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Public Accounts Committee: Health Service Executive Financial Statements 2018
2017 Annual Report of the Comptroller and Auditor General and Appropriation Accounts
Vote 38 - Department of Health
Chapter 16 - Control of Private Patient Activity in Acute Public Hospitals
(27 Jun 2019)

Marc MacSharry: I appreciate the numbers. All I know from listening to colleagues is the level of demand. I know that I am edging into the area of the Joint Committee on Health, but at the end of the day it is about money.

Public Accounts Committee: Health Service Executive Financial Statements 2018
2017 Annual Report of the Comptroller and Auditor General and Appropriation Accounts
Vote 38 - Department of Health
Chapter 16 - Control of Private Patient Activity in Acute Public Hospitals
(27 Jun 2019)

Marc MacSharry: Why is there not enough money to provide care?

Public Accounts Committee: Health Service Executive Financial Statements 2018
2017 Annual Report of the Comptroller and Auditor General and Appropriation Accounts
Vote 38 - Department of Health
Chapter 16 - Control of Private Patient Activity in Acute Public Hospitals
(27 Jun 2019)

Marc MacSharry: Was the increase substantially eaten up by whatever agreements were in place with carers for remuneration, travel subsistance payments and so on?

Public Accounts Committee: Health Service Executive Financial Statements 2018
2017 Annual Report of the Comptroller and Auditor General and Appropriation Accounts
Vote 38 - Department of Health
Chapter 16 - Control of Private Patient Activity in Acute Public Hospitals
(27 Jun 2019)

Marc MacSharry: What was the percentage increase in money terms? How much of the increase has had to be dedicated to meeting commitments in respect of remuneration?

Public Accounts Committee: Health Service Executive Financial Statements 2018
2017 Annual Report of the Comptroller and Auditor General and Appropriation Accounts
Vote 38 - Department of Health
Chapter 16 - Control of Private Patient Activity in Acute Public Hospitals
(27 Jun 2019)

Marc MacSharry: The witnesses can come back to me with it. Let me outline the message. We have the Minister trumpeting budget increases, but in real terms there has not been an increase in the level of care provided because we have reached the summer and vulnerable persons in certain CHO areas - I know that this is the experience nationwide from talking to colleagues across parties - are being refused home...

Public Accounts Committee: Health Service Executive Financial Statements 2018
2017 Annual Report of the Comptroller and Auditor General and Appropriation Accounts
Vote 38 - Department of Health
Chapter 16 - Control of Private Patient Activity in Acute Public Hospitals
(27 Jun 2019)

Marc MacSharry: Figures wise, it all sounds great, but at the end of the day the proof of the pudding is in the eating. There is demand. There are 83 year olds waiting who cannot care for themselves. They are being discharged because there is a need to free up beds, but they do not have anybody to advocate for them because they are a widow or a widower. I am thinking of a specific case, but everyone here...

Public Accounts Committee: Health Service Executive Financial Statements 2018
2017 Annual Report of the Comptroller and Auditor General and Appropriation Accounts
Vote 38 - Department of Health
Chapter 16 - Control of Private Patient Activity in Acute Public Hospitals
(27 Jun 2019)

Marc MacSharry: Does Mr. Reid accept that there is a problem?

Public Accounts Committee: Health Service Executive Financial Statements 2018
2017 Annual Report of the Comptroller and Auditor General and Appropriation Accounts
Vote 38 - Department of Health
Chapter 16 - Control of Private Patient Activity in Acute Public Hospitals
(27 Jun 2019)

Marc MacSharry: I know that there is a need for budget savings, but these are ill and vulnerable people. Can they not be prioritised? I could wear a delay on a capital project for a short period to cater for people who in the here and now are badly in need of support.

Public Accounts Committee: Health Service Executive Financial Statements 2018
2017 Annual Report of the Comptroller and Auditor General and Appropriation Accounts
Vote 38 - Department of Health
Chapter 16 - Control of Private Patient Activity in Acute Public Hospitals
(27 Jun 2019)

Marc MacSharry: It would be a lot easier to cover than an overrun on the national children's hospital project.

Public Accounts Committee: Health Service Executive Financial Statements 2018
2017 Annual Report of the Comptroller and Auditor General and Appropriation Accounts
Vote 38 - Department of Health
Chapter 16 - Control of Private Patient Activity in Acute Public Hospitals
(27 Jun 2019)

Marc MacSharry: I will wait for it.

