HSE boss says he was 'shocked' by revelation of misuse of public money

Extra.ie​

2 days ago

HSE boss Bernard was warned two years ago about alleged abuses of the National Treatment Purchase Fund (NTPF) – despite saying this week he was 'shocked' at revelations that a consultant in a children's hospital was using the body, set up to reduce waiting times, to top up his salary.
The revelation comes amid growing concern at the highest levels of Government that the NTPF is being used to line consultants' pockets.
Extra.ie has learned that the head of the country's health services was contacted by a concerned senior hospital employee in June 2023 about the alleged misuse of public money. Pic: Gareth Chaney/Collins
The whistleblower claimed the NTPF was being used to pay private doctors as much as 20 times more in fees than it cost to pay HSE staff who had previously been working their way through the waiting lists.
They told the HSE chief: 'The [hospital] management continues to run a very expensive NTPF service using its own HSE staff to process referrals and a private tele­ radiology company to report them. I am very suspicious of where this NTPF money is going because of the way they are protecting this service.'
Mr Gloster, who recently announced that he will step down as chief executive of the health service next March, responded, saying: 'I have noted the concerns and wish to enquire further into them.' Pic: Sam Boal/RollingNews.ie
Last week, in an interview on RTÉ's This Week programme, Mr Gloster said he was 'shocked' after it emerged in an unpublished internal Children's Health Ireland (CHI) report that the NTPF was being abused by a hospital consult­ ant to top up his salary with payments worth a total of €38,800.
He also said he would report any misuse of public funds to gardaí.
Mr Gloster told the programme: 'I assure you, if anything connected with or near­connected with alleged people ingratiating themselves financially in the pub­ lic health system, the first step I'll be taking is I'll be referring that matter to the gardaí.' Pic: Leah Farrell/RollingNews.ie
However, despite promising to 'enquire further' into the June 2023 allegations that the NTPF was being abused for financial gain, the whistleblower did not receive a response from Mr Gloster.
The HSE boss declined to confirm if he alerted gardaí to the whistle­ blower's allegations.
A spokeswoman would only say: 'The CEO engages with people who raise concerns about the HSE directly with him, and delegates to the most appropriate staff member for further action where warranted.' Jennifer Carroll MacNeill Pic: Collins Courts
The latest revelations will come as an embarrassment to Mr Gloster after Health Minister Jennifer Carroll MacNeill publicly said she is considering subsuming CHI into the HSE.
A senior Cabinet colleague of Ms Carroll MacNeill last night said there is growing political concern about wider abuses of the NTPF.
They told Extra.ie: 'You always like to think that you can trust that your doctor has your best interest at heart. Health Service Executive (HSE). Pic: File
'It would appear that there are instances of doctors delaying the treatment of patients in the public system so they can make more money in their private practice at weekends.
'Even more gratuitously, they are abusing a State­funded scheme as fewer questions are asked by the NTPF than health insurers.
'And with further revelations that this may be widespread in the health service, then we have a seri­ ous threat of a failure of trust in the system. I'm sure Jennifer Carroll MacNeill will listen to the urgings of her colleagues to get to the bottom of this immediately.' Jennifer Carroll MacNeill. Pic: Fran Veale
CHI has been plagued by a string of controversies since it was established by then-Health Minister Simon Harris in 2019.
The now­-Tánaiste said at the time: 'This is an extraordinary opportunity to transform paediat­ ric services for children in Ireland and will improve the experience and outcomes for children and their families.'
Four CHI board members resigned over the past week following successive controver­ sies, including the implantation of unapproved springs into children with scoliosis and the carrying out of unnecessary hip surgeries on children. Tánaiste Simon Harris. Pic:But senior political leaders are even more concerned about the latest scandal involving abuses of the NTPF.
One minister said: 'Ultimately, the revelations about spinal springs and hip surgeries for children were not about fraudulent behaviour. There are many reasons that a doctor could participate in these irregular treatments, but we would always like to think they were done with their understand­ing of the welfare of the patient at the forefront.
