St James’s Hospital in Dublin, the largest hospital in the country, has issued an apology after paying more than €4.7 million for cancer-related and other services to a radiology firm based on its own campus, where 18 of the company’s directors were also hospital staff members.
The Public Accounts Committee heard today that the services were provided without any public tender process, reports RTE.
The privately run radiology firm leases premises on the St James’s Hospital grounds.
Chief Executive Mary Day said it was unfortunate that not all individuals involved in the commercial entity had declared their interests, although this was later rectified through the HR process, reports RTE.
The arrangement covered the provision of more than 35,000 diagnostic scans.
Representatives of the hospital, which operates over 1,000 beds and employs around 5,000 staff, told the PAC that it had fallen short of the standards expected of the organisation, reports RTE.
The hospital stated that urgent patient requirements, particularly in cancer care and also in cardiology, had driven the decision, in order to avoid delayed diagnoses and ensure the highest standard of patient care.
St James’s informed the PAC that the cost per diagnostic scan was fair and remained within the pre-set maximum fee outlined by the National Treatment Purchase Fund (NTPF), which supports waiting list reduction initiatives across public and private hospitals, reports RTE.
Insourcing refers to the NTPF funding additional in-house clinical activity within public hospitals to reduce waiting lists, with hospitals required to comply with NTPF guidelines.
In its statement to the PAC today, St James’s said it was responding to “urgent demand” and noted that in 2024 there were 28 adverse incident reports linked to delayed diagnoses due to limited access to diagnostic imaging, reports RTE.
To illustrate the length of procurement processes, the hospital said that sourcing insourced MRI services took 12 months to complete following a competitive tender run by the HSE.
Comptroller & Auditor General (C&AG) Seamus McCarthy stated that St James’s annual income of approximately €682m is largely derived from public funding, reports RTE.
Regarding the €1.44m insourcing arrangement, he said there was no formal contract in place between the hospital and the company providing the services.
He also noted that six of the 18 company directors had failed to submit statutory statements of interest for 2024, reports RTE.
The C&AG said the remaining 12 directors had not declared their involvement in the company or the services it delivered within their statements of interest.
Separately, in examining the hospital’s 2024 accounts, the C&AG found that private health insurers had either rejected or were expected to reject claims from St James’s amounting to nearly €400,000, reports RTE.
He said the claims had not been processed within the agreed timeframes.
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