The Health Service Executive will be able to employ around 2,200 extra staff next year, its CEO has told an Oireachtas committee.
Bernard Gloster told the Oireachtas Committee on Health that the HSE will reach, if not exceed, its funded staff target for 2023 by the end of the year and this is the sole reason for the recruitment freeze in certain grades.
The committee is examining the funding allocated to the health service in the Budget, which Mr Gloster has described as inadequate.
Mr Gloster said that unplanned care and waiting lists are two areas that are well-funded for 2024 and that many new health strategies and programmes developed in recent years will not see growth next year, due to budget pressures.
He has described the funding situation for 2024 as "very constrained and challenging".
He told the committee that the HSE intends to agree with the Department of Health a clear budget and staffing numbers for 2024 and this will have to be managed very carefully.
Mr Gloster told the committee that he rejected the idea that the HSE was wasting public money.
"The notion that we're just a complete bunch of wasters of public money, I absolutely reject that," he said.
"Everyone wants to talk about overspending, but not about the increase of 85% in energy costs the HSE has faced," he said.
Mr Gloster said that the HSE needs to cut "one third" of its spend on agency staff, noting that "it is a dependency that has grown".
"We're overspending on pay" which accounts for "about a third of acute's deficit", Louise McGirr, Assistant Secretary (Resources) at the Department of Health, said.
"From a safety perspective agency is seen to be not as good as staff," she added.
'Unprecedented investment in healthcare'
Secretary General of the Department of Health Robert Watt told the committee that there had been unprecedented investment in healthcare over the last number of years.
He said that on a like-for-like basis, spending has doubled over the last eight years and this was more significant investment than most other developed countries.
Mr Watt said that an extra 178,000 patients have been treated in the year to date compared with last year.
He said that pay makes up 42% of the health budget and that savings and efficiencies are required and will be part of the HSE Service Plan for 2024.
Mr Watt said that the key factors driving the rising health spend are higher demand and higher prices and told the committee that the extra ask for the health budget for 2024 was around €2bn.
He said that health got an extra €800m in day-to-day funding plus no-core funding of €1bn for next year.
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The committee will hear too that next year a drug for Alzheimer's disease - Lecanemab - is expected to be ready.
If approved, Lecanemab could cost €100m based on 4,000 patients needing treatment.
Mr Watt could not confirm if any of the 1,500 rapid-build beds which the Minister for Health has announced would be delivered in 2024.
The HSE is "going through the procurement process" and "awaiting final allocations of funding", he said.
Sinn Féin TD David Cullinane said that it "is quite obvious" from the Budget allocation "that they are not funded".
"I would be amazed if we had any of those beds delivered in 2024", the deputy said.
Year-round winter and trolley crisis, says Cullinane
Earlier, Mr Cullinane said he agreed with Mr Watt that more must be done to invest in primary and community care.
Speaking on RTÉ's Morning Ireland, he expressed concern that overcrowding at University Hospital Limerick, will be replicated across the country and said there is "an all year round winter and trolley crisis" in hospitals and talking about UHL is like "groundhog day".
Yesterday, the Irish Nurses and Midwives Organisation said a record 130 admitted patients were waiting for admission to a bed at UHL.
Mr Cullinane said overcrowding "happens now almost every day of every week .... but it's not just Limerick. It's hospitals in Dublin, in Galway, and Cork, and in other parts of the country where we have real pressures. Unless we have the capacity in the system and the beds that we need, we're not going to solve the problem."
He said the Government made a deliberate decision "not to properly fund the health system next year," which, he warned, will have consequences for patient safety.
In addition, the recruitment embargo imposed by the Government has given those in training "a green light to emigrate", he said.
Additional reporting: Mícheál Lehane
