I wish to continue with the same theme, as it is important and the Taoiseach has not really given an answer. Last week it was reported that seven children at Our Lady’s Children’s Hospital, Crumlin, who are ready to go home and whose parents have been trained to bring them home cannot do so because the HSE cannot provide home care packages for them. The mother of one child has to come from Kilkenny every Monday, go home on Thursday and come back at the weekend with her family to be with her child at the hospital. It is an outrage that such a thing can happen in this day and age.

Hear, hear.

We have found out that the CEO of Our Lady’s Children’s Hospital, Crumlin, is getting a €30,000 top-up payment in addition to his HSE payment of €110,000. The secret top-up is taken out of receipts from the shops in the hospital. I am sure the people working in the shops only get the average minimum wage.

In a statement the hospital board complained that the information had been given in confidence to the HSE. It seems that board members were upset that a secret payment had been made known to the public at a time when there are cuts in services for children and when staff are expected to take more cuts on foot of the Haddington Road agreement. The arrangements were seemingly made between the boards and the CEOs. There are political appointees on every single hospital board in this country. There are a Labour Party councillor and a Fine Gael Party councillor on the board of Our Lady’s Children’s Hospital, Crumlin.

Did they know?

One could ask whether they were complicit or whether they knew about it. Did they vote on it and just not tell anyone about it, or were they not there?

Of course they did.

It is outrageous. It is disgraceful.

These are serious questions that must be answered about the payments that have been made.

We now also have senior HSE sources saying the level of cuts required next year will be approximately €1.2 billion, which is double the figure presented by the Government in the budget only a month ago. Three members of the Cabinet are responsible for the health service and various aspects of it, but it seems no one is responsible.

Could Deputy Collins ask a question, please?

The situation is a shambles. The people in charge should be sacked. Is it not time for the Taoiseach to make changes?

I read the report last week about a number of children in Our Lady’s Children’s Hospital in Crumlin with tracheostomies. I understand parents have been trained to deal with the very difficult issues that arise for them personally due to their young children requiring such serious operations. They need to be able to deal with suction of the children’s air passages. Our Lady’s Children’s Hospital, Crumlin, has done extraordinary work with babies and young children for many years. When parents are trained to deal with the problems that arise frequently in babies and young children, it is important for hospital staff to be fully satisfied that all the facilities in respect of home care packages - not least of which is the training given to parents, which I am sure is exceptional - are entirely focused on the protection, comfort and development of the baby or child. I have asked the Department of Health for a report on the issue. I would be happy to talk to Deputy Joan Collins about it again.

In respect of the chief executive she mentioned, no more than anyone else, I have read the reports. I already answered questions from Deputy Martin and Deputy Adams on the matter. We need a complete picture of all of the section 38 agencies, of which there are 44. Today was the last day for receipt of the information. It is clearly stated in the circular letter and the internal audit information sent to all the agencies that non-Exchequer funding such as the receipts mentioned by Deputy Collins should not be used for top-up payments that are in breach of the public service pay contract.

There is a contract between the HSE and the voluntary hospitals. As we move towards hospital groupings, which will evolve into trusts, it will be possible to deal with all such situations in the future. We have a problem currently. I do not have the information because it will not be available until the close of business today. I hope that will be the case. When the report is furnished to the Minister for Health, he will publish it and it can be debated and dealt with in the context of the contract that exists between the HSE and the voluntary hospitals and agencies.

The Taoiseach’s reply is, again, not good enough. It seems that those people who were used to living Celtic tiger lifestyles have kept them. In the meantime, people on the front line and at the coalface have had to take massive cuts in their wages and conditions. There are political appointees on all of the hospital boards. Were the appointees aware that the top-up payments were being made to CEOs and other hospital staff? Was the issue discussed by the boards? When Deputy Eric Byrne was a councillor, he was a member of the board of Our Lady’s Children’s Hospital, Crumlin, for many years. He was replaced by Councillor Michael O’Sullivan. Did those people report to their party leaders that such practices were going on? If they knew what was going on, why did they not report it? If they did not know, why did they not know about it?

It is not in order to question the integrity of any member of a board.

I am asking the Taoiseach a direct question.

Deputy Collins knows that as well as I do. She does not need me to tell her. That is totally out of order.

It is a really important question. The Taoiseach said he had only become aware of such a practice now, but given that there are political appointees on the boards, he should have known about it before if the matter was discussed. It is not good enough to come to the Dáil today to say otherwise. The Taoiseach should admit in the Dáil that it is an outrage, that it will not happen again and that it should never have happened. He should also explain how we will get the money back from those people.

Hear, hear.

That is what we want - the money back.

I am not aware of when this kind of arrangement was first approved and how far back it goes. I do not agree with the practice. The instruction from both the Minister for Health and the HSE to the section 38 hospitals and agencies is very clear and is not in contention. It was said that they must comply with the direction that non-Exchequer payments could not be made to chief executives, putting them in breach of agreed public pay policy.

Public pay policy is decided by the Government in negotiations. Such payments are paid for by the taxpayer. The buildings - in this case, hospitals - where such people work are also paid for by the taxpayer. We cannot and will not have a situation in which chief executives breach the public service pay agreements through unauthorised non-Exchequer payments.

The top-ups were agreed by the board.

In the HSE-run hospitals it is very clear what people are paid, but because the voluntary hospitals are run by boards - yes, with political appointments - they operate in a quasi-independent way. Unauthorised top-up payments are now subject to a contract that can be assessed against public pay levels. That instruction has gone out following the internal audit of the HSE.

I hope we understand a few basic principles in everyone’s interests. Those further down the line in the health service, who have accepted serious structural change involving roster reform and pay reductions, will not be treated any differently from chief executives-----

But they are.

-----with regard to the information that is now coming to light because of the internal audit carried out on the instructions of the Minister for Health. We must sort out the issue and that is what we will do.

That completes Leaders’ Questions. The next item of business is questions to the Taoiseach. I note that in the Distinguished Visitors' Gallery we have representatives of the Power family, who are present for the expressions of sympathy on the death of the late Paddy Power, a distinguished Member of this House.

Unfortunately, I do not know whether it is as a result of a breakdown in communications that the expressions of sympathy are listed after Taoiseach's questions. My only difficulty is that some of the Deputies for the Kildare constituency are not present and may be under the impression that expressions of sympathy are not taking place. My comments are just to let the Deputies know the position. I am sorry if there is any delay.