Oireachtas Joint and Select Committees
Thursday, 19 October 2017
Public Accounts Committee
HIQA: Governance and Management of Conflict of Interest Issues
On 28 September we met the Health Information and Quality Authority, HIQA, to discuss its 2016 financial statements. At that meeting we discussed briefly management of conflicts of interest, and the committee was quite satisfied with the responses. However, an article appeared on 8 October 2017 in the Sunday Independent on a meeting attended by HIQA chairman, Mr. Brian McEnery, with members of Nursing Homes Ireland in October 2015. This has raised concerns for the committee, and the purpose of today's session is to clarify the extent, if any, to which there was a conflict of interest and whether HIQA governance standards are appropriate or sufficient to manage any such conflicts of interest.
We invited a representative of Nursing Homes Ireland to attend today's meeting voluntarily, but Nursing Homes Ireland declined the invitation stating it was unable to attend at this time. It has stated it will reconsider the request for a future date, and just before the witnesses came in we agreed to reissue the invitation to Mr. Tadhg Daly from Nursing Homes Ireland to attend at a mutually agreed time as soon as possible. We also invited representatives of the National Treatment Purchase Fund because we understand Mr. McEnery has advised members on the fund. It was unable to attend today because of another commitment.
From HIQA I welcome Mr. Brian McEnery, chairman, Mr. Phelim Quinn, chief executive officer, CEO, and Ms Mary Dunnion, director of regulation and chief inspector of social services. We are also joined by Mr. David Keating and Mr. Niall Redmond from the Department of Health. Members have received a document, which is a memorandum of the meeting referred to in the newspaper article mentioned earlier. Nursing Homes Ireland has stated it has not waived legal privilege over this document or the setting in which the meeting took place. As we have not had time to get our own legal advice on this I will insist that members do not refer to the document, which is a minute of that meeting prepared by Nursing Homes Ireland's legal adviser, which contains the heading that the document contains legal advice which is legally privileged. Members are free to discuss the opening statements and content of the meeting, but not reference the exact document mentioned because it is legally privileged. I do not want reference to that particular document, but the contents of the article in the Sunday Independent, which deals with the meeting and HIQA's attendance at it, is fully open for discussion here today.
I also want to put on record that because of the late receipt of the reply from Nursing Homes Ireland, which we received yesterday, we had expected it would be here today, so we have not had time to get full legal advice. In the meantime, as Chairman I am taking the cautious view, pending legal advice, not to refer to the document, which is legally privileged. HIQA had already submitted its statement, in which it refers in detail to the contents of that meeting. Through the secretariat, I sent word yesterday to HIQA not to include that aspect of its opening statement today because, as Chairman, without the benefit of legal advice I was taking the cautious view I do not want to trespass into that meeting where we have been informed by Nursing Homes Ireland that the minutes of the meeting are legally privileged. However, the committee had a detailed discussion in private session this morning, and I am quite happy to be guided by the committee that HIQA's original statement should be read into the record as it was originally intended, and my sending a message to HIQA was merely exercising a cautious approach pending legal advice. We are very happy for HIQA to discuss it and I apologise for any discommoding I caused yesterday evening by asking HIQA to shorten its statement. The committee is very happy, and I am happy to go along with the advice of the committee, for the full statement to be on the public record today.
I remind members, witnesses and those in the Public Gallery that all mobile phones should be switched off.
I advise the witnesses that by virtue of section 17(2)(l) of the Defamation Act 2009, witnesses are protected by absolute privilege in respect of their evidence to the committee. However, if they are directed by the committee to cease giving evidence on a particular matter and they continue to so do, they are entitled thereafter only to a qualified privilege in respect of their evidence. They are directed that 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, persons or entity by name or in such a way as to make him, her or it identifiable.
Members are reminded of the provisions of Standing Order 186 that the committee shall also refrain from inquiring into the merits of a policy or policies of the Government or a Minister of the Government or the merits of the objectives of such policies.
I believe Mr. Quinn will make a brief opening statement, followed by Mr. McEnery. The speakers have indicated in the following sequence: Deputies McDonald, MacSharry, Cullinane, Connolly and Catherine Murphy. I invite Mr. Quinn to make his opening statement.
Mr. Phelim Quinn:
On behalf of HIQA, I wish to thank the Chairman and members for the opportunity to address the Committee of Public Accounts this morning. As the Chairman has said, I am accompanied by my colleagues Ms Mary Dunnion, director of regulation and chief inspector of social services and Mr. Brian McEnery, chairperson of the board.
At our appearance before this committee on Thursday, 28 September, the issue of potential conflicts of interest arose, specifically with regard to Mr McEnery and his role as both chairperson of the board of HIQA and as an adviser to nursing home operators. Subsequently, an article was published in a Sunday newspaper, which was discussed by the committee last week. In order to help answer any questions the committee may have, I wish to outline HIQA's governance arrangements and how we handle conflicts of interest.
HIQA is committed to high standards of corporate governance. We have a clear policy on conflicts of interest, which ensures that staff and board members are aware of their obligation to act in the best interests of HIQA and to avoid situations where there may be a potential or actual conflict of interest. This policy is in line with Government policy, as set out in the Code of Practice for the Governance of State Bodies 2016.
HIQA’s code of governance and code of business conduct, which was approved by the Minister for Health in October 2014, also reflects the obligations of board members and staff under the ethics in public office legislation. Both documents have been submitted to the committee for reference. Our policy and procedures on conflicts of interest apply to board and staff members and are adhered to at all times. Furthermore, at the beginning of every board session, the sub-committees of the board and attendees from HIQA's management team are requested to declare any real or potential conflicts of interest. Any declarations are recorded in the relevant minutes.
All of HIQA's inspection staff work within a scheme of determination, which must be agreed to and signed upon commencing employment with HIQA. This scheme of determination clearly shows the level of regulatory decision-making the chief inspector permits her regulatory staff to make. In addition, regulatory staff work within a specific code of conduct, which includes a confidentiality clause.
The regulation of designated centres is based on a series of steps. This includes the initial receipt of information, which can include mandatory notifications, unsolicited concerns and protected disclosures; inspection activity, that is announced, unannounced or registration inspections; and the creation of a centre profile, which contains a description of the centre, a regulatory assessment of information received and the findings of inspections.
All regulatory activities, whether information or evidence received, regulatory judgments or inspection reports, are gathered, generated and saved within a secure information management system. Access to this system is determined and approved only by the chief inspector. No member of HIQA's board has access to this system.
