The Health Service Executive spent €38 million on external cleaning companies last year.

In a letter to the Dáil Public Accounts Committee (PAC), HSE assistant national director Ray Mitchell said the bill reached €38,222,274 in 2014. He confirmed €12,219,932 was distributed to five companies in the HSE East region alone.

PAC chairman John McGuinness said there were serious questions over the spend.

“This is an astonishing amount of money. There are a lot of concerns over value for money here. Several reports by the Health Information and Quality Authority have criticised hospitals for their lack of cleanliness,” he said.

“There have been a number of patients reporting dirty surroundings including dirty bed sheets.

“Yet the bill for cleaning companies is increasing every year. So there have to be some questions over whether this is the most appropriate way of doing business.”

The letter to the PAC shows Noonan was the biggest beneficiary from the outsourcing. It earned €16,252,614 for its services last year. It was followed by a firm called ISS, which received €12, 163,909 in 2014.

There are also 757 staff hired by the HSE as full-time cleaners. The gross pay cost for these staff in 2014 was €24 million.

This brings the total amount spent on cleaning by the HSE to €62 million.

Mr McGuinness said the PAC would be seeking further clarification from the HSE on the amount spent.

The correspondence from the HSE shows the breakdown of the bill by each region.

HSE West had a spend of €6,141,653, with ISS the biggest beneficiary; and the Southern region had a bill of €6,448,439, with Noonan receiving the majority of that.

In the North West region, €183,456 was split between two companies; and the HSE Midlands region had a cost of €444,306.

Fine Gael TD Paul Connaughton said it seemed an "excessive" amount that required more detail from the HSE.

“We all want safer and cleaner hospitals but a conversation needs to be had about whether we are getting the best value for our money,” he said.

“There are issues around government procurement services and the HSE is one of the biggest sinners. We need to check where that money is being spent, on what and whether there is scope for change. The HSE will need to be in a position to stand over the money spent and clarify the concerns surrounding it.”

The HSE will not appear before the PAC until after the summer recess.

Mr Connaughton said it would be raised with officials at that stage