Executive top-up payments widespread for health bosses

For years the full remuneration package of senior managers in voluntary hospitals and agencies which are funded by the State remained a closely guarded secret in many cases.

In 2011 the Department of Health said in in answer to a parliamentary question that the maximum pay ceiling for senior executives in public hospitals stood at just over €145,000.

A different picture began to emerge when as part of healthcare reforms introduced by the Minister for Health James Reilly, senior voluntary hospital managers began to move into the mainstream HSE and perhaps naturally, wanted to retain their existing earnings.

The Department of Health sought, and received, approval from the Department of Public Expenditure to pay a senior executive from St Vincent's University Hospital a salary of up to €195,000 for the post he was taking up in Galway. It said that, "as would be expected, his secondment from St Vincent's University Hospital had to be on a basis of no reduction in earnings".

However, the amount the Department of Health said was needed was far higher than the official maximum salary applying in the public hospital sector.

Additional earnings
Eventually, St Vincent's Healthcare Group (which runs the publicly funded St Vincent's University Hospital, St Michael's and St Vincent's Private Hospital) confirmed to The Irish Times that three of its senior executives were being paid from non-State funding for private work on top of their public commitments.

Subsequently a report into Tallaght Hospital by health watchdog HIQA found that sizeable top-up payments had been made to senior managers in addition to basic salaries. In one case, a staff member received an additional €150,000.

The Irish Times also later revealed that senior executives at St James's Hospital were also receiving additional earnings on top of base salaries, in some cases for lecturing at Trinity College.

Widespread practice
The new confidential HSE report shows that the payment of additional money or top-up benefits is a widespread practice at the top of the voluntary State-funded health service, as distinct from hospitals and agencies operated directly by the HSE.

The report, based on a snapshot taken in June 2012, says that at least 36 allowances or top-up benefits are being paid by voluntary hospitals and agencies to nearly 250 managers from HSE-provided funds at a cost of €3.224 million.

The additional allowances or benefits include private health insurance, income continuance policies, motor allowances, additional payments for work carried out for hospital or agency boards.

The report also maintains that some agencies pay “on-call -type allowances to non-clinical management and there are no sunset clauses applied to any sanctioned allowances”.

The report also says that State funds are being paid into private pensions of managers in some agencies in the non-acute sector as they have not been admitted to the State superannuation schemes. In some cases pension contributions range up to 46.6 per cent of salary.

The report says that in cases where the salary levels for chief executives exceed the official consolidate pay scales, the voluntary hospitals and agencies concerned had argued that verbal approval had been sought and received in the past from the Department of Health.

However the report says that there are no records of these agreements on Department of Health files.