HSE chief financial officer and interim deputy director general Stephen Mulvany admitted the situation amid fresh questioning over the recently revealed €7m St John of God’s top-ups controversy, which has occurred almost four years on from the Central Remedial Clinic crisis.
Speaking during a Dáil Public Accounts Committee (PAC) meeting, which also heard that HSE claims the organisation was “systemically starved” of necessary funding when it was created in late 2004, and warnings patients are treated like “collateral damage”, Mr Mulvany said staff issues mean financial scandals are always possible.
Responding to questions from Social Democrats TD Catherine Murphy about how the St John of God’s controversy could be allowed to occur after such focus on addressing top-up scandals in the wake of the CRC, Rehab, and Console scandals, Mr Mulvany said the reality is the HSE does not have enough staff to examine all deals with groups.
The comment came after the comptroller and auditor general, Seamus McCarthy, told the PAC there are severe “weaknesses in the oversight and monitoring of grants” to section 38 and section 39 voluntary agencies.
In a detailed statement about the HSE’s 2015 and 2016 financial accounts, Mr McCarthy said his examination found “grant aid agreements had not been put in place by the end of 2016” which would ensure hidden management top-up payments would not occur.
In addition, he said, in a significant amount of cases he examined, there was limited or no “evidence of monitoring” of the situation by the HSE, “no evidence” of funding reviews, and “a significant level of non-competitive procurement”.
HSE director general Tony O’Brien admitted when the HSE was set up in late 2004, it was “systemically starved” of the funding it needed, partially because only one of two Government reports needed for the system to properly function was implemented.
Mr O’Brien was responding to criticism from Independent TD Catherine Connolly patients on trolleys are being treated like “collateral damage”; accusations from Sinn Féin TD David Cullinane that mental health waiting lists in the south east are as long as 16 months; and further claims over the failure to resolve a series of long-term service problems putting patients at risk.
“When the HSE was created, it was in my view systemically starved of what was needed,” said Mr O’Brien. “I was told on my first day [in 2012] I was personally responsible for finances, and that the finances were completely unworkable.”