Review of voluntary hospitals in delivering health and social services

The Government is to establish a formal review examining the future role of voluntary hospitals in the delivery of health and social services in Ireland.

Minister for Health Simon Harris is to seek Cabinet approval on Tuesday to set up an expert group to inquire into the status of such organisations. The move follows controversies over the ownership of State-funded assets, the payment of additional salary top-ups to senior managers in voluntary hospitals and governance issues.

The terms of reference for the review will be modelled on the forum of patronage and pluralism set up by former minister for education Ruairí Quinn in 2011.

Some 20 major voluntary hospitals and health facilities are owned by religious orders, but this inquiry could ultimately lead to hospitals moving under State control.

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The review will look specifically at the ownership of voluntary health services, the practicalities of how divestment could work and the consequences for the State. The financial implications and the constraints within which the State is operating will form a key part of the examination.

The expert group will also be tasked with making recommendations on how the relationship between the State and voluntary organisations should evolve. The need for guidelines on how interactions between the two sides should be drawn up will also be considered as part of the review.

It is understood a period of consultation with the public will be included, and the input of clinicians sought. It is hoped the review can be completed within 12 months.

Service level agreements

The State has paid out billions of euro to such organisations over recent years and their staff are considered to be public servants. Voluntary hospitals and agencies have service level agreements with the HSE governing services to be provided in return for exchequer funding. However, the organisations own their own facilities and have their own boards of directors.

Last week a HSE internal audit report maintained that the National Maternity Hospital Holles Street was in breach of public service pay policy over the payment of additional salary to a number of senior executives.

A similar internal audit last month was critical of payments made to senior figures in the St John of God organisation.

In an answer to a written parliamentary question from Fianna Fáil health spokesman Billy Kelleher last week, Mr Harris said Ireland was not unique in the participation of voluntary organisations, including those with religious involvement, in the delivery of publicly funded healthcare

However, he added it was proper “that the frameworks within which service providers operate in delivering publicly-funded health services are subject to ongoing consideration”.

The Minister said there were different views on the ownership and governance of publicly-funded healthcare facilities sparked by the recent controversy over the location of the proposed new €300 million National Maternity Hospital on the St Vincent’s Hospital campus in Dublin, which is owned by the Sisters of Charity.

No involvement

Following a heated debate and a number of protests, the Sisters of Charity announced they were to end their involvement in the St Vincent's Healthcare Group, and would have no involvement in the new national maternity hospital on its campus.

Mr Harris said he now believed it was timely “to consider more broadly the role of voluntary organisations in the public healthcare system”.

“I intend that this will be an inclusive process of consideration, and will provide an opportunity for views from all interested parties. It is my intention to bring proposals to Government shortly.”