Second hospital investigated for financial irregularities in national waiting list fund
The national fund covering hospital waiting list initiatives is now investigating a second hospital for "potential financial irregularities" and has asked all hospitals to report on their use of this money.
The National Treatment Purchase Fund (NTPF) has faced scrutiny since an unpublished report revealed that extra clinics held on weekends at Children's Health Ireland (CHI) did not meet the required criteria.
In fact, the report raised concerns that some children waited longer than they would have through standard care due to how the funding was used in this case.
The NTPF paused funding for this insourcing work — where a hospital pays a sister facility in its group to treat patients — at CHI.
On Tuesday, they said they are now to 'recommence insourcing work, effective immediately, with CHI after a review of the assurances given by CHI in relation to its ongoing compliance with existing NTPF protocols and procedures.'
However, in the first sign that these issues extend to other hospitals, as opposition politicians recently warned, the NTPF confirmed that another site is now under investigation.
'The NTPF confirms it has also alerted the Department of Health and HSE about potential financial irregularities in relation to NTPF-funded insourcing work at another public hospital. The NTPF has suspended all insourcing work with that hospital since 11th April,' a spokesman said.
'The NTPF immediately informed the Department and HSE of these concerns and is working with them in relation to the ongoing review. The matter has been referred to the HSE's Internal Audit team. The NTPF is restricted from making further comment at this stage.'
A spokesman did not immediately respond to questions about when the HSE and Minister for Health were informed of the issue.
The fund has written to all hospitals receiving insourcing funding, requesting confirmation that the work complies with required guidelines.
'A strict deadline of next Monday, June 16th has been given for the completion of these replies and the NTPF will report on this to the Department and the HSE,' the spokesman said.
Chief Executive Fiona Brady said the NTPF is 'deeply concerned' that proper procedures were not followed.
'The NTPF will now increase governance and oversight across its insourcing work with public hospitals, who up to now have been responsible for this internal governance,' a spokesman said.
They have shared this plan with the HSE and the Department of Health.
Read More
Mental Health Bill may delay treatment for teenagers, Oireachtas committee hears
Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles
The Journal
an hour ago
- The Journal
Redacted version of CHI report could be published this week, Health Minister says
THE MINISTER FOR Health has indicated that a version of an unpublished report detailing concerns at Children's Health Ireland (CHI) may be published this week. The internal investigation, the details of which were first reported by the Sunday Times and subsequently seen by The Journal and other media outlets, came about after concerns were raised about how waiting list initiatives were being carried out at a hospital run by CHI. It detailed how a consultant was paid €35,800 by the hospital after money was received from the National Treatment Purchase Fund (NTPF) to help cut long waiting lists. The HSE has referred the report to gardaí and the Irish Medical Council. Jennifer Carroll MacNeill has previously called for a redacted version of the report to be published. Speaking on Newstalk's Anton Savage Show this morning, she said she had not published the report after checking with the Attorney General because she has 'no legal basis' to do so. 'This was an internal human resources-type report going into some very serious cultural issues, and the people who participated in it, nurses, junior doctors and so on, they participated in it on that basis, in a confidential way,' she said. Carroll MacNeill said the report reflects what some staff said in confidence and that some of them would be identifiable In the normal course, you'd never publish something like that, but the issues in this are of such seriousness that in the broader public interest, a version of it must be published. She said that CHI are reflecting on how to publish the report 'responsibly' so that it 'tells the maximum story behind it and the steps of what has been taken next'. Advertisement When asked if she knows when this will be published, she said: 'I suspect it will be this week.' The Fine Gael TD said it is important that the people 'who might have given descriptions about what they were feeling and perhaps some of the pressures they felt' are appropriately protected. On hospital governance, Carroll MacNeill said she had a lot of questions about the different governance structures across the country. 'Ireland is a small country. It's five and a half million people. We spend a very significant amount of our taxpayers money on health, quite appropriately, but we need to make sure that we're getting the best value for that.' She said CHI was formed in an effort to create a single entity that would bring Temple Street and St James's hospitals together, adding that it has 'done that and has brought it to a certain point'. 