HSE board meeting minutes 17 July 2025

Present:

Mr Ciarán Devane (Chairperson), Dr Yvonne Traynor, Mr Brendan Whelan, Mr Aogán Ó Fearghail, Mr Tim Hynes, Ms Anne Carrigy, Mr Matt Walsh, Mr Michael Cawley, Mr Kenneth Mealy and Ms Lily Collison

In Attendance for Board Meeting:

Mr Bernard Gloster (CEO), Mr Damien McCallion (CTTO), Mr Stephen Mulvany (CFO), Ms Sandra Broderick (REO Mid West), Ms Kate Killen White (REO Dublin & Midlands), Ms Martina Queally (REO Dublin & South East), Ms Sara Long (REO Dublin & North East), Dr Andy Phillips (REO South East), Ms Anne Cosgrove (IHA Manager), Mr Joseph Duggan (Chief Internal Auditor), Ms Grace Rothwell (ND Access & Integration), Ms Geraldine Crowley (AND ECC & Primary Care Contracts), Mr Patrick Lynch (ND Planning & Performance), Ms Anne Marie Hoey (Chief People Officer), Mr Joe Ryan, (National Director, Public Involvement, Culture and Risk Management), Mr JP Swaine (Culture Lead, Organisational Culture Group), Ms Niamh Doody (CEO Office), Mr Brian Murphy (CEO Office), Ms Sara Maxwell (CEO Office), Mr Dara Purcell (Corporate Secretary), Ms Niamh Drew (Deputy Corporate Secretary), Ms Patricia Perry (Office of the Board).

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 members to the meeting and provided an update to the Board during their private session.

2.1 Declarations of Interest

No conflicts of interest were declared.

2.2 Chairperson’s Remarks

The Chairperson provided an update to the Board on a number of matters that would be discussed during the meeting.

2.3 Minutes of Board meeting

The Board approved the minutes of the Board meeting of 27 June 2025.

3.1 Audit and Risk Committee

The minutes of the Committee meeting of 13 June and Special meeting on 16 June 2025 were noted. The Committee Chairperson provided an overview to the Board on the matters considered at the Committee meeting that took place on 11 July 2025.

The Board held a discussion on the following areas:

• The high number of consultants not included in the Irish Medical Council Specialist Register and the need for an urgent focus in reducing the number.
• The new Levels of Authority agreed which will become HSE policy from 01 October 2025. The CEO advised the Board of his memo regarding Non-Pay Control: Additional Measures Immediate Effect dated 15 July 2025, which included temporary immediate measures required to all non-pay expenditure.

3.2 Performance Committee

The minutes of the Committee meeting of 12 June 2025 were noted. The Committee Chairperson provided an overview to the Board on the matters considered at the Committee meeting that took place on 15 July 2025.

The Board held a discussion on the following areas:

• National Performance Report (NPR)
• The New Children’s Hospital (NCH), Children’s Health Ireland (CHI) and the waiting times and patient experience for children requiring spinal surgery. It was noted that the Committee would visit the NCH site on 24 July 2025.
• Briefing papers submitted to Board and Committee meetings, additional refinement would be beneficial to ensure they fully meet requirements.

4.1 CEO briefing to Board

The Board and CEO held a discussion in relation to the HSE’s year-end financial projections and the requirement to achieve substantial break even by year-end. The Board considered the establishment of a Task and Finish Group to review the work done by the SLT, to provide feedback and ensure clarity on the requirement for the HSE Breakeven Plan 2025 to deliver the agreed final position for 2025 and report back to the Board.

4.2 CEO Monthly Report

The CTTO provided an update to the Board in relation to the National Electronic Health Record Preliminary Business Case which has now been considered by the Department of Health, and noted that an update will be brought to the September Strategy and Reform Committee meeting.

Further to the Chair’s letter to the CEO of 08 July 2025, the CFO presented the HSE Breakeven Plan 2025 to the Board. He outlined that after initial efforts, involving a review and reduction in projected spend and identification of additional savings, a position was reached where two regions indicated substantial breakeven and four regions had residual challenges. The Board noted the proposal for savings relating to reduction in projected spend growth; additional savings; timing of developments; and noted the CFO’s recommendation.

Each member of the SLT provided an update to the Board in relation to the review in their area for the implementation of necessary financial measures, including the required savings, to deliver on the breakeven plan.

