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Non-compliance was found around payments made in two cases for accumulated untaken annual leave. Stock image
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Eilish O'Regan Twitter Email
A HSE internal audit into 68 hospital consultants who earned between €300,000 and €760,000 last year found serious financial control failings which need urgent attention.
It found €4m in top-up payments – additional to doctors’ salaries – were paid out under a variety of local agreements for work such as reading X-rays but it was not possible to find out if they were all properly approved and compliant.
Non-compliance was found around payments made in two cases for accumulated untaken annual leave and compensatory rest days contrary to standard terms and conditions of employment. The sum paid last year was €161,000 with a further €100,000 paid subsequently.
There was also evidence of where the individual consultant’s €30,000 a year cap on call-out payments was breached with seven cases totalling €224,000.
Seven doctors were each paid over €100,000 for compensatory rest days and this was compliant with their contract.
Nine consultants were paid €712,000 for undertaking work for the National Treatment Purchase Fund which aims to tackle waiting lists and was additional to their salary. This was in compliance.
However, the report from the HSE’s Internal Audit Division found numerous local agreements with consultants are in place across hospitals and other areas of the health service resulting in some “earning significantly above their salary scales”.
The cost of these agreements to the HSE was over €4m last year.
“It was not possible for internal audit to determine whether these remuneration elements are deemed to be properly approved.”
These top-ups covered areas such as reading X-rays, additional clinics and sessions, additional basic hours, cross cover for annual leave and overtime at a double rate.
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The basic pay of the doctors was €16.3m and the total payout was €24.9m with the extras under headings such as overtime, on-call payments, allowances, compensatory rest days and arrears.
The auditors found weaknesses in the system of governance, risk management and controls which create a serious and substantial risk that the system will fail or has failed to meet its objectives.
It warned that “urgent action is required to improve the adequacy or effectiveness of the system”.
It found that overtime payments ranged from €1,032 to €227,218.
Compensatory rest day payments ranged from €2,990 to €522,185.
The report said the management has accepted the recommendations and findings of the audit.
“While the payments highlighted in the report arise in response to critical service pressures and resource deficits the audit has identified shortcomings in the control environment which HSE is committed to address.”
It said that a steering group has been established, chaired by the chief operating officer and comprising members of the senior leadership team, to oversee the response to the issues raised.
It added that a “detailed action plan has been developed and a working group has been set up to co-ordinate implementation at an operational level.”
Another audit looked at the remuneration packages of the HSE’s executive management team, 11 of whom share basic pay of over €2m, including its former chief executive Paul Reid.
The audit found a satisfactory level of financial assurance with five members having use of a company credit card. The highest expenditure was by chief clinical officer Colm Henry who lives in Cork and must travel to Dublin with overnight stays at €105 a night. Along with the chief executive, Dr Henry was paid around €50,000 annual allowance.
An audit of the Irish Family Planning Association found gaps in travel and subsistence documentation and maintenance and around petty cash.
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