Measuring hospital waiting lists and the numbers of patients on trolleys is a crude approach that “leads to reactive and pressure-based planning” of our health services, according to Fórsa’s head of health Éamonn Donnelly.

In a submission to an Oireachtas committee looking into workforce planning in the sector, Donnelly championed a better balance between well-resourced and adequately staffed community and hospital services, along with strong health promotion, and called for immediate planning for the introduction of the Sláintecare model.

The proposed Sláintecare programme would see a single-tier public health system, free at the point of use, with more emphasis on primary care and community services. It won cross-party report when it was unveiled in 2017.

Donnelly described workforce planning as “planning to place the right number of people with the right skills in the right place at the right time.” But he said it was hard to achieve in a disjointed, 90-year-old health service where political and operational planning was dominated by pressures in the acute hospital sector.

“The Irish health service is resourced with highly competent workers whose diligence is often compromised by a systems failure that prevents them delivering the required levels of improved patient outcomes. Effective workforce planning requires taking a step back and planning to resource the type of health system envisaged in the Sláintecare model,” he said.

Donnelly also called for multi-annual budgeting to underpin effective planning and service delivery, and to get away from “a cap in hand approach that directs resources to whatever area of healthcare is attracting the most noise at a particular point in time.”

He called for a proper mobility policy to ease pressures in staff recruitment and deployment, and criticised recruitment freezes for introducing “layer upon layer of derogation processes, which take months to navigate and leave vital posts either vacant or filled by agency workers at a higher cost to the state.”

Donnelly also highlighted the need to recruit more health and social care professionals (HSCPs), who needed a formal advocate in the health department.

“At over 7%, the rate of churn of HSCPs is second only to hospital consultants. Meanwhile, the Sláintecare model references the need for an additional 1,400 HSCPs, though this figure doesn’t take account of alarming and critical gaps in the current structure,” he said.