The Board welcomed the plan and the commitment by the CEO and SLT on the execution of the HSE’s year-end financial projections and the requirement to achieve substantial break even by year end. The Board outlined concern regarding the delivery of the plan, noting that further work remains to be done to get to a final position on some of the proposals, and ensuring clarity on the requirement for the plan to deliver the agreed final position for 2025 of a deficit not exceeding €250m. The Board emphasised that the objective is to drive urgency on the delivery of 2025 savings, strengthening the current proposal, and that a change in leadership style and culture is essential to succeed.

As I previously noted achieving success requires a fundamental shift in our leadership and organisational culture, a shift which will be vital for the HSE’s sustainability amid any future, less favourable financial conditions. As we inevitably move to a position of more restricted funding at some point we will need to match demand, with cost control and enhanced productivity through process innovation and capital investment. (taken from 2nd Chair letter)

National Performance Report

The monthly National Performance Report (NPR) May 2025 data was presented to the Board. The Performance Committee also reviewed this at its meeting on 15 July 2025. The Board approved the May 2025 NPR for submission to the Minister for Health, and Department of Children, Disability and Equality, and noted that once submitted, the NPR will be published on hse.ie.

5.1 Contracts & Properties

As recommended by the Audit & Risk Committee for approval, the Board considered and approved the following proposed contracts and properties:

1. CAR HSE 25387 Temperature Controlled Supply Chain Decision No.: 170725/32
2. CAR HSE 12061 Mini Competition, Voice and Data Communications 170725/33
3. CAR HSE 25431 Dynamic Purchasing System Mini Competition, Threat Detection and Response 170725/34
4. CAR HSE 24333 Dynamic Purchasing System Tender Competition Managed Extended Detection and Response 170725/35
5. CAR HSE 26593 Authorisation Scheme for the provision of Assisted Human Reproduction (AHR) Medical Services (Extension) 170725/36
6. CAR HSE 26435 Extension of the Authorisation Scheme for Provision of Home Support Services to Older People 170725/37
7. Property Disposal – Enniskerry Health Centre 170725/38
8. Disposal of Knockanarrigan Health Centre (also referred to as former Dispensary), Knockanarrigan, Co. Wicklow 170725/39
9. Proposed Lease of Primary Care Centre at Galway City West, Seamus Quirke Road, Galway 170725/40

6.1 Organisational Culture

Mr Joe Ryan, National Director, Public Involvement, Culture and Risk Management (ND PICRM) and the Culture Lead, Mr JP Swaine presented to the Board a paper and presentation for their consideration in relation to Organisational Culture.

The Board noted that the development, growth and sustaining of a positive organisational culture is essential in building and sustaining public trust and confidence in the health service, and that a positive organisational culture contributes significantly to workforce satisfaction, improved retention, productivity, quality and safety.

The ND PICRM and the Culture Lead updated the Board in relation to the consultation and development process relating to the Enabling Framework for Organisational Culture (Enabling Framework), which consisted of behaviours and values workshops; organisational culture workshops; and national and regional consultation.

The Enabling Framework was presented to the Board, and the ND PICRM advised that he would publish the Enabling Framework following the Board’s feedback. The Board was advised that the Organisational Culture Advisory Group (OCAG), which will be chaired by the CEO and consist of staff and senior management representatives, academic leaders, Patient and Service Users and civil society organisation leaders, will oversee the work of developing the desired culture across the health system. The Board noted that the OCAG will provide strategic advice, guidance, and oversight to the HSE Organisational Culture Programme on the development, implementation, and continuous improvement of a positive, inclusive, and values-driven organisational culture that promotes excellence in patient care, staff wellbeing, and public trust.

The Board discussed the successes and experience gained through Values In Action, and noted that consultation work revealed that previous organisational culture approaches focused primarily on the individual, and that there is now a need to focus increasingly on the role of leadership and management and that maintaining good culture requires continuous commitment by all.

The Board welcomed the programme of work in the Enabling Framework to develop metrics to evaluate the progress in developing a positive organisational culture which will form part of the regular reporting to the Board, a Board Committee and the Senior Leadership Team.

The Board discussed the Regional and National culture development stages noting the top down / / bottom up and the process of identifying culture leads and the culture team workstreams outlined in the culture development plan implementation model.

The Board welcomed and accepted the Enabling Framework and agreed to the establishment of a reporting regime to the Strategy and Reform Committee. The Board highlighted the need for the Enabling Framework to tie in with the People Strategy.

There was no further business. The meeting concluded at 15.04.