St James's Hospital struggling to meet demand since deal with staff-owned company suspended, PAC told

St James's Hospital had made use of the services of a private radiology clinic, hosted on its own campus, between 2017 and 2024 to provide a range of cancer screening services, using emergency funding apportioned by the National Treatment Purchase Fund (NTPF). That funding ceased in March 2024. File Picture:Wanderley Massafelli/RollingNews.ie

One of Dublin’s largest hospitals is struggling to meet the demands of patients since the supension of an arrangement which saw €4.7m paid out to a company owned by its own staff, the Public Accounts Committee (PAC) has heard.

Despite apologising that the company in question was used for cancer diagnostic services without a formal contract, executives from St James’s Hospital said the arrangement had been necessary due to the “severe pressure” it routinely comes under to provide services.

The hospital had made use of the services of a private radiology clinic, hosted on its own campus, between 2017 and 2024 to provide a range of cancer screening services, using emergency funding apportioned by the National Treatment Purchase Fund (NTPF). That funding ceased in March 2024.

Some 18 directors of the private company are employees of St James’s Hospital. Their dual status had not been divulged in the statements of assets required by law to be lodged with the hospital.

Professor Mary Day told the PAC that the money was initially used for mammography only, before the demand for various other cancer screens and associated diagnostics ramped up during the pandemic.

She apologised that the services had been procured without a formal public tender competition, saying that in doing so the hospital had failed to “meet the standards expected of us”.

However, she stressed the move had been made in good faith given the extent of patient demand for emergency diagnostics at the hospital.

Cancer patient survival

Since the funding was suspended in March 2024, the hospital has seen a 50% increase in people looking for CT scans, a 70% increase in demand for ultrasounds, and a 90% jump in requests for MRI scans, John Kennedy — a consultant oncologist at the hospital — said.

“It’s really important that we understand what’s going on here,” he said. 

“The population has increased by 15% over the last decade. Those over 65 have increased by 36%, and they’re the people that get cancer.”

He noted the “great success story” of the Irish health system is that survival of cancer patients has also greatly increased, but added “the implications are relentlessly increasing demand”.

Mr Kennedy said the constraints on treatments during the pandemic had created a backlog that has never been overcome.

“Covid really set this off, but we have never gotten back to a stable situation since then,” he said.

Prof Day said the ongoing non-compliance of the procurement of the private radiology clinic was partly explained by the extent to which going to public tender during the pandemic would have proved to be “very challenging”.

The committee heard the MRI function has already been officially awarded to the radiology company in question, while Prof Day said she "expects” the HSE will award contracts for the necessary CT and ultrasound scan capacity at the hospital by the end of this month.

Asked by Social Democrats TD Aidan Farrelly if any similar arrangements to the radiology clinic existed at the hospital, chief operating officer at St James’s Hospital Aisling Collins noted that, since 2022, St James's Hospital has employed Dermview — which is owned by two consultants at the hospital — but said that the conflict of interest had been dealt with up front, while the service itself had been procured in an appropriate manner via the HSE.