HSE Audit and Risk Committee meeting minutes 17 April 2026

Members Present

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

HSE Executive Attendance

Joseph Duggan (Chief Internal Auditor), Michael Lane (Acting Chief Financial Officer), Joe Ryan (ND Public Involvement, Culture and Risk Management / CRO), Kate Killeen White (REO Dublin Midlands), Mairead Dolan (Asst CFO), Niamh Drew (Deputy Corporate Secretary), Patricia Perry (Office of the Board)

Joined the Meeting

Fran Thompson (CIO), Brian O’Connell (ND, Head Strategic Health Infrastructure & Capital Delivery), Gareth Morton (ND Procurement), Leonard Clinton (Asst CFO Finance Shared Services), Fiachra Bane (Interim ACFO Costing & Pricing and Head of Healthcare Pricing Office) Mark Brennock (ND Communications), Irena Grzebieniak (Deputy Director of Audit, C&AG), John Byrne (Audit Manager C&AG), Theresa Heller (Acting CPO), Hugh Brady (AND HR Corporate Compliance & Resource Optimisation), Lorna Bannon (General Manager – CAAC and Employed Consultant Advisor)

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 13 March 2026.

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 Matters for Noting

(i) Pension Abatement in the HSE

The Committee noted the update received in relation to the application of pension abatement deductions not applied to HSE pensions between 2022 and 2025 where the pensioner was in public service employment. The Committee discussed timings and noted some concerns relating to the role of the Committee and its authority in relation to this. It was noted that the briefing provided was for noting and information on the matter is due to come back to the Committee’s May meeting.

The Committee noted the papers provided by the CCO.

The Committee requested clarification regarding the reference to the voluntary nature of clinical audit and in relation to the uptake of the flu vaccine among HSE staff, what were the actions to address the uptake and reasons for non-participation.

3.1 Internal Audit – Implementation of Public Only Consultant Contract

The Chief Internal Auditor (CIA) presented to the Committee an Internal Audit – Implementation of Public Only Consultant Contract issued in March, which had an unsatisfactory rating. The IA report was presented to the Committee outside of the regular quarterly reporting schedule. The Committee held a discussion with the CIA in relation to the report. The audit found there had been inadequate oversight and management of two key elements, one of which was, the new contract did not have a significant impact on the number of consultants available to work on the weekends or evenings. The Committee were advised that the Chief People Officer in conjunction with the REOs and Clinical Directors are developing and implementing a coordinated national plan to realise the rostering flexibilities provided for in the contract.

The Committee highlighted that more urgency is required in the identification of operational enablers for rostering; the need for a dedicated taskforce to drive implementation within a national operating model; e-rostering; and proposed the sharing of best practices to support more consistent performance be considered.

The Committee emphasised the importance of alignment and coordination with projects, and the consideration of a post-implementation review to identify issues and improve future processes.

3.2 Colposcopy Patient Management Systems Update

Fran Thompson, Chief Information Officer (CIO) joined the meeting.

The CIO provided an update to the Committee in relation to Colposcopy Patient Management Systems, in response to queries raised by the Committee at the March 2026 meeting. The Committee noted the current status of the review.

4.1 C&AG Audit Update for year ended 31 December 2025

(C&AG officials in attendance).

Irena Grzebieniak, Deputy Director of Audit, and John Byrne from the Comptroller & Auditor General (C&AG) attended the meeting.

The Deputy Director of Audit C&AG provided the Committee with an update on the progress to date of the audit for the year ended 31 December 2025. She advised that the final audit is ongoing and that there are a number of key account areas where information and explanations are awaited. The Committee noted the estimated completion date for all outstanding work for submission to the C&AG of 30 May 2026.

The Committee noted and discussed the matters that may be included in the audit cert including Supplier Payment Controls; Non-compliant procurement; Duplicate Payments, Oversight of Grants to Outside Agencies; High Earners, Fixed Assets and Patient Income. These issues are included in the draft Statement on Internal Control.

