Mr. Seamus McCarthy:

As members are aware, Beaumont Hospital is a major voluntary hospital funded substantially by the Health Service Executive under section 38 of the Health Act 2004. The hospital's financial statements, like those of some others in the health sector, are presented with separate income and expenditure accounts for recurrent and capital spending. This format is in line with the framework for hospital financial reporting directed by the Minister for Health.

The hospital's recurrent expenditure in 2023 was just under €660 million, of which €404 million related to staff salary and pension costs. At the end of 2023, the board employed just under 4,500 whole-time equivalent staff.

Beaumont Hospital's income is almost entirely from public funding sources. In 2023, the HSE allocated a grant of €529.4 million for the day-to-day running of the hospital. Recoupment of drugs costs and salaries in respect of staff seconded to the HSE totalled €33.6 million. A total of €11.4 million was received from the National Treatment Purchase Fund in 2023 and €4.5 million was received in fair deal funding. The hospital also retained €8.8 million in payroll deductions, which mainly comprised employee pension contributions. The main non-State source of funding comprised receipts totalling €29.2 million in 2023 in respect of charges for patient accommodation or emergency department attendances.

The hospital recognised capital funding of €30 million received from the HSE in 2023. Total capital expenditure was €29.2 million.

I issued a clear audit opinion in respect of the board's 2023 financial statements. However, I drew attention to a material level of non-compliant procurement by the hospital. The statement on internal control reported that the hospital had identified non-compliant procurement for 2023 totalling €18.5 million. Subsequently, the hospital identified further contracts that were procured in a manner that was non-compliant, which raised the estimated value to €20 million.

I issued my audit report on the hospital's 2023 financial statements on 8 October 2024. In recent days, I finalised my review of the draft 2024 financial statements, which I understand will be signed off by the hospital's board in the next few weeks when some outstanding issues have been addressed.

On 3 July this year, the committee examined the 2023 financial statements of the board of the National Treatment Purchase Fund. At that stage, I had just issued my report on the board's 2024 financial statements but they had not yet been presented for the committee's examination. The board's financial statements for 2024 show income of €239 million received directly from Vote 38 - Health. Expenditure of €247 million was reported, resulting in a deficit for the year of €8.5 million. This resulted in a reduction in the retained revenue reserves.

The board secures treatment and assessments for patients on public waiting lists from private hospitals and from public hospitals that can offer spare capacity. In 2024, payments made to private hospitals amounted to €155 million, while payments to public hospitals amounted to €80 million. Payments to individual hospitals are not shown in the fund's financial statements.

The board's payroll costs and other administrative expenditure amounted to €12.3 million in 2024. Included in this are administrative costs of just under €1 million in respect of the board's function to negotiate with private nursing homes on the charges they impose on residents availing of the HSE's fair deal scheme.

I issued a qualified audit opinion in respect of the board's financial statements for 2024. However, the qualification is only in respect of the accounting treatment of retirement benefit liabilities for the board's staff, which are recognised only as they fall to be paid. This is not in line with generally accepted accounting practice but does comply with the accounting directions of the Minister for Health, which are common to a number of health sector bodies I audit. In all other respects, I am satisfied that the financial statements present a true and fair view of the board's financial situation at the year end and of its transactions for the year.