Naas hospital voluntarily paused insourcing amid concerns over use of public funding
waiting lists
, after concerns were raised about the way in which public funding was used.
The
National Treatment Purchase Fund
(NTPF), a vehicle set up to reduce waiting lists, provides funding through outsourcing – the use of private facilities – and insourcing – the use of public facilities and staff outside of core working hours.
In recent months concerns have been raised about the way in which the use of insourcing has been governed, after a leaked 2022 report from
Children's Health Ireland
(CHI) highlighted allegations about potential misuse of these funds.
Funding for the hospital was temporarily suspended in light of these allegations but has since resumed, while funding for
Beaumont Hospital
has also been suspended in light of 'potential financial irregularities'.
READ MORE
Speaking at a meeting of the Oireachtas health committee on Wednesday,
Bernard Gloster
, chief executive of the
Health Service Executive
(HSE), confirmed concerns have also been raised about Naas General Hospital.
According to Mr Gloster, the regional executive officer received correspondence outlining potential issues at the hospital.
'It's not unusual when the CHI report.. came the way it did that you would start to see sequentially people starting to express concerns. There is a concern about how NTPF funding was used or governed by Naas hospital. [An] internal audit will look at that,' Mr Gloster said.
'Conservatively' the audit will take about three months, he added.
Fiona Brady, chief executive of the NTPF, said: 'Naas of their own volition stopped their own insourcing temporarily while they liaised with myself and my executive team and we are happy they will be rectifying this issue immediately.'
Mr Gloster said the issue around insourcing is widespread, and not about individual doctors or hospitals.
'Fundamentally it appears to be a systemic issue, albeit very different in every hospital,' Mr Gloster said.
He said there are 'mechanisms of governance' but the 'effectiveness of the governance is probably questionable' in relation to insourcing.
In Mr Gloster's report to Minister for Health
Jennifer Carroll MacNeill
on the topic, published late on Tuesday, he outlines a desire
to wind down the use of insourcing
by June of next year.
The report states that a growth in insourcing without adequate oversight and controls can create conflicts of interest and lead to noncompliance with procurement rules; inequitable use of public funds, risk of abuse, misuse, fraud and low public confidence.
Mr Gloster said the risks of insourcing are 'too high for the public', which is why he believes it should be phased out. An 'over-reliance' on the system has developed over time, he said.
In the interim, he said there will be new 'protections' in relation to potential conflicts of interests.
In recent years, the health service has taken steps to move towards a longer working week, with health unions last week agreeing to work five over seven days – increasing the hours of work outside of a typical Monday to Friday, 9am to 5pm.
Mr Gloster agreed the existence of insourcing creates an impediment to the extended working week.
'For as long as we have this type of third party insourcing, we will not get to five over seven in the management of waiting lists,' he said. 'Productivity will not be encouraged and risk of conflicts of interest remain.'
The health chief was also critical of CHI's decision to to publish an anonymised version of the 2022 report. He expressed confidence in Lucy Nugent, the new chief executive, and the new board members, but said there is a 'way to go to see whether the entity [CHI] is sustainable in the future'.
Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles
Irish Independent
an hour ago
- Irish Independent
‘We are deeply sorry for the harm and distress caused' - CHI boss faces another grilling at PAC today
'We are deeply sorry for the harm and distress caused' - CHI boss is facing another grilling at PAC Senior executives from Children's Health Ireland (CHI) have struck a contrite tone at the opening of the today's Public Accounts Committee (PAC). But will it be enough to dampen the interrogation they face from committee members during the proceedings? "CHI fully acknowledges that we have fallen short of the high standards children and families deserve. We are deeply sorry for the harm and distress caused," said Lucy Nugent, chief executive of CHI, in a statement this morning. 'We want to do better and we are committed to building an organisation defined by openness, compassion, and learning.' Managers and doctors from Children's Health Ireland (CHI) which oversees the three Dublin children's hospitals are up before the Public Accounts Committee (PAC) again today to be quizzed on recent revelations around patient care and use of public waiting list funds. The Comptroller and Auditor General Seamus McCarthy will also add financial scrutiny. Speaking ahead of the meeting, committee chairman John Brady said: 'This meeting is the resumption of the Committee of Public Accounts' examination of the CHI 2023 financial statements in May 2023. 'A key focus of our meeting will be the alleged failures in respect of clinical controls , for example medical device implants and the necessity for the number of hip dysplasia operations carried out -as well as delays in carrying out required surgeries. 'In May 2025, Children's Health Ireland (CHI) has published the findings of the Independent External Medical Audit into the clinical thresholds for performing pelvic osteotomy surgeries in children with developmental dysplasia of the hip (DDH) at CHI Crumlin, CHI Temple Street and the National Orthopaedic Hospital in Cappagh (NOHC). 'The audit reviewed 147 random and anonymous cases across the three hospitals. Based on criteria that had been retrospectively applied for the purpose of the audit, the auditor raised concerns about the indications for surgery in many cases in CHI at Temple Street and NOHC. 'We will also discuss the ICT transformation projects to ensure electronic patient records (a national health service pilot project), material non-compliant procurement, the settlement with the former CEO of CHI and other legal costs incurred during 2023.' Also before the committee is the National Treatment Purchase Fund (NTPF) which pays for public hospitals to carry out in-house additional work and also for private hospital care. It is under the spotlight after concerns that it is not keeping proper track of the use of the funding. In her opening statement CHI chief executive Lucy Nugent has also apologised unreservedly to the families impacted by the Hiqa report showing the use of unauthorised implants during spinal surgery. She also apologised for the unnecessary use of hip dysplasia surgery in some children and also for the findings of an internal report from 2021 showing misuse of NTPF funds for extra clinics which may have left some children at risk and waiting longer for care. 'I wish to apologise unreservedly. Children, young people and their families were failed and we need to rebuild trust in CHI." She told the committee: 'I want to speak briefly to the issue of publication of the various reports and the suggestion that CHI has been evasive in reporting or commenting on these issues. CHI is a statutory body and must respect the legal advice we receive, not to mention the moral imperative to protect the confidentiality of patients. We also have a duty to see that matters are properly investigated and that due process is carried out. 'This can sometimes mean that we cannot comment on matters even if they are reported in the media or elsewhere. This does not mean that we are not mindful of the great upset that such reports cause parents and children and the gravity of the issues. "But I want to assure members that this is never the intention; our intention is always to ascertain the facts and take steps to fix the issues whilst at the same time telling parents and children what we are doing.' She has spoken of strengthening management. 'In my first 5 months I have worked with the Board and my executive colleagues to enhance our governance structures and stabilise the executive management team with the hiring of a permanent Director of People & Culture, Deputy Chief Executive Officer and Chief Operations Officer. The recruitment of a Chief Finance Officer and Director of Quality, Safety and Risk Management has commenced. I am delighted that these high calibre, new colleagues have chosen to join CHI." Referring to the use of NTPF money for extra clinics held by a consultant in 2021 she said: "There was some misunderstanding in media reports in relation to NTPF payments to a CHI Consultant. I can confirm that the clinics at the centre of the reports did not take place in the consultant's private rooms. "They occurred in a public clinic, in one of our hospitals, on a Saturday. It was a waiting list initiative for an outpatient appointment only. A longer-term sustainable solution for referral management was put in place and the roll out of this system is ongoing. All services will be on this central referral systems in the coming months.' She told the committee; 'CHI will, move into the newly named, National Children's Hospital Ireland. In May, we updated you on plans to undertake a programme of commissioning to see our services, finally, move into a building worthy of the children of Ireland, operational to international standards.' Ms Nugent added; 'For the last six years, we have been building our own organisation for that moment. We are integrating our teams. We are integrating our ways of working. And we are integrating and improving our culture. This is complicated, difficult- but vital.' Ms Nugent has finished her statement saying: 'We are committed to being open about our challenges as well as our successes. "We will publish regular updates on our progress in reducing waiting lists, improving outcomes, safety, and strengthening governance. "We recognise that rebuilding trust will take time. But we are determined to ensure that every child who comes to CHI receives the safest, most innovative and compassionate care possible.' Eilish O'Regan
