The health service pre-paid €81 million to 10 suppliers previously unknown to the Health Service Executive for nearly 2,200 ventilators at the start of the Covid-19 pandemic.
Only 465 of these were delivered and none were put into clinical use, health service internal auditors have found.
A HSE internal audit report, released on Tuesday, said more than €35 million in refunds was still outstanding and legal action against four suppliers was ongoing.
It said testing had indicated a failure rate of 41 per cent in relation to 100 of the initial 465 ventilators received from China. It said this initial testing, coupled with delays in receiving the equipment, resulted in many of the orders being cancelled from April last year.
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“The quantity of ventilators ordered was far in excess of the ventilator requirement identified by the technical expert Medical Devices Criticality Assessment Group. There was a lack of evidence of how the new suppliers had been identified, the basis on which order quantities had been placed with them and by whom authorised, while due diligence was not performed in all instances prior to making prepayments to them.”
The audit said on April 3rd, 2020, in response to a due diligence request from the HSE, a consultancy firm raised concerns in relation to two suppliers, identified as “D” and “F”.
‘Concerns communicated’
"Supplier F had total revenues in the prior year of only $6.6 million and Supplier D was only set up in June 2019. The HSE committed to purchasing 316 units from these suppliers prior to the receipt of the consultancy firm's response. On April 7th, 2020, subsequent to the receipt of the email from the consultancy firm, and despite the concerns communicated, the HSE paid a further €8.24 million to Supplier F to complete their order.
“Of the total orders valued at €17.4 million placed with these two suppliers (€925,000 with Supplier D and €16.5million with Supplier F), none of the equipment ordered was delivered. [A total of] €920,000 has been refunded by Supplier D and a refund of €16.5million remains outstanding from Supplier F.”
In a statement on Tuesday night on the audit, the HSE said it was important to note that at that time it was operating “in a volatile and effectively closed market where we had to secure equipment in extremely high demand, in an expedited timeframe and under considerable pressure, in the face of a global pandemic”.
Separately HSE auditors also described as “unsatisfactory” the control environment that existed at the Pieta House charity when it conducted an audit in 2018.
Pieta House provides crisis intervention and therapeutic services in the field of suicide and self-harm prevention. Management did not accept a number of the findings.
Among the concerns set out by auditors was that Garda vetting of some staff had not been renewed on a three-yearly basis.
“A counsellor was appointed without having a Garda clearance certificate. When Garda clearance was obtained, there was a record which warranted the employee being interviewed by the HR manager,” the audit said.
The report noted the charity's flagship Darkness Into Light (DIL) walks took place in about 30 venues overseas, organised by local committees and funds raised were shared between local charities and Pieta House Ireland.
Pieta House
“There is no formal licensing system in place for DIL or other funding event which are organised by or for the benefit of Pieta House Ireland. Internal Audit identified two instances in 2017 and 2018 where the lack of clarity at the outset in relation to an overseas DIL Walk and another fundraising event led to misunderstandings between Pieta House and third parties. The trustees confirmed to Internal Audit that these misunderstandings were resolved to their satisfaction.”
In a statement, Pieta chief executive Elaine Austin said "The HSE report is an assessment of Pieta which was carried out during a time of significant growth for the organisation. In 2015, we provided free counselling to 5,500 people, just two years later that number had grown by 30 per cent to well over 7,000 and clearly that put a strain on the organisation's resources. Since my appointment in March of 2019, I have put significant focus on corporate governance, ensuring that Pieta is a well-managed and well-governed organisation."
In a separate report, HSE internal auditors also outlined shortcomings and breaches of guidelines and procedures in the recruitment of non-consultant doctors to non-training positions in hospitals . The audit found a requirement for the hiring consultant to obtain a verbal reference was not being adhered to in the case of doctors being recruited from overseas.
Auditors said they were told by hospital management that the HSE requirement under a 2019 circular was not feasible due to the workload of consultants, time zone differences and language constraints.
Auditors said none of the hospitals examined as part of the audit process required a candidate for non-training, non-consultant hospital doctor posts to present official identification at interview.
“Two hospitals performed interviews via telephone call rather than the permitted methods. This is contrary to recruitment guidelines.”
