A LITANY of waste and value- for-money failings across key areas such as staffing, patient transport, drug payments and computer systems has been revealed in a series of confidential internal audits carried out by the HSE.
The audits, obtained by the Irish Independent, come as the health service is forced to inflict cuts of more than €721m this year, including withdrawing medical cards from 40,000 people.
The findings from the HSE's national office of internal audit showed that a number of staff were reporting for duty to an unnamed special care unit in Limerick and receiving weekend premium payments even though it was closed.
A random audit of transport provided by taxi firms in the mid-west for kidney dialysis patients also found the spending went 65pc over budget in 2011.
Some taxi drivers -- who were ferrying patients to attend centres in Limerick, Tullamore, Galway and Dublin -- were more than doubling the mileage if they had two passengers.
One taxi firm charged €8.33 a mile for a six-mile journey.
In contrast, another covered a distance of 66.6 miles and the payment worked out at 0.75c a mile.
The audit said it was difficult to work out from invoices if mileage was charged per journey or per person travelling.
Three taxi firms charged for patients on a particular day even though they were not named on the booking schedule. There was limited checking of invoices through checking with the dialysis centre if the booked patient kept the appointment.
A sample of payment claim forms from pharmacists under the Drugs Payment Scheme had no patient signature to confirm the patient received the medication.
A review of accounts of external agencies, which get around €1.74bn HSE funding to provide services in areas like disability, found just 11 of 23 surveyed had a written code of governance to ensure they were well run.
The HSE does not have a complete record of assets held by these agencies even though, as a condition of the provision of funding, it has a hold over the property.
The auditor warned that income which these agencies with charity status were getting from other sources was not sufficiently analysed and some of them failed to declare the money in their annual accounts.
Client funds held by the agencies are sometimes not disclosed in their balance sheet.
Sligo General Hospital entered into an agreement with a private provider to provide MRI services without going through a proper procurement process.
An audit of Waterford General Hospital found inadequate protection of patient data.
No monitoring and reporting of how it is complying with data protection is in place.
Staff cannot send patient details through email in an encrypted format.
Patients are not adequately informed about the potential further use of their personal information.
The audit report found that a number of the failings were due to a "gap at national level".
Major weaknesses were found in the management of computer operations.
Variations emerged in the amount of annual leave allocated to nurses working in mental health services and intellectual disability care in the HSE South, with some getting much longer for working a public holiday than others.
An examination of primary care teams in the Dublin Mid-Leinster region of the HSE found €20.8m was spent in setting them up between 2006 and 2010.
These teams, designed to provide one-stop shops for patients with GP, nursing and therapy professionals working together, need to do more work to extend their hours of cover. They are also failing to provide proper services for patient with long-term illness.