Richard Boyd Barrett demands scrapping pay-in-number in health crisis
Richard Boyd Barrett accused the minister of misleading the public on housing and the health service and said a 'pay-in-number' recruitment embargo is driving staff shortages. He demanded the pay-in-number strategy be scrapped and warned of strikes, trolley waits, nearly a million people on waiting lists, and shortages of public health nurses.
Boyd Barrett told the minister they had been caught misleading the public on housing completion numbers and argued the same pattern applies to health. He said the lack of staffing across the health services is a result of a pay-in-number strategy that acts as a backdoor recruitment embargo.
He said the recruitment restraint has prompted health workers' unions to ballot overwhelmingly for industrial action, listing nurses, midwives, porters, medical scientists and laboratory assistants as among those pushing for strikes. He warned that unless the pay-in-number strategy is scrapped, strikes may be inevitable as staff seek to break through the embargo.
A government speaker responded by pointing to large increases in health spending and staffing. The speaker said the 2024 allocation was £22.8 billion but actual 2024 expenditure reached £24.58 billion, £1.75 billion over profile, and that the 2025 allocation has been set at £25.75 billion - about £1.2 billion higher than the previous year. The speaker also said there is "absolutely no moratorium on staff" and that staff numbers will increase by over 3,500 full-time equivalents this year.
Boyd Barrett highlighted direct patient impacts he attributed to the recruitment limits - the trolley crisis, nearly a million people waiting for treatments and insufficient public health nurses to carry out developmental checks for infants. The government speaker acknowledged the need for better management and value for money, urging parliamentary scrutiny and citing examples of small-sum purchases in the context of much larger budgets.
Key allegations
Boyd Barrett told the minister they had been caught misleading the public on housing completion numbers and argued the same pattern applies to health. He said the lack of staffing across the health services is a result of a pay-in-number strategy that acts as a backdoor recruitment embargo.
Pay-in-number strategy and industrial action
He said the recruitment restraint has prompted health workers' unions to ballot overwhelmingly for industrial action, listing nurses, midwives, porters, medical scientists and laboratory assistants as among those pushing for strikes. He warned that unless the pay-in-number strategy is scrapped, strikes may be inevitable as staff seek to break through the embargo.
Government response on spending and staffing
A government speaker responded by pointing to large increases in health spending and staffing. The speaker said the 2024 allocation was £22.8 billion but actual 2024 expenditure reached £24.58 billion, £1.75 billion over profile, and that the 2025 allocation has been set at £25.75 billion - about £1.2 billion higher than the previous year. The speaker also said there is "absolutely no moratorium on staff" and that staff numbers will increase by over 3,500 full-time equivalents this year.
Patient impact and oversight concerns
Boyd Barrett highlighted direct patient impacts he attributed to the recruitment limits - the trolley crisis, nearly a million people waiting for treatments and insufficient public health nurses to carry out developmental checks for infants. The government speaker acknowledged the need for better management and value for money, urging parliamentary scrutiny and citing examples of small-sum purchases in the context of much larger budgets.
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Transcript
You were caught out misleading the public, to put it kindly, about the housing completion numbers to try and win an election. Will you now admit that the crisis in our health service is also another area where you've been misleading the public about what's actually going on? The lack of staffing across the health services, which has prompted all of the health workers' unions to ballot overwhelmingly for industrial action. Nurses, midwives, porters, every grade, medical scientists, laboratory assistants, to ballot for industrial action over the pay-in-number strategy. A backdoor embargo on recruitment in vital areas of the health service that is the real explanation why we can't address the trolley crisis, why there are waiting lists of nearly a million people waiting for treatments, why, for example, our public health nurses, we don't have enough of them now to do important developmental checks on young infants, all because you are preventing health areas and hospitals being able to recruit the staff they need to actually meet patient need. Will you scrap the pay-in-number strategy so we don't end up with strikes in this country by health workers to break through this embargo? The Boyd Barrett raised, you know, crisis in health care and pay-in-number strategy. I think we need to stand back and look at what actually has happened in health expenditure in the last four or five years. It's been quite phenomenal and quite exponential in its growth. I mean, if you look at the budget, 2024's allocation was £22.8 billion, but by the end of 2024, the expenditure was actually £24.58 billion, and that was £1.75 billion over profile. If you go forward to the budget for 2025, it is already, the initial allocation has been set at £25.75 billion. That's an increase of approximately £1.2 billion on last year. And so these are huge sums of money, and that's why I'm surprised by Strike Action in that context. There is absolutely no moratorium on staff. There will be an increase in staff this year of up to over 3,500 staff all-time equivalents to the health service. And we have to also look at innovative ways of getting value for that money. I mean, people have talked earlier about scanners and so on in an art gallery. People have created huge, you know, rightly so, about £100,000. We're talking about £25.5 billion here. And that will go up again before the years old, it seems to me, in 2026 and 2027. So I don't think we can argue whatever, and there's more to be done in health, don't get me wrong. But we can't argue that someone is cheap-sparing or that there's pullback in funding. There's not. There's not. There absolutely is not, Deputy. And there's an issue, either in terms of the management of all of this, or getting value for money in all of this. But we do need to critically, and it's a role for the Oireachtas as well. Well, because, you know, people will condemn and give out and criticize, but equally then, people also look for more money. But I think there's a number of strands to this that are important. Deputy.