Regulatory risk and judgments, and potential and actual enforcement actions, are managed by HIQA's regulatory risk committee, chaired by the chief inspector. All records of this meeting, decisions made and actions planned are stored within the information management system.
The chief inspector provides a monthly assurance report to HIQA's executive management team, a bi-monthly report to the board of HIQA and a quarterly report to the board's regulation committee. These assurance reports include an update on progress made against annual business plan objectives, details on the frequency of meetings of HIQA's regulatory risk committee and details of mitigating actions taken against any regulatory risks. Reports on quality assurance include information on key performance indicators, internal audit reports and an update on the external stakeholder engagement schedule. Furthermore, the chief inspector produces and publishes an annual report detailing all regulatory activities, which is a requirement of the Health Act 2007.
As CEO, I, along with the chief inspector and director of regulation and other officials from HIQA, regularly attend Oireachtas committees when requested. So far this year, we have presented to the Committee on the Future of Healthcare, the Joint Committee on Health, the Joint Committee on Children and Youth Affairs and, of course, this committee.
Finally, HIQA has received correspondence from a private nursing home provider containing a number of assertions regarding perceived conflicts of interest. This correspondence was copied to some Members of the Oireachtas. HIQA has directly replied to this through our chief inspector and director of regulation, Mary Dunnion, and separately through our board chairperson, Brian McEnery. We have made all of this correspondence available to committee members. I will now hand over to chairperson of HIQA's board, Mr. McEnery, who will address specific points raised.
Mr. Brian McEnery:
I thank the committee for the invitation to appear before it. In May 2013, I was appointed chairperson of the board of HIQA. It is a great honour to chair the board of the authority because its work is important in improving quality in our health and social care sectors. Since the authority's formation, I have been enormously impressed by the impact it has had on service improvement. As a student, I worked as a care assistant in the UK and saw, at first hand, the positive impact of regulation in that health system. I am enthusiastic about the role of Ireland’s regulatory body in our health service.
The board has in recent times been particularly focused on ensuring that there are prudent and effective controls which enable risk to be assessed and managed. We have devised a new and more comprehensive risk management suite of tools in the authority and these are aimed at ensuring that risks to the delivery of the authority's agenda are managed and mitigated. The board and its committees are also focused on ensuring that the resources of the authority are used optimally. Some of the key work undertaken by the board in recent times includes: approval of annual budget and corporate plan; approval of the annual report of the authority and its financial statements; and the assessment of performance of the CEO.
I am conscious that the committee wishes to address issues of conflict of interest and a recent report in the media surrounding a meeting of nursing home operators that I attended. I will address both of these issues in this statement. I suspect this is what committee members wish to ask me about so I am more than happy to address it directly. I am also happy to inform committee members about the exact nature of my contribution to the event.
First, just to set out the background to my appointment, I applied for the position of chairperson through the Public Appointments Service system. I displayed current and comprehensive experience of the health care arena garnered throughout my professional career. I have at all times before, during and since my appointment tried to ensure that I maintain the highest ethical standards in accordance with the code of practice for the governance of State bodies and, indeed, the code of governance of my own professional body, the Association of Chartered Certified Accountants. In that context, I have been clear at all times that I am currently a partner in BDO Ireland and head of health care in that practice. I indicate openly and transparently on the HIQA website that I am one of the firm's health care consulting partners. I additionally outline on the HIQA website that I have been an adviser in the older person care sector for the past 17 years and that I edited the Nursing Homes Ireland annual nursing home survey. I further outline that I produced the report A Fair Price for Care - Ireland on behalf of Age Action Ireland. I also outline on the HIQA website that I worked as a care assistant in a UK older person dementia care home in the past. In addition, I outline that I have acted as financial adviser to primary care centres, acute care facilities and older person care centres throughout Ireland and that I have a broad range of health care sector experience from both a financial and operational perspective. In a sense of openness about my professional life, I believe I could not have made it more transparent that I am a financial adviser to the health care sector and in particular to nursing home operators. This comprises a significant portion of the professional work which I do and I have never tried to hide or deny that.
When I came before the Joint Committee on Health and Children as a new chair to present my credentials in 2013, I outlined then that I have specialised in the area of advisory services in health care. I went on to state that for the past ten years or more, I have provided financial, operational and strategic advisory services to acute, older person and primary care services throughout Ireland. In my annual declaration of interests to the Standards in Public Office Commission, I state my professional capacity within BDO. Finally, the BDO website states clearly that I negotiate rates for nursing homes with the National Treatment Purchase Fund, NTPF, and work in health care advisory. It is clear that I advise nursing homes, hospitals and primary care centres. In 2015, I believe I spoke at six conferences on the topic of nursing homes, the financial implications impacting the sector, the fair deal as it impacts on nursing homes and the statistics of the industry. In the middle of 2015, BDO launched the nursing home survey, Ireland's most in-depth nursing home research publication, which analysed the financial performance of the sector. This was launched by the then Minister of State, Kathleen Lynch. At the time of launch, I spoke extensively to the press and media about the report and its findings.
I was invited by Tadhg Daly, the CEO of Nursing Homes Ireland, to attend an operator meeting in my professional capacity on 23 October 2015 to speak about the sector. I spoke about financial matters and answered questions that were asked of me based on my professional experience. I was there as an invited speaker and participated when invited by the meeting. I left the meeting before it concluded as my professional advisory input was no longer required. In that respect, I left prior to the attendees discussing next steps or actions. It was not unusual for me to speak at conferences relating to nursing homes as I had, by 2015, given a number of presentations to the pillar banks and a commercial conference provider for nursing home operators and at the formal launch of the nursing homes survey. This was the context in which I came to speak at the event on 23 October 2015. I accepted an invitation, was there as a financial expert and spoke about financial matters.
I would like to set out what I said at the meeting and to show that my contribution was based on advice for the sector in general. I am of the view that advice was entirely appropriate to the audience and was good advice for the sector in general. I outlined the following in answer to questions put to me after I was welcomed to the meeting by Tadhg Daly. I spoke about the finances of the industry and the fair deal scheme.
I spoke about the genesis of the scheme and the criteria the NTPF applies when agreeing rates with nursing homes. I also spoke about the financial impact of the NTPF reducing fair deal rates and about labour rate inflation and staffing shortages. In response to a question, I said that the NTPF acknowledged that nursing home costs were increasing. It often accepted that these costs were reasonable and prudently incurred and that it would like to be able to give a better fair deal rate but the budget simply was not there. I relayed to the meeting that the NTPF negotiators often stated to me and to operators during negotiations that it was important that there was a voice calling for an increased budget for the fair deal to back up its own requests. I outlined that the NTPF frequently stated to operators that the fair deal budget was reduced as a result of austerity and that increases in the fair deal rates to cover cost increases would not be forthcoming to any great extent until the fair deal budget increased.
