Seán Fleming (Laois-Offaly, Fianna Fail)
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I thank the Ceann Comhairle for giving me the opportunity to raise the issue of salary top-ups to senior staff in various areas of the health service. I am very pleased the Minister for Health, Deputy James Reilly, is present to respond. He will know that the public was shocked by the coverage in recent days of the secret top-up payments to staff in very well paid jobs in some major hospitals. Recent newspaper reports, probably based on the internal audit report produced for the HSE on this exact topic, which was finalised on 15 March 2013, list hospitals such as Holles Street, the Rotunda, the Coombe, Crumlin and the Mater in respect of top-ups for individual members of staff in addition to their basic salaries, which are already paid for and financed by the taxpayer. There was a top-up in the order of €45,000 in one case, €20,000 in another, €53,000 in another, €30,000 in another and €26,000 in yet another. I will not mention any individuals as I am not in the business of carrying out a witch-hunt of individuals. The issues have been well publicised and the people are shocked that staff on salaries in the order of €200,000 are receiving these types of top-ups. All the hospitals in question are substantially funded by the taxpayer. Some extra funds from fund-raising and other sources are received by them. Income from initiatives such as car parks and shops may have been used to pay some of the allowances. It is disconcerting to know that some people who have been involved in fund-raising activities on behalf of the hospitals have been paid an allowance to engage in some of the activities.

The Minister has known about this issue for a long time, yet he concealed it. I am looking at the report he would have seen last March. It is clear from page 16 that, in March 2012, The Irish Times reported that three senior executives in a HSE-funded organisation were being paid for private work on top of their public commitments.

In May 2012 HIQA published a report on Tallaght hospital which found a lack of clarity around decisions to pay substantial additional remuneration to individual postholders for taking on additional roles, to the tune of more than €150,000 in one instance. In June 2012, almost a year and a half ago, the Sunday Business Postreported on the remuneration packages of the CEOs of four of the section 38 funded organisations. A memo from the Department of Health in June last year stated it knew that some of the salaries of the CEOs were being topped up from other funds. This was all well known to the Minister and his Department. When did he decide to take action? I am very concerned that during the negotiations on public service pay he presided over the talks on the health services area and set out to reduce weekend pay rates for nurses, emergency medical technicians and others. When the Haddington Road agreement was being negotiated before the summer recess, he insisted on cuts being made to increments for some front-line staff. He is part of a Government that forced the Financial Emergency Measures in the Public Interest Act through this House in July, yet many of the 44 agencies had not replied at the time and were not in compliance with the basic rules. He was aware of this while he was asking nurses to take pay cuts and various other health service workers to forgo their increments. He knew this was going on and in the light of the sacrifices people were being asked to make, it was most unfair that he sat on this information, did not bring it to light and did not have the issue dealt with as part of the Haddington Road agreement earlier this year.

James Reilly (Dublin North, Fine Gael)
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I will deal with some of the specific issues raised by the Deputy. First, this is a Government which is actively pursuing reform of the health service. The issues emerging are as a result of a HSE audit of section 38 bodies, both hospitals and disability agencies. This is a Government which is trying to weed out additional sweeteners and expenditures within the health service at a time when any funding, whether Exchequer or private, should be going into the provision of services for patients, not towards unsanctioned payments to senior managers. Front-line staff in health services are working within the Government's pay policy and also playing their part in the reform of health services through new working practices, rosters, etc. The same rules must be applied to senior managers as to those on the front line. I take the opportunity to commend the great work done by those on the front line to keep health services safe. I also commend them for the improvements made in terms of the numbers who have to endure long waits on trolleys. There has been a 34% improvement in that regard since we came into office.

What we need is a clear picture of all payments made. On foot of the circular issued in September by the Department of Health clearly restating public pay policy, the HSE wrote to all of the agencies in question. On 30 September copies of the HSE's audit report and Government pay policy were sent to all section 38 agencies with a request that they respond by 28 October, ensuring compliance. In total, 33 agencies responded, some with a holding position and others requesting to seek legal advice. On 5 November the HSE again wrote to them, reiterating the requirement that they respond and ensure compliance, with a deadline of today, 19 November.

