I welcome everyone to today's meeting of the Committee of Public Accounts. We have received apologies from Deputy Eoghan Kenny.

Before proceeding, I will go through a few housekeeping matters. Members are reminded of the provisions of Standing Order 226 whereby the committee shall refrain from enquiring into the merits of a policy or policies of the Government, a Minister of the Government or the merits of the objectives of such policies. Members are also reminded of the long-standing parliamentary practice that they should not comment on, criticise or make charges against a person outside the Houses or an official either by name or in such a way as to make him or her identifiable. I also remind members of the constitutional requirement whereby in order to participate in public meetings they must be physically present within the confines of the Leinster House complex or precinct.

The agenda for today is as follows: minutes, accounts and statements, correspondence and upcoming meetings. We will then suspend and begin the engagement with officials from the Department of Social Protection. The minutes of the meeting of 8 October were agreed earlier and will be published on the committee's webpage.

Five sets of accounts and financial statements, laid between 12 and 16 October 2026, are due to be considered today. We are joined by the Comptroller and Auditor General, Mr. Seamus McCarthy, who is a permanent witness to the committee. I ask him to address these before I open the floor to members.

Go raibh maith agat, a Chathaoirligh. First, we have the financial statements of the Irish Museum of Modern Art for 2025. These received a clear audit opinion.

No. 2 is the financial statements of St. James's Hospital for 2025. These also received a clear audit opinion. However, I drew attention to three issues in relation to disclosures in the 2025 financial statements. The first was a material level of non-compliant procurement, which is estimated at approximately €41 million. Second, the hospital paid €514,000 to a company owned by employees on an insourcing basis, of which €456,000 was not subject to an open competitive process. The third point is that hospital claims to the value of €259,000 were rejected by private insurers, including claims worth €201,000 that lapsed as they had not been submitted with the required consultant signature within the required timeframe. I do not know if anybody wants to comment.

Members may comment if they wish.

The Comptroller and Auditor General mentioned €41 million.

That is an estimate of the non-compliant procurement.

To what is that attributed? It sounds like an enormous amount of money - €41 million.

It is very broad. Effectively, as I understand, it was on a sample basis that they estimated that 86% of their procurement was compliant, which, by deduction, leaves 14% that is non-compliant. To actually compile a listing of the non-compliant procurement may be difficult, but it is on that scale so it is very significant.

We should write to St. James's Hospital to find out further information as to the level of non-procurement and the reason for the high level. We dealt with the insourcing issue at length here when the hospital's representatives were here. For this calendar year, that seems to be to the value of €455,000. From memory, I think over this period it was about €5 million but I do not want to misquote. Over a number of years, that was the totality of that insourcing arrangement. If there is another whole host of areas we are not aware of within the hospital that have not been subjected to public procurement, then we should ask the question and get the answer from it as to the reason.

Yes.

Is it €41 million?

Yes, that is an estimate.

I echo what Deputy Geoghegan said. Can we get a breakdown of where that procurement is? Does Mr. McCarthy have it listed here?

I do not have it, no.

Could we get the full list of non-compliant procurement areas next week?

The difficulty would be it is a sample of the procurement. On the basis of the sample, 86% was deemed to be compliant and, obviously by implication, 14% non-compliant, but that is only the sample the hospital has the detail of. While you can extrapolate to its whole procurement that 14% would be equivalent to €41 million, the hospital will not necessarily be able to give a schedule of €41 million of non-compliant procurement.

Non-compliance usually refers to not seeking tenders from three or more entities. Is that correct?

Correct. The level of competitive tendering that would be required normally depends on the scale of the procurement.

If I can briefly ask, is this an issue Mr. McCarthy has examined with the hospital before?

Yes, it has been a repeated item.

Has there been change over the years? Is this a high level or a middle level?

I think it disclosed in the financial statements for 2025 that it is about the same as the previous year, 2024. I cannot remember what the figure was for previous years but I think it is of roughly the same order-----

Has the hospital ever-----

-----so recurrently it is reporting about 86% compliance.

Has the hospital ever given excusatory circumstances for why there are such high levels of non-public procurement?

It has certainly provided explanations in relation to the samples. In most other entities that we audit we would expect to see a full schedule of procurement and to have it declared as compliant or non-compliant. If it is non-compliant, there should be an explanation recorded as to why, but I do not think that kind of system is in place in St. James's Hospital.

On non-compliance, Mr. McCarthy said it has happened before. What were the circumstances?

It would be recurrent. It could be that the hospital wanted to extend a procurement or it just did not, for administrative reasons, follow the appropriate procedures.

