Department of Health’s new Recruitment Sanction Process means any health region running over 2% of its pay budget must overcome prohibitive hurdles to replace existing positions or employ new staff – this is a de facto recruitment freeze

‘Where will accountability lie for the introduction of this measure when it inevitably has a negative effect and introduces risk into our public healthcare?’

 

Saturday  October 24, 2026. The Irish Medical Organisation (IMO) has warned that the introduction of a new recruitment process by the Department of Health represents a “clear and significant risk to patient safety”.

The Department’s Recruitment Sanction Process, which has already commenced, means that any health region running more than 2% over its pay budget looking to replace or recruit staff must first consider whether the work can be delivered differently or met using staff and resources already available.

Speaking today, Professor Matthew Sadlier, President of the IMO, said: “This draconian new recruitment measure poses a clear and significant risk to patient safety and is a de facto recruitment freeze. Not only does the measure in isolation place unrealistic and prohibitive barriers on doctor recruitment, but it comes against the backdrop of a department setting wholly inappropriate budgets and in a health system that does not have nearly enough doctors to meet ever-growing demand.

“To meet the needs of our population we need 6,050 consultants – we currently have 4,945 whole time equivalents and, of those, 20% are not filled on a permanent basis with over 325 posts unfilled. Consultants are covering long-term vacancies right across the system which is unsustainable. Waiting lists will continue to grow until we have a sustainable and funded workforce which means patients will be denied timely care.

He added: “It is wholly unacceptable that, when a consultant leaves or retires, time must now be wasted making an unnecessary case for their replacement. We need rapid turnover of doctors throughout the system to ensure patients are not adversely affected by natural attrition. The timelines from business case to approval to appointment are already too long.”

Prof Sadlier said it was unclear if a risk assessment for the introduction of this measure had been carried out by the Department of Health or HSE. “Where will accountability lie for the introduction of this measure when it inevitably has a negative effect on doctor numbers, waiting lists and patient outcomes? Was this process assessed and agreed by the Board of the HSE?”

He added that the measure was likely to represent a clear breach of employment rights, in that doctors who have applied and interviewed for, then accepted a role, would now have no guarantee it would be funded. He noted that the IMO is already in the process of representing members who have been impacted in this way.

Prof Sadlier said the Government needed to start being honest with the public about the real provision of health services. “With this measure, the reality is there will be no new services and no expansion of capacity, with the current level of services under threat. It is obvious that the Government’s aim is to reduce the number of people delivering care, not increase them.”

He said that this measure would lead to specific problems for non-consultant hospital doctors (NCHDs). “More than 40% of our NCHD cohort who are not on training schemes are on short-term contracts and the impact of this measure is uncertain. We also know from the HSE’s own estimates that we need to recruit an additional 800 NCHDs to enable legal and safe working hours across the system.”

The IMO is seeking immediate engagement with both the Department of Health and the HSE on this matter.