In response to a question about the four criteria used to determine the fair deal rate, I outlined to the meeting that the NTPF, in meetings with me and my clients, recognised the criteria it uses are somewhat arbitrary and need to change. In response to a question about the first Deloitte report on the fair deal scheme, I stated that in my opinion it failed to recommend sufficient changes to the scheme’s methodology, changes which I believed the NTPF may have also wanted. In response to another question about the criteria for pricing care, I stated that the scheme lacked sophistication and outlined that as a financial adviser, I believed setting a rate for a home was wrong. I suggested that it would be much better to have a rate pertaining to the resident and their needs rather than to a building.
When responding to a question about the appeals process, I outlined to the meeting that my experience was that operators were better off not just accepting the rate offered by the NTPF off the bat and that engagement and challenge around their case was likely to be better than not negotiating. When asked about the need to provide more beds, I said I believed that different parts of Government were sending different signals to the sector. The EIIS scheme, for example, was extended to nursing homes to encourage new developments, but simultaneously fair deal rates were being cut, which was a contradictory message.
On a final question to me about the possible direction of travel, I suggested there should be engagement with the NTPF and good communication channels between providers and commissioners, that the cost of care should be a consideration and not just an arbitrary pricing mechanism, and that there should be some equality between providers with similar circumstances, that is, blatant inconsistencies in the scheme should be focused on and removed. I suggested an independent appeals process should be sought in future enhancements of the fair deal scheme and that operators should not be afraid of engaging in the appeals process, as I had found it useful in a number of instances. However, I suggested the appeals process can, if it goes the full way, take as long as nine months and this is too long. Beyond answering the questions posed to me, I did not contribute to discussions surrounding strategy. As the guest attendee, I left when the questions and answers session finished and before the attendees went on discuss follow-up actions.
On the board and governance, the role of the board of HIQA is to be the governing body of the authority. I am the non-executive chairperson of the authority’s board and I, or other board members, do not have operational involvement in the workings of the authority. I want to outline this to the committee for a few reasons. Section 42 of the Health Act states the chief inspector is accountable to the Oireachtas in his or her work. The chief inspector is not accountable to the board and so the board and I, as chair, do not have any remit over the regulation of nursing homes or other facilities regulated by HIQA. Legislatively, this is the case.
The board does not get involved in executive decision-making. The chief executive is the accountable person under section 24 of the Act and so, in operational matters, he is the person who runs the authority and has the responsibility and accountability. Operational matters are not brought to the board for decisions because that is not its role. The way HIQA is legally constituted means that I, as board chairperson, cannot, do not and would not intervene or even have information relating to HIQA inspections. I have, on one occasion, been asked to intervene personally by a nursing home operator who sought that a HIQA report would not be published on the HIQA website. I refused to intervene. In the follow-up correspondence, I was informed that the disappointed party intended to inform Oireachtas Members of my professional role. I say this as I wish to provide members with all of the relevant information regarding my role.
I welcome the opportunity to be present at this committee. There is no conflict of interest in providing nursing home owners with financial advice, including advice on negotiating with the NTPF, and being chairman of the regulatory authority. This is because of the unique way HIQA is legally constituted. Clearly this was established at the point of me being appointed to the role of Chairman from the very outset.
I thank Mr. McEnery. Deputy Mary Lou McDonald is the first speaker, with 20 minutes. Deputy Marc MacSharry is next, with 15 minutes. Deputies David Cullinane, Catherine Connolly, Catherine Murphy and Alan Farrell will follow in that order, and they all have ten minutes. We must be out of here before 1 p.m.
It is custom and practice. The last time Mr. McEnery was before us, he was wearing his National Asset Management Agency, NAMA, hat. He is welcome here this morning. How long has he been the financial adviser to Nursing Homes Ireland?
More than ten years? I was reading all about Mr. McEnery and saw a report in the Irish Medical Times which said that he was a national adviser to Nursing Homes Ireland, I think since the 1990s, but that he has had no involvement with the representative organisation for the private and voluntary nursing home sector since being appointed HIQA chairman by the Minister for Health, now Senator James Reilly. That was confirmed by HIQA.
Okay. In Mr. McEnery's opening statement he makes no bones about the fact that he currently negotiates with the National Treatment Purchase Fund, NTPF, on behalf of nursing homes. I went to his professional profile on BDO Ireland's website, and he does not actually say that at all. He refers to the fact that he did, in the past, carry out those types of negotiations but it is not made clear that he currently acts in that capacity.
Let me help Mr. McEnery because I have his profile from the BDO Ireland website here. It says that he undertakes a variety of assignments and "In 2009 and 2010 he worked with over 70 nursing homes preparing a cost model for each nursing home and negotiated rates with the National Treatment Purchase Fund". That is "negotiated" in the past tense. It makes no reference to the fact that he currently engages on behalf of nursing homes in direct negotiations with the NTPF.
Mr. Brian McEnery:
I have made it very clear that is the work which I do. I outlined it to HIQA board at the very first meeting of that board which I attended in the capacity of chairman. I outlined the work which I do. I declared that to the HIQA board. The minutes of meetings of the board of HIQA are a public-----
I think it was rather unclear, but we have now established that it is Mr. McEnery's function to carry out these negotiations. In his opening statement he referred to the fact that he speaks at many conferences. I do not doubt that he does. The October meeting, however, was not a conference.
What was the nature of the conversation? Mr. McEnery knows better than anyone that negotiations between individual nursing homes and the NTPF must happen on an individual basis. Is that not right?
Exactly. Mr. McEnery has given us an account of what he said at this meeting and so on, which I will come to. Is it not the case that the meeting included discussions on the kind of influence which could be leveraged on the NTPF and the Minister in respect of the quantum of funding for the fair deal scheme and so on? Doe Mr. McEnery recall that?
It certainly would be. Would it not be very troubling if the chairman of the board of HIQA, the regulator for nursing homes, was in the middle of a conversation about suggestions or ideas in respect of such collective leveraging? That would be deeply disturbing, would it not?
Mr. McEnery is aware that the Chairman has alluded to the fact that we are in receipt of the minutes of that meeting. We are not allowed to delve into the precise detail of them, but I have read them.