Irish Independent
an hour ago
- Irish Independent
Fears Donegal hospital will be downgraded if rejected as location for surgical hub in favour of Sligo
The ongoing debate on Sligo University Hospital (SUH) being selected as the preferred option for a new surgical hub in the North West, with no consideration being given to Letterkenny University Hospital (LUH), was raised on Wednesday in the Dáil. It comes as Minister for State, Deputy Harkin stated on Highland Radio that the location of the surgical hub in Sligo was decided as part of a deal made during negotiations on the Programme for Government to secure support from the Independent TDs. Speaking on Highland Radio, Minister Harkin said, 'One of the things I was insistent on was that we had, what then was in the HSE business plan, described as a surgical hub for Sligo and I still support that.' Minister for Health Jennifer Carroll MacNeill has said no decision has been made on the location of the surgical hub. HSE West and North West has submitted a business case supporting the implementation of a North West Surgical Hub. Within the business case, a greenfield site owned by the HSE in Sligo has been identified as a potential development location for a hub. However, Consultants and General Practitioners from Donegal have met with the Minister for Health to discuss Letterkenny University Hospital and the positioning of the surgical hub in the North West. The doctors believe that based on geography, population and demographics, day case numbers, staffing numbers and a range of other key metrics, the surgical hub should be at LUH. Speaking in the Dáil, Donegal Deputy Pearse Doherty said if the surgical hub is located in Sligo, LUH is at risk of losing the accident and emergency department and maternity services while the hospital could be downgraded to a model three hospital. 'We have heard from an unprecedented number of doctors, surgeons and consultants in Letterkenny hospital and they have told us that without the surgical hub there, they are at serious risk of losing accident and emergency services and maternity services within a short period. ADVERTISEMENT "That is why they and all the politicians in Donegal have come together and made it very clear that we need to see a surgical hub delivered in Letterkenny. "This would not be to the detriment of Sligo – we believe the north-west region has been left behind for far too long – but there has to be a location in Letterkenny,' said Deputy Doherty. Deputy Doherty called on the government to come clean and questioned if the Department ascertained whether there was any 'secret deal' in respect of the location of the surgical hub. 'That is news to us, the TDs who sat across the table from the Minister for about an hour and a half making the case for the surgical hub because the Minister will eventually be the person who decides on the location. "It is news to us, having sat repeatedly in meetings with the HSE arguing the toss about why the surgical hub should be in Letterkenny. "I am sure it was news to the 160-plus surgeons, consultants and doctors who signed the letter making very reasonable medical arguments for the locations. 'I want the Minister of State to come. That clarity is needed,' said Deputy Doherty. Deputy Pádraig MacLochlainn said the Donegal TDs are not asking for special treatment but are asking that citizens do not have to travel long distances for care that should be provided in their own community. 'We are asking that our emergency services not be allowed to collapse and that we have the necessary number of surgeons and consultants in Letterkenny University Hospital. "If there is to be only one surgical hub for the north-west region, a huge region extending from the top of Donegal down into Roscommon, I imagine, and that hub is not in Letterkenny, it will be a disaster for County Donegal and our services. "Those are not my words but those of the consultants.' Deputy MacLochlainn also raised that the number of permanent surgeons at LUH has reduced from six to three in a short period of time. "We cannot attract the level of surgeons we need. "If the Minister decides the surgical hub for the Northwest is in one place, Sligo, it is just a death knell. "It is extremely serious. I have never seen 171 doctors, consultants and GPs, sign a letter. I do not know anywhere in this State where this has happened. "That is how serious this is. "I will reiterate that we are not playing the game of divide and conquer. "Sligo, the north-west, Donegal and all of us deserve this. "There is an absolute unique case now for a surgical hub in Letterkenny and Sligo to be delivered at exactly the same time to have the quality of services our people deserve, to protect what we have and to protect our emergency services,' said Deputy MacLochlainn. Speaking on behalf of the government, Minister of State at the Department of Education and Youth, Deputy Michael Moynihan said no decision has yet been made on the location of the north-west surgical hub. "The Minister is taking time to consider and understand the situation in Donegal. "This includes engagement with local representatives, doctors and consultants. "I know she was due to meet some of them last night. She remains committed to positively engaging with everyone who is interested in delivering the best healthcare for the people of Donegal.' Deputy Moynihan said the Government is committed to the ongoing development of the hospital and has allocated significant resources to meet the needs of patients there, including an increase in the hospital's budget by 57% over the last five years. "I will take the points the Deputies raised back to the Department and seek clarification for them,' said Deputy Moynihan.
