Oireachtas Joint and Select Committees
Thursday, 25 June 2026
Public Accounts Committee
Financial Statements 2024: Beaumont Hospital Board
2:00 am
Paul McAuliffe (Dublin North-West, Fianna Fail)
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This morning, we will engage with the Beaumont Hospital board to examine its financial statements for 2024. On behalf of the committee, I welcome all of the officials from Beaumont Hospital. They are Ms Anne Coyle, chief executive officer, Mr. David Sweeney, deputy chief executive officer and director of human resources, Mr. Francis Hanlon, director of finance, Mr. John Reilly, director of capital projects, Ms Claire Noonan, chief operations officer and Professor Sam McConkey, chair of the medical board. Professor McConkey has some experience of Oireachtas committees, so he is welcome back. We are also joined by an official of the Health Service Executive, Mr. Robert Kidd, integrated healthcare area manager HSE Dublin north county, who is attending in a representative capacity. We are also joined by officials from the Office of the Comptroller and Auditor General, including Mr. Seamus McCarthy, Comptroller and Auditor General, who is a permanent witness to the committee, and Mr. Mark Scully, audit manager. They are all welcome.
Before I move to the note on privilege I will refer to an item that was not addressed in the committee correspondence earlier. It is R2026/0334 and was flagged by Deputy Farrelly.
Aidan Farrelly (Kildare North, Social Democrats)
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I seek the committee's approval to write to the OPW with regard to the Natural History Museum, which we might know as the dead zoo. We have seen that the dead zoo is dead late. They signed a preliminary business case for approval in 2022, and we still do not have any movement on that. I ask that the committee write to the OPW to get a full list of what has been spent so far, the cost of that, and the detailed timeframe for when we can expect to see this progress.
Paul McAuliffe (Dublin North-West, Fianna Fail)
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Excellent. Is that agreed? Agreed.
Before I begin I explain some limitations to parliamentary privilege and the practice of the House as regards references the witnesses may make to other persons in their evidence. The evidence of witnesses physically present or who give evidence from within the parliamentary precincts is protected pursuant to both the Constitution and statute by absolute privilege. This means they have absolute defence against any defamation action for anything they say at the meeting. However, they are expected not to abuse this privilege, and it is my duty as Cathaoirleach to ensure that this privilege is not abused. Therefore, if their statements are potentially defamatory in relation to an identifiable person or entity they will be directed to discontinue their remarks. It is imperative that they comply with such direction. Witnesses are also reminded of the long-standing parliamentary practice that they should not criticise or make charges against any person or entity by name or in such a way as to make him or her identifiable or otherwise engage in speech that might be regarded as damaging to the good name of the person or entity.
I now call on the Comptroller and Auditor General to deliver his opening statement.
Mr. Seamus McCarthy:
Beaumont Hospital is a voluntary hospital funded primarily by the Health Service Executive under section 38 of the Health Act 2004.
In compliance with a financial reporting framework for hospitals set out by the Minister for Health in 1999, the hospital's financial statements are presented with separate income and expenditure accounts for current and capital spending. The income and expenditure account on the current side records total income in 2024 of just under €695 million. Core section 38 funding from the HSE accounted for €598 million. In addition, the hospital received specific HSE funding support totalling €30.75 million for drugs and medicine purchases, and €4.1 million for care of fair deal patients. It was allowed to retain employee pension contributions and other payroll deductions totalling €10 million to fund current expenses. The hospital also received €8.1 million in funding from the National Treatment Purchase Fund. Taken together, these Exchequer related funding sources provided €651 million or 94% of the hospital's income in 2024. Income from patient charges accounted for €24.5 million or 3.5% of the hospital's income.
The hospital's recurrent expenditure in 2024 was just under €712 million. Payroll-related costs totalled €460 million or 65% of all expenditure. In 2024, the hospital's headcount was just under 4,550 whole-time equivalents.
The hospital recognised capital funding of just under €36 million in 2024. Just under €39 million was spent on ongoing capital projects, including construction of a 95-bed ward block, a 20-bed cystic fibrosis unit and an additional operating theatre.
I issued a clear audit opinion in respect of the board's 2024 financial statements. However, there were a number of matters to which I drew attention in the audit report. The finalisation of disclosures around these matters delayed completion of the audit cycle for 2024.
First, I noted the hospital board was reporting an accumulated non-capital deficit of €51.3 million at end 2024. This was up from €33.7 million at end 2023, indicating a deficit of €17.6 million in 2024.
I drew attention to claims to the value of €413,000, which were submitted to private insurers that were not collectible or disallowed often because the hospital had not finalised the claims within the required timeframe.
I noted that the hospital had continued in 2024 to incur a material level of non-compliant procurement, which was of the order of €17.9 million. Separately, I drew attention to the board having paid €1.5 million to a company involved in providing radiology services that were not competitively procured. Twenty of the hospital's own staff members were directors of the supplier company but only four had made declarations regarding the company in their statutory statements of interest for 2024.
Members will recall previous discussion of a new integrated human resources and payroll system that Beaumont Hospital brought into use in January 2024, after some project delays and cost overruns. The final project cost was €4.8 million compared with a July 2022 projected cost of €2 million. In addition, public procurement guidelines were not followed in awarding the contract to develop the system. Also, due to initial payroll processing failures, the hospital incurred Revenue interest and penalties of €66,000.
At end 2024, the financial statements show payroll overpayments totalling €704,000 that were due for recovery. This was after uncollected payroll overpayments, to the value of €195,000, had been written off in the year.
I drew attention to disclosures of a number of other capital project cost overruns and the steps being taken by the board to address control weaknesses identified in project delivery.
Finally, I drew attention to a loss incurred due to a supplier bank account redirection fraud to the value of €39,600. This is a well-recognised fraud risk and the hospital has stepped up its controls to prevent further such incidents. Go raibh maith agat, a Chathaoirligh.
Paul McAuliffe (Dublin North-West, Fianna Fail)
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Go raibh maith agat, an tArd Reachtaire Cuntas agus Ciste. I now ask Ms Coyle from Beaumont Hospital to make her opening statement.
Ms Anne Coyle:
I am CEO of Beaumont Hospital and I am by my colleagues, Mr. David Sweeney, Mr. Francis Hanlon, Mr. John Reilly, Ms Claire Noonan and Professor Samuel McConkey.
Beaumont Hospital, incorporating St. Joseph's in Raheny, is a large level 4 academic teaching hospital. The hospital is the principal teaching hospital for the Royal College of Surgeons in Ireland. Beaumont Hospital enjoys close links with Dublin City University, in addition to other academic institutions, in respect of training and research. As a level 4 hospital, we provide the highest level of medical care 24-7, offering advanced highly specialised care, critical care facilities, a 24-hour emergency department and complex medical procedures.
In Beaumont Hospital, our patients are at the heart of everything we do. We are driven by a shared commitment to provide excellent and compassionate care to our patients from their first visit and beyond through every step in their care. Over 5,700 valued people work in the hospital across a range of functions and disciplines ranging from medical, nursing and therapy disciplines to administrative, cleaning, portering, catering, maintenance and laboratory scientists, to name but a few.
Beaumont Hospital is regulated under section 38 of the Health Act 2004. The current hospital board was appointed during 2023-2024. The current executive team were appointed from late 2024 to early 2025.
The hospital operates within a governance and accountability framework in accordance with the code of practice for the governance of State bodies, providing assurances on its statutory, regulatory and professional obligations. A set of internal and external controls are in place that demonstrate and strengthen financial, property and operational effectiveness, with appropriate risk management procedures in place to deliver safe and effective patient care.
In 2023, the board identified several issues in the governance and accountability frameworks, and initiated a substantive programme of actions to address them. These actions included the recruitment of experienced executive managers to unfilled positions, the strengthening of controls through improved oversight, and the establishment of new protocols governing clinical, operational and financial processes.
To satisfy board assurance requirements, reviews were undertaken to assess the effectiveness of the board and its subcommittees, and to make recommendations to fully align with the standards outlined in the code of practice. Governance represents a continuous improvement initiative for the hospital, designed to inspire confidence and trust, internally and externally, in the governance of our operations. The reconstitution of board subcommittees has resulted in increased oversight on the procurement and operation of key capital and ICT transformation projects.
Procurement compliance currently stands at 94% based on a rolling 12 months to the end of April 2026. From a benchmarking perspective, that ranks Beaumont Hospital in the highest echelons of compliance at acute hospital level.
From a capital projects perspective, the establishment of a joint Beaumont-HSE capital projects governance group and reconstitution of board subcommittees, to improve oversight over major capital and ICT transformation projects, have further enhanced and strengthened internal controls and will continue to do so. The hospital recognises its responsibilities, as a public body, and regrets the issues, which we have set out in the statement of internal control. Notwithstanding this, the hospital has confidence in the corrective actions that it has taken and the improved governance structures now in place to mitigate any potential for recurrence.
It is important to note that while there were historic gaps in procurement and budgeting in relation to certain capital and ICT projects, including our new human resources and payroll system, in each case Beaumont Hospital got value for money. The overall spend was benchmarked and found to be in line with peer costs elsewhere for the same type of facilities and systems. An external review, and direct engagement with the HSE, have also confirmed that the introduction of our new payroll and HR system means that the hospital is very well positioned for the planned move to a unified HR and payroll system across the HSE.
Over the past two years, the new board and executive have overhauled and strengthened governance controls across all areas of the hospital. We now have a robust suite of governance procedures in place. We will continue to work to refine and upgrade these, as appropriate.
The hospital is funded by the HSE through the annual service level agreement, which was signed by the hospital in March of this year, for 2026. It carries an historic deficit. However, working with the Dublin and north east region, the hospital broke even for the 2025 financial year. The 2026 opening budget allocation for the hospital was €619 million. We continue to work closely with the region to avoid adding to the deficit through cost containment and value-for-money initiatives while simultaneously maintaining services to our patients.
Some 83% of the consultant workforce in Beaumont Hospital has subscribed to the public-only consultant contract. Work is ongoing in consultation with HSE Dublin North East to develop an implementation plan to further realise productivity gains.
The annual financial accounts for 2024 identify a number of historic control issues, for which the hospital offers an unreserved apology.
These were disclosed by Beaumont Hospital voluntarily and transparently following identification and serve as testimony to the improvements in financial oversight and governance structure which have been made.
Towards the conclusion of our engagement in October last year, the committee conveyed its dissatisfaction with the hospital for having disclosed certain matters at a late stage in proceedings. The hospital had signalled these matters to the Office of the Comptroller and Auditor General during the audit in 2025. I wish to reiterate that it was never the intention of the hospital to withhold information from the committee. At this juncture, the hospital is working through the 2025 audit cycle in collaboration with the Comptroller and Auditor General. In a spirit of transparency, we would like to reference that an issue of note in relation to a misclassification of some vendors has been signalled to the Comptroller and Auditor General following an internal audit. I assure the committee that the board and the executive team of Beaumont Hospital are deeply committed to ensuring the hospital is managed responsibly and transparently. We recognise the trust placed in us to use public and donated funds prudently and this responsibility guides every decision we make.
My colleagues and I are keen to provide clarity, to contribute proactively to the committee’s deliberation and to ensure that the public can have confidence in the services we deliver. I thank members for their invitation to appear before the committee, and we look forward to addressing any questions they may have.
Paul McAuliffe (Dublin North-West, Fianna Fail)
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Thank you. Just to note for witnesses that we will suspend at 12 noon for a 15-minute break and resume shortly thereafter. As I am the lead speaker on the rota, I will have 15 minutes of questioning. All other members will have ten minutes. I am sure my colleagues will ensure that I remain within my time. I have been in Beaumont Hospital many times. It is in my constituency. I want to put on record the significant work done by the staff of Beaumont Hospital in delivering a public service in an area where it is incredibly needed. I have been struck by the expertise and passion of many of the staff members who I have met there. I also acknowledge the passion of the leadership team, including Ms Coyle, on how they have advocated for capital projects in order to improve the services available to the local area. This has been incredibly impressive.
That said, sometimes at the Committee of Public Accounts we must focus on those issues that went wrong. I will use my time to dwell on those things but it is not to take anything from the incredibly positive work that is done in the hospital. I am a member of this committee since 2020. The Comptroller and Auditor General presents accounts with notes attached. I think this is the longest list of notes attached to a set of accounts, certainly it is one of the longest in my time. There is a general concern about overall financial management or the management of the budget and public finances as a result of that. When we look at the list, we are talking about €51 million in accumulated deficit; €17.9 million in non-compliant procurement; a payroll system that is coming in at twice the budget and which has triggered Revenue penalties; a conflict of interest situation regarding 20 staff who are directors of another company; the NTPF bidding issues; and this morning we have had news regarding vendor misclassification. I know a number of things were brought forward voluntarily. Could Ms Coyle just address the breadth of issues there and how she intends to approach how we go forward with this?
Ms Anne Coyle:
Yes, in response to your question on the breadth of issues that presented in the 2024 accounts, a number of these issues had been identified in previous accounts within the hospital. In my opening statement, I referenced the changes in the board and in the executive team. In the 2024 accounts, there is further detail added to the issues that there had been. This gives rise to the breadth of issues that have been disclosed.
