Large increase in outsourced occupational medicine expenditure

The HSE spent almost €794,786 on outsourced occupational medicine services in 2020, compared to €99,292 in 2019 and €297,413 in 2018. The largest amount expended in 2020 was for “support services” accounting for €772,925, according to figures released to the Medical Independent (MI) under Freedom of Information law.

The HSE refused to release its service level agreements with private companies for occupational medicine services, as the documents “provide details of costs and prices, which generally are regarded as commercially sensitive information”. Since before the pandemic there has been significant outsourcing, which stood at 25 per cent in 2017, according to a HSE workforce paper.

HSE-employed specialists in occupational medicine are not granted consultant contracts and have terms and conditions that are less attractive than specialist colleagues in the hospital system.

Previous HSE documents obtained by MI, on Covid-19 hospital outbreaks, stated that the pandemic had exposed the resource deficits in occupational health services. Departments have reported major manpower deficits leading to difficulties in timely contact tracing of healthcare workers.

Commenting to MI in late January, the HSE said “a proposal is with the contact management programme to include a specified healthcare pathway as part of the contact tracing process. The required resources for this are still being planned.”

Its spokesperson said additional development posts in occupational medicine will facilitate the “reinstatement of usual services” including provision of pre-employment health assessments in-house.

The Workplace Health and Wellbeing Unit has run six advertising campaigns to recruit for occupational health posts of various grades, supported by the winter plan.

As of 21 January, 22 posts had been advertised under these campaigns. As a result, there were six candidates either in post or with an imminent start date, stated the HSE.