Again, there were no consequences. This happened before and nothing came of it. From the Department to the HSE, there were no consequences.

I cannot speak for what the Department might have done about that.

The Department saw there was non-compliance. I want to know what the consequences were. Was there any thought given afterwards to ensuring this did not happen again? We are seeing it has happened again to the tune of €41 million this year.

We will have the Department before us in the coming weeks and there will be opportunity to raise the issue at that point.

Yes.

I have a couple of questions of my own. On the hospital claims to the value of €259,000 that were rejected by private insurers, these included claims worth €201,000 rejected because they had been submitted outside the required timeframe. This is something we have given considerable attention to and it is quite concerning. I am aware we have received correspondence back from the HSE and the figures it provides for St. James's Hospital between 2022 and 2025 show nearly €1 million was written off because claims were not properly submitted by the HSE. However, for 2025 a figure of €305,000 is given as having been written off by the HSE in St. James's Hospital because the claims were not properly submitted.

The distinction might be that it wrote off the figure the Chair mentioned of about €300,000-----

It was €305,000.

That is the figure that was written off in 2025 but the claims that were presented and rejected in the year were €201,000. There may be a difference in timing between when you write it off and when you actually incur the loss.

That explains that. I am sure we will return to the issue when we are discussing the correspondence back from the HSE. It is quite concerning, to state the obvious. Do any other members wish to come in on that? No.

Will I continue?

Yes.

No. 3 is the financial statements of the Sustainable Energy Authority of Ireland for 2025. These received a clear audit opinion. However, I drew attention to the overpayment of €4 million in electric vehicle grants to car dealerships for sales demonstration purposes. This is an issue I examined in chapter 20 of the Report on the Accounts of the Public Services for 2025.

I suggest we write to the SEAI on that point. I note in the further information that it is in the process of recovering this money.

Correct.

We have not received confirmation that it has recovered it. It is approximately €4 million.

It is approximately €4 million and at the time I was reporting it, the SEAI had recovered a very small amount. I cannot remember the figure but it was certainly a small amount, with much to be recovered.

Can we agree to write to the SEAI and seek an update on the recovery of that €4 million?

Agreed. Deputy Boland is online and she has just indicated.

When we have the Department of climate and energy in could we also get the SEAI in? I am conscious it has a huge responsibility in administering substantial grant programmes. Given the Comptroller and Auditor General's recent findings, it would be an opportune time to speak to the SEAI about its work.

We will certainly have a look at that and try to facilitate it.

Thanks, Chair.

No. 4 is the financial statements of the National Tourism Development Authority, or Fáilte Ireland, for 2025. These received a qualified opinion. In my view, the accounts give a true and fair view of the National Tourism Development Authority, except for non-compliance with the requirements of FRS 102 in relation to the non-recognition of a deferred retirement benefit funding asset for one of the authority's pension schemes. The authority has four pension schemes, three of which are closed to new entrants, but obviously existing employees are continuing with the main scheme. The authority has liabilities and has properly recognised those under all four schemes, but for three of them it has recognised a matching asset. In other words, it is expecting it will be grant-funded in the future to meet the liabilities as they arise. However, the authority has not done so for the fourth scheme. It is the only State body that is not doing that and in my view it should have recognised a matching funding asset. I have set out the basis of that in the audit certificate.

I thank the Comptroller and Auditor General. What does that organisation, the National Tourism Development Authority, do? I am well aware of Fáilte Ireland-----

It is Fáilte Ireland.

It just comes under a different name.

That is its official name. It trades as Fáilte Ireland.

I was beginning to wonder about such a vast amount of money. I know about Tourism Ireland and Fáílte Ireland, so I was wondering whether this was another entity I was unaware of.

No, it is the same entity.

I thank Mr. McCarthy.

Finally, we have the financial statements for the Special European Union Programmes Body, SEUPB. These relate to 2024. This is one of the North-South bodies which I audit jointly with my counterpart in the North. There was a delay due to a specific matter. We issued a clear audit opinion on the financial statements and the transactions they represent. However, we issued a qualified audit opinion on the regularity of some of the transactions. This was arising from ineligibility of on-call allowance expenditure in 2024 of over £30,000 paid to nine members of staff, including two directors and the chief executive. As of the signing date, only the chief executive had repaid the allowance. The allowances actually continued for a longer period.

They continued from a date in 2023 until May 2025, when they were terminated. The total cost over the period was of the order of €88,000. We have presented a supplement to the audit opinion that outlines the matter in further detail. Completing the audit work and the report actually led to a delay in the completion of the 2024 audit.

I thank Mr. McCarthy for that. There are no questions. Do members agree to note the listing of accounts and financial statements? Agreed.