In terms of the points referenced on conflict of interest, when we were last before the committee in October, we reported 75% of our conflicts of interest had been declared. That has now moved to 100% of our staff. In terms of procurement, we are now 94% compliant with procurement. There has been a lot of work done to address the breadth of issues. Obviously, there is work to be done to continue to do that. Part of it is in identification of the internal control gaps, the work that has been done to address the governance issues and the oversight of those. An example is our work is the establishment of a joint HSE capital committee to oversee the capital development programmes in the hospital. A number of issues were raised in previous accounts, and there was further detail in 2024. I assure the committee of our commitment to strengthening our internal controls through the work we have done, which I referenced in my opening statement, on the reconstitution of our governance, to provide that accountability and oversight.
Paul McAuliffe (Dublin North-West, Fianna Fail)
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I take Ms Coyle's comments on board as I know the committee will. When you were with us last in October, and it is unusual that a body would be before us again so soon, there were discussions later on in the conversation. Members were unhappy that there were issues of which perhaps they had not been aware in advance. Ms Coyle raised the issue of misclassification with us this morning - I presume in an effort to avoid being accused of the same. Could she tell us a little bit about the misclassification, which type of vendors were included in it and what the nature of it was?
Mr. Francis Hanlon:
This relates to two issues: professional sales withholding tax, which is a tax deducted at source and paid to Revenue; and relevant contract tax, RCT, which is a withholding tax made by the principal contractor, in this case, Beaumont Hospital, on the work of subcontractors onsite. Following an internal audit within the hospital, an issue was presented regarding legacy classification of suppliers. The internal audit identified the issue and, following an internal review by finance team, it emerged that there was a manual-led process within our systems, and manual work around and staff turnover were leading to these issues.
Paul McAuliffe (Dublin North-West, Fianna Fail)
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Was it that the value of the overall contract exceeded a certain threshold and therefore required the-----
Paul McAuliffe (Dublin North-West, Fianna Fail)
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Why it was not previously applied?
Mr. Francis Hanlon:
A number of factors led to that, including staff turnover and a lack of training of our accounts payable staff and our maintenance staff, to identify contracts that we have with suppliers that needed to be registered with the Revenue Commissioners to apply the correct withholding tax.
Paul McAuliffe (Dublin North-West, Fianna Fail)
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You have been in discussions with Revenue.
Mr. Francis Hanlon:
First of all the internal audit report was sent to the audit and risk committee, ARC. I had a very quick turnaround to identify that there was a possible issue here. We employed external tax advisers that Beaumont Hospital has and they confirmed there was an issue. We have made an unprompted voluntary disclosure to the Revenue Commissioners. That allows us to have 60 days to try to understand the issue before we approach the Revenue Commissioners.
Paul McAuliffe (Dublin North-West, Fianna Fail)
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When was that triggered?
Paul McAuliffe (Dublin North-West, Fianna Fail)
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You should be coming towards the end of the 60 days at this point.
Paul McAuliffe (Dublin North-West, Fianna Fail)
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I am reminding Mr. Hanlon of what the chief executive has said in terms of providing as much information as possible to the committee at this stage. Does he have any indication of what the liability to Revenue will be at this point?
Mr. Francis Hanlon:
No, but I just want to give you a context first. We make payments to the Revenue Commissioners of approximately €169 million a year across a number of tax heads, PAYE, RCT and PSWT. It is not material to that. It affects potentially 60 of 3,000 live vendors. The core issue appears to be the application of reverse-charge VAT, which is where we purchase services from overseas vendors.
Paul McAuliffe (Dublin North-West, Fianna Fail)
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Do you have any indication at this stage of what the ballpark figure is likely to be in terms of a payment that might be required to Revenue?
Paul McAuliffe (Dublin North-West, Fianna Fail)
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Is it likely to be a significant figure compared to the €169 million?
Paul McAuliffe (Dublin North-West, Fianna Fail)
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You might alert the committee to that as soon as you are aware of it.
Paul McAuliffe (Dublin North-West, Fianna Fail)
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Could you clarify the date on which you think you will be-----
Paul McAuliffe (Dublin North-West, Fianna Fail)
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Okay. I will turn to the NTPF double billing issue. On the last occasion, Ms Coyle identified that, as well as rheumatology, eight further specialties were being audited. Will she give us an update regarding the outcomes of those audits?
Mr. Francis Hanlon:
To clarify, this was a self-reported issue by the hospital in March 2025. The HSE internal audit carried out an audit of the rheumatology services within the hospital from the period 2020 to 2024.
Paul McAuliffe (Dublin North-West, Fianna Fail)
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The committee is aware of the issue. The question is about the result of the audits of the eight other specialties.
Mr. Francis Hanlon:
The key observation from the HSE internal audit was to review any cases across all specialties where the hospital hired permanent staff using temporary NTPF income. We have reviewed all specialties and produced a report that is going to our committee next week to understand and confirm the issue. That will then go to the HSE Dublin and North East region for a review.
Paul McAuliffe (Dublin North-West, Fianna Fail)
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Obviously, rheumatology was identified as an area where there was an element of double billing. My question is about the other eight areas of specialty. Was evidence of double billing found in any of those eight other specialties?
Mr. Francis Hanlon:
No. This is an observation from the HSE internal audit where we were asked to review any permanent staff recruited using temporary income. There were no examples of double funding.
Paul McAuliffe (Dublin North-West, Fianna Fail)
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Okay. Has the NTPF resumed funding to Beaumont Hospital?
Ms Anne Coyle:
The arrangements now with NTPF have changed with the establishment of the regions. We are part of HSE Dublin and North East. We are working very much through the regional and integrated healthcare area, IHA, structures in terms of our-----
Paul McAuliffe (Dublin North-West, Fianna Fail)
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The funding was suspended.
Paul McAuliffe (Dublin North-West, Fianna Fail)
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Has it resumed?
Paul McAuliffe (Dublin North-West, Fianna Fail)
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It is in line with the policy of the HSE.
I will turn to the issue of conflicts of interests. I am interested in the figures stating that 100% of staff have complied with conflict of interest requirements. The difficulty is with – the witnesses might clarify in case I am wrong – the 16 who submitted declarations of interests regarding the €1.5 million contract for radiology. Of those 16, only four disclosed their directorships in that company. Is that correct?
Paul McAuliffe (Dublin North-West, Fianna Fail)
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Of the 16 people who had fully complied with returning the declaration of interest, only four of them had actually made a correct declaration.
Paul McAuliffe (Dublin North-West, Fianna Fail)
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At the end of that form, someone signed it to say that it was a truthful account of their declaration of interests.
Paul McAuliffe (Dublin North-West, Fianna Fail)
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Am I correct in saying that they were a director of company and they failed to declare that in their declaration of interests?
Paul McAuliffe (Dublin North-West, Fianna Fail)
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Has the hospital decided to take any action as a result of that? These are employees of the hospital. Am I correct in saying that?
Mr. David Sweeney:
In terms of conflicts of interests, the question we ask on an annual basis, through the SIPO portal we have developed, relates to declarations that may influence decisions within the hospital. An element of education was required in relation to what constitutes a conflict of interest and how it can impact decisions within the hospital-----
Paul McAuliffe (Dublin North-West, Fianna Fail)
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I am not familiar with the specific form but, for many of us here, we will be asked whether we are directors of a company. Was the question as clear as that on the form?
Mr. David Sweeney:
We apply this to those on grade 8 or above. We have a higher threshold for this. The question ultimately asks whether an individual has an interest that may create a level of bias in their decision-making or influence their actions. That is in accordance with the SIPO requirement.
Paul McAuliffe (Dublin North-West, Fianna Fail)
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They are not specifically asked whether they are a director of a company or to reveal directorships of companies of which they are members.
Paul McAuliffe (Dublin North-West, Fianna Fail)
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Is that a form the hospital drafted internally or has it been taken from-----
Paul McAuliffe (Dublin North-West, Fianna Fail)
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It seems an oversight, at whatever level, that someone could be a director of a company and it is left to their own judgment as to whether they have an interest.
Paul McAuliffe (Dublin North-West, Fianna Fail)
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Clearly, in this case, a number of people had a declarable interest. They were a director of a company that was a beneficiary of funding from the hospital to deal with excessive waiting lists. I am being careful in what I am saying here. Has the hospital followed up individually with any of those 12 people?
Mr. David Sweeney:
We followed up at the conclusion of our last session here. We went back over the previous year and brought up our compliance. I think I quoted 75% at the time. We actually achieved 90% for our consultants. Last year, obviously, we had our 100% compliance in the directorships that have been outlined. We have shared that with procurement as well as with the board and the chief executive. We have put additional controls in place to ensure that when we are engaging in memorandums of understanding, MOUs, or service-level agreements with entities, there is a conflict of interest declaration. We put a number of measures in place.
In terms of the directors, the radiology practice operates separately from the main directorship. We would-----
Paul McAuliffe (Dublin North-West, Fianna Fail)
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Mr. Sweeney can imagine the concern. I have to finish because I am under time pressure. A total of 16 out of 20 returned a declaration of interest, so there was a fairly high level of compliance. However, it was worth nothing because the conflict of interest was not included in the actual declaration returned. When Mr. Sweeney tells us that there is 100% compliance with the declaration of interest now, the question obviously arises as to how useful that 100% figure is. Is there any sort of auditing of those declarations?
Ms Anne Coyle:
As soon as it came to our attention that the conflict of interest was not being fully adhered to, there was work to do to address that. There was a decision to go to procurement for the contract. The decision to award the contract was taken in the best interests of patient care. The prices that were charged by the provider were consistently benchmarked with other third-party providers to ensure value for money. The contract now, to provide assurance to the committee, has been publicly tendered. It was awarded in 2026. The radiology practice is one of a number of providers in an overarching framework-----
Paul McAuliffe (Dublin North-West, Fianna Fail)
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I am conscious of my time. I have no doubt that my colleagues will pick up on some of what Ms Coyle said. I call Deputy Geoghegan.
James Geoghegan (Dublin Bay South, Fine Gael)
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I thank the Chair and the witnesses. A total of €1.5 million was paid to this company in 2024. Do we know the total amount that was paid to this company?
James Geoghegan (Dublin Bay South, Fine Gael)
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Ms Coyle must have those figures.
James Geoghegan (Dublin Bay South, Fine Gael)
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Ms Coyle is the chief executive of the hospital. I would like to direct my questions to the chief executive of the hospital, unless she is telling me that she does not have the information.
Ms Anne Coyle:
I have it. Payments were made to Beaumont Private Clinic, BPC, for two modalities, namely, CT scans and ultrasound and mammography. In 2019, it was €181,676. In 2020, for the two modalities, it was €288,731. It was €555,000 in 2021, €739,000 in 2022, €1.2 million in 2023, €1.5 million in 2024, and €1.1 million in 2025.
James Geoghegan (Dublin Bay South, Fine Gael)
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What is the total? What does that all add up to?
James Geoghegan (Dublin Bay South, Fine Gael)
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This company received €6.2 million.
James Geoghegan (Dublin Bay South, Fine Gael)
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Of that €6.2 million, how much was publicly procured?
James Geoghegan (Dublin Bay South, Fine Gael)
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Just to help me, was any of the €6.2 million subject to public procurement?
James Geoghegan (Dublin Bay South, Fine Gael)
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No.
James Geoghegan (Dublin Bay South, Fine Gael)
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So €6.2 million was paid out by Ms Coyle's hospital with no procurement. In any of the €6.2 million provided what is the status of declarations of conflict of interest? We know from the Comptroller and Auditor General's report that only four of the 20 members of staff who were directors of this company made declarations. What is the status in respect of the €6.2 million? Is it the same?
James Geoghegan (Dublin Bay South, Fine Gael)
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It is the exact same. So €6.2 million was given to this company with no public procurement and there were no declarations. When Ms Coyle says she is making an unreserved apology-----
James Geoghegan (Dublin Bay South, Fine Gael)
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-----what is she making an unreserved apology for? Is it for the €6.2 million with no public procurement and no declarations?
James Geoghegan (Dublin Bay South, Fine Gael)
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I am just trying to understand what Ms Coyle's apology is about. I find it extraordinary that hers is the third public voluntary hospital we have had before the committee, of the five I think the Comptroller and Auditor General has direct auditing responsibility for, and Ms Coyle is the third chief executive to come before us and deliver an unreserved apology for governance failures. That leads me to be concerned about what other governance failures are out there because in each of the three cases these were matters that were identified simply by random audit questions from the Comptroller and Auditor General. When Ms Coyle says she is making an unreserved apology will she clarify to the committee what she is apologising for?
Ms Anne Coyle:
I am apologising for the failures in governance within the hospital. I am apologising for the gaps we had in our internal controls. There has been significant work done to address those. Some of these, as I mentioned in my opening statement, date back to 2019. They were issues that were raised at different points. They had been raised in the accounts. As the information came to light and we became fully aware of the detail we made that declaration within the 2024 accounts and I am sorry that has taken place. It has taken place over a number of years.
James Geoghegan (Dublin Bay South, Fine Gael)
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I do not want to misquote Mr. Hanlon but I was surprised by the replies he gave to Deputy McAuliffe about obligations to disclose directorships. What is Ms Coyle's position as CEO of the hospital? Did these people have an obligation to submit that they were directors of this company that was receiving €6.2 million?
James Geoghegan (Dublin Bay South, Fine Gael)
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Okay, and Ms Coyle is not equivocating on that. They had an obligation to disclose their directorship-----
James Geoghegan (Dublin Bay South, Fine Gael)
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-----and to identify the company.
James Geoghegan (Dublin Bay South, Fine Gael)
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Is that still her understanding? Obviously there are moneys still going to this company. Did I hear her say the hospital has gone to public procurement in 2026?
