A report on waiting list irregularities and a “toxic” work culture at a hospital run by Children’s Health Ireland (CHI) is to be referred to gardaí , the Cabinet committee on health has been told.
The report, which not been published but has been widely reported in some media outlets, has caused shock in Government over the past week.
It is also understood the Health Service Executive (HSE) has indicated it may refer a consultant to the Medical Council arising from concerns over the CHI internal review if the hospital group does not do so.
The HSE said on Thursday it would refer matters raised the internal report to the Medical Council, as well as gardaí. It said it would consult with CHI on the issue. The Medical Council is the regulatory body for doctors in Ireland.
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The revelations come after a series of scandals in CHI, which is due to run the new national children’s hospital when it opens.
The Cabinet committee on health was told on Wednesday that the HSE has referred the report to the Garda with a view to it being assessed for a possible investigation.
The meeting was attended by Taoiseach Micheál Martin, Tánaiste Simon Harris, Minister for Health Jennifer Carroll MacNeill, Minister for Finance Paschal Donohoe, Minister for Public Expenditure Jack Chambers and Minister for Children Norma Foley.
The National Treatment Purchase Fund (NTPF), which buys treatments in the public and private sectors for patients on long waiting lists, has said it will pause funding for CHI while potential irregularities are investigated. Ms Carroll MacNeill has assured parents scheduled surgeries will not be delayed.
Earlier this week, The Irish Times reported further findings, including about reports of a “toxic” work culture in parts of a CHI hospital, where there were complaints of bullying and victimisation of trainees, and where one consultant had taken proceedings for defamation against another.
The CHI internal report was drawn up in late 2021/early 2022 but was not given to the then minister for health, the HSE or the NTPF.
The report found CHI had a “broken culture” created by dysfunctional relationships and challenging behaviour.
It said there were also concerns about management of NTPF funding and a lack of oversight of access initiatives that ultimately were not in keeping with a memorandum of understanding between CHI and the NTPF.
The report raised concerns about five special weekend out-patient clinics for 179 children carried out by a consultant. These were funded by the NTPF. The consultant received €35,800 for seeing these patients at the special out-patient clinics that operated over five Saturdays.
The report questioned whether these clinics were needed and suggested the patients could have been treated by other doctors in the public system.
On Tuesday. the NTPF suspended payments on a temporary basis pending an investigation into the operation of the waiting list schemes in CHI.
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According to the report, which CHI said it cannot publish for legal reasons, the consultant was indefinitely removed from on-call duty for “health reasons” in 2019, a commitment under his public contract.
CHI hired a locum to fill these hours, spending about €450,000 on the locum between 2019 and when the review took place in 2021.
The report said : “It needs to be explored how one consultant can undertake a series of NTPF-funded clinics over numerous Saturdays and during these clinics see a much greater number of patients than they are able to see in their routine public clinics, working at a very fast pace with significant throughput – a substantial undertaking of additional work, yet is unfit for any on-call duties for the past three years.”
The NTPF-funded clinics were not sought by or offered to any of the other eight general surgeons in CHI, it said .
In a statement earlier this week, CHI said the NTPF-funded clinics were a waiting-list initiative and were “over and above the consultant’s contractual hours”.
