On September 8th, a letter was sent from the Health Service Executive (HSE) to Bishop Brendan Leahy, chairman of the board of St John’s Hospital in Limerick, requesting he attend a meeting to discuss the salary of the hospital’s chief executive, Emer Martin.
The topic had been a bone of contention for a number of months, with the hospital having in 2023 increased Ms Martin’s salary to a higher pay band – in breach of the consolidated public pay scales.
The meeting – which was between Sandra Broderick, HSE Midwest regional executive officer; Ian Carter, chief executive of acute and older people services; Bishop Leahy; and Richard Leonard, deputy chair of the hospital board – was scheduled for the morning of September 23rd.
But after nine minutes it was all over, according to a letter from Bishop Leahy, which was released under the Freedom of Information Act.
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The meeting had a busy agenda, including the expansion of the Limerick hospital campus, But according to Bishop Leahy’s letter, Ms Broderick terminated it prematurely following “aggressive” questioning around Ms Martin’s remuneration.
“To put it mildly, we were very disappointed with how you conducted the meeting, which you concluded so abruptly at 11.19,” his letter states.
“It would be remiss of me not to say that over our long careers of dealing with a myriad of issues and difficulties, many of which were very complex, we have rarely if ever experienced such an unreasonable and unwarranted conduct. You abruptly concluded the meeting after repeatedly asking for a ‘yes or no’ answer regarding “compliance” relating to a pay increase that we have clearly substantiated in the business case. It is not a simple ‘yes or no’.”
According to Bishop Leahy’s letter, the hospital wanted the meeting to continue “as there were other issues on the agenda”. The hospital board said the approach “has not in any way helped to advance this matter”.
Bishop Leahy’s description of the meeting paints a clear picture of the divide between the board and the wider health service’s administrators, stating there was “hostility” from the HSE, as well as “indifference, intransigence and lack of understanding on this matter”.
A few hours after the meeting concluded, Ms Broderick wrote to Bishop Leahy acknowledging their stance that they would not be changing the chief executive’s salary.
“As you are aware, statutory bodies cannot be autonomous in setting salaries,” she said.
Relations between the two bodies had been growing increasingly fractious in recent months.
The issue of chief executive salaries has been a long-standing bugbear in the voluntary hospital sector. Again and again, these bodies have told senior officials that they cannot recruit or retain chief executives at the current salary bands that were introduced in 2015.
The new bands reduced pay rates for existing chief executives of voluntary hospitals by up to 10 per cent and for new-hire chief executives by up to 25 per cent.
In September 2023, Ibec, the State’s largest business lobby and representative group, wrote to then minister for health Stephen Donnelly calling on the Department of Health to “remedy the income discrepancies as a matter of priority”.
[ Limerick hospital expansion at risk over chief executive pay rowOpens in new window ]
It was on November 30th of that year that the board of St John’s Hospital took matters into their own hands, informing the HSE that it intended to increase its chief executive’s salary to a higher pay band.
The organisation provided a business case to the national human resources (HR) department of the HSE seeking a salary of €126,516 for Ms Martin’s role.
It outlined a number of reasons why it felt such a salary was justified, including recruitment and retention concerns, the responsibility of the role, and that under the approved rates the chief executive would earn less than the deputy chief executive.
Emails released under FOI show Ms Martin wrote to the HR department on a number of occasions requesting an update on the business case over a number of months.
On March 21st of this year, 15 months later, Anne Marie Hoey, chief people officer at the HSE, responded that the Department of Public Expenditure had not sanctioned regrading the role. As such, they were in breach of the pay rules.
In the intervening months, tensions have ratcheted up between the HSE and the hospital board as the health service has made continued demands for the salary to be brought into line.
In a series of letters between July and August, Ms Broderick said pension entitlements would be at risk and “unsanctioned” payments would have to be repaid.
Furthermore, she announced all current and future developments have been “paused” in light of the HSE’s concerns around governance in the hospital.
This was of significant concern to the hospital, which has planned for an expansion of bed capacity at the healthcare facility.
In his letter after the meeting, Bishop Leahy said these letters as well as the discussion in September “creates an overriding concern that St John’s Hospital will be summarily ‘punished’”.
“Saddest of all is that this punishment is an utterly disproportionate response to the issue at hand and a response that could potentially disadvantage the significant cohort of patients treated at this hospital annually,” he added.
Asked about the meeting, a spokesman for HSE Midwest said the organisation is “obliged to comply with public pay policy”.
“Section 38 organisations including St John’s Hospital have all the benefits of being public servants and are also fully obliged to comply with public pay policy,” he said.
“The [regional executive officer, Ms Broderick] has correctly represented and restated the position to St John’s Hospital. We expect nothing other than full compliance. We have no further comment to make on the matter.”
St John’s Hospital declined to comment.
