March 2020 was a fraught time for the HSE. While the situation in Ireland is currently facing is dreadful, it doesn’t have quite the apocalyptic feel of the beginning of the pandemic, when no one among us even knew what a lockdown was.
Nine months ago Ireland, and much of the world, faced a terrifying hurdle - the urgent need to acquire vast quantities of personal protective equipment (PPE) and specialised medical devices like ventilators in order to allow medical practitioners to simply do their job without endangering themselves, or others.
This led to a situation broadly described as “panic” within the HSE’s procurement division. Not everyone was able to catch the HSE’s ear, but for those that did, lucrative contracts were on the table with no need for tenders and a relatively liberal approach to due diligence.
€1.1 billion was spent by the executive between the end of February and early May, on contracts ranging in size from €225 million down as far as €90m. All told 88 separate companies received payments of €1 million or more in that time.
Roqu Media International Limited, was one such company.
The then media management company, experienced in managing festivals in countries like Bulgaria and Saudi Arabia with its headquarters in an upscale apartment complex in Dublin, approached the HSE with a view to procuring ventilators for the health service from China, where owner Robert Quirke said he had an ‘in’ with a reputable manufacturer, Shenzhen Probe.
Roqu had existed in some shape or form since 2013, but it wasn’t incorporated until 2016, when it was known as Roqu Ventures. Mr Quirke (41) had worked for a digital sales agency before joining the IDA as a vice president of technology in October 2015.
He left the State investment agency in April 2017, and since then it appears Roqu has been his sole concern. He was involved in organising a children’s festival at Malahide Castle in Dublin in 2014.
In 2017, he was promoting a fan zone at MMA star Conor McGregor’s boxing bout with Floyd Mayweather in Las Vegas. For the following two years his principal preoccupation was the Jeddah festival in Saudi Arabia. By March, when that event’s 2020 iteration was cancelled due to Covid, Mr Quirke’s attention had already turned to ventilators.
On March 20, at Mr Quirke’s own expense, two Boaray ventilators were flown by private charter to Cork Airport, before being field-tested at Cork University Hospital in the early hours of the morning, where they were found to be of sufficient standard for clinical deployment.
Roqu had informed the HSE that it was in a position to provide 1,000 such ventilators for €35 million, at a time of a global shortage, in short order but that a deal would have to be finalised by close of business on Monday, March 23, four days before Ireland entered into its first national lockdown.
Why the deal needed to be sealed so quickly has not been confirmed either by Roqu or the HSE.
There were problematic aspects to the deal, of which the HSE was aware. However, neither Mr Quirke’s apparent lack of experience with medtech nor the fact that, in the HSE’s own words, Roqu didn’t “have a fantastic track record from a paperwork sense” were rated as being significant, or “overt and obvious”, risks.
The HSE had other worries - per Chief Medical Officer Tony Holohan’s predictions at the time 15,000 people could have tested positive for Covid-19 in Ireland by March 31, translating to 750 people in intensive care going by the World Health Organisation’s guidance at the time. Ireland’s stock of ventilators at the time stood at just 500.
HSE Director of Procurement Sean Bresnan recommended on March 22 that the deal should proceed as the “clinical need outweighs the identified risks”. Given the scale of those risks identified elsewhere in this newspaper today, it can be inferred that the HSE felt its predicament at the time was a desperate one.
What happened next is unclear. The HSE made an initial payment of €14.1 million to Roqu on or about March 23 as part of its strategy to mitigate its risks by paying in tranches. The full consignment of ventilators was due to have arrived in Ireland by April 7.
On April 22, Roqu sent a ‘save the date’ notice to Irish media saying that 100 ventilators were due to arrive into Shannon Airport two days later. However, that flight had to be “rescheduled” due to a “technical issue”.
There are varying accounts on the number of machines that were actually delivered. Roqu said at the time that it had already supplied 100 ventilators to the HSE, along with 150 intensive care beds and other medical equipment. It said that the April 25 flight was projected to be the “fourth and final” one as “the required supply by the HSE is now secured”.
Subsequently Mr Quirke told the Irish Examiner that five, not four, deliveries in total had been made, equating to the delivery of 72 devices, as “the quantity of ventilators was less than initially expected, which was good”.
Similar opacity abounds over the amount the HSE eventually paid to Roqu. The executive has said that it received a refund of €2.7 million from the company following an ‘adjustment’ of the purchase order.
Mr Quirke said however that €3.8 million was refunded due to additional ICU equipment not being required, which would put the HSE’s total outlay at €10.3 million.
Most importantly of all, unfortunately, was the fact that the delivered ventilators were not used. To date, they have never been clinically deployed, while the HSE has declined to confirm where the machines currently reside.
Mr Quirke said the issue was that the devices required “specific ongoing calibration”, and that he had put the HSE in touch with the manufacturers “for clarification”.
Since the Irish Examiner revealed that the ventilators had not been used, neither the HSE nor Roqu has provided further comment of any note on the matter, with the executive stating simply that it remains in “discussions” with Roqu with a view to resolving things. Mr Quirke for his part has stated that his company “has at all times acted in good faith under the direction and supervision of the HSE”.
That is unlikely to be the end of the matter. The deal has been raised in both Dáil Eireann (where Leo Varadkar insisted that there was no political involvement in the procurement), and perhaps more significantly, at the Public Accounts Committee.
At its meeting on December 16, the committee agreed that the HSE should be called before it to explain its procurement spending during the early stages of the pandemic, with Sean Bresnan in particular also expected to attend. That meeting is scheduled for next month, although given the current virus restrictions that may change.
Tellingly, comptroller and auditor general Seamus McCarthy, the State’s accountant which is expected to focus upon Covid procurement for its 2020 annual report, told the PAC that the pandemic itself is not an excuse for poor procurement practices.
“You need good strategies; you don’t need a new way of doing it,” Mr McCarthy said at the time.
Mr McCarthy added that his investigation will be conducted with a view to “a value for money evaluation” and “lessons learned”. The HSE chapter in the published report, due in December of this year, should make for interesting reading.
Does the HSE have a case to answer? It was far from the only health administrator under horrendous pressure in March 2020, and while some problematic deals have emerged, they pale in significance in comparison to the splurge carried out by Boris Johnson’s Government in the UK.
Chief executive of the HSE Paul Reid was asked about the Roqu deal at a briefing in mid-December - in response he said that people needed to “cast your mind back” to the crazy situation the HSE found itself in as the pandemic began, “which was a worldwide chase for ventilators”.
Nevertheless, in just two deals that we know of €23.3 million was wasted during that procurement dash. That is money that helped no doctor, no patient, no one at all. At the very least you would hope that were the circumstances to be repeated, the HSE would handle them differently.
And what of Roqu itself? Roqu Group has not been idle in the past 12 months, having engaged in ventures such as rapid Covid testing for schools and the once-weekly testing of an entire Roscommon village. It is also involved in promoting an immunity passport solution in South Africa, similar to the one it has already launched in Ireland, known as Health Passport Europe.