HSE Board Meeting Minutes 26 September 2025

Present

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

Apologies

Dr Yvonne Traynor, Mr Michael Cawley.

In Attendance for Board Meeting

Mr Bernard Gloster (CEO), Mr Damien McCallion (CTTO), Mr Stephen Mulvany (CFO), Mr Pat Healy (ND Services and Schemes), Ms Sandra Broderick (REO Mid West), Ms Kate Killen White (REO Dublin & Midlands), Mr Tony Canavan (REO West North West), Dr Andy Phillips (REO South East), Mr Joseph Duggan (Chief Internal Auditor), Dr Colm Henry (CCO), Mr Patrick Lynch (ND Planning and Performance), Ms Anne Marie Hoey (Chief People Officer), Mr Mark Brennock (ND Communications), Mr Joe Ryan, (National Director, Public Involvement, Culture and Risk Management), Brian O’Connell (ND Strategic Health Infrastructure and Capital Delivery), Gareth Morton (ND Procurement), Valerie Plant (Assistant CFO IFMS), Robert Kidd (IHA Manager Dublin North), JP Nolan (AND Access and Integration), Philip Crowley (ND Wellbeing, Equality, Climate and Global Health), Miin Alikhan (AND Planning), Roseanne Killeen (IHA Manager Carlow Kilkenny), Ms Niamh Doody (CEO Office), Mr Brian Murphy (CEO Office), Mr Dara Purcell (Corporate Secretary), Ms Niamh Drew (Deputy Corporate Secretary), Ms Rebecca Kennedy (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.

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 Ministerial Correspondence

The Board noted the following correspondence.

• Letter from Minister for Health re HSE Annual Report and AFS 2024 laid before Oireachtas dated 22 July 2025
• Letter from Minister for Children, Disability and Equality re HSE Annual Report 2025.

2.4 Minutes of Board meeting

The Board approved the minutes of the Board meeting of 17 July 2025.

3.1 Audit and Risk Committee

Anne Carrigy, on behalf of the Committee Chairperson, provided an overview to the Board on the matters considered at the Committee meeting that took place on 12 September 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.
• HSE Procedures for the Handling of Protected Disclosures.

3.2 Task and Finish Group - HSE Financial Position

The minutes of the Task and Finish Group meetings of 19 August and 05 September 2025 were noted. Anne Carrigy, on behalf of the Task and Finish Group Chairperson, provided an overview to the Board on the matters considered.

The Board held a discussion on the following area:

• Regional assurances provided by REOs and Centre assurances provided by CFO

3.3 Performance Committee

The minutes of the Committee meeting of 15 July 2025 were noted. The Committee Chairperson provided an overview to the Board on the matters considered at the Committee meeting that took place on 19 September 2025.

The Board held a discussion on the following areas:

• National Performance Report (NPR)
• The New Children’s Hospital (NCH), and Children’s Health Ireland (CHI) and the waiting times and patient experience for children requiring spinal surgery.

3.4 Strategy and Reform Committee

The minutes of the Committee meeting of 17 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 09 September 2025.

The Board held a discussion on the following areas:

• The HSE Transformation Programme Quarterly Portfolio Report
• Financial planning including improved forecasting, demand modelling and cost control

4.1 CEO briefing to Board

The CEO briefed the Board on two matters in private session.

4.2 CEO Monthly Report

Members of the Senior Leadership Team joined the meeting

The CEO reported to the Board on a number of the key significant areas as set out in the CEO Monthly Report.

The CEO reported to the Board on Urgent Care, and advised that overall, there is a mix of progress and challenge in the system. There is regularly 14-17 of 29 sites Green and then serious challenges in a number of others. The CEO advised that he is currently working through a series of oversight and improvement responses in challenged sites and that formal correspondence of concern has been received from the Minister in respect of UEC performance recently at SVUH and the hospitals in the West / North West.

The CEO advised that Scheduled care continues to receive focus and updated the Board in relation to July waiting times in areas including: Sláintecare wait time targets; Patients Waiting Less Than 12 Months and Waiting List Volumes YTD.

The CEO reported that since the last Board meeting, with the agreement of the Minister for Health, new controls have been introduced on third party insourcing within the HSE. These controls allow for the use of third party insourcing by REOs, only as a last resort and subject to a number of limitations. The CEO confirmed that the long term intention is to phase out the use of third party insourcing, with direction from the Minister expected to follow.

The CEO advised the Board that the HSE has made a non-binding offer to acquire a property in Dublin, and the REO Dublin & Midlands will now proceed with financial, legal, HR, estates and clinical due diligence and an overall Board decision will be required at a later date.

The CEO confirmed that he has received a draft Letter of Determination (LoD) from the Department of Health (DoH) and this is working its way through the estimates and budgetary cycle with the Minister and the Department of Public Expenditure, Infrastructure, Public Service Reform and Digitalisation (DPEIPSRD).

