The costly employment of agency staff across the health system, including in mental health services, reflects a deep failure in workforce planning by successive governments, according to Social Democrats TD Liam Quaide.
Deputy Quaide, who is the party’s spokesperson on mental health and disability, said:
“Figures released to me by the HSE showed that the overall spend on agency staff in 2024 for its Mental Health Division was €196.4m, out of a total €726m agency staffing costs.
“Further exploration of these figures shows that the breakdown of monthly salary expenses for mental health clinicians is in excess of 40 per cent more costly than the average spend on directly employed staff.
“The average monthly salary of a psychiatry registrar is €9,148. An agency psychiatry registrar costs the HSE €14,233, with €800 of that sum paid directly to the agency per clinician, per month, while €2,662 is paid in VAT.
“For a clinical nurse specialist, the HSE pays an average of €562 per month directly to the agency employing them, and €1,650 in VAT. Nursing makes up a large proportion of mental health service agency staff.
“The costly employment of agency staff across the health system, including in mental health services, reflects a deep failure in workforce planning by successive governments. HSE recruitment restrictions imposed by the government – both through the official embargo and the Pay and Numbers Strategy – are a significant factor in this trend.
“It makes no sense to place a stranglehold on the recruitment of essential health service staff while at the same time paying exorbitant sums to agencies to fill the gaps created, in part, by these restrictions.
“An over-reliance on agency staff makes for disjointed service development within a sector where continuity of care and stable therapeutic relationships are vital.
“The government needs to invest more in directly employed mental health clinicians who have good working conditions and opportunities for progression that will sustain them within our health system long-term.”
June 25, 2025