Category: Health/HSE

Formal complaint against Robert Watt

By Anthony Sheridan

Department of Health secretary general Robert Watt recently committed several millions of taxpayer’s money to fund the secondment of Dr. Tony Holohan to Trinity College Dublin.

Mr. Watt had no authority to commit such public funds without the knowledge and permission of the Minister of Health.

I have submitted the following formal complaint to the Standards in Office Commission [SIPO] in response to Mr. Watt’s actions.

To Whom It May Concern:

Please find a formal complaint against the Secretary General of the Department of Health, Robert Watt, submitted under the Civil Service Code [The Code] of Standards and Behaviour.

I believe Mr. Watt is in breach of  several sections of the above standards and requirements as set out in the Code.

This complaint is based on evidence taken from Mr. Watt’s Briefing Note and his letter of intent to Professor Linda Doyle of Trinity College Dublin. 

This complaint is divided into two parts.

Complaint – Part One

The drafting and sending of the letter of intent by Mr. Watt to Professor Linda Doyle of TCD.  Mr. Watt was in breach of his duties and responsibilities on two counts regarding this letter.

One:  He did not possess the authority to write such a letter without the knowledge and permission of the minister.

Two: He did not possess the authority to offer a contract to TCD that involved a potential cost to the state of several millions. In his briefing note Mr. Watt defends his actions by claiming that the final details regarding Mr. Holohan’s secondment were not finalised. 

This defence does not stand up.  Whether or not the final details were agreed is irrelevant.  

It is the act itself of drawing up the letter and sending it to Professor Doyle for signature that constitutes Mr. Watts breach of the code under section 11. Regard for state resources [11.1] [11.2]

11.1 Civil servants should endeavour to ensure the proper, effective, and efficient use of public money.

11.2 Civil servants are required to: • take proper and reasonable care of public funds and departmental property and not to use them, or permit their use, for unauthorised purposes; • incur no liability on the part of their employer without proper authorisation and • ensure that expenses, such as travel and subsistence payments, are not unnecessarily incurred either by themselves or by staff reporting to them.

Complaint – Part Two

In his Briefing Note Mr. Watt, in an obvious attempt to spread responsibility for his own decisions and actions, dishonestly implicates other agencies and individuals in those decisions.

Two examples:

[1] He promised an allocation of €2 million for the duration of Mr. Holohan’s secondment to be administered through the Health Research Board [HRB].  The HRB have made it absolutely clear that they were neither informed nor consulted in regard to this decision.  Whether or not the HRB would have administered Dr. Holohan’s salary is irrelevant in the context of this complaint. 

What is relevant is that Mr. Watt failed in his responsibility to inform or consult with the HRB on a decision that would have had a serious impact on the obligations and resources of that organisation. 

Furthermore, Mr. Watt’s failure to inform or consult with the management of the HRB regarding his decision demonstrates a serious lack of respect and consideration for his civil service colleagues.

[2] Mr. Watt strongly suggests that the Secretary to the Government, Martin Fraser, the Taoiseach and other members of the Government were aware of the proposed secondment.

Mr. Watt writes:

The Secretary to the Government was aware of the proposed secondment move (but not of course the precise details) and I understood that the fact of discussions regarding the CMO’s future plans were known in the Department of An Taoiseach. I assumed that key decision-makers were aware of the proposal but of course not the precise details. [Source: Robert Watt’s Briefing Note: Other Matters [5].

The facts are:  The Taoiseach has made it crystal clear that he had ‘no hand, act or part’ in the plans surrounding Dr. Holohan’s secondment. 

Similarly, no other government minister had any knowledge whatsoever of the details as drawn up by Mr. Watt and Dr. Holohan and agreed to by the provost of TCD, Linda Doyle. Mr. Fraser and Mr. Watt’s boss, the Minister for Health, were given only the vaguest details of what was planned. 

Mr. Watt’s use of terms such as ’I understood that’ and ‘I assumed that’, in mitigation of his actions are not credible coming from a public official of his rank, power and responsibilities.

I believe that Mr. Watts’ decisions and actions in respect of the above are in breach of Part 2 [4] [Impartiality] [paragraphs [a] [b] and [c] of the Code.

Civil servants in the performance of their official duties: 

(a) must conscientiously serve the duly elected Government of the day, the other institutions of State and the public; 

(b) must advise and implement policy impartially and, in particular, be conscious of the need to maintain the independence necessary to give any future Minister or Government confidence in their integrity and 

(c) should not display partiality whether as a result of personal or family ties or otherwise.

