Oireachtas Joint and Select Committees
Tuesday, 24 March 2015
Joint Oireachtas Committee on Health and Children
Remuneration of Section 38 Agency Staff: Health Service Executive
3:30 pm
Jerry Buttimer (Cork South Central, Fine Gael)
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I welcome from the Health Service Executive Mr. Ian Tegerdine, interim national director of human resources, and Ms Paula Lawler, deputy national director of human resources. The purpose of the meeting is to receive an update from the HSE on the implementation of recommendations in its internal audit report on section 38 agency staff remuneration. Since July 2014 the joint committee has maintained an ongoing monitoring role in this matter. Mr. Tegerdine who has taken over the role of interim national director of human resources is attending his first meeting with the committee. With Ms Lawler, he will update the committee and clarify issues members might have. I congratulate him on his appointment and wish him well. We look forward to working with him.
Witnesses are protected by absolute privilege in respect of the evidence they give to the committee. However, if they are directed by it to cease giving evidence on a particular matter and continue to do so, they are entitled thereafter only to qualified privilege in respect of their evidence. Only evidence connected with the subject matter of these proceedings is to be given and they are asked to respect the parliamentary practice to the effect that, where possible, they should not criticise or make charges against any person or an entity by name or in such as way as to make him, her or it identifiable. Members are reminded of the long-standing parliamentary practice to the effect that they should not criticise, comment on or make charges against any person outside the Houses or an official by name or in such a way as to make him or her identifiable.
I invite Mr. Tegerdine to make his opening statement.
Mr. Ian Tegerdine:
I thank the Chairman and members of the joint committee for the invitation to attend to provide an update on the implementation of the recommendations in the HSE's internal auditor's report on the remuneration of staff in section 38 agencies. This issue was discussed by the committee in July 2014.
I am interim national director of human resources in the HSE. I took office on 1 December 2014 and have been with the HSE for a period of six to nine months. I am joined by my colleague Ms Lawler who is deputy national director of human resources.
Members will be aware that the internal audit report contains 22 recommendations which deal, in the main, with issues of compliance with approved public sector remuneration levels for senior management in agencies funded under section 38 of the Health Act 2004. A report detailing progress in the implementation of the 22 recommendations has been made available for members. Some 13 of the recommendations were dealt with through the development and implementation of an overall health sector pay policy which was issued in September 2013 to the statutory and voluntary health sector by way of Department of Health Circular 11/2013. The circular reflects Government policy on senior public service pay. The policy makes it clear that bodies funded under section 38 of the Health Act 2004 may not supplement approved rates of remuneration, either with Exchequer or non-Exchequer funding.
A total of 17 recommendations have been implemented in full; a further three are still in progress - Nos. 10, 20 and 21; while it has not been possible to implement two of them, Nos. 14 and 19, owing to information gained or decisions made since the audit was completed.
Recommendation No. 9 is still in progress and is awaiting decision from the Departments of Health and Public Expenditure and Reform as it relates to decisions in respect of applications to red circle remuneration arrangements on a personal to post holder basis owing to legal contractual entitlements. These applications have been made under section 7(4) of the pay policy and have been made by the agencies after they obtained independent legal advice to ensure action taken by the agency as an employer is done in a legally compliant manner. This mitigates the risk of future legal action to the greatest extent possible.
Where support has been given for cases it is on the very strict understanding that once the current post holder no longer holds that post, the non-compliant red-circled remuneration shall cease. In addition, when the post holder vacates the position, all future appointees will be remunerated in line with the Department of Health consolidated pay scales and the practice of paying the particular non-compliant remuneration will therefore cease.
If I may, I will correct something from the report. On recommendation No. 9, the report refers to 85 individually named employees. My apologies. That should read 85 cases. A total of 85 cases have now been submitted for consideration from 25 agencies. We are disappointed that one agency has declined to engage fully with the process and this is being dealt with through the management arrangements described in the service arrangements between the Health Service Executive and that agency.
