A review of income used by Naas General Hospital under the National Treatment Purchase Fund has found that consultants were paid €2 million between 2022 and 2025. Of this, close to €500,000 was paid to two external companies, in which a director in each company also works as a consultant at Tallaght hospital. The audit found that consultants were paid significantly higher levels under the fee-per-patient structure than they would have been through standard contractual or overtime arrangements. More importantly, there was no evidence of approval being sought by hospital management for a derogation from standard public procurement procedures. First, what are the consequences if and when reviews find such misappropriation of NTPF funds? Second, is it time for a national review of the NTPF programme to make sure that this is not a widespread issue in hospitals throughout the country?

There has been a HSE review of the insourcing programme and practice. There has been huge investment since 2025. The Minister undertook a detailed survey of all insourcing activities within the HSE in light of concerns about an over-reliance in the system on supplementary capacity. That report was submitted and published by the Minister in July of last year. That led to a number of measures being taken, stricter control measures, to reduce reliance on inappropriate third-party insourcing while maintaining all options for the provision of care to patients. Those controls are now in place to restrict the use of third-party insourcing. We are moving away from our dependence on the model to fully use the internal under-utilised capacity we have within our core health service.