HSE hospitals have racked up staggering costs of almost €2.4m since 2005 hiring debt collection agencies to chase former patients for alleged unpaid bills.
According to figures obtained by the Herald following a two-month probe, a total of €2.35m has been handed over by hospitals in all four regions in the past five to six years to company's involved in the controversial practice.
In some cases, HSE hospitals have been employing the services of an international debt collection company to recoup cash they are allegedly owed, despite the existence of complaints against the firm.
Figures show more than a dozen Irish hospitals, including Tallaght and Beaumont, have paid Intrum Justitia almost €900,000 to recoup outstanding bills between 2006 and 2010.
However, the firm, which describes itself as "Europe's leading credit management services company", has been at the centre of complaints here and abroad over allegations of undue harassment directed at people it claims owe money on utilities ranging from phone bills to unpaid bin taxes.
Brian Hayes, the Fine Gael junior minister for public service reform, says he will examine the "substantial issue" of hospitals using debt collection firms.
"We need more transparency to be confident that we are not wasting money on cases where people have no possible way of paying," he said.
In 2009, Dublin City Council employed the firm to collect alleged outstanding bin tax debts and in letters to residents, Intrum Justitia warned that it would call to people's homes in what would have resulted in a "a potentially embarrassing encounter".
"We would like to give you a final opportunity to contact us before we send our collection agent to call at your address or pass your account directly to our solicitor for legal action," the letter stated.
Independent councillors slammed the move as "undue harassment". The council admitted it had received complaints from residents "concerning the activities" of the company, but said it had instructed representatives not to visit people's homes.
In addition to this, internet consumer protection message sites list numerous complaints from people who say the firm is "threatening" and "aggressive".
"I've had dealings with this horrible company," one poster to the British Consumer Action Group website wrote. "They can be quite aggressive and, to be honest, they do scare me. I try not to answer my phone sometimes, so the sooner I can pay these off the better."
HSE hospitals have paid the company €880,650 since 2006, according to figures obtained by the Herald, but the spend is likely to be higher as some hospitals did not give a full breakdown of the cash given to the firm.
By far the highest spender is Tallaght Hospital which has given the company a staggering €395,000 in the last five years to collect debts. A hospital spokeswoman did not respond to queries from the Herald.
An analysis of the total figures also reveals the Dublin Mid-Leinster region to have the biggest debt collection bill from the four regions shelling out almost €1.1m.
Following Tallaght, the Waterford Regional Hospital has spent €172,000 chasing ex-patients between 2005 and 2009 and is the next worst offender. Hospitals in Portlaoise (€134k), Tullamore (€134k), Ennis (€128k), Cork (€102k), Drogheda (€103k), Blanchardstown (€110k) and Mullingar (€114k) all shelled out an average of €20,000 a year or €100,000 in total since 2006.
The Mid West Regional Hospital in Ennis is the second-highest spender with the company and has shelled out €128,978 on pursuing former patients for outstanding bills.
A spokesman said the hospital was not aware of any "serious issues". However, he said: "There have been a number of instances where people paid their bills while noting that they did not like the use of debt collectors."
The HSE did not provide details of the level of cash recouped for the taxpayer. Almost all of the contracts for collecting debts are held by Cash Flow Services -- now in examinership -- and Intrum Justitia.
Defending the company, Mark Ridout, the firm's managing director in Ireland, said the service it provides to hospitals is of the "utmost importance" and claimed IJ had received no complaints through its "stringent complaints procedure".
"As with all professional organisations, there are always some complaints, but when you work within our industry, you realise that the majority of the complaints stem from the fact that a consumer feels aggrieved that we have been engaged in the first place to collect any outstanding monies due and not in fact about any inappropriate conduct."
He said any comments on internet forums "cannot be upheld as factual". He pointed out that workers are vetted, abide by legislation when performing their duties and go through "stringent training and retraining".
"We are acutely aware of the financial hardship patients may endure after attending/incurring a hospital bill. That is why our approach to any overdue medical bill is one of compassion and understanding."
No complaints have been received by it over its handling of the bin charge for Dublin City Council, he added.
An HSE spokeswoman said it has received a "limited number" of complaints from former patients but added the overall spend on debt collection was small when compared to the income generated by hospitals.
Despite being invited to comment on Intrum Justitia, the HSE would not answer specific questions.