A major row around top-up allowances to three senior staff at the National Maternity Hospital in breach of Government pay policy could see the hospital fined.
The Health Service Executive (HSE) has said that the row over top-ups with the hospital was disappointing but warned that should Holles Street continue to refuse to cooperate then financial penalties would be applied.
Ian Tegerdine, National HR director with the HSE has told the Oireachtas Health Committee said the stand-off is now being dealt with at national director level.
"If the hospital fails to comply, there will be sanction. They could receive a financial penalty," he said.
Given the hospitals failure to cooperate, Mr Tegerdine said there would be a process of escalation toward financial penalty.
He added that the board must now consider the matter as to the potential impact of the financial penalties on patient safety.
Mr Tegerdine said the HSE was unable to say whether the top-ups were being paid out of the public purse as the hospital had refused to disclose the contract terms with it.
He said the hospital claimed inability to cooperate on the grounds of confidentiality.
"The HSE hasn't seen the contracts. We haven't done due diligence on contracts.
"We stalled with them on the first hurdle, they have refused to disclose those details," he added.
At the committee, Mr Tegerdine was asked by Billy Kelleher of Fianna Fáil as to the levels of cooperation from the voluntary hospitals and agencies who were subjected to this internal audit.
He said the level of cooperation from the agencies could be described as "reluctant".
"The agencies reluctantly provided us with the information. It took a bit of time," he said.
He said the contracts requires them to reveal remuneration to their CEOs and other senior staff in their annual reports.
Under questioning from members of the committee, Mr Tegerdine said that many top-up allowances while in breach of the public pay policy were "legally unbreakable".
He said that in those cases, personal or "red circle" arrangements were decided upon, whereby the allowances will continue to be paid, but all future occupants of the role involved would not receive the payment.
"These cases are not desirable, but legally unavoidable. They are legally unbreakable."
The HSE said that it was not possible to reclaim these top-up payments from people who received them.
He said it was never the intention to back date the claimant of payments.
Mr Tegerdine said that it was inevitable that healthcare workers could be attracted to work in other, better paid sectors, given the restriction on pay rates in Ireland.
Mr Tegerdine said there was anecdotal evidence that there was difficulty recruiting talent given the limits on pay.
Mary Mitchell O'Connor raised the situation that several leading hospitals are without full time CEOs.
In a report to the Health Committee, the HSE that the National Maternity Hospital had been deemed to be non compliant with Government pay policy.
The Irish Independent reported last year that an audit carried out by the HSE into top-up payments to senior executives in voluntary hospitals and agencies funded by the exchequer – known as Section 38 bodies – had found that additional money from private sources was paid to three managers at the National Maternity Hospital. The amounts ranged from €30,000 to €39,000 a year.
The National Maternity Hospital receives about €45 million in State funding a year.
The HSE told the Oireachtas committees on Monday that 25 health agencies had made submissions seeking official permission to continue to pay specified additional payments or perks to 84 named employees.
The HSE said these employees were deemed to have an entitlement by virtue of their contract and the voluntary hospitals and agencies had sought approval to continue to make these payments on a person-to-holder basis .
The HSE has asked the Department of Health to sanction these payments.
“The support for all cases has been given on the strict understanding that once the current post holder no longer holds the roles and responsibilities attaching to the role, the non-compliant remuneration will cease,” it said. “ In addition, future appointments to the role will be in line with the Department of Health pay scales.”