Jennifer Carroll MacNeill (Dún Laoghaire, Fine Gael)

I thank both Deputies for their very clear political direction and statement of intent on this issue, which align with mine and with the broader public interest in the supervision of public funds.

From the perspective of the patient, I honestly believe the patient does not know whether he or she is attending a voluntary hospital or HSE hospital. If you are attending hospital due to a trauma or in a vulnerable situation, you honestly do not care whether the structure of the hospital to which you are presenting in need is a voluntary one or otherwise. Patients particularly do not care when they know that, as taxpayers, they are funding all of the hospitals. Indeed we are essentially funding all of the hospitals between 95% and 100%. There is simply no question that they are publicly funded and the staff are public servants. The background to voluntary hospitals is that they come from the days before when health services were in large part provided by religious orders and that is as may be. Many of them are providing a simply exceptional service with extraordinary clinical outcomes and research but they are nevertheless entirely funded by the public system and must adopt those structures.

I set out some measure of reserve, as it were, to bring Seanad amendments because I am very conscious that there has been sustained engagement for a number of years on this and it has not happened. There has been sustained political direction and engagement from me and from the Minister for public expenditure in this part of the year and the service level agreement going into 2026 will be exceptionally clear as to the need to do this. However, I reserve some position because what I would like to see from the voluntary hospitals is communication to me about their timeline for this. It is incumbent on me to provide to the health committee or the public accounts committee a list of the voluntary hospitals, the budget each of them received in 2024 and 2025 and the number of public servants that are working there. I believe it is appropriate for me to be able to provide the Deputies with a timeline as to the implementation, hospital by hospital, of IFMS. I am not in receipt of information that enables me to do that at present. Were I to receive that sort of enthusiastic engagement from the voluntary hospitals within the next number of weeks, it would ease my path to providing that sort of accountability both to the Comptroller and Auditor General and to your good selves as the lead members of the health committee.

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