These are challenging times for those in charge of Ireland’s health services.
To well-schooled observers of the interaction between the HSE and its overseer, the Department of Health, the idea that these two entities might not be especially enamoured of each other wouldn’t exactly be a surprise.
But the sheer alleged frostiness of relations between the two, detailed in a series of disclosures by a Department of Health whistleblower over the past four days, is still gobsmacking.
And it looks set to cause political and social waves for some time to come.
The whistleblower is Shane Corr, a senior official at the Department of Health and veteran public servant of more than 20 years’ standing. Mr Corr was with the office of the Comptroller and Auditor General prior to his stint in Health.
He first came to public attention last May when he blew the whistle on the alleged practice at the Department of Health of collating ‘dossiers’ on autistic children to aid in legal battles demanding compensation.
He wasn’t done there. Having preserved his employment status by virtue of making his revelations subject to whistleblower legislation, Mr Corr has made at least six further disclosures since last September — first to his own department, and latterly to the Oireachtas committee on health and then the Public Accounts Committee.
The first five made little impression on the Oireachtas, though at least one of them was discussed by the PAC in private session.
But the most recent, chronicling the goings-on at an internal departmental meeting to discuss the financial status of the HSE on January 27, was disclosed four days later, before making its way into the
newspaper — courtesy of a 45-minute recording of the meeting in question — last Sunday.What was revealed was startling. The disclosure stated that the HSE had been funded for the recruitment of 10,000 new employees in 2022, but was only planning on hiring just over half that number. The chasing of “fake targets” in that manner was giving rise to “so much dysfunction”, the meeting heard, in terms of “trying to explain… stuff that we were never going to do”.
It revealed a disparity between the wants of ministers and politicians and what the department felt it either could or should be doing.
“On mental health, the HSE originally wanted €10m. We gave them €23m for 300 new staff. They said, in no way they could recruit those 300 new staff, and it was the minister actually wanted to give them €36m,” a department line manager told the meeting, according to the disclosure.
The meeting also heard the HSE may have to make a prior year adjustment to its financial reporting to the tune of “hundreds of millions”.
Regarding the “fake” recruitment targets, a senior official at the meeting said “it’s really problematic in terms of trusting us”, which seems like quite an understatement.
The revelations have kept coming all week, including in this newspaper.
- That recruitment targets for home care hours in Budget 2021 were allegedly “batshit”
- That HSE public nursing homes overran their budgets by €25m in 2019, €55m in 2020, and were projected to overrun by €107m for the full year 2021;
- That the HSE in terms of financial management and accountability is “kind of bit (sic) rogue”, and has a “blatant disregard” for what its oversight department says;
- That the Department of Health’s supplementary budget estimate for 2021 of €515m may never have been needed or ever even actually spent;
- That the €73m Temporary Assistance Payments Scheme of May 2020, designed to aid nursing homes that had suffered financial loss due to the pandemic, was allegedly being used to purchase ‘One for All’ vouchers for frontline workers in those homes, with a potential liability of €12m.
Mr Corr says he can back up each of his various disclosures. There are likely more to come.
The various reactions to these revelations meanwhile have been telling.
HSE CEO Paul Reid was out on Monday morning denying that the disclosures reflected reality, and said if there were to be a prior year adjustment “it won’t be in the region of hundreds of millions”.
The Taoiseach said the disclosures were not reflective of reality, and for some reason chose to focus on the fact that the January 27 meeting had been secretly recorded and that officials are entitled to “brainstorm”.
That avenue of attack seems particularly inappropriate — surely the only thing that matters here is that issues of massive public interest are being exposed?
The HSE, in terms of the January meeting, said any accounting adjustment would reduce expenditure, not increase it (which is scarcely the point, if the money wasn’t spent, where did it go?), and said it was “deeply disappointing” to see phrases such as ‘fake targets’ being used, and that the transcript of the departmental meeting represented a “serious slur” on the reputations of identifiable individuals.
Regarding the older disclosures, the executive said it hadn’t seen them and would not be commenting on them.
And the Department of Health? Well, it went on radio silence for nearly two days before issuing a bland statement saying that Minister Stephen Donnelly “meets regularly” with the HSE executive, meetings which are “professional, constructive, and respectful”.
So what can we read into all this?
It’s best to start with Mr Reid’s joint appearance with the secretary-general of the Department of Health Robert Watt at Wednesday’s health committee, ostensibly to discuss Sláintecare.
At that meeting, Mr Reid acknowledged there would indeed be an accounting adjustment, and that while it may not be for more than €100m, it would certainly be for more than €90m.
So straight off we have serious questions about the management, oversight and transparency of how the HSE spends, or not, vast amounts of taxpayers' money.
The idea that a €515m budget hike was granted to the HSE last year and no one seems to know what it was spent on makes a lot more sense in that context.
You can be sure the Oireachtas committees, which have dragged their heels on the disclosures to date, are likely to start taking them much more seriously.
Ditto the Dáil — the Oireachtas business committee has reportedly requested that time be given over for a special debate on the disclosures.
But in the end, it comes back to two men, Mr Reid and Mr Watt, the two best-paid public servants in the country.
They have some major fires to put out here. Time to start earning those massive salaries.