HSE board meeting minutes 27 May 2026

Present

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

In Attendance for Board Meeting

Ms Anne O’Connor (CEO), Mr Damien McCallion (CTTO), Mr Pat Healy (ND Services and Schemes), Mr Mark Brennock (ND Communications), Ms Anne Marie Hoey (CPO), Mr Michael Lane (A/CFO), Ms Sara Long (REO Dublin and North East), Dr Andy Phillips (REO South East), Mr Brian Murphy (Head of Corporate Affairs), Mr Dara Purcell (Corporate Secretary), Ms Niamh Drew (Deputy Corporate Secretary), Ms Patricia Perry (Office of the Board).

Joined the Meeting:

Dr Jennifer Carroll MacNeill (Minister for Health), Mr Patrick Lynch (ND Planning & Performance), Mr Brian O’Connell (ND Strategic Health Infrastructure and Capital Delivery), Mr Gareth Morton (ND Procurement), Mr Neal Mullen (CISO), Mr Pat Moran (PwC)

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 held a discussion in advance of the meeting with the Minister for Health.

The Chair welcomed the Minister for Health, Dr Jennifer Carroll MacNeill TD, to the Board meeting. A discussion was held on Ministerial priorities, including system performance, accountability, and reform delivery across a number of key areas: finance, agency conversion, POCC implementation, and urgent and emergency care (UEC).

Minister for Health left the meeting.

The Board held a discussion in private session following the meeting with the Minister for Health.

4.1 Declarations of Interest

No conflicts of interest were declared.

4.2 Chairperson’s Remarks

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

4.3 Ministerial Correspondence

The following Ministerial correspondence were noted by the Board:

• Letter from Minister for Health dated 24 February 2026 re Urgent and Emergency Care
• Letter to Minister for Health dated 15 May 2026 re Urgent and Emergency Care

4.4 Minutes of Board meeting

The Board approved the minutes of the Board meeting of 29 April 2026.

5.1 Task and Finish Group HSE Financial Position 2026 and Funding Challenges and 5.2 Audit and Risk Committee

The minutes of HSE Board Task and Finish Group regarding the 2025 HSE Financial Position of 23 April 2026 and minutes of the Audit and Risk Committee meeting of 17 April 2026 were noted.

The Chairperson of the Task and Finish Group (TFG) and the Audit and Risk Committee (ARC) provided an overview to the Board on the matters considered at the ARC meeting of 15 May and TFG of 22 May 2026 relating to the Financial Position and discussed areas where savings can be achieved, noting that there must be urgent attention on budget control, delegated authority, and governance, ensuring robust financial controls are in place.

The A/CFO reported to the Board on the YTD Financial Position as at 30 April 2026, noting that the HSE is over the overall expenditure budget by €334.2m / 3.5%, (deficit of €348.6m Department of Health (DoH) and surplus of €14.3m Department of Children, Disability and Equality (DCDE)).

The Board noted that the position requires immediate corrective action, stronger central oversight, system-enforced compliance, and clear accountability across the Regions. It acknowledged that the current financial position is not attributable to a single factor, noting that by the end of 2025 and into early 2026, several underlying pressures had already become embedded within the system, including an imbalance between funding and cost base, sustained growth in pay costs, ongoing non-pay inflation and demand pressures, and a decline in patient income resulting from the transition to Public-Only Consultant Contracts. Some concerns were expressed about the timing of responses in a number of areas. It was noted that some of the issues had been identified in Q1 but had not been implemented until more recently. It was suggested that earlier, planned intervention may have provided an opportunity for a more proactive and controlled approach.

The Board welcomed the establishment of the Cost and Productivity Oversight Group, reporting to the CEO and chaired by the CTTO/Deputy CEO. The Board noted that the Group held its inaugural meeting on 22 May and has been established to provide cross-functional executive governance of the cost and productivity improvement programme. The Board further noted that the Cost Recovery Team is the first programme operating under the Group’s governance framework.

The Board discussed areas where savings can be achieved, such as income collection, agency, postage and management consultancy; and it was noted that the cost reduction proposals circulated by the TFG had been mapped against the savings plans.

Discussions took place regarding agency expenditure which remains a significant and unacceptable contributor to the current financial position, with key areas of focus outlined including agency-to-direct employment conversion, strengthening of authorisation controls, reduction in off-framework agency usage, improved roster efficiency, and the expansion of flexible contracting and staff bank arrangements. The Board noted the establishment of an Agency Performance Action Group, co-chaired by the CPO and CFO, which will provide assurance to the CEO, Board and Department of Health regarding the implementation of the 2026 agency savings programme across all Regions.

Terms of Reference

The Terms of Reference of the Task and Finish Group HSE Financial Position 2026 and Funding Challenges were considered and approved by the Board. Decision No.: 270526/27

5.3 Performance Committee

The minutes of Committee meetings of 23 April 2026 were noted. The Committee Chairperson provided an overview to the Board on the matters considered at the Committee meeting that took place on 21 May 2026.

The Board held a discussion on the following areas:

• The status of Section 38 Service Arrangements, with concerns outlined regarding delays in the sign-off process, and the requirement to improve arrangements going forward.
• HR challenges including agency, POCC, junior doctors, and the process being employed to address the matters.

