Mr Cullinane told the Oireachtas Health Committee on Wednesday: “It never ceases to shock me when I get (these figures) but they are up again. That is almost €1bn which is a doubling of investment over a very short period of time.” 

In response, the health minister acknowledged the scale of the problem, saying she is “driven demented” by the spending.

“What I really want to do is establish our own agency,” she said.

“I want to establish our own HSE agency. I am tired of paying agency fees to third parties, I don’t see any value in it. I believe there is a role for agency in the future of the health system, in so far as we will need a certain measure of flexibility.” 

She added: “It is reasonable that we establish our own HSE staff bank. It is something that I asked for last October and it is being progressed now in the HSE.” 

It would mean if HSE staff choose extra hours they could apply through this agency rather than through external bodies, she said. Ms Carroll MacNeill added: “That might result in some kickback from people who’ve been used to work in this way." 

Labour health spokeswoman Marie Sherlock welcomed the suggestion, saying the NHS in the UK already does this.

Fine Gael TD Colm Burke suggested there is no need to legislate on agency work but it does need to be considered, saying a locum can cost double the wages paid to a permanent worker.

Consultant contracts

The committee discussion overall centred on the Health (Amendment) Bill. Ms Carroll MacNeill also discussed the row over the consultants' contract and working times. 

She described the Sláintecare reforms as "a unique opportunity" to move towards six- or seven-day working for patients' benefit.  She said changes also include standardising shift start times in order to enable more efficient use of theatres or other facilities. 

She called on opposition politicians present to "stop reflecting the language of the different interests and take the State's position sometimes".  This was in reference to the debate over how the Rotunda maternity hospital interpreted the consultants’ contract.

Ms Carroll MacNeill described the hospital’s position as incorrect "at both a contractual level and at SLA (service level agreement) level and a policy level".

She added: “Not only is it incorrect in law, it is incorrect in the spirit of it as well.”

In addition, she singled out HSE Midwest for having "the best Saturday rostering" despite having a low uptake of the new contract and relying on overtime hours to offer this for patients.