There are a number of B items of correspondence to consider today, and these have been received from Departments and public bodies. The first is No. 0520, received from the Department of Further and Higher Education, Research, Innovation and Science regarding the delay in laying the Royal Irish Academy 2025 audited financial statements, dated 7 October 2026. Is it agreed to note and publish? Agreed.

The next item is No. 0521, correspondence received from the chief executive officer of the HSE following the recent engagement with the committee, dated 6 October 2026. I have flagged this. I call Deputy McAuliffe.

In some ways, this crystallises the work that a number of members have been pursuing through our work with some of the voluntary hospitals. However, when it is put together on one page by the HSE and it states that over four years €37 million has been written off because claims were not properly submitted to the agency, we see that a breathtaking amount of money is involved. Thirty-seven million euro is not a small amount of money in any budget.

What is even more surprising is the scale of some of it in individual hospitals. For example, University Hospital Limerick failed to claim nearly €9.2 million over the four years, while Roscommon hospital failed to claim €2.1 million, and so on. There does not seem to be an automatic connection between the scale or size of the hospital and the type of work being carried out. There are some real outliers in this regard. The committee now has enough information before it to establish, at its next opportunity to question the HSE, a national picture and a national response to ensure that this issue that is arising on a hospital-by-hospital basis is dealt with. There are some instances in which the HSE is claiming for things to which it is not entitled, and in some ways you would like to see that because you want to see it try to claim as much as possible from potential insurance sources. I acknowledge that work, but there is a significant issue with claims not being correctly submitted. We know from some of the claims that the issue relates to something as simple as a consultant signing off on a claim. The HSE needs to be prepared with very significant answers on this when its representatives appear before us.

I flagged this item. I will speak to it briefly and then let Deputy Geoghegan in.

I agree with Deputy McAuliffe. It has to be said, in fairness, that the Comptroller and Auditor General has been reporting on this as far back as 2009, with specific chapters highlighting what is essentially easy money for the HSE to recoup and reinvest in the provision of health services and healthcare. To see €37.6 million written off as a result of the HSE not properly submitting claims to insurers is grim. It is quite stark.

We see the breakdown between 2022 and 2025. Unfortunately, the figure is static, which would clearly indicate that enough is not being done. Enough oversight and controls are not in place at every level to ensure the money is being recouped. It was €9.8 million in 2022, €9.745 million in 2023 and €8.784 million in 2024. In 2025, it was back up to €9.272 million.

For the HSE to explicitly state that these amounts were written off because claims were not properly submitted by it, when we know through evidence given previously that one of the main reasons is that a consultant has not signed off on the insurance claim, is a massive failure that affects patients and also taxpayers.

We were told previously that there has been a private insurer claims management system in place since 2016. I would seriously have to question what that is achieving. It is said that it covers all acute hospitals, but to me the system is not working. Therefore, we need to follow up and get a specific breakdown on that management system. What does it do? What is its purpose? Who oversees it? Who controls it?

We have been given evidence here, and it has been indicated, that some of the claims were submitted late, or that they were outside the agreed timeframe. The committee has asked for a memorandum of understanding with one of the private health insurance companies, and we were told that it was commercially sensitive. I question that. We need to follow up and get any memorandums of understanding that exist with all the private health insurance companies. It appears that preference had been given to one of them. I think there was a 12-month timeframe indicated. We need to get a line of sight on the timeframes within which these claims have to be submitted to each of the insurance companies.

I heard the Minister say yesterday that a collective approach is needed to ensure the money is recouped. Someone has to take responsibility. This is €37 million that has been written off between 2022 and 2025. It is not sufficient to say everyone has to take collective responsibility. There has to be one person taking control to ensure this money is recouped and that it is not going into the pockets of private health insurance companies.

We need to write back to the Minister and ask specifically what actions she, as Minister for Health, and the HSE are taking to ensure that this money is not, essentially, going into the pockets of private health insurers but is instead recouped and put back into front-line services.

We have had a lot of discussion and focus around car parking charges within hospitals and how hospitals rely on that money. It is unfair to be taking money from patients and family members going into hospitals through car parking charges when the money in question is going uncollected. Again, it is taxpayers and the sick who are being taxed in this instance to ensure private health insurance companies are benefiting rather than the public system.

We have covered this at length, and credit to the Comptroller and Auditor General for flagging this in a number of accounts. When representatives of the relevant hospitals came before us, we probed them on the specific issues. As mentioned by Deputy McAuliffe, some of the figures, and particularly the idea that University Hospital Limerick has left €9 million on the table when we have the challenges that the mid-west is facing at the moment, are galling. It is astonishing.