Irish Times
3 hours ago
- Irish Times
NTPF ready to restore funding to Beaumont Hospital when it receives ‘assurances over use'
The National Treatment Purchase Fund (NTPF) is ready to restore funding for insourcing initiatives to tackle waiting lists at Beaumont Hospital when it receives sufficient assurances regarding its appropriate use, the organisation's chairman Don Gallagher is to tell the Dáil Public Accounts Committee today. The provision of such NTPF funding for Beaumont has been paused since April on foot of what were described as 'potential financial irregularities'. The HSE this week defined insourcing as the practice of engaging external companies or third-party providers to deliver services often outside of normal working hours using public-owned facilities and equipment. It often employs existing healthcare personnel on premium rates. In an opening statement to the Dáil Public Accounts Committee on Thursday, Mr Gallagher will say that upon learning of 'potential issues in relation to NTPF-funded insourcing work at Beaumont Hospital, it immediately suspended all insourcing work and payments at Beaumont and informed the Department of Health and HSE of its concerns'. READ MORE He will say that HSE internal auditors are currently carrying out a detailed review in Beaumont. 'We are ready and willing to recommence insourcing in Beaumont once we receive the necessary assurance regarding the appropriate use of NTPF funds. We are working closely with the HSE regional executive office on this matter.' 'The public must have full confidence and trust in the insourcing process. We are working alongside the Department of Health and HSE to increase governance and oversight across our insourcing work with public hospitals.' The Irish Times reported last month that the catalyst for the suspension of funding for insourcing initiatives was a letter sent by consultants in one specialty to the chairwoman of Beaumont. The letter maintained the hospital had billed the NTPF for about 1,400 patients over a number of years who had actually been seen at regular public clinics. On Wednesday, Fiona Brady, chief executive of the NTPF, told the Oireachtas Joint Committee on Health that the letter had been written by rheumatologists at Beaumont Hospital. She said the issue had emerged after she noticed in January that Beaumont Hospital had not applied for insourcing funding. It had received about €8 million the previous year. Ms Brady said she had arranged a meeting with her counterpart at Beaumont at which she was shown a copy of the letter sent by the rheumatologists. She said subsequently a review of invoices submitted over a one-year period had been carried out. 'The NTPF had been billed as if it was additionality,' Ms Brady told the committee. [ HSE chief tells Oireachtas group that 'we took our eye off the ball' Opens in new window ] The Public Accounts Committee is also expected on Thursday to question senior management at Children's Health Ireland (CHI), which runs paediatric hospitals in Dublin. Questioning is expected over an unpublished and highly controversial internal report from 2022 which questioned whether special weekend clinics funded by the NTPF in one specialty had been needed. The NTPF suspended funding for insourcing initiatives at CHI for a period in May and early June after details of the 2022 report were leaked. The funding was later restored.
