The chief executive of Children’s Health Ireland (CHI) says she was never been briefed on taking up the role about a highly controversial internal report which identified a toxic culture at one of its hospitals. The report also identified concerns over the use funding provided by the National Treatment Purchase Fund (NTPF).
Lucy Nugent told the Dáil Public Accounts Committee she only learned of the existence of the unpublished internal report, which was drawn up in 2022, when a media query was sent to the group.
CHI’s former chief executive Eilish Hardiman, who currently holds another senior position with the group, said she had gone on sick leave in October 2023 before Ms Nugent had been appointed.
The internal report raised questions about whether special waiting list clinics funded by the NTPF - and for which a consultant was paid over €35,000 in fees - had been necessary.
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Ms Nugent said she did not believe there had been any misuse of public funds involved and that the matter did not warrant being referred to gardaí .
However, she said in hindsight the issues in the report should have been raised with the HSE and the NTPF.
She also told the Public Accounts Committee on Thursday that the Medical Council would not be taking any action regarding the consultant concerned.
Ms Hardiman said there had been an employment law issue involved after former minister for health Stephen Donnelly had rejected an application by the CHI board to re-appoint her for a third successive five-year term. The minister had maintained government policy had stipulated that a chief executive in a non-commercial State body should serve no more than two terms.
Ms Hardiman said that after having completed two terms, she was eligible for a contract of indefinite duration. She said she initiated legal action and the issue went into mediation.
CHI told the committee that legal fees in dealing with this issue had amounted to €123,000 but that the agreement had been reached by the Chief State Solicitors Office.
Ms Hardiman said the CHI board had considered the internal report at a meeting in 2022 but the priority focus was on patient safety issues raised.
She regretted that the NTPF was not engaged about the issues raised about waiting list clinics.
Beaumont Hospital
The National Treatment Purchase Fund (NTPF), meanwhile, said it was ready to restore funding for insourcing initiatives to tackle waiting lists at Beaumont Hospital when it receives sufficient assurances regarding its appropriate use.
The provision of such NTPF funding for Beaumont has been paused since April on foot of what were described as “potential financial irregularities”.
The HSE this week defined insourcing as the practice of engaging external companies or third-party providers to deliver services often outside of normal working hours using public-owned facilities and equipment and often employing existing healthcare personnel on premium rates.
In an opening statement to the Dáil Public Accounts Committee on Thursday NTPF chairman Don Gallagher said that upon learning of “potential issues in relation to NTPF-funded insourcing work at Beaumont Hospital, it immediately suspended all insourcing work and payments at Beaumont and informed the Department of Health and HSE of its concerns”.
He said that HSE internal auditors were currently carrying out a detailed review in Beaumont.
“We are ready and willing to recommence insourcing in Beaumont once we receive the necessary assurance regarding the appropriate use of NTPF funds. We are working closely with the HSE regional executive office on this matter.”
“The public must have full confidence and trust in the insourcing process. We are working alongside the Department of Health and HSE to increase governance and oversight across our insourcing work with public hospitals.”
The Irish Times reported last month that the catalyst for the suspension of funding for insourcing initiatives was a letter sent by consultants in one specialty to the chairwoman of Beaumont. The letter maintained that the hospital had billed the NTPF for about 1,400 patients over a number of years who had actually been seen at regular public clinics.
On Wednesday, Fiona Brady, chief executive of the NTPF, told the Oireachtas Joint Committee on Health that the letter had been written by rheumatologists at Beaumont.
She said the issue had emerged after she noticed in January that Beaumont Hospital had not applied for insourcing funding. It had received about €8 million the previous year.
Ms Brady said she had arranged a meeting with her counterpart at Beaumont at which she was shown a copy of the letter sent by the rheumatologists. She said subsequently a review of invoices submitted over a one-year period had been carried out.
“The NTPF had been billed as if it was additionality,” Ms Brady told the committee.
