Dáil Éireann Debate, Tuesday - 16 December 2025
1084. Deputy Ken O'Flynn asked the Minister for Health the governance framework used by her Department to obtain assurance that the HSE and all section 38 and 39 providers comply with national standards on governance, audit and risk; the date of the last full assurance review; and the actions her Department takes when risks are escalated. [72292/25]
View answerI thank the Deputy for his query. As the Deputy is aware my Department operates to high standards of professionalism and effectiveness when dealing with the HSE. Under the Health Act 2004, the HSE has primary responsibility for funding the Section 38 & Section 39 bodies for the provision of health and social care services on it’s behalf. As a result, primary oversight responsibility for the non-statutory bodies is with the HSE and this includes dealing with issues relevant to the delivery of healthcare services as they arise.
In accordance with section 38, Health Act 2004, the HSE may enter into a service arrangement with a body for the provision of a health or personal social service on behalf of the HSE. These organisations receive the majority of their funding from the HSE, sourced from government allocations under the national health budget, and employees are classified as public servants.
Bodies funded under Section 39, Health Act 2004, are independently operated, grant funded bodies that provide a service similar or ancillary to a service that the HSE may provide and the employees of such bodies are not public servants.
My Department has Governance oversight of HSE, while the HSE has governance oversight of the S38 and S39 bodies. The HSE has a formal national governance framework within which such funding relationships are managed. As part of this governance framework, the HSE requires all grant-aided non-statutory agencies to submit their annual audited accounts to it. It is the responsibility of HSE to escalate issues regarding S38 and S39 bodies to the Department in the first instance with relevant Units in the Department assisting depending on the issue(s) involved.
The Minister for Health appoints Board Members for six S38 bodies, these are Beaumont Hospital Dublin, St. James’s Hospital Dublin, Tallaght University Hospital, the Dublin Dental Hospital, Leopardstown Park Hospital, and Children’s Health Ireland (CHI). All other S38 and S39 bodies are non-statutory or private bodies that provide health and social care services to the HSE.
My Department, in conjunction with the Board of the HSE, conducts a quarterly high-level meeting which involves the CEO of the HSE, the Chair of the HSE Board, the Secretary General of the Department of Health and the Minister for Health (myself). Issues arising from the HSE Statement of Internal Control (SIC) are a standing agenda item for these meetings. The HSE arrangements for governance of voluntary hospitals is not specifically included on the SIC and may arise in the broader context of consideration of issues with potential to impact service delivery.
In addition to the quarterly Ministerial meeting, my Department also holds a quarterly risk management meeting with the HSE Chief Risk Officer and the HSE Enterprise Risk Management team to enhance governance and oversight of risk management.
Overall, by using these governance, audit and risk standards, my Department ensures that top level management in the HSE and the HSE Board are held accountable in managing the delivery of healthcare services.
