This morning, we will engage with the Beaumont Hospital board to examine its financial statements for 2024. On behalf of the committee, I welcome all of the officials from Beaumont Hospital. They are Ms Anne Coyle, chief executive officer, Mr. David Sweeney, deputy chief executive officer and director of human resources, Mr. Francis Hanlon, director of finance, Mr. John Reilly, director of capital projects, Ms Claire Noonan, chief operations officer and Professor Sam McConkey, chair of the medical board. Professor McConkey has some experience of Oireachtas committees, so he is welcome back. We are also joined by an official of the Health Service Executive, Mr. Robert Kidd, integrated healthcare area manager HSE Dublin north county, who is attending in a representative capacity. We are also joined by officials from the Office of the Comptroller and Auditor General, including Mr. Seamus McCarthy, Comptroller and Auditor General, who is a permanent witness to the committee, and Mr. Mark Scully, audit manager. They are all welcome.

Before I move to the note on privilege I will refer to an item that was not addressed in the committee correspondence earlier. It is R2026/0334 and was flagged by Deputy Farrelly.

I seek the committee's approval to write to the OPW with regard to the Natural History Museum, which we might know as the dead zoo. We have seen that the dead zoo is dead late. They signed a preliminary business case for approval in 2022, and we still do not have any movement on that. I ask that the committee write to the OPW to get a full list of what has been spent so far, the cost of that, and the detailed timeframe for when we can expect to see this progress.

Excellent. Is that agreed? Agreed.

Before I begin I explain some limitations to parliamentary privilege and the practice of the House as regards references the witnesses may make to other persons in their evidence. The evidence of witnesses physically present or who give evidence from within the parliamentary precincts is protected pursuant to both the Constitution and statute by absolute privilege. This means they have absolute defence against any defamation action for anything they say at the meeting. However, they are expected not to abuse this privilege, and it is my duty as Cathaoirleach to ensure that this privilege is not abused. Therefore, if their statements are potentially defamatory in relation to an identifiable person or entity they will be directed to discontinue their remarks. It is imperative that they comply with such direction. Witnesses are also reminded of the long-standing parliamentary practice that they should not criticise or make charges against any person or entity by name or in such a way as to make him or her identifiable or otherwise engage in speech that might be regarded as damaging to the good name of the person or entity.

I now call on the Comptroller and Auditor General to deliver his opening statement.

Beaumont Hospital is a voluntary hospital funded primarily by the Health Service Executive under section 38 of the Health Act 2004.

In compliance with a financial reporting framework for hospitals set out by the Minister for Health in 1999, the hospital's financial statements are presented with separate income and expenditure accounts for current and capital spending. The income and expenditure account on the current side records total income in 2024 of just under €695 million. Core section 38 funding from the HSE accounted for €598 million. In addition, the hospital received specific HSE funding support totalling €30.75 million for drugs and medicine purchases, and €4.1 million for care of fair deal patients. It was allowed to retain employee pension contributions and other payroll deductions totalling €10 million to fund current expenses. The hospital also received €8.1 million in funding from the National Treatment Purchase Fund. Taken together, these Exchequer related funding sources provided €651 million or 94% of the hospital's income in 2024. Income from patient charges accounted for €24.5 million or 3.5% of the hospital's income.

The hospital's recurrent expenditure in 2024 was just under €712 million. Payroll-related costs totalled €460 million or 65% of all expenditure. In 2024, the hospital's headcount was just under 4,550 whole-time equivalents.

The hospital recognised capital funding of just under €36 million in 2024. Just under €39 million was spent on ongoing capital projects, including construction of a 95-bed ward block, a 20-bed cystic fibrosis unit and an additional operating theatre.

I issued a clear audit opinion in respect of the board's 2024 financial statements. However, there were a number of matters to which I drew attention in the audit report. The finalisation of disclosures around these matters delayed completion of the audit cycle for 2024.

First, I noted the hospital board was reporting an accumulated non-capital deficit of €51.3 million at end 2024. This was up from €33.7 million at end 2023, indicating a deficit of €17.6 million in 2024.

I drew attention to claims to the value of €413,000, which were submitted to private insurers that were not collectible or disallowed often because the hospital had not finalised the claims within the required timeframe.

I noted that the hospital had continued in 2024 to incur a material level of non-compliant procurement, which was of the order of €17.9 million. Separately, I drew attention to the board having paid €1.5 million to a company involved in providing radiology services that were not competitively procured. Twenty of the hospital's own staff members were directors of the supplier company but only four had made declarations regarding the company in their statutory statements of interest for 2024.

Members will recall previous discussion of a new integrated human resources and payroll system that Beaumont Hospital brought into use in January 2024, after some project delays and cost overruns. The final project cost was €4.8 million compared with a July 2022 projected cost of €2 million. In addition, public procurement guidelines were not followed in awarding the contract to develop the system. Also, due to initial payroll processing failures, the hospital incurred Revenue interest and penalties of €66,000.

At end 2024, the financial statements show payroll overpayments totalling €704,000 that were due for recovery. This was after uncollected payroll overpayments, to the value of €195,000, had been written off in the year.

I drew attention to disclosures of a number of other capital project cost overruns and the steps being taken by the board to address control weaknesses identified in project delivery.

Finally, I drew attention to a loss incurred due to a supplier bank account redirection fraud to the value of €39,600. This is a well-recognised fraud risk and the hospital has stepped up its controls to prevent further such incidents. Go raibh maith agat, a Chathaoirligh.

Go raibh maith agat, an tArd Reachtaire Cuntas agus Ciste. I now ask Ms Coyle from Beaumont Hospital to make her opening statement.

I am CEO of Beaumont Hospital and I am by my colleagues, Mr. David Sweeney, Mr. Francis Hanlon, Mr. John Reilly, Ms Claire Noonan and Professor Samuel McConkey.