Mr. Brian McEnery:
I outlined how the NTPF works and the criteria which it uses in its interactions with nursing homes. The NTPF outlines these working to each and every nursing home itself in the first instance. I outlined the exact modus operandiof the NTPF. I did encourage nursing home owners to engage with the NTPF and for them to do so under that auspices of the provisions of the NTPF's role in negotiating care.
I suggest to Mr. McEnery that there is a very troubling difference between the contemporaneous note of that meeting, which we have read, and his account which, reading this, comes across as a very sanitised version of what he said, if I can use that term without offending Mr. McEnery. Does Mr. McEnery accept that is the case?
No, we have limited time. Mr. McEnery has made the point that he was a guest. That was his statement here.
Mr. McEnery also said that he was at the meeting but that he left it before any decisions were taken. Is he sure that is the case?
Mr. Brian McEnery:
The meeting was in session when I arrived and I was invited into the meeting room. I had travelled from the United Kingdom that morning. I was not present when the meeting commenced and I left before it concluded. Questions were posed to me and I tried to address them in my professional capacity. I then left the meeting before it was summarised and brought to a close.
Again, that is not what is reflected in the minutes of the meeting to which we all have access. The minutes do not suggest that Mr. McEnery arrived late to the meeting, that he was anything other than an active participant in it or that he left early for whatever reason.
Mr. Brian McEnery:
I believe that the minutes inaccurately reflect that I was answering questions which were posed to me, which was the case. I did leave before the meeting concluded. On conclusion of the questions and answers session, and in particular the questions posed to me, I left the meeting. The meeting continued - I do not know for how long - but I was not there.
For the purposes of the record, it should be recorded that the minutes to which we are both referring were recorded by a legal person and signed off in that person's name. I am sure any suggestion that there are inaccuracies, whether by accident or design, would be greatly resented by the person who took the notes.
Mr. Brian McEnery:
I represent nursing homes in different capacities. For example, I represent some nursing homes in their interactions with the National Treatment Purchase Fund, NTPF, and I represent others in securing bank finance. The services that we can provide differ. For some, it will be audit-----
How can Mr. McEnery state that there is no conflict of interest in him providing nursing home owners with financial advice, including advice on negotiating with the NTPF and him being chairman of the regulatory authority?
Has Mr. McEnery found himself in the position whereby he would be advising and providing a client with financial advice in regard to the acquisition of a nursing home that is in difficulty, perhaps because it has fallen foul of the new regulatory standards?
To acquire small operations, family-type businesses, that might have got into financial distress for whatever reason, including that they might not have been able to keep pace with the new regulations around standards and occupancy levels and so on.
Okay. Mr. McEnery does not see a conflict of interest in him, as the chairman of the regulatory board, individually providing financial advice to either a nursing home or more large corporate groups in the context of the apparatus of the fair deal scheme and the crash, during which time the nursing homes were under massive financial pressure, and to the big players that came into the market and acquired them. Am I correct that there is a lot of money to be made in the private nursing homes area?
I thank Mr. McEnery. I am astonished at his persistence in decrying conflict of interest when it is obvious. The fact that he was at the October meeting - we can dispute what he said and why he said - crystalises and demonstrates without a shadow of a doubt his absolute conflict of interest. I do not believe that he should be the chairperson of the board of HIQA. In fact, I do not believe he should even be on the board.
Mr. Brian McEnery:
I thank the Deputy. I am happy and have always been happy to put on the record, as I did at the HIQA meeting, how we will deal with conflicts of interest should they arise. I made that clear during the Public Appointments Service process and I have tried to ensure at every stage that it is clear that my professional role is financial adviser, including to the healthcare sector, of which nursing homes form a part, but that this does not conflict with my role of chairperson of HIQA because HIQA does not have a role in relation to financial affairs. The role of HIQA is in regard to other aspects, into which I do not have an input as board chairman.
I thank all of the witnesses for being here today. My first question is to Ms Dunnion. In regard to her role as regulator and the board generally, in regard to the appointment of a chairman and the Public Appointments Service, does the board have an input into that process? For example, does the board ratify the appointment by Government or is its nomination just accepted?
Does Mr. McEnery appreciate that the role of this committee is to assess value for money for the punter, and in the context of HIQA, to ensure that care for the elderly or those requiring long-term care is appropriate? In terms of HIQA carrying out its functions, does Mr. McEnery accept that public confidence is paramount in this regard?
That is fine. I am sorry for cutting Mr. McEnery off at times but my time is short and I mean no disrespect. Clearly, he is the go-to person in a number of these matters. If I were setting up a nursing home or negotiating a price or dealing with health related economics, I would look to him to help me. The fact that he declares what he undertakes to do in his business and in all his roles is admirable and transparent, but whether that is a conflict of interest is a completely different matter and I have substantial concerns. We have established from his engagement with Deputy McDonald that while having advised Nursing Homes Ireland in the past, he is not currently on record for it, to use a legal term. Is that correct?
I appreciate the expertise is there. How did it occur? Did Mr. Tadhg Daly or somebody from Nursing Homes Ireland ring and say "Hello, Mr. McEnery. We are having a meeting on such an evening. Could you pop in and give us a bit of insight for free?" Is that what happened?
The organisation invited Mr. McEnery along. If the Irish Countrywomen's Association, ICA, rang him up and said, "Would you come to an event and provide financial advice for free?", what would the answer be?
It does not provide financial advice. Deputy McDonald asked about Mr. McEnery advising various bodies. Clearly, he is the go-to man for advising on any of these organisations. She mentioned Letsbuyhealthcare. Mr. McEnery said he never heard of it.
Mr. Brian McEnery:
The committee knows a great deal about the NTPF. It is the body that is mandated to negotiate. The budgetholder is the HSE.
Mr. Brian McEnery:
The overall governing body for all accountants worldwide is the International Federation of Accountants, IFAC, and it publishes the provisions around which audit has to be an independent function. General business advisory is no problem, but in respect of audit, which is a statutory function, there are safeguards.
While he has been transparent about all he does, I query whether the fact that he has said this absolves the potential for a conflict of interest. In any event, because public confidence is such an important issue and because he negotiates on behalf of one side and is the chairman for the other side, the complexion is grubby and is one where the gamekeeper is acting as an adviser to the poacher, for want of a better expression.
Does Mr. McEnery not believe, given his professional experience, as one of the foremost experts in these matters, that it would be in the public interest that he should step aside from being chairperson of HIQA to preserve the good standing and integrity of that organisation?
