HSE Audit & Risk Committee Meeting Minutes 14 November 2025

Members Present

Anne Carrigy (Chair), Michael Cawley (left circa 12.34pm), John Moody, Éimear Fisher, Sharon Keogh and Peter Lynch

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), Dara Purcell (Corporate Secretary), Niamh Drew (Deputy Corporate Secretary), Patricia Perry (Office of the Board)

Joined the Meeting

Brian O’Connell (ND, Head Strategic Health Infrastructure & Capital Delivery), Micheal Conneely (ND Capital and Estates) and Henry Kerr (AND Capital and Estates), Tony Canavan (REO), Gareth Morton (ND Procurement), Leonard Clinton (Asst CFO Finance Shared Services), Michelle Galvin (AND ICT Audit and Data Analytics), Elaine Kilroe (AND ERM), Damien McCallion (CTTO), Martina Queally (REO), Fran Thompson (Chief Information Officer), Priscilla Crombie (AND Programme Director Community Connect), Dr Tom Foley (Clinical Lead), Tom Laffan (Chief Data and Analytics Officer, Technology and Transformation)

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 welcomed and introduced the new External Committee member, Peter Lynch to the meeting and remarked that the Audit & Risk Committee was now considerably strengthened as a result. 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 September 2025, 17 October 2025 and 03 November 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 and an update be brought to the December Committee meeting.

2.4 Committee meeting dates 2026

The Committee noted the scheduled meetings for 2026 and it was agreed to hold a meeting in January 2026.

2.5 Committee Workplan 2026

The Committee noted the Workplan 2026, and requested further items to be included.

3.1.i. IBAN Issues IFMS

The Committee noted the paper provided by the CFO, which had been requested at a previous meeting regarding the introduction of instant payments. The CFO advised the Committee that instant payments do not pose a risk for the HSE and that there are potential benefits that could be realised in the future. The Committee noted that HSE Treasury will continue to engage with Danske Bank.

3.1.ii Update re historical invoices exercise re duplicate payments

The Committee noted the update provided by the CFO, which had been requested at a previous meeting on the approach, progress and planned next steps to complete the historical duplicate invoice check. The Committee asked that the historical check cease and a duplicate invoice check to take place in one area and an update be brought back to the January 2026 meeting.

Brian O’Connell, ND, Head Strategic Health Infrastructure & Capital Delivery (ND SHICD), Micheal Conneely (ND Capital and Estates) and Henry Kerr (AND Capital and Estates), joined the meeting

4.1 HSE Infrastructure Capital Plan 2026

The National Director, Head of Strategic Health Infrastructure and Capital Delivery (ND SHICD) presented the draft HSE Capital Plan 2026 to the Committee and advised that the final draft will be presented to the Board on the 18 November 2025 for approval prior to formal submission to the Minister for Health and Minister for Children, Disability and Equality.

The ND SHICD outlined that the Letters of Determination from the Department of Health and Department of Children, Disability and Equality provided capital funding of €1.3 billion in 2026 for building and equipment. In addition €50 million is to be provided from the HSE’s income account (proceeds from insurance claims, project contributions, sale of assets etc.) A summary of the capital allocation from each Department was provided to the Committee.

The Committee considered with close scrutiny the detail of the Draft Capital Plan and provided commentary on a number of issues relating to the draft Plan.

The Chair thanked the ND SHICD and team for their input and the time given to the draft Capital Plan.

The Committee agreed to endorse the draft Capital Plan 2026 for onward submission to the Board for consideration and approval.

The Committee asked that a review of Capital and Estates Strategy 2022 – 2050 be brought to the Committee.

4.2 Building Contracts and Properties

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

The Committee approved the following contracts:

1. Lease of The Talbot, Block B, 8th Lock, Ratoath Road, Finglas, Dublin 11
2. Proposed Lease of Additional Space at the Primary Care Centre at Bishopstown PCC, Bandon Road, Bishopstown, Cork

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

1. Contract Award for a new Acute Inpatient Ward at University Hospital Limerick (UHL)
2. Proposed Acquisition of the ‘CLS/Zenimax’ Building at Galway West Business Park, Rahoon, Galway and appendix 1
3. Strategic Acquisition of Bailis Resource Centre, Athlumney, Navan, Co. Meath

The Committee noted following contract:

The Committee asked for a list of disposals to be brought to the next meeting.

