Mr. Seamus McCarthy:

Obviously, there has been a systemic problem, and no doubt there are challenges in the health sector in achieving competitive procurement. The table included at point 5 on page 2 of the submission is interesting in that it compares the five major teaching hospitals in Dublin and one can see that Beaumont Hospital and St. James's Hospital have the highest level of tendering. They are publishing tenders to the market. The other three have much lower levels of public competitive tendering. What is instructive in that is that my office audits the first two, Beaumont and St. James's, and one can see that the pressure we and the committee have been putting on in seeking explanations has had an effect in ensuring there is competitive procurement. I think Beaumont has made the point that between 2018 and 2019, it significantly increased the level of its expenditure that was competitively procured and compliant with the rules. That is an indication that, although there are challenges, it can be done. It is partly a responsibility on the hospitals, but certainly with a centralised procurement function assisting hospitals, much better competitive and compliant procurement can be achieved.

I think a number of years ago, in the lifetime of the previous committee, the HSE reported to the committee about an exercise it was undertaking looking at the compliance by voluntary hospitals, section 38 hospitals, with the code of practice. One of the sticking points for many of the hospitals was compliance with the procurement rules. Pressure does need to be kept up to ensure there is proper competitive procurement.