Yours etc.,

Anthony Sheridan

Fergus Finlay and the maternity hospital ‘gotcha’ trap

Illustration by Tom Halliday

By Anthony Sheridan

HSE board member and Irish Examiner columnist Fergus Finlay is so strongly in favour of the current arrangement for building the National Maternity Hospital that he took the unusual step of breaking board confidentiality rules to support the Government’s plan for the project.

In his column he clearly stated where he stands on the issue. 

Here’s my bottom line. As a citizen, campaigner, and advocate; as a husband; as the father and grandfather of women and girls; there are simply no circumstances under which I would support the development of a new national maternity hospital in Ireland that was influenced by anything — anything — other than the public interest and the interests of women.

He then went on to outline the enormous amount of work he and his colleagues on the audit and risk committee put into checking every aspect of the deal to ensure that nothing was left to chance.

We devoted many, many hours, over many months…examining and analysing the huge set of documents that had been developed to give legal underpinning to the project. We worked with senior management colleagues and had the benefit of legal advice at every stage.

Given all that, it would be reasonable to assume that Mr. Finlay is familiar with all aspects of the project and would have no difficulty in answering questions put by those who are deeply concerned about the entire project.

Such an assumption would be badly mistaken. 

During a discussion on RTE radio with Prof. Louise Kenny, who has serious question on the issue, Finlay was unable to answer even the most basic questions. 

For example:  Why is St. Vincent’s so determined to hold on to ownership of the site?

Finlay: 

Well, you would need to ask them that but I would hazard a guess:  I think they see it as a great act of generosity and they don’t understand why they should be asked to go further.  The rest of the world would like them to gift the land to the state, but they haven’t. 

St. Vincent’s have claimed that ownership of the land is required in order to facilitate integrated care.

Prof. Kenny refutes this.  It doesn’t stack up, she said.  There are many hospitals across the UK  and Europe where the leasehold has no effect whatsoever on care integration.

Incredibly, Finlay agreed, contradicting his core claim that everything has been checked,  that months of forensic investigation with the best legal minds has answered all the questions:

I think you can work out arrangements for integrated care without owning the land…I don’t think that’s a good reason.  My hunch is that it’s about tradition, it’s about history, it’s about pride in their own ownership. 

So here we have  a member of the HSE board, the authority that will decide whether the project proceeds or not, guessing and expressing hunches surrounding the most fundamental questions being asked by those who are deeply worried about the consequences if the project is allowed to proceed in its present form.

Finlay was equally befuddled when asked about the worrying inclusion of the term ‘clinically appropriate’ in the contract.  Kenny said the term was incredibly vague and open to interpretation.  It could mean a doctor having the power to override the wishes of a woman seeking a particular service. 

Finlay:

I think that phrase has been misinterpreted and I wish to god we could find a better phrase that wouldn’t be open to misinterpretation.

When asked if lawyers should come up with a better phrase Finlay did a lot of muttering before lamely concluding with the by now standard excuse of those defending the project – it would involve further delay.

In addition to his ignorance of the facts Finlay’s attitude was also patronising and insulting, not just to Prof. Kenny but to all those who have genuine worries about the Byzantine conditions surrounding this project.  Effectively accusing Prof. Kenny of being a conspiracist, he asked:

Is it that you really believe that somewhere in the background there’s someone waiting to leap out and say ‘we gotcha now’?

Clearly Finlay is unaware of or not concerned about a number of clauses in the contract.  For example, the strong possibility that the apparent generous €10 per annum rent could mushroom into an astonishing €850,000 per annum if certain conditions are not adhered to.

Given the shady and convoluted shenanigans surrounding this whole deal, only the most naïve would believe that it will not eventually turn into a very, very expensive ‘gotcha’ trap for Irish taxpayers.

Tom Parlon launches new career in comedy

By Anthony Sheridan

Tom Parlon, former politician and Director General of the Construction Industry Federation [CIF] has come out as a comedian. 

It’s not clear if Parlon intends continuing with his job at the CIF but the quality of his comedy sketch on yesterday morning’s Today with Sean O’Rourke would surely indicate that he’s bound for global fame on the comedy circuit.

Basing his sketch on the Government’s open cheque book joke  for contractors to build the National Children’s Hospital Parlon led with one of his oldest but most hilarious jokes.

This is the one about contractors, while struggling to make a few cents profit against all the odds, recklessly risking everything they possess in order to help out the national economy and those seeking to put a roof over their heads.