5.1 Internal Audit Monthly Report

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

The CIA presented the results of the Internal Quality Assessment (IQA) that was carried out as part of Internal Audit’s Quality Assurance Programme, with a ‘generally conforms’ rating, noting that it was the first IQA completed under the new standards which came into effect on 09 January 2025.

The Committee reviewed the IQA and requested that an action plan and update on recommendations will be brought back to ARC in Q2 2026; and that an annual effectiveness assessment of the Internal Audit function and performance evaluation of the Chief Internal Auditor be included on the ARC Workplan for 2026.

5.2 Draft Audit Plan 2026

The CIA presented to the Committee the draft list of proposed Internal Audit topics for 2026, and advised that the detailed risk assessment of all proposed topics is currently being undertaken, and the overall risk coverage analysis will be presented to the Committee in December, as part of the full Internal Audit Plan submission for approval, which will also set out the methodology for topic selection, prioritisation, and risk-based planning.

The Committee discussed Internal Audit functions within the Section 38 and Section 39 agencies; the liaison between the HSE Protected Disclosures Office and Internal Audit in informing the plan; and future audit activity related to the revised thresholds of financial delegated levels of authority.

Elaine Kilroe, AND Enterprise Risk Management (ERM) joined the meeting

6.1 Q3 2025 Corporate Risk Register (CRR)

The Chief Risk Officer (CRO) presented to the Committee the Q3 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.

The Committee noted that the Q3 2025 CRR reflects updates arising from quarterly risk assessments and engagements with relevant senior managers.

The CRO advised the Committee that a Senior Leadership Team workshop was held on 10 October 2025, attended by members responsible for risks collectively owned on the CRR, and that these workshops are now established as part of the quarterly cycle to review key risks, agree on risk reduction strategies and ensure alignment. Following the centre restructure, the corporate risk process set out earlier in the year is becoming increasingly embedded. The network of nominated representatives, monthly support forums, and quarterly workshops will continue through Q4 to further refine risk assessments and strengthen mitigation strategies.

The Committee noted the CRR Risk Metric Report and were advised that based on their feedback at the September meeting with regard to enhancing metric reporting, communications have issued to relevant stakeholders by the CRO, and that the enhancements will be implemented in the next reporting period and continue through 2026.

The Committee noted risks R003 Disruptive Events, R005 Financial Management, R006 Major Infrastructure, R009 Compliance, R010 Data Protection and W006 Climate Change, and held a discussion in relation to R007 Cyber Security; the movement in residual risk ratings and the rreciprocal arrangement between Internal Audit and Risk to inform future risks.

The CRO briefed the Committee in relation to the impending Data Protection Commissioners (DPC) Statutory Inquiry report in relation to the storage and retention of personal data in paper records held by the HSE. The Committee noted that the Inquiry was carried out last year and it is understood that the publication of the report is imminent.

7.1 YTD Expenditure and Financial position to year end and Non Pay Savings 2025

The CFO provided a briefing to the Committee on the YTD Financial Position as at 30 September 2025, noting that the HSE is over the overall expenditure limit budget by €24.6m / 0.1%, (€134.9m surplus Department of Health (DoH) and €159.5m deficit Department of Children, Disability and Equality (DCDE)). He advised that within DoH funded services, Health Regions are reporting a €88.3m surplus against their limit.

The Committee noted that the current cash position for the HSE is €248.1m over profile as at 31st October, where DoH is over profile by €129.8m and DCDE over profile by €118.3m. In relation to YTD savings, it was reported as at 31 August 2025, €91.7m savings against a YTD target of €77.5m, with an over delivery against savings target of €14.2m.

The Committee discussed disability services, and were advised that a total of €3.88 billion has been allocated for disability services in the NSP, which acknowledges the pressures within the system of service delivery, both in terms of sustainability and the need for expansion to meet increasing demand.

The REO advised the Committee of the challenges in the communities and the Committee welcomed that a single point of access in relation to disability, mental health and primary care services are outlined in the NSP as priority actions for 2026 to improve timely access to the right care.

