Committee of Public Accounts to examine 2023 Financial Statements and chapter from C&AG’s report with Health Service Executive (HSE)

The meeting at 9.30am in Committee Room 3 of Leinster House will be joined by the Comptroller and Auditor General, Mr Seamus McCarthy; representatives of HSE led by the CEO, Bernard Gloster; and officials from the Department of Health.

During the afternoon session, beginning at 1.30pm, the Committee will consider correspondence and other business of the Committee.

Deputy Mairéad Farrell was this week appointed Cathaoirleach of the Committee of Public Accounts by Dáil Éíreann. Ahead of Thursday’s meeting, Deputy Farrell said: “The HSE provides, or funds the provision of, all of Ireland’s public health services in hospitals and communities across the State. While expenditure by the HSE has grown rapidly in recent years, spending patterns have been distorted by exceptional spending in the last three years in response to the Covid-19 pandemic.

“The bulk of the HSE’s income comes from grant funding provided from Vote 38 Health. In 2023, the funding determination notified to the HSE by the Minister for Health was €20.750 billion for recurrent spending and €1.097 billion for capital spending. From 2023, €2.7 billion was provided by Department of Children, Equity, Disability, Integration and Youth after a transfer of responsibility for the funding of disability.

“The HSE’s National Service Plan (NSP) outlines the health and social care services that will be provided nationwide within the budget allocation: these are set out by service type, including acute hospitals, primary care, mental health, health and wellbeing, and disability and older services. The HSE’s spend in 2023 was just over €24.749 billion, some 5.9 per cent higher than 2022, while capital spend was €1.055 billion, a 9.6 per cent decrease on 2022.

“Key issues in the 2023 Financial Statements that the Committee wishes to examine include significant budget overruns, staffing shortages, delayed rollout of the integrated financial management system (IFMS) project, losses related to Covid-19 and losses in relation to private patient charges. Other areas of interest relate to significant non-compliant procurement, inadequate monitoring and oversight of grants to outside agencies, weakness in controls over fixed assets, additional premium payments to high earners and the settlement of an employment case.”

Chapter 17 – The Health Service Executive’s integrated financial management system from the C&AG’s 2023 Report on the Account of Public Services examines and reviews the progress and costs to date in the rollout of a fully integrated financial management system (IFMS) developed to replace multiple legacy finance and procurement systems across the HSE, Tusla and over 60 other publicly-funded health agencies.

Deputy Farrell said: “The HSE’s 2015 business plan underpinning the IFMS envisaged that the rollout of the IFMS, on a phased basis, would commence in 2017 with a view to being fully rolled out in the HSE by 2020. The projected cost at that time was €82 million for capital and once-off costs and €50 million in recurrent funding for licencing and systems’ maintenance costs over the 11-year period 2016 to 2026. Additional funding of €40 million was allocated in 2024 for the accelerated roll out of the IFMS, bringing the total budget to €172 million.

“A number of delays have occurred and the rollout plan has been revised on a number of occasions mainly due to delays associated with project mobilisation, the original systems integrator procurement and related design challenges, Covid-19, the HSE cyber attack and the subsequent change in systems integrator. Some difficulties were also encountered with the implementation of the first rollout of the system in July 2023 and it is now planned to roll out the system across the rest of the HSE in two phases, for completion in 2025.

“The Committee welcomes this engagement with the HSE and looks forward to examining with Mr Gloster and his colleagues the issues identified in the 2023 statements and Chapter 17 of the C&AG’s report, and related matters.”

The meeting in Committee Room 3 can be viewed live on Oireachtas TV.

PAC is a standing committee of Dáil Éireann which focuses on ensuring public services are run efficiently and achieve value for money. Further information on the role and remit of the Committee can be found here.

Committee proceedings can also be viewed on the Houses of the Oireachtas Smartphone App, available for Apple and Android devices.