HSE costs up to 66% higher in Cork/Kerry region due to use of agency staff

Seán McCárthaigh

The hiring of agency staff by the HSE in Cork and Kerry to fill administration posts at Covid-19 centres cost up to 66 per cent more than if someone had been hired directly to fill the same vacancy, according to an audit report.

HSE auditors also found that no competitive process was undertaken by 10 of the 11 locations in the region reviewed for the supply of administrative agency staff by the top five highest paid recruitment agencies.

Overall, an internal audit by HSE officials found “limited” levels of assurance that the procurement and payment of agency staff for clerical, administrative and management positions in Cork and Kerry were compliant with National Financial Regulations set by the HSE.

It revealed that over €11 million was spent on agency staff by the HSE in the two counties in 2021 with a further €6.8 million spent in the first nine months of 2022.

The HSE acknowledged that it employs staff through employment agencies on a short-term, temporary basis where roles cannot be filled by traditional recruitment methods.

It also accepted that while it has a national framework agreement for certain staff provided by agencies including doctors, nurses and healthcare assistants, there is none in place for clerical, administrative and management grades.

“Uncontracted services can result in an absence of control over service and costs,” the audit noted.

The audit showed that the hourly rate for a clerical officer at the Cork Contact Tracing Centre directly employed by the HSE was €13.00 compared to €22.03 for an agency worker – creating a differential of €14,754 over a full year.

The role of a project manager in the HSE’s Department of Health would cost €84,357 if hired directly but actually cost €144,430 as a result of using a recruitment agency to fill the position.

The figures excluded HSE pension costs.

The audit verified claims by the HSE that the rates paid to agency staff were in line with HSE consolidated pay scales, although it also highlighted how agencies charged different rates of fees.

HSE auditors recommended that management should examine the feasibility of undertaking a national framework agreement for the hiring of clerical, administrative and management grades through agencies.

In reply to the audit’s findings, the HSE said it had active panels for entry grade levels such as clerical officers and assistant staff officers, which were replenished on a regular basis.

Temporary placements

The HSE said it used the panels for temporary placements for periods of up to six months, which reduced the need to use agencies at such levels.

While a review could be conducted on the feasibility of a national framework for the supply of administrator and management grades in the third quarter of 2023, the HSE said it was envisaged that there would be “significant resistance” from staff representative bodies to formalise what could be perceived as an “outsourcing arrangement” and a barrier to promotion for their members.

Although the HSE said that there was a derogation from the normal requirement to seek competitive tenders introduced at the outset of the Covid-19 pandemic to deal with an emergency staffing requirement, auditors found that such arrangements remain in place for some temporary roles.

Over the audit period, it was established that over €280,000 had been paid to recruitment agencies in relation to such staff.

The audit said the situation created the potential for increased costs without a competitive process, while there was also non-compliance with procurement guidelines.

The HSE said it was recognised in 2022 that it was timely to review all contracts that were subject to the derogation to see what was required to bring them in line with the requirements of its National Vaccination and Test & Trace programme.

It said the review had led to the termination or reduction of service as appropriate and the establishment of interim contracts where necessary until they could be stood down or transitioned to in-house roles.

However, the audit showed there were 46 agency staff employed at the Cork Contact Tracing Centre in February 2023 – three more than in December 2022, despite a decrease in the requirement for testing and tracing for Covid-19.

The HSE said numbers working in contact tracing centres nationally were reduced from 142 to 54 in April this year.