James Geoghegan (Dublin Bay South, Fine Gael)
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Was this company successful in the public procurement?
James Geoghegan (Dublin Bay South, Fine Gael)
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Do we know yet how much money that company will receive? How long is the procurement period?
James Geoghegan (Dublin Bay South, Fine Gael)
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People were asking what the consequences are of the failure to disclose and the receipt of moneys with no public procurement. It would appear there are no consequences and this company is going to continue to receive moneys to the same extent it did when it did not have public procurement.
Ms Anne Coyle:
It is going back to the demand we have got for radiology services. It is going back, in part, to patient need and demand. It is going back to the reasons for the derogation in the first place. We are holding ourselves and working to strengthen the governance and the internal controls and oversight. When it came to light as part of our third-party audit that the conflicts of interest were not declared we managed the transition. We did not want to disrupt patient care or to create additional waiting time for our patients. We went to the market and we tested the market. When we benchmarked the prices charged by the provider they were consistently in line to ensure value for money was achieved, which we believe it was.
James Geoghegan (Dublin Bay South, Fine Gael)
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I do not know if we have any board members here, but at a board level was the issue of non-public procurement being provided to a company to the level it was ever a risk or issue flagged at the relevant subcommittees? Or did the officials hear about this for the first time because the Comptroller and Auditor General's office flagged it in its audits?
James Geoghegan (Dublin Bay South, Fine Gael)
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What about the ones in the years after that?
James Geoghegan (Dublin Bay South, Fine Gael)
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Was it never flagged by, say, an audit and risk committee? I can see Mr. Hanlon looking to jump in here. It was flagged, was it?
James Geoghegan (Dublin Bay South, Fine Gael)
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If he could address the question. Was it flagged by an audit and risk committee at any stage, to his knowledge? If he does not have the knowledge that is fine.
James Geoghegan (Dublin Bay South, Fine Gael)
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Okay, so let us say on a yearly basis when these moneys were going out to a non-procured company - though I hear what Ms Coyle is saying about it being a five-year derogation - was this flagged? Did these issues come up in the meetings?
James Geoghegan (Dublin Bay South, Fine Gael)
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Did any member of that audit and risk committee say a discussion was needed? If these issues made it from the audit and risk committee to the overall board was there ever any discussion about the need to examine why the board was providing such a level of funding to a company that was not subject to public procurement?
James Geoghegan (Dublin Bay South, Fine Gael)
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This is where I get confused. Mr. Hanlon says the derogation is valid but Ms Coyle is giving an unreserved apology. Is the board apologising for the non-public procurement in respect of this company?
James Geoghegan (Dublin Bay South, Fine Gael)
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But is non-public procurement of this company a governance failure?
James Geoghegan (Dublin Bay South, Fine Gael)
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So then Ms Coyle is not apologising for the non-public procurement to a company of €6 million. I just want to be clear what she is apologising for. It should be straightforward enough. She has said she has come to the committee with an unreserved apology. I do not want to put words in her mouth but she does not appear to know what she is apologising for. Is she apologising for the non-public procurement to a company of €6.2 million? It is a fairly straightforward question.
Ms Anne Coyle:
The decision was made at the time in 2019 and 2024 around the derogation. The derogation was due to patient need and providing timely access to scans like ultrasound and CT. The demand we have and the capacity internally at Beaumont at that point was not sufficient to meet the timely access demand in terms of making sure patients had their treatment and care in a timely manner. What the hospital did not do was around the conflicts of interest and making sure that had properly been taken into account.
James Geoghegan (Dublin Bay South, Fine Gael)
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So Ms Coyle is apologising for the declarations. My time is up so I will conclude on something which the witnesses might reflect on. When St. James's Hospital was before us an apology was given by the CEO and I can the check the transcript of this but I am fairly sure the CEO of the hospital was apologising for the non-public procurement element. Obviously facts are very different in two different hospitals and there might be lots of reasons Beaumont's situation is different, but I am just highlighting she was very clearly apologising for the fact this was non-publicly procured, in addition to the exact same SIPO declaration failings. It does not appear Ms Coyle is adopting the same position and I wanted to note and flag that. Perhaps she might reflect on it.
Grace Boland (Dublin Fingal West, Fine Gael)
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I want to ask about agency staff. It is not very clear to me how much the hospital is spending on agency staff. What was the level for 2024, what is the level for 2025, and why is it not more transparent in the accounts?
Grace Boland (Dublin Fingal West, Fine Gael)
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I would like to see it. It is really important that we see agency costs in the accounts. Even though it may not be a requirement, it is necessary to include the level of spend in future accounts.
Grace Boland (Dublin Fingal West, Fine Gael)
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That is great. I ask Mr. Hanlon to tell me the levels.
Mr. Francis Hanlon:
In 2024 the level was €7.4 million across a number of different staff categories. It was €8.7 million in 2025, and in 2026 until April it was €3 million. We had a saving of €453,000 on healthcare assistant agency staff in the first four months of the year, and we are tracking to deliver €1 million in savings as part of our cost-containment plan in our 2026 projections.
Grace Boland (Dublin Fingal West, Fine Gael)
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What is the total projected for 2026?
Grace Boland (Dublin Fingal West, Fine Gael)
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That is still an awful lot of money. What is the hospital going to do to minimise that? We really should be looking at very minimal costs on agency staff.
Mr. Francis Hanlon:
I can address one part, and my colleague will come in another part. We have a cost-containing plan within the hospital, which is non-patient facing. Myself and the director of nursing review agency requirements on a weekly basis, and try to bring in cost containment and ensure that agency staff who are employed are required.
Grace Boland (Dublin Fingal West, Fine Gael)
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Is it agency staff only for nursing, or is it across-----
Mr. Robert Kidd:
In Beaumont Hospital, 1.6% of its direct-pay budget is spent on agency staff. When we look at other hospitals, Beaumont performs better than most of our other hospitals in that context. It is ahead in terms of that percentage of its direct pay, although the number seems high. Obviously its direct pay budget is significant compared to other sites.
Grace Boland (Dublin Fingal West, Fine Gael)
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I would like to see the HSE making sure it is transparent in all of the hospitals' accounts as to what the spend on agency is. There has to be a real focus on reducing that to a very minimum.
Grace Boland (Dublin Fingal West, Fine Gael)
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I want to move on to public-only consultant contracts. Some 81% of consultants have taken up the contract, is that correct?
Grace Boland (Dublin Fingal West, Fine Gael)
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In terms of the activity, we have invested a huge amount in the public-only contract. What is the specific return on activity? Can the witnesses give me any metrics as to how the public-only contracts have actually resulted in the treatment of more patients?
Grace Boland (Dublin Fingal West, Fine Gael)
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There is no need to thank me for the questions.
Ms Claire Noonan:
There has been additional activity over the past two years since our consultants have started moving towards the public-only consultant contract. We have an increase of 11% in the number of new consultant-led outpatient appointments. That equates to 5,300 total outpatients, including new and return. That is 17,000 in addition to our annual numbers over the past two years. Day case is somewhere we have seen significant growth as well, and that is excluding dialysis. We have seen an additional 8,200 patients over the past two years. Specifically, 2025 is where we saw the most growth. The investment has been in the public-only consultant contract, not in additional support. We are confident in attributing this increase in activity to an additional workload for our consultants through the public-only contract.
Grace Boland (Dublin Fingal West, Fine Gael)
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That underscores the value of the public-only contract. It really does. I thank Ms Noonan for that. In terms of theatre productivity, what is the average theatre utilisation rate?
Ms Anne Coyle:
We just recently participated in the HSE theatre productivity programme. That has been concluded on our Beaumont site and is currently under way in St Joseph's Hospital in Raheny. Ms Noonan has the percentages in terms of our productivity.
Ms Claire Noonan:
We have been deemed to have the highest utilisation of theaters in any model 4 hospital that has been measured. It is at 80% at the moment. A national or international target is anywhere between 80% to 85%. That is what the target would be. As part of that, they did uncover that 44% of our activity is unscheduled, meaning there is a constant demand for unscheduled and emergency care in our theatres. At our St. Joseph’s site, we have one of the highest utilisations of a model 2 hospital, with 74% of our theatres available utilisation, which is slightly above what we would aim for in a model 2.
Grace Boland (Dublin Fingal West, Fine Gael)
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With the opening of the surgical hub in Swords, I assume that will alleviate pressure.
Grace Boland (Dublin Fingal West, Fine Gael)
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Brilliant.
Mr. Robert Kidd:
The hospital has also voluntarily put its hands up around that NPHET programme. It is called theatre productivity in the HSE and is led by the HSE. It is an external view. Second, I mention the utilisation in its outpatients as well. Again, it is part of the hospital coming forward to ask if it can do better and whether its utilisation is standing up to scrutiny.
Grace Boland (Dublin Fingal West, Fine Gael)
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I am glad to hear that. In terms of the average knife to skin time in the theatre, does the hospital record that? Does it have metrics for that? What would that be like? Is it making sure that if operations are supposed to start at 8 a.m., they are actually starting at 8 a.m.?
Ms Claire Noonan:
As part of the productivity programme, the HSE measured where there was any potential. There was only 3% potential to increase productivity. One of the areas that it did identify is that time to skin piece. It measured from the point of the patient arriving to the anesthetic room. There is small room for improvement-----
Grace Boland (Dublin Fingal West, Fine Gael)
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What is the average?
Grace Boland (Dublin Fingal West, Fine Gael)
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The average wait time.
Grace Boland (Dublin Fingal West, Fine Gael)
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The hospital is looking at addressing it.
Grace Boland (Dublin Fingal West, Fine Gael)
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We will move on to diagnostic capacity. Obviously CTs, MRIs and X-rays are critical pieces of infrastructure. We need to make sure that we are absolutely utilising them to maximum effect. What metrics are there, and do we need to improve, or what is the plan?
Ms Claire Noonan:
Radiology and diagnostics are some of the areas over the past two years where we have seen a significant increase in productivity in the hospital. There is a relentless demand for diagnostics, particularly in a hospital like Beaumont where we have the thrombectomy service, the national neurosurgical service, and one of the largest cancer centers in the country. For CT, we are projected to run at a 29% deficit in terms of our capacity to meet our demand.
Grace Boland (Dublin Fingal West, Fine Gael)
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In terms of the machines sitting idle, what is the percentage of the week that they sit idle?
Grace Boland (Dublin Fingal West, Fine Gael)
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They are used seven days a week.
Grace Boland (Dublin Fingal West, Fine Gael)
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Are they fully staffed every single day of the week?
Ms Claire Noonan:
For the services that we run, they are. There are additional scanners which we do not operate 24/7, 365 days a year but we are working with the region to increase that. We have some pilot programmes at the moment where we are testing out in terms of value for money, where we are running additional lists in the evenings, on Saturdays and at weekends. We will work with the region to convert them through Invest to Save initiatives if they are showing value for money, which they absolutely are. We have had a 19% increase in the utilisation of our CT scanners alone through some of those pilots, and we will convert those.
Grace Boland (Dublin Fingal West, Fine Gael)
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How much of an increase?
Grace Boland (Dublin Fingal West, Fine Gael)
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What concentrated the minds to make sure that these machines were being used better?
Ms Claire Noonan:
I suppose it was a relentless demand. It impacts our turnaround times in the hospital. We have reduced the turnaround times for both CT and MRI by four hours, which might seem insignificant, but is absolutely not. We try to focus patients to if they can have urgent scans as outpatients so they do not need to remain in hospital, and we have reduced the turnaround time for a CT scan from 11 days to four days for an outpatient. We are seeing improvements in productivity throughout the radiology service but it is really to try to support hospital flow. We have our new EDCT scanner, which is open since October of 2025, and we have taken two and a half hours off the waiting time in the emergency department for a CT scan from the time of order through to scan.
Grace Boland (Dublin Fingal West, Fine Gael)
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In terms of further savings, the hospital is obviously on a plan at the moment and is trying to be as productive as possible. If it had to reduce its spend by about 5% without reducing patient care, what would it target?
Grace Boland (Dublin Fingal West, Fine Gael)
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Across the board.
Mr. Francis Hanlon:
In the year to date, we delivered €2.8 million of non-patient-facing savings. They ranged from agency healthcare assistant savings that I mentioned previously and overtime review, savings and controls. In non-pay, we had savings delivering on translations. We also have an internal building maintenance project committee that ensures that any building maintenance that happens in the hospital is reviewed by senior management before it proceeds. That has delivered savings in the year to date of €630,000 on last year's run rate.
Grace Boland (Dublin Fingal West, Fine Gael)
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I might just ask one more question. It is for Ms Coyle. It sounds like we are trying to be as productive as possible, maximising equipment, utilising staff seven days a week, etc., but where is the patient in all of this? Is the patient seeing the benefit of this? I am a TD for north County Dublin and I am repeatedly told of sick people not wanting to go to Beaumont because of the very long delays and what they feel is a lack of patient care. How is she making sure that patient care and communication are being put first in everything the hospital is doing?
Ms Anne Coyle:
First of all, my apologies to Deputy Boland's constituents for the delays and waits. We have a particular focus on patient access. Our strategy, entitled "Building Excellence in Care, Together", sets out the work programme to improve access for patients, in particular around the emergency department and the delays there. We made progress in 2025 with our trolley waits and delays. We are also very focused on patient experience times. We have increased staffing in zone 4 for ambulatory patients, those being, patients who do not require admission. It is really a whole-hospital focus at very senior clinical director level on reducing the time. When a patient is admitted, the time to bed is kept as short as possible.