'There's no question about that, but I do think that there's very much more work to be done to integrate a single pediatric system.' National Children's Hospital The Minister was also asked whether it was appropriate that CHI are permitted to run the new National Children's Hospital (NCH). The earliest date that the hospital will now be open to patients is June 2026. 'I think we'll be reflecting on that sort of policy structure over the next year,' she said, adding that her first concern is that the NCH is opened at the earliest possible date. She said that there are 140 consultants within CHI, and that these issues have been created from 'a very small proportion'. 'I am a parent of a child in CHI, many, many others are and they know that it's a very good service. It's very, very functional. But that doesn't mean we don't need to get deep into these problem areas.' Last month, Carroll MacNeill appointed two HSE board members to the board of CHI after three of its members resigned following the release of an independent review into children's hip surgeries at three CHI hospitals. Related Reads HSE to refer unpublished Children's Health Ireland report to gardaí and Medical Council Health Minister calls for CHI report on consultant misuse of waiting list system to be published Three members of Children's Health Ireland board resign after review into hip surgeries 'I do have another a number of vacancies which I think will need to be filled, and I think we will reflect on that in policy terms over the next number of months,' she said. She said the Government would keep 'a steady focus' on the delivery of services, the implementation of reforms where they need to happen and planning for the NCH. 'But I am watching and managing this very carefully from a medium-term policy perspective,' she added. National Treatment Purchase Fund The matter of the National Treatment Purchase Fund (NTPF) was also raised. The NTPF provides funding for patients on waiting lists to get treatment in both public and private settings. It pays for clinics to be set up in public hospitals outside of normal working hours, i.e on weekends, wherein staff already working at the hospital are paid additionally to carry out extra work. This is known as 'insourcing'. The NTPF had suspended funding to CHI hospitals over concerns raised in an internal audit, related to an insourcing clinic at the hospital. On Wednesday, it cut funding to another public hospital temporarily after finding ' potential financial irregularities' in relation to NTPF-funded insourcing work. Carroll MacNeill said that an audit of insourcing that she and HSE chief Bernard Gloster commissioned has been completed and that she expects to see the results 'possibly' in the next two to three weeks. She said the matter needs 'very serious and careful analysis', as does the issue of insourcing more broadly 'because of how it intersects with getting the best productivity within the public system'. 'We cannot have a fully public system and also be creating these other incentives. We cannot cut off these other incentives overnight because of the impact on patient care, but by God, we're going to be weaning ourselves off them.' Readers like you are keeping these stories free for everyone... A mix of advertising and supporting contributions helps keep paywalls away from valuable information like this article. Over 5,000 readers like you have already stepped up and support us with a monthly payment or a once-off donation. Learn More Support The Journal
Irish Examiner
2 hours ago
- Irish Examiner
Nursing home bed shortage looms as construction of new facilities stalls, experts warn
Few new private nursing homes are expected to be built for the foreseeable future, leading construction experts have warned, as a shortage of beds looms. Members of the construction industry and the nursing home care sector have predicted bed shortages, which could lead to price hikes in private nursing homes, with further questions hanging over the State's €1bn-a-year fair deal scheme. Officially known as the nursing home support scheme, the means-tested scheme helps people pay for basic care in private nursing homes. Home Care Direct chief executive Michael Harty said: 'Any shortage of beds in private nursing homes will force people either to pay over the odds for a bed, or will force them to look closely at home care. 'Private operators will dedicate less beds to the fair deal scheme and more to customers who can pay above the odds.' The Irish division of the world's largest commercial real estate services and investment firm, CBRE, has also flagged a 'very worrying' scenario for the Irish nursing home sector. CBRE research senior director Maureen Bayley has heard of plans for two new private nursing homes. One of the homes will be built in Kerry, while the other will be built in Dublin. 'They have yet to get off the ground,' she said. 'Other than those, there are no new private nursing homes due to be built for the foreseeable future.' She believes the Government needs to create more incentives for the development of homes, undertaking a 'long overdue' reform of the fair deal scheme. More should also be done, she believes, to help people grow old in the villages, towns, and cities where they have lived for most of their lives or settled in before they retired. Ms Bayley, whose updated nursing home report is due later this year, said: 'We don't have a well-established senior living sector. 