The internal HSE audit examined the roll out of the Pandemic Special Recognition Payment given to frontline staff covering 223,000 health workers and found many got it on the double.
Of the €211m, some €88m was paid to 90,000 HSE workers and €51m to 53,000 Section 38 employees across 44 organisations. Another €72m was given to staff in 773 organisations involved in healthcare delivery.
However, up to €712,000 may have been paid out in excess as many staff received a double payment, it revealed.
It found control weakness and governance gaps and now agencies which are funded by the HSE who staff were included in the gift are rejecting efforts to look at the payments citing GDPR issues although the Data Protection Commissioner has said it would not constitute a breach.
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Today’s News in 90 Seconds – Wednesday, December 17.
The Section 38 agencies were included in the payments with eligibility verification decentralised to local service managers with no national oversight..
This increased the risk of inconsistent application of eligibility criteria, said the audit.
Payments to HSE senior management grades and the high approval rate of HSE appeals with 69pc successful indicate “potential misinterpretation of eligibility rules at local levels.
Some 539 senior managers in the HSE had received the payment which indicated a potential misinterpretation of eligibility rules .
“Payment accuracy controls were also inconsistent and the lack of early PPSN based validation in Section 38 organisations delayed duplicate payment detection with €712,000 of potential duplicate payments still under investigation.
This is in contrast to a private contractor which was hired to distribute the payment to non-public service healthcare in areas like nursing homes and had successfully prevented €4m in duplicate payments.
There were also overpayments to HSE staff , mainly due to duplicate payroll submissions were largely recouped but 63 remained under investigation at the time of the audit.
The auditors found no post-implementation or “lessons learned “ review was carried out representing a missed opportunity to strengthen governance.
In response a spokesman for the HSE said yesterday that a small number of duplicate or exceptional payments were identified as part of the normal post-payment validation process, primarily arising from individuals working across more than one employer during the qualifying period. The majority of these cases have already been resolved through standard reconciliation and repayment arrangements, and remaining cases continue to be progressed directly and confidentially with the individuals concerned.
The HSE has started a formal “lessons learned” review to ensure that enhanced national oversight, PPSN validation and centralised reporting mechanisms are in place should a similar scheme be required in the future. This review will build on the stronger controls used in later phases of the programme to ensure that future initiatives can be delivered both rapidly and with even greater assurance, he added
Meanwhile a separate audit looked at the how Beaumont Hospital in Dublin claimed for €25,000 from the National Treatment Purchase Fund (NTPF) for rheumatology clinics which were supposed to be additional to routine work but were done during core hours. It meant effectively the hospital was paid on the double for treating individual patients.
This was in breach of the agreement with the NTPF which pays hospitals to do additional waiting list work only.
Four rheumatology consultants in Beaumont Hospital wrote to the hospital board in August 2023 saying they had made multiple attempts to engage with management saying the under-reporting of work they did in regular clinics made them look less productive and made it difficult for them to advocate for additional staffing and resources.
This led to management discussing the matter with the doctors and no further claims for rheumatology patients were made to the NTPF since September 2023.
During a meeting in March this year the new chief executive of the hospital shared the consultants’ concerns with head of the NTPF and this led to the suspension of all insourcing funding to the hospital pending a reivew.
The NTPF said it has since introduced enhanced oversight and monitoring and while most hospitals already supplied details of how waiting list initiatives are being delivered it is not mandatory.
A current and signed memorandum of understanding must also be in place before any NTPF funded additional in-house work is done by a hospital.
In response a spokesman for Beaumont Hospital said that at all times, the hospital’s overriding focus “ has been to reduce waiting lists and the delivery of patient care to the community we serve.”The HSE audit confirms that throughout the period under review, NTPF funding enabled the delivery of around 1,700 rheumatology treatments.
Beaumont Hospital issued a full repayment of the €25,000 to the NTPF and the NTPF funding is now restored.