Minister for Health Stephen Donnelly has instructed the Health Service Executive to carry out an audit of how it buys, manages and uses personal protective equipment (PPE) for healthcare staff on which it will spend close to €1 billion this year.
The move follows serious concerns within Government over several months that the HSE was not following official rules governing such expenditure. The Department of Public Expenditure maintained that at one stage earlier this year the HSE had spent about €120 million on PPE over and above the amount sanctioned by the Cabinet.
Mr Donnelly told HSE chairman Ciarán Devane it was essential that the exchequer’s investment was protected and maximum value for money achieved.
Mr Donnelly said in a letter at the end of August that most of the expenditure that had already occurred or which had been committed up to that point “has not been in compliance with the agreed sanctioning process”.
The Minister said that he was obliged to seek the Government in the summer “to regularise the financial sanctioning position” of the Health Service Executive in respect of personal protective equipment procurement.
In essence the Government decision in late July to allocate a further €670 million to the HSE was in part to authorise retrospectively expenditure on PPE that had already been made over and above officially-sanctioned levels or commitments which had been entered into.
Mr Donnelly said he had been advised that the HSE had introduced new control measures around sanctioning to ensure such a situation could not happen again.
Mr Devane told the Minister that the Health Service Executive had successfully supplied personal protective equipment to frontline staff “in an unprecedented, astonishingly competitive and highly volatile global market”.
He said the HSE's procurement response to the pandemic had been "swift and decisive and resulted in Ireland being ahead of many larger healthcare systems in securing key supply lines.
“As a consequence, arrangements to provide PPE to healthcare workers where and when they need it have stabilised considerably. The Irish healthcare system currently has strong availability of and access to PPE across all settings; and robust supply chains are well established. It is a strategic priority for the HSE that PPE is, and will continue to be, made available to healthcare settings at a scale commensurate with clinical guidance,” he said in a letter at the end of October.
Mr Devane said a new strategy as well as a stabilisation in the market had meant a 30 per cent reduction in the price of personal protective equipment compared with in the earlier part of the pandemic.
Mr Donnelly told the HSE he wanted it to carry out a “thorough audit” of its systems and controls in relation to the sourcing, management and usage of personal protective equipment.
“This should take account of the clinical guidance in place in relation to usage, practical experience in actual use of PPE, relative rates of usage across the system and arrangements to ensure the most cost-effective approach across procurement, financial and stock management systems.”
Tender process
A spokeswoman for the Minister said the Health Service Executive was engaging at present with the Office of Government Procurement in relation to a tender process to appoint an appropriate body to conduct the audit on personal protective equipment sought by the Minister. The spokeswoman said it was expected that this audit would be under way in the first quarter of next year.
“Securing an adequate supply of high-quality personal protective equipment was and is critical for the protection of healthcare workers, patients, and the management of Covid-19 in line with infection prevention and control guidelines. It is important to acknowledge the success of the HSE, with the support of other Government agencies, in securing supplies of PPE for the Irish health and social care services in very challenging and indeed unprecedented national and international circumstances.”
The spokeswoman said that nevertheless, given the scale of the financial commitments involved and the much-increased level of personal protective equipment usage, the Minister had sought the HSE to carry out the proposed new audit.