The Deputy Director of Audit advised that the final decision on the audit opinion rests with the C&AG and therefore the matters to be included in the audit certificate will depend on his final review.

C&AG officials left the meeting.

5.1 Finance Update

The A/CFO provided a briefing to the Committee on the YTD Financial Position as at 28 February 2026, noting that the HSE is over the overall expenditure budget by €150.7m / 3.2%, (deficit of €145.8m Department of Health (DoH) and €5.0m Department of Children, Disability and Equality (DCDE)). It was noted that the DoH Letter of Determination requires the HSE to produce a plan to reduce agency costs below €720m, and with agency expenditure at €137.4mm at the end of February, this will need to decrease in order to meet this ceiling.

The A/CFO reported on the closing cash-at-bank position of €4.5m across all revenue accounts at end February 2026. For March the estimated position is €43m, and a cash acceleration of €110m was applied for in March. The Committee noted that 2025 supplementary funding for HSE Disability Services of €267m has been allocated to the Regions, leaving a residual deficit of €1.5m (0%).

The Chair advised members that the Task and Finish Group (TFG) - HSE Financial Position 2026 and Funding Challenges has been set up with its first meeting scheduled for 23 April 2026, where the financial position at 30 March 2026 will be discussed. The A/CFO provided a verbal update to the Committee in relation to March data figures and advised that a co-ordinated approach to the implementation of the non-pay Savings Plan; the agency reduction plan and other associated finance plans are being implemented with the REOs, and an update would be brought to the next meeting of the TFG scheduled for 22 May 2026.

5.2 Lead area (set of diagnosis related group or specialty) for ABF funding update

Fiachra Bane, Interim ACFO Costing & Pricing and Head of Healthcare Pricing Office joined the meeting.

The Committee were provided with an update in relation to Activity Based Funding (ABF). Outlined was two interim initiatives supporting the HSE's transition toward ABF, ahead of the planned shift to ABF-based hospital budget allocations from 2028 onwards. The initiatives outlined included an initiative which links a portion of hospital funding to reductions in OPD waiting lists, specifically targeting patients waiting more than 12 months for an appointment; and a lead area that covers admitted patient activity in two Major Diagnostic Categories - Diseases and Disorders of the Circulatory System; and the Musculoskeletal System, representing approximately 13% of national admitted patient activity and 20% of costs.

The Committee welcomed both initiatives and noted that they form part of the 2026 Productivity and Savings Taskforce Action Plan.

5.3 ED charges at point of presentation – update and action plan

The Asst CFO provided an update to the Committee on the progress in relation to the Collection of Emergency Department Charges at Point of Attendance. He advised that in Q1 2026 Finance Shared Services led out on a number of engagements with the Regional Directors of Finance and REO West in order to make progress on enhancing local collections targets.

The Committee noted the paper and raised concerns that certain local factors and barriers may influence the pace of improvement. However, they highlighted the importance of making steady progress and reiterated the need to work towards achieving a 100% collection rate as a priority.

The Committee noted that the number of ED invoices for Q1 2026 and ED receipts collected, highlighting that over a 6 year period this amounts to a significant amount of charges not collected. The A/CFO confirmed that non collection at point of presentation while sub optimal does not necessarily result in all the income being forfeit. The A/CFO reflected that dunning processes are engaged in to ensure as much debt as possible is subsequently collected.

The Committee discussed the referral of debts to a third party collection agency, and noted that a business case is being drafted which will be brought back to the Committee.

The Committee outlined their commitment to continue to focus on this issue, and that significant improvements are expected by the next quarterly update and if non-compliance continues, the A/CFO should identify and highlight the relevant areas, and management will be requested to attend a Committee meeting to provide an explanation.

5.4 Contract Approval Requests

The CFO and ND Procurement presented to the Committee the following Contract Approval Requests (CARs).

The Committee held a discussion with the ND Procurement and CIO and were not satisfied to recommend the CAR for Board approval. The Committee requested further clarifications, and it was agreed that the CAR would come back to the May 2026 meeting.

