In April 2018 my Department and HSE management agreed monitoring arrangements, including the development and implementation of a comprehensive framework by the HSE to operate at both national and local levels, to monitor and ensure consultant compliance with the public/private provisions of their contracts. It was agreed that:-
- The HSE would incorporate within the framework a process map allocating individual responsibilities at local, Hospital Group and national levels;
- The revised framework should specify processes for monthly reporting of compliance from Hospital Group CEO to the National Director for Acute Hospitals with quarterly escalation to the Deputy Director General;
- Annual compliance would form part of the HSE’s internal control assurance process. The HSE Audit Committee would be asked to include consultant contract compliance on its work programme and will, in particular, consider compliance as part of its review of the annual internal control assurance process; and that
- The HSE would submit reports to the Department of the position at end September 2018 and end December 2018 and annually thereafter.
The HSE submitted an initial report in the autumn of 2018 and earlier this year submitted the report to the year end 2018. This included the Framework developed to give effect to the agreed arrangements - with specific responsibilities assigned to the Hospital Clinical Director, the Hospital CEO/GM, the Hospital Group CEO/Clinical Director and the National Director Acute Operations. It also included a summary of compliance at Hospital Group level, details concerning work being undertaken to improve monitoring arrangements in the acute sector and measures in train to ensure the completeness of monitoring arrangements within Community Operations.