He continues with some brilliant one liners on why costs continue to rise into the stratosphere.

It’s a busy, busy time for contractors.

There’s been some big accidents in China and elsewhere in the world.

Stuff is scarcer.

Contractors don’t get a penny more than they’re entitled to.

[No, seriously, he did say ‘stuff is scarcer‘.]

And the new comic genius introduced a brand new type of joke – the one worder.

Brexit…snapped Tom and the audience fell about in stitches. 

Before listeners could catch their breath with their laughing he followed up with some great new jokes.

The rising costs of the 2 billion hospital, said the budding comedian, can be compared to someone ordering a gear-change car and, when going to collect it, suddenly says:

Jesus, I want to change my mind and buy an automatic, only to discover that it will cost more.   

And, like all great comedians Parlon roped in a member of the audience to help him make his jokes even funnier.

After telling Sinn Fein health spokesperson Louise O’Reilly that a delay in the delivery of fireboards had added substantially to cost overruns she helpfully asked:

Tom, what percentage of the 1.7 billion overrun is down to the delay in fireboards?

Haven’t a clue… the hilarious Tom responded.

Poor old Sean O’Rourke finally realised he had been set up by his producers.   This wasn’t a serious interview analysing the out of control billions for the National Children’s Hospital. 

 It was the launch pad for Tom Parlon’s new career in comedy.

Listen to the full comedy sketch here, highly recommended.

Copy to:

Tom the comedian

Sean O’Rourke

Varadkar spouts the usual waffle in response to patient’s suffering and death

excuses-are-tools-of-incompetence-tj-smith

By Anthony Sheridan

Minister for Health Leo Varadkar was dealing with the latest scandal in the HSE which included the usual suffering and death of patients.

He said he sympathised with the latest victims of the HSE particularly with the family of the deceased.

He said there would be full disclosure.

He said he was concerned about how long the review was taking.

He said he was determined to improve quality assurance (whatever that is).

He said lessons must be learnt.

He said mistakes must not be repeated.

He said he knew all about the scandal since early 2015.

A journalist asked him how the investigation into the horror inflicted on Grace was going.

Grace…Who’s Grace?

Ah no, he wasn’t asked that question. But still, we know there’s truth in it.

HSE qualifications

So, Mr. X, why do you think you’re the best man to fill this high level position in the Health Service Executive?

Three reasons:

First, I have a first class PhD degree in spin. There is no situation, no matter how indefencible, no matter how horrific, no matter how damaging to patients that I cannot present as a progressive development in the health service that all right thinking people will applaud.

Incidentally, my PhD thesis focused on how to deliver apologies that can reduce the most well informed, most ardent opponent of HSE policies, to tears.

Second, my loyalty is completely and utterly to the organisation. I am prepared to do anything, say anything to ensure that the organisation is protected above all other considerations.

Third, I have abandoned my moral compass to remove any possibility of hindering the ruthless and efficient realisation of the above two skills.

You’re hired.

Senator Crown has lots of questions to answer

What a very curious statement made under privilege in the Senate by independent senator John Crown (See full statement below).

The senator makes extremely serious allegations not just against staff at St. Vincent’s hospital where he works as a consultant oncologist but also against staff in other organisations.

The senator’s statement is curious because of its timing.

Eleven years ago in 2002 Crown discovered that staff of the hospital had been deliberately and fraudulently charging private health insurers in respect of cancer drugs which had been provided to that institution for free.

He notified the relevant authorities, the Irish Medicines Board at the time. An investigation began but was inexplicably stopped and reformatted several days later.

And there, it appears, the matter was laid to rest.

Now, eleven years on, the senator suddenly feels the need to have the matter further investigated.

He claims that new documents that have recently come into his possession and the increased scrutiny of the Public Accounts Committee are the reasons for his new enthusiasm for an investigation.

But there’s something not right about this sudden enthusiasm for further investigation.

For example; senator Crown tells us that he has long been troubled, on many fronts, about how his hospital and other hospitals do their business.

That’s a wide-ranging allegation apparently covering many matters in many hospitals. We need chapter and verse from the senator on exactly what matters and what hospitals he’s referring to.

The senator also needs to answer some other questions; for example.

Why didn’t he pursue the very serious allegations of fraud in 2002?

Why, when the Irish Medicines Board effectively stopped investigating the matter, didn’t he report the matter to other authorities like the Gardai?

Was he the one that suffered substantial intimidation at the time? If he was, did he tell anybody about it, did he make a complaint?

If not him, then who and what action, if any, was taken by him or other relevant authorities?