Grace Boland (Dublin Fingal West, Fine Gael)
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What is the average time?
Grace Boland (Dublin Fingal West, Fine Gael)
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I thank Ms Coyle.
Aidan Farrelly (Kildare North, Social Democrats)
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I thank everybody for being here. This is a very quick question that I tend to ask. Did Ms Coyle or any of her colleagues participate in training in preparation for today's meeting?
Aidan Farrelly (Kildare North, Social Democrats)
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Was that specifically for this meeting or was it part of a wider brief?
Aidan Farrelly (Kildare North, Social Democrats)
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What was the cost of that training in preparation for today's meeting?
Aidan Farrelly (Kildare North, Social Democrats)
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I thank Ms Coyle.
Did she have any reservations or were any reservations raised at board level in regard to offering a new contract to the company that has benefited from a contract it has had for the last six years and that was not a publicly procured contract?
Aidan Farrelly (Kildare North, Social Democrats)
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I refer to the contract that was signed in May of this year. Did Ms Coyle have any reservations about offering that contract? What is hard for me to get my head around is the idea that this is the definition of cronyism, whereby this company was perfectly suited to win the public contract because of the opportunities it had simply by being staff members in Beaumont for the last six years. It is arguable that the odds were stacked in their favour to win at least part of this procurement piece.
Ms Anne Coyle:
Mr. Hanlon has responsibility for procurement and is better able to speak to the detail of this, but that contract will have gone through and been published to an agreed specification. It will have been reviewed by the board's subcommittee – the finance subcommittee – before a recommendation was made to the full board.
Aidan Farrelly (Kildare North, Social Democrats)
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Did Ms Coyle have any reservations or were reservations expressed at board level with regard to this contract in May 2026?
Aidan Farrelly (Kildare North, Social Democrats)
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It was just a basic "Yes" or "No", but it is fine if Ms Coyle does not have that.
Aidan Farrelly (Kildare North, Social Democrats)
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I thank Ms Coyle. The HSE requires Beaumont to submit an annual compliance statement in respect of corporate governance standards. Has it been submitted on an annual basis over each of the last five years?
Aidan Farrelly (Kildare North, Social Democrats)
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Was that done every year, including in 2021?
Aidan Farrelly (Kildare North, Social Democrats)
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The question was about the last five years. I will direct the question to Mr. Kidd. What I have seen reported is that, in 2021, Beaumont Hospital sought to have certain elements of corporate governance disapplied with regard to its annual corporate governance statement. What is the HSE's stance on that, given that it is in the context of significant non-compliant procurement?
Mr. Robert Kidd:
Yes, absolutely. What I can say to the Deputy is we had concerns in line with some of the issues raised here by the members of the committee. On taking up the post last year, I met with the chair of the board and the CEO directly. The chair of the board is very clear about their role in terms of governance and compliance. They recognise the issues - the failures and weaknesses within the hospital's controls. They have embarked on a programme of work to address it. What we are seeing in the annual financial statement, AFS, is part of them coming forward with that. Their first intention as part of meeting with them was ensuring that the executive and corporate governance within the organisation was stable. That resulted in the appointment of a CEO, just prior to my time – Ms Coyle. The Deputy has already heard from Mr. Hanlon and other members of the executive team. One of our biggest concerns was around the capital programmes. What the Deputy has heard of is the appointment of the director of estates and a tripartite group with me, our own HSE estates and Beaumont sitting around a table with specific governance over its capital programme.
There are strengthened controls. The board has been very clear about wanting to work with the HSE on its compliance issues.
Aidan Farrelly (Kildare North, Social Democrats)
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Is Mr. Kidd confident that, with regard to the 2025 annual corporate governance statement, the hospital is fully compliant as it stands?
Mr. Robert Kidd:
I am confident that it is compliant on the issues it has found. The board has been very clear that it would see itself in a process. It has been very open about that. Similar to some of the issues that were raised here, I know that the committee was concerned about the issue that was raised about the payroll system. Within the previous AFS in 2024, the board has also been very clear with us that it does not want to bring half an issue forward without being sure it is fully validated. It is very clear around what the issues are, how they occurred and how it is going to address them. The board has have been very open with us. It invited the HSE to board meetings, in terms of both performance and compliance. Following on from Deputy Boland's questions, the board is very keen to ensure that the hospital performs on the delivery of patient care as well, not just in compliance terms.
Aidan Farrelly (Kildare North, Social Democrats)
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I thank Mr. Kidd. Will Ms Coyle outline what the financial sum is in terms of total staff overpayments that have been written off in the last three years?
Ms Anne Coyle:
As mentioned in the opening statement, we have 5,700 employees. We have five payroll runs, 1,000 salary rates and 25,000 transactions per month. I am not negating what happened in any way, but to give a sense of the scale of overpayments, it was 0.16% of our total payments in 2024. It is an area I am personally very focused on. I chair a fortnightly meeting on overpayments. My colleague, Mr. Sweeney, has got the detail on that.
Aidan Farrelly (Kildare North, Social Democrats)
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Mr. Sweeney might give the sum, please.
Aidan Farrelly (Kildare North, Social Democrats)
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In total.
Aidan Farrelly (Kildare North, Social Democrats)
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Then, for 2024, what was the figure of staff overpayment? Was that fully recouped?
Aidan Farrelly (Kildare North, Social Democrats)
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Mr. Sweeney does not have the sum.
Aidan Farrelly (Kildare North, Social Democrats)
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Did that increase or decrease in 2025?
Aidan Farrelly (Kildare North, Social Democrats)
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How can a new payroll system be rolled out in 2024 that costs close to €5 million and still have such significant flaws? I cannot make sense of that.
Mr. David Sweeney:
There are a number of drivers for overpayment. I will break them down into three categories. One is a communication from the shop floor centrally to HR and finance. The second category would fall within HR and finance itself in terms of processing. The third issue might be system-generated issues from upgrades and their effect. Since the system has gone live, we have experienced a 44% reduction in the number of overpayment instances. We may have a case where there were two errors, which had a blanket application to 50 or 60 staff. We have had a 44% reduction in overpayments. In terms of the categories of the drivers of that, 1% is related to the system and 90-odd % relates to notifications and human error within processes.
Aidan Farrelly (Kildare North, Social Democrats)
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How much is human error of that approximate 90%?
Aidan Farrelly (Kildare North, Social Democrats)
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That would be a systematic problem as well, though.
Aidan Farrelly (Kildare North, Social Democrats)
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If the system is allowing for human error, there is something wrong with the system.
Mr. David Sweeney:
We have employed measures internally. The CEO actually chairs the group. My focus is working on analysing the drivers of overpayments and working with teams around the hospital to ensure they have full understanding of the implications of changes. It may be a relatively simple matter from an operational perspective but it can have a real impact for the hospital in terms of its scope. One error can affect one hundred people. We have worked with managers on that and the system is providing some insights for them in relation to it.
Aidan Farrelly (Kildare North, Social Democrats)
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I thank Mr. Sweeney.
Cathy Bennett (Cavan-Monaghan, Sinn Fein)
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The witnesses are welcome. I want to go back to this. In relation to the IT system for the payments role, can Mr. Hanlon remind me how much that system cost?
Cathy Bennett (Cavan-Monaghan, Sinn Fein)
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Was that a customised payroll system? Was that one made specifically for Beaumont Hospital?
Cathy Bennett (Cavan-Monaghan, Sinn Fein)
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It was actually designed specifically for Beaumont Hospital.
Cathy Bennett (Cavan-Monaghan, Sinn Fein)
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Does Mr. Hanlon feel that the system is working well now?
Cathy Bennett (Cavan-Monaghan, Sinn Fein)
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Mr. Hanlon might remind me again. That system cost €4.8 million in total.
Cathy Bennett (Cavan-Monaghan, Sinn Fein)
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What year was that in?
Cathy Bennett (Cavan-Monaghan, Sinn Fein)
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Was there any cost in 2025?
Cathy Bennett (Cavan-Monaghan, Sinn Fein)
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Does the hospital pay that additionality every year then?
Cathy Bennett (Cavan-Monaghan, Sinn Fein)
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It is €762,000 every year on top-----
Cathy Bennett (Cavan-Monaghan, Sinn Fein)
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The hospital pays that every year.
Cathy Bennett (Cavan-Monaghan, Sinn Fein)
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How many overpayments had the hospital in 2024? What was the overpayment?
Cathy Bennett (Cavan-Monaghan, Sinn Fein)
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Yes, please. I thank Mr. Sweeney.
Cathy Bennett (Cavan-Monaghan, Sinn Fein)
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That happened even though the hospital pays €762,000 per year and it paid €4.8 million for the system.
Cathy Bennett (Cavan-Monaghan, Sinn Fein)
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That is fact, yes.
Cathy Bennett (Cavan-Monaghan, Sinn Fein)
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Where did the hospital gets its advice to get its IT system? Who actually procured it? The hospital did not procure the system in the first instance either. Is that correct?
Cathy Bennett (Cavan-Monaghan, Sinn Fein)
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It is €4.8 million.
Cathy Bennett (Cavan-Monaghan, Sinn Fein)
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Does the hospital go through the Department of Health or Department of Public Expenditure Infrastructure, Public Service Reform and Digitalisation or anybody to get sanction for €4.8 million? Who sanctions that €4.8 million?
Cathy Bennett (Cavan-Monaghan, Sinn Fein)
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I believe that all Departments have thresholds for which officials have to get sanctions.
Cathy Bennett (Cavan-Monaghan, Sinn Fein)
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Who sanctioned the €4.8 million? I just need the name of the person who sanctioned the €4.8 million.
Cathy Bennett (Cavan-Monaghan, Sinn Fein)
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How does the hospital get the money? When it goes to the Department of Health and the HSE and tells them it spent €4.8 million, are there no sanctions? I just do not understand how it works so maybe Ms Coyle can break it down for me.
Cathy Bennett (Cavan-Monaghan, Sinn Fein)
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I am sorry, Ms Coyle. I just want to go back. What sanctions were put in place? What happened when there was €4.8 million spent with no public procurement? Was there no sanction since that? That is what I want to know. I want to know, first, who sanctioned it and what happened afterwards. Were there any consequences? If it is going on right across every Department that €4.8 million can be spent without any public procurement, I want to know whether there was a sanction from the Department or if anything happened.
Ms Anne Coyle:
When this became apparent and it was identified that the gap in procurement existed, the hospital added it to its non-compliant procurement in 2023. By that point, the system had already been purchased and the implementation of the system was well under way. We have really been focused going forward on optimising the product, optimising its implementation and undertaking a review, which we have done. As Mr. Hanlon referenced, it is a top-tier system. The challenge has been in our implementation-----
Cathy Bennett (Cavan-Monaghan, Sinn Fein)
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It must be really top tier to spend €4.8 million non-procurement and then another €762,000 per year with no public procurement. It must be top class.
Cathy Bennett (Cavan-Monaghan, Sinn Fein)
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However, I want to know where the oversight is. Is the board doing oversight? Is Ms Coyle doing oversight? Is the Department of Health or the HSE? I want to know where the oversight is and what the consequences were.
Ms Anne Coyle:
The oversight of it going forward would be through e-procurement. First, we are very minded that we are part of and would be working towards a national mandated HSE and payroll system. Going forward, the value of what is referenced should have triggered a procurement. It did not, and we have identified it as part of our non-compliant procurement for 2023. When that came up and became apparent, that was the action this board and this hospital took.
Cathy Bennett (Cavan-Monaghan, Sinn Fein)
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At the start, Ms Coyle mentioned a disclosure in relation to the misclassification of vendors. Will the witnesses explain that to us again?
Mr. Francis Hanlon:
This relates to the application of professional services withholding tax and relevant contracts tax. Professional services withholding tax is a tax deducted at source for professional services that we use from third-party vendors. Relevant contracts tax is a withholding tax paid by the principal contractor. In that case, we were the principal contractor for works done around the hospital. Over a number of years, we believe it impacts 60 out of 3,000 live vendors.
Cathy Bennett (Cavan-Monaghan, Sinn Fein)
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What was the monetary value?
Cathy Bennett (Cavan-Monaghan, Sinn Fein)
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The hospital does not know the value.
Cathy Bennett (Cavan-Monaghan, Sinn Fein)
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The hospital does not know the value of what was misclassified.
Cathy Bennett (Cavan-Monaghan, Sinn Fein)
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Surely there is an income and expenditure sheet to work from, so the hospital can see what has been spent, what went in and what went out.
Cathy Bennett (Cavan-Monaghan, Sinn Fein)
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How much is that?
Cathy Bennett (Cavan-Monaghan, Sinn Fein)
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A sum of €270 million a year. You have reclassified that, and you do not know-----
Mr. Francis Hanlon:
No Deputy, I have not. To clarify, this relates to a classification of vendors that we would have paid. This relates to the professional services withholding tax and the relevant contracts tax. The hospital has an obligation to register contracts for relevant contracts tax with the Revenue Commissioners. It has an obligation to deduct 20% from the professional services that we use. In this regard, going back a number of years, we have not applied that correctly.
Cathy Bennett (Cavan-Monaghan, Sinn Fein)
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How many years?
Cathy Bennett (Cavan-Monaghan, Sinn Fein)
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How much are the external tax advisers costing the hospital?
