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Jerome Reilly: Public service exodus has potential to prove deadly

The exodus from the public service, approximately some 7,500, is fast descending into a dangerous and potentially deadly fiasco.

Robbed of many experienced and essential public servants mid-career, the promised savings to the taxpayer have been exposed as a myth and the health service will be plunged into a period of chaos.

Try not to get sick in the next few months -- and if you live in the Mid-Western Region where a quarter of all midwives will be gone by February 29, stock up on prophylactics.

Large swathes of the country, perhaps 30 large towns by some estimates, will be left without a senior experienced garda.

The insanity of allowing the best police officers to retire early will perhaps only come home to roost in two or three years when high-profile murder trials begin to collapse because investigations were fatally flawed during initial investigations for a lack of wise old heads in uniform.

The plan to reduce public service numbers by some 9,000 in total has been botched from the start. The whole plan has lacked subtlety and foresight.

A blind eye was turned on the essential truth that some public servants are simply more valuable than others.

A back office pay clerk, beavering away in Coillte, is not as important to the common good as a specialist nurse in an intensive care unit.

But under the Howlin plan, and at the insistence of public service unions who sealed the deal with the last government at Croke Park, all were lumped together.

Skilled, life-saving and overworked clinicians who cost tens of millions to educate and train were given the same ultimatum as those in overstaffed, heavily duplicated administrative roles.

All were told to leave by February 29 to retain their pension and retirement tax-free lump sum based on their salary in 2009. These retirements will cost the taxpayer an estimated €1bn, according to figures secured by the Fianna Fail public expenditure and reform spokesman, Sean Fleming.

Union chiefs will no doubt use the inevitable chaos caused by the reduction in vital frontline workers in the coming months as cover to protect the broader public sector with its endemic problems of gross overstaffing, inefficiency, lack of flexibility, absenteeism and institutionalised sick days.

The upside, according to the Government, is that a leaner, meaner, more flexible and cost-effective public sector will emerge.

It won't.

Those who suspected that the public sector exodus would show savings in one column of the national accounts, but an extra cost in another part of the ledger have been proved correct.

Last week, a meeting of the Dail Public Accounts Committee elicited a truly shocking admission from the HSE.

The loss of a highly trained specialist nurse earning €60,000 will actually mean savings to the Health Service Executive of just €20,000 -- even if they are not replaced.

HSE chief executive Cathal Magee revealed that when a staff member left, the HSE lost out on their superannuation contribution as well as their health levy payment.

He said that the HSE had to pay out the cost of the lump sum payment and pension from funds for the year. It means that, on average, the saving for the year was only about one-third of the salary of the person who left.

When the country's largest public sector employer, which looks like losing 3,000 staff including frontline nurses and medics, makes such an admission it's time to sit up and take notice.

And there is still time to finesse the scheme so that there could be an ordered retirement of the staff who matter most -- say over 18 months.

Mr Fleming suggested that to avoid further pressure on health services, a moratorium should be put on frontline posts such as nurses so the current incentives for early retirement are extended for another year. It's an idea worth exploring in the next two weeks.

Consultant obstetrician and Labour Party official, Dr Gerry Burke, is convinced that some women and babies may pay "with their lives" as midwives leave.

He says St Munchin's Regional Maternity Hospital in Limerick, which treats 6,000 women and 5,200 newborn babies every year, will have lost 47 midwives out of just over 200 through retirement. And he is not convinced the HSE has a contingency plan.

Other clinicians agree. Dr Sam Coulter Smith, master of the Rotunda, says midwife/ patient ratios were already severely compromised -- even before the latest exodus.

"You reach a point when you can't stretch the service any further, and we are at that point now," he said.

Dr Coulter Smith said the "accepted norm" for midwife/ patient ratios was 1:28 up to 1:33, but that the ratio at the Rotunda was now 1:47 and that situation would worsen when 29 staff leave by the end of February.

In response to queries from the Sunday Independent, the HSE said it was acutely aware of the challenges that face the health services this year, both in terms of reduced staffing levels and a reduced budget.

"Contingency plans are being developed at a local service level to cover any gaps that may arise as a result of staff, including midwives, retiring at the end of February. The full extent of staff reductions will become clearer at this time.

"Local managers and senior clinicians are engaged in developing innovative solutions in order to deal with reduced resources in 2012," the HSE said.

But while the HSE's measured response at least acknowledges the challenge on health services retirements will inevitably bring, the Taoiseach Enda Kenny said he thought that Dr Burke's comments were outrageous.

"To equate the legitimate leaving of the health services under the programme, by staff who wish to leave, with an attack on babies and pregnant mothers with a view to paying German banks is beyond the norm for a medical person of his stature to do so," he said.

In fact Dr Burke had a responsibility as a senior clinician to point out that losing one in four midwives in a hospital where the birth rate is going up was both unwise and potentially deadly.

We all want a better, more efficient public service. We don't want mothers and unborn infants paying for "greater efficiencies" with their lives.

Sunday Independent