€130m patient nest eggs held by HSE 'are open to fraud'
The HSE has found several glaring gaps in how it manages €129.4m worth of private accounts belonging to nursing home residents and other long-term patients, leaving the finances vulnerable to fraud.
Currently, 9,645 nursing home residents, as well as people in disability or psychiatric facilities who live there permanently, have left their private accounts with the HSE for safe-keeping.
They can include bank accounts, pension books, property documents, investments or jewellery.
However, the HSE's latest annual report on the management of the accounts reveals how a lack of staff in some care centres means the same person may have been doing lodgements, payments and bank reconciliations.
Best practice is that these duties be split among different health workers to avoid the risk of fraud.
The report, which relates to 2015, and is signed off by HSE chief Tony O'Brien and financial controller Stephen Mulvany, said that due to the size of many care centres it was not economically feasible for the HSE to assign extra staff to such locations to ensure there was full segregation of duties at all times.
Instead it has put "compensating controls" in place which include minimising the level of surplus funds held in care centres and transferring dormant sums to the HSE's central unit for private property accounts.
The report also highlights other weaknesses including the failure of some care homes to complete reconciliations on a monthly basis.
There were specific problems in completing reconciliations in the southern area and this led to the appointment of a staff officer to address issues in some centres in the region.
The HSE said it had drawn up a work plan on managing the build up of accounts that had not been subject to bank reconciliation and the aim was to have had it completed at the end of 2016.
The report also pointed to instances where there was inadequate documentation supporting withdrawals from patient accounts in the care centres.
This led to guidelines being issued to care centres but some breaches continued. There has been no evidence of misappropriation of the patient's funds or evidence of fraud, according to the annual report.
Centres should keep the patients' balances at between €200 and €800.
The rest should be sent to the HSE's central unit where it is invested in a central fund, currently with the National Treasury Management Agency.
New rules governing private patient accounts were introduced a decade ago after it was found that care centres could no longer retain the interest as an administration fee for handling the financial transactions.