'Incompetence could be at play, but it could also be down to doctors or a hospital culture failing to keep up with rapid progressions in medical care and/or best practice. That is not good either, but it's not wilful.'
The internal CHI report revealed that a consultant working at a children's hospital broke rules by diverting patients on his waiting list to his own private clinic.
It is believed the consultant was already earning in the region of €250,000 a year. Despite this, the report found he abused the NTPF to allow some of his patients to jump the queue ahead of others with more urgent health needs.
In addition, some of those diverted to his private practice were selected ahead of those waiting longer for care.
The consultant at the centre of the controversy retired after the report was commissioned. The Department of Health and the HSE were unaware of the existence of this CHI report until last weekend.
Mr Gloster said of the report: 'It is absolutely shocking and… I am even more shocked because nobody has told me about it and in the light of everything we were doing in the last number of months with CHI, I am quite shocked.
'I have asked for a copy of the report myself. I have said to the CEO of CHI that I expect her and her board, other than or saving for highly personal information, that report should be published in the public interest and I have made it clear that I reserve my position, based on what I see in that report, as to whether or not further questions arise.'
However, it appears abuse of the NTPF is more widespread and extends beyond a single consult­ ant. In the June 2023 email sent to Mr Gloster, a whistleblower described how the NTPF – set up to cut waiting lists by paying for public patients to be treated pri­ vately – was also allegedly abused at another public hospital.
They made a series of serious allegations relating to the misuse of public money, including claims: A private company was hired at a cost of €200 per patient under the NTPF scheme to do scans, replacing an earlier system to clear waiting lists at a fraction of the cost, under which HSE staff were paid just €10 per patient. These scans were done out of hours by HSE staff. The private company hired to conduct the scans under the NTPF was permitted to use limited resources in a public hospital.
A source familiar with alleged abuses in the health service this weekend said it is clear that some consultants are using the NTPF to treat their private patients.
They told Extra.ie: 'Normally, when someone who has private health insurance is recommended to have surgery by their consultant, their health insurance company will ask the consultant why the surgery is needed. The consultant will have to justify why the operation is needed. But consultants can avoid these questions if they use the NTPF.
'I know of people with private health insurance who were told by their consultant, 'Oh, you don't have to pay anything. You only have to pay for the consultation and maybe €80 for the surgery.' And the surgery went ahead.
'That is why there have been cases where patients were given surgery they did not really need and why some were given treatment ahead of others.'
The HSE has been requested by Ms Carroll MacNeill to conduct an audit of how the NTPF funding is utilised. Around €300m is spent every year to help public patients get treatment sooner.
The money is allocated under various funds. One of these is the NTPF scheme, while a separate 'blitz' fund pays HSE staff to work through waiting lists over the weekends and during time off.
However, Sinn Féin health spokesman David Cullinane yesterday claimed the schemes are being abused because there are not enough checks and balances to ensure the money is spent wisely.
The Waterford TD told Extra.ie: 'There is a perverse incentive for consultants to delay care for patients to essentially treat them at weekends and profit from it, but obviously that needs to stop.
'There has to be transparency and better management of conflicts of interest. There has to be full disclosure in relation to any application for funding to the NTPF in relation to procedures – who requested the procedure be carried out, and then who is going to carry out the procedure?
'Hundreds of millions is available for waiting list initiatives, but we have to make sure the money is spent appropriately and that there is no misuse of waiting lists.'
The Department of Health yesterday confirmed Mr Gloster, 'at the request of the Minister for Health, has initiated a detailed survey of all in-sourcing activity within the HSE, which will be assisted by Finance, Internal Audit, HR and Access/Integration functions. In-sourcing can be funded either directly by the HSE/ hospital concerned, or by the NTPF.'
A spokeswoman said Ms Carroll MacNeill 'has sought legal advice on the publication' of the internal CHI report, and 'this advice is currently under consideration'.