Irish Examiner view: No oversight of payments to consultants
An internal audit report prepared for the HSE reviewing the pay of consultants has found that 99 doctors earned more than €350,000 in 2023, an increase of 57 from the 42 recorded in 2022.
The revelations this week about consultants’ pay packets will give many readers pause, particularly those who engage with the health service on a regular basis.
As reported here by Cianan Brennan, an internal audit report prepared for the HSE reviewing the pay of consultants has found that 99 doctors earned more than €350,000 in 2023, an increase of 57 from the 42 recorded in 2022.
The combined remuneration for those 99 consultants was €41m for the year, or €416,000 each on average.
These are eye-watering figures by any metric, and it is understandable that readers would focus on the amounts involved — one of the consultants involved, working in a public hospital, received €963,000 in payments over the course of 2023, for instance.
To an extent, we have become immune to shock at the sums of money spent in the health sector, from the costs associated with the new children’s hospital on down.
However, there may be greater significance to a less eye-catching element of the HSE audit report: It was also meant to focus on how payments are approved — and the findings in that regard are concerning.
The audit found that there is no oversight mechanism at a national level for consultant payments “to ensure consistency, transparency, or accountability across health regions”.
Lessons about governance and oversight have been hard-learned in many parts of the public service, and this is a glaring example of the need for tighter controls.
It is surely significant that the auditors involved in preparing this report have called for specific actions to remedy this situation, such as the creation of a single live register for “exceptional” payments to consultants, a register to be validated quarterly by the HSE’s regional finance director.
The auditors also called for the “systematic wind-down” of payments to consultants outside the HSE’s framework, and for all vacant consultancy posts to be filled.
If we are not to be shocked by the figures unearthed in another report in the future, such proposals should be implemented immediately.
US president Donald Trump recently made a characteristic observation on the use of paracetamol, if by characteristic we mean repeating dangerous and unfounded generalities.
Mr Trump advised pregnant women against using paracetamol, known in the US as Tylenol, as he has claimed there is a link between the use of the drug by pregnant women and an increased risk of autism in some children.
He also suggested major changes to the vaccination regime for infants, such as delaying vaccinations until those children are as old as 12.
Mr Trump’s views are not borne out by the science.
A study of 2.5m children in Sweden as recently as last year, for instance, provided “pretty strong evidence against the notion that paracetamol would cause harm”, according to the scientist in charge of the study.
A World Health Organization spokesperson has already pushed back against Mr Trump’s vaccination proposals, pointing out that vaccines have saved countless lives: “This is something that science has proven, and these things should not be really questioned.”
Other eminently qualified authorities have echoed these sentiments.
In making these claims, Mr Trump is following the lead of his secretary for health, Robert F Kennedy Jr, who has endorsed outlandish beliefs about medicine for years.
It should also be acknowledged that Mr Trump is a consummate distraction artist.
In the past, he has often made bizarre statements or issued odd orders to deflect attention from areas where he is vulnerable to criticism, such as the ongoing controversy about his association with convicted sex offender Jeffery Epstein.
Such distractions can also take hold in the popular imagination, however.
In recent days, we have seen Independent TD Michael Healy-Rae ask in the Dáil whether the rise in autism can be linked to lack of vitamins, a statement criticised by other politicians and autism advocacy groups.
Anti-scientific sentiment should not be ignored but combatted with the facts immediately.
At the time of writing, common sense had prevailed in the short-lived stand-off between the Football Association of Ireland (FAI) and the joint Oireachtas committee on arts, media, communications, culture, and sport.
The FAI had initially refused to attend a scheduled meeting on Wednesday, citing its fear of prejudicing an ongoing Garda investigation, but that decision sparked a wave of criticism and has now been reversed.
There remain some questions about those attending the committee hearing.
Former Republic of Ireland women’s team manager Eileen Gleeson was scheduled to attend, for instance, but she has written to the committee stating that a directive from the FAI has said it would be “inappropriate” for her to attend.
Ms Gleeson is taking a legal case against the association.
While it is reasonable to cite concerns about prejudicing an ongoing investigation, refusing to attend an Oireachtas committee and then reversing that decision does no favours for the FAI’s credibility.
It is also difficult to argue with the position of minister for sport, Patrick O’Donovan: There cannot be a situation where the Government is funding organisations that do not engage with the Oireachtas.
It is a fundamental responsibility of the Oireachtas to hold such organisations to account when it comes to funding, and a precedent cannot be established where those organisations can refuse that scrutiny.
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