Cathy Bennett (Cavan-Monaghan, Sinn Fein)
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Did the hospital not have public procurement for them before it-----
Mr. Francis Hanlon:
We did have a public procurement, but it depends on the number of days they need to review. They are looking back four years. It is a very complicated area. It relates to reverse charge VAT in some cases, professional services withholding tax and relevant contracts tax. This is a sign that we are trying to be as compliant as possible, ensuring that we are compliant with the Revenue Commissioners and ensuring that we carry out our tax obligations correctly.
Cathy Bennett (Cavan-Monaghan, Sinn Fein)
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The car parking charges at Beaumont increased from €950,000 to €1.4 million in 2025. What was the reason for the 50% increase in car parking charges?
Cathy Bennett (Cavan-Monaghan, Sinn Fein)
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The witnesses said there are over 4,000 staff. Are there enough car parks for the 4,000 staff?
Mr. John Reilly:
There are two projects under the HSE capital plan to expand car parking capacity at the hospital. They are currently going through the detailed design phase. We recognise that there is huge pressure at the moment, and we are looking at interim measures. We have published-----
Cathy Bennett (Cavan-Monaghan, Sinn Fein)
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The hospital does not have enough car parks for its staff but it charges additionality. It is using the public car parks to make money out of them. Is that correct? It is reducing the car parking for staff but increasing the public car parking to make money. Is that correct?
Cathy Bennett (Cavan-Monaghan, Sinn Fein)
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But there are 4,000 staff.
Mr. John Reilly:
There are approximately 1,200 car parking spaces for staff. There are over 4,000 staff in the hospital but they do not all work at the same time. There are 600 public car parking spaces within the hospital as well. We have an expression of interest out to look for off-site car parking and park-and-ride facilities for staff car parking. That is to look to expand our capacity by an additional 40%. That is currently going through a procurement process. We would hope to implement that as a temporary measure.
Cathy Bennett (Cavan-Monaghan, Sinn Fein)
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I will finish on that section but I reiterate the hospital has nearly doubled its car parking charges in a year.
Joe Neville (Kildare North, Fine Gael)
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I thank the witnesses for coming in. We will be going through a litany of issues but at the same time, I am conscious that the hospital has a lot of good staff and a lot of people who do a lot of great work. Like most of us, I have had family members in the hospital who were well looked after. That does not take away from our role here today because we are here to question the governance and the running of the hospital. At the same time, I want to speak to those in the hospital who deal so well with people.
I do not want to make a big speech, but we have this litany of issues. When the Committee of Public Accounts deals with the hospitals and the HSE, it can be the most complex element and it is one of the largest elements of the State to get your head around. It seems that we have almost a cliché level of issues here. We have governance weaknesses, control weaknesses, financial systems and an ICT overrun, and we even have fraud thrown into the mix. They are probably all elements of different things that we have heard before, but at the same time, there are so many issues that we could bring up.
It was stated that there was a reallocation of some of the vendor element. Mr. Hanlon outlined that there are 60 vendors.
Joe Neville (Kildare North, Fine Gael)
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What is the total cost of the 60? I know 60 out of 3,000 is a small number. What is the value?
Joe Neville (Kildare North, Fine Gael)
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The hospital has done a review on that basis. If there is no value, that is fine. That was my question. I know why the hospital is doing it.
At a high level, the opening statement referenced the 2023 governance issues. Are any of the people related to the 2023 governance issues still here, or is it a new group?
Joe Neville (Kildare North, Fine Gael)
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Once again, that is another trend that we often see here.
Joe Neville (Kildare North, Fine Gael)
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Broadly speaking, it is a new broom. Mr. Kidd is here to help to oversee that. I know he spoke to the improvements that he has seen, and we will not hold that against him if he is here again next year. At the same time, he said that he has seen improvements. All too often, we come in here and we hear that.
Mr. Robert Kidd:
I do not know if there is a question in that. On taking up office, the chair of the board looked specifically to meet with the HSE, the regional executive officer and me. They are very clear on the gaps and the issues, but they are also very clear on the requirements to address them.
Joe Neville (Kildare North, Fine Gael)
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I have several specific questions. For the public-only contracts, 83% have signed up and 17% have not. It is something that keeps coming up here. Do the public-only contracts people do only public contract work?
Joe Neville (Kildare North, Fine Gael)
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We have had issues at other hospitals where that has not been the case. Is there any example anywhere of someone on a public-only contract doing private work?
Joe Neville (Kildare North, Fine Gael)
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Do we know if they have been doing it elsewhere?
Joe Neville (Kildare North, Fine Gael)
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It does not exclude them from doing work elsewhere. Is that what Ms Coyle is saying? Is that Mr. Kidd’s view?
Mr. Robert Kidd:
To be clear, as I pay health insurance through my wife, I have the right to waive my rights under the Health Act, as a citizen. When I arrive at a hospital, if I feel that I have paid my health insurer, it does not mean a POCC consultant can get income off my treatment when I am in the public hospital, if that makes sense. I can decide to be private in the hospital, but it does not mean a POCC consultant can get income off my attendance at the hospital. I have a right, as a citizen, to waive my rights under the Health Act. I can use my insurance when I arrive at any public hospital.
Joe Neville (Kildare North, Fine Gael)
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Mr. Kidd is saying that somebody on a public-only contract could be getting private work.
Mr. Robert Kidd:
No. They cannot claim income off that individual, to be clear. There is a differential there. The individual person - the citizen - has a right under the Health Act to determine that they want to waive their rights to be treated as a public patient and use their health insurance. That does not mean a consultant can get income off that. That does not preclude an individual being treated in the hospital.
Joe Neville (Kildare North, Fine Gael)
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I get that. At the same time for a public-only contract person we are saying that-----
Joe Neville (Kildare North, Fine Gael)
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That is my question. That is fine. Another issue that keeps coming up in relation to hospitals is the integrated financial management system, IFMS, that the HSE has rolled out. I know a lot of the hospitals have come on board. Where is Beaumont with that?
Mr. Francis Hanlon:
We are part of implementation group 5, IG5, so we are starting implementation in August 2026, and plan to go live in March 2027. We have already engaged. As part of our monthly reporting, we submit an IFMS report and template on our monthly reporting costs. In addition, because we have been commended for our engagement on IFMS, we are a pilot site for the forecasting module of IFMS.
Joe Neville (Kildare North, Fine Gael)
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Is there a HR element to IFMS?
Joe Neville (Kildare North, Fine Gael)
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There is no payroll element to the system.
Joe Neville (Kildare North, Fine Gael)
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They will be going in a new payroll system.
Joe Neville (Kildare North, Fine Gael)
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It will be an integration element as opposed to a brand-new system.
Joe Neville (Kildare North, Fine Gael)
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I just wanted to clarify. That system is obviously where the specific major overrun was. That was one of the issues and one of the overruns.
Joe Neville (Kildare North, Fine Gael)
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When was it realised that there would be an overrun? What was the main complicating factor? We come up against these issues all the time, so I want to see if there are any trends. What was the main issue with the overrun? Why did it happen and how did it happen? When was it realised that they would have this issue? This is for our own report.
Joe Neville (Kildare North, Fine Gael)
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Was that a scoping issue?
Joe Neville (Kildare North, Fine Gael)
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Who was doing the scoping issue? Was that third party as well?
Mr. David Sweeney:
It was in consultation with the provider, but we had an initial scoping exercise internally to look at the various factors. Some of that scoping extended to the fact that our legacy systems did not integrate and did not speak so there were a lot of manual transactions. In any given month we would put approximately 25,000 transactions through that payroll system through various offices.
Joe Neville (Kildare North, Fine Gael)
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The scoping brief keeps coming up in the context of the HSE and some of the largest elements of State spending in the past ten years, so it is something to be conscious of. It is obviously something we are struggling to get right. It is something that we need to seriously-----
Joe Neville (Kildare North, Fine Gael)
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If there are any more lessons learned in PAC, we will be-----
Joe Neville (Kildare North, Fine Gael)
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One issue that keeps coming up is the private insurer write-off of €113,000. Is that the usual where the consultants do not sign off a document, the document does not go, we do not look for money and then too much time passes, and the insurer does not have to pay? Is that what it is?
Joe Neville (Kildare North, Fine Gael)
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There seems to be some slackness in getting the paperwork in. This seems to be the trend. I am not talking about Beaumont. That is the trend.
Mr. Francis Hanlon:
I can tell the Deputy we have made great progress on that. In December 2025 it was 48 days for a claim awaiting consultant action. In May 2026 it was 24 days and the target for the HSE is 20 days. We are moving in the right direction. In value terms there was €2 million awaiting consultant action in December 2025. In May 2026, it was €700,000. We have monthly meetings with our directorates, which include the clinical directors. At that forum we bring up claims awaiting consultant action. We also email about 47 consultants monthly who are approaching an issue to remind them of their obligation to sign and submit their-----
Joe Neville (Kildare North, Fine Gael)
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You can email them, but I presume there are no consequences.
Mr. Francis Hanlon:
The consequences are that we discuss it at the clinical performance meetings. We single out consultants who need to address particular issues. It is a collaboration and co-operation process between my staff and accounts receivable, as well as the consultants. We are continually engaging with them to ensure we try to meet our 20-day deadline. We are now at 24 days from 48 days.
Joe Neville (Kildare North, Fine Gael)
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This is not a question, but I highlight that we have gone through lots of different issues. There is even the declaration of interests. It is another basic issue that consistently comes up. I did not want to pass my time without referencing that we have a significant amount of funding going to different companies where people are not saying what they are and who they are involved with. That is a basic requirement of any organisation. I think it is shocking that with so many elements, not just the hospitals, we keep coming across this. People are not saying who it is, and it looks so bad. The risk is that it ends up stinking because people just ask why they would not. That is almost the holy trinity, trifecta or multitude of issues we are seeing here. It is reflective across, and in the worst case we are seeing a lot of them here specifically.
Albert Dolan (Galway East, Fianna Fail)
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I thank the Beaumont Hospital board for being here. I echo the sentiments of Deputy Neville. I am cognisant of the phenomenal work that the more than 5,000 staff carry out day in, day out. I know everyone in the hospital wants to contribute to the welfare and well-being of all patients who walk through the door to ensure they receive an incredible service and the best care possible. That is something everyone in the Beaumont Hospital community can be proud of and it has a fantastic reputation. I acknowledge that because I think it is important.
That leads to me to point out why it is even more important for Beaumont to have both solid governance and solid systems in place, and not to trip itself up unnecessarily. We have seen it over the past year since this committee was formed. There are recurring themes and issues of non-compliant procurement, insurance claims or overspend on IT projects. I could list off the five things we talk about here every week, no matter who is in front of us. We come in and talk about them. I could go down through all of them, but I would rather go down through something that caught me off guard. In 2024, Beaumont Hospital Board paid €1.5 million to a company involved in providing radiology services. The hospital directly awarded contracts to this company without competitive procurement. Will anyone speak to why that did not go through a competitive procurement process?
Ms Anne Coyle:
It was because there was an understanding from 2019 that a derogation applied. The derogation was applied by the then executive team and that continued. The derogation was applied on patient need and location of the services. In 2024, there was again the view that contract was a derogation, and it was rolled over. That then became an issue-----
Albert Dolan (Galway East, Fianna Fail)
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Is that radiology service provided on the grounds of Beaumont?
Albert Dolan (Galway East, Fianna Fail)
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Does that company utilise Beaumont's equipment of did it provide its own equipment?
Albert Dolan (Galway East, Fianna Fail)
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Okay. Did they rent the space in the hospital from the board?
Albert Dolan (Galway East, Fianna Fail)
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Does Ms Noonan know the value of the lease?
Albert Dolan (Galway East, Fianna Fail)
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That is okay.
Albert Dolan (Galway East, Fianna Fail)
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That is €1,700 per year in rent for a medical facility.
That is very generous of the board. How many of the directors of this company that earned €1.5 million in 2024 are also employees at Beaumont?
Albert Dolan (Galway East, Fianna Fail)
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How many of the directors are employees at Beaumont? Is it all of them?
Mr. David Sweeney:
To give context, but answer the Deputy's question directly, Beaumont Private Clinic was established in 1991 under a lease agreement. It dates back to a healthcare system that was of its time in terms of how public–private healthcare was set up under the Health (Amendment) Act, etc. The restrictions around its practice are purely related to outpatients and radiology. The terms of the lease agreement from 1991 made provision for only Beaumont Hospital consultants to be undertaking their-----
Albert Dolan (Galway East, Fianna Fail)
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According to my notes, 20 staff members were directors to the supplier company. From the outside looking in, it looks like a very cosy relationship between the 20 directors and the board. My problem with that is that, while I accept the clinic was established in 1991 and the public-private model has changed since, this contract was renewed in 2024. For continuity of care, that would have had to happen, I understand. However, my big gripe is that the 20 members who are directors are also employees of Beaumont. This is like a little top-up for all of them. Why on earth could Beaumont not just run the radiology service itself as opposed to paying a company to do so, given that it is already paying 20 staff who are directors of the company? It is a joke. That is the sort of thing that is too close and too cosy. How is there independence between the contract signer and the employees? The witnesses should not tell me they do not know the directors because they all must know who they are.
Mr. David Sweeney:
Might I address a couple of points? Ms Noonan might assist in terms of why we have to outsource in that direction in the first instance.
First, there is a radiology practice within Beaumont Private Clinic. It is not that all the directors of that clinic benefit from any outsourcing arrangement. It is limited to a handful of radiology consultants. In terms of why we have not looked to be self-sufficient in our radiology services, Ms Noonan mentioned earlier, in response to another question, our productivity, our utilisation and the sweating of our assets. I might just ask her to give a sense of why.