Mr. Brian McEnery:
There are two very important reasons: HIQA has no role in the financial affairs of nursing homes and there is a complete firewall around the regulation of nursing homes. HIQA regulates nursing homes in respect of inspection and regulation and the board, and I as chairman, cannot and do not and would not have anything to do with that aspect. I believe that I came through the public appointments process on the basis that I had sectoral experience as a care assistant and as an adviser.
Mr. McEnery should reflect on his position, notwithstanding, and not undermining, his own experience and expertise. The nature of the organisation, its importance and the right of the public to have absolute confidence in that organisation is not helped by the proximity he has to so many other matters. I ask that he come back to us about the former director of finance with the National Treatment Purchase Fund, NTPF, David Allen, who I understand anecdotally is involved in the establishment of Letsbuyhealthcare, and say whether Mr. McEnery or his team have been advisers in its establishment. It creates the complexion for me, and I imagine for the public, that the chairman of the gamekeepers is involved in advising the poachers.
Would Ms Dunnion be comfortable, notwithstanding that, as I have put on record, Mr. McEnery has expertise and is probably the foremost expert in that field available in Ireland, and given the public confidence currency that is involved in HIQA, with a chairman of the board who is involved in so many other aspects of the industry which her organisation regulates?
Ms Mary Dunnion:
I am totally confident in the arrangements that the office of the chief inspector has within HIQA in the regulation of designated centres for older people and disability. The chairman of the board of HIQA is appointed by the Minister, as are the board members. We recognise in the conflict of interest area that people have a professional life outside their board membership. That is widely publicised and acknowledged. I can say unequivocally that at no time has the chairman or a member of the board of HIQA in any way asked or questioned me or influenced any decisions. In that context I have absolutely no experience where there would be a conflict of interest.
Ms Mary Dunnion:
I can understand that perception is very important but the reality of where I work, and of my position, is that in no way has the chairman of the board influenced, asked about or questioned any of the decisions we make in that context. That is enshrined in the legislation and the scheme of determination through the inspectorate, to which everyone has to sign up and agree. The controls are there within the legislative framework, the Health Act 2007.
The reporting relationship is to the Oireachtas and the only relationship I have to the board of HIQA is as an assurance to the board in its function working for HIQA.
Were Mr. Quinn advising on the recruitment of a chairman of the board for an organisation like HIQA, would he think it wise or ill-advised to appoint somebody who was a negotiator for the prices of the care the regulation of which he is responsible for?
Mr. Phelim Quinn:
I appreciate that but I would have to say that during the past three years of my tenure as chief executive officer, CEO, I have been determined that whoever sits on the board of HIQA does not interfere in its executive functions. The public confidence issue is, as Ms Dunnion has pointed out, that we have very clear controls that divide the role and function of the non-executive from the executive. I appreciate that we are here talking about these perceptions today but we also need to convey the facts and they are, as Ms Dunnion pointed out today, that we have very clear controls within HIQA and the public should have confidence in the role that HIQA plays in its regulation of designated centres for older persons.
Does Mr. Quinn appreciate that, as a chairman and even a board member, occasionally information may be discussed that endows a competitive advantage on Mr. McEnery and his colleague with BDO in marketing their services elsewhere?
In his opening statement he has listed 18 points that he was asked about and to which he replied. He must have an extraordinary power of recollection that he was able to put such a good report together at this remove in time when he had made no presentation.
Mr. Brian McEnery:
I have been advising in the health care sector for over 20 years and I know exactly the context. It was about the finance. I do not advise in any other aspect of health care. I do not know enough for instance about regulation. I advise on financial matters so I know what I discussed.
The meeting was held in 2015, two years ago. Mr. McEnery has had no contact with this issue, no formal presentation, no notes, just a date in his diary. It is an outstanding summary of an event two years, if Mr. McEnery has not revisited the matter in two years.
Mr. Brian McEnery:
I have not revisited the matter and I do not think I have not spoken at any events with Nursing Homes Ireland since. I remember vividly the circumstances. I know, for instance, that I travelled back from the UK that morning.
I know that I was not at the meeting when the meeting commenced. I know that I was not there at the end when it finished, and I know the content of what I what I spoke about. I spoke in great predominance about the fair deal scheme.
I have to ask Mr. McEnery a straight question in the understanding he had no fee or anything. Did he meet any growing clients? He said in his opening statement he did not recognise some of the people there. I take that to mean he did recognise some of them.
May I just ask a final question? Mr. McEnery is chairman of HIQA, which is involved in this sector. The National Treatment Purchase Fund is involved financially in the sector. Would it be feasible for Mr. McEnery, or anybody from his firm, to be a member of the board of the National Treatment Purchase Fund?
Since we are down to ten-minute slots, I will be very distinct and clear in my questions. I am sure the witness will be equally clear and distinct in his responses.
Mr. McEnery said already – I will not rehearse it all – that he was not at the meeting as a paid adviser. Is that correct?
Please do not dance on the head of a pin. Mr. McEnery was certainly there as an unpaid adviser because he was obviously brought in to give advice. He was not invited to sit there. He was there to contribute to the meeting and give an opinion and advice. Is that fair to say?
I will get to all of that in a second. I have media reports on what happened at the meeting. I can only stick to those because we cannot deal with the actual notes that have been presented to the committee, although Mr. McEnery says he is seeking legal advice and is uncomfortable with some of the content, which also troubles me. I will stick to the newspaper reports. My point is that they certainly seem to suggest that Mr. McEnery gave advice. I will walk Mr. McEnery though all of that in one second. Is Mr. McEnery still holding to the view that he did not give any advice whatsoever to the nursing home providers?
-----I deserve a response. Either Mr. McEnery gave advice or he did not. If he says he did not give advice, he should say it. If he did, he should say it. It is one or the other; it cannot be in the middle. He either gave advice or he did not. He should please answer the question as put to him.
He is not. He is bluffing, with respect. I am asking him to answer the question as to whether he gave advice or not. It is a very straight question. It is very obvious to anybody in a meeting. If one gives advice to an organisation, one gives advice. If one does not, one does not. Either he gave advice or he did not.
He is not answering the question, with respect. He is answering it in a way he wants to answer it but he is not actually answering the question that is being put.
Let me go back to the point the Chairman made, on Mr. McEnery’s very clear and precise understanding of what happened at the meeting and his account of it. It happened two years ago.