Recommendations Nos. 20 and 21, which are also reported as in progress, relate to a sizing exercise undertaken to determine appropriate pay rates for chief executives of section 38 agencies, which was undertaken by the Department of Health in conjunction with the HSE. This resulted in a proposal on the recommended sizing which has been submitted to the Department of Public Expenditure and Reform, and we await its decision.
Recommendations Nos. 14 and 19 are reported as not implementable as these relate to access to the public pension scheme and the recoupment of payments under the provisions of the Financial Emergency Measures in the Public Interest, FEMPI, Act. We have information and decisions from the Departments of Health and Public Expenditure and Reform that it is not possible to recoup the payments under FEMPI. As far as the issue of the public sector pension scheme is concerned, the requirement is that employees have access to a pension scheme, not necessarily the public pension scheme.
Members will be aware that since the findings of the internal audit report was accepted by the HSE board at its meeting in July 2013 and subsequently implemented as reported to this committee, this has been challenging for a number of parties. We should not underestimate the impact of public and media attention on senior executives in the public service and the complexity of the legal contractual relationships this has brought under scrutiny. It is important to hold focus that this process was started to ensure public funding is directed appropriately to patient care.
The HSE has implemented enhanced governance arrangements in 2013 through the development and implementation of an annual compliance statement process as part of the requirements of the service arrangements between the HSE and the section 38 organisations. This, together with the twice yearly meetings between the HSE and the chairs of section 38 agencies, will ensure a better working relationship between funder and provider in maintaining compliance with Government policy. The HSE is committed to building on this process to ensure continuous improvement of effective governance arrangements with the sector in line with legislative and good practice requirements.
That concludes my opening statement and, together with my colleague, I will endeavour to answer questions members may have.
Jerry Buttimer (Cork South Central, Fine Gael)
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Before calling Deputy Billy Kelleher, I want to ask Mr. Tegerdine one question. In the context of his report on recommendations Nos. 14 to 19, can he explain what he is trying to recoup under FEMPI? It is unclear what he is trying to get at in that regard. He might comment further on the non-compliance by one of the organisations, which I believe is the National Maternity Hospital.
Billy Kelleher (Cork North Central, Fianna Fail)
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I thank Mr. Tegerdine for informing us of his progress with regard to section 38 organisations. I have a number of questions. What was the level of co-operation? Was there any obstruction or were agencies upfront in terms of providing documentation? Was there a requirement for detailed investigations from the point of view of the HSE in trying to ascertain the level of compliance or was there full co-operation by the majority of the agencies involved that are governed under section 38 of the Health Act 2004?
Recommendation No. 20 states a review of remuneration rates of section 38 agency chief executives and senior management should be undertaken using the pay classification model developed for HSE, or any other model deemed appropriate, to ensure the pay rates reflect the comparable size, scale and complexity of each organisation. The audit states that it is in progress and that a sizing exercise undertaken jointly between the Department of Health and the HSE to determine appropriate rates of pay for chief executives of section 38 organisations has been concluded. A proposal has been submitted to the Department of Public Expenditure and Reform. Is that correct?
Billy Kelleher (Cork North Central, Fianna Fail)
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Is that proposal published or is it a confidential document in terms of the presentation that has been made by-----
Jerry Buttimer (Cork South Central, Fine Gael)
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Mr. Tegerdine can respond at the end.
Billy Kelleher (Cork North Central, Fianna Fail)
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Mr. Tegerdine might clarify whether that has been published and whether he can share it with us today.
The comment is made in recommendation No. 9 that the National Maternity Hospital has indicated that three employees are in receipt of remuneration not in line with Department of Health pay scales and that there are contractual entitlements. It further states they have not provided the necessary documentation in support of this entitlement to the HSE citing confidentiality reasons, that the agency is deemed non-compliant with Government pay policy, and that this matter is being addressed by the national director of acute hospitals in the context of the standard service agreement between the hospital and the HSE. There are three employees at the National Maternity Hospital. Is it Mr. Tegerdine or the three employees who are saying they cannot provide the documentation citing confidentiality reasons? If there is documentation, what actions will the HSE take to access that documentation and if nothing is forthcoming, what could it do in terms of breaking the service level agreement between the hospital and the HSE in view of the fact that it is a substantial piece of infrastructure in terms of maternity services in this country? Obviously, that is not easily addressed. What sanction can the HSE take or what sanction has it said it will implement if there is continued non-compliance? I could use the word "non-co-operation" as well in view of the fact that it has not furnished documentation. Is documentation available?