Even if I go up the list, I see that Midland Regional Hospital Tullamore left €1 million on the table last year. Relative to the revenue of that hospital, that is an extraordinary amount of money. There are hospitals that have not provided figures. For some reason, Beaumont Hospital has not put down the figures, but we know, because its representatives were before us, that the amount was over €500,000 or €600,000. It will not surprise me at all if, when we put the figures together for the whole country, the picture we paint will show that €37 million for the last four years is understated.

I made this point when we had witnesses from Children's Health Ireland, CHI, here. Think of the enormous amount of work that a lot of foundations that sit alongside hospitals do. People raise money, do marathons and all sorts of things, and they take out the biscuit tin to raise money for children's hospitals. In some cases, boards of hospitals have allowed what we are talking about to happen. Ultimately, this should fall under the governance of every hospital. If there is money like this being left on the table, the boards should be breathing down the necks of the executives of the relevant hospitals, demanding zero tolerance.

What we learned when representatives from Beaumont Hospital were here is that there are zero consequences for the consultant who fails to fill out the form that gets submitted, if it is not supplied to an administrator. That just simply has to stop. It cannot be the case that if it is the responsibility of a consultant in a hospital to fill out a form and he or she has not done so and the hospital loses money - we know that the whole system has lost €37 million - that there are no consequences. This just simply has to end. It is outrageous that €37 million has been left on the table in the way it has. Hopefully, through shining a light on this work, as we have done in this committee, when these hospitals and the HSE come before us, we will get to a zero euro figure which, in fairness, is what the CEO of CHI said she would get her hospital to. We need to see that from every single hospital in the country. There should be zero euro left on the table for filling out forms.

I agree with everything that has been said. This is clearly a systemic problem across the board, given the range of hospitals included here. To see that figure of €37 million over a four year period is shocking. The one thing the HSE is not short of is administrators and the fact that they could not submit these claims in a proper fashion is very significant. We also need to look at the other columns here too. We need to look at the €71 million figure, for example, where it is deemed that they were correctly rejected. If €71 million worth of claims were submitted, think of the work and administration involved in that. The HSE is now saying that those claims were correctly rejected. All of this needs to be scrutinised in more detail. We are rightly focusing on the €37 million but the other columns are very interesting as well. This whole area of the interaction between hospitals and private insurance companies needs to be probed further and we need to consider how we do that.

It is just so maddening to see this complete waste of taxpayer's money again. It is not just €37 million. If we add €125 million, €37 million, €71 million and €13 million, it is actually a complete write-off of €246 million, which the taxpayer has funded. Again we are here with dealing with the issue of no governance within the hospitals. There is absolutely no oversight by the Government and to top it off, there are no consequences from the Government. This is happening on an ongoing basis and €246 million of taxpayer's money has been wasted by the HSE. I would add, as Deputy Geoghegan pointed out, that one hospital not on this list is Beaumont Hospital, and I notice that my own local hospital in Monaghan is not on it. How many other hospitals are missing from this list? The sum is €246 million. There is nowhere to hide. This committee needs to find out as much information as possible in relation to this. Again, I want to highlight the fact that there is no governance, no oversight and no consequences. How many times has this happened? It has been going on for years. This list is only for four years. We need to see the real picture here and find out how much taxpayer's money has been lost, over all of the years, from insurance companies. Again, €246 million in the last four years is a complete waste of taxpayer's money. Where is it going? The Government needs to stand up and be accountable.

Just on the figures, the total figure is €125 million. The other columns are a breakdown of it. They are not additional to it. So, it is not a figure of €246 million. It is €125 million in total.

It is €125 million.

Yes.

It is still a staggering amount.

Yes, a staggering amount of money.

It is a staggering amount of money and there appears to be a lack of corporate urgency around this. We are told that it requires individual consultants to sign off on the claims. When we put questions to the HSE and the Department previously on this, there seemed to be a lack of urgency to reform the claiming process and decouple, for example, the treating consultant, management, the hotel costs, the laboratory costs and all of the rest of the costs associated with a stay in hospital for someone who is insured. I cannot understand why, given that this has been going on for so long, this negotiation has not happened. It has been said to me by people in the HSE that the insurance companies have been resistant to negotiating on a new process. We need to bring weight to bear, not just on the HSE but also on the insurance companies. I know they are not directly under control and we cannot have them in here but we really do need to at least publicly create that pressure to get that process going. The figures involved here are absolutely astounding.