Beaumont Hospital, incorporating St. Joseph's in Raheny, is a large level 4 academic teaching hospital. The hospital is the principal teaching hospital for the Royal College of Surgeons in Ireland. Beaumont Hospital enjoys close links with Dublin City University, in addition to other academic institutions, in respect of training and research. As a level 4 hospital, we provide the highest level of medical care 24-7, offering advanced highly specialised care, critical care facilities, a 24-hour emergency department and complex medical procedures.

In Beaumont Hospital, our patients are at the heart of everything we do. We are driven by a shared commitment to provide excellent and compassionate care to our patients from their first visit and beyond through every step in their care. Over 5,700 valued people work in the hospital across a range of functions and disciplines ranging from medical, nursing and therapy disciplines to administrative, cleaning, portering, catering, maintenance and laboratory scientists, to name but a few.

Beaumont Hospital is regulated under section 38 of the Health Act 2004. The current hospital board was appointed during 2023-2024. The current executive team were appointed from late 2024 to early 2025.

The hospital operates within a governance and accountability framework in accordance with the code of practice for the governance of State bodies, providing assurances on its statutory, regulatory and professional obligations. A set of internal and external controls are in place that demonstrate and strengthen financial, property and operational effectiveness, with appropriate risk management procedures in place to deliver safe and effective patient care.

In 2023, the board identified several issues in the governance and accountability frameworks, and initiated a substantive programme of actions to address them. These actions included the recruitment of experienced executive managers to unfilled positions, the strengthening of controls through improved oversight, and the establishment of new protocols governing clinical, operational and financial processes.

To satisfy board assurance requirements, reviews were undertaken to assess the effectiveness of the board and its subcommittees, and to make recommendations to fully align with the standards outlined in the code of practice. Governance represents a continuous improvement initiative for the hospital, designed to inspire confidence and trust, internally and externally, in the governance of our operations. The reconstitution of board subcommittees has resulted in increased oversight on the procurement and operation of key capital and ICT transformation projects.

Procurement compliance currently stands at 94% based on a rolling 12 months to the end of April 2026. From a benchmarking perspective, that ranks Beaumont Hospital in the highest echelons of compliance at acute hospital level.

From a capital projects perspective, the establishment of a joint Beaumont-HSE capital projects governance group and reconstitution of board subcommittees, to improve oversight over major capital and ICT transformation projects, have further enhanced and strengthened internal controls and will continue to do so. The hospital recognises its responsibilities, as a public body, and regrets the issues, which we have set out in the statement of internal control. Notwithstanding this, the hospital has confidence in the corrective actions that it has taken and the improved governance structures now in place to mitigate any potential for recurrence.

It is important to note that while there were historic gaps in procurement and budgeting in relation to certain capital and ICT projects, including our new human resources and payroll system, in each case Beaumont Hospital got value for money. The overall spend was benchmarked and found to be in line with peer costs elsewhere for the same type of facilities and systems. An external review, and direct engagement with the HSE, have also confirmed that the introduction of our new payroll and HR system means that the hospital is very well positioned for the planned move to a unified HR and payroll system across the HSE.

Over the past two years, the new board and executive have overhauled and strengthened governance controls across all areas of the hospital. We now have a robust suite of governance procedures in place. We will continue to work to refine and upgrade these, as appropriate.

The hospital is funded by the HSE through the annual service level agreement, which was signed by the hospital in March of this year, for 2026. It carries an historic deficit. However, working with the Dublin and north east region, the hospital broke even for the 2025 financial year. The 2026 opening budget allocation for the hospital was €619 million. We continue to work closely with the region to avoid adding to the deficit through cost containment and value-for-money initiatives while simultaneously maintaining services to our patients.

Some 83% of the consultant workforce in Beaumont Hospital has subscribed to the public-only consultant contract. Work is ongoing in consultation with HSE Dublin North East to develop an implementation plan to further realise productivity gains.

The annual financial accounts for 2024 identify a number of historic control issues, for which the hospital offers an unreserved apology.

These were disclosed by Beaumont Hospital voluntarily and transparently following identification and serve as testimony to the improvements in financial oversight and governance structure which have been made.

Towards the conclusion of our engagement in October last year, the committee conveyed its dissatisfaction with the hospital for having disclosed certain matters at a late stage in proceedings. The hospital had signalled these matters to the Office of the Comptroller and Auditor General during the audit in 2025. I wish to reiterate that it was never the intention of the hospital to withhold information from the committee. At this juncture, the hospital is working through the 2025 audit cycle in collaboration with the Comptroller and Auditor General. In a spirit of transparency, we would like to reference that an issue of note in relation to a misclassification of some vendors has been signalled to the Comptroller and Auditor General following an internal audit. I assure the committee that the board and the executive team of Beaumont Hospital are deeply committed to ensuring the hospital is managed responsibly and transparently. We recognise the trust placed in us to use public and donated funds prudently and this responsibility guides every decision we make.

My colleagues and I are keen to provide clarity, to contribute proactively to the committee’s deliberation and to ensure that the public can have confidence in the services we deliver. I thank members for their invitation to appear before the committee, and we look forward to addressing any questions they may have.

Thank you. Just to note for witnesses that we will suspend at 12 noon for a 15-minute break and resume shortly thereafter. As I am the lead speaker on the rota, I will have 15 minutes of questioning. All other members will have ten minutes. I am sure my colleagues will ensure that I remain within my time. I have been in Beaumont Hospital many times. It is in my constituency. I want to put on record the significant work done by the staff of Beaumont Hospital in delivering a public service in an area where it is incredibly needed. I have been struck by the expertise and passion of many of the staff members who I have met there. I also acknowledge the passion of the leadership team, including Ms Coyle, on how they have advocated for capital projects in order to improve the services available to the local area. This has been incredibly impressive.

