HSE board meeting minutes 18 February 2022

A meeting of the Board of the Health Service Executive was held on Friday 18 February 2022 at 5:00pm by video conference.

Present:

Mr Ciarán Devane (Chairperson), Mr Aogán Ó Fearghaíl, Mr Brendan Lenihan, Mr Fergus Finlay, Dr Yvonne Traynor, Dr Sarah McLoughlin, Mr Brendan Whelan, Prof Fergus O’Kelly, Ms Anne Carrigy, Mr. Tim Hynes.

Apologies:

Prof Deirdre Madden.

In Attendance for Board Meeting:

Mr Paul Reid (CEO), Mr Stephen Mulvany (CFO), Ms Anne O’Connor (COO), Mr Dean Sullivan (CSO), Mr Mark Brennock (ND Communications), Liam Woods (ND Acute operations), Ms Yvonne O Neill (ND Community Operations), Ms Yvonne Goff (ND Change and Innovation), Mr John Kelly (Corporate Governance), Mr Dara Purcell (Corporate Secretary), Ms Niamh Drew, Ms Hannah Barnes.

The Chair welcomed the Board members to the meeting and held a private session to consider the agenda and papers for the meeting.

No conflicts of interest were declared.

2.1 Draft Waiting List Action Plan

The CEO and CSO presented the joint DoH, HSE, NTPF 2022 Waiting List Action Plan to the Board for consideration prior to it being shared with the Government. The CEO advised that the 2022 Waiting List Action Plan focuses on delivering immediate reductions in scheduled care waiting liststhrough increased activity to impact volumes, while building on the work done in 2021 to lay the foundations for longerterm reforms. The Plan is the first stage of a comprehensive multi-annual reform programme of work to deliver sustained reductions in waiting lists numbers and waiting times so that people in Ireland receive the healthcare they need within defined timeframes. The CEO highlighted that the plan builds on the work done through the 2021 Waiting List Action Plan and that through the 2022 Plan, €350m is being allocated to the HSE and the NTPF to provide additional public and private activity to further stabilise and reduce scheduled care waiting lists and waiting times and that this will supplement the core activity of the HSE as detailed in the HSE National Service Plan (NSP) 2022.

The Board welcomed the Plan as a key first step to tackling long waiting times and acknowledged that it is working towards the maximum waiting times as identified in Sláintecare. The Board highlighted the importance of full alignment between all parties involved i.e. the HSE, DoH, and the National Treatment Purchase Fund (NTPF) in relation to the delivery of the targets as set out in the plan.

Following a discussion on governance and oversight the Board highlighted the absence of references in the Plan to the formal role to be played by the Board and requested that the Plan recognise and document the Board’s role more clearly. The Board requested that regular updates be brought forward for consideration by the Performance and Delivery Committee and the Board on an ongoing basis given that the Board has oversight and accountability for delivery of these services.

The Board requested that they are given the opportunity to review the updated Plan in advance of its finalisation and publication.

A discussion was held regarding recent media reports of internal meeting of officials in the Department. It was noted that many of the issues raised in these reports involve mischaracterisations of well-known issues that arise from the fact that the HSE is obliged by law to use a different approach to accounting than do Government departments, namely Vote and accrual accounting. Issues in relation to financial reporting around cash balances are issues of timing, not substance. Furthermore, there will not be, nor was it ever indicated by the HSE that there might be, any adjustment in the order of “hundreds of millions of euros” to the HSE’s Accounts. The technical accounting adjustment(s) being referred to in the article will arise as a result of a detailed review, instigated by the HSE Finance team, into a subset of our overall accruals carried on the Balance Sheet. To the extent any accounting adjustment is required it will reduce (rather than increase) any previously reported level of expenditure and also reduce the carrying value of liabilities in the Balance Sheet.

The HSE and DoH work collaboratively, and it was noted that the nature of some of the commentary on these issues does not reflect the actual content and tone of the relationship. The Board expressed its disappointment at the tone, nature, and misleading content of the reports of meetings in the Department and has communicated this position to the Minister.

The Board acknowledged the professionalism of the HSE CFO and finance team who continue to work collaboratively and in a positive spirit with the DoH. The Board also commended the ND HR and her team for their work in the implementation of major changes, targeted strategies and developments to recruitment approaches, in order to achieve unprecedented sustained growth levels in the health service.

The ND Communications will engage with Department officials to prepare a detailed issue-by-issue set of answers to the Business Post and issue a press response to the media commentary as appropriate.

The Chair thanked Board Members and Management Team members for their time.

No further matters were discussed.

The meeting concluded at 19:20.