HSE audit committee’s ‘inability’ to influence spend

The ability of the HSE’s audit committee to “materially influence” the Executive’s financial problems in 2019 was limited, according to minutes of the committee’s meeting in August.

The audit committee heard from the HSE’s Chief Financial Officer (CFO) Mr Stephen Mulvany at its meeting on 27 August, the minutes of which were obtained by the Medical Independent through Freedom of Information law.

“There was a general discussion about the nature and effect of the implementation of controls in the home care packages area (and other transitional packages to facilitate discharge from acute settings) and the care, economic and cashflow impact of tightening controls in this area,” according to the minutes. Mr Mulvany “indicated that expenditure had expanded in this area in 2019 and therefore it was not appropriate in his view to say that the area was being cut”.

The CFO also undertook to provide committee members with data on the extent of legal costs in relation to State claims.

“The committee noted management focus in recent months to bring expenditure back in line, having significantly exceeded budget in recent periods,” the minutes stated.

“It was agreed that future reports could helpfully be tailored for the committee, with clearer explanation of abbreviations/in-house terminology, along with highlighting of areas of concern and management action to address such areas.” However, the minutes noted that “notwithstanding the important role” the committee has in terms of monitoring expenditure, “the scope for committee oversight to materially influence 2019 outturn at this point in the year is somewhat limited.”

“The committee will have a focus on ensuring that 2020 plans are improved and accompanied by enhanced control.”

In relation to a discussion about the HSE’s Capital Plan, it was agreed that there needed to be “greater visibility” in relation to risk associated with under-investment in medical equipment and estate upkeep. There was also the need for “a robust system of communication of risks to the Department of Health [and] greater integration of the ICT capital plan into the overall capital plan”.