Top-up payments, double jobbing and additional earnings for healthcare staff are now under the scrutiny of the State's financial watchdog, the Comptroller and Auditor General, writes MARTIN WALL
THE HIQA report into Tallaght hospital may have started as an investigation into patients being treated on corridors in the emergency department, but it might end up prompting a full inquiry into payments to health service managers in the sector.
One of the main findings of the Hiqa report was that sizeable top-up payments had been made to senior managers in addition to basic salaries. In one case, a staff member received an additional €150,000. On Sunday, a former chairman was quoted as saying top-up payments came from the hospital’s foundation.
Yesterday The Irish Times reported that some senior executives at the State’s largest hospital, St James’s, were also receiving additional earnings over their official State salaries. This included an €11,000 allowance paid to one manager for acting as secretary to the hospital board.
Separately, this manager and another executive at the hospital had part-time lecturer posts at Trinity College and received an additional €30,000 and €35,000 respectively.
Hiqa recommended that all health and social care providers in receipt of State funds should come under the remit of the State’s financial watchdog, the Comptroller and Auditor General. The issue of the top-up payments at Tallaght has been referred to the Comptroller.
The Hiqa revelations also led on Sunday to the chairman of the Dáil Public Accounts Committee, John McGuinness, to announce that it would be carrying out its own inquiry into top-up payments for managers.
He said the role of the Public Accounts Committee should extend to the end-user of every cent of State funds, irrespective of how the money had been channelled to them.
McGuinness said when the HSE came before his committee in the weeks ahead he would be seeking details on the history of these top-up payments to senior managers, the amounts involved and any crossover between the public and private sectors.
He also said the issue raised concerns about parliamentary accountability.
As this newspaper has reported previously, the Dáil has not been given details of the payments that are now emerging in answers to questions on the earnings of senior hospital managers.
Indeed, up until earlier this year, the official position of the Department of Health and the HSE was that the maximum pay ceiling for senior executives in public hospitals stood at just over €145,000.
Last June, Fine Gael backbench TD Derek Keating submitted parliamentary questions to the Minister seeking details of salary payments and bonus arrangements for the chief executives of hospitals around the State.
Such questions are routinely answered within weeks but this one bounced around between the HSE and the Department of Health until the following September. Eventually a table was provided which stated that the chief executives of most of the larger hospitals, both voluntary and HSE-run institutions, were on a salary level of €145,959.
However, details of the full picture began to emerge late last year after the Minister for Health James Reilly asked Bill Maher, the acting chief executive of St Vincent’s University Hospital, to take over the running of the Galway group of public hospitals on a secondment.
The Department of Health sought, and received, approval from the Department of Public Expenditure to pay Mr Maher a salary of up to €195,000 for the post. It said that, “as would be expected, his secondment from St Vincent’s University Hospital had to be on a basis of no reduction in earnings”.
However, the pay level the Department of Health proposed to pay was €50,000 more than the official rate for the job of chief executive of St Vincent’s (and St Michael’s in Dún Laoghaire) which it had set out itself in the reply to the parliamentary question only a couple of months before.
Eventually, St Vincent’s Healthcare Group (which runs the publicly funded St Vincent’s University Hospital and St Michael’s as well as St Vincent’s Private Hospital) confirmed that three of its senior executives were being paid for private work on top of their public commitments.
It said that “three senior managers in St Vincent’s Healthcare Group had private contractual arrangements with the group for additional work carried out over and above their public sector obligations. Compensation for this additional work does not involve any public funds.”
A spokesman for St Vincent’s Healthcare Group said details of these private contractual arrangements were “private”.
Any new inquiry is also likely to seek to examine the payments to executives in voluntary organisations other than hospitals which receive funding from the Exchequer.
In March, it was reported that Department of Health officials involved in a review of the €1.5 billion spent on disability services could not gain access to the remuneration of the chief executives of some of the organisations.
The hearing of the Public Accounts Committee, which is routinely attended by representatives of the Department of Public Expenditure and Reform, may also seek to examine the rules for full-time public service personnel accepting money for outside work.
Some highly placed sources have argued that once health service managers complete their contractual obligations they should be free to carry out work elsewhere.
However, just over a year ago the HSE said it was moving to ban its staff as well as employees of bodies funded by it from “double-jobbing” for agencies that supply personnel such as nurses, non-consultant doctors, therapists and healthcare assistants.