Critical frontline posts in the health service, such as those of doctors and nurses that are vacant since last year, cannot now be filled unless another post is done away with, it has emerged.
In a circular issued to hospitals in recent days by Martin McDonald, the Health Service Executive's national director of human resources, it is made clear there will be strict control of staff numbers in the health service this year.
The circular states employment levels will only rise to deliver Government or ministerial-approved service developments.
"Where there are critical front-line vacancies predating the start of 2008, the filling of such vacancies can occur when another post falling vacant after 1st January 2008 is identified and suppressed," it says.
It suggests staff in the health service returning from career breaks have no guarantee they will immediately be taken back.
"Staff returning from career break should be afforded priority in the filling of vacancies arising after 1st January, 2008," it says.
Last September the HSE imposed an outright ban on recruitment to control its rising deficit and this included a ban on people returning from career breaks.
While the overall ban on recruitment, including the ban on people returning from career break, was subsequently lifted, it appears from the latest circular that a stiff employment control framework persists.
The circular, dated January 8th,states that prior to the filling of any post that falls vacant this year, a review of the post must be conducted to ensure it is still required in its current format.
Furthermore, it says that hospitals planning to employ extra consultants this year should try to do so "on a cost-neutral basis through conversion of existing non-consultant hospital doctor posts to consultant posts".
It says no additional nursing or midwifery staff should be appointed, which would have the effect of "undermining or distorting" the plan to reduce nurses' working hours to 37½ hours a week by next June on a cost-neutral basis.
The Irish Hospital Consultants Association said yesterday it was seriously concerned the circular meant the HSE was planning to delay the filling of critical frontline vacancies. The contents meant the recruitment embargo, which was implemented from last September onwards, was continuing and the problems it created for patients will get worse.
Martin Varley, IHCA assistant secretary general, said delays in filling what the HSE described as "critical frontline vacancies" will undermine the capacity of hospitals to provide the required level of services to patients.