Jerry Buttimer (Cork South Central, Fine Gael)
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I call Sandra Deputy McLellan. Apologies have been received from Deputy Caoimhghín Ó Caoláin.
Sandra McLellan (Cork East, Sinn Fein)
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I thank Mr. Tegerdine for his presentation and apologise on behalf of Deputy Caoimhghín Ó Caoláin who unfortunately could not be here today.
We are told that future appointments to the role will be in line with the Department of Health pay scales. Is it good enough that these amounts above and beyond what the Department recognises as fair remuneration will be paid until a future appointment is made, however far away that might be?
This application is understood to be still under consideration by the Department of Health but when will that process finish? What other institutions might be involved? What will be their roles and the level of top-ups?
The HSE said at the time that where a body did not stop paying the allowances, it would consider a different relationship with the organisation. What does that mean and will there be consequences or sanctions against such an organisation?
Colm Burke (Fine Gael)
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I thank Mr. Tegerdine for his presentation. First, will he outline the total number of section 38 organisations we are discussing? Have we an idea of the total budget among all those organisations? I am not asking for precise figures but a rough guideline.
Second, were there structures in place before the circular of September 2013? What was the structure in place in terms of the Department, the HSE and the section 38 organisations?
Were there contractual arrangements? What was the structure? I think we need clarification on that issue. I may have missed this but Mr. Tegerdine referred to one organisation that is not co-operating. Is it possible to disclose who we are talking about here in this case?
Jerry Buttimer (Cork South Central, Fine Gael)
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It is contained in the last paragraph of Recommendation No. 9 on the right-hand side of the column.
Jerry Buttimer (Cork South Central, Fine Gael)
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It is in the report that was given to members prior to the meeting. It is the National Maternity Hospital.
Colm Burke (Fine Gael)
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Recommendation No. 19 in the report on the implementation of recommendations is recorded as unable to implement. Will Mr Tegerdine give the committee some further clarification on that issue? What are we talking about? Mr Tegerdine refers to a statement by Ms Oonagh Buckley to the Committee of Public Accounts on 19 December 2013. Can we have some clarification on that because it is not written into Mr Tegerdine's report?
If there was no structure in place prior to this circular of 2013, are we in difficulty if there are now legal contracts in place which are not compliant with the 2013 document? Will Mr. Tegerdine clarify that issue further?
Mr. Ian Tegerdine:
I will take the questions as they arose. The first one was on FEMPI. FEMPI introduced new public sector pay arrangements from a particular point. The question on FEMPI was, where arrangements were in place that were not compliant with FEMPI, whether we could recoup the payments that were made after FEMPI came into effect. Ms Oonagh Buckley is an officer from the Department of Public Expenditure and Reform and its view is that it was never the intention and it would not be possible to backdate the reclaiming of payments before FEMPI. That is the issue around FEMPI.
The non-compliance, as we have said, is the National Maternity Hospital. The level of co-operation-----
Jerry Buttimer (Cork South Central, Fine Gael)
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Has Mr. Tegerdine exhausted all efforts with the National Maternity Hospital to reach compliance?
Jerry Buttimer (Cork South Central, Fine Gael)
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What is left in the armoury?
Mr. Ian Tegerdine:
We are still in dialogue with the National Maternity Hospital. Obviously, there is a legal service agreement between them and us. The national director for acute hospitals is leading those contract negotiations. The disclosure of the information is being discussed as part of that contractual process, which picks up on some later points. What will happen next is that if the hospital, after we explain again the importance of this, and we have had a number of interactions with it already on this, still fails to comply, the sanction we have is the withholding of income to the hospital. That is the sanction that is possible under the service agreement. It could potentially receive a financial penalty.