The Committee noted the update in relation to the National Hospital Medicine Management System CAR which was provided by the ND Procurement in response to queries raised by the Committee at the March 2026 meeting. The Committee considered the details of the proposed CAR and agreed to recommend to the Board for approval.

6.1 Risk Management Report - HSE Annual Report 2025

The Committee noted and approved the draft Risk Management report which is to be included in the HSE Annual Report 2025.

6.2 External Review of the HSE Risk Management Framework – verbal update

The ND Public Involvement, Culture and Risk Management (ND PICRM) provided the Committee with a verbal update in relation to the External Review of the HSE Risk Management Framework which has now commenced by the Institute of Public Administration (IPA), noting that the review process comprises a number of key steps, one of which is the completion of online questionnaires and meetings with selected members of the Board and ARC.

6.3 Data Protection / Retention

The ND PICRM provided an update on the Data Protection and National Retention Policy aligned to actions in the Data Protection Corporate Risk.

He advised that during 2025, the Data Protection transformation programme led to significant enhancements in governance and compliance, improving organisational accountability and the effectiveness of the data protection framework. The Committee noted the strengthening of Data Protection Framework to meet GDPR standards in Articles 24-32 GDPR; and strengthening of Data Protection capability outlined by the ND PICRM.

The Committee were advised of the Data Protection Commission Statutory Inquiry, which found significant failures in the HSE’s management of paper-based records, and its decision in relation to two personal data breaches. The Committee noted that in recognition of these failings, a Records Management Programme has been stood up to develop and oversee the implementation of the project across the HSE to bring the HSE into compliance with the management of all its records.

Mark Brennock, ND Communications joined the meeting.

7.1 HSE Communications Approach - Good News, Media Coverage and Public Trust

The ND Communications provided the Committee with a presentation in relation to the HSE Communications approach - Good News, media Coverage and Public Trust.

The Committee held a discussion with the ND Communications in relation to the use of digital and social platforms; use of influencers and new channels; use of clinical staff and patient voices; rebuttal and responsiveness to negative press; Corporate media strategy; and the importance of reinforcing public ownership of the HSE system.

It was agreed that the ND Communications would consider the points raised by the Committee and return to a future meeting for further discussion.

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

8.1 HSE Capital Projects Manual & Approvals Protocol - Incl. Strategy Health Investment Framework

The National Director for Strategic Health Infrastructure and Capital Delivery (ND SHICD) provided the Committee with an update in relation to the Capital Projects Manual & Approvals Protocol (CPM&AP) which is expected for publication late Q3 2026 (this will be subject to the publication date of the Department of Health’s (DOH) Common Appraisal Framework (CAF), in which the CPM&AP will be aligned to). The CPM&AP will also incorporate alignment with the publication of the DoH Strategic Healthcare Investment Framework (SHIF). The Committee noted that the HSE have and continue to implement and support new governance processes and roll-out important aspects of the new CPM&AP while the final document is being developed.

8.2 Reportable property transactions under the authority delegated to the ND, of Strategic Health Infrastructure and Capital Delivery

The Committee noted and discussed the reportable property transactions under the authority delegated to the ND, Strategic Health Infrastructure and Capital Delivery (ND SHICD) for Q1 2026.

The Committee asked for an update on the progress of disposals be presented to the Committee at the next meeting.

8.3 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 contracts:

i) Contract Award for the Construction of a 96 Bed Acute Inpatient Ward Block Development – Phase 2 at University Hospital Limerick

ii) Contract award for an extension to the Emergency Department at Mayo University Hospital, including an Acute Medical Assessment Unit

iii) Contract award for Passive & Active Fire Safety Works at Midlands Regional Hospital Portlaoise

iv) Capital grant to St. Francis Hospice Raheny New In-Patient Unit and Mortuary

The Chair thanked the Committee and SLT members. The meeting ended at 1.23pm

Terms of Reference: Audit and Risk Committee