Why, given that the senator is not exactly shy about speaking his mind on a whole range of matters, has he remained silent on this matter for so many years?

We need a much fuller account from the senator otherwise it may look like he’s a rat abandoning a sinking ship as the allegations of corruption and scandal continue to spew from the health/charity sector.

The senator’s statement:

It is a matter of record that I have long been troubled on many fronts by the way in which the boards of my hospital in particular and of other hospitals do their business.

I would like to personally disassociate myself and any research organisations that I have the privilege of running from any connection with St. Vincent’s hospital group or the St. Vincent’s hospital foundation.

It will become apparent that the board of St. Vincent’s hospital does not enjoy my confidence.

This began in 2002 when I discovered that members of the staff of the hospital had been deliberately and fraudulently charging private health insurers in respect of cancer drugs which had been provided to that institution for free.

I notified the relevant authorities, the Irish Medicines Board at the time, an investigation began and inexplicably stopped and was reformatted several days later.

Documents have recently come into my possession which I’m quite happy to discuss and share with the minister for Health because they refer to money that was fraudulently taken from the VHI of which he is the sole shareholder and of other private insurers.

Documents that show conclusively that there is a cover up conducted by the management and board of St. Vincent’s hospital in respect of this.

Substantial intimidation was brought to bear at the time the whistle was blown on this ten years ago but I believe in light of these new documents coming my way and in light of the increased scrutiny of the Public Affairs Committee it is now time for this matter to be further investigated.

And I’m asking the leader to bring this to the attention of the minister.

Thank you.

Savita Halappanavar report: A great relief to all, except her family

Oh what a great relief.

It seems that the draft report investigating the death of Savita Halappanavar shows that there was ‘a great systems breakdown’ among the clinicians and medics at University Hospital Galway.

The relief will not, of course, apply to Ms. Halappanavar’s family who will be devastated.

But all those ‘responsible’ will be relieved that the great Irish solution of ‘systems failure’ has been utilised to ensure nobody is to blame.

Next scandal please…

Tallaght Hospital scandal: No need for accountability

I wrote recently about the missing link that marks the difference between how things are done in Ireland and how they’re done in functional democracies.

When suspicions of corruption are raised in functional jurisdictions there usually follows an investigation by an independent authority.

If the suspicions are confirmed consequences follow such as sackings, heavy fines or perhaps a trial followed by appropriate punishment.

All this is done under the principle of justice being seen to be done and the whole matter is usually followed up with new rules/regulations to prevent such events from happening again.

All these stages of accountability are also carried out in Ireland with the notable exception of holding anybody to account.

The recent scandal at Tallaght Hospital, as reported in the Irish Examiner, is a great example.

Background:

The hospital is unable to explain why five senior officials received almost €700,000 in non-salary ‘top-up’ fees between 2005 and 2010.

Ernst and Young carried out a financial investigation last year as a result of concerns raised by the Health Information Quality Authority (HIQA).

The investigation found:

The hospital was unable to provide any documents showing why the large payments were made.

The hospital was unable to explain why the supplementary payroll, under which the payments were made, was set up or what approval procedures were followed.

Board members at the time provided inconsistent recollections as to the existence and approval of the fund.

One individual received €225,833 in extra pay. Four other staff members received €104.667, €61,250, €24,000 and 259.000 respectively.

This was all taxpayer’s money at a time when Tallaght Hospital was making severe cutbacks to its budget.

We have now reached the critical point where, in a functional democracy, stronger action would ensue – police investigation, courts etc.

In Ireland this stage is skipped completely and replaced by an excuse stage.

Significant management structure changes have been carried out at the hospital – we’re told.

The new management has ‘noted’ the findings of the investigation.

The external payroll system responsible for the payouts has been abolished.

The new board has appointed a new remuneration and terms of services committee.

The new board said they were disturbed and upset by what happened.

So, no further action, no police, no investigation, no courts.

And, we can ask, is the new board a genuine improvement on its predecessor. Will this ‘new broom’ sweep all the old habits away and act in a professional and responsible manner when it comes to accountability?

No, is the emphatic answer.

When asked if the five members at the centre of the scandal were still working at the hospital and whether any of the paid out money can be retrieved they declined to comment.

Or, in plain English – Take a hike, we’re saying nothing.

The only reason, I suspect, the board of Tallaght Hospital can feel confident in refusing to answer this most basic of questions is because of the missing link in Irish accountability.

It there’s no system of accountability – there’s no need to be accountable.