The HSE will claw back funds from any hospital or health agency which continues to flout a ban on top-up payments to senior officials.
HSE director general Tony O’Brien, confirmed the move at the latest Dáil Public Accounts Committee hearing, and revealed the arrangement has been ongoing since 1995.
Mr O’Brien told the cross-party group that, “at the moment”, the voluntary hospitals and agencies involved are still being funded.
However, he said a “new financial arrangement” is likely for next year due to the top-ups controversy, with funds to be clawed back from groups failing to stamp out the practice.
To date, one body — the Cope Foundation — has been told an “equivalent amount” will be taken from its HSE grant next year to cancel out “second salaries”.
Fine Gael TD and PAC member Paul Connaughton asked Mr O’Brien if the move would effectively “end up punishing patients”, as any budget cut cold ultimately hit services.
Mr O’Brien replied that this is “the great dilemma” for the HSE, but that he cannot allow the top-up system to continue.
He said the issue has been taking place since “at least” 1995, when an unapproved payment at the South Infirmary Victoria University Hospital in Cork City was flagged.
He said there was “no paper trail” to support any top-ups approval.
Noting that some groups had claimed they received “verbal approval”, Mr O’Brien said this “nod and a wink” suggestion was a “convenient” defence, adding it was “inconceivable” this would have happened without some form of documentary evidence.
For the first time in the controversy, the HSE also revealed all section 38 groups breaking the top-up rules. The full list, available at www.irishexaminer.com, states that:
- Seven — including St Vincent’s, Stewart’s Hospital, St James’s, and the Royal Victoria Eye and Ear Hospital — said they are compliant but have been contradicted by audit evidence;
- 12 — including the Coombe, Harold’s Cross hospice, the Rotunda, Holles St, and the Central Remedial Clinic — are not compliant;
- 15 — including the National Rehabilitation Hospital, the Mater, Temple St, Crumlin, the Cope Foundation, and numerous disability charity groups — said they are compliant but “indicated exceptions”;
- The Cork University Dental School and Hospital failed to reply;
- The South Infirmary Victoria University Hospital is compliant but wants approval to pay a new top-up;
- Only seven — including St John’s Hospital, the Mercy University Hospital. and the Children’s Sunshine Home — obey the rules.
Mr O’Brien said formal audits are needed as some bodies claim to be in compliance but have “recorded deviation” from the policy.
He said a second investigation is being considered, warning: “It is now very clear we cannot operate on the basis of trust.”
Last night, Crumlin issued a statement saying: “The hospital has fully engaged with the HSE and has confirmed that the remuneration of the chief executive includes an allowance funded from on-site commercial activities... No charitable donations have been used to pay this allowance.”
Holles Street’s decision to outsource obstetric scans to a private clinic run by five of its consultants, including hospital boss Dr Rhona Mahony, is to be investigated by the health service.
HSE director general Tony O’Brien confirmed the move to the Public Accounts Committee.
He was asked about the €45,000 payment to Dr Mahony in addition to other contractual allowances and her €183,562-a-year salary.
She defended the fund last week by saying the money was from treating private patients.
Last weekend, the Sunday Times revealed she is involved in the private Merrion Fetal Clinic.
Mr O’Brien was asked if the group’s relationship with the hospital was a cause for concern as these patients could have been treated in Holles Street.
He said the issue would be “specifically investigated” as part of the HSE’s examination of extra payments to section 38 and 39 officials.
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