The country's 10 health boards have commenced negotiations with the Department of Health over a freeze which the Government is seeking on 800 jobs.
The cuts are in approved posts rather than posts which have already been filled. The health boards have already been given "indicative" figures on the number of planned jobs which each will be expected to cut.
The Department of Health said yesterday that it was in talks with the health boards on the exact numbers in each board and on which posts would be involved.
The posts are mainly in management and administration, according to the Government announcement earlier this month.
The Department has already undertaken that the posts to be affected "will have a minimal impact on patient services. Priority will be given to the filling of those posts which are directly related to the delivery of services to patients."
However, the Irish Medical Organisation warned that administrative backup for consultants and other hospital doctors was already inadequate and that the proposed expansion of consultant posts and of the hours during which outpatient clinics were open would require more, and not fewer, clerical administrators.
The Irish Nurses Organisation has also warned that nurses must not be expected to take on administrative duties which would otherwise be done by people employed for that purpose.
For some health boards the latest move represents a second stream of spending restrictions. Prior to the government announcement, they were already seeking ways of getting back within budget because of overspending caused by the winter vomiting virus and other factors.
When the public spending estimates for 2002 were announced last November the Minister for Health, Mr Martin, listed five main areas as benefiting in the revenue (mainly pay) area. It seems likely that the decision not to proceed with 800 approved posts will involve jobs in these areas. They are:
• acute hospitals which are to get new units, more investment in cancer prevention and treatment and more beds. Mr Martin has said front-line services will not be affected. Attempts to set up new hospital units without clerical and administrative backup could run into opposition from nurses and consultants;
• childcare services, including more spending on foster care and youth homelessness. These areas require intensive input from social workers and childcare workers who are already limited by scant administrative backup;
• community care, including services in mental health, intellectual disability and autism, physical and sensory disability and services for older people.
• Expansion of any of these services requires managerial and administrative backup;
• primary care, to include dental services, immunisation programmes,
• AIDS/HIV and drug services, food safety programmes and GP co-ops.
• Expansion of these services would have to include a strong administrative component;
nursing degree programme - the new four-year nursing degree programme is being implemented this year. It has required a large investment in expansion of facilities in higher education institutions. It seems highly unlikely that these particular cuts will affect this programme.