The National Treatment Purchase Fund (NTPF) has suspended funding for an initiative aimed at tackling waiting lists at Beaumont Hospital in Dublin.
The NTPF said on Wednesday that it had paused funding for what is known as “insourcing” arrangements at a public hospital on foot of “potential financial irregularities”.
The NTPF said it had alerted Minister for Health Jennifer Carroll MacNeill and the HSE about the issue at a public hospital in April.
The Minister said the matter had been referred to internal auditors at the HSE.
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Insourcing is where funding is provided to hospitals and staff to provide treatment to patients waiting longest for care. This is to take place outside of core working hours or at weekends. Hospitals and their staff receive additional payments for carrying out such work.
The NTPF did not identify the hospital concerned. However, The Irish Times has confirmed it is Beaumont Hospital in Dublin.
The Minister said she was awaiting the outcome of a wider review of all insourcing initiatives across the system, which she asked the head of the HSE to undertake.
The HSE said this nationwide survey and review of insourcing remained a work in progress. It said chief executive Bernard Gloster anticipated having the first analysis of this survey very shortly.
The HSE said on Wednesday that a public voluntary hospital had received an allegation associated with a single NTPF-funded clinic.
It stated: “The hospital notified the NTPF, who then notified the Department of Health that it had received this allegation. The Department of Health on the same evening notified the relevant HSE regional executive officer who in turn immediately notified the CEO.
“Almost immediately, in consultation with the chief executive of the HSE, they commissioned an internal audit to establish the facts. The NTPF are aware of this. All information gathered during this process relevant to the NTPF will be provided to the NTPF.
“This remains an allegation. We take it very seriously, but the information in relation to it needs to be gathered and the facts have yet to be established.”
A spokesperson for Beaumont Hospital said it approached the NTPF last March “of its own volition” to clarify activities under the terms of an existing memorandum of understanding.
The hospital confirmed the NTPF’s decision to discontinue funding of patient activity from April 11th. Consequently, the spokesperson said, the hospital “engaged directly with the HSE for the purpose of seeking an independent review of related issues”. There has been “minimal impact on patient care”, the spokesperson said.
The NTPF also said on Wednesday that it had recommenced funding for insourcing arrangements at hospitals run by Children’s Health Ireland (CHI). This money had been suspended a fortnight ago on foot of concerns raised in an internal CHI audit originally drawn up in 2022 but which was not published or shared elsewhere at the time.
This internal report raised questioned over whether a series of five special clinics, which were run by a consultant at CHI over a number of Saturdays for patients on waiting lists, were needed. It also questioned whether the children concerned could have been treated in the public hospitals system.
The consultant was paid an additional sum of €35,800.
Separately, in a letter to the Dáil Public Accounts Committee, CHI chief executive Lucy Nugent publicly identified the hospital at the centre of its internal report from 2022 as the children’s hospital in Crumlin.
In a letter to the chairman of the committee John Brady of Sinn Féin, she described what was carried out as “largely a HR examination of a service and not a review”.
She said it showed that when there were issues within a department, “actions were taken to resolve same”.
Ms Nugent said the clinics in question did not take place in a consultant’s private room.
“They occurred in a public clinic in Crumlin Hospital on a Saturday. It was a waiting list initiative for an outpatient appointment only. The NTPF funded the hospital for this clinic/initiative and there was no charge to patients. This was over and above the consultant’s contractual hours. There are no direct payments to CHI staff from NTPF.”
The NTPF said on Wednesday that it had suspended all insourcing work at a public hospital since April 11th without naming the institution.
“The NTPF immediately informed the Department and HSE of these concerns and is working with them in relation to the ongoing review. The matter has been referred to the HSE’s internal audit team. The NTPF is restricted from making further comment at this stage.
“The board and executive of the NTPF take their responsibilities very seriously and will take whatever actions are necessary to ensure our spend with public hospitals is fully protected for the benefit of public patients. Any proven misuse of public money by public institutions will be treated with the gravity it deserves”, NTPF chief executive Fiona Brady said.
