Two-thirds of Fianna Fail backbenchers are unhappy with the HSE's performance, according to a study carried out by the Lunchtime with Eamon Keane radio show on Newstalk last week.

Of the 43 backbenchers approached, 37 responded and 23 expressed dissatisfaction with the HSE. Fourteen were unhappy with the performance of health minister Mary Harney, criticising her over cuts to frontline health services.

Friday's survey came just days after the minister for community, rural and Gaeltacht affairs, Eamon O Cuiv, commented that the HSE was "impossible to deal with" and he couldn't "make head nor tail of it". O Cuiv's party colleague Mary O'Rourke added her criticisms, saying, "I am quite astounded at the remove of the minister and the department of health from the day-to-day doings of their citizens in health matters. . . it's all a bit of a morass."

While acknowledging that the old health boards were very politicised, O'Rourke claimed, "At least with the 11 kingdoms of the health boards, you could actually get to someone with a name, an identifiable name and sometimes an identifiable face to which you could address your queriesf I do feel sorry for Professor Drumm. He has a most unbelievable task to get to grips with everything."

Few would argue that Drumm has an unbelievable task on his hands, and a look at the structure of the HSE confirms this. The HSE is the biggest employer in the state with a complement of over 111,000 full-time staff and a budget of 14bn a year. One person in 20 of the national workforce is on the HSE payroll, with two-thirds of these directly employed by the HSE and the other third working in HSE-funded jobs.

The results of the most recent quarterly Health Service Personnel Census, show that the HSE employs 111,570 fulltime staff. The highest proportion of these work in nursing (38,609), while the second-highest are in administration and management (18,257). Health and social care professions make up 15,441 staff, while the lowest proportion are medical and dental personnel (7,926).

Meanwhile, the overall health wage bill has trebled over the last 10 years, soaring from just under 2.5bn in 1998 to 7.2bn this year, according to Department of Finance figures. By comparison, the wage bill in education, the state's other big spender, has doubled in the same period, from 2.2bn to 5.5bn.

But the soaring wage bill in health really stands out when compared to the state's other main sectors such as security, which includes gardai, prison officers and soldiers, and the civil service, which includes all staff working in government departments. The wage bills in both these sectors have doubled over the same period, meaning that the wage bill in health is increasing twice as fast as the wage bill for gardai and civil servants.

The main reason behind health's increasing share of the total public sector wage bill is the increasing number of health workers recruited year after year.

Total numbers employed in the health sector have increased from just short of 68,000 in 1998 to 107,500 in 2007. Again, this is well ahead of education, where the numbers employed have increased from over 63,000 in 1998 to just short of 86,000 this year.

Here, comparisons with security and the civil service are more marked. While health recruited an extra 40,000 staff . . . an almost 60% increase . . . in the past 10 years, the number of gardai, soldiers etc increased by just over 800, or 3%. Similarly, the civil service swelled its ranks by under 6,000 over the period, or 21%.

For the HSE, the irony is that the more money and bodies it throws at the health service, the worse the criticism seems to be, much of it coming from the extra staff who have been employed.

Now Harney and Drumm have decided that the upward spiral of pay and numbers which appears to be having a minimal effect on services has to be cut.

Hence the recruitment and promotion freeze which, even if it is accepted by the unions, will have only a minimal impact on the wage bill.