Will the culture of secrecy ever end?

  • Niall Hunter, Editor

There's an old saying that what you don't know won't hurt you.

The message we are receiving from the ongoing controversy over the financial operations of health agencies and charities is that the opposite is in fact the case.

Detailed information about the use of public money by health agencies and charities has for too long been kept secret from the public.

Judging by what has been revealed in recent weeks, a cynic might say some people had good reason to keep these things a secret, or at least not to ask too many questions about what was going on in their organisations.

What the the Dail Public Accounts Committee and the media have justifiably revealed has led to serious damage to the charity sector in health and related areas and the services it funds. Recent revelations have also further chipped away at the shaky foundations of probity upon which the health service uneasily rests.

And it should be pointed out that whether the money used in contentious ways came from the HSE, charity donations or private hospital income, it is all essentially money that comes from the public. To seek to make a distinction between 'private' and public funds in this regard to justify a lack of public accountability on staff pay is dubious to say the least.

One cannot escape the impression, after listening to PAC hearings in recent weeks, that, notwithstanding the good work that they undoubtedly do, health agencies and charities are taking some time to cop on about their duty to inform the public in detail about about how funds are being spent.

Hence, for example, the totally unwarranted confidentiality clause in in former CRC chief Paul Kiely's generous retirement settlement from charity funds and the lack of clarity provided to the Public Accounts Committee by his successor Brian Conlan. We still don't know exactly how this agency could justify tapping its related charity for top-ups.

Hence the head of Rehab, Angela Kerins, going on the radio, making the right call for greater transparency but then failing to confirm to the public how much she is currently paid.

Hence the somewhat Jesuitical definitions provided to the PAC by Noel Whelan, Chair of the St Vincent's Healthcare group, of whether or not its hospitals were in compliance with public pay policy. And if, as he seemed to be asserting, they always had been, why is the Group now seeking to 'swing around to compliance' with the HSE?

Hence the fact that extra unauthorised payments in health agencies went unreported and lightly regulated by the HSE and the Department of Health over many years.

Hence the exhortations on health charity websites to donate money to their worthy causes, without any details being provided on these websites of how that money is spent.

Hence the questionable use from time to time of legalese relating to contract law, data protection etc to obscure the quest for transparency in voluntary health agencies and charities.

What has emerged to date through PAC hearings and media reports is a large measure of institutional arrogance, notwithstanding the good reputation and records of the institutions that have come under scrutiny.

The public has essentially been told for decades to be glad that these services are being provided, but please don't ask any potentially awkward questions about what is decided behind closed doors.

In this regard, the announcement by St Vincent's that it is to establish a public interest committee is welcome, albeit long overdue, and other agencies should follow suit.

The charity top-ups at the CRC and unauthorised top-ups at other health agencies remained a secret for years.

That is, until the media and the PAC, prompted by HIQA's discovery in 2012 of the Tallaght Hospital top-ups, started to piece together the information that eventually hit the fan last November.

And speaking of the Tallaght top-ups, let's shine a small light of retrospective indignation on that particular controversy.

A total of €700,000 was paid out of HSE funds for unauthorised top-ups to senior staff running the hospital between 2005 and 2010. This website revealed last year that an internal probe at the hospital could find no documentary evidence to explain the rationale or approval process for the hospital setting up the fund that paid out this money.

The same lack of transparency that runs through recent financial scandals has also permeated the treatment scandals of recent years.

It is probably unnecessary at this stage to recite the sad litany of clinical scandals that have emerged in recent years.

Again, a thread running through these controversies is lack of transparency. Were it not for whistleblowers, the media and HIQA, we might still be blissfully in the dark about fault lines running through our health service.

And still, despite lip service that things are getting safer and more transparent, there is precious little evidence yet that more accountable systems are in place to ensure the maintenance of quality and safety in the health service.

We have seen professional resistance to James Reilly's plan to publish comparative treatment results for public hospitals. Seven of the country's 19 public maternity units produce no annual reports of their clinical statistics.

There is still no sign of a long-promised hospital licensing system.

But there is some good news-the charity regulator will, we are told, finally be appointed by Easter - and not before time.

For now, let's be grateful that the events of recent weeks have shown that parts of our democracy can work quite well and that people can (under pressure) be held to account, although there is a long way to go before we have full transparency.

Public info lacking on hospital charity spending

 


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