HSE Audit and Risk Committee Meeting Minutes 13 February 2026

A meeting of the HSE Audit & Risk Committee was held on Friday, 13 February 2026 at 9.00am, Boardroom, Dr Steevens’ Hospital.

Members Present

Anne Carrigy (Chair), Michael Cawley, Patrick Bailey, John Moody, Sharon Keogh and Peter Lynch

Apologies

Yvonne Traynor and Éimear Fisher

HSE Executive Attendance

Joseph Duggan (Chief Internal Auditor), Michael Lane (Acting Chief Financial Officer), Elaine Kilroe (AND ERM), Kate Killeen White (REO Dublin Midlands), Mairead Dolan (Ass CFO), Dara Purcell (Corporate Secretary), Niamh Drew (Deputy Corporate Secretary), Patricia Perry (Office of the Board)

Joined the Meeting

Dr Colm Henry (Chief Clinical Officer), Anne Marie Hoey (Chief People Officer), Dr Hugh Brady (AND HR, Corporate Compliance & Resource Optimisation), Dr Grant Jeffrey (Director Workplace Health & Wellbeing Unit), Brian O’Connell (ND, Head Strategic Health Infrastructure & Capital Delivery), Gareth Morton (ND Procurement), Leonard Clinton (Asst CFO Finance Shared Services), David Langton (AND CCF),

Minutes reflect the order in which items were considered and are numbered in accordance with the original agenda. All performance/activity data used in this document refers to the latest information available at the time.

The Chair held a private session to consider the agenda, papers and the approach to conducting the meeting.

2.1 Conflicts of Interest

No conflicts of interest were declared.

2.2 Minutes

The Committee approved the minutes of the 23 January 2026, subject to an amendment.

2.3 Action Log and Follow Up Items

The Committee reviewed the action log, discussed progress on actions, and requested that all outstanding actions be reviewed with SLT members.

2.4 Review of Committee effectiveness 2025

It was agreed that Committee members would forward individual comments to the Board office.

2.5 Annual Internal Audit Effectiveness Review

It was agreed that Committee members would review and forward their comments to the Board office.

Brian O’Connell, ND, Head Strategic Health Infrastructure & Capital Delivery (ND SHICD) joined the meeting

3.1 Capital Plan 2026 – verbal update

The National Director for Strategic Health Infrastructure and Capital Delivery (ND SHICD) provided the Committee with an update on the revisions to the Capital Plan 2026, which is expected to be approved shortly by the Minister for Health for publication.

The Committee discussed recent media coverage concerning a site in Co Meath and noted that the location is included in the Primary Care Network Plan.

3.2 Quarterly Report - final account for completed construction projects – verbal update

ND SHICD provided a verbal update confirming that there are no final accounts agreed for Q4 2025 for completed construction projects.

3.3 Current Status of Healthcare Estate Tenure

The Committee noted the update on the current status of Healthcare Estate Tenure, encompassing freehold, leasehold, long-leasehold (equivalent to freehold), licence arrangements, and vacancies. The analysis is based on the Core Database Report for Q4 2025 and the Vacancy Property Report as at 31 December 2025.

It was further noted that the analysis relates solely to HSE-owned or leased properties and does not include properties owned or leased by Section 38 or Section 39 organisations.

3.4 Building Contracts & Properties

The Committee considered the details of the following proposed contracts which was presented by the ND SHICD.

The Committee agreed to recommend to the Board for approval the following contract:

1. Contract Award - Cavan General Hospital Ward Block

The ND SHICD provided a verbal update to the Committee in relation to the overturning by An Coimisiún Pleanála of the decision to approve the proposed development of a new four-storey critical care wing at the Rotunda Hospital in Dublin.

4.1 Non Specialist Division of the Register (SDR) Consultants – Quarterly update

The Committee noted the quarterly update provided by the Chief People Officer (CPO) and Chief Clinical Officer (CCO) in relation to Consultants who are not on the Specialist Division of the Register employed as Consultant in a temporary capacity (non SDR consultants).

The Committee were concerned that there had been an overall increase compared to Q3 2025 report +14, in the number of non SDR consultants employed.

The CPO and CCO informed the Committee that the employment of Non SDR doctors in consultant posts should only be in exceptional circumstances once the clinical site has exhausted all efforts to recruit a doctor registered on the Specialist Division. The HSE put in place an exceptions process to allow Consultants who are not on the Specialist Division of the Register to temporary take up consultant posts with the following controls:

• Risk assessment undertaken
• Defined clinical governance arrangements in place
• Approval by the Regional Executive Officer to employ the non SDR for three months
• Three monthly review and approval to employ beyond three months
• Region must actively manage the number of non SDR consultants and maintain a regional log to oversee the numbers, approvals and extensions of arrangements.

The Committee discussed the role of the Medical Council and whether any fitness to practice concerns or complaints had arisen in relation to non SDR practices. The CCO advised that requirement to be on the Specialist register was a requirement introduced by the HSE and is not mandated by the Medical Council. He further noted that quarterly meetings are held with the Medical Council, and no fitness to practice concerns or complaints have been reported.

