth County Hospital19 Our Lady of Lourdes, Drogheda19 Cavan/ Monaghan9 Rotunda11 Beaumont Hospital15 Mater Hospital5 Total71 ( 19.88%) Total retirees357

15. 15 Consultant posts Dublin North East Numbers of staff retiring and being replaced Hospital No. retiringNo. being replaced Specialties Beaumont44 Anaesthetics, Nephrology, Psychiatry Connolly11 Surgery Mater22 Anaesthetics, Opthalmology Rotunda11 Histopathology Cavan20 Anaesthetics, Registrar ED/ MIU Total108

16. 16 Maternity Services Dublin North East Numbers of staff retiring and being replaced Maternity Hospitals / Services No. retiringNo. being replaced Rotunda Hospital 88 Our Lady of Lourdes, Drogheda 88 Cavan/ Monaghan Hospital Group 54 Total Dublin North East 2120

17. 17 Community services : Key risks Dublin North East  General  531 retiring, 109 to be replaced  Figures do not include the new investment mental health/ primary care  Public Health Nursing  24 Public Health Nurses to retire.  Nurse management posts to be reorganised.  A number of PHNs to be replaced with Registered General Nurse community nurses  Mental Health  After maximising reconfiguration a number of critical mental health posts are to be replaced.  St Joseph’s Intellectual Disability services  Clinical posts to be replaced  Primary Care Cavan/ Monaghan  Key members of PCTs to be replaced.

18. 18 Hospitals: Key risks Dublin Mid Leinster  General  415 retirees, 83 replacements  Consultant posts  18 Consultants will be retiring, all of whom will be replaced.  Maternity services  31 staff retiring, mainly midwives, 25 critical staff to be replaced

19. 19 Hospitals Dublin Mid-Leinster Numbers of staff retiring and being replaced HospitalTo be replaced CUH Temple St1 Eye & Ear7 Our Ladys Hospital for Sick Children4 Naas General Hospital8 AMNCH, Tallaght5 Midland Regional Hospital, Tullamore4 Midland Regional Hospital, Portlaoise11 Midland Regional Hospital, Mullingar17 St. Vincent's University Hospital4 National Maternity Hospital6 Coombe Maternity Hospital9 St. James's Hospital7 Total83 (20%) Total retirees415

20. 20 Consultant posts Dublin Mid-Leinster Numbers of staff retiring and being replaced Acute Hospital No. retiringNo. being replaced Specialties Holles St 11 Temple St. 11 Orthopaedics Mullingar 33 Medicine, Paediatrics, Anaesthetics Portlaoise 11 Obstetrics Tullamore 11 Anaesthetics Tallaght 44 Anaesthetics, Orthopaedics, Radology, Urology St. James' 22 Histopathology, Medicine St. Vincent's & St. Michaels 44 ENT, Orthopaedics, Radiology Royal Victoria Eye & Ear 11 Opthalmology Total Dublin Mid-Leinster 18

21. 21 Maternity Services Dublin Mid-Leinster Numbers of staff retiring and being replaced Maternity Hospitals / Services No. retiringNo. being replaced Coombe Women & Infants Hospital 77 National Maternity Hospital, Holles Street 106 Midland Regional Mullingar 76 Midland Regional Portlaoise 76 Total Dublin Mid-Leinster 3125

22. 22 Community services: Key risks Dublin Mid Leinster  General  583 retiring, 50 being replaced  Figures do not include the new investment mental health/ primary care  Central Mental Hospital  7 nurses will be retiring.  Hospital impacted by the cumulative effect of the Moratorium.  Business case for staff replacement plan developed.  Nursing in the community  183 nurses including 33 Public Health Nurses to retire. 30 additional nurses to be recruited.  Nurse management posts to be reorganised.  A number of PHNs to be replaced with Registered General Nurse community nurses  Public Analysis Laboratory  1 x Medical scientist to be replaced. (specialist post)

23. 23 Hospitals: Key risks West  General  392 retirees, 77 replacements  Figures do not include the new investment mental health/ primary care  Consultant posts  11 Consultants will be retiring and 8 critical posts will be replaced.  Maternity services  27 midwifery staff are retiring, particularly in the Limerick Maternity Hospital. Of these 12 will be replaced including 5 in Limerick Regional (A further 5 midwives will be transferred from general nursing duties to the Maternity Unit).  Midwest Hospital Group  Particular risks and challenges remain as a result of the cumulative impact of the Moratorium and reconfiguration.

24. 24 Hospitals West Numbers of staff retiring and being replaced Hospital To be replaced Sligo General Hospital 2 Mayo General Hospital 5 Letterkenny General 7 Galway University Hospital Group 25 Mid Western Regional Hospital Group 38 Total 77 ( 19.64%) Total retirees 392

25. 25 Consultant posts West Numbers of staff retiring and being replaced HospitalNo. retiringNo. replacedSpecialties Galway University 44 Respiratory, General/Vascular Surgery; Cardiology, Obstetrics/Gynae Letterkenny 32 Orthopaedics, Paediatrics (non- replacement), Surgery Limerick University 11 Consultant Biochemist St. John's, 21 Consultant Surgeon; Casualty officer Ennis 10 Consultant Anaesthetist Total HSE West 118

26. 26 Maternity Services West Numbers of staff retiring and being replaced Hospitals No. retiringNo. being replaced Limerick Maternity Hospital 195 Letterkenny General 11 Sligo General 22 Mayo General 22 University Hospital Galway 11 Portiuncula Hospital 21 Total HSE West 2712

27. 27 Community services : West  General  802 retirements, 46 replacements  Nursing in the community  318 nurses including 32 including Public Health Nurses to retire.  Nurse management posts to be reorganised.  A number of PHNs to be replaced with Registered General Nurse community nurses  Community Nursing Units  Sacred Heart Castlebar  Conlans, Limerick

28. 28 Conclusion  The HSE is satisfied that following the planning process appropriate measures are in place to deal with the impact of these retirements. Thank you