That said, sometimes at the Committee of Public Accounts we must focus on those issues that went wrong. I will use my time to dwell on those things but it is not to take anything from the incredibly positive work that is done in the hospital. I am a member of this committee since 2020. The Comptroller and Auditor General presents accounts with notes attached. I think this is the longest list of notes attached to a set of accounts, certainly it is one of the longest in my time. There is a general concern about overall financial management or the management of the budget and public finances as a result of that. When we look at the list, we are talking about €51 million in accumulated deficit; €17.9 million in non-compliant procurement; a payroll system that is coming in at twice the budget and which has triggered Revenue penalties; a conflict of interest situation regarding 20 staff who are directors of another company; the NTPF bidding issues; and this morning we have had news regarding vendor misclassification. I know a number of things were brought forward voluntarily. Could Ms Coyle just address the breadth of issues there and how she intends to approach how we go forward with this?

Yes, in response to your question on the breadth of issues that presented in the 2024 accounts, a number of these issues had been identified in previous accounts within the hospital. In my opening statement, I referenced the changes in the board and in the executive team. In the 2024 accounts, there is further detail added to the issues that there had been. This gives rise to the breadth of issues that have been disclosed.

In terms of the points referenced on conflict of interest, when we were last before the committee in October, we reported 75% of our conflicts of interest had been declared. That has now moved to 100% of our staff. In terms of procurement, we are now 94% compliant with procurement. There has been a lot of work done to address the breadth of issues. Obviously, there is work to be done to continue to do that. Part of it is in identification of the internal control gaps, the work that has been done to address the governance issues and the oversight of those. An example is our work is the establishment of a joint HSE capital committee to oversee the capital development programmes in the hospital. A number of issues were raised in previous accounts, and there was further detail in 2024. I assure the committee of our commitment to strengthening our internal controls through the work we have done, which I referenced in my opening statement, on the reconstitution of our governance, to provide that accountability and oversight.

I take Ms Coyle's comments on board as I know the committee will. When you were with us last in October, and it is unusual that a body would be before us again so soon, there were discussions later on in the conversation. Members were unhappy that there were issues of which perhaps they had not been aware in advance. Ms Coyle raised the issue of misclassification with us this morning - I presume in an effort to avoid being accused of the same. Could she tell us a little bit about the misclassification, which type of vendors were included in it and what the nature of it was?

Thank you. I will hand over to my colleague, Mr. Hanlon, to address that.

This relates to two issues: professional sales withholding tax, which is a tax deducted at source and paid to Revenue; and relevant contract tax, RCT, which is a withholding tax made by the principal contractor, in this case, Beaumont Hospital, on the work of subcontractors onsite. Following an internal audit within the hospital, an issue was presented regarding legacy classification of suppliers. The internal audit identified the issue and, following an internal review by finance team, it emerged that there was a manual-led process within our systems, and manual work around and staff turnover were leading to these issues.

Was it that the value of the overall contract exceeded a certain threshold and therefore required the-----

No. Sorry to interrupt. This relates to approximately 60 of 3,000 live suppliers. It relates to how we apply RCT and professional sales withholding tax-----

Why it was not previously applied?

A number of factors led to that, including staff turnover and a lack of training of our accounts payable staff and our maintenance staff, to identify contracts that we have with suppliers that needed to be registered with the Revenue Commissioners to apply the correct withholding tax.

You have been in discussions with Revenue.

First of all the internal audit report was sent to the audit and risk committee, ARC. I had a very quick turnaround to identify that there was a possible issue here. We employed external tax advisers that Beaumont Hospital has and they confirmed there was an issue. We have made an unprompted voluntary disclosure to the Revenue Commissioners. That allows us to have 60 days to try to understand the issue before we approach the Revenue Commissioners.

When was that triggered?

That was triggered at the end of April. The internal audit report was done in March.

You should be coming towards the end of the 60 days at this point.

Correct. It should be in the first week of July that we will approach the Revenue Commissioners.

I am reminding Mr. Hanlon of what the chief executive has said in terms of providing as much information as possible to the committee at this stage. Does he have any indication of what the liability to Revenue will be at this point?

No, but I just want to give you a context first. We make payments to the Revenue Commissioners of approximately €169 million a year across a number of tax heads, PAYE, RCT and PSWT. It is not material to that. It affects potentially 60 of 3,000 live vendors. The core issue appears to be the application of reverse-charge VAT, which is where we purchase services from overseas vendors.

Do you have any indication at this stage of what the ballpark figure is likely to be in terms of a payment that might be required to Revenue?

I do not at the moment. It is with our external advisers and they are trawling through four years of payments to all our vendors in that four-year period.

Is it likely to be a significant figure compared to the €169 million?

Absolutely not. It will not be material to that.

You might alert the committee to that as soon as you are aware of it.

Absolutely.

Could you clarify the date on which you think you will be-----

We should be approaching the Revenue Commissioners in the first week of July.

Okay. I will turn to the NTPF double billing issue. On the last occasion, Ms Coyle identified that, as well as rheumatology, eight further specialties were being audited. Will she give us an update regarding the outcomes of those audits?

At the last meeting in October, the audit was under way. Mr. Hanlon has the up-to-date progress.

To clarify, this was a self-reported issue by the hospital in March 2025. The HSE internal audit carried out an audit of the rheumatology services within the hospital from the period 2020 to 2024.

The committee is aware of the issue. The question is about the result of the audits of the eight other specialties.

The key observation from the HSE internal audit was to review any cases across all specialties where the hospital hired permanent staff using temporary NTPF income. We have reviewed all specialties and produced a report that is going to our committee next week to understand and confirm the issue. That will then go to the HSE Dublin and North East region for a review.

Obviously, rheumatology was identified as an area where there was an element of double billing. My question is about the other eight areas of specialty. Was evidence of double billing found in any of those eight other specialties?

No. This is an observation from the HSE internal audit where we were asked to review any permanent staff recruited using temporary income. There were no examples of double funding.

Okay. Has the NTPF resumed funding to Beaumont Hospital?