Jerry Buttimer (Cork South Central, Fine Gael)
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Is its failure to comply caused solely by privacy and contractual elements?
Jerry Buttimer (Cork South Central, Fine Gael)
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Are those employees being paid out of the public purse?
Jerry Buttimer (Cork South Central, Fine Gael)
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The HSE has not seen the contracts.
Mr. Ian Tegerdine:
No. That is the issue. The first stage in moving towards a business case as all the others have done is for us to do due diligence on the contracts the hospital has in place with its employees. Once we have been through that and checked that with it, we move that into the business case process, but we have stalled with the hospital at the first hurdle because it has declined to share the contracts with us and hence we have moved into a contractual dispute with it over it.
Jerry Buttimer (Cork South Central, Fine Gael)
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Is it fair to ask how many meetings the HSE has had with the hospital?
Mr. Ian Tegerdine:
I am afraid I would not know that because that would have been led by the national director of acute hospitals. The contracts rest with him.
The next question was about the level of co-operation. How would I describe the level of co-operation? As I understand the agencies reluctantly provided us with the information, it took a little bit of time but they all complied with providing the information, other than the ones to which we referred. Our current contract with them requires them to reveal their remuneration arrangements within their annual reports. In terms of whether we need to do more detailed analysis, the remuneration has to be a matter of public record.
Recommendation No. 20 relates to the sizing exercise. My understanding of the status of that report is that it is still under confidential discussion between the Department of Health and the Department of Public Expenditure and Reform. It has not been published and I do not think it is possible at this stage to make it available.
Jerry Buttimer (Cork South Central, Fine Gael)
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In the short term.
Jerry Buttimer (Cork South Central, Fine Gael)
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Is there a timeline for that in terms of its implementation or its publication in the future?
Jerry Buttimer (Cork South Central, Fine Gael)
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That is fine.
Mr. Ian Tegerdine:
I want to make sure I have covered the issues around recommendation No. 9 on the maternity officer. The confidentiality issue comes from them. What happens next is the contractual process moves on. The action we have taken is to raise a contract dispute. I do not think one would use the word "threatened", but I think we have highlighted to them the potential consequences of continued non-compliance.
Jerry Buttimer (Cork South Central, Fine Gael)
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Does Deputy Billy Kelleher have questions on recommendation No. 9?
Billy Kelleher (Cork North Central, Fianna Fail)
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Yes. As it stands, we are unsure whether some of the remuneration package in the National Maternity Hospital is coming from public funds. We simply do not know. It could be coming from income streams, patient payments or car parking. We do not know.
Billy Kelleher (Cork North Central, Fianna Fail)
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The National Maternity Hospital is critical infrastructure but penalties could be imposed if there is not full compliance and co-operation at some stage. I assume breaking the service level agreement is the ultimate sanction. What would that entail in terms of penalty? Could it impact on the delivery of health care in that hospital if funding streams were to be reduced?
Mr. Ian Tegerdine:
That would be possible but I would hope we would not need to get to that level. We would have to understand what level of penalty would get us the required contractual action versus the level of penalty that could potentially damage patient care through income streams. It would be a very delicate balance. It would have to be very carefully considered by my colleagues in acute hospital management. I am not sure what the size would be. I do not want to give the committee a figure, but I think it would have to be a balance between what would provoke action.
Billy Kelleher (Cork North Central, Fianna Fail)
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There are two parties to an employment contract. There is the employee and the employer. As the HSE is dealing with the employer in this case, there would be no discussion with the employee. Is there a potential for the employee to waive their contractual confidentiality clause?
Mr. Ian Tegerdine:
There is, but the relationship, as the Deputy has pointed out, is between the employer and the employee. We are the third party to it.
If they were to come to us, of course, we would welcome the information, but I do not think we would try to get involved in that employment relationship.