-----and events. He mentioned seminars and all sorts of different events. It would be amazing if he had such a forensic understanding of everything that happened at every meeting. Does he have any contemporaneous notes of the meeting that took place two years ago?
I have that. He said he has no contemporaneous notes, yet, as the Chairman has pointed out, he has a very clear, precise understanding of what happened. Can I put it to him his very clear and precise understanding is based on the notes of the meeting that he now disputes, or that he is essentially reacting to those notes?
It is amazing that Mr. McEnery's opening statement from a meeting that took place two years ago is so clear and so precise given that there are no contemporaneous notes whatsoever. The statement goes into very clear detail of exactly what was said and Mr. McEnery's role, which are actually contradicted in the media reports. I will proceed to them now, and perhaps we will tease some of this out. I am looking at two different media reports, both of which were covered in the Irish Independent, one on 8 October and one on 18 October. The first says the chairman of HIQA, Mr. McEnery, attended a confidential meeting of private nursing home operators at which a boycott of the fair deal scheme was mooted. Does he dispute that there was any talk of a boycott of the scheme at the meeting?
The word "boycott" was used at the meeting. Mr. McEnery is the chairman of HIQA and he does not see any difficulty with that. In fact, he stayed at the meeting. I am referring to the reports on the meeting. It astounds me that Mr. McEnery would stay at the meeting when the possibility of a boycott was put on the table.
The media reports, of 8 October and 18 October, state Mr. McEnery made a contribution in which he talked about agreeing a cost of care, equal treatment of the same and similar nursing homes and that there was immediate intervention, following his contribution, from legal advisers, who said there was a very serious danger of discussing anti-competitive behaviour. Therefore, they were directly responding to a contribution Mr. McEnery made. That is an account of what is in the media.
That, obviously, would be very troubling for me and, I imagine, very troubling for Mr. McEnery. If he has read those media reports and also the notes that we cannot discuss here - and they say very similar things and chime very much with what is in the media reports - that would be very concerning. It would be very concerning if the media accounts were true and if Mr. McEnery did in fact say these things. That would amount to advocating anti-competitive practices, would it not?
Mr. Brian McEnery:
I absolutely and emphatically say I did not advocate anything that would be anti-competitive. What I have in fact said is what I have outlined in my opening statement, that is, that I have at all times indicated that engagement with the National Treatment Purchase Fund can take three forms. It can take the form of an initial meeting, and the National Treatment Purchase Fund will give an offered price; one can negotiate with the National Treatment Purchase Fund; and then there is the possibility of an appeals process. That is exactly what I suggested.
The media reports say that Mr. McEnery was talking about an agreed cost of care and uniformity in respect of the price that would be paid to the individual nursing homes. He does not dispute that part of it.
Mr. Brian McEnery:
If I may explain to the Deputy, I absolutely did not use the word "threatened" and I would not do so. There is not really a basis to threaten the National Treatment Purchase Fund, quite frankly, and I did not use that term. Secondly, I produced a model around cost of care which gives the components of how a cost of care is calculated. That is what I alluded to - a model around not saying that here is a price-----
I have to stop Mr. McEnery there because that is not what the media reports say was said at the meeting. Unfortunately, we do not have time to go into it all and we have to wait until we get legal opinion as to whether we can actually discuss a note which clearly contradicts almost everything that was in Mr. McEnery's opening statement, but we will just park that for one second. Is Mr. McEnery aware that there is now an examination by the competition watchdog in respect of some of this as well? Is he aware that it has commissioned an investigation?
I am absolutely astounded, obviously, by what I have heard from Mr. McEnery. I am equally astounded that both Ms Dunnion and Mr. Quinn can still sit there today and have confidence in Mr. McEnery and that they do not see any difficulty. I agree with the previous speakers. In my view, without question, Mr. McEnery should stand down as chair of HIQA, without prejudice, pending the outcome of an examination and an investigation which is ongoing and pending the very serious questions and concerns that I and other members have. Mr. McEnery can account for himself. If I were him, I would offer my resignation before close of business today, but Ms Dunnion and Mr. Quinn have a duty and the organisation has a duty to protect itself. I am absolutely astounded that HIQA has taken the course of action it has taken and I do not think it will end well for the organisation. Everything we have seen here is very troubling and very alarming, Mr. McEnery's opening statement is very troubling and alarming to me and his responses are troubling. If they are troubling to me, I cannot for the life of me understand how they do not cause the same alarm bells to go off in Mr. Quinn's head and Ms Dunnion's head. I ask them to respond to that.
Mr. Phelim Quinn:
I would have a concern that there should be any interference from a non-executive in the reputation and the business of the authority, whether that be under section 8, concerning functions of the authority, or section 42, concerning sections of the authority. That is in health care and-----
However, notwithstanding how somebody is appointed, is there a facility in an organisation like HIQA, when issues like this emerge, for people to say that red flags have been raised and need to be dealt with? Is there any mechanism in place within the organisation to deal with this, where if Mr. McEnery is not prepared to take the decision himself, individuals within HIQA can decide that, in the best interests of the organisation, Mr. McEnery should, without prejudice, step aside from his position? Is Mr. Quinn telling me that is not possible?
May I be very clear on one question to Mr. McEnery, following on directly from that? He has indicated that as chairman of the board this issue - his appearance here today and the issues surrounding it - will be discussed at the board.
Welcome back, Mr. McEnery, Mr. Quinn and Ms Dunnion. It is quite unfortunate that we are here discussing conflicts of interest, which seem to take up an extraordinary amount of our time, not withstanding all the codes of governance and ethics. It is truly shocking the amount of time they have taken up. I am a little confused about an event - a meeting - and its purpose. If I am wrong, Mr. McEnery can correct me. He went to a meeting on an invitation through a phone call from Mr. Tadhg Daly. Is that correct?
That is okay. I am not going to hold Mr. McEnery to the wording verbatim. However, he uses the word "event". Is he sticking with that? He was invited to an event and he will have an email to show us that.
This meeting was two years ago, and the Chairman has already pointed out that Mr. McEnery has given a detailed recollection. Now he is changing from an event to a meeting. What was the purpose of his attending this meeting?
The witness told us he was late and that he left early. When he went along to that meeting did they say that he was very welcome or that it was a private or confidential meeting? What was Mr. McEnery told?
Why has the board not met since this very serious issue was reported in the papers - whether it is correct or incorrect, we do not know? Mr. McEnery accepts that it is very serious and why has a board meeting not been called?
