Public nursing homes exceeded their budgets by €55 million in 2020, and the overrun is projected to almost double this year, according to documents provided to the Public Accounts Committee (PAC) by a whistleblower.
The documents, which claim to be “careful verbatim notes” of meetings in the civil service, allege that officials discussed “critical issues” with the Nursing Home Support Scheme (NHSS), usually known as the Fair Deal scheme.
It describes how there have been ongoing issues for six years, and that a recent value for money report found a “massive cost of care issue”. This year, there is projected to be a €107 million overrun against budget, the document suggests.
The conversation between the officials describes how there are two and a half times as many nurses in public nursing homes compared with private outfits, and twice as many healthcare assistants. They discuss difficulties in getting staff to redeploy from “overstaffed” facilities, which they suggest has been rejected by the HSE over concerns it could spark industrial action.
They discuss efforts to bring “the HSE to the table to focus on it rather than kicking that can further down the road”. Other documents allege that One for All vouchers were being purchased for staff under the Temporary Assistance Payment scheme, which was set up to provide financial support for nursing homes during Covid.
The whistleblower, Shane Corr, says that he raised the purchases – amounting to €12 million – with his line manager. It details exchanges on the issue, allegedly related to the whistleblower, outlining how the payments were raised with the HSE. The whistleblower argues in his submission to the committee that staff in the HSE “seemed reluctant to confront and address the matters”.
Elsewhere in the whistleblower documents civil servants described health recruitment targets as “batsh*t”, and said current targets are “incredible” and not in “anyway realistic”.
Mr Corr is the same civil servant whose disclosures led to reports last year that the Department of Health had been maintaining dossiers of medical and educational information on children involved in dormant court cases against the State.
In one document, an official tells another civil servant that targets were set for recruitment “when we’ve got all this additional money and recruitment targets were batsh*t”. Increased budgetary allocations were made for the Department of Health and HSE during the pandemic to drive the hiring of extra personnel.
According to the disclosure, which is presented as “careful verbatim notes” of a briefing for a senior civil servant, a second official replies: “When you say ‘were’ – are. The fact that they’re put out as anyway realistic is incredible.” They go on to discuss the allocation of budget for home support hours.
Mr Corr told The Irish Times that he wanted to be invited before the health committee or PAC to discuss his disclosures. “I think it’s in the public interest, and there’s a whole lot more like it.” He said he was confident he could back up his disclosures fully.
The HSE had no comment on the documents, and the Department of Health did not respond to a request for comment. The health committee will this week hear from HSE chief executive Paul Reid and Robert Watt, the secretary general of the Department of Health.
While it is likely members will raise the issues referenced, the committee chair Seán Crowe said he would be keeping the meeting closely on the topic of Sláintecare, the plan to reform the health service, which it has been convened to address. “If people are asking, it’ll have to be on the basis of Sláintecare,” he told The Irish Times.
Róisín Shortall, the Social Democrats co-leader, who is a member of the health committee, says she intends to raise the documents as they pertain to the financial management of the health service and key issues like staff hiring.
“The first thing is to have financial accountability, which is patently not there at the moment.”
Her party colleague and fellow co-leader, Catherine Murphy said she expects the issue to be raised at the PAC, and that she is “absolutely” taking it seriously.
Brian Stanley, the Sinn Féin TD and chair of the PAC, said the intention is to have the HSE and Department in again and to “tease out these matters to see what the issues are”, and would be seeking to explore the matters alleged in the documents.