Albert Dolan (Galway East, Fianna Fail)
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That is a joke. I refer to the sweating of our assets where there is a peppercorn rent of €1,700 a year. Renting at €1,700 a year to people the hospital knows means a close-knit relationship. Was there a valuation of what that rent should be?
Albert Dolan (Galway East, Fianna Fail)
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So the lease value has not been updated since 1991.
Albert Dolan (Galway East, Fianna Fail)
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Does Mr. Sweeney think it is time now for the board to review the rent?
Albert Dolan (Galway East, Fianna Fail)
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The first thing the hospital should do is review the rent. A sum of €1,700 a year from any medical facility a year is a joke. These people are ultimately profiting off services from the hospital's assets. If Beaumont wants to sweat its assets, it should absolutely go ahead and do it.
Albert Dolan (Galway East, Fianna Fail)
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Who owns it? Beaumont owns the land, but does the clinic own the building?
Albert Dolan (Galway East, Fianna Fail)
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So it is the clinic's equipment in its building. It owns the building and there is only a land lease.
Albert Dolan (Galway East, Fianna Fail)
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That is an important detail.
Whatever about the relationship that exists between Beaumont Hospital and the directors of this company, who are also staff of Beaumont, it is very important that there be transparency around it if what has been said is the case and close relationships exist. I am not trying to cast aspersions, but I am trying to say that if the people in question are going to be directors of the company, they might as well at least report that. How many of the 20 people who are directors registered their interests with the hospital?
Albert Dolan (Galway East, Fianna Fail)
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It is all fully up to date now as of 2025.
Albert Dolan (Galway East, Fianna Fail)
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The figures I have show that, in 2024, only 16 of the 20 had responded with their statements of interest. Therefore, four had not. Of the 16 who had, only four had listed the work they did in Beaumont Private Clinic. They had not listed their directorships of that. Are the witnesses telling me now that they have got the number up to 20 declarations of an interest in Beaumont Private Clinic?
Albert Dolan (Galway East, Fianna Fail)
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That is really welcome because it is a positive step forward for transparency. I genuinely do not understand, however, why the hospital cannot seek to deliver the service itself if the people are already working for it. Maybe I am missing something.
Ms Claire Noonan:
I suppose our ultimate aim is to ensure that all staff and all reporting are within our own facilities. We are really working towards that with extended days and weeks. That is the goal we hope to get to, but that will not be without resource investment. There are a number of different treatment modalities or diagnostic modalities. We are working closely with the region to run pilots to see if they demonstrate value for money, productivity and increased service. Then we do invest-to-save initiatives where we can demonstrate that. For example, we paid overtime to a number of staff to deliver the service over a period. They delivered what we expected within six months. We approach and work with our colleagues in the region through an invest-to-save initiative to determine whether we can increase our headcount because we have to work within our headcount limits. It is not a case that we can just increase our number of staff to be able to meet the need.
It is our ultimate goal because the level of service required in a hospital like Beaumont entails a service that is so specialist that it cannot just be outsourced to anybody. Often, it is just the scan that is outsourced. The reporting of the scan is actually done by our consultants on their public time in the hospital, because that specialism, particularly for our cancer patients and neuro patients, does not exist in many other providers. The scan might be what is outsourced, but it actually comes back to be reported in public time. Absolutely, we want to get to having our staff doing our scans on our scanners for our patients.
Albert Dolan (Galway East, Fianna Fail)
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It is €1,700 a month for the land.
Albert Dolan (Galway East, Fianna Fail)
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I appreciate that. That is clear. I thank Mr. Hanlon.
Paul McAuliffe (Dublin North-West, Fianna Fail)
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The only outstanding person in our first round is Deputy Byrne, so she will be the first speaker after the break. If other members intend to speak in the second round, they might indicate that over the course of the break and this will allow me to allocate the maximum time to people. We will take a short break for ten to 15 minutes. I ask members to be back here for 12.25 p.m.
Paul McAuliffe (Dublin North-West, Fianna Fail)
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We will head into our second round of questions. I will allocate ten minutes to each member. I will take the first of the second-round questions. I want to return to the issue of conflicts of interest. It was very interesting listening to the engagement with Deputy Dolan regarding Beaumont private hospital services. Is that the correct name of the company?
Paul McAuliffe (Dublin North-West, Fianna Fail)
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What is the name of it?
Paul McAuliffe (Dublin North-West, Fianna Fail)
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Previously it was referred to here as Beaumont Private Clinic.
Paul McAuliffe (Dublin North-West, Fianna Fail)
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Is that a colloquial name and the official name is-----
Paul McAuliffe (Dublin North-West, Fianna Fail)
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The witness might revert to us with the name of that.
Paul McAuliffe (Dublin North-West, Fianna Fail)
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I was just reflecting on the conversation with Deputy Dolan. The year 1991 is a very long time ago and the entire model of practice has certainly changed, but it does show the degree to which consultants within a hospital were working in a public system and also had an established interest in a private entity on the campus. There were financial arrangements in place whereby consultants could do both public and private work. In some ways, with the public-only contract, the State is seeking to emerge beyond that.
Even the arrangements of that lease, the building and everything being on the campus is worth reflecting on. I can understand the issue, reflecting on what Mr. Hanlon said earlier about the knowledge or awareness of people with regard to SIPO declarations - perhaps it was Mr. Sweeney who said it - in respect of whether they fully understood their obligations with regard to the declaration. Am I correct in saying all 20 are hospital consultants? Yes. I find it incredibly difficult to understand how those particular consultants completing a conflict of interest form - I have not seen the wording and I would be obliged if the witnesses could provide the committee with the wording of the form - and would not reveal a directorship of a company related to the employment they have or which may have resulted in a conflict of interest, given the company operated on the grounds of the hospital. In many ways, the witnesses are here answering for their failures, but they are also employees of the hospital. I find it very difficult, even after the hearing we have had, to understand how people could complete that form and not declare those interests. I do not know if Mr. Sweeney has a comment on that.
Mr. Seamus McCarthy:
I have some wording here from a standard form which states that in relation to each of the following disclosable interests, that they should state any interest held to their actual director, be it personal knowledge by them or a connected person, which could materially influence them in or in relation to the performance of the functions of their office.
That is a cover-all.
Paul McAuliffe (Dublin North-West, Fianna Fail)
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Deputy Dolan used the word "closeness", but given the proximity in the operation of the two companies, at the very least, I cannot see how anybody filling out that form could have avoided declaring that dictatorship or why they would have avoided declaring it. Surely, out of an abundance of caution, it would have been far better for them to have done so.
Paul McAuliffe (Dublin North-West, Fianna Fail)
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Does it speak to a failure of those consultants to understand there is a conflict of interest?
Mr. David Sweeney:
We feel that is the case. When we were looking at reinforcing messaging around conflict of interest, what constitutes a conflict of interest and the different guises that may present under that, we would have originally had about 70% compliance on an aggregate level, dating back a number of years, around conflicts of interest. We have promoted and developed a wider conflict of interest policy and we have brought it through our executive management team. It has gone to the board and has cascaded out to the hospitals as a general policy. We are factoring it into our induction programmes and learning material.
Certainly, there was maybe an underestimation of the potential for a conflict of interest. I imagine those who did not declare an interest most likely did so on the basis that they did not see that any of their activities were----
Paul McAuliffe (Dublin North-West, Fianna Fail)
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That also strikes to culture and to-----
Ms Anne Coyle:
If I may interject, our meetings now start with asking people to declare any conflicts of interest, as do our board meeting. The Leas-Chathaoirleach is right that it speaks to that culture piece. It is about building conflicts of interest into the day-to-day working of the hospital. That is where we are now. It is becoming more familiar.
Paul McAuliffe (Dublin North-West, Fianna Fail)
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May I ask a question? Are any of the 20 members who are directors of that other company, which the witnesses will name, on the board of the hospital? None of the 20 consultants were in any way members of the board or have ever been members of the board of the hospital.
Paul McAuliffe (Dublin North-West, Fianna Fail)
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I am aware of that. The question is are they or were they ever members. If the witnesses do not have the information, they can-----
Paul McAuliffe (Dublin North-West, Fianna Fail)
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None of the 20 were ever members of the board of Beaumont Hospital.
Paul McAuliffe (Dublin North-West, Fianna Fail)
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Okay, I want to move on. When we talk about the procurement process that had the derogation, what led Beaumont Hospital to believe the derogation existed?
Paul McAuliffe (Dublin North-West, Fianna Fail)
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Why did the witnesses believe the derogation existed?
Paul McAuliffe (Dublin North-West, Fianna Fail)
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You are not citing the reasons for the derogation. What were the witnesses' reasons for the derogation?
Mr. Francis Hanlon:
The reason was it enabled same-day scans for oncology patients. This particular company had beam technology, which I do not personally understand but Ms Noonan can speak to it, and the diagnostic medical services are governed by EU Directive 2014/24. These types of services are not subject to the full regulations of procurement.
Paul McAuliffe (Dublin North-West, Fianna Fail)
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The main reason I pull from that is the same-day services.
Paul McAuliffe (Dublin North-West, Fianna Fail)
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In other words, they are on the campus and therefore, they can have the same-day service. Does that not mean almost nobody else could provide the service, if the witnesses were to take that approach?
Paul McAuliffe (Dublin North-West, Fianna Fail)
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I am not talking about the service delivery; I am talking about the contract. If one of the reasons why the witness is citing a derogation is that they are able to access same-day services, in that case, the board itself had helped establish the relationship with the on-campus presence. I am just saying it is effectively a closed loop. The board established the private presence on the campus and it carried out a procurement. It believed there was a derogation as a result of the company being on the campus, and that was one of the arguments for the derogation the witnesses just put forward. As a result, there was no procurement process. In effect, a closed loop was established.
Paul McAuliffe (Dublin North-West, Fianna Fail)
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But it was the only one Mr. Hanlon cited in terms of the reason derogation was applied.
Paul McAuliffe (Dublin North-West, Fianna Fail)
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With respect, that is related to the contract. I am talking about the derogation.
Paul McAuliffe (Dublin North-West, Fianna Fail)
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Is Mr. Hanlon saying there were no other providers that could have done that?
Paul McAuliffe (Dublin North-West, Fianna Fail)
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How was that established?
Paul McAuliffe (Dublin North-West, Fianna Fail)
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That is my point. The nature of their being onsite effectively hamstrung the hospital in the procurement process.
Paul McAuliffe (Dublin North-West, Fianna Fail)
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The point I am making is the witnesses applied the derogation because they believed this was the only way a same-day service could be provided. However, the only reason that exists is because the board itself created that scenario.
Paul McAuliffe (Dublin North-West, Fianna Fail)
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The witnesses can speak to the derogation, however. Does Ms Coyle accept it was incorrect to apply the derogation in the way it was?
Ms Anne Coyle:
The derogation at the time in 2019 would have been created, as we understand it, from the capacity and demand on the radiology and diagnostic services at the time. It was to ensure that timeliness of access.
As we look back on that, we understand there were other providers and other work was also outsourced to other providers. Again, this is us looking back on what our previous board and colleagues-----
Paul McAuliffe (Dublin North-West, Fianna Fail)
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But we are not talking about 1991, we are only talking about 2019 and then again in 2024.
While the chief executive has made an apology to the committee, it was incorrect for the hospital to apply the derogation in the way that it did.
Ms Anne Coyle:
On the derogation at the time, it is something, I suppose, that going forward we have corrected it. We have looked to address it. In 2024, when it came to light the conflict of interest was not in place. For the reasons that the Leas-Chathaoirleach has outlined, we took it through the procurement process.
In terms of value for money, we understand that the services that were provided by the-----
Paul McAuliffe (Dublin North-West, Fianna Fail)
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My point was specifically on the derogation rather than the broader contract and I wanted to stick to that. I am over my time and I will allow my colleagues to continue that questioning and Ms Coyle has an opportunity to come again.
James Geoghegan (Dublin Bay South, Fine Gael)
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I thank the Vice Chair and I will continue with this line of questioning because it is frustrating for us all. I could ask for a show of hands as to who thinks the derogation was correctly applied in accordance with public procurement law. Does anybody want to lift their hand and say that in 2019 that it was correctly applied, that is, the justification given for the derogation? Does anybody here think that was justified? I do not see a big clamour.
James Geoghegan (Dublin Bay South, Fine Gael)
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I do not think it is that difficult. Either the law is the law as it relates to public procurement or is not. Either the derogation complied with public procurement or it did not. The derogation is either justified or it is not. Where is the grey area, Mr. Sweeney, if there is one?
James Geoghegan (Dublin Bay South, Fine Gael)
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I have no difficulty examining the circumstances in which a board or a hospital took a decision to exercise a derogation that subsequently turned out to be wrong or incorrect. My problem is that the witnesses are here trying to tell us that everything has changed and saying they unreservedly apologise for certain things but they are not apologising for this thing. Then they wants us to accept that governance changes have actually happened. Does the CEO see the difficulty there?
James Geoghegan (Dublin Bay South, Fine Gael)
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Am I correct in saying, and this speculation on my part, that this has been examined at length by yourselves and the board? The CEO has probably obtained some kind of advice and has not been given an instruction that she can say that it was wrong. Am I correct?