In relation to Consultants Not on the Specialist Register, the CEO Reported to the Board that following completion of the recent Internal Audit Report, he has written to all REOs outlining their need to establish regional governance structures, including a named responsible person and approval process for each Region. Updates will be required through National HR every 6 months on the status of the controls and the relevant consultants.

The CEO reported that regarding the Public Only Consultants Contract (POCC), he co-hosted a day long workshop with the Minister for Health and approximately 90 senior managers, including all REOs, RCDs, CEOs and Managers of Model 3 and 4 hospitals, and it is intended to have another event January 2026, to review progress and maintain momentum.

The CEO confirmed that national and regional engagements aimed at creating a single point of access between Primary Care, Disability and CAMHS have commenced and a detailed progress report on early implementation will be provided to the October meeting.

In relation to the development of the New Children’s Hospital, the CEO confirmed detailed engagements with the Minister for Health, REO Dublin & Midlands, National Director Planning and Performance, the National Paediatric Hospital Development Board (NPHDB) and CHI.

The CEO reported that the National EHR programme is currently on track against the key milestones and activities identified as part of the planning process. The Preliminary Business Case (PBC) is currently in the DPENDR Major Projects Advisory Group (MPAG) Process. Establishment of the Peer Review Group to undertake the peer review is in progress with DPEIPSRD.

The ND Wellbeing, Equality, Climate and Global Health (WECGH) briefed the Board on the HSE Climate and Sustainability Programme. The update covered the current status of the Climate Action Strategy; Government / Legal requirements and reporting structures; Budget / Resources; and the Impact to delivery of services / Social Factors. The ND WECGH highlighted three key recommendations for consideration by the Board: Appointment of one full time dedicated regional lead for Climate and Sustainability in each region; establishment of a Regional Green Committee in each region that functions in line with recommended governance; and appointment of one full time dedicated WTE to lead on Measurement and Assurance, supported by an IT platform for measurement. The Board acknowledged and commended the work to date and supported the direction of travel as set by the ND WECGH.

The Board thanked ND WECGH for the presentation and for his work in the HSE, wishing him well on his upcoming retirement.

National Performance Report

The monthly National Performance Report (NPR) June / July 2025 data was presented to the Board. The Performance Committee also reviewed this at its meeting on 19 September 2025. The Board approved the June / July 2025 NPR for submission to the Minister for Health, and Department of Children, Disability and Equality (DCDE), and noted that once submitted, the NPR will be published on hse.ie.

5.1 Contracts and Properties

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

5.2 Banking Arrangements - Update to existing Bank Mandate

The Board considered and approved to update the HSE Bank Mandate to remove Colum Maddox, Asst CFO as a main signatory and add Monica Percy, Asst CFO to the HSE Bank Mandate as a main signatory. Decision No.: 260925/48

6.1 National Service Plan 2026

Mr Patrick Lynch, National Director, Planning and Performance presented to the Board a paper and presentation for their consideration in relation to the National Service Plan (NSP) 2026. The briefing covered: Legislative and policy context for the NSP; Letters of Determination (LODs) and early indications of Ministerial priorities 2026; Essential building blocks of NSP 2026; Proposed changes to the NSP for 2026; Monitoring the NSP’s implementation; and Indicative timelines NSP 2026.

The DoH and DCDE will each issue a Letter of Determination to the HSE within 21 days of Budget Day on 7 October 2025. The Board noted that the HSE expects the 2026 LOD from the Minister for Health will mark a major change of approach from that adopted in previous years. Once these changes are confirmed, additional work will be required to ensure the changes, together with the Ministers’ priorities and requirements are adequately reflected in the post-LOD draft of the NSP.

The ND Planning and Performance confirmed that the HSE has provided both Departments with its estimates of requirements for Existing Levels of Service (ELS) and New Developments. It was highlighted that the Corporate Plan and organisational changes, particularly the establishment of health regions, requires the NSP 2026 to be different to previous years. The NSP 2026 is intended to be more concise and have a focus on delivery; have explicit priorities; be measurable; and address what is reasonably fixable.

The Board discussed the expected changes in the NSP 2026 and highlighted that the role of the Regions and the lines of accountability to the REOs will need to be clearly outlined. The ND Planning and Performance advised that a key change in the process this year will be that the Performance Accountability Framework (PAF) will be submitted alongside the NSP for agreement by the Minister.

The Board queried whether there has been any formalisation of Activity Based Funding (ABF) and the CFO confirmed that an update is due to come back to the Board before the end of the year. The Board also queried whether more information on the methodology of budget allocation was available and the CFO agreed to share draft budgets as part of the NSP process this year.

There was no further business. The meeting concluded at 15:38.