The arrangements now with NTPF have changed with the establishment of the regions. We are part of HSE Dublin and North East. We are working very much through the regional and integrated healthcare area, IHA, structures in terms of our-----

The funding was suspended.

The funding was suspended.

Has it resumed?

There have been changes with third-party insourcing and so on. I will hand over to Ms Noonan to go through those details.

Essentially, funding has been resumed but we no longer use an insourcing model with the NTPF.

It is in line with the policy of the HSE.

I will turn to the issue of conflicts of interests. I am interested in the figures stating that 100% of staff have complied with conflict of interest requirements. The difficulty is with – the witnesses might clarify in case I am wrong – the 16 who submitted declarations of interests regarding the €1.5 million contract for radiology. Of those 16, only four disclosed their directorships in that company. Is that correct?

Yes, that is correct.

Of the 16 people who had fully complied with returning the declaration of interest, only four of them had actually made a correct declaration.

That is correct. That came to light through the work we did on the review of third-party insourcing. That brought that contract to our attention.

At the end of that form, someone signed it to say that it was a truthful account of their declaration of interests.

There were conflicts of interests. That resulted in the procurement of-----

Am I correct in saying that they were a director of company and they failed to declare that in their declaration of interests?

Yes, that is our understanding.

Has the hospital decided to take any action as a result of that? These are employees of the hospital. Am I correct in saying that?

Yes. In terms of sanctions, I will ask Mr. Sweeney to comment.

In terms of conflicts of interests, the question we ask on an annual basis, through the SIPO portal we have developed, relates to declarations that may influence decisions within the hospital. An element of education was required in relation to what constitutes a conflict of interest and how it can impact decisions within the hospital-----

I am not familiar with the specific form but, for many of us here, we will be asked whether we are directors of a company. Was the question as clear as that on the form?

We apply this to those on grade 8 or above. We have a higher threshold for this. The question ultimately asks whether an individual has an interest that may create a level of bias in their decision-making or influence their actions. That is in accordance with the SIPO requirement.

They are not specifically asked whether they are a director of a company or to reveal directorships of companies of which they are members.

No, not under the terms of SIPO.

Is that a form the hospital drafted internally or has it been taken from-----

We have taken it directly from the Ethics in Public Office Act and SIPO, broadly.

It seems an oversight, at whatever level, that someone could be a director of a company and it is left to their own judgment as to whether they have an interest.

We have worked on that. We have developed a conflict of interest policy to expand and broaden that, even in terms of our code of conduct.

Clearly, in this case, a number of people had a declarable interest. They were a director of a company that was a beneficiary of funding from the hospital to deal with excessive waiting lists. I am being careful in what I am saying here. Has the hospital followed up individually with any of those 12 people?

We followed up at the conclusion of our last session here. We went back over the previous year and brought up our compliance. I think I quoted 75% at the time. We actually achieved 90% for our consultants. Last year, obviously, we had our 100% compliance in the directorships that have been outlined. We have shared that with procurement as well as with the board and the chief executive. We have put additional controls in place to ensure that when we are engaging in memorandums of understanding, MOUs, or service-level agreements with entities, there is a conflict of interest declaration. We put a number of measures in place.

In terms of the directors, the radiology practice operates separately from the main directorship. We would-----

Mr. Sweeney can imagine the concern. I have to finish because I am under time pressure. A total of 16 out of 20 returned a declaration of interest, so there was a fairly high level of compliance. However, it was worth nothing because the conflict of interest was not included in the actual declaration returned. When Mr. Sweeney tells us that there is 100% compliance with the declaration of interest now, the question obviously arises as to how useful that 100% figure is. Is there any sort of auditing of those declarations?

All directors made declarations for last year.

As soon as it came to our attention that the conflict of interest was not being fully adhered to, there was work to do to address that. There was a decision to go to procurement for the contract. The decision to award the contract was taken in the best interests of patient care. The prices that were charged by the provider were consistently benchmarked with other third-party providers to ensure value for money. The contract now, to provide assurance to the committee, has been publicly tendered. It was awarded in 2026. The radiology practice is one of a number of providers in an overarching framework-----

I am conscious of my time. I have no doubt that my colleagues will pick up on some of what Ms Coyle said. I call Deputy Geoghegan.

I thank the Chair and the witnesses. A total of €1.5 million was paid to this company in 2024. Do we know the total amount that was paid to this company?

I thank the Deputy. I will ask Mr. Hanlon to answer.

Ms Coyle must have those figures.

Mr. Hanlon has them to hand.

Ms Coyle is the chief executive of the hospital. I would like to direct my questions to the chief executive of the hospital, unless she is telling me that she does not have the information.

I have it. Payments were made to Beaumont Private Clinic, BPC, for two modalities, namely, CT scans and ultrasound and mammography. In 2019, it was €181,676. In 2020, for the two modalities, it was €288,731. It was €555,000 in 2021, €739,000 in 2022, €1.2 million in 2023, €1.5 million in 2024, and €1.1 million in 2025.

What is the total? What does that all add up to?

The total is €6.2 million.

This company received €6.2 million.

Yes.

Of that €6.2 million, how much was publicly procured?

In 2019, the contract was originally awarded by a competition to the radiology practice based on a derogation due, in part, to patient need and demand.

It was understood that derogation applied when the contract was rolled over and renewed.

Just to help me, was any of the €6.2 million subject to public procurement?

No.

No.

It was-----

So €6.2 million was paid out by Ms Coyle's hospital with no procurement. In any of the €6.2 million provided what is the status of declarations of conflict of interest? We know from the Comptroller and Auditor General's report that only four of the 20 members of staff who were directors of this company made declarations. What is the status in respect of the €6.2 million? Is it the same?

It is the same. That is my understanding.

It is the exact same. So €6.2 million was given to this company with no public procurement and there were no declarations. When Ms Coyle says she is making an unreserved apology-----

Yes.

-----what is she making an unreserved apology for? Is it for the €6.2 million with no public procurement and no declarations?