James Geoghegan (Dublin Bay South, Fine Gael)
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Why can the CEO not do so now? Ms Coyle, as the CEO of the hospital, knows every detail of this derogation. It has been examined at length by the CEO, the board and everyone. You do not need to go back and examine it. Why can Ms Coyle not now say that, as the CEO, she accepts that the derogation was incorrectly applied? It should not have been the case that €6.2 million of, essentially, public money went to a company without any public procurement. Why can the CEO not just say that?
James Geoghegan (Dublin Bay South, Fine Gael)
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What does the CEO mean that is a deficit in her understanding of public procurement? That does not give us a lot of confidence into the future in relation to public procurement if the CEO cannot say whether or not it was justified. The CEO has had months to prepare for this hearing in terms of what the unreserved apology was about but a decision was made not to apologise for this public procurement failing that I think is as obvious to anybody sitting across from me. The derogation cannot be justified. Ms Coyle knows that, does she not?
Ms Anne Coyle:
The points made in today's committee are appropriate. I suppose our focus had been on going forward but I take the points made and include that in my unreserved apology for the derogation in 2019 and the ongoing derogation in 2024. Our focus had been and has been on addressing it, addressing the conflicts of interest, getting it back out to the procurement and making sure that it was properly compliant. The challenge always is balancing the past with the present and the future. I include that in my unreserved apology.
James Geoghegan (Dublin Bay South, Fine Gael)
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Does the unreserved apology include the IT project that was not properly publicly procured?
James Geoghegan (Dublin Bay South, Fine Gael)
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One of the points that the witnesses from St. James's Hospital made to us, which had similar issues, was that having learned of this - in terms of its conflict of interest procedure - it they now have a live and ongoing process. A public procurement manager will know exactly what is happening. It is not a case of waiting until the end of the year. There is a live fluency. What has Beaumont Hospital done in respect of that?
Mr. David Sweeney:
I made reference to it there. In terms of what we have applied is that we have shared that information with key decision points around the hospital and, most prominently, procurement. We have shared it with the board. We have it stitched into our structures in terms of our own structures and meetings, and that extends from cost issues down to recruitment.
James Geoghegan (Dublin Bay South, Fine Gael)
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When public procurement is taking place, what I understood what St. James Hospital had done was that the obligation arises there and then, not just at the end of the calendar year. Is that the situation in Beaumont Hospital?
James Geoghegan (Dublin Bay South, Fine Gael)
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I can see Ms Noonan nodding.
Ms Claire Noonan:
A lot of that would sit with me or my team, either through the business managers or the operations team. We have a very clear protocol where conflicts of interest are declared at the point of procurement, through the procurement team, to begin with. We look at every service where we are seen to have a conflict of interest. There is an algorithm that people work through and we need to balance the risk with that conflict to see if that will impact us in the future. At every point of service procurement now we are looking to see if there an issue.
James Geoghegan (Dublin Bay South, Fine Gael)
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This company was procured for 2026 and I cannot recall the duration of the contract.
James Geoghegan (Dublin Bay South, Fine Gael)
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What is the practical impact? In this circumstance, conflicts were properly disclosed.
James Geoghegan (Dublin Bay South, Fine Gael)
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They have gone through the public procurement process. Where did the two things relate? What practically happened here? The conflict was looked at and did the hospital conduct an assessment? Talk me through the procedure and how it relates to board level decisions.
Ms Claire Noonan:
They are procured as part of a multi-party framework. They are one provider on the framework. One of the most important things to understand what drives where we use a service is in terms of what they can deliver to us as opposed to who is working in that company, and whether they have a turnaround time for a specific service be it ultrasound or a CT.
James Geoghegan (Dublin Bay South, Fine Gael)
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I fully accept that. I am curious about the conflict of interest declaration piece, the component. They have done the declaration. Is it just that they have done it, a box is ticked and it goes into another box? When does the hospital assess whether there is a conflict of interest and that is or is not relevant to the public procurement for the following reasons? I assume it is relevant.
Ms Claire Noonan:
With this example we did identify that there was a potential conflict of interest. Audits are put in place, for example within the radiology department, where we are able to see time stamps of reporting where we can demonstrate that private work that is done by any of our employees is done outside of their work practice plan. That is an example of where an audit is put in place where we have identified a potential conflict of interest.
James Geoghegan (Dublin Bay South, Fine Gael)
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Ms Coyle said that there was no public-only contract employees doing private work on the hospital's grounds.
James Geoghegan (Dublin Bay South, Fine Gael)
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Did Ms Coyle include the private building in that? Are any of the 20 directors on the public-only contract, of this company?
James Geoghegan (Dublin Bay South, Fine Gael)
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They are.
James Geoghegan (Dublin Bay South, Fine Gael)
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Mr. Sweeney mentioned it was just a couple of radiologists. I do not want to paraphrase him but he said it was just the radiology consultants-----
James Geoghegan (Dublin Bay South, Fine Gael)
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-----that benefited. In numerical terms, how many of the 20 are those people?
James Geoghegan (Dublin Bay South, Fine Gael)
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No, that is fine. Roughly, it is four. Is Mr. Sweeney's point that the income that is generated to the company actually goes to these four people and not the other 16 people?
James Geoghegan (Dublin Bay South, Fine Gael)
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That is Mr. Sweeney's understanding of it. Are those four people on the public-only contract?
James Geoghegan (Dublin Bay South, Fine Gael)
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Sorry, I am asking the question.
James Geoghegan (Dublin Bay South, Fine Gael)
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Why can Mr. Sweeney not tell me?
James Geoghegan (Dublin Bay South, Fine Gael)
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He can endeavour to get that information.
James Geoghegan (Dublin Bay South, Fine Gael)
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That all of them are on the public-only contract.
James Geoghegan (Dublin Bay South, Fine Gael)
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That all four of them are on the public-only contract.
James Geoghegan (Dublin Bay South, Fine Gael)
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They are doing this work outside of their 37 hours on the public-only contract.
Ms Claire Noonan:
If I could just clarify, it might just be the scan that is done. The reporting is done by a consultant. We do not necessarily always procure the reporting. We are procuring the physical scan. The reporting is done by public consultants on public-only time. If we send 200 scans to that clinic, it might be for the physical scan done by a radiographer. I understand that the radiologists are the directors of the company but the work that they do then might be different.
James Geoghegan (Dublin Bay South, Fine Gael)
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I do not know what the euro value will be for this four-year contract to this company. We know that this company earns €6.2 million and we know from Mr. Sweeney that there are about four radiologist consultants who, according to him, are earning all of this income. We are trying to achieve public-only contracts and to maximise them. I fully understand that the public-only contract specifies that in excess of 37 hours one is entitled to do private work. We do not know how many hours private work they are doing. Clearly, the services that the hospital is procuring are for the public hospital. It is doing private work for public patients for the public hospital through the private building that is adjacent to the public hospital.
James Geoghegan (Dublin Bay South, Fine Gael)
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Before the final decision is made whoever the panel of evaluators are look at it.
James Geoghegan (Dublin Bay South, Fine Gael)
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I will conclude. Ms Noonan gave some words of encouragement about alternative ways to deliver what this company is providing. However, it is going to be doing this for the next four years.
James Geoghegan (Dublin Bay South, Fine Gael)
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Ultimately, the hospital wants to move away from all of that.
James Geoghegan (Dublin Bay South, Fine Gael)
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I see Mr. Kidd of the HSE. How do we get there? The witnesses understand this. This is their world. But for the public watching this, they find it unbelievably confusing that public money is going to this public hospital, it is going to private companies and public-only contracts are doing their public patients in their private clinic. Why can we not solve this issue?
Mr. Robert Kidd:
I will come to the solving piece in a second. As was referenced earlier, part of this is that there was a legacy piece related to co-location, which was a policy position many years ago, as the Deputy knows, in our public system.
In terms of solving it, the Deputy will have heard the guys earlier, the demand at the moment is outstripping the capacity we have on site in the public system. Another CT scanner has been commissioned in the emergency department in Beaumont Hospital. That is in place so it will increase diagnostic access. Alongside that, there are additional radiographers, radiologists, consultants and other support staff. That is part of it.
Second – the Deputy will have heard the guys – how do we sweat our assets? We are using our existing equipment rather than investing in more - to the extent that we can. Part of that is the public-only consultant contract and the extended hours for other staff.
Third, our planning is looking at developing St. Joseph's into the future into a diagnostic hub, but it is a bit down the road. It would look to serve both the community and the hospital. Again, they are future plans that are a bit away but that would be us looking at maintaining services within the public system rather than relying on some element of the private system.
James Geoghegan (Dublin Bay South, Fine Gael)
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I thank the witnesses.
Cathy Bennett (Cavan-Monaghan, Sinn Fein)
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I would like to tidy up a few issues I raised previously. Is the land for the car park owned by Beaumont Hospital?
Cathy Bennett (Cavan-Monaghan, Sinn Fein)
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The land the car park is on.
Cathy Bennett (Cavan-Monaghan, Sinn Fein)
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Yes.
Cathy Bennett (Cavan-Monaghan, Sinn Fein)
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Does Beaumont lease that out to a car parking company?
Cathy Bennett (Cavan-Monaghan, Sinn Fein)
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Is there no leasing company there?
Cathy Bennett (Cavan-Monaghan, Sinn Fein)
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How much does Beaumont have the pay the company every year?
Cathy Bennett (Cavan-Monaghan, Sinn Fein)
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How much is that?
Cathy Bennett (Cavan-Monaghan, Sinn Fein)
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Is that the income Beaumont received from them?
Cathy Bennett (Cavan-Monaghan, Sinn Fein)
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Is the car parking company completely private with none of its staff working for Beaumont Hospital?
Cathy Bennett (Cavan-Monaghan, Sinn Fein)
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It was fully tendered out. That is okay.
I want to ask about income from charges to patients for treatment of €24.5 million. What are they charged for?
Cathy Bennett (Cavan-Monaghan, Sinn Fein)
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Private.
Cathy Bennett (Cavan-Monaghan, Sinn Fein)
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Is Beaumont not a public hospital?
Cathy Bennett (Cavan-Monaghan, Sinn Fein)
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What is that for?
Cathy Bennett (Cavan-Monaghan, Sinn Fein)
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If somebody is sick or waiting for an operation would the hospital say if the patient pays €1,000 they can get the operation done?
Cathy Bennett (Cavan-Monaghan, Sinn Fein)
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Could Mr. Hanlon tell me how it works?
Cathy Bennett (Cavan-Monaghan, Sinn Fein)
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If a patient comes to Beaumont to have a procedure done, how does the hospital decide if they are to get it done publicly or privately?
Cathy Bennett (Cavan-Monaghan, Sinn Fein)
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I have heard of so many cases where somebody is waiting on a public list but if they go private they can get it just like that. There is no point in the witnesses shaking their heads. I have heard it. I have seen it myself.
Cathy Bennett (Cavan-Monaghan, Sinn Fein)
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When I saw Mr. Sweeney shaking his head I was thinking, no this is happening. It is the real world.
Cathy Bennett (Cavan-Monaghan, Sinn Fein)
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But if they pay the money, they will get the appointment faster.
Cathy Bennett (Cavan-Monaghan, Sinn Fein)
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Yes.
Cathy Bennett (Cavan-Monaghan, Sinn Fein)
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Not in Beaumont.
Cathy Bennett (Cavan-Monaghan, Sinn Fein)
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Okay. I will get some evidence of that then. Mr. Sweeney says it does not happen in Beaumont.
I want to ask about the private radiology company on Beaumont's grounds. Are there any other companies working privately on the grounds of Beaumont Hospital?
Cathy Bennett (Cavan-Monaghan, Sinn Fein)
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Are they in lease agreements with the hospital or how are they getting the buildings?
Cathy Bennett (Cavan-Monaghan, Sinn Fein)
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How much does it pay for rent or lease?
Cathy Bennett (Cavan-Monaghan, Sinn Fein)
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Does it lease buildings on the actual grounds?
Cathy Bennett (Cavan-Monaghan, Sinn Fein)
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Are the buildings owned by Beaumont?
Cathy Bennett (Cavan-Monaghan, Sinn Fein)
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Is the radiology building the only one that was built privately? Are the other buildings all owned by Beaumont?
Mr. David Sweeney:
The Irish Kidney Association support centre is accommodation for patients when they are undergoing transplants in the hospital, and their families. It is a non-profit organisation that complements our national kidney renal transplant programme. It is an arrangement that goes back to a time immediately post the opening of the hospital. That is one.
From an RCSI perspective, as an academic teaching hospital we need linkages from a training perspective to train nurses, doctors and other healthcare professionals.
Cathy Bennett (Cavan-Monaghan, Sinn Fein)
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Are staff from Beaumont working in the RCSI training facility?
Cathy Bennett (Cavan-Monaghan, Sinn Fein)
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Who pays for their time in the RCSI? Is that through the salaries section in Beaumont Hospital?
Cathy Bennett (Cavan-Monaghan, Sinn Fein)
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Again, it is-----
Cathy Bennett (Cavan-Monaghan, Sinn Fein)
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Again, we are not getting our consultants. This is the issue. We are not getting value for money from our consultants in the public system. We are not getting those 35 hours in our hospital clinics. Clinicians are not doing the 35 hours. They are out working in the RCSI, the radiology department or other private practices. I am trying to find out who is working and how many staff members who are working in the RCSI building are supposed to be working on the 35-hour public-only contract. We again come back to the public-only contract.
Mr. David Sweeney:
I will need to come back to the Deputy with details of the numbers. As a teaching hospital, in terms of training, we must have that association and affiliation with, and accreditation from, a training body. Our consultants are not working for the RCSI. They are working on developing and training doctors, nurses and all other health and social care professionals.
