HSE cut €108,000 in funding from mental health charity over poor ‘value for money’

The Health Service Executive cut €108,000 funding from a mental health service in Dublin last year because the charity “did not in any way represent value for money” or “represent efficient and effective use of limited resources”, documents show.

Multiple serious governance issues led to the HSE's decision to withdraw almost half of its funding from Hesed House in Inchicore, which had been providing counselling and psychotherapy to adults, children and families for almost 30 years before it suddenly closed in June, with no information shared with staff, or those who used its services.

The charity’s clinical director, Dr Padraic Gibson, was listed in 1½ roles as both a full-time therapist and part-time manager which, according to the HSE, had “never been declared” in the service level agreement or any discussions with it.

Staffing lists did not match the income and expenditure reports for salary expectations at the charity, and the HSE said it was not made aware of how many clients Hesed House had, or what income payments by clients had generated.

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The HSE was subsequently informed the charity had raised €11,486 in 2018 and €15,000 in 2019 through client contributions, but it was unclear what happened with that income, and it had not been reported in income and expenditure accounts, the HSE said in correspondence with Dr Gibson.

In September 2020, Dr Gibson was informed by the HSE that it “may not be best practice” under the Charity Regulatory Authority for him to be listed as company secretary, as employees were “not encouraged to act at board level for transparency and accountability reasons”. Dr Gibson, who is also clinical director of three other clinics in Dublin city, did not respond to this concern.

“A lack of attention to detail, including vital company information” in legal documentation was flagged as an issue that “could be highlighted by an auditor’s review and may not inspire confidence that all systems are properly monitored or inputted”.

In addition, the Health Service Executive said Hesed House had “significant” waiting lists of up to five months for appointments, gave no priority to drug service referrals, and supplied no evidence to the HSE about interagency work.

Initially, Dr Gibson did not respond to queries by the Health Service Executive and only began responding when contacted by it further to query why services were not operational or not responding to emails.

In response to questions from The Irish Times, the Health Service Executive said – with the exception of Dr Gibson – board members at Hesed House “never responded to HSE queries” and there was “no confirmation” of an active board at all. Only the clinical director, Dr Gibson, participated in meetings with the Health Service Executive.

The HSE was engaging with the charity about governance concerns for several years, and this “intensified since 2018,” said a spokeswoman.

Similarly, local drugs task force Canal Communities had “concerns about the practices” at Hesed House. And “despite strenuous efforts to find and speak to the chair – or any members of the board – have not been able to locate a single board member”, correspondence released under the Freedom of Information Act shows.

Of more than 20 governance issues highlighted by the HSE, “about a third of the items were addressed and not within the timeframe stated”, said a spokeswoman.

In total, the charity received €240,000 funding from the Health Service Executive annually, of which €108,572 was under section 39 of the Charities Act, and additional interim funding of €132,701.

Dr Gibson was advised that €108,572 in annual HSE funding would cease from June 2021 and that the board would need to make alternative arrangements for staffing and funding from then on.

However, a liquidator was appointed in June to close the service. Further documents show the HSE sought clarification from the liquidator about the rationale for closing Hesed House.

Staff at the charity were told it would be closing due to a withdrawal from all its funders, which the Health Service Executive said was a “false statement”.

No response

The charity retained some of its HSE funding and separately received €45,000 per year in funding from Tusla, as well as funding from the local drugs and alcohol taskforce and its client contributions.

Letters to staff were signed on behalf of the project director, which “suggested that the Board of Directors have not ‘authorised’ these letters”, said the Health Service Executive.

The Irish Times did not receive a response to requests for comment from Dr Gibson.It called to the home address for the listed chairman, Francis Perri, who refused to comment, and to the home of another listed board member, who said no one by that name lived at the address.

A former board member, noted as leaving the charity in 2019, said he had not been on the Hesed House board in more than 10 years.

Another listed board member shared the same home address as Dr Gibson.

Asked whether there would be a formal investigation into the practices at Hesed House, the HSE replied this was “dependent on the outcome of the liquidation process”.

Meanwhile, funding has been redirected to locally based addiction services in the area and the local drugs task force has agreed a mechanism to provide support to clients on an interim basis.