Jerry Buttimer (Cork South Central, Fine Gael)
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Is the board or whoever Mr. Tegerdine is dealing with aware of Circular No. 11 issued in 2013 on compliance with public sector pay policy? It clearly references the issue of remuneration in that non-Exchequer sources may not be used or supplements approved. Is the circular not the guiding document we should all be using as regards public sector pay?
Mr. Ian Tegerdine:
Absolutely. To answer the Chairman's question, it would be disappointing if the board was not cited. We have made clear the reason we want to engage with it in a conversation on these employees.
To respond to the other committee member's question concerning the impact on patient care, there would be a process of escalation as we moved towards a potential financial sanction. The board would have to consider this, as well as its duty to ensure safe patient care.
The other question was on what we call "red-circling" in the document. Is it okay to continue to pay those who had arrangements in place before the change under a red-circling arrangement? It may not be desirable, but, unfortunately, it is legally unbreakable. Hence, the only way we can cope with this is to say we have a personal arrangement for the persons concerned that will not continue after them. We have taken full legal advice on this issue, which was the obvious thing to do. With the employing agencies, we are clear that this is an unbreakable arrangement.
Jerry Buttimer (Cork South Central, Fine Gael)
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Is that why the exceptions are being granted?
Mr. Ian Tegerdine:
If contractually we could reverse the payments or stop them - that has happened in some areas - we would. Where there is an absolute, solid contractual arrangement, it will require the individual to give up the payment voluntarily. We cannot force him or her to do so. If he or she does not wish to do so, the best we can do is to say we will respect these conditions until such point as there is a change in the post-holder.
The next question was about the Department of Health's process for dealing with business cases. I am afraid that I do not have a timeline for when it will be concluded. The business cases are under consideration between the Department of Health and the Department of Public Expenditure and Reform, but I am afraid I do not have a deadline.
The next question was whether there were consequences for other organisations in terms of roles and top-ups. In this regard, we are focusing on section 38 providers under the Health Act. That is the boundary of our work and I would not want to speculate outside it.
As regards seeking a different relationship with organisations that continue to be non-compliant, it would start with a change in the contractual relationship we have already explored. There would be a future discussion on whether one would continue. For example, if we had some new and different work to do and had a choice in to whom we could give it, would we choose to give it to a non-compliant or a compliant provider? Where we had a choice, we would probably choose to go with the compliant provider. That is the type of thing we might see in terms of a change of relationship. The key difference would be the legal sanction imposed.
The total number of organisations and the total budget represented were explored at the last committee meeting. As I do not have the figures in front of me, I do not know the size of the sector or the numbers involved. I am sorry, but I do not have the numbers.
Jerry Buttimer (Cork South Central, Fine Gael)
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In April last year 143 business cases were received from section 38 agencies.
Colm Burke (Fine Gael)
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As regards section 38 agencies, it is relevant in that 25 have made business cases. My understanding is that we are not talking about a huge number of section 38 agencies overall. That is why I am wondering from where the figure of 25 came. That is why the question is relevant.
Colm Burke (Fine Gael)
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A total 25 of the 39 agencies have submitted business cases.
Colm Burke (Fine Gael)
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I accept that, but 25 of the 39 agencies have made submissions where they are non-compliant.
Billy Kelleher (Cork North Central, Fianna Fail)
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I wish to ask about recommendation No. 20. As regards the review of remuneration rates for section 38 agency CEOs and other members of senior management, how was the pay classification model developed by the HSE? Was it developed along the lines of pay scales within the HSE or through an assessment of international comparators? What matrix was used in determining the appropriate rates of pay for CEOs and senior management? Did it take into account the complexity of the job or security of tenure? I know that the matter is complex, but what comparators or benchmarks were used?
Mr. Ian Tegerdine:
I am afraid that I will have to plead some ignorance because I was not here when the work was done. It was subsequently lodged. My understanding is that the key sizing issues considered were whole-time equivalent staff numbers and the scale and size of the organisation in terms of its procedures and budget. There was a view of the complexity of the role involved. As far as I am aware, there was no consideration of security of tenure. These three key aspects were used in developing the model. It led to a link with existing pay scales such that complexity of X-size led to a point on the existing approved pay scales. If the Deputy wants to know more than this, I will have to go back and get it.
