A shortage of medical consultants is the primary driver behind a number of health service staff being paid considerable sums in addition to their core salaries, the HSE has said.
The additional earnings were linked to the overriding requirement of maintaining essential services where critical vacancies or staff shortages existed, it said, and this was particularly the case in certain specialities including “radiology, psychiatry, emergency medicine and in certain geographic areas”.
The Irish Times reported on Saturday that one HSE employee – understood to be a hospital consultant – received almost €1 million in total remuneration last year. About €700,000 of this was paid for treating patients outside the employee’s normal hours. The individual concerned had a contract that allowed for premium payments to be made in respect of each patient seen during rest period call-outs.
Details of the €1 million payment were set out by the State’s spending watchdog, the Comptroller & Auditor General, in a report attached to the HSE annual accounts for last year. The comptroller said that during one weekend call-out “the employee was paid at a rate of six hours’ pay per patient for each of four patients treated within a single period of 60 minutes, ie in excess of €2,800 for the call-out”.
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Ten HSE employees earned more than €500,000 last year.
HSE chief executive Bernard Gloster said on Friday that “while some levels of high earning are unavoidable, it is clear that in some cases this has reached unacceptable levels which cannot continue into the future”.
In respect of the employee who received close to €1 million last year, the HSE said “additional consultant staff have been recruited to this service, which means the on-call arrangements described are no longer necessary to the extent they were previously”.
More broadly, it said, one of the primary drivers behind high earnings in the health service remained the shortage of consultant staff. “Considerable additional investment has been directed towards increasing the health and social care workforce in recent years. This includes specific initiatives aimed at increasing the number of medical consultants in frontline services.”
The HSE said it was continuing to implement an action plan agreed on foot of an internal audit report from 2022 “to ensure that the control environment in the area of high earnings is strengthened and improved”.
It declined to comment on the background to a separate €1.6 million termination payment to a former employee – also likely to have been a doctor. It said it came about on foot of an unspecified “context”. The comptroller’s report said this payment included €1.37 million for potential loss of private earnings over a period of three years and eight months during which the individual had been suspended.
“The employee was in receipt of full salary while on suspension,” the comptroller’s report notes, adding that the overall package also included an ex-gratia sum of €200,000 and €30,000 in respect of reputational damage.
The HSE said it could not comment on individual employment matters regarding current or former employees. “The settlement referred to in this report had a particular context and was agreed with the Department of Health and the Department of Public Expenditure,” it said.
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