HSE Audit and Risk Committee Meeting Minutes 17 October 2025

Members Present

Yvonne Traynor (Chair), Anne Carrigy, Michael Cawley and John Moody

Apologies

Éimear Fisher and Sharon Keogh

HSE Executive Attendance

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

Joined the Meeting

David Langton (AND Central Compliance Function), Fiona MacNamara (IFMS Deputy Project Manager) Gareth Morton (ND Procurement), Colm Waters (General Manager, Head of Tax), Brian O’Connell (ND Head Strategic Health Infrastructure & Capital Delivery)

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

The amended Terms of Reference were reviewed and deemed appropriate to be sent to the Board for consideration and approval.

2.1 Conflicts of Interest

No conflicts of interest were declared.

2.2 Minutes

The Committee approved the minutes of the 12 September 2025 meeting subject to amendments.

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 and an update be brought to the November Committee meeting.

3.1 Update re Non Specialist Division of the Register (SDR) of Medical Practitioners of the Medical Council

The Committee noted the update provided by the CPO regarding Non Specialist Division of the Register (SDR) of Medical Practitioners of the Medical Council which had been requested at a previous meeting.

The Committee expressed its continued concern on the high number of consultants not included on the SDR, and requested assurance in relation to the audit recommendations set out in the Internal Audit report presented at a previous meeting were being implemented. It was agreed that the Chair would discuss this issue with the CPO.

3.2 HR Pay Assurance Unit Overview

Arising from the recent internal audit on payroll-related overpayments, the Committee noted the update provided by the CPO regarding the HR Pay Assurance Unit which had been requested at a previous meeting. The Committee noted the figure of €16.4m owed to the HSE for 2025, and asked that a report be brought back to a future meeting outlining the areas where overpayment of salaries have taken place. The Committee requested that Internal Audit provide input to Human Resources on the current leaver control process, specifically in relation to employees who leave the organisation with outstanding payroll-related overpayments.

4.1 Internal Audit Monthly Report

The Chief Internal Auditor (CIA) provided a verbal report to the Committee in relation to the Internal Audit Change programme.

4.2 Audit Plan 2026 – Planning Update

The CIA provided a planning update to the Committee for the Audit Plan for 2026, and outlined the changes to the Internal Audit approach, the revised methodology which will strengthen assurance, enhance governance oversight and aligns with the Global Internal Audit Standards. The Committee noted that a draft list of Internal Audit topics will be presented at the November meeting, with the final Audit Plan for 2026 to be brought to the December meeting which will then be presented to the Board for approval.

The Committee noted the continued co-sourced arrangement for the delivery of ICT Internal Audit services.

AND Central Compliance Function (CCF) joined the meeting

5.1 External Review of the HSE Risk Management Framework – Proposed Scope

The Chief Risk Officer (CRO) presented to the Committee a briefing with regard to the proposed scope prior to proceeding with procurement of an external review of the HSE Risk Management Framework. The Committee noted that in line with cost control measures, the review will be commissioned via the Office of Government Procurement (OGP), which allows for the appointment of providers at a defined cost threshold on a fixed-cost basis, supporting timely commencement of the review while providing cost assurance once awarded.

The Committee noted the update and discussed including in the Terms of Reference international comparators or benchmarks as part of the process, particularly in relation to the translation of risk appetite into actions. It was agreed that a further update will be brought back to the Committee in Q1 2026 / early Q2 2026.

5.2 Maturity Assessment of HSE Compliance Functions

The ND Public Involvement, Culture and Risk Management (ND PICRM) and AND Central Compliance Function (CCF) presented the Maturity Assessment of HSE Compliance Functions paper to the Committee which outlined the movement in maturity scores across the system. The Committee discussed the reporting line of the Compliance Function and two areas outlined in the paper with an initial maturity assessment result, noting an increase should be targeted in the short term.

AND Central Compliance Function (CCF) joined the meeting

5.1 External Review of the HSE Risk Management Framework – Proposed Scope

The Chief Risk Officer (CRO) presented to the Committee a briefing with regard to the proposed scope prior to proceeding with procurement of an external review of the HSE Risk Management Framework. The Committee noted that in line with cost control measures, the review will be commissioned via the Office of Government Procurement (OGP), which allows for the appointment of providers at a defined cost threshold on a fixed-cost basis, supporting timely commencement of the review while providing cost assurance once awarded.

The Committee noted the update and discussed including in the Terms of Reference international comparators or benchmarks as part of the process, particularly in relation to the translation of risk appetite into actions. It was agreed that a further update will be brought back to the Committee in Q1 2026 / early Q2 2026.

5.2 Maturity Assessment of HSE Compliance Functions

The ND Public Involvement, Culture and Risk Management (ND PICRM) and AND Central Compliance Function (CCF) presented the Maturity Assessment of HSE Compliance Functions paper to the Committee which outlined the movement in maturity scores across the system. The Committee discussed the reporting line of the Compliance Function and two areas outlined in the paper with an initial maturity assessment result, noting an increase should be targeted in the short term.

