€44,000 private fee came from public payroll
The cash-strapped National Maternity Hospital in Holles Street was €43,849 out of pocket for two years due to a private fee paid to master Dr Rhona Mahony, according to a HSE audit.
The money was paid to Dr Mahony through the payroll of the publicly funded hospital in 2012 and should have been recouped promptly from the proceeds of the semi-private clinic, operated by consultants, which is part of the complex.
Dr Mahony was fully entitled to the private payment for services to the clinic.
But the method of channelling it through the hospital's payroll has since stopped.
The audit, which was carried out in the wake of the salary top-ups controversy, found that four senior managers in the public hospital received additional payments for working in the semi-private clinic.
The HSE claimed this is against public pay policy, which dictates additional fees cannot be earned on top of a public salary. This is rejected by the hospital.
The clinic was provided with supports such as administration, staffing and managerial services. Two nurses, whose salaries were paid for from public funds, also worked on a part-time contract basis at the clinic, the audit showed.
The HSE review claimed there are "blurred boundaries" between the public hospital and the private activities at the hospital.
The maternity hospital will move to the campus of St Vincent's Hospital and will continue to house private suites for consultants.
The audit also found the semi-private clinic provided a loan of €1.4m to the public hospital to fund the development of four derelict buildings nearby. These properties were used as collateral for a €4.5m loan taken out by the clinic.
The properties were leased by the hospital to the clinic for a peppercorn rent.
In response to the audit, a spokesman for the hospital said: "It is hugely disingenuous to suggest the hospital was in some way mortgaged or used as collateral for loans to the semi-private clinic.
"The four buildings involved were bought by the hospital before there was State funding, when the maternity hospital was funded by wealthy do- gooders and charitable donations. It was therefore never HSE funded."
He said the hospital leased them to the semi-private clinic at a very modest rent.
The hospital has moved a large part of its administration out of a Merrion Square building, which cost €144,000 a year, and this now occupies one-and -a-half floors of the refurbished building rent free.
Commenting on the income from the semi-private clinic, he said it is pooled and distributed among consultants.
It welcomed the HSE's acknowledgement that the €40,000 payment to Dr Mahony "to which the HSE drew so much attention over a protracted period" is sourced from professional fee income, as the hospital has always stated.
The complex also includes Merrion Fetal, which provides scans to pregnant women and a fertility clinic.
However, the HSE said the "many close linkages" between the public maternity hospital and the semi-private clinic are a "matter of concern".
It could lead to "conflicts of interest".
There was a delay of one year in the semi-private clinic repaying a payment of €43,839 to a former master when it was also paid through the public hospital payroll, said the audit.
The Holles Street spokesman said, however, that despite over three-and-a-half years in preparation, the HSE internal audit had not "identified any actual conflict of interest in relation to the interaction of the various parts of the complex".