Billy Kelleher (Cork North Central, Fianna Fail)
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The employment contract did not deem people's pay.
Jerry Buttimer (Cork South Central, Fine Gael)
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Was all of this work carried out in-house, or were external consultants appointed?
Jerry Buttimer (Cork South Central, Fine Gael)
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Therefore, no external consultants were appointed.
Jerry Buttimer (Cork South Central, Fine Gael)
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For those who arrived late, Mr. Tegerdine has just taken up his new post in the HSE. That is why he might not have some of the answers sought. To be fair to him, the caveat is that he has only just been appointed.
Colm Burke (Fine Gael)
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Before 2013, what structure was in place between the Department of Health, the HSE and the various agencies involved?
Ms Paula Lawler:
It was reported at our July meeting that service level agreements had been developed throughout 2009 and 2010. The compliance process in which we are involved came into being in 2013.
The process and framework commenced in 2009 to firm up on service level arrangements that had been in place prior to the establishment of the Health Service Executive.
Colm Burke (Fine Gael)
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Was there anything to prevent any of the agencies from entering into a legal agreement before 2013?
Colm Burke (Fine Gael)
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Does that mean that they were not in breach of any regulation if they did sign a legal agreement prior to the circular of 2013?
Ms Paula Lawler:
The Department of Health always had consolidated pay scales to which all public sector employees had to adhere. Payment had to relate to these pay scales which had been in place for a long time. While there was no overall Government pay policy, we would have regularly advised agencies that they had to pay their staff in line with the consolidated pay scales. There would have been numerous communications and circulars to that effect.
Colm Burke (Fine Gael)
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At the same time, however, there was no regulation in place preventing agencies from entering into a higher level of pay with individuals to whom they were giving a contract?
Colm Burke (Fine Gael)
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There was nothing to prevent them from entering into such contracts.
Colm Burke (Fine Gael)
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The reason I am asking this question is that I know of a case in which a person moved from a HSE job to a position in the voluntary hospital sector and it was widely rumoured at the time - this was eight or ten years ago - that there was a huge difference in salary scales, even though the funding for the voluntary hospital was provided through the HSE. There did not appear to be restrictions in place in terms of what arrangements could be entered into in respect of the pay element of the contract that was subsequently signed.
Colm Burke (Fine Gael)
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There was guidance but no regulation.
Jerry Buttimer (Cork South Central, Fine Gael)
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Agencies are now obliged to have twice-yearly meetings with the HSE. I assume it is Mr. Tegerdine's office which meets the chairpersons of the section 38 agencies?
Mr. Ian Tegerdine:
No, it is done through the contractual process under the direction of the national director of acute hospitals. My office helps to develop the sections of the contracts that relate to pay and so on, but they are delivered through contract negotiations between the national director of acute hospitals and the organisation involved. The director, of course, has the opportunity to call on our advice and support.
Jerry Buttimer (Cork South Central, Fine Gael)
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Senator Colm Burke referred to oversight and service level agreements. How is the process being improved and made more streamlined as a consequence of the changes made?
Mr. Ian Tegerdine:
As well as the actions we have described which have been taken within the HSE, we have also developed what we call a compliance unit which has responsibility for oversight and management of the service level agreements with voluntary providers. There is a team of people whose job it is to manage and monitor that process.
Jerry Buttimer (Cork South Central, Fine Gael)
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The Department of Health and Mr. Tegerdine's office were involved in producing the report. Has it been independently verified and, if not, is there a need for such?
Mary Mitchell O'Connor (Dún Laoghaire, Fine Gael)
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Recommendation No. 6 in the report is that a clear policy statement on allowances, including clear guidance on where authority lies in approving allowances and other prerequisites, should be developed and issued to all agencies. Has this been done?