6.1 YTD Expenditure and Financial position to year end incl update re Budget Profiling

The CFO provided a briefing to the Committee on the YTD Financial Position as at 30 August 2025, noting that the HSE is over the overall expenditure limit budget by €15.3m / 0.1%, (€127.9m surplus Department of Health (DoH) and €143.2m deficit Department of Children, Disability and Equality (DCDE)). He advised that within DoH funded services, Health Regions are reporting a €62.8m surplus against their limit.

The Committee noted that the current cash position for the HSE is €248.1m over profile as at 30th September, where DoH is over profile by €155.0m and DCDE over profile by €93.1m.

At the request of the Committee at the September meeting the CFO provided a paper with regard to the overall approach to profiling of budgets, and advised that as part of issuing budgets for 2026, a clear outline of expected good practice in the profiling of budgets for the year will be communicated to senior regional and other finance colleagues, and that an update on the matter would be brought back to the Committee in Q2 2026.

6.2 Non Pay Savings 2025 – verbal update

The CFO provided the Committee with the YTD Savings report, noting that savings are reflective of the information provided by the relevant areas regional and National and are subject to caveats. He advised that the July YTD €78.8m savings delivered against the July YTD target of €68.3m resulted in an overachievement July YTD of €10.4m, and outlined the savings summary by regions.

The Committee referred to the CEO’s memo of 15 July 2025 regarding Non Pay control additional measures and asked for an outline of savings made.

The Committee requested that this item be a standing item on the agenda.

6.3 Activity Based Funding – verbal update

The CFO provided a verbal update to the Committee in relation to Activity Based Funding. He advised that a discussion document which will set out a number of key recommendations for the advancement of ABF in Ireland, based on examination of experience to date with ABF Ireland, interim findings from the deep dive exercises, and a review of international implementations of ABF, is being considered by senior HSE stakeholders, which will support senior decision makers in determining the future form(s) of ABF.

The Committee noted the proposals being considered included introducing value-based payments and moving to full ABF for elements of acute hospital activity with the potential for earlier adoption of ABF for a lead area (set of diagnosis related group or specialty).

6.4 Health Budget Oversight Group (HBOG) minutes

The Committee noted the minutes of HBOG meetings of 15 May 2025 and 10 June 2025, and queried why a hospital had not provided the HSE with detailed data regarding on call expenditure as highlighted in the minutes.

6.5 ED charges at point of presentation

The Committee noted the update from the CFO in relation to Emergency Department charges at point of presentation, noting that the Financial Shared Services (FSS) Collections team have conducted two surveys, one due to close shortly, to provide insight into the practices across all acute statutory and Voluntary hospitals where ED, local or minor injury units are in operation. The CFO advised that FSS will collate and analyse the results of the 2nd survey, which will form part of a high level gap analysis to aid decision making and determine next steps, which will be shared with the CFO and relevant ACFO’s. A further update and action plan will be brought back to the Committee in December 2025.

6.6 IFMS Briefing on IBAN Issue in IG3

The CFO provided briefing to the Committee in relation to an IBAN issue and advised that a root cause analysis was conducted by the IFMS System Integrator with input from the IFMS Project Team and Finance Shared Services. The Committee noted and discussed the details of the event, the corrective actions, project controls and additional operational measures which had been put in place. The Committee requested a further update in relation to the level of checking the external banking system does around the actual name on the payees account rather than fully relying on IBAN/ NSC and Bank Account Number.

6.7 Report on final account for completed commercial projects

The Committee noted the update provided by the ND Procurement regarding a report on final account for completed commercial projects, which had been requested at a previous meeting. The Committee noted that while the contract utilisation functionality is in place, it is recommended that publication of contract utilisation reports be deferred until process adoption and data quality have stabilised and matured. Publishing reports at this stage could present an inaccurate picture of performance and undermine confidence in the system’s data integrity.

6.8 Tax Update

Colm Waters Head of Tax joined the meeting

The Asst CFO introduced Colm Waters, Head of Tax to the meeting for consideration of this item, who provided an overview of the key activities conducted by the HSE Tax Team. The Committee noted the recent significant achievements including the success in obtaining a VAT refund from Revenue of over €65m related to Covid Testing services which has been received by the HSE.

The Committee discussed the monitoring and disseminating information on legislative changes, including Enhanced Employer Reporting, which leads to increased information being shared with Revenue. The Committee asked for a cumulative list of potential liabilities faced by the HSE to be brought back to a future meeting. A discussion took place in relation to the recoupment of salary overpayments made to HSE staff and queried if the figure that was presented earlier at the meeting was a net or gross figure.

Head of Tax left the meeting

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

7.1 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 Q3 2025.

7.2 Quarterly Report – final account for completed construction projects – verbal update

ND SHICD provided a verbal update confirming that there are no completed construction projects for this quarter.

7.3 Building Contracts and Properties

The Committee considered the following contract which was presented by the ND SHICD.

1. Acquisition of Units 2 and 3 University Technology Park, Curraheen Road, Bishopstown, Cork, which the Committee agreed to approve.

The Committee considered the details of the following proposed contracts and agreed to recommend both contracts to the Board for approval.

The Committee discussed the approval of resources for surgical hubs, and an update brought back to a future meeting relating to the cost effectiveness of surgical hubs.

The Chair thanked the Committee and SLT members. The meeting ended at 1.05pm.

Terms of Reference: Audit and Risk Committee