The Committee emphasised that all efforts should be made in the Regions to reduce the number of Non SDR consultants as soon as practicable.

The Committee requested the HSE put in place a process of quarterly reporting on non SDR consultants, which will allow the Committee to track the movement of non SDR consultants as well as confirming the defined exemption protocol for the hiring of non SDR consultants has been adhered to. The report should give a view of the non SDR consultants in model 3 hospitals.

4.2 Pay Related Overpayments

The CPO and the AND HR Corporate Compliance & Resource Optimisation provided the Committee with a quarterly update on ongoing measures to mitigate/avoid pay-related overpayments and to increase repayments.

The Committee noted the initiatives in place to reduce the occurrence of new overpayments and received an update on their current status. It also considered the actions being taken to increase repayments, including the current repayment position, the status of the closing balance, and the implications of the statute of limitations.

4.3 Ill Health Retirements

At the request of the Committee at the December 2025 meeting, the CPO provided an update in relation to the consideration of increasing the number of Occupational Health Physicians (OHP) who conduct assessments relating to Ill health retirements. The CPO outlined to the Committee the recommendation that the HSE retain a single-OHP assessment model for ill-health retirement determinations and outlined the assurance model that will be implemented which will provide appropriate assurance to the organisation, support continuous improvement, and mitigates operational, clinical, and reputational risk.

The Committee requested statistics on the number of ill health retirements referred and approved. It also sought clarification on how frequently the maximum additional years of service are granted where an employee retires on the grounds of ill health, including how this is calculated based on actual years of service and the criteria applied in awarding such additional years.

4.4 Podiatry Workforce

As requested by the Committee at its December 2025 meeting, the CPO provided an update on the comparison of the number of podiatrists per population in Ireland versus the UK. She advised that engagement had taken place with colleagues in Strategic Workforce Planning and Recruitment Reform & Resourcing. The Committee noted the ratio of public podiatrists per 100,000 population and observed that Ireland’s ratio is lower than that of the UK.

The CPO outlined the current position regarding the employment of podiatrists and presented strategic options for the HSE to consider in relation to the podiatry workforce, referencing developments in the profession across the UK and Northern Ireland.

The CCO provided a verbal update to the Committee in relation to an update in relation the reports on Children’s Health Ireland (CHI) spinal services.

CPO,CCO, AND HR Corporate Compliance & Resource Optimisation and Director Workplace Health & Wellbeing Unit left the meeting

C&AG officials joined the meeting

6.1 C&AG Audit Planning Memorandum – audit plan for year ended 31 December 2025

The Deputy Director of Audit C&AG presented to the Committee the audit plan for year ended 31 December 2025, which set out the C&AG’s proposed approach for the audit of the HSE, which will be conducted in line with International Standards on Auditing (ISA’s). The audit will provide an opinion on whether the financial statements properly present the state of the HSE’s affairs at year end and the income and expenditure for the year in accordance with the accounting standards specified by the Minister for Health (in consultation with the Minister for Children, Disability and Equality), as set out in the basis for preparation section of the accounting policies.

She identified for the Committee the significant business and financial statement risks faced by the

HSE and explained the approach to dealing with these in the audit. Any matters of significant

importance identified during the course of the audit would be reported to the Committee. It was noted that a further update will be brought back to the Committee before the final audit report in May 2026.

The Committee discussed non-compliant procurement and the change to authority levels in 2025, losses in relation to patient charges, as well as weaknesses in grants to outside agencies and the signing of Service Level Agreements (SLAs). With regard to SLAs, the Committee noted that an update is scheduled on the Committee Workplan.

6.2 AFS Timelines and Issues 2025

The Committee noted the briefing paper circulated, outlining the statutory and regulatory background to the production of the Annual Financial Statements (AFS), the associated timelines and an overview of any issues which may have a material impact on same. The paper provided an overview of key issues of the Audit of AFS 2025 and the key issues that have arisen in the past 2 years that are reflected in the Statement of Internal Controls (SIC) and/or Audit Certificate only. The Committee discussed matters reported by the C&AG which relate to items contained in the SIC, noting that they are management matters and should be resolved accordingly.

The Committee noted that the final draft AFS would be brought to the March meeting for recommendation to the Board.

The Asst CFO provided the Committee with a verbal update in relation to the Controls Assurance Review Process which is now completed with findings being assessed, and advised that a more detailed update will come to the March Committee meeting.

6.3 Finance Update

The A/CFO provided a briefing to the Committee on the YTD Financial Position as at 31 December 2025, noting that the HSE shows a full year limit of €24,333.8m, with actual expenditure for the same period of €24,342.9m resulting in a variance from the limit of €9.2m / 0.04%. He advised that the HSE is over the overall expenditure limit budget by €8.1m / 0.03%, (€9.2m deficit Department of Health (DoH) and €1.0m surplus Department of Children, Disability and Equality (DCDE)). It was noted that within the variance of €9.2m, the Health Regions are under their respective expenditure limits by €34.2m / 0.2%; with Corporate and National Services & Schemes non demand led areas under their limit by €65.0m and €21.2m respectively given an overall surplus position against the breakeven plan of €120.3m / 0.7%.