Second, in the time since this story broke, are we getting good quality applicants coming forward to fill posts? In the case of hospital consultants, as a consequence of the decision to reduce their pay, we are seeing difficulties arise in filling posts. Is this a problem for section 38 agencies?
Mr. Ian Tegerdine:
Regarding recommendation No. 6, the statement on allowances is being captured within the pay policy we mentioned. It is embodied in that policy which now represents the rules by which the agencies are held accountable.
On the Deputy's second question, in terms of what we in HR call talent management, I am not sure I have any definitive evidence of a difficulty in filling posts. However, I definitely have anecdotal evidence in so far as people are saying it is difficult to recruit the right talent to the health system because of some of the pay restrictions. As I said, this is merely anecdotal.
Mary Mitchell O'Connor (Dún Laoghaire, Fine Gael)
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On my first question, is Mr. Tegerdine saying there is now a total pay figure and that no allowances are allowed, or are allowances built into it?
Mr. Ian Tegerdine:
There are some allowances. For instance, people may claim travel expenses and subsistence at the approved rates. These allowances are available because they are part of the pay policy. However, other allowances that were payable before are no longer available. The arrangements are very clearly the same for all public sector employees and this is captured within the pay policy with which the agencies are required to comply.
Mary Mitchell O'Connor (Dún Laoghaire, Fine Gael)
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Mr. Tegerdine has indicated there is anecdotal evidence of a difficulty in recruiting people to the agencies. When does he expect to have an evidence-based answer to the question?
Mr. Ian Tegerdine:
It is not a question we are trying to answer, but it definitely is one we need to consider as we work through the development of our leadership and management strategy across the HSE which is in the very early stages of development. Balanced against the anecdotal evidence of a difficulty in recruitment is the fact that we are not holding too many vacancies which we are unable to fill. There is a balance between the anecdote and the reality. Whether the people we are recruiting are the ones we could recruit is a different question.
Jerry Buttimer (Cork South Central, Fine Gael)
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Does Mr. Tegerdine believe the pay issue is having an impact on the quality of people we are able to attract?
Jerry Buttimer (Cork South Central, Fine Gael)
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Going back to the national maternity hospital issue, has Mr. Tegerdine taken steps to ensure the confidentiality clauses in contracts cannot be cited in the future by other organisations as a reason for not co-operating until late in the day?
Jerry Buttimer (Cork South Central, Fine Gael)
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Mr. Tegerdine said in his presentation that 17 recommendations had been implemented, that a further three were in progress and that it was not possible to implement two of them. If my maths are right, that is an implementation rate of approximately 77%. Is Mr. Tegerdine satisfied with this?
Mr. Ian Tegerdine:
At this stage I am content that we have implemented the vast majority of the recommendations made. One of our concerns is the question of which are the most important recommendations and which are the ones that perhaps might have a lower priority. I am content with the two we are seeing as not implementable. I would like to see progress on the ones in respect of which we have work lodged and are awaiting an outcome.
I am anxious to see this work completed.
Colm Burke (Fine Gael)
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Mr. Tegerdine said recommendations Nos. 20 and 21 had been sent to the Department of Public Expenditure and Reform. Does he believe the delay on the part of that Department in dealing with the issue will cause problems within the section 38 organisations or within the HSE? Is there a need for that Department to be put under pressure to make a decision on this matter?
Mr. Ian Tegerdine:
In the absence of decisions the status quoremains. I would not push the Department to make an early decision but would prefer if it made the right decision. I understand from conversations with officials that they are heavily involved in the work in question. It will take a certain amount of time to complete, as it is quite complex. There is a lot of thinking to be done and the Department has to think about the consequences for the whole public sector rather than just one part of it. It is trying to work out what the consequences will be if it agrees to certain things.
Jerry Buttimer (Cork South Central, Fine Gael)
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I thank Mr. Tegerdine and Ms Lawler for their candour in answering our questions. It is important that they get back to us with further updates on the remaining issues arising from the report. I also extend our thanks to the organisations which work with the HSE. I hope finality can be brought to the matter. I thank Mr. Ray Mitchell for his co-operation in facilitating the meeting.