'There are some retirement villages outside of towns and cities, but people should be supported to 'age in place' in the towns, suburbs, cities where they spent their lives, so they still have the community support around them.' Officially known as the nursing home support scheme, the means-tested scheme helps people pay for basic care in private nursing homes The CBRE statement comes as the HSE confirmed just 160 extra beds will be provided from new public nursing homes, which are due to open fully this year under the State's community nursing unit investment programme in 2025. A HSE spokesperson told the Irish Examiner: 'For beds to be completed in 2026, the national service plan for 2026 has yet to be finalised — which would include the planned beds. 'It is also too early in the cycle to provide firm details on beds to be completed due to various factors which affect construction projects, for example: Design progression, availability of resources, market constraints, and weather conditions.' Age Action head of advocacy Camille Loftus cautioned that nursing homes alone are not the answer. 'While we are all living longer, it doesn't automatically mean we are getting sicker. We believe more emphasis should be given to not just building on existing home supports, but also building age-friendly housing,' she said. In the meantime, the existing nursing homes and home care models are all facing the same crisis: A lack of staff. Mr Harty said: 'Nursing homes and home care are incredibly lucrative businesses. Perversely, they don't provide [financially] attractive careers.' The ESRI has estimated that about 4.5% of all people aged over 65 will require a nursing home bed. Meanwhile, the number of people aged 65 and over is estimated by the CSO to have risen by over 40% between 2013 and 2023 — from 569,000 to 806,000. In its January 2024 snapshot of the lives of older people in Ireland, the CSO stated this figure is expected to double again to 1.6m by 2051. The HSE runs 127 community nursing units that have a total of 6,563 short and long-term beds, just over 16.3% of the total available beds. These include beds provided by the 10 homes run by the voluntary Section 38, HSE-funded bodies. The average State-funded paid cost of care, per bed, per week in public and voluntary nursing homes is €1,931 — up from €1,865 last year and €1,698 in 2022. By contrast, the average figure for what private nursing homes — in a sector that supports around 415 homes and 26,000 beds — receive in 2025 on the fair deal scheme is a little north of €1,206. The home care sector, which represents 60,000 people whose home care is up to around 21 hours a week, receives around €850m State aid annually. 'Hiqa is not short of laws, it is short of ambition' Former minister of state John McGuinness has said Hiqa has to explain 'exactly' why it has never held a statutory investigation into nursing homes. The watchdog has, he said, initiated statutory investigations under the 2007 Health Act into hospitals at the request of ministers or the HSE, and it has also initiated its own investigations. The former Public Accounts Committee chairman said: 'Hiqa is not short of laws. It is short of the ambition to ensure nursing homes are up to standards and residents are treated fairly. 'Hiqa needs to be made accountable for not using the laws it already has.' His comments follow the airing last week of the RTÉ Investigates documentary Inside Ireland's Nursing Homes. It showed shocking scenes — recorded by two healthcare assistants operating under cover — of older people being mistreated. Former minister of state John McGuinness has said Hiqa has to explain 'exactly' why it has never held a statutory investigation into nursing homes. File photo Hiqa is due next week before the Oireachtas health committee where members are expected to grill the watchdog. Colm Burke, a former minister of state at the Department of Health, will be at the meeting. He said: 'Hiqa has questions to answer.' Social Democrats TD Pádraig Rice, who is another committee member due to attend, said: 'Hiqa has serious questions to answer at next week's Oireachtas health committee meeting. 'The RTÉ programme exposed serious failings in inspection, oversight, and intervention in the nursing home sector. 'The problems with the State's over-reliance on this private model were laid bare during the pandemic, and after that an inquiry should have taken place. 'We need a regulator with teeth, long-promised safeguarding legislation, statutory homecare, and an urgent review of our hyper-privatised model of elder care.' In response to Mr McGuinness's criticism, a Hiqa spokesperson said the body looked forward to answering questions in the Oireachtas next week. They also pointed out that Hiqa has begun a review of all nursing homes operated by Emeis Ireland, which runs the two nursing homes — Beneavin Manor and The Residence Portlaoise — that featured in the recent RTÉ exposé. It also said that, once that is finished, Hiqa will then review how it inspects and regulates nursing homes and use the learning to 'strengthen how we do our inspections'. Read More Does the latest nursing home scandal show that Hiqa is a regulator with no bite?
