Charitable and Voluntary Organisations

Dáil Éireann Debate, Tuesday - 12 July 2016

Tuesday, 12 July 2016

Ceisteanna (4)

Alan Kelly

Ceist:

4. Deputy Alan Kelly asked the Minister for Health to provide an up-to-date list of section 38 entities which receive funding from the HSE and the amount of funding each organisation received from 2013 to 2015, inclusive; if he will publish all HSE audits of section 38 organisations; and if he will consider a policy of seeking to ensure a representative of the HSE serves on the board of each of these entities on at least a pro tem basis to ensure transparency and public confidence in the spending of public money. [21096/16]

Freagraí ó Béal (6 píosaí cainte)

Deputy Alan Kelly

I have just left my office after reading some very worrying documentation related to the HSE and a section 39 organisation that will be discussed on Friday at the Committee of Public Accounts, of which I am Vice Chairman. There is a crisis in the transparency of funding organisations under sections 38 and 39. I listened to the Minister's response to Deputy John Browne and the Tánaiste's response to my party leader earlier. To be honest, they did not fill me with confidence on these issues. I ask the Minister to publish the audits of all section 38 organisations in a spirit of transparency. Will he consider pro tem putting a representative of the HSE on the board of each of the organisations, or asking the organisations to do so, to ensure public confidence in the spending of money?

Deputy Simon Harris

I congratulate the Deputy on his election as Vice Chairman of the Committee of Public Accounts. I have previously served on that fine body and know that the Deputy will have an interesting day on Friday. I have read the same documentation he has read on a certain organisation. It is very disturbing and disgusting in parts.

I have received a breakdown of the funding received by the 40 section 38 agencies from the HSE. I will supply this information to the Deputy in tabular format. It would not be possible to read all of it the House. The total funding for these agencies was €2.735 billion in 2013, €2.747 billion in 2014 and €2.883 billion in 2015. As I said to Deputy John Browne, the annual grants provided for these agencies range from €2.05 million in the case of the Daughters of Charity to €356.87 million in the case of St. James's Hospital.

Under its establishing legislation, the HSE is responsible for financial and performance oversight of agencies funded under sections 38 and 39 of the Health Act 2004. The HSE has a formal national governance framework within which such funding relationships are managed. As part of this governance framework, the HSE requires all grant-aided non-statutory agencies to submit their annual audited accounts to it. Furthermore, as part of its annual audit plans, the internal audit division of the HSE conducts audits of a number of agencies each year. Several audits are in progress. The documentation the Deputy was reading before he came into the Chamber, which has been referred to in the media, was the subject of an internal HSE audit. Such audits generally focus on the systems of internal controls operated by the funded agencies and compliance with the HSE service level agreement.

In addition, a number of internal audits have been conducted of the HSE’s management processes and controls in the funding and monitoring of services provided by the non-statutory agencies. When these internal audit reports are fully concluded, they are sent to the Comptroller and Auditor General and routinely issued under freedom of information legislation. I want to look at publishing all of them, as the Deputy has called on me to do. However, I do not want to bring about an inadvertent delay in finalising an audit as a result of requiring it to be published automatically. I want to work with the Deputy and his colleagues to try to get this done. As I outlined to Deputy John Browne and as the Tánaiste outlined, it is not good enough merely to have an internal look at this matter. We also need to have an external look at it in order that we can ascertain how many lessons have been learned and how many recommendations have been made. That is why we have brought in external consultants.

The following revision was received from the Department on 20 Juy 2016

The Reply at that time indicated that there were 40 Section 38 agencies. This was incorrect; there are 39 section 38 agencies. Annual funding to these agencies ranges between €1.7 million to Cork University Dental School and Hospital and €361.4 million to St James’ Hospital. Total funding allocated by the HSE in each year to those agencies was €2.69 billion, €2.7 billion and €2.84 billion respectively.

