Dáil Éireann Debate, Tuesday - 12 July 2016
1. Deputy James Browne asked the Minister for Health if, in view of recent events, he has plans to review arrangements for the funding and auditing of section 38 agencies; and if he will make a statement on the matter. [21103/16]
View answerIn view of recent events, does the Minister for Health have plans to review the arrangements for the funding and auditing of section 38 agencies? Will he make a statement on the matter?
I thank Deputy Browne for this important and timely question in light of a number of public concerns that have been raised in respect of organisations funded by the Health Service Executive.
I wish to inform the Deputy and the House, as the Tánaiste did some moments ago, that a review of all section 38 providers is being conducted by external consultants. This review is now under way. The purpose of these reviews is to build on some of the measures previously put in place in recent years, to establish the standard of governance in place in these organisations and to confirm independently that the governance practices and procedures accord with those set out in the annual compliance statements of those agencies. These reviews will involve an examination of key governance processes and documents, including obtaining confirmation that internal financial controls and formal written financial procedures are in place in these organisations. Six of these reviews are currently under way. The outcomes of these reviews will inform the HSE's relationship with the agency concerned and any further enhancement that might be required in respect of the HSE's overall governance framework.
The HSE is funding approximately 40 agencies under section 38 of the Health Act as well as providing funding for or grant aid to a far wider group of what we know as section 39 agencies. The size of the 40 agencies delivering services ranges significantly from the Daughters of Charity, with an annual budget of a little over €2 million, to St. James's Hospital, with a budget of almost €357 million. Section 38 agencies have played an important role in the development of our health and social care services. Some agencies delivering services under section 38 arrangements are among the best we have in terms of the quality of care provided and the systems of governance employed. However, there is an absolute requirement for all agencies to review their governance processes continually to ensure these are sufficiently robust. In recent years, the HSE has taken significant steps to enhance its system for performance oversight of section 38 agencies. However, I believe these additional measures, involving an external review and independent oversight, are essential and welcome.
The Minister will be aware of the recent outrage over top-ups to executive salaries at St. John of God hospital. This revelation coincides with news of cutbacks in the services of St. John of God. The HSE maintains it does not consider the St. John of God organisation to be compliant with public pay policy in light of recent disclosures about the remuneration of senior staff. Furthermore, I understand from newspaper reports that talks are under way which may see a number of senior personnel in the National Maternity Hospital being permitted to retain higher salaries. How does the Minister reconcile these reports with those concerning St. John of God? Can the Minister identify which, if any, section 38 organisations are believed to be not complying with Government pay policy? Is the Minister satisfied with the level of policing of pay policy in section 38 organisations in the wake of the top-up scandals? Is the Minister satisfied that all Government requirements are being met by section 38 organisations?
I too am very concerned by what I am seeing in St. John of God. That is why an investigation is now under way by the HSE in respect of those payments. I have been clear, the HSE has been clear and, today, the Minister for Public Expenditure and Reform has been clear in stating that if any payments have been made above and beyond the allowable level of payments, then those payments must be returned. We cannot have a situation whereby some people working in St. John of God are earning salaries lower than that of the chief executive and are subject to the FEMPI Act while people at the very top are earning large salaries and are not subject to it.
That is not fair and is not in accordance with the rules. That investigation is ongoing.
It is not just about whether I can guarantee or I can be assured, it is about whether we have the structures in place to have a degree of certainty. I am not satisfied that we just have an internal HSE review as I want to bring in the external layer. I want independent external consultants to examine all section 38 bodies to ensure they are not just signing on the dotted line to indicate that they are in compliance, but that they are actually in compliance. That body of learning will inform whether we need to take more steps beyond what we are doing.
I welcome that there will be an investigation into the matter and I welcome the confirmation that if there have been any overpayments they will have to be returned. There is a level of disquiet over whether other payments have been made. People will be disconcerted that this specific question cannot be answered. I welcome the announcement of the review, which should be carried out as quickly as possible with any recommendations implemented as quickly as possible so we can ensure that no such overpayments will recur.
I agree with the Deputy. I sat on the Committee of Public Accounts when we discussed this issue back, I think, in 2013. I, like most people on both sides of the House, was repulsed by the carry-on. A number of measures have been implemented in terms of the charity regulator and with new structures in the HSE, but clearly more needs to be done. I do not want and I know no Member of this House wants to see that voluntary sector damaged by bad practice. Some of the best examples of high governance are present in the section 38 bodies. Some of the best examples of care are present in the section 38 bodies. However, any bad behaviour or wrongdoing needs to be weeded out as quickly as possible. I will act on any recommendations. As I said already, six of the 40 reviews are under way. Every section 38 body will be subject to this external review. That is about 40 agencies, which I think is appropriate. It can give all of us reassurance and most importantly it can give the service users, who are often vulnerable people who depend on these services the level of reassurance they deserve.