The Committee discussed the possibility of a final Task and Finish Group and it was agreed that the Chair would discuss this with Board Chairperson. It was agreed that the monitoring of finances would continue into 2026 by the ARC and that a look back would be held in July 2026.

7.2 Procurement update re Cost Reductions

The ND procurement provided an overview to the Committee of cost saving initiatives, achievements, and ongoing opportunities within the HSE’s procurement function which highlighted the global cost pressures currently within the environment along with strategic sourcing achievements, cost saving examples and future areas of opportunity for Procurement. He outlined key initiatives include the launch of the HSE Green Procurement Strategic Framework, the pending Corporate Procurement Plan, and improvements in materials master data management and contract uploads.

The Committee discussed potential savings plans in relation to vaccines, drugs and medicines, and rebates due on contracts for surplus demand, and it was agreed that an update would issue to the Committee.

7.3 National Service Plan 2026

Update on financial element of Draft National Service Plan

The CFO provided a brief to the Committee on the Financial Management Framework of the draft National Service Plan 2026 and outlined the context including the focus and high-level ambition for 2026. The Committee discussed the 2026 budget setting for services including the Section 38 and Section 39 agencies.

Letters of Determination

The Committee noted the Letters of Determination dated 30 October 2025 from the Minister for Health, and the Minister for Children, Disability and Equality.

7.4 Health Budget Oversight Group (HBOG)

The Committee noted that there were no minutes of HBOG available.

7.5 Special Legislative Accounts

The Asst CFO advised the Committee that in addition to the Annual Financial Statements (AFS) the HSE is required to prepare certain accounts under legislation, and present for consideration and recommendation to the Board the following special legislative accounts, which have been audited by the C&AG:

• Patient Private Property Accounts (PPP) as required by Health (repayment scheme) Act 2006
• Hepatitis C Insurance Scheme Accounts as regulated by the Hepatitis C Compensation Tribunal (amendment) Act, 2006.
• Long Stay Repayments Account as regulated by Section 18 of the Health Act 2006.
• Long Stay Donations fund as regulated by Section 11 of the Health Act 2006

The Committee noted that the draft accounts had previously been reviewed at the Committee’s July 2025 meeting, and subsequently these accounts had been audited. The Committee noted the accounts were submitted within statutory timelines, have been audited and remain unchanged with the exception of the removal of Note 7 in the PPP National Accounts, details of which are contained with the Statement of Internal Control. All 4 sets of accounts were submitted to the C&AG in line with the statutory requirement.

The Committee considered the special legislative accounts and recommended them to the Board for signing as part of the Boards reserved functions. They also nominated the CEO and Chairperson to sign the accounts in line with signature protocols as agreed with the C&AG as set out in the paper.

7.6 Contract Approval Requests

Damien McCallion (CTTO), Martina Queally (REO), Fran Thompson (Chief Information Officer), Priscilla Crombie (AND Programme Director Community Connect), and Dr Tom Foley (Clinical Lead) joined the meeting

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

1. Satellite Haemodialysis Unit for University Hospital Waterford (Kilkenny)
2. DPS National Tender for Pre-Poured Media

The CTTO and REO along with the CFO presented to the Committee the following CAR:

1. Competition Specialised Care Services Clinical Management System ‘Community Connect’

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

REO, Chief Information Officer, AND Programme Director Community Connect and Clinical Lead left the meeting.

8.1 PPSN Briefing

Tom Laffan, Chief Data and Analytics Officer, Technology and Transformation joined the meeting

The CTTO and Chief Data and Analytics Officer provided an update to the Committee in relation to the use of the national PPSN as a health identifier in health and social care services, including legal basis, operational progress, associated risks, and controls; and outlined the role of the Individual Health Identifier (IHI).

The Committee noted that the widespread collection of the PPSN will deliver a practical and efficient means of verifying identity at the point of care. When used in conjunction with the IHI, it will enable a significantly stronger identity-matching capability than either identifier alone, and will strengthen patient safety, improve data quality, reduce duplication and administration, and directly support the ambitions of the “Digital for Care” programme for seamless, integrated and digitally enabled healthcare.

The Chair thanked the Committee and SLT members. The meeting ended at 1.10pm

Terms of Reference: Audit and Risk Committee