I agree with all of that. We can write to some of the individual hospitals that have been referenced here. We can write to them and seek a breakdown. On the issue of the consultants, that has been identified as one of the primary reasons these claims are being rejected by the private insurance companies. We need to dig into that further and get further information from the HSE on it. If consultants are not doing their job and signing off on these reports, there should be repercussions for breaching their contract, in my view. We need to delve into that and see whether there are provisions within the public-only consultant contracts to ensure full accountability and that consultants are actually doing the job for which they are being extremely well paid.

Column C details the amounts rejected by insurance providers but which the HSE considers should be disputed. We need to get a further breakdown of that because the sum there is huge, at nearly €14 million. It goes back to 2022, when there was €2.356 million. We need to get further information on that and possibly go back even further. I am conscious that we are looking at a snapshot here, a four-year period. Prior to those dates, how many other claims that should be disputed are actually being disputed? We need to get a line of sight on that.

Members have a particular interest in this issue. We have questioned it extensively and, ultimately, we will report on this with strong recommendations. In our work programme we have a meeting scheduled with the HSE in the coming weeks and I am sure that will be a focus for members and at that time we will be reporting on this issue.

I have one supplementary suggestion. I suggest that we write to the CEOs of every single one of those hospitals and ask them what their plans are over the next year to get the number of forms not being submitted on time down to zero. When one goes through the list of hospitals one sees that, in some, the amount of claims they have failed to submit the forms on time for is actually increasing. It is actually going up. It is going in the wrong direction. In other hospitals, it is going down. We should write to the CEOs of every single hospital asking them to explain to us how they are going to get that down to zero, and if they are not going to get to zero, to explain what the impediments are.

On a point of information, respecting what Deputy Geoghegan has just said, the likelihood is, with the public-only contract, that insurance claims for public hospitals are going to go down quite considerably. Second, this is probably an anomaly in the consultant contract. Where there is private and public work going on in the same site, there is probably no contractual obligation for a consultant to sign off on private work in the hospital. I am not saying that is right. I am saying it should be dealt with. That is why the decoupling of the consultant's signature is important. It could be the CEO of the hospital or a clinical manager who signs off on claims in order to facilitate those payments to the hospital.

We can seek further information on that. To go back to a point I made earlier in relation to the private insurer claims management system, a briefing we received previously says that there is a single national claims management system, that reports from that system issue to all regions in order for them to actively manage collection performance and that this also identifies claims which are approaching submission deadlines. There seems to be a serious problem with the system that the hospitals rely on heavily. We need to delve into that and get a full briefing note on that system which, clearly, is failing.

I agree. The €71.9 million clearly shows that there is a systemic problem. In Tallaght, for example, the hospital submitted over €10 million in claims that it now says were correctly rejected. Look at the resources, time and staff hours that had to have been involved in that. There is clearly a lack of proper assessment of what should and should not be claimed for. The HSE now says that they were correctly rejected, yet they were all submitted in the first place. That has to be a core part of our focus in terms of the overall system in place.

I agree. It speaks of a chaotic system. We will move on. Is it agreed to note and publish this correspondence? Agreed.

No. R2026/0523 is correspondence received from the HSE regarding accountability and oversight of publicly funded health bodies, dated 13 October 2026. Is it agreed to note and publish? Agreed.

No. R2026/0254 is correspondence received from the Secretary General of the Department of Climate, Energy and the Environment providing clarification on the purpose and scope of the Department's national landfill remediation grant scheme, dated 15 October 2026. Is it agreed to note and publish? Agreed. That concludes the B items for today's meeting.

Moving to the work programme, the committee will next week examine the provision of school transport with the Department of Education and Youth. Bus Éireann and the Department of Transport will attend in a representative capacity.

The committee has agreed its work schedule for the remainder of the year and this will be posted on the committee's webpage.

The last item is any other business. Are there any issues that members wish to raise?

May I please write a letter from the committee to the CEO of Uisce Éireann? Last week, he said that he had been independently reviewed by a committee in respect of the increase in his salary. Could we send a letter to Mr. Niall Gleeson or the Department that had oversight of this and ask what independent review committee authorised this large increase in the CEO's wages? Given that over €10 billion is being given to Uisce Éireann yearly, may I also ask the Department what consequences have been put in place for underperformance? Since our meeting last week, I have received an enormous amount of emails and correspondence as regards people on boil water notices. Given that Uisce Éireann receives over €10 billion per year and is underperforming to the extent that many people do not have drinking water, the Department needs to act. I would like to ask the Department what consequences or ramifications are in place to ensure that Uisce Éireann performs for the money it receives.

I think that is agreed. We had extensive discussion on our engagement with Uisce Éireann last week in our private session. I know that members wish to follow up on a number of areas, so we will do that.