Varadkar promises action on HSE overpayments, expenses

Minister and HSE says audit showing excessive spending is still draft

Minister for Health Leo Varadkar has said he expects the Health Service Executive to put in place a plan to deal with overpayments or incorrect expense claims where these are shown to have occurred.

However, Mr Varadkar and the HSE both sought to downplay a leaked report which points to excessive claiming and overpayments in the organisation.

The audit by the Comptroller and Auditor General, which was inadvertently sent to Senators, lists examples of uncollected debts, large expense claims and overpayments which have not been recouped by the HSE.

An examination of three HSE regions found overpayments totalling €2.9 million, or which no repayment had been made in respect of €1.4 million.

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An audit of Our Lady’s Children’s Hospital, Crumlin, a voluntary hospital entirely funded by the HSE, found the chief executive received a €30,000 allowance in addition to his salary and said this was in excess of HSE allowable pay scales. There were no written policies and procedures on entertainment, credit cards and travel expenditure, and the hospital does not notify the HSE of instances of fraud as required.

In HSE South-West, a retired consultant who was rehired was put on the €156,000 a year former salary instead of the new entrant scale starting at €109,000.

A review of 44 allowances found in 13 cases there was no evidence they had been appropriately sanctioned.

Issues were raised in nearly half of the 20 claims examined for continuing medical expenses. These included two duplicate payments, a claim for a personal item and two claims for alcohol. Two hotel claims - €300 a night in Dublin’s Merrion Hotel and €500 for a hotel in Milan - “appeared excessive”.

In one case, an employee travelled to New York to a conference with a personal guest. Flights were claimed for the guest and the hotel bill showed the two stayed in the room.

In three hospitals, almost €11 million due to the HSE from private insurers cannot be collected because the consultants who carried out the treatment have yet to sign off on it, the audit also showed.

Mr Varadkar and the HSE pointed out the report by the Comptroller and Auditor General was a draft one and may be amended before it is finally completed. Some of the rules regarding claims had been changed since 2013, the year covered by the report, he added.

“It’s important that proper controls are always in place to ensure that spending is controlled and that any over-spending or incorrect claims are prevented in the future. This particular draft report relates to 2013 and we need to see the final conclusion before making any judgment on individual matters.”

Mr Varadkar said if further changes were necessary on foot of the completed report, he would ensure they were implemented. “And if any overpayments or incorrect claims are identified in the final C&AG report then I expect the HSE to put in place a plan to address each of those matters.”

The HSE said it hadn’t yet been given an opportunity to comment or clarify the contents of the report “The HSE is responding to the C&AG who will then finalise the report & publish it in due course”.

In a statement, Our Lady’s Children’s Hospital, Crumlin said it “has not received the draft audit report by the Comptroller and Auditor General and therefore has not had an opportunity to respond to any references or comments made in respect of the hospital.”

Paul Cullen

Paul Cullen

Paul Cullen is Health Editor of The Irish Times