5.4 Strategy and Reform Committee

Appointment of External Members

The Chairperson of the Committee requested that the Board approve the appointments of Mr Nigel Donovan and Mr David Codd as external members of the Strategy and Reform Committee for a term of 3 years until 27 May 2029, which the Board approved. Decision No.: 270526/28

6.1 CEO briefing to the Board

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

6.2 CEO Monthly Report

Members of the Senior Management 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 briefed the Board on the industrial action involving the National Ambulance Service, which has now been stood down following positive developments at the Labour Court. The publication of the Labour Court's recommendations is awaited.

In relation to disabilities, the CEO reported that progress is underway on the €5m respite investment, with improvements including an expanded services database, new neurodiversity respite and therapeutic supports, and a partnership with the GAA to support children with additional needs participating in community camps. The Board noted the launch of the new Autism Assessment and Intervention Pathway Protocol and that the National Director for Disabilities post has been re-advertised with revised terms following an unsuccessful recruitment campaign.

With regard to Urgent and Emergency Care (UEC), the CEO reported that weekly meetings have been established with the Regions to address systemic and governance challenges impacting performance. These meetings will review trends, identify improvement opportunities, develop Quality Improvement Plans, and agree corrective actions and timelines to support sustainable improvements in patient flow and overall UEC performance.

The Board noted increasing international risks associated with high-consequence infectious diseases (HCID) and limitations in current national preparedness capacity. The CEO advised that approval was given to the CCO to progress the establishment of an HCID Preparedness Oversight Group to strengthen coordination and develop a national response model.

The CEO provided an update to the Board in relation to the draft report of the Audit of Governance and Equity in Patient Access and Waiting List Management, with the final report expected in June, noting that work is underway in parallel to prepare for the publication of the report and also the Report on Waiting List Management at CHI by L Collison.

The Board noted updates relating to the Transformation Programmes including One Health Record; HSE Shared Care Record; HSE Laboratory Record; Medication Management: Hospital Medicines Management System (HMMS); Artificial Intelligence; and Innovation Framework and HealthTech Ireland Collaboration.

National Performance Report

The monthly National Performance Report (NPR) March 2026 data was presented to the Board.

The Performance Committee also reviewed this at its meeting on 21 May 2026. The Board approved the March 2026 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.

7.1 Final Annual Financial Statements (AFS) 2025

The Board reviewed with the CEO and A/CFO the final draft AFS 2025, notes to the accounts, Statement of Internal Control (SIC), Operating and Finance Review (OFR), Letter of Representation (LOR) 2025, Chair’s Comprehensive Report and draft C&AG audit certificate, which had been circulated in advance.

It was noted that the audit of the AFS was still ongoing but is at a very advanced stage, and that there have been no material changes other than those outlined in the AFS, SIC and associated documentation.

The Board proceeded with their re-adoption of the AFS and related documents on the grounds that they have been recommended by the Audit & Risk Committee as confirmed by the Committee Chairperson and nominated the Board Chairperson and the CEO to re-sign these accordingly. Decision No.: 270526/29

7.2 Contracts & Properties

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

1. 1. 1. Provision of Salesforce Licences, Implementation Services, Development and Support for the National Immunisation Information System (NIIS) Decision No.: 270526/30
      2. National DPS Tender for CT Scanners Decision No.: 270526/31
      3. Contract Award for construction of a 3 Storey extension to the Corduff Primary Care Centre for the Enhanced Community Care Programme Decision No.: 270526/32
      4. Proposed extension of lease of Primary Care Centre at Youghal, Co. Cork to provide a Permanent National Ambulance Service Training College Decision No.: 270526/33

8.1 Cyber Security Progress Update 2026

The Deputy CEO / CTTO introduced Mr Neal Mullen, Chief Information Security Officer (CISO) and Mr Pat Moran, Partner Consulting, PwC to the meeting, noting documentation circulated in advance of the meeting.

Mr Moran presented to the Board the 2025 HSE Cyber & OES Assessment Overview conducted over 12 weeks from September 2025 which included 28 workshops and a review of 489 artefacts. The Assessment covered all NIST functions: Govern, Identify, Protect, Detect, Respond, Recover.

The Board noted the overall maturity increase in 2025, with all functional areas showing year‑on‑year improvement. An outline of key positives and key areas of improvement were outlined, and PwC’s assessment of the HSE’s progress in addressing findings from the 2024 Mazars audit.

The Board noted the key recommendations outlined relating to Governance; Critical Service Taxonomy; Business Continuity; Supplier Governance; and Cyber Risk Assessments.

The Board discussed the progress in relation to Cyber Security noting that the HSE’s cyber security maturity continues to improve, with the 2025 cyber security maturity reassessment exceeding the Board’s target and demonstrating sustained progress across governance, risk, and technology capability development.

The Board noted the strategic priorities for the coming period include enhanced threat detection, strengthened cyber resilience, NIS2 readiness, and development of a national cyber security strategy, supported by a national cyber community and improved collaboration across statutory and voluntary hospitals. Operational capability has advanced through investment in incident response, infrastructure protection, resilience planning, and large‑scale simulation exercises. A broad programme of initiatives continues across governance, risk, asset management, threat and vulnerability management, data protection, detection, and incident response and recovery.

The Board noted that ongoing support and endorsement will be required to maintain progress, underpin digital transformation, and ensure the organisation can effectively manage evolving cyber risks.

The Executive left the meeting and the CISO provided an update to the Board on a third party cyber security incident.

The Board noted the update provided by a Board member in relation to CHI and discussed the integration into the HSE.

There was no further business. The meeting concluded at 2.43pm