HSE to review role of doctors in clinic
THE involvement of the master of the National Maternity Hospital Dr Rhona Mahony and four consultant colleagues in a private clinic is to be reviewed by the Health Service Executive.
HSE chief Tony O'Brien said he will have to examine whether the Merrion Fetal Health clinic located next door to the hospital, which provides ultrasounds and is run in partnership with five consultants, represents a potential conflict of interest for these doctors.
Mr O'Brien was replying to queries from members of the Dail Committee on Public Accounts in the wake of an audit showing voluntary hospitals and agencies funded by the HSE are flouting public pay rules by paying salary top-ups to managers.
Dr Mahony, who is listed in a HSE audit as receiving a €45,000 privately funded allowance, has said the money comes from private patients.
She is among five doctors in the hospital who are partners in the private clinic.
Mr O'Brien said funding had already been cut from one disability organisation, the Cope Foundation in Cork, which is paying a publicly funded top-up of nearly €25,000 to its chief executive.
Other hospitals and agencies are now facing the same sanction but he admitted that the HSE was in a dilemma because any cuts in funding could hurt patients and clients.
"We will have to find ways of doing that without any diminution in service," he added.
Dr Mahony was among the senior managers listed in a HSE audit as getting a €45,000 privately funded allowance.
But she has since insisted that this is money which comes from private patients.
Questioned on how the allowance was termed "privately funded", the HSE auditor Geraldine Smith said this was how it was described in the information she received from the National Maternity Hospital. She was "further assured" by the hospital, which said it was validated by its chairman, Archbishop Diarmuid Martin.
"It clearly states that there are four privately funded allowances paid," she said.
When questioned on the sources of funding, she was told it came from "rents, licence fees and other incomes". It made no mention of payments from private patients.
Meanwhile, the committee was told that there was no paper trail for the 36 allowances discovered in the audit which would indicate that the Department of Health sought clearance for the payments from the Department of Finance -- which was the correct procedure.
Some agencies referred to verbal agreements, but the HSE admitted that the senior management allowances were reflective of the "nod and a wink" culture of the times.
The committee was told that St James's Hospital in Dublin was among the health agencies which told the HSE that it is not paying salary top-ups, but which is under fresh investigation.
Mr O'Brien said several hospitals and agencies, which are claiming to be compliant with public pay policy outlawing top-ups, may be flouting the rules.
The latest information showed that 30 of the 42 are claiming compliance. Some are claiming to be compliant while identifying certain "exceptions".
"Some agencies are currently claiming to be compliant while at the same time identifying individual exceptions. For this reason, a further process of verification and clarification is now required.
"Until the situation in each organisation has been fully verified none of these organisations can be deemed fully compliant."
He faced strong criticism of the failure of the HSE to properly monitor and stamp out the practice over the years.
The committee is now going to ask the hospital managers and the chairman of their boards to appear before them to account for the payments.