The original contract was awarded without competition in 2019 and that was on a derogation due in part to patient need and demand. That is my understanding of why-----

I am just trying to understand what Ms Coyle's apology is about. I find it extraordinary that hers is the third public voluntary hospital we have had before the committee, of the five I think the Comptroller and Auditor General has direct auditing responsibility for, and Ms Coyle is the third chief executive to come before us and deliver an unreserved apology for governance failures. That leads me to be concerned about what other governance failures are out there because in each of the three cases these were matters that were identified simply by random audit questions from the Comptroller and Auditor General. When Ms Coyle says she is making an unreserved apology will she clarify to the committee what she is apologising for?

I am apologising for the failures in governance within the hospital. I am apologising for the gaps we had in our internal controls. There has been significant work done to address those. Some of these, as I mentioned in my opening statement, date back to 2019. They were issues that were raised at different points. They had been raised in the accounts. As the information came to light and we became fully aware of the detail we made that declaration within the 2024 accounts and I am sorry that has taken place. It has taken place over a number of years.

I do not want to misquote Mr. Hanlon but I was surprised by the replies he gave to Deputy McAuliffe about obligations to disclose directorships. What is Ms Coyle's position as CEO of the hospital? Did these people have an obligation to submit that they were directors of this company that was receiving €6.2 million?

My understanding of the SIPO declarations Mr. Sweeney referenced earlier is people had that responsibility to declare.

Okay, and Ms Coyle is not equivocating on that. They had an obligation to disclose their directorship-----

That is my understanding and-----

-----and to identify the company.

At a certain level of------

Is that still her understanding? Obviously there are moneys still going to this company. Did I hear her say the hospital has gone to public procurement in 2026?

Yes.

Was this company successful in the public procurement?

It is one of a number of providers in an overall framework agreement to provide this service, yes.

Do we know yet how much money that company will receive? How long is the procurement period?

It has just been awarded - May 2026. We are just managing the transition to those providers.

People were asking what the consequences are of the failure to disclose and the receipt of moneys with no public procurement. It would appear there are no consequences and this company is going to continue to receive moneys to the same extent it did when it did not have public procurement.

It is going back to the demand we have got for radiology services. It is going back, in part, to patient need and demand. It is going back to the reasons for the derogation in the first place. We are holding ourselves and working to strengthen the governance and the internal controls and oversight. When it came to light as part of our third-party audit that the conflicts of interest were not declared we managed the transition. We did not want to disrupt patient care or to create additional waiting time for our patients. We went to the market and we tested the market. When we benchmarked the prices charged by the provider they were consistently in line to ensure value for money was achieved, which we believe it was.

I do not know if we have any board members here, but at a board level was the issue of non-public procurement being provided to a company to the level it was ever a risk or issue flagged at the relevant subcommittees? Or did the officials hear about this for the first time because the Comptroller and Auditor General's office flagged it in its audits?

No, the 2019 decision was based on a derogation. That was a decision made by the then executive of the board.

What about the ones in the years after that?

That was a five-year award that took us through to 2024 and that was rolled over. It was understood the derogation continued to apply and renewed but when that-----

Was it never flagged by, say, an audit and risk committee? I can see Mr. Hanlon looking to jump in here. It was flagged, was it?

I just want to address a couple of points. Derogations-----

If he could address the question. Was it flagged by an audit and risk committee at any stage, to his knowledge? If he does not have the knowledge that is fine.

Procurement compliance is reviewed at all board subcommittee, finance committee.

Okay, so let us say on a yearly basis when these moneys were going out to a non-procured company - though I hear what Ms Coyle is saying about it being a five-year derogation - was this flagged? Did these issues come up in the meetings?

Derogated contracts would be reviewed as part of the finance committee review of compliant procurement.

Did any member of that audit and risk committee say a discussion was needed? If these issues made it from the audit and risk committee to the overall board was there ever any discussion about the need to examine why the board was providing such a level of funding to a company that was not subject to public procurement?

The derogation would be valid. It was based on patient need. The company has certain technology that allows us to have same-day scans for oncology patients, so the derogation-----

This is where I get confused. Mr. Hanlon says the derogation is valid but Ms Coyle is giving an unreserved apology. Is the board apologising for the non-public procurement in respect of this company?

The apology, in response to the Deputy's earlier question, is really around the failures in governance and the controls.

But is non-public procurement of this company a governance failure?

Going back to 2019 our understanding, which we have no reason to doubt, is that was based on a derogation that applied also when the contract was renewed in 2024. It was the issue really around the conflict of interest that that had not been declared.

So then Ms Coyle is not apologising for the non-public procurement to a company of €6 million. I just want to be clear what she is apologising for. It should be straightforward enough. She has said she has come to the committee with an unreserved apology. I do not want to put words in her mouth but she does not appear to know what she is apologising for. Is she apologising for the non-public procurement to a company of €6.2 million? It is a fairly straightforward question.

The decision was made at the time in 2019 and 2024 around the derogation. The derogation was due to patient need and providing timely access to scans like ultrasound and CT. The demand we have and the capacity internally at Beaumont at that point was not sufficient to meet the timely access demand in terms of making sure patients had their treatment and care in a timely manner. What the hospital did not do was around the conflicts of interest and making sure that had properly been taken into account.

So Ms Coyle is apologising for the declarations. My time is up so I will conclude on something which the witnesses might reflect on. When St. James's Hospital was before us an apology was given by the CEO and I can the check the transcript of this but I am fairly sure the CEO of the hospital was apologising for the non-public procurement element. Obviously facts are very different in two different hospitals and there might be lots of reasons Beaumont's situation is different, but I am just highlighting she was very clearly apologising for the fact this was non-publicly procured, in addition to the exact same SIPO declaration failings. It does not appear Ms Coyle is adopting the same position and I wanted to note and flag that. Perhaps she might reflect on it.