RTÉ News
7 hours ago
- RTÉ News
Safeguarding concerns in the spotlight after RTÉ exposé
On Thursday, families of nursing home residents and those in disability services protested outside Leinster House in pouring rain. One by one, daughters, sons, nephews and nieces, mothers and fathers addressed those gathered about abuse and neglect of their loved ones in care, including in nursing homes. The event was organised by Care Champions. It is an independent advocacy group which was established when nursing home deaths and visiting restrictions were to the fore during the Covid-19 pandemic. Since then, a small team led by Majella Beatty has been fighting for the rights of so many families nationwide who feel they have no one else to turn to for support and empathy. For years, concerns have centered around safeguarding in nursing homes. Since the transmission of the RTÉ Investigates programme, Care Champions has been inundated. When he watched the programme, Minister for Older People Kieran O'Donnell rang Health Service Executive CEO Bernard Gloster to ask that the HSE put safeguarding teams into the two nursing homes in question. However, families claim they were told by local HSE safeguarding teams that they could not go in and assess private nursing homes under current legislation. In a statement, the HSE said that while safeguarding and protection teams do not have a legal right of entry to private nursing homes without the owners' permission, under the current statutory framework, they can and do, when required, enter private nursing homes with the owner's consent to respond to allegations of abuse and harm to residents and work with providers. Which led to the question, are safeguarding teams in the homes as requested by the minister, or not? The Department of Health said that the HSE had confirmed that the directors of nursing from both local HSE Community Support Teams had been onsite in the nursing homes and "are continuing to engage with them". Almost two weeks from the transmission of the programme, Majella Beatty says the families of residents feel abandoned. The HSE said that Department of Health policy "will provide legislative underpinning to strengthen governance across all parts of the health and social care system, including private nursing homes". That policy, due to be published this year, has moved at snail's pace in the last number of years and in the meantime, there have been repeated calls for adult safeguarding legislation following the Brandon case, the Grace case and the Emily case, to name but a few. Many are astonished that it has not been dealt with more urgently, considering the proliferation of private nursing homes in Ireland. As the older population increased in the 1990s, so too did the privatisation of nursing home care, with approximately 80% of beds now privately owned. In 2005, undercover filming by RTÉ's Prime Time resulted in the establishment of the regulator, the Health Information and Quality Authority. There has been much criticism of the watchdog in the wake of the latest RTÉ Investigates programme and it has been invited before an Oireachtas Committee to provide answers. In this case, there is a body to be held to account, but there is growing concern about the privatisation of other forms of care, including the care of children and those who are in disability services - some of the most vulnerable in society. During the week, there was a briefing on the issue organised by The Wheel, which represents charities and community organisations. It expressed concern over the increase in people with disabilities receiving essential care from profit-driven providers while voluntary service providers decreased. In April, the independent think-tank Social Justice Ireland pointed out that the Government continues to look to the market and engage private enterprise to provide the public services that should be part of "a basic floor" that everyone in the State should expect. "They do this notwithstanding continuous evidence that it is more expensive and less effective. "The rationale given is that the private sector can provide more, faster and cheaper, but again and again, this is not borne out in the evidence," it stated. The National Association of Voluntary Residential Childcare and Aftercare providers CRAVA have also been vocal about children in the care of the state being sent to 'privates'. It has pointed to the "phenomenon" of growing privatisation in residential childcare in other jurisdictions, including the UK, where it has been sharply criticised by the Children's Commissioner and the Markets and Competition Authority as the primary cause of the increasing dysfunction in children's social care in England. CRAVA has said that the dominance of private for-profit provision is viewed as being directly responsible for spiralling costs and poorer outcomes for children in residential care and aftercare. Many children are being placed in residential care centres, often hundreds of kilometres from their own family, community, social networks and left more open to exploitation. There are similar concerns about residential care for children with disabilities in Ireland, which has been working on an emergency basis for many years. Many of the protesters outside Leinster House on Thursday, some of whom were very raw from the RTÉ Investigates programme, spoke about their loved ones being "warehoused". They spoke of their helplessness in witnessing what they did on screen and yet two weeks on they continue to feel helpless. The families want transparency, they want safeguarding reviews completed on their loved ones, and for the HSE to take over the home or that residents will be moved into an HSE-run home with one-to-one care. A former staff member who worked in one of the homes featured in the RTÉ Investigates programme wrote to Care Champions following its transmission. The letter, seen by RTÉ News, began by describing the hope, excitement and enthusiasm for their work with the residents. However, that staff member left, unable any longer to deal with inexperienced colleagues, overwork and poor management. Covid-19 and Leas Cross were failures and should have ignited far more action by the Government, which will point to initiatives like Healthy Age Friendly homes which provides support packages to people to remain at home, but this is not possible for everyone. Therefore, policymakers need to think about what care looks like in Ireland. It should look like "warehousing", nor should it be solely about shareholders. It should be about offering a quality of life which includes physical health, psychological support, a level of independence, social relationships, and a relationship with the environment, with sufficient staff to offer support and care.
