HSE Audit and Risk Committee meeting minutes 23 January 2026

Members Present

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

Apologies

Yvonne Traynor 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/Chief Risk Officer), Kate Killeen White (REO Dublin Midlands), Dr Colm Henry (Chief Clinical Officer), Mairead Dolan (Ass CFO), Dara Purcell (Corporate Secretary), Niamh Drew (Deputy Corporate Secretary), Patricia Perry (Office of the Board)

Joined the Meeting

Bernard Gloster (CEO), Brian O’Connell (ND, Head Strategic Health Infrastructure & Capital Delivery), Gareth Morton (ND Procurement), Leonard Clinton (Asst CFO Finance Shared Services), Elaine Kilroe (AND ERM), David Langton (AND CCF), Ronan Buckley (CCO office)

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 12 December 2025.

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.

3.1 Safeguarding issue update

The Committee noted the update provided by the REO Dublin Midlands regarding actions taken in response to emerging Trust in Care issues at a healthcare facility. It was noted that the Safeguarding Principal Social Worker and the Chief Social Worker continue to engage with on-site social workers, as well as national and regional response teams, to provide advice and guidance on appropriate safeguarding matters.

4.1 Clinical Audit Plan 2026

The Chief Clinical Officer (CCO) provided the Committee with the Clinical Audit Plan for 2026.

The Committee reviewed the Clinical Audit Plan 2026 and welcomed the proposed programme of national clinical audits and registries, including the expansion of coverage across integrated care pathways and community-based services. The Committee noted that the Plan supports the effective discharge of its oversight responsibilities by ensuring that robust, reliable and timely clinical audit information continues to inform governance, risk management, and the delivery of safe, high-quality care.

The Committee approved the Plan, subject to a number of suggested matters being addressed. It was agreed that the CCO would liaise with the Board Office regarding the provision of updates to the Committee on any significant findings arising outside the scheduled quarterly reporting cycle.

The Committee discussed with the CCO the closure of hospital beds and the need to evaluate risks by balancing them against conflicting risks.

CCO left the meeting.

Mr Bernard Gloster, CEO joined the meeting.

5.1 Finance Update

• Financial Position November 2025
• Q2 Projections 2025
• Savings October 2025

The CEO attended and based on the advice from A/CFO, reported to the Committee on the YTD Financial Position as at 30 November 2025, noting that the breakeven plan line is flagged with a positive variance of €191.8m within the DoH funded non-Demand Led Scheme spend areas, which is made up of a total Health Region surplus of €59.8m and a total Corporate and National non-DLS surplus of €132.0m. Outside of the breakeven plan, total Corporate and National DLS have a deficit of €88.5m, leading to an overall DoH funded surplus of €103.3m. The Department of Children, Disability and Equality (DCDE) have a deficit of €232.9m and overall the HSE is reporting an October YTD deficit of €129.7m.

He advised that the Q2 Forecast, updated with October actuals, is projecting a positive variance of €171.1m within the DoH funded non-Demand Led Scheme spend areas covered by the breakeven plan, which is broken down by a total Health Region surplus of €50.0m and a Corporate and National non-DLS surplus of €121.1m. In relation to Demand Led Schemes for Corporate and National DLS have a deficit of €102.0m, leading to an overall DoH funded surplus of €69.1m, with DCDE YTD have a deficit of €253.0m and the overall HSE October YTD position is a deficit of €184.0m against the updated forecast.

The Committee noted that in relation to the cash position, the HSE has drawn down its full supplementary entitlement from both DoH and DCDE and as at 31 December 2025, the HSE had a closing cash balance of €40.6m excluding capital. In relation to YTD Savings at 31 October 2025, €121.7m savings against a YTD target of €112.6m, with an over delivery against savings target of €9.1m.

The CEO indicated that on information available to him he expected the overall enterprise wide I&E position at year end to be a variance of 0.03%, a major improvement on most previous years excluding Covid 19 period.

The CEO acknowledged the progress made compared with previous levels of health spending. He noted that to deliver health services that truly benefit service users, improvements are required in how resources are managed and utilised. He further acknowledged the need for the HSE to clearly demonstrate the benefits of IFMS across the organisation and to foster a culture in which every opportunity for efficiency is valued, regardless of scale. The Committee sought assurance that there will be a clear, organisation-wide strategy identifying key enablers to drive cost reduction, supported by end-to-end benefits tracking and delivery, and the CEO outlined four key enabler streams such as Pharma, Technology, Workforce and Digital.

The Committee thanked the CEO for the update and wished him well on his retirement.

CEO left the meeting.

The Acting CFO and REO provided the Committee with an update in relation to the Service Arrangements with acute Voluntary Hospitals.

5.2 Health Budget Oversight Group (HBOG)

The minutes of the HBOG meetings of 28 August 2025 and 21 October 2025 were noted. The Committee requested sight of a presentation mentioned in the minutes of 21 October 2025 and noted the update with regard to the forecasting function in IFMS.

5.3 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, noting that investigations relating to 2023 and 2025 have been completed. The remaining investigations for 2020, 2021 and 2022 are expected to conclude by mid-February 2026 and will be brought back to the Committee.

The Committee held a discussion with the Asst CFO and Acting CFO and identified and detailed a number of issues for consideration and inclusion in the next update.

5.4 Private Health Insurance DPER Sanction

The Committee were advised in relation to Private Health Insurance Claims Settlement and DPER Sanction involving a hospital. The Committee asked for further assurance relating to the responses from the 48 acute hospitals to the national survey, to determine whether similar practices existed elsewhere, and once received, would be considered for recommendation to the Board for approval.