The witness made that very clear and I accept that he made it clear when he attended his first meeting, for which we have the minutes. Did any board member question Mr. McEnery on what he declared on that date? It is recorded on page 2, under conflict of interests. No one seems to have done so. They thanked Mr. McEnery for his openness. They thanked the chairperson for the declaration. Was there ever any discussion of how that conflict of interest might materialise or how the board might handle it?
Mr. Brian McEnery:
-----that the following measures were discussed with the deputy chairperson and the CEO, that the chairperson would absent himself from any discussion of the matter, the deputy chairperson will chair any such instances should they arise, and other personnel within BDO would be allocated responsibility for the client.
Mr. Brian McEnery:
At a recent meeting in July I saw an item that was for information from the chief executive. It was in his report. He was reporting on an item that had happened and I saw a reference to a client of BDO, which I recognised; I declared it. I told the deputy chairperson that should the matter come up for discussion that I would recuse myself and I asked her to chair the meeting if that happened.
I want to go back to the minutes that are privileged. Has Mr. McEnery any difficulty in publishing those minutes subject to what he is saying is incorrect? Has he any difficulty in waiving his privilege in relation to those minutes? He was there.
This is my difficulty. Mr. McEnery is the chairman of HIQA.
I do not want to put him in a spot when it comes to privilege but this is something that he must reflect on. It is possible that he does not have a role in it because he is an invited guest. He is, however, the head of HIQA and he attended a meeting. According to him the subsequent minutes are inaccurate. The criteria for his attendance are not clear and he cannot quite remember whether they came in the form of an email or not. Looking back now in his capacity as chairman of HIQA, does he think it appropriate that he attended a meeting for which he did not see the minutes until two years later?
Looking back at that meeting and given how the minutes were written and privilege managed and so on, does Mr. McEnery think, on reflection, that it was an appropriate role for him as chair of HIQA?
Other members here have already brought up the issue of the minutes. I have asked Mr. McEnery what difficulties he had with the minutes and those difficulties were limited to specific words that were or were not said. Would it have been wrong had he been down as an attendee at that meeting?
The role requires Mr. McEnery to manage key relationships with the Minister for Health; to judge and evaluate the performance of the CEO; and to manage relationships with key external parties. Who are these parties?
Our time is very tight so I will ask some quick questions. There was a slight deviation in what Mr. Quinn said from what is written on page 2 of the short version of the second report, which states that HIQA had received correspondence from a private nursing home provider. Speaking before us here today, Mr. Quinn said that he had made some of the correspondence available. According to the document, however, all of the correspondence was made available.
In his opening statement, Mr. McEnery said that he presented his credentials to the Joint Oireachtas Committee on Health. These procedures are not always followed to the letter. Sometimes people are appointed and then go before the committee. Sometimes they go before the committee and are then appointed. Can Mr. McEnery recall which was true in his case?
I just wanted to establish that. Based on recent figures, a significantly growing number of nursing home beds are provided by the private sector. We heavily rely, then, on regulation and on the need for that regulation to be independent. Is that correct?
HIQA has a role in setting standards. Some of those standards cost money: residents getting individual rooms, for example, as opposed to two, three or four sharing a room. By virtue of driving up standards then, HIQA also has a role then in actually driving up costs. Does Mr. McEnery accept that is the case?
Mr. Brian McEnery:
I will explain this to the committee because it is important. Standards are not a matter for the board of HIQA. We have no input into the devising of standards. This is a matter for the executive of HIQA. Board members have no input when it comes, for example, to whether there should be three, four, or two residents to a room.
He has also indicated that the amount of money available is limited because budgets were cut a few years ago, so that is something he would have taken into consideration. In the event of Mr. McEnery going along to the conference in question here, or to the meeting or session or whatever it was, would it be fair to say that people at that event might feel that they had somebody there with an inside role, whether perceived or real? Does Mr. McEnery think that perception could arise among the people in attendance that he spoke to, advising them of inflation in wages, which there is of course, or on a whole range of other matters that he listed out in his opening statement? Would somebody sitting in the audience not think that they should go to Mr. McEnery because he is the one to give them advice, because he is on their side, because he is also on the inside? Does Mr. McEnery not think that people would think this?
Mr. Brian McEnery:
I would not think so. I can tell the committee that the NTPF are expert negotiators. I know that many other financial advisors approach the NTPF to make representations, and I know that the NTPF is enormously competent in negotiation. I absolutely do not think, then, that the perception described by Deputy Murphy might arise. Many advisors help nursing home clients; we only have a small portion. I do not think that people might assume me to be on the inside, because I am not. There is no link or crossover between the two roles.
Does the Department of Health believe that there is either a conflict of interest or a perception of such a conflict? Does the Department have concerns about this issue? Has it been discussed with the Minister? What is the situation?
Mr. David Keating:
As Mr. Quinn mentioned in his statement, the Department is involved in a range of the governance mechanisms that are in place for HIQA. Under the Health Act 2007, for example, there are requirements for business planning, annual reporting and so on. There is also a code of practice for State agencies as put forward by the Department of Public Expenditure and Reform. The Department of Health has an oversight and governance role through the mechanisms mentioned. It will also reflect on today's discussions.
I am afraid we will not be in a position to give an immediate response to the Deputy's question.
Mr. David Keating:
We will be reviewing the transcript of today's proceedings and examining the documentation, which, again, has only recently been received by us. Rather than formulating any judgments immediately, we will be reflecting on all of that. I am not suggesting that any issues have arisen but if they do arise they will be examined in due course.
Mr. Keating might as well be sitting watching this on television if that is the case. He has no role here. He cannot tell us if the Department has a view on some very serious matters of public concern that have ended up in the newspapers. Conflicts of interest arise all the time and one has to find ways of resolving them but sometimes they cannot be resolved. If, for example, somebody is acting for both sides, such a conflict cannot be resolved. Did Mr. Keating receive any guidance at all before coming to this meeting?
Mr. Keating has obviously gone to the school for civil servants. He is saying nothing. Let us just leave it there because that is what I am hearing.
I wish to ask Mr. McEnery about Chinese walls. I have been hearing such walls a great deal in recent years. Does he see this as something that falls within that category, namely, that he has Chinese walls himself in respect of this issue?
Mr. Brian McEnery:
No, I would not actually and I will explain why. HIQA has nothing to do with financial matters. I am a financial adviser and there is nothing neither I nor any board member of HIQA could do to impact upon the regulatory role of the chief inspector. There is not a cross-over. I am a financial adviser. HIQA does not have a role in respect of financial matters. In fact, the reason I had an interest in this role, as chairperson - and when I submitted my application to the Public Appointments Service - is that I had experience operationally, as a care assistant, and a strong knowledge of the health care sector. There is not a crossover between the financial aspects that I advise on and the regulatory aspects that are the preserve of HIQA.