I want to ask about agency staff. It is not very clear to me how much the hospital is spending on agency staff. What was the level for 2024, what is the level for 2025, and why is it not more transparent in the accounts?

I will answer the last question first. It is contained within our direct pay that is a part of the Department of Health's accounting standards, which we apply for reporting our AFS. To address the questions-----

I would like to see it. It is really important that we see agency costs in the accounts. Even though it may not be a requirement, it is necessary to include the level of spend in future accounts.

Of course, and we are moving from the dated accounting standards of 1999 and-----

That is great. I ask Mr. Hanlon to tell me the levels.

In 2024 the level was €7.4 million across a number of different staff categories. It was €8.7 million in 2025, and in 2026 until April it was €3 million. We had a saving of €453,000 on healthcare assistant agency staff in the first four months of the year, and we are tracking to deliver €1 million in savings as part of our cost-containment plan in our 2026 projections.

What is the total projected for 2026?

The total projected for 2026 is €7.4 million.

That is still an awful lot of money. What is the hospital going to do to minimise that? We really should be looking at very minimal costs on agency staff.

I can address one part, and my colleague will come in another part. We have a cost-containing plan within the hospital, which is non-patient facing. Myself and the director of nursing review agency requirements on a weekly basis, and try to bring in cost containment and ensure that agency staff who are employed are required.

Is it agency staff only for nursing, or is it across-----

No. The majority of the costs are related to healthcare assistants.

In Beaumont Hospital, 1.6% of its direct-pay budget is spent on agency staff. When we look at other hospitals, Beaumont performs better than most of our other hospitals in that context. It is ahead in terms of that percentage of its direct pay, although the number seems high. Obviously its direct pay budget is significant compared to other sites.

I would like to see the HSE making sure it is transparent in all of the hospitals' accounts as to what the spend on agency is. There has to be a real focus on reducing that to a very minimum.

Just to note, and I am sure Mr. Sweeney will come in, the controls Beaumont has put in place are controls which would be beyond other sites as well. It has performed well in that space.

I want to move on to public-only consultant contracts. Some 81% of consultants have taken up the contract, is that correct?

That is correct.

In terms of the activity, we have invested a huge amount in the public-only contract. What is the specific return on activity? Can the witnesses give me any metrics as to how the public-only contracts have actually resulted in the treatment of more patients?

I thank the Deputy. My colleague, Ms Noonan, will go through that.

There is no need to thank me for the questions.

There has been additional activity over the past two years since our consultants have started moving towards the public-only consultant contract. We have an increase of 11% in the number of new consultant-led outpatient appointments. That equates to 5,300 total outpatients, including new and return. That is 17,000 in addition to our annual numbers over the past two years. Day case is somewhere we have seen significant growth as well, and that is excluding dialysis. We have seen an additional 8,200 patients over the past two years. Specifically, 2025 is where we saw the most growth. The investment has been in the public-only consultant contract, not in additional support. We are confident in attributing this increase in activity to an additional workload for our consultants through the public-only contract.

That underscores the value of the public-only contract. It really does. I thank Ms Noonan for that. In terms of theatre productivity, what is the average theatre utilisation rate?

We just recently participated in the HSE theatre productivity programme. That has been concluded on our Beaumont site and is currently under way in St Joseph's Hospital in Raheny. Ms Noonan has the percentages in terms of our productivity.

We have been deemed to have the highest utilisation of theaters in any model 4 hospital that has been measured. It is at 80% at the moment. A national or international target is anywhere between 80% to 85%. That is what the target would be. As part of that, they did uncover that 44% of our activity is unscheduled, meaning there is a constant demand for unscheduled and emergency care in our theatres. At our St. Joseph’s site, we have one of the highest utilisations of a model 2 hospital, with 74% of our theatres available utilisation, which is slightly above what we would aim for in a model 2.

With the opening of the surgical hub in Swords, I assume that will alleviate pressure.

Absolutely. That will give us more capacity, and we have our lists ready to go for extended days and Saturdays working for the surgical hub.

Brilliant.

The hospital has also voluntarily put its hands up around that NPHET programme. It is called theatre productivity in the HSE and is led by the HSE. It is an external view. Second, I mention the utilisation in its outpatients as well. Again, it is part of the hospital coming forward to ask if it can do better and whether its utilisation is standing up to scrutiny.

I am glad to hear that. In terms of the average knife to skin time in the theatre, does the hospital record that? Does it have metrics for that? What would that be like? Is it making sure that if operations are supposed to start at 8 a.m., they are actually starting at 8 a.m.?

As part of the productivity programme, the HSE measured where there was any potential. There was only 3% potential to increase productivity. One of the areas that it did identify is that time to skin piece. It measured from the point of the patient arriving to the anesthetic room. There is small room for improvement-----

What is the average?

-----particularly in some of the specialties. Is that the average time?

The average wait time.

It is probably about 30 to 35 minutes where we want to see an improvement but there is very minimal room for improvement, and to be fair-----

The hospital is looking at addressing it.

Absolutely, but many of the delays are outside the remit of the theatre department itself. It is to do with getting the patients down on time.

We will move on to diagnostic capacity. Obviously CTs, MRIs and X-rays are critical pieces of infrastructure. We need to make sure that we are absolutely utilising them to maximum effect. What metrics are there, and do we need to improve, or what is the plan?

Radiology and diagnostics are some of the areas over the past two years where we have seen a significant increase in productivity in the hospital. There is a relentless demand for diagnostics, particularly in a hospital like Beaumont where we have the thrombectomy service, the national neurosurgical service, and one of the largest cancer centers in the country. For CT, we are projected to run at a 29% deficit in terms of our capacity to meet our demand.

In terms of the machines sitting idle, what is the percentage of the week that they sit idle?

Our machines do not sit idle, unfortunately.

They are used seven days a week.

All of our modalities run seven days a week, because we are the national service. We have our services running 365 days a year.

Are they fully staffed every single day of the week?

