HSE was aware of report on allegations of toxic culture and waiting list irregularities, CHI tells Minister

Internal report ‘discussed’ with senior Health Service Executive figure at performance review meetings

A Children’s Health Ireland report raised questions over whether a series of clinics run on Saturdays was necessary. Photograph: Getty Images
A Children’s Health Ireland report raised questions over whether a series of clinics run on Saturdays was necessary. Photograph: Getty Images

The Health Service Executive was made aware of a controversial report containing allegations about a toxic work culture and potential irregularities in the operation of schemes to tackle waiting lists, Children’s Health Ireland (CHI) has told the Minister for Health.

The Irish Times understands CHI, which runs children’s hospitals in Dublin, said the contents of an internal report on issues in one of its hospitals had been “discussed” with a senior HSE executive.

CHI maintained in correspondence with Minister for Health Jennifer Carroll MacNeill that the report had been raised as part of performance review meetings. The assertion was made last week as part of a submission to the Minister, who had asked questions about the background to the internal report.

CHI did not reply to a series of questions submitted by The Irish Times about the internal report.

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The report was drawn up by Children’s Health Ireland in late 2021 and early 2022 but never published. The document caused consternation in Government after parts were first revealed by the Sunday Times a fortnight ago.

HSE chief executive Bernard Gloster, who took up office in 2023, said he had never been told about the document.

He described the allegations in the CHI report as “absolutely shocking”. The HSE this week referred the report to gardaí.

The report raised questions over whether a series of clinics run by a consultant at CHI on Saturdays for patients on waiting lists were necessary. It said the consultant had been paid an additional €35,800 under the National Treatment Purchase Fund (NTPF), which buys care for patients on long public waiting lists.

CHI consultant at centre of review did not fulfil on-call hours for three years due to ‘health issues’Opens in new window ]

The Irish Times reported this week that the CHI document maintained that there were “significant concerns relating to the prudent and beneficial management of NTPF funding and lack of oversight of access initiatives which are ultimately not in keeping with the memorandum of understanding between CHI and the NTPF”.

The report also said Children’s Health Ireland had a “broken culture – created by dysfunctional relationships and challenging behaviours”.

The National Treatment Purchase Fund said that on learning of the allegations a fortnight ago, it suspended, pending a review, arrangements at CHI – known as insourcing – that saw hospitals and staff receive additional payments for treating patients on waiting lists outside core working hours.

The Department of Health said on Friday that it believed NTPF funding for waiting list initiatives at Children’s Health Ireland would recommence imminently.

The NTPF said it took the issues around insourcing raised by the Children’s Health Ireland report very seriously and was working closely with the department and HSE on this matter.

“It is completely unacceptable that there would be any misuse of public money and that children would wait longer for surgery when the whole purpose of the National Treatment Purchase Fund is to ensure faster access to treatment for public patients. The NTPF will fully reserve its position in relation to any proven misuse of public money and explore all options for restitution while ensuring public patients get the treatment they deserve.”

It said that following initial reports about the CHI internal report, it immediately placed a temporary pause on all insourcing work with the children’s hospital group “while it initiated a review of this work to gather the necessary assurances regarding compliance, value for money and appropriate use of funding mechanisms”.

“This work is ongoing at the highest level with CHI to obtain and review these assurances. The intention is that the temporary pause will be lifted as soon as the NTPF is satisfied with the assurances given by CHI in this review so as to minimise any disruption to children and their families.”

It said media reports that claimed “thousands” of children would face surgery delays due to this pause were inaccurate, ill-informed and very disappointing to read.

Martin Wall

Martin Wall

Martin Wall is the Public Policy Correspondent of The Irish Times.