5.5 Procurement Compliance (Progress of self- assessment of non- compliant procurement)

Mr Gareth Morton, National Director Procurement joined the meeting.

The Committee noted the update from the ND Procurement in relation to Q1 – Q3 2025 procurement compliance self-assessment returns completed as at 17 November 2025. A snapshot of invoice lines returns taken shows by value a compliance rate of 94%, and a completion rate to date of 76% for invoices over €25k.

The Committee discussed the low levels of response in relation to the return rates completed and awaiting completion from the Health Regions. The Committee expressed concerns at the poor level of returns completed in two Regions and requested that the ND Procurement communicate the Committee’s concerns in this regard and ensure full compliance in these two Regions. A further update would be brought back to the Committee relating to Q4 2025 at the March 2026 meeting.

5.6 Contract Approval Requests

Gareth Morton (ND Procurement) joined the meeting.

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

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

The Committee requested an update in relation to the Aids & Appliances Reprocessing contract.

6.1 Internal Audit Monthly Report

The Chief Internal Auditor provided the Committee with an update in relation to the Internal Audit Reconfiguration and the 2026 Internal Audit budget.

The Committee noted that the final phase of staff redeployments is currently underway and is expected to be completed by the end of January 2026.

The Committee noted the Internal Audit budget allocation and discussed the non-pay element. It was noted that this element is being assessed to determine whether it is sufficient to support agreed departmental priorities for 2026, and that the CIA would return to the Committee with a breakdown of line items.

Elaine Kilroe, AND Enterprise Risk Management (ERM) and David Langton (AND CCF) joined the meeting.

7.1 Q4 2025 Corporate Risk Register

The Chief Risk Officer (CRO) presented to the Committee the Q4 2025 Corporate Risk Register (CRR) Report. The Committee noted the 11 Open risks and 5 Watched risks on the Register, of which 5 Open risks were rated High, 6 Open risks rated Medium. In relation to risk R001 Urgent and Emergency Care Services (UEC), the Committee noted the change to the likelihood rating which increased as insights from the REO Workshop support increasing both the Inherent and Residual risk rating.

The Committee noted risks R003 Disruptive Events, R005 Financial Management, R006 Major Infrastructure, R009 Compliance, R010 Data Protection and W006 Climate Change, and R008 Health Regions. The increase in the likelihood rating to R001 UEC was driven by system wide operational pressures expected to persist throughout the winter, the Committee highlighted the low vaccination uptake, and it was agreed that the CRO would discuss this with the CCO and revert to the Committee.

The Committee asked that the low ranking of W004 Healthcare workforce be reconsidered, and it was agreed that the CRO would reflect on this for Q1 2025.

7.2 Central Compliance Function- Compliance Reports

The Committee were provided with the following updates.

KPMG Compliance Report Implementation Update

The AND CCF presented to the Committee the quarterly update in relation to the KPMG Compliance Project Implementation Plan and progress to date. The Committee noted the update and the overview of the recommendations completed since the September 2025 meeting.

Principal Compliance Obligations Register (PCOR) Q3 2025 Update & Annual Review

The AND CCF presented the Principal Compliance Obligations Register (PCOR) Metric Reporting Q3 2025 to the Committee, with 12 obligations listed on the PCOR. The Q3 update also encompassed an annual review of the PCOR and suggestions received from SLT for consideration for inclusion were outlined to the Committee.

Compliance Obligations Register (COR) Q3 2025 Update

The AND CCF presented the Compliance Obligations Register (COR) Q3 2025 to the Committee. It was noted that Internal Obligations have increased by 7 (1%) from 833 to 840; and External Obligations have increased by 23 (5%) from 461 to 484.

The AND ERM advised the Committee of engagement with the Strategic Director of EHR programme and that it was agreed that risk reporting will be established for Q1 and Q3 each year and brought to the Committee.

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

8.1 Review of Capital Plan 2025 outturn

The National Director for Strategic Health Infrastructure and Capital Delivery (ND SHICD) provided the Committee with an update on the review of the 2025 Capital Plan out-turn, including capital funding allocations, funding reallocations, and the final 2025 out-turn, all of which were noted by the Committee.

8.2 Quarterly Report on delegated authority for property transactions

The Committee noted the Quarterly Report from the ND SHICD in relation to delegated authority for property transactions.

The ND SHICD provided an update to the Committee in relation to the acquisition of a property in Dublin.

8.3 Building Contracts and 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:

1. 1. 1. Contract Award for the Construction of the new 30 Bed Inpatient Ward Vertical Extension at University Hospital Kerry, South West Region
      2. Disposal of Scarriff Health Centre, Waterville, Co. Kerry
      3. Proposed Acquisition of a building in Cherrywood for use as a Primary Care Centre & ECC Hub
      4. Proposed Strategic Acquisition of Lands, Limerick

Ms Maire Lennon, Head of Legal Services joined the meeting.

The Head of Legal Services presented to the Committee the HSE Strategic Legal Matters half year report for June 2025 to December 2025,and outlined instances of work carried out in-house in the HSE and measures taken by HSE Office of Legal Services to achieve legal cost savings.

The Committee noted the report which provided a summary of 56 significant legal matters in the reporting period, with 10 matters identified as matters of highest priority.

Head of Legal Services left the meeting.

The Chair thanked the Committee and SLT members. The meeting ended at 1.34pm.

Terms of Reference: Audit and Risk Committee