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Public Accounts Committee: 2012 Annual Report of the Comptroller and Auditor General and Appropriation Accounts
Vote 39 - Health Service Executive
(27 Nov 2013)

Seán Fleming: Give us the gist.

Public Accounts Committee: 2012 Annual Report of the Comptroller and Auditor General and Appropriation Accounts
Vote 39 - Health Service Executive
(27 Nov 2013)

Seán Fleming: Million.

Public Accounts Committee: 2012 Annual Report of the Comptroller and Auditor General and Appropriation Accounts
Vote 39 - Health Service Executive
(27 Nov 2013)

Seán Fleming: More than every few days, in other words?

Public Accounts Committee: 2012 Annual Report of the Comptroller and Auditor General and Appropriation Accounts
Vote 39 - Health Service Executive
(27 Nov 2013)

Seán Fleming: Maybe once per quarter.

Public Accounts Committee: 2012 Annual Report of the Comptroller and Auditor General and Appropriation Accounts
Vote 39 - Health Service Executive
(27 Nov 2013)

Seán Fleming: Let us consider some of the larger hospitals such as the maternity hospital that has attracted a lot of publicity, Holles Street. It has an income from the HSE in the order of €43 million. I have looked at its foundation's summary of the figures. Some 70% of its funding comes from the HSE. Typically, would an organisation of that scale receive payments weekly, every few days or...

Public Accounts Committee: 2012 Annual Report of the Comptroller and Auditor General and Appropriation Accounts
Vote 39 - Health Service Executive
(27 Nov 2013)

Seán Fleming: Mr. O’Brien should remind those people who are not replying to his letters of that fact. He should make that point.

Public Accounts Committee: 2012 Annual Report of the Comptroller and Auditor General and Appropriation Accounts
Vote 39 - Health Service Executive
(27 Nov 2013)

Seán Fleming: Let me move on to two final points. Were the appointments of the people getting the top-ups cleared by the HSE? Did the board say it was proposing to appoint such a consultant as the master, for example? Were the appointments approved by the HSE?

Public Accounts Committee: 2012 Annual Report of the Comptroller and Auditor General and Appropriation Accounts
Vote 39 - Health Service Executive
(27 Nov 2013)

Seán Fleming: But they did not come back to Mr. O'Brien with the names subsequently and said they proposed to appoint certain individuals.

Public Accounts Committee: 2012 Annual Report of the Comptroller and Auditor General and Appropriation Accounts
Vote 39 - Health Service Executive
(27 Nov 2013)

Seán Fleming: That is not the procedure. Somebody asked when these payments all started. One of the organisations, the South Infirmary-Victoria University Hospital in Cork, got approval for a non-standard allowance. It was on 21 April 1995, almost 20 years ago. Is that still being paid to the person in that post, or is it the same person who received the approval? It is the only evidence I have seen...

Public Accounts Committee: 2012 Annual Report of the Comptroller and Auditor General and Appropriation Accounts
Vote 39 - Health Service Executive
(27 Nov 2013)

Seán Fleming: Let me outline the last topic I want to raise. Has Mr. O'Brien any concerns regarding public procurement guidelines? I will pick an example that has been mentioned in the newspapers a lot. I am reading from a document stating the National Maternity Hospital has outsourced some of its obstetric scans to a private clinic next door that is run by a partnership including the master and other...

Public Accounts Committee: 2012 Annual Report of the Comptroller and Auditor General and Appropriation Accounts
Vote 39 - Health Service Executive
(27 Nov 2013)

Seán Fleming: Last night I printed off from the website extensive documentation on the organisation called Merrion Fetal Health. We all know the organisation we are talking about. I am not suggesting there is anything wrong but believe it is interesting that the hospital all the consultants are working in does not have the resources to carry out the obstetric tests although all five consultants are able...

Public Accounts Committee: 2012 Annual Report of the Comptroller and Auditor General and Appropriation Accounts
Vote 39 - Health Service Executive
(27 Nov 2013)

Seán Fleming: Has that been examined yet?

Public Accounts Committee: 2012 Annual Report of the Comptroller and Auditor General and Appropriation Accounts
Vote 39 - Health Service Executive
(27 Nov 2013)

Seán Fleming: Could that be an issue of wider application than the section 38 arrangements? Could it happen in some of the normal HSE public hospitals throughout the country where there are groups of consultants with private practice arrangements? We have no problem with that in that there is public health and private health in the country we live in. There is no issue with either once there are proper...

Public Accounts Committee: 2012 Annual Report of the Comptroller and Auditor General and Appropriation Accounts
Vote 39 - Health Service Executive
(27 Nov 2013)

Seán Fleming: However, Mr. O'Brien cannot say that about the case I am talking about.

Public Accounts Committee: 2012 Annual Report of the Comptroller and Auditor General and Appropriation Accounts
Vote 39 - Health Service Executive
(27 Nov 2013)

Seán Fleming: Mr. O'Brien might look into it and revert to us. I will leave it at that.

Public Accounts Committee: 2012 Annual Report of the Comptroller and Auditor General and Appropriation Accounts
Vote 39 - Health Service Executive
(27 Nov 2013)

Seán Fleming: I appreciate that. Moving on to what I would call the specifics of income from top-ups or private sources, would Mr. O'Brien be satisfied that these 44 organisations are tax compliant and have tax clearance certificates?

Public Accounts Committee: 2012 Annual Report of the Comptroller and Auditor General and Appropriation Accounts
Vote 39 - Health Service Executive
(27 Nov 2013)

Seán Fleming: Reading a little into what Mr. O'Brien stated, he is saying they produce a tax clearance certificate but he has some niggling doubts as to whether they are tax compliant. Is that the gist of it?

Public Accounts Committee: 2012 Annual Report of the Comptroller and Auditor General and Appropriation Accounts
Vote 39 - Health Service Executive
(27 Nov 2013)

Seán Fleming: On the individuals highlighted in the report, has the HSE gone the next step to see some of these P60s? This is the question I want answered. Did what is now being described as private top-up income appear on the main P60? Do the staff concerned have separate employers for these top-up payments? Would there be differing practices as to whether some of the funds came from the foundation or...

Public Accounts Committee: 2012 Annual Report of the Comptroller and Auditor General and Appropriation Accounts
Vote 39 - Health Service Executive
(27 Nov 2013)

Seán Fleming: Dr. Smith did a reasonableness check, which, for the non-accountants, is where the overall picture of what she got seemed to make sense with where she felt it should be, rather than a specific check. Is she satisfied that the reasonableness check, even though it was not exactly specific, is accurate enough?

Public Accounts Committee: 2012 Annual Report of the Comptroller and Auditor General and Appropriation Accounts
Vote 39 - Health Service Executive
(27 Nov 2013)

Seán Fleming: In other words, the top-up payments from a sweet shop or car park were on their mainline P60s.

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