Cathy Bennett (Cavan-Monaghan, Sinn Fein)
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They are not working in the medical field if they are in the RCSI.
Cathy Bennett (Cavan-Monaghan, Sinn Fein)
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Is there provision in the public-only contract whereby the consultants would go outside and work in the RCSI? Would they go over and work in the RCSI building?
Cathy Bennett (Cavan-Monaghan, Sinn Fein)
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What is the commitment? How many hours is that?
Mr. Robert Kidd:
It depends. Every individual application for a consultant goes through a consultant appointments committee centrally within the HSE. It would differ. In some instances, as Mr. Sweeney has described, there are shared professorial posts, for example, but that too goes directly to a central consultant appointments committee. The consultants' commitment to the RCSI versus their on-site commitment in the public system and ability to see patients is very clear at the start. That is around the development of our medical workforce.
Cathy Bennett (Cavan-Monaghan, Sinn Fein)
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I know it is about the development of our work force, but as Ms Coyle said earlier, we are back to the lack of capacity. We do not have consultant capacity in our hospitals. That is why people have to go and pay privately. They do not have radiology. What was said earlier? It is on patient-based needs. That is why we are having to go private. Why are we not staying within the public system? Everything is going out, and people have to pay. People had to pay €24.5 million for private appointments. That is a huge amount of money. People pay their taxes and still had to pay €24.5 million in 2024. I would like to see the figures for the past five years. How much have people paid to get an appointment in Beaumont Hospital?
How many patients per day or per year did Ms Noonan refer to earlier? She mentioned a large figure.
Cathy Bennett (Cavan-Monaghan, Sinn Fein)
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Yes.
Ms Claire Noonan:
We have seen an additional 70,000. We see up to 200,000 patients. To put it into context, 56,000 patients had new consultant appointments last year alone. We had 113,000 referrals. What is most important for us is that we have demonstrated that it is not that there is idle capacity. We have 87%, which is 2% above the benchmark, for our utilisation. We appreciate that all of our consultants have other commitments and that they have private practice outside their contracted hours. From an academic point of view, we have seen significant growth in productivity for patients. I appreciate that it is not meeting the demand-----
Cathy Bennett (Cavan-Monaghan, Sinn Fein)
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It is not.
Cathy Bennett (Cavan-Monaghan, Sinn Fein)
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Most people are waiting for appointments for one or two years in the public system. Patients must go private and pay for it because they cannot get into the public system. Imagine a doctor saying to you that it will be two years before you can have an appointment. The system has completely crashed. It is not working.
Cathy Bennett (Cavan-Monaghan, Sinn Fein)
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What are statutory charges?
Cathy Bennett (Cavan-Monaghan, Sinn Fein)
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What are the charges?
Cathy Bennett (Cavan-Monaghan, Sinn Fein)
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This is patient income. Charges for treatment were €24.5 million. The other income, as far as I can see, for outpatients is not included. It is separate. The €24.5 million is for the patient income contracts. That €24.5 million in 2024 was actually for treatment.
Cathy Bennett (Cavan-Monaghan, Sinn Fein)
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That is what I am saying. Beaumont Hospital is charging €24.5 million for private treatment.
Cathy Bennett (Cavan-Monaghan, Sinn Fein)
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That is what I am saying. A person is not availing of the public health system because it is broken. The public health system is broken and this additional fee is being charged.
Paul McAuliffe (Dublin North-West, Fianna Fail)
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There are a couple of points of clarification. I have one issue and Deputy Geoghegan has a small one. Mr. Hanlon mentioned a figure of €776,000 as an annual licence fee for the payroll system. Am I right in saying that?
Paul McAuliffe (Dublin North-West, Fianna Fail)
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What was the figure for the total payroll?
Paul McAuliffe (Dublin North-West, Fianna Fail)
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Mr. Hanlon is content that the figure is within the normal parameters of a percentage of the total cost of processing the payroll? It should probably be-----
Paul McAuliffe (Dublin North-West, Fianna Fail)
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-----1% of the payroll itself.
Paul McAuliffe (Dublin North-West, Fianna Fail)
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Is Mr. Hanlon confident that the €762,000 figure, along with the other costs for payroll, is within the normal realm?
Paul McAuliffe (Dublin North-West, Fianna Fail)
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My second question is for Mr. Kidd. This is not just Beaumont Hospital. There has been a litany of hospitals where because of a failure of consultants to act, the hospitals have lost income from private insurers. My assessment is that the consultant has more money than they need to worry about and does not need to fill out the forms. If they needed the money, they would make sure to fill out the forms. If the consultant does not need to fill out the forms, they will lose out but the hospital will lose out, too. From a HSE perspective, across a number of hospitals, we have seen some improvement but hospitals are losing millions of euro that they should otherwise be due.
Mr. Robert Kidd:
I accept that. Beaumont Hospital obviously falls within my area, so I will speak to it. I will certainly come back to the Leas-Chathaoirleach on the details across the board. Mr. Hanlon will speak to the detail, but from a Beaumont Hospital perspective, we have seen a specific focus, not just in the hospital but across our region, in that area. Beaumont Hospital is seeing fully completed claims going to the insurers. The number of outstanding claims has reduced to approximately €1.4 million, if I am not mistaken, and the number of days that they are outstanding has reduced. It is not down to any lack of effort or incomplete forms on the side of the public system. As the Leas-Chathaoirleach would imagine, insurers come back with queries post submission.
Paul McAuliffe (Dublin North-West, Fianna Fail)
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Is it true that when a claim is not processed as a result of the paperwork not being signed off, both the consultant and hospital lose the income? Is that correct?
Paul McAuliffe (Dublin North-West, Fianna Fail)
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Therefore, there is no incentive for the consultant to complete the paperwork. There is no financial penalty if they do not.
Mr. Francis Hanlon:
Mr. Sweeney can speak to the particular penalty if claims are not submitted in time. To clarify, we regularly engage with consultants through our clinical oversight performance directorate meetings or email those consultants directly to tell them they are approaching a deadline and need to submit their claims with their clinical information. It is complex information that the consultant has to submit, so it does take time.
Paul McAuliffe (Dublin North-West, Fianna Fail)
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That has not been the evidence of other hospitals. The representatives of other hospitals have said that this is often a matter of a signature. It is a wider issue, but it is interesting to hear the perspective from various hospitals.
Paul McAuliffe (Dublin North-West, Fianna Fail)
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Of course, yes.
Mr. Francis Hanlon:
There are a number of issues as to why private health insurance would not pay out. I will list two or three. The patient may have a pre-existing condition. In such a circumstance, the insurer will not pay out.
If the patient has a new insurance provider and has not completed their waiting period, the insurer will not pay out. If there is incomplete or insufficient clinical data, according to the insurance company, it will not pay out. It is not just an administration problem. There is a-----
Paul McAuliffe (Dublin North-West, Fianna Fail)
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The training company said the hospital should not have provided additional information. I am now going to ask Mr. Hanlon if he could give me a breakdown of the claims that were denied based on that.
Paul McAuliffe (Dublin North-West, Fianna Fail)
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It would be great if he could give that to me.
James Geoghegan (Dublin Bay South, Fine Gael)
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He has it.
Paul McAuliffe (Dublin North-West, Fianna Fail)
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Excellent. He has it here, brilliant.
Paul McAuliffe (Dublin North-West, Fianna Fail)
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It would be useful as part of our overall work in this area.
Mr. Francis Hanlon:
I do have it; I apologise. A figure of €1.5 million was rejected by insurance companies for the full year 2025: €390,000 was rejected due to cover issues; €487,000 was rejected due to treatment issues; and €603,000 was related to either contract issues or a memorandum of understanding, which we had with one particular insurance company. It is a broad spectrum as to why they may reject it, but we employ a company to try to address those rejected claims.
Paul McAuliffe (Dublin North-West, Fianna Fail)
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Which of those categories would be administration or where the paperwork element would be?
James Geoghegan (Dublin Bay South, Fine Gael)
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They are different figures.
Paul McAuliffe (Dublin North-West, Fianna Fail)
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They are different figures, yes.
James Geoghegan (Dublin Bay South, Fine Gael)
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I take the point - I am sorry to interrupt, Chair-----
Paul McAuliffe (Dublin North-West, Fianna Fail)
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I will move on to Deputy Geoghegan anyway.
James Geoghegan (Dublin Bay South, Fine Gael)
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-----but I think Mr. Hanlon is conflating two issues. There is going to be one figure for the forms that have not been submitted that should have been submitted within the deadline. Does Mr. Hanlon know what that figure is for his hospital?
James Geoghegan (Dublin Bay South, Fine Gael)
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Does Mr. Hanlon have the figure for the forms? We have had this with all the hospitals. If a consultant has not signed the paperwork and it has not been administered, does Mr. Hanlon have the figure relating to that specific issue?
James Geoghegan (Dublin Bay South, Fine Gael)
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The unsubmitted claims.
Paul McAuliffe (Dublin North-West, Fianna Fail)
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Am I correct in saying that none of the reasons Mr. Hanlon referenced, such as cover and so on, are the grounds for waiting to do that.
James Geoghegan (Dublin Bay South, Fine Gael)
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No, it has nothing to do with that.
Paul McAuliffe (Dublin North-West, Fianna Fail)
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It is nothing to do, in fact-----
James Geoghegan (Dublin Bay South, Fine Gael)
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They are two very seperate issues.
Paul McAuliffe (Dublin North-West, Fianna Fail)
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To go back to my original point, with Deputy Geoghegan's assistance, the amount outstanding was as a result of internal paperwork issues regarding consultants, not because of any other issues.
Paul McAuliffe (Dublin North-West, Fianna Fail)
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I accept that, but it is €2 million-----
Paul McAuliffe (Dublin North-West, Fianna Fail)
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That €2 million would pay for the hospital's payroll licence for two years in a row.
Paul McAuliffe (Dublin North-West, Fianna Fail)
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Nearly three years in a row.
Paul McAuliffe (Dublin North-West, Fianna Fail)
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It is not unique to Beaumont Hospital but it is a phenomenal amount of money.
James Geoghegan (Dublin Bay South, Fine Gael)
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There should be zero tolerance for it, particularly if consultants are getting paid. It is absolutely ridiculous that their failure to fill out a form they are benefiting from damages the hospital and they face no consequence.
Paul McAuliffe (Dublin North-West, Fianna Fail)
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There are no consequences on the declaration of interest either.
Mr. Robert Kidd:
It is worth saying that the HSE board has taken a zero-tolerance approach to this and has issued very clear instruction on it. Second, the Department of Health and the HSE have issued guidance in terms of the public only consultant contract, POCC. We spoke about people's rights in terms of deciding to waive their rights under the Health Act. In the midst of toing and froing around this, they have issued clear guidance as to whether patients can elect to be private or not. Again, that is with a view to unloading that issue or problem occurring in the first place.
James Geoghegan (Dublin Bay South, Fine Gael)
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I do not have the figures in front of me but a lot of HSE-run hospitals are the exact same.
James Geoghegan (Dublin Bay South, Fine Gael)
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I mean no disrespect-----
James Geoghegan (Dublin Bay South, Fine Gael)
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-----but I do not think the hospital is showing itself with glory either. The HSE-run hospitals on this issue are very similar to the voluntary run hospitals.
I would like one point of clarification, which I do not think was asked. Are there any other circumstances where a company that has been established by employees of the company has received moneys from the hospital over the last five years without public procurement?
James Geoghegan (Dublin Bay South, Fine Gael)
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I thank the witnesses.
Cathy Bennett (Cavan-Monaghan, Sinn Fein)
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Somebody mentioned a memorandum of understanding with the insurance company. Why would the hospital have a memorandum of understanding with an insurance company?
Cathy Bennett (Cavan-Monaghan, Sinn Fein)
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Which company is it?
Cathy Bennett (Cavan-Monaghan, Sinn Fein)
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It suits Vhi to have a memorandum of understanding with the hospital. It suits Beaumont Hospital, actually, to get paid through the insurance company so it does not have to make things more private than public.
Cathy Bennett (Cavan-Monaghan, Sinn Fein)
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I have to leave for a vote in the Dáil Chamber. Perhaps the witnesses could send me a report on why the hospital has a memorandum of understanding.
Paul McAuliffe (Dublin North-West, Fianna Fail)
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That concludes our engagement. I thank all the witnesses for being here today. I know that attendance at the Committee of Public Accounts is not a usual part of their day. Members wish to explore all the issues. There are a lot of positives in what the hospital does, particularly the staff of the hospital. Today, we wanted to focus on the issues the Comptroller and Auditor General has brought to us. Ms Coyle is indicating to come in.
Paul McAuliffe (Dublin North-West, Fianna Fail)
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Of course.
Ms Anne Coyle:
I will just make a very minor point of clarification. The point was made that we doubled our income as a result of car parking. We have the lowest public car parking charges. It is €9 maximum per day. The increase in the income has come through the changes to staff paying for use of the car parking. It is just to be clear that it is not because we have increased the car parking prices.
Paul McAuliffe (Dublin North-West, Fianna Fail)
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That is a useful clarification. I thank the members and witnesses for being here today. I also thank the officials from the Health Service Executive and the Comptroller and Auditor General. It is agreed that the clerk will seek follow-up information and carry out the agreed actions arising from the meeting.
The committee will next meet on Thursday, 2 July 2026 with officials from the National Asset Management Agency.