The Committee noted that the HSE Capital Plan 2025 expenditure at 31 December 2025 of €1,275.4m against a budget profile of €1,196.0m leading to a negative variance against profile of €79.4m / 6.6%, which includes a year-end virement from capital expenditure to revenue on a once off basis for €46.5m in respect of commissioning costs for the Children’s Hospital project.

The Committee noted that the closing cash position for the HSE is €40.6m across all revenue accounts with a closing capital bank balance of €101.8m, giving a total year end cash holding of €142.4m, and that the HSE received €80.9m of 2026 cash on 30 December 2025, to discharge cash obligations on 31 December 2025 relating to HSE staff payroll on 01 January 2026 due to banking payment restrictions on bank holidays.

6.4 Update re duplicate payments

Mr Leonard Clinton, Asst CFO joined the meeting

The Committee received an update on the review and investigation of potential duplicate payments, and noted the actions taking since the January meeting. As previously advised, 2025 and 2023 investigations of potential duplicates had been completed, the Committee noted that the review of 2024 had now also been completed, with a small number of queries remaining with the local areas, based on the review of payments over €10k between the years 2020 to 2025). The Asst CFO advised that all invoices over €10K had been identified for review based on the matching criteria.

The Committee held a discussion with the Asst CFO and Acting CFO and flagged that if there are weaknesses in the processes, these must be addressed internally and highlighted the need to assess whether there is a systematic pattern to the submission of duplicate payments. It was proposed that the top 100 suppliers be reviewed in detail and a report be brought back to the Committee.

6.5 Private Health Insurance DPER Sanction

The Committee were provided with an update in relation to Private Health Insurance Claims Settlement and DPER Sanction involving a hospital and noted that further assurance relating to the responses from the 48 acute hospitals to a national survey, which is to determine whether similar practices existed elsewhere was still ongoing. The Committee agreed that it was appropriate to make the payment to the private health insurer VHI and that the additional assurance was to be provided as soon as possible.

6.6 Contract Approval Requests

Gareth Morton (ND Procurement) joined the meeting13.05

The CFO and ND Procurement presented to the Committee the following Contract Approval Requests (CAR):

• Supply and Distribution of Hologic Liquid Based Cytology ThinPrep Slides and Consumables

The Committee considered the details of the proposed CAR and agreed to recommend to the Board for approval.

As discussed at a previous meeting, the Committee discussed with the ND Procurement the low level of response rates from the Health Regions in relation to the Procurement Compliance Self-Assessment, and asked that an update on the regions action plans to ensure that compliance returns targets are improved with the aim to achieve 100% return completion as a matter of urgency and be brought back to the March meeting.

David Langton (AND CCF) joined the meeting

7.1 Corporate Risk Update – verbal update

The AND ERM provided the Committee with a verbal update in relation to the progress of the risk appetite statement consultation and that a deep dive on a corporate risk be included in the March meeting.

7.2 2025 Annual Report on Protected Disclosures and PDA-1 & PDA-2 form

The Committee noted the Protected Disclosures Annual Report 2025, which fulfils the statutory obligation to publish a statement confirming that the HSE has internal reporting channels in place, which once approved would be published by the statutory deadline of the 31 March 2026 and included in the HSE’s Annual Report 2025.

The Committee considered the detailed year-end activity report and noted a 50% increase in Protected Disclosures (PDs) received, along with a 77% increase in case closures compared with 2024. It was further noted that there are no remaining legacy cases (2017–2022), with the final 11 such cases closed during 2025.

The Committee discussed the key themes emerging from PDs received and investigated, noting that 38% related to endangerment of health and safety. The Committee emphasised its role in ensuring that any significant increase in this category is brought to the attention of the SLT.

In reviewing the analysis of reports closed in 2025, it was noted that allegations contained within 65% of valid PDs were not upheld. It was agreed that a year-on-year trends paper would be prepared and presented to the Committee.

The Committee acknowledged and commended the good work undertaken by the Protected Disclosure Unit.

The AND CCF advised the Committee that under Section 22(1) of the Protected Disclosures Act the HSE shall provide information to the Minister for Public Expenditure, Infrastructure, Public Service Reform and Digitalisation on the number of the reports made in each preceding calendar year by 01 March. The Committee considered and approved Form PDA-1 (information concerning reports made to the HSE via internal reporting channels); and Form PDA-2 (information concerning reports made to the HSE or transmitted to the HSE via external reporting channels). The Committee noted that both Forms will be shared with the Department of Health, and Department of Public Expenditure, Infrastructure, Public Service Reform and Digitalisation before the 1 March 2026 deadline, and published on the HSE website before the 31 March 2026 deadline.

The Chair thanked the Committee and SLT members.

The meeting ended at 1.15pm

Terms of Reference: Audit and Risk Committee