Concern over HSE audit findings

Concerns about the financial sustainability of Cheshire Ireland, breaches of public pay policy at St John of God, and a 1,000% increase in overtime payments to mental health nurses are among the damning findings of a series of HSE internal audits, published yesterday.

At Cheshire Ireland, which has 20 centres spread across 10 counties providing support services for people with physical and neurological conditions, a plan agreed with the HSE to achieve long-term financial sustainability has not been implemented.

The auditor said this failure “could result in Cheshire Ireland not being a going concern”. The plan was entered into after Cheshire Ireland approached the HSE in 2013 to discuss its deteriorating financial position.

The audit noted “significant difficulties and a lack of co-operation” on the part of Cheshire Ireland when trying to carry out its work, at odds with its normal experience.

An audit of St John of God (SJOG) prompted the HSE to warn it needed to address “fundamental issues of trust” in light of the charity’s payment of secret salary top-ups and lump sums to 14 senior managers in 2013, amounting to €2.4m, to circumvent public pay policy.

SJOG received €511m from the taxpayer between 2012 and 2015. The charity told the HSE in 2013, 2014, and 2015 that it was compliant with public pay policy.

Three senior managers left SJOG’s employment in 2015 and 2017 and there was no clawback of the compensation paid to them.

The audit warns that the:

quid-pro-quo required from organisations receiving taxpayer funding is an organisational culture of transparency, accountability, compliance with all public policies, full candour and full co-operation… the organisational culture in SJOG did not meet these standards.

The order declined to comment yesterday. 

The HSE said it was engaged with SJOG “to address a number of issues aimed at ensuring the future provision of services to children and adults with intellectual disability, and children, adolescents and adults with mental health support needs”.

The HSE audits also found:

  • Overtime payments to nurses in Kilkenny mental health services increased more than 1,000% between 2013 and 2015, from €4,979.74 to €586,584;
  • A report on South Lee Mental Health Services in Cork found it was paying more than double the staff rate to an agency consultant who was also employed elsewhere by the HSE. The report said the consultant “is currently employed by the HSE directly elsewhere on a part-time basis while also in receipt of a HSE retirement pension, in addition to operating as an agency consultant in South Lee MHS”;
  • An audit of recoupment of payroll overpayments by the HSE, described one overpayment of €191,225 as “an inevitable bad debt”, for which sanction for write-off should be obtained. A previous report found the employee had been given 561 years to repay the debt;
  • Cheshire Ireland received about €25m from the HSE each year from 2012-2014. Coollattin Properties Limited, a company holding a land bank in Shillelagh Co Wicklow and associated shooting and hunting rights, was bequeathed to Cheshire Ireland in 1992.

In 2006, it was found the company had been struck off the Companies Registration Office register of companies in February 1999. 

The audit report said that, in 2006 and 2007, “substantial funds were expended in the reinstatement of the company, and in obtaining title to the company’s lands”. 

However, Cheshire Ireland was “unable to provide Internal Audit with the specific amount”.

Between 2009 and 2014, Cheshire Ireland paid €183,484 in respect of Coollattin Limited’s legal fees, audit and accountancy fees, and tax compliance fees but could not provide supporting documentation.

“Included in the figure of €183,484 were six transactions totalling €15,835 for which the payee and the purpose of the expenditure were unknown,” the report said.

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