There were notable control weaknesses and governance gaps in arrangements for paying out the State’s €1,000 special payment to healthcare staff in recognition of their work during the pandemic, HSE internal auditors have maintained.
Auditors said that while the scheme successfully delivered payments to 223,000 people at a cost of €211 million, lessons could be learned to inform any such future arrangements.
The audit report said payments were made to HSE staff, those working elsewhere in the public system such as voluntary hospitals (known as Section 38 organisations) and personnel outside the State sector including employees of private nursing homes or employment agencies.
“At the HSE public cohort level (ie HSE and Section 38 employees), eligibility verification was decentralised to local service managers with no national oversight, increasing the risk of inconsistent application of eligibility criteria,” said the report.
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“Payments to HSE senior management grades (539 Grade VIII and above) and the high approval rate of HSE appeals (69 per cent of 3,558 submitted) indicate potential misinterpretation of eligibility rules at local levels.”
The audit report also said that payment accuracy controls were inconsistent across the different groups.
“The lack of early PPSN-based validation in Section 38 organisations delayed duplicate payment detection, with €712,000 of potential duplicate payments still under investigation, whereas the scheme administrator’s PPSN checks for non-public cohorts successfully prevented €4 million in duplicate payments.”
The audit said HSE overpayments, primarily due to duplicate payroll submissions, were largely recouped, although 63 cases remained under investigation.
The HSE said on Tuesday that the scheme had been delivered at pace during an unprecedented public health crisis. It said the audit had identified a small number of duplicate or exceptional payments primarily arising from individuals working across more than one employer. It said the majority of these cases had already been resolved through standard reconciliation and repayment arrangements, and remaining cases continued to be progressed directly and confidentially with the individuals concerned.
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“Importantly, there is no suggestion of wrongdoing by staff or employers,” the HSE said.
The report said the KOSI Corporation was awarded a contract in late 2022 to work with the HSE as administrator of the scheme. It said KOSI was paid a daily rate under its contract and had so far received payments of €1.259 million.
A separate HSE audit report found that Beaumont Hospital had used temporary funding provided by the National Treatment Purchase Fund (NTPF), in part, to meet the cost of appointing a full-time hospital consultant.
The audit was commissioned following a row between Beaumont Hospital and the NTPF earlier this year in relation to funding provided to deal with waiting lists for rheumatology patients.
The NTPF announced in June that, on foot of “potential financial irregularities”, it had suspended funding to Beaumont for what is known as “insourcing”, an initiative aimed at tackling waiting lists.
The Irish Times reported in October that Beaumont had repaid €25,000 to the NTPF.
The auditors said that in April 2020 a full consultant post – which up to then had essentially been a half-time position – had been established using temporary NTPF funding to meet the additional costs involved. The report says Beaumont did tell the HSE in its application to convert the post that it would use non-recurring NTPF income.
The auditors found that Beaumont’s delivery of the rheumatology initiative “represented a departure from the expected approach” and was inconsistent with the intended delivery model for NTPF initiatives.
“Key issues included hiring a permanent consultant with temporary funding, treating NTPF patients across all rheumatology consultants rather than through designated clinics, using a random process to select patients for NTPF invoicing, and relying on core-funded staff to support clinics for patients billed to the NTPF.”
Beaumont Hospital said its overriding focus had been to reduce waiting lists. It said that throughout the period under review, NTPF funding enabled the delivery of about 1,700 rheumatology treatments.