I will be very brief. I thank our guests for attending. I appreciate the amount of time they have spent here. I also thank Deputy Catherine Murphy for that final question. It was also one of the final questions I had on my list, which illustrated my satisfaction in general and in particular with the responses Ms Dunnion, as director of regulation, provided in terms of her opinion on whether there is a conflict. I do not have any further questions.
I will not delay proceedings very long because all the questions have been asked. All I want to do is inquire of Mr. McEnery whether the board understands why we are all concerned and why HIQA was brought back in here when the issue appeared in a Sunday newspaper and we found out about an obvious conflict of interest? In hindsight, does the board have any regrets about its position?
Mr. Brian McEnery:
First, I can tell Deputy Aylward that I am happy to be here. In addition, I am happy to get the opportunity to explain the context of what I believe I have explained many times, which is that I have a role as financial adviser in all aspects of the health care sector but particularly in respect of nursing homes. I am also happy to say that there is no link between HIQA and the financial aspects of the matter and there is no link then between my professional capacity and, for example, interacting with the NTPF and HIQA. That is the most emphatic thing that I want to say here today, which is that they are not related because HIQA does not have a role in financial affairs and I would not have any ability or capacity to influence an aspect of the regulation on behalf of any nursing home. That is why I included in my statement that where I was forcibly asked to intervene on behalf of a nursing home I refused because that is exactly the role I do not have, namely, to interfere with the work of the chief executive.
Mr. Brian McEnery:
I do not know whether that is the case but I am very pleased to be able to take this opportunity to clarify that I could not, would not and did not intervene, and I will not do so for as long as I am in this position because that would not be tolerated, quite frankly, by the chief inspector and it should not be either.
Does Mr. McEnery not see any problem with his being chairman of HIQA and head of health care with BDO Ireland and providing advice? Does he see any conflict there at all? I know he has told us he is not interfering in anything and that he has no capacity to interfere. We accept all that, but does he see no conflict there or that questions would arise over the two positions he holds?
Mr. Brian McEnery:
If I can explain the position to Deputy Aylward, I know when I looked at the original invitation for the position of chairperson it referred to a few things. It referred to, for example, having experience of health care, which I have. I acted in the capacity of a care assistant. It specified having boardroom experience and I felt I have that. It also referred to having an understanding of the health care system and I believe I have a deep understanding of it. I believe they are three of the facts that I set out to the Public Appointments Service as to why I was a suitable person for the role and obviously the Public Appointments Service so selected. I do not believe there is a conflict and I do believe that part of the reason why I was chosen by the Public Appointments Service was because of my experience.
I accept that. For future reference, if Mr. McEnery was asked again to give a presentation to a body such as Nursing Homes Ireland, as he did in October 2015, would he reconsider his position or would he give that presentation if was asked? Would he inquire as to why he was being asked? In hindsight, would he look at it in a different way?
Mr. Brian McEnery:
I am head of health care and I do give advice. I will be giving advice to nursing homes next week. That is the truth. I have never tried to hide the fact of what I do, whether it is a hospital or a nursing home. That is my specialism. That has been my experience in life. I spoke at a conference organised by a company called CMG Events, which arranges conferences attended by many nursing homes. In fact, often there are a lot of nursing homes in attendance. I cannot control who is in attendance. I did not know who the attendees would be at that event in 2015. I was invited as a guest, I spoke and I left. I am disappointed at how it is being presented because I was not there in the capacity of an attendee, I was there to speak as a guest.
This my final question. Could Mr. McEnery comment on the anomaly between what is the cost per resident between private and public nursing homes? As a politician, I have been told by private nursing homes that public nursing home care costs a lot more per resident than the private equivalent.
Can the witness comment on that, in the context of his role as a financial adviser?
I wish to raise two matters. First, I wish to clarify something. I said that the witness should consider his position. It may well be, without prejudice, because of his successful career in acquiring knowledge and expertise that he has something of a monopoly on information. I mean this in a respectful way. As a result of the latter and because of the public confidence issue, it is on that basis, and without having done anything wrong, it might be better for the authority if the witness stepped aside. However, I have a specific question. He mentioned that a nursing home had approached him and asked him to remain silent on a report that was, perhaps, going to have a negative impact on it and the witness point-blank refused to do so. That is admirable and I respect it. In light of the fact that we were given information that cannot be mentioned here due to legal privilege, when that nursing home approached the witness to intervene in the matter, were threats made by the nursing home to the effect that if the witness did not comply with the request, it would seek to make public conflicts of interest that it was alleging, be they true or untrue? In essence, was there an attempt by this nursing home to blackmail the witness?
Mr. Brian McEnery:
I will be careful. In some of its communications it said, "We are shocked by the manner in which you and the HIQA board are exercising statutory powers". The HIQA board was not exercising statutory powers. It was the chief inspector. It also said, "We strenuously resist all efforts by the HIQA board to reduce our bed numbers in circumstances where we receive fair deal rates lower than those paid to our competitors and do not intend to charge additional service charges to our residents ...". It continues, "We are now writing to Mr. McEnery to assist us." It specifically wrote to me and said that it sought my intervention in not having the report published and it alluded to the fact that if it was published it would make that known to the Members of the Oireachtas, the media and the courts. It said in part of the letter that I would be subpoenaed.
To summarise, notwithstanding everything else that has been addressed, Mr. McEnery has confirmed that he attended a meeting convened by Nursing Homes Ireland on 23 October 2015. He confirmed that at that meeting a matter of boycott of the fair deal scheme was discussed and he has acknowledged that, on the basis of that meeting, an investigation by competition authorities is now under way. Those are statements of fact. Mr. McEnery attended the meeting.
Boycott was discussed and an investigation is now under way. Whatever the witness might say about the distinctions between HIQA and the NTPF, we all understand that architecture. However, for the witness to suggest that it was in any way tolerable for the chairman of the board of HIQA to attend and speak and give advice, insights or experience at a meeting whose subject was the boycott of the fair deal scheme is absolutely untenable and, quite frankly, outrageous.
I am bringing this part of the meeting to a close. I thank the witnesses from HIQA for attending at such short notice and for their responses. We will suspend until 2.30 p.m., when we can commence our business with Tusla. I apologise to the representatives from Tusla for the late start.