For the services that we run, they are. There are additional scanners which we do not operate 24/7, 365 days a year but we are working with the region to increase that. We have some pilot programmes at the moment where we are testing out in terms of value for money, where we are running additional lists in the evenings, on Saturdays and at weekends. We will work with the region to convert them through Invest to Save initiatives if they are showing value for money, which they absolutely are. We have had a 19% increase in the utilisation of our CT scanners alone through some of those pilots, and we will convert those.

How much of an increase?

We have had a 19% increase of utilisation in 2025 alone.

What concentrated the minds to make sure that these machines were being used better?

I suppose it was a relentless demand. It impacts our turnaround times in the hospital. We have reduced the turnaround times for both CT and MRI by four hours, which might seem insignificant, but is absolutely not. We try to focus patients to if they can have urgent scans as outpatients so they do not need to remain in hospital, and we have reduced the turnaround time for a CT scan from 11 days to four days for an outpatient. We are seeing improvements in productivity throughout the radiology service but it is really to try to support hospital flow. We have our new EDCT scanner, which is open since October of 2025, and we have taken two and a half hours off the waiting time in the emergency department for a CT scan from the time of order through to scan.

In terms of further savings, the hospital is obviously on a plan at the moment and is trying to be as productive as possible. If it had to reduce its spend by about 5% without reducing patient care, what would it target?

Is that in radiology?

Across the board.

We have a cost-containment plan and we would focus on the non-patient facing spend. I will pass over to Mr. Hanlon to answer that because he is very meticulous about where we can reduce that.

In the year to date, we delivered €2.8 million of non-patient-facing savings. They ranged from agency healthcare assistant savings that I mentioned previously and overtime review, savings and controls. In non-pay, we had savings delivering on translations. We also have an internal building maintenance project committee that ensures that any building maintenance that happens in the hospital is reviewed by senior management before it proceeds. That has delivered savings in the year to date of €630,000 on last year's run rate.

I might just ask one more question. It is for Ms Coyle. It sounds like we are trying to be as productive as possible, maximising equipment, utilising staff seven days a week, etc., but where is the patient in all of this? Is the patient seeing the benefit of this? I am a TD for north County Dublin and I am repeatedly told of sick people not wanting to go to Beaumont because of the very long delays and what they feel is a lack of patient care. How is she making sure that patient care and communication are being put first in everything the hospital is doing?

First of all, my apologies to Deputy Boland's constituents for the delays and waits. We have a particular focus on patient access. Our strategy, entitled "Building Excellence in Care, Together", sets out the work programme to improve access for patients, in particular around the emergency department and the delays there. We made progress in 2025 with our trolley waits and delays. We are also very focused on patient experience times. We have increased staffing in zone 4 for ambulatory patients, those being, patients who do not require admission. It is really a whole-hospital focus at very senior clinical director level on reducing the time. When a patient is admitted, the time to bed is kept as short as possible.

What is the average time?

That is monitored on a weekly basis. Ms Noonan will have the detail on that to hand.

I thank Ms Coyle.

I thank everybody for being here. This is a very quick question that I tend to ask. Did Ms Coyle or any of her colleagues participate in training in preparation for today's meeting?

We have done work in preparation for today's meeting. We have done it with the support of a company that we contracted and tendered for media relations.

Was that specifically for this meeting or was it part of a wider brief?

For this meeting, but the contract is part of a wider brief. We have done work with the company for this meeting.

What was the cost of that training in preparation for today's meeting?

I do not have that to hand but I will make it available to the committee.

I thank Ms Coyle.

Did she have any reservations or were any reservations raised at board level in regard to offering a new contract to the company that has benefited from a contract it has had for the last six years and that was not a publicly procured contract?

The understanding is that a decision by the executive and board at the time was that derogations applied to the contract in 2019. The contract continued in 2024-----

I refer to the contract that was signed in May of this year. Did Ms Coyle have any reservations about offering that contract? What is hard for me to get my head around is the idea that this is the definition of cronyism, whereby this company was perfectly suited to win the public contract because of the opportunities it had simply by being staff members in Beaumont for the last six years. It is arguable that the odds were stacked in their favour to win at least part of this procurement piece.

Mr. Hanlon has responsibility for procurement and is better able to speak to the detail of this, but that contract will have gone through and been published to an agreed specification. It will have been reviewed by the board's subcommittee – the finance subcommittee – before a recommendation was made to the full board.

Did Ms Coyle have any reservations or were reservations expressed at board level with regard to this contract in May 2026?

The requirements of the full procurement, the publication of the tender and the process through the board and subcommittees adhered to our procurement processes. Mr. Hanlon may have further detail to add to that.

It was just a basic "Yes" or "No", but it is fine if Ms Coyle does not have that.

No, I did not because of following the procurement process and the internal controls and board oversight.

I thank Ms Coyle. The HSE requires Beaumont to submit an annual compliance statement in respect of corporate governance standards. Has it been submitted on an annual basis over each of the last five years?

We have every year. The deadline each year is 31 May. We submit it for the previous year.

Was that done every year, including in 2021?

I am sorry, I will rephrase that. I am in the post since April 2025 and I am aware that it has been submitted for the past three years – 2023, 2024 and 2025.

The question was about the last five years. I will direct the question to Mr. Kidd. What I have seen reported is that, in 2021, Beaumont Hospital sought to have certain elements of corporate governance disapplied with regard to its annual corporate governance statement. What is the HSE's stance on that, given that it is in the context of significant non-compliant procurement?

Yes, absolutely. What I can say to the Deputy is we had concerns in line with some of the issues raised here by the members of the committee. On taking up the post last year, I met with the chair of the board and the CEO directly. The chair of the board is very clear about their role in terms of governance and compliance. They recognise the issues - the failures and weaknesses within the hospital's controls. They have embarked on a programme of work to address it. What we are seeing in the annual financial statement, AFS, is part of them coming forward with that. Their first intention as part of meeting with them was ensuring that the executive and corporate governance within the organisation was stable. That resulted in the appointment of a CEO, just prior to my time – Ms Coyle. The Deputy has already heard from Mr. Hanlon and other members of the executive team. One of our biggest concerns was around the capital programmes. What the Deputy has heard of is the appointment of the director of estates and a tripartite group with me, our own HSE estates and Beaumont sitting around a table with specific governance over its capital programme.