Every organisation that receives public funds must be accountable and transparent. The Department of Health will receive a comprehensive report within the next few days from the HSE on compliance with public pay scales which I will publish on my Department's website.

As the House will be aware, top-up payments of this nature first came to light in May last year when HIQA published a report on governance at Tallaght hospital. It emerged that an employee of the hospital had been receiving an additional €150,000 in payments since 2005. In total, five senior management staff had received €739,000 in top-up payments between 2005 and 2010, when Deputy Seán Fleming's party reigned supreme. Last May I requested that the HSE conduct an internal audit of all section 38 funding recipients, both hospitals and disability agencies, to ensure similar unsanctioned payments were not being made in other locations. The HSE's audit report concluded that there were 36 different types of allowance being paid to 191 senior managers at an annual cost of €3.224 million. In fairness, some of these allowances such as those to clinical directors are in compliance with salary scales as negotiated under the 2008 consultant agreements. However, in some private cases private funding is used to top up approved rates of pay. A total of 13 agencies pay additional remuneration or benefits such as company cars, car expenses or pension contributions to a total of 34 managers to a value of €912,472. In response to the audit, my Department has issued correspondence which clearly states "salary scales must be strictly adhered to and in no circumstances should an employee receive remuneration in the nature of pay and allowances of an amount greater than the amount prescribed".

Seán Fleming (Laois-Offaly, Fianna Fail)
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I thank the Minister for the summary information on where we stand today in terms of the background to the report, the internal audit report and the circulars, reminder circulars and deadlines issued by his Department. That is all fine, but the question now is: what action will the Minister take on foot of the information now in the public arena? This is the last day for section 38 organisations to submit the information requested. If it is helpful, this House will support the Minister if he chooses to call in the chairperson of each of the boards of the organisations which are not in full compliance or which have not confirmed that they are in complaince. Officials in the Minister's office should telephone the chairpersons tomorrow morning to arrange to meet them straightaway in order that he can lay it on the line to them that they must implement Government pay policy. These organisations receive substantial funding from the Exchequer.

The people also want to know when these payments will stop. That is the issue. We know the payments were made and that matter has been examined, but when will they stop? That is what the people want to know, particularly in the context of the various cuts made to health services, with children waiting for cochlear implants, tracheotomies and so forth. I spoke to two mothers last week whose children had been in Crumlin Hospital for over 12 months because budgeting issues within the HSE meant home care packages had not been put in place for them. While this is happening, certain individuals are able to receive these extra payments. The Minister is also aware that many persons undertake voluntary fund-raising for these organisations and that people are happy to give generously when they know that all of the money is being spent on patient care. They will be disturbed to see that some money from private sources is going to already well paid executives. It is important, in the interests of public trust in voluntary fund raising, that the Minister give a commitment that as of the close of business today, payment of all of these allowances will stop. He would be doing a good service for the House and the institutions in question if he were to give us that assurance.

James Reilly (Dublin North, Fine Gael)
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We expect all of the disclosures to be made by the close of business today, 6 p.m. The HSE will then take some time to examine them, with any extenuating circumstance and any contractual or legal issue that arises. The Government is committed to public pay policy being adhered to in section 38 agencies and hospitals. The rationale is quite simple. Staff of these bodies enjoy all of the privileges, including permanency and other arrangements, enjoyed by public servants generally. Therefore, they must be held accountable and submit to the arrangements that apply to public servants in general.

It is interesting to note the spirit in which Deputy Seán Fleming has raised this issue and his questions about the action we are going to take. It was during the terms of office of successive Fianna Fáil-led Governments that these arrangements first started and were allowed to continue. It is only now, when the Government has identified them and is taking action, that the Deputy and his colleagues have become concerned.

Derek Keating (Dublin Mid West, Fine Gael)
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The Deputy has some neck.

James Reilly (Dublin North, Fine Gael)
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We will taken action, unlike the previous Government, and bring transparency and fairness to the system, as we promised to do.

The HSE will issue a report to me in the coming days and advise me on the best way forward, given the circumstances that may pertain in different areas. That is something to which the Government and I are committed and which we have every intention of pursuing. The people can be assured that this issue will be addressed comprehensively.