Patient appointment reform delays criticised in HSE report

HSE employee overpaid by €5,500 after being employed in two jobs at the same time, separate audit report finds

Plans to give patients more control over the timing of their hospital appointments have been delayed by low participation in most hospitals, a report shows.

Minister for Health Stephen Donnelly’s plans to tackle long waiting lists in health include the provision of patient-initiated reviews, rather than automatic appointments being allocated.

New patient-centred booking arrangements also provide for a single point of contact for appointment and referrals, and increased choice of booking time.

However, the participation by hospitals in these reform initiatives is low across hospital groups, according to a review by Health Service Executive internal auditors.


Only Children’s Health Ireland and University of Limerick Hospital Group have implemented the initiatives or will meet the target for implementation. Royal College of Surgeons in Ireland Hospital Group did not reply to questions posed by HSE auditors.

This represents a “missed opportunity to reduce waiting times and utilise improved methods”, the report warns.

As of last October, 71 per cent of the 589,000 people waiting for a hospital appointment were on the list longer than the target of 10 weeks. Of the 83,000 patients waiting for a procedure, 59 per cent were waiting longer than the 12-week target.

The HSE’s efforts to meet the Government’s climate action plan are criticised in a separate audit report, which says only two updates have been provided to the board in the last 12 months.

There is no independent expertise from outside the HSE or the Department of Health on the HSE climate action implementation steering group, and no annual percentage target for reducing greenhouse gas usage and increasing efficiency, the report points out.

Meanwhile, a separate internal audit found a nurse was overpaid more than €5,000 after starting a new job while being on sick leave in another.

The HSE staff member was overpaid for 56 calendar days between November 2022 and January 2023, according to the audit.

It said there may be sufficient evidence to indicate “suspected irregular behaviour” by the employee during the crossover period between the two jobs.

“It would appear to internal audit that the employee simultaneously provided the HSE with medical certificates in one area, and worked in another area, thereby collecting duplicate payments for their financial gain,” it said.

The HSE has accepted a recommendation that the suspected fraud be reported to An Garda Síochána.

The employee went on sick leave from Kerry mental health services on October 26th, 2022, and ceased working there on January 22nd, 2023, according to the report.

Their employment in Limerick started on November 28th, 2022. They declared their last date of employment in Kerry was November 25th. One reference was provided but it did not relate to their employment in Kerry.

An investigation established the amount of the overpayment was €5,539.14.

The audit has also recommended that senior HSE management in Limerick report the “ethical breach” to the staff member’s professional body, the Nursing and Midwifery Board of Ireland.

Paul Cullen

Paul Cullen

Paul Cullen is a former heath editor of The Irish Times.