Seán Fleming (Laois, Fianna Fail) | Oireachtas source

I forgot to put a bit into the question. We also want to know how many of these cash disbursement acceleration payments were outstanding at the end of each of the years concerned. Let us suppose that an organisation is going to get €120 million to deliver a service over a year. Let us say it is €10 million a year. It is also known that there is a problem and we want to know what happens towards the end of the year. There is a necessity to be cash neutral during the course of the year and everything has to be balanced by the end of the year. I do not know how that works but such organisations are required to be cash-neutral at the end of the year. We will ask for confirmation of that. The Deputy is correct in stating that some of the organisations might require re-profiling. If cash advances have increased from €17 million in 2016 to €73 million in 2018 an issue is building up somewhere in the system. Now is a good time to highlight it. We will ask the HSE for further details because it seems to be an emerging problem.

The next topic concerns primary care centres being operated under a service level agreement with private companies to include any centres being leased from private consortia and a range of private companies involved. I refer to the PPP that Deputy Munster mentioned earlier. We asked for information on that. There was also a query regarding the total value of claims received by the HSE in 2008. There is a large chart on page 16 and the information from that will feed into our report on the State Claims Agency.

The next matter was the cross-Border initiative, including the number and value of claims paid out in 2018. That figure was €12.3 million, which represented 6,728 claims. I estimate that is an average of €1,828 per claim. We know that many cataract operations take place in Belfast, as well as hip, knee and similar types of operations. There has, however, been a serious slowdown in reimbursement. Some people were able to borrow €5,000 to go and get the operation and some had to go to the credit union. I am told by my constituents that credit unions are not now giving out those types of loans because of the delay in the HSE doing the recoupment. That is making it more difficult for people who would have relied on the credit union to get a loan. We will ask for a note to be provided on the payment record and how quickly payment is being made. We all know from constituency level that there is a growing problem.

The next topic concerns expenditure on legal services by the HSE. We queried this as part of its financial statement. It was €17.5 million in 2008. Some €9 million was spent on solicitors working for the HSE, €3.37 million on barristers, €3 million was reimbursed for third party legal costs and the cost of the guardian ad litemservices, in respect of associated legal services, was €161,000. That figure of €17.5 million spent on legal services is a large one. A new arrangement for the provision of legal services is being examined.

This all follows from the HSE's financial statement. We next asked for a breakdown of consultancy costs incurred by the HSE. We also need further details on this issue. I am on the bottom of page 8. Regarding the national children's hospital, the HSE - not the National Paediatric Hospital Board - incurred consultancy costs of €11.2 million regarding the Children's Hospital Group in 2018. We want the figures for each of the previous years and the current spending to date. We are asking for further information. A breakdown is given of the €11 million. Some €3.6 million was spent on an ICT digital hospital project, while clinical and operational support was €3.5 million. Design, operation, commission, transitioning and medical equipment cost €1.8 million. Corporate services workforce change management was €1.6 million and project management and other costs were €400,000.

There is €11 million in consultancy services in respect of the Children's Hospital Group that has not come into anybody's figure for the cost of reconfiguring the children's hospital. The costs are popping up all over the place. The other consultancy costs can be seen down the line. We will note and publish this. Some people will want to read this documentation in detail, and members are free to raise any point arising.

The next item in the correspondence was the insurance bill for the HSE, including a breakdown of categories of cover. The HSE spent €6 million on its own insurance. We told the HSE we thought it was covered by the State Claims Agency. The HSE said it has other costs outside the State Claims Agency. Obviously, it has some of its buildings insured. The premium was €3.4 million. It spent €6 million on insurance. This is all laid out in the different categories of equipment and assets it has. Then we asked about private contributions to nursing homes.