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Public Accounts Committee: National Paediatric Hospital Development Board and Children's Health Ireland: Discussion (22 May 2025)

James Geoghegan: Would Ms Nugent be able to share with the committee all correspondence that CHI had with the Department and the Minister relating to the appointment of the CEO or reappointment of the then CEO? Is that something she could do?

Public Accounts Committee: National Paediatric Hospital Development Board and Children's Health Ireland: Discussion (22 May 2025)

James Geoghegan: Thank you. There was a slight disparity between what Ms Nugent was saying about how the CEO was not reappointed and what Ms Conroy was saying on behalf of the Department of Health. Ms Conroy was very firm and clear that the Minister did not consent to that appointment. The clear implication and inference of the decision of the Minister not to consent to the reappointment is that it related...

Public Accounts Committee: National Paediatric Hospital Development Board and Children's Health Ireland: Discussion (22 May 2025)

James Geoghegan: It would be highly unusual for a board of a hospital to recommend the appointment of a CEO and then for the Minister to intervene and not consent to that appointment. Would Ms Nugent accept that contention?

Public Accounts Committee: National Paediatric Hospital Development Board and Children's Health Ireland: Discussion (22 May 2025)

James Geoghegan: Ms Nugent was the chief executive of Tallaght hospital, however, am I right?

Public Accounts Committee: National Paediatric Hospital Development Board and Children's Health Ireland: Discussion (22 May 2025)

James Geoghegan: So Ms Nugent is very familiar with the appointment processes of chief executives as it relates to hospitals generally. Does she agree with the contention that it would be highly unusual for a Minister not to consent to the appointment of a CEO on the recommendation of a board?

Public Accounts Committee: National Paediatric Hospital Development Board and Children's Health Ireland: Discussion (22 May 2025)

James Geoghegan: In Ms Nugent’s opening statement, she made absolutely clear that CHI accepts in full the findings and recommendations of the HIQA report. In terms of the position that the outgoing CEO currently holds within the hospital, does that sit in the governance framework recommendations that HIQA has recommended? Have there had to be any changes to where her role currently sits arising from...

Public Accounts Committee: National Paediatric Hospital Development Board and Children's Health Ireland: Discussion (22 May 2025)

James Geoghegan: So there has been no change to her role arising from the recommendations of the HIQA report-----

Public Accounts Committee: National Paediatric Hospital Development Board and Children's Health Ireland: Discussion (22 May 2025)

James Geoghegan: -----and it does not impact on CHI’s governance structures?

Public Accounts Committee: National Paediatric Hospital Development Board and Children's Health Ireland: Discussion (22 May 2025)

James Geoghegan: And none were recommended. I will conclude on insurance issues. Is Ms Nugent aware – the Comptroller and Auditor General can correct me if I am wrong on this – that CHI is the only hospital that the Comptroller and Auditor General audits where issues relating to insurance claims not being processed correctly have been flagged? CHI is an outlier in that respect.

Public Accounts Committee: National Paediatric Hospital Development Board and Children's Health Ireland: Discussion (22 May 2025)

James Geoghegan: Yes.

Public Accounts Committee: National Paediatric Hospital Development Board and Children's Health Ireland: Discussion (22 May 2025)

James Geoghegan: One final question. Who are the third parties? Is Mr. Fitzpatrick talking about doctors?

Public Accounts Committee: National Paediatric Hospital Development Board and Children's Health Ireland: Discussion (22 May 2025)

James Geoghegan: Getting down to brass tacks, CHI emails or contacts the consultant to say, “You need to send us a form here. Could you please send us that form so we can send it in?” and in 70 cases that did not happen, amounting to a loss of €0.25 million. There is a report in The Irish Times that next year it will be €200,000. That is correct, yes? Does CHI think it will get...

Public Accounts Committee: National Paediatric Hospital Development Board and Children's Health Ireland: Discussion (22 May 2025)

James Geoghegan: I thank Ms Nugent.

Public Accounts Committee: National Paediatric Hospital Development Board and Children's Health Ireland: Discussion (22 May 2025)

James Geoghegan: I thank the witnesses for staying on. It is greatly appreciated. When Ms Nugent phoned the Chief Medical Officer this morning about the audit, she asked whether the audit was ready and she said-----

Public Accounts Committee: National Paediatric Hospital Development Board and Children's Health Ireland: Discussion (22 May 2025)

James Geoghegan: He said. I am sorry-----

Public Accounts Committee: National Paediatric Hospital Development Board and Children's Health Ireland: Discussion (22 May 2025)

James Geoghegan: In terms of the call, however, Ms Nugent phoned the Chief Medical Officer and asked whether the audit was ready. He said-----

Public Accounts Committee: National Paediatric Hospital Development Board and Children's Health Ireland: Discussion (22 May 2025)

James Geoghegan: Presumably he said to Ms Nugent that it could come within the next hour or tomorrow.

Public Accounts Committee: National Paediatric Hospital Development Board and Children's Health Ireland: Discussion (22 May 2025)

James Geoghegan: It will arrive today or tomorrow.

Public Accounts Committee: National Paediatric Hospital Development Board and Children's Health Ireland: Discussion (22 May 2025)

James Geoghegan: Going back to the former CEO, I have no difficulty with Ms Nugent having training before coming to the Committee of Public Accounts, given it is Ms Nugent's first time appearing before it. Her answers on the former CEO, however, were clearly a trained response. Ms Nugent does not own this situation that she has found herself in, but it was a clear case of a certain line being given out....

Public Accounts Committee: National Paediatric Hospital Development Board and Children's Health Ireland: Discussion (22 May 2025)

James Geoghegan: Ms Nugent can see that, for the public listening in and watching on, this is a most unsatisfactory outcome from a process whereby a Minister has taken a decision and we do not know the full reasons for that decision. We know the context and what is taking place surrounding that decision not to provide the consent, but we have absolutely no clarity regarding it. For Ms Nugent, as CEO of...

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