		2013	2014	2015
		Total Grants	Total Grants	Total Grants
No #	Name of Agency	€000	€000	€000
1	Beaumont Hospital	269,116	270,175	290,285
2	Brothers of Charity	162,614	163,383	174,092
3	Cappagh National Orthopaedic Hospital	28,899	26,715	31,341
4	Carriglea Cairde Services Ltd	8,647	8,639	9,682
5	Central Remedial Clinic	16,149	15,695	15,408
6	Cheeverstown House Ltd	22,101	22,736	24,183
7	Childrens Sunshine Home (Laura Lynn Children's Hospice)	3,875	3,907	3,884
8	Coombe Women's Hospital	53,250	51,609	56,863
9	COPE Foundation	44,116	45,059	46,786
10	Cork University Dental School and Hospital	1,948	1,867	1,715
11	Daughters of Charity	108,461	100,898	106,828
12	Dublin Dental Hospital	6,071	6,538	6,230
13	Incorporated Orthopaedic Hospital of Ireland, Clontarf	8,171	9,195	10,016
14	KARE, Newbridge	14,759	15,986	17,260
15	Leopardstown Park Hospital	13,202	13,117	13,409
16	Mater Misericordiae University Hospital Ltd	244,578	240,971	254,910
17	Mercy University Hospital, Cork	68,917	70,226	71,618
18	Muiriosa Foundation	38,934	41,938	45,171
19	National Maternity Hospital	48,376	53,308	49,350
20	National Rehabilitation Hospital	27,861	28,256	29,388
21	Our Lady's Children's Hospital, Crumlin	126,874	123,452	138,328
22	Our Lady's Hospice & Care Services (Sisters of Charity)	27,373	27,734	27,553
23	Peamount Hospital	23,832	24,261	24,645
24	Rotunda Hospital	48,894	48,929	51,678
25	Royal Hospital Donnybrook	18,305	17,666	18,080
26	Royal Victoria Eye and Ear Hospital	21,269	24,326	25,297
27	South Infirmary Victoria University Hospital	50,987	53,814	54,347
28	St James' Hospital	335,888	346,027	361,432
29	St John of God Services	128,370	130,300	133,069
30	St Johns Hospital, Limerick	18,740	20,940	21,267
31	St Michael’s Hospital, Dun Laoghaire	27,762	25,518	25,477
32	St Michael’s House Group	72,016	73,082	75,199
33	St Patrick's Centre, Kilkenny (Sisters of Charity)	11,974	11,989	13,171
34	St Vincent's Hospital Fairview	14,156	14,130	13,910
35	St Vincent's University Hospital, Elm Park	221,607	217,435	225,815
36	Stewart's Care Ltd	43,502	44,122	44,072
37	Sunbeam House Services	19,461	19,803	21,440
38	Tallaght (Adelaide and Meath) Hospital	203,227	196,150	206,366
39	Temple Street Children's University Hospital	87,286	94,421	97,437
	Total Grants to S38 Agencies	2,691,568	2,704,317	2,837,002
		0	0	0
	Total Grants to Outside Agencies per AFS	3,546,023	3,478,746	3,705,023
	S38 as a percentage (%) of Total	77%	79%	78%

Deputy Alan Kelly

I thank the Minister for his reply and look forward to the provision of the documentation. I remind him that I asked a considerable number of questions as part of the Estimates process. A number of weeks have passed and I have yet to receive any response. I hope this question will be answered within the timeline suggested by the Minister.

The supervision of the agencies in question is a source of significant public concern. The Minister has not answered the question I asked. The public is rightly concerned about this issue. Everybody in the House is aware of the level of public concern. If an organisation such as Console can get away with what it got away with, even though it was receiving such a volume of funding, we must look at the incredible volume of funding being received by many other organisations.

They do fantastic work but we must ensure there is public confidence. I am happy that, as the Minister says, the audits will be published as quickly as possible but what about pro tem? The Minister said earlier in response to a question that he wished to ensure that there are established practices of governance. That does not fill me with confidence that the current practices in place work. Can we ensure somebody is put on the boards of these 40 organisations pro tem or have some type of relationship to ensure public confidence?

Deputy Simon Harris

While I am endeavouring to fill the Deputy with confidence, we must be careful not to fill Irish people with a lack of confidence in some of the best service providers we have in this country in the delivery of health care. Some of the section 38 organisations, in fact many of them, are operating to the highest governance standards-----

Deputy Alan Kelly

Agreed.

Deputy Simon Harris

-----and are delivering vital health services which, frankly, were never delivered by the State. If they were not there, God knows what type of situation vulnerable people in this country would have found themselves in. What we must do is take out the bad apples. We must find the people who are not living within the rules. That is the reason we have an annual compliance statement. What is particularly upsetting and disturbing is that people in some cases are signing on the dotted line to say they are in compliance and that they are living within the pay structures, when they simply are not. That is the purpose of the external review and the internal audit. It is the reason for sending the internal audits to the Comptroller and Auditor General.

On the question about pro tem, I have examined this and I do not believe it works. The reason is that when I was a member of the Committee of Public Accounts, we had representatives of the Dublin Docklands Development Authority, DDDA, appear before the committee to discuss that debacle. The Department of the Environment, Community and Local Government had a representative on the board of the DDDA. The committee also had representatives of the Red Cross appear before it. The Department of Defence had a representative on the board of the Red Cross. The issue is that roles and responsibilities got extraordinarily confused. I believe there are inadvertent consequences. Who is the person responsible to - the board or the HSE? I prefer to beef up these controls first.