The head of the Dail's spending watchdog has said he has no confidence that officials working for Public Reform Minister Brendan Howlin will finally bring an end to the hospital top-ups controversy.
In a stinging attack, Public Accounts Committee chairman John McGuinness said he did not believe they had the appetite to take on the voluntary hospitals and charities where certain staff are receiving unauthorised payments.
"They won't grasp the nettle on anyone. They can talk about reform, but they aren't good at implementing it," said Mr McGuinness.
His comments came after the Department of Public Expenditure and Reform (DPER) said it could not predict when a review of top-up arrangements would be completed.
Department officials are considering business cases put forward on behalf of 75 health workers, who are earning above HSE guidelines, to decide whether the arrangements can continue.
The cases involve people who believe they have a contractual entitlement to the additional payment.
In one case, a staff member at Stewarts Hospital has been in receipt of an on-call allowance worth 15pc of salary since 1991. Officials acting for Health Minister Leo Varadkar referred the matter to DPER last month after receiving the business case documentation from the HSE.
The HSE had pledged to end top-ups last year, but rowed back on this after a number of hospitals and charities sought to be indemnified against potential legal action for breach of contract.
Asked when a decision on the business cases could be expected, DPER said in a statement: "The Department of Public Expenditure and Reform is reviewing business cases submitted in consultation with the Department of Health and will be responding formally when the review is complete."
Pressed on the issue, a department spokeswoman said she could not give a date for the completion of the review.
Mr McGuinness said the lack of clarity simply wasn't good enough as the issue had been "trundling along" since late 2013.
"DPER has been demanding these changes and talks a good talk, but that is it," he said.
"I would be challenging them to step up to the plate and do what they say they are doing. Because all we are hearing at the moment is a lot of guff and no action, predictions of savings and no savings."
The HSE had previously insisted top-up payments should end by July of last year.
However, many organisations maintained they could be sued by staff members if the payments are ended.
Sources said some hospitals had sought an indemnity from the HSE in the event of being sued, a proposal rejected by the HSE.
Initially, 202 business cases were made by hospitals and disability agencies. The majority of these subsequently fell by the wayside due to a combination of factors.
Some were dropped, others rejected by the HSE, and a number ceased to be an issue due to retirements.
However, 75 cases remain to be adjudicated on.
If DPER officials decide these people can continue to receive the unauthorised allowances, whoever replaces them on retirement would not be entitled to the same additional payments.
The top-up payments being scrutinised include:
• A €18,478 allowance paid to a senior staff member at Beaumont Hospital on top of their €85,407-€103,943 salary scale;
• Allowances of €7,083 paid to two other staff members at the same hospital in addition to their salary scale of €65,376-€79,481;
• Arrangements for 13 managers at different Brothers of Charity organisations around the country;
• Flexibility and on-call allowances of €8,000 paid to staff at the Cappagh National Orthopaedic Hospital on top of salaries ranging between €64,812 and €103,943;
• Allowances ranging in value from €2,166 to €20,000 for four staff at the Coombe;
• A €9,637 on-call allowance for a member of staff at Leopardstown Park Hospital;
• Allowances from €14,017 to €28,035 paid to six people at the Mater Hospital;
• Sums of between €4,000 and €10,000 paid as allowances to six staff at Our Lady's Hospice in Harold's Cross;
• An allowance of €30,000 paid to a staff member at Our Lady's Hospital in Crumlin;
• An €11,485 allowance for a senior staff member at the South Infirmary Victoria University Hospital;
• Additional payments worth up to 15pc of salary for several staff members at Stewarts Hospital;
• An on-call allowance of €7,724 paid to a manager at St James's Hospital;
• A €43,468 allowance paid to a consultant at the same hospital;
• A €13,527 sum paid to a tutor at St Vincent's Healthcare Group.
Separately, several staff members at the Central Remedial Clinic saw allowances they were receiving cease last month.