Public Accounts Committee: Health Service Executive Financial Statements 2018
2017 Annual Report of the Comptroller and Auditor General and Appropriation Accounts
Vote 38 - Department of Health
Chapter 16 - Control of Private Patient Activity in Acute Public Hospitals
(27 Jun 2019)

Marc MacSharry: I have several questions on section 38 agencies. If this was substantially covered while I was not present, the Chairman might tell me because I do not want to go over ground that has been covered. The majority of section 38 agencies were non-compliant or not fully compliant with public procurement. What are we doing about that?

Public Accounts Committee: Health Service Executive Financial Statements 2018
2017 Annual Report of the Comptroller and Auditor General and Appropriation Accounts
Vote 38 - Department of Health
Chapter 16 - Control of Private Patient Activity in Acute Public Hospitals
(27 Jun 2019)

Marc MacSharry: I love the language. It sounds like addiction recovery: "We are on a journey". Anyway, we will watch this space. For people watching, a section 38 agency is basically a privately owned, independent operator that is contracted by the HSE to carry out services. Is that it, in layman's terms?

Public Accounts Committee: Health Service Executive Financial Statements 2018
2017 Annual Report of the Comptroller and Auditor General and Appropriation Accounts
Vote 38 - Department of Health
Chapter 16 - Control of Private Patient Activity in Acute Public Hospitals
(27 Jun 2019)

Marc MacSharry: It is voluntary, such as an NGO. It is a voluntary organisation and the HSE contracts it to do a particular job, pays it to do that job and assesses its performance on that.

Public Accounts Committee: Health Service Executive Financial Statements 2018
2017 Annual Report of the Comptroller and Auditor General and Appropriation Accounts
Vote 38 - Department of Health
Chapter 16 - Control of Private Patient Activity in Acute Public Hospitals
(27 Jun 2019)

Marc MacSharry: Name a hospital.

Public Accounts Committee: Health Service Executive Financial Statements 2018
2017 Annual Report of the Comptroller and Auditor General and Appropriation Accounts
Vote 38 - Department of Health
Chapter 16 - Control of Private Patient Activity in Acute Public Hospitals
(27 Jun 2019)

Marc MacSharry: There is also Rehab.

Public Accounts Committee: Health Service Executive Financial Statements 2018
2017 Annual Report of the Comptroller and Auditor General and Appropriation Accounts
Vote 38 - Department of Health
Chapter 16 - Control of Private Patient Activity in Acute Public Hospitals
(27 Jun 2019)

Marc MacSharry: With regard to the procurement that the Comptroller and Auditor General refers to in the context of the €2.2 billion, which is based on the sample, is that different altogether?

Public Accounts Committee: Health Service Executive Financial Statements 2018
2017 Annual Report of the Comptroller and Auditor General and Appropriation Accounts
Vote 38 - Department of Health
Chapter 16 - Control of Private Patient Activity in Acute Public Hospitals
(27 Jun 2019)

Marc MacSharry: That is HSE non-compliance. That is a sample that suggests we are possibly not getting value for money on €600 million worth, if the sample is indicative. Is that correct?

Public Accounts Committee: Health Service Executive Financial Statements 2018
2017 Annual Report of the Comptroller and Auditor General and Appropriation Accounts
Vote 38 - Department of Health
Chapter 16 - Control of Private Patient Activity in Acute Public Hospitals
(27 Jun 2019)

Marc MacSharry: Is there any analysis? I know that, sometimes, something is needed immediately and it is perhaps not possible to tender. Is any analysis done of the companies where procurement is not being met or there are not proper tendering processes in regard to conflicts of interest? Has any analysis been done of those operators who are doing work or service providers or wholesalers where, for...

Public Accounts Committee: Health Service Executive Financial Statements 2018
2017 Annual Report of the Comptroller and Auditor General and Appropriation Accounts
Vote 38 - Department of Health
Chapter 16 - Control of Private Patient Activity in Acute Public Hospitals
(27 Jun 2019)

Marc MacSharry: I get that. On the potential for conflicts of interest, while I appreciate there is no evidence, do we look for that?

Public Accounts Committee: Health Service Executive Financial Statements 2018
2017 Annual Report of the Comptroller and Auditor General and Appropriation Accounts
Vote 38 - Department of Health
Chapter 16 - Control of Private Patient Activity in Acute Public Hospitals
(27 Jun 2019)

Marc MacSharry: Statutory, in this instance, because that is what I had moved to. It is more the Comptroller and Auditor General's role as opposed to the section 38s.

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