There are strengthened controls. The board has been very clear about wanting to work with the HSE on its compliance issues.

Is Mr. Kidd confident that, with regard to the 2025 annual corporate governance statement, the hospital is fully compliant as it stands?

I am confident that it is compliant on the issues it has found. The board has been very clear that it would see itself in a process. It has been very open about that. Similar to some of the issues that were raised here, I know that the committee was concerned about the issue that was raised about the payroll system. Within the previous AFS in 2024, the board has also been very clear with us that it does not want to bring half an issue forward without being sure it is fully validated. It is very clear around what the issues are, how they occurred and how it is going to address them. The board has have been very open with us. It invited the HSE to board meetings, in terms of both performance and compliance. Following on from Deputy Boland's questions, the board is very keen to ensure that the hospital performs on the delivery of patient care as well, not just in compliance terms.

I thank Mr. Kidd. Will Ms Coyle outline what the financial sum is in terms of total staff overpayments that have been written off in the last three years?

As mentioned in the opening statement, we have 5,700 employees. We have five payroll runs, 1,000 salary rates and 25,000 transactions per month. I am not negating what happened in any way, but to give a sense of the scale of overpayments, it was 0.16% of our total payments in 2024. It is an area I am personally very focused on. I chair a fortnightly meeting on overpayments. My colleague, Mr. Sweeney, has got the detail on that.

First, it goes without saying that we take responsibilities to check-----

Mr. Sweeney might give the sum, please.

It is €195,000.

In total.

In total, so right over the period 2015 to 2021. They were no longer employees of the hospital or, in some cases, outside the jurisdiction.

Then, for 2024, what was the figure of staff overpayment? Was that fully recouped?

I can talk to the number of cases of overpayments within the hospital-----

Mr. Sweeney does not have the sum.

My colleague will provide the sum.

For 2024, the overpayment value was €733,000. The recovered amount was €541,000.

Did that increase or decrease in 2025?

The value in 2025 has fallen to €571,000 in overpayments and the amount recovered is €355,000.

How can a new payroll system be rolled out in 2024 that costs close to €5 million and still have such significant flaws? I cannot make sense of that.

There are a number of drivers for overpayment. I will break them down into three categories. One is a communication from the shop floor centrally to HR and finance. The second category would fall within HR and finance itself in terms of processing. The third issue might be system-generated issues from upgrades and their effect. Since the system has gone live, we have experienced a 44% reduction in the number of overpayment instances. We may have a case where there were two errors, which had a blanket application to 50 or 60 staff. We have had a 44% reduction in overpayments. In terms of the categories of the drivers of that, 1% is related to the system and 90-odd % relates to notifications and human error within processes.

How much is human error of that approximate 90%?

About 22%.

That would be a systematic problem as well, though.

Yes.

If the system is allowing for human error, there is something wrong with the system.

We have employed measures internally. The CEO actually chairs the group. My focus is working on analysing the drivers of overpayments and working with teams around the hospital to ensure they have full understanding of the implications of changes. It may be a relatively simple matter from an operational perspective but it can have a real impact for the hospital in terms of its scope. One error can affect one hundred people. We have worked with managers on that and the system is providing some insights for them in relation to it.

I thank Mr. Sweeney.

The witnesses are welcome. I want to go back to this. In relation to the IT system for the payments role, can Mr. Hanlon remind me how much that system cost?

The implementation costs were €4.8 million to the end of 2024, which was the end of the implementation period.

Was that a customised payroll system? Was that one made specifically for Beaumont Hospital?

The system is SAP so it would be is standard but it would have been implemented taking into account the complexities of a model 4 hospital with over 5,000 staff. It is a HR integrated system and payroll.

It was actually designed specifically for Beaumont Hospital.

There would have been an off-the-shelf element to it but then there would have been configurations that would be unique to the Irish public healthcare system.

Does Mr. Hanlon feel that the system is working well now?

It is, yes. We are working on enhancements at the moment to try to ensure that the self-service options for line managers are improving.

Mr. Hanlon might remind me again. That system cost €4.8 million in total.

That includes licences, support and implementation costs.

What year was that in?

That ranged from 2022 to 2024.

Was there any cost in 2025?

In 2025, there was an annual cost of €762,000, which is for annual support, annual licences-----

Does the hospital pay that additionality every year then?

For a top-tier integrated HR payroll system, that would be typical. There would be ongoing licence-----

It is €762,000 every year on top-----

Correct.

The hospital pays that every year.

Correct. Our payroll would account for about €430 million annually. This is a system for which we pay €762,000 for licences and support to support that payroll.

How many overpayments had the hospital in 2024? What was the overpayment?

Would the Deputy like me to address that?

Yes, please. I thank Mr. Sweeney.

In 2024, the number of overpayment cases was 139. That was about a 35% reduction relative to-----

That happened even though the hospital pays €762,000 per year and it paid €4.8 million for the system.

That is fact.

That is fact, yes.

There was a reduction in the number of cases relative to the pre-go live of 35% in terms of instances.

Where did the hospital gets its advice to get its IT system? Who actually procured it? The hospital did not procure the system in the first instance either. Is that correct?

That is correct. We did not procure it. It was declared in our 2023 accounts as non-compliant procurement.

It is €4.8 million.

The challenge we have in looking back is that there was a lack of a business case created at the time for the product.

Does the hospital go through the Department of Health or Department of Public Expenditure Infrastructure, Public Service Reform and Digitalisation or anybody to get sanction for €4.8 million? Who sanctions that €4.8 million?

In terms of-----