HAVE you heard about the ‘Chinese walls’ in hospitals? These walls separate tranches of money gathered for the functioning and upkeep of the hospitals, it was revealed last week.
Money collected by charity goes to frontline services, while other, ancillary income is used, in some instances, to top up payments to executives.
Does it matter what money is put to what use?
Are we, like mushrooms, simply being fed manure and kept in the dark?
Take Lorcan Birthistle, CEO of Our Lady’s Hospital for Sick Children, in Crumlin. Mr Birthistle is in receipt of a top-up payment, above and beyond the cap imposed by the HSE. He is not unusual. Out of 43 hospitals and health-service agencies asked by the Government how much they paid their senior executives, 10 responded that they were in breach of salary caps. Another six said they weren’t, and the remainder said: “We’ll get back to you on that one.”
Salary caps, across the public sector, have come to the fore in the last five years, as the country has woken up to the excesses of the Celtic Tiger bubble. If those at the top benefited exponentially through the wild years, the adjustments required must be reflected in a modicum of fairness. The alternative would be an obscenity, at a time when legions at the lower reaches of the socio-economic ladder are experiencing genuine hardship.
In this context, the salary cap for the CEO of Our Lady’s Hospital was set at €110, 808. Last week, it emerged that Mr Birthistle also receives another €30,000, from the profits of shops on the hospital campus.
With this news, the hospital was quick to say that no money raised through charity goes to the CEO’s top-up.
Naturally, if the hard-pressed public believed that their donations were being used to top up the salary of a relatively well-paid executive, they might think twice about handing over their money.
People donate to Our Lady’s, in one form or another, simply because the plight of sick children strikes a chord.
Now that the details of top-up payments have been made public, there is a scramble to reassure the public about the destination of their donations.
But is this little more than semantics?
Surely, the concept of raising money for health services is that a gap is required to be filled to deliver the proper service.
Whatever way you look at it, that gap is 30-grand bigger to top up the CEO’s salary. If there was no requirement to top up, the profits from the shops could be added to the charitable donations in filling the gap. Does it really matter if the top-up cash comes directly from donations or via the shop? Surely, all the money goes into one pot to fund the shortfall of services?
There is no escaping that reality, and the sense of panic among those engaged in fundraising is entirely understandable. This has been a public-relations disaster for those raising funds for strapped health-service agencies, but somebody should have thought of all that long before the news became public.
Birthistle was one of four CEOs in Dublin hospitals who wrote to the Minister for Health, James Reilly, last month, warning that under-funding of the system was putting patient safety at risk.
The letter noted that the shortfall in funding was leading to “unacceptable delays in treatment access for certain cancer patients, due to overwhelming pressures on services”.
It also stated that budgetary reductions are “short-sighted and random” and likely to “seriously damage the foundation of the system”.
These concerns are, no doubt, genuinely held, as much by Mr Birthistle as his fellow CEOs, but it does ring a little hollow when money has to be set aside to top up salaries, beyond what is publicly deemed appropriate.
Taoiseach Enda Kenny isn’t happy about it. He told the Dáil, on Thursday, that organisations in the health service that fail to come clean on top-up payments “are going to be called to account for their failure to respond”.
Right you are, Mr Kenny. He knows a thing or two about the subject of breaching salary caps.
At least seven advisors to Cabinet members are receiving salaries in breach of their notional cap. Back in 2011, Kenny personally overruled both Brendan Howlin and Michael Noonan, to ensure that party PR man, Ciaran Conlon, be awarded a 37% hike above the salary cap.
Advisors were capped at €92,000, but Enda went to bat for Mr Conlon and secured him a nice little earner, at €127,000 PA.
The outstanding feature of that little episode was the sense of entitlement in Mr Conlon’s communications on the matter: “This is getting ridiculous,” he wrote in one email, frustrated that he had to put up with all this toing and froing, before receiving the salary he desired.
Bank chiefs have found it just as easy to circumnavigate the pesky caps imposed on our betters.
Richie Boucher, of Bank of Ireland, was last year paid €623,000 — despite the Government committing to holding the line at half a million for the big brains who run banks.
Even the art world rids itself of constraints imposed on the peasantry. On Thursday, the Public Accounts Committee heard that the director of the National Gallery, Sean Rainbird, is paid an extra €40,000, on top of his €99,000 salary, to fly home to his family in Britain on a near-weekly basis.
The top-up is not considered an expense, so the cost to the gallery — and the State — is actually €87,000.
The song remains the same throughout the upper echelons of the public service. Salary caps had to be imposed to demonstrate to the peasantry that those at the top were willing to take ‘pain’. These caps were really little more than a PR exercise, designed to keep a lid on residual anger, generated by the suspicion that those at the top are continuing on their merry way.
Every now and again, the truth seeps out. Anger swells, but, after a few days, it deflates again and we all revert to the fiction that serious readjustments are happening at all levels of society.
Good luck to those charged with raising funds for health services and hospitals. Their cause is entirely just, and vital in a country where it is accepted that charity, rather than Exchequer funding, is used to make up shortfalls in basic services.
After last week’s news, the lot of fundraisers has just been made more difficult.
But pulling the wool over the eyes of potential donors is not the way to address the matter. At times like these, it’s never been as important to hold a mirror up to society, and look at what exactly is going on.
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