The ongoing growth in the use of agency workers to provide healthcare services “devalues workers and undermines patient care,” a Siptu health division conference in Wexford was told on Thursday.
The union’s health division organiser, Kevin Figgis, said: “When services are outsourced, the focus shifts from health outcomes to profit margins. Private contractors cut costs wherever they can, usually at the workers’ expense or the quality of the service experienced by the patient or service user.”
The Health Service Executive’s total spend on agency and other outside service provision has grown hugely in the past decade and reached €863 million in 2024.
Reducing the figure for actual agency workers has been a target for the organisation, according chief executive Bernard Gloster, who it said it was converting substantial numbers of agency workers to direct employees. The spend has continued to increase, however, causing anger among unions at a time when limits have been set on staff numbers and pay costs.
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“Workers in outsourced roles often face significantly reduced pay rates and the loss of the public-service pension scheme or sick-leave benefits,” Mr Figgis told delegates at the conference. “Job security becomes a distant dream, replaced by precarious contracts and constant uncertainty.
“Outsourced roles often come with fewer protections, less training and create a two-tier workforce. Let’s be clear, when workers are undervalued and overworked, they, their patients or service users suffer. You cannot provide high-quality care when the workforce is demoralised and stretched to its limits.”
The conference passed a motion, meanwhile, calling on the Government “to double the investment in a professional ambulance service within the health services”.
A HSE audit published last year, but relating to 2023, suggested funding for new vehicles was about half what it should be. Funding was increased last year, to €231 million, but the union says it still falls well short of what is required by an organisation that answers some 400,000 calls each year and employs almost 2,500 staff.
Paramedic and Siptu sector president Stephen McGuinness said the Government’s failure to provide the funding required to maintain services was impacting on staff.
“Unfortunately, I’ve witnessed a steep decline in the morale of our members. The funding provided by government has not kept pace with the ever-dynamic changing circumstances that are intrinsic in a modern ambulance service.”
He said he and his colleagues were forced to endure reports in the media of inadequate services when “these communities deserve a fit for purpose effective ambulance service”.
“Good reputations such as the one currently enjoyed by the NAS are difficult to build but easily shattered. Our overriding concern is that the cutbacks have resulted in detrimental shortages and gaps in the services given to patients,” he said.
