THE HSE IS to pause recruitment for some non-frontline roles in three of its six health regions as it grapples with a significant overspend across the health service.

An internal memo sent to senior management by the HSE’s chief executive officer Anne O’Connor stated that the HSE’s financial position “is now significantly over-budget”.

The combined overspend in January and February of this year within the health department funded HSE services was €146 million. By the end of March, this overspend had increased to €250 million, she said.

“The situation has significantly worsened.”

The overspend has been attributed to sustained overspending on pay, including overtime, agency staff, other non-pay expenditure, and lower income than expected.

Outlining the measures that are to be taken to bring the service back in line financially, O’Connor said she was cognisant that the overspend ultimately relates to patient care, but that the HSE’s position as a publicly-funded body means it must be accountable for proper spending.

“The controls being applied focus on discretionary spend, on the use of agency staff and on recruitment,” she said.

“Recruitment can only take place to approved and affordable positions and only after approval by the REO [Regional Executive Officer] or those authorised to approve posts at the centre.”

REOs are the six senior leaders appointed in early 2024 to manage the HSE’s regions.

Three health regions – Dublin and Midlands, Dublin and South East, and South West — have been placed into Tier 3 escalation. This adds specific conditions on regional controls.

The executive management teams overseeing the three regions in Tier 3 escalation have been informed that all recruitment must be actively reviewed.

A pause on recruitment will apply across all non-frontline, non-critical posts. Exceptions will only be considered where supported by a documented business case and approved at REO Level, including recruitment on all non-frontline management and administration staffing.

All agency engagements, extensions and conversions require prior written approval at REO level, with some specific exceptions.

The Irish Nurses and Midwives Organisation said the recruitment pause must not include nurses and midwives.

“The INMO is clear embargoes are incredibly damaging to staff and patients alike. Nurses and midwives must be exempt from recruitment controls in all areas,” its director of industry relations, Tony Fitzpatrick, said.

“We know that there are currently over 5,000 vacant nursing and midwifery posts. The non-filling of clinically necessary nursing and midwifery posts should not continue to be the norm.”