It is shocking that, when patient services are being cut, remuneration for senior executives at State-funded voluntary hospitals and health agencies should breach pay formal policy. Additional funds are being sourced from voluntary sources, such as campus retail outlets, and are needed for other purposes. The extent of the top-up practice is unclear. But fewer than half of the agencies contacted by the Department of Health confirmed they operate in compliance with Government pay policy. One in five declined to respond, pending legal advice.
This culture of perceived entitlement and lack of accountability permeates the health services. When the Health Service Executive was established in 2005 to impose some sort of financial order and control, health boards operated like independent fiefdoms and medical consultants ran much of the show. They still do, in hospitals or as administrators. Some appear to have become as detached from their social and ethical obligations as those judges who, five years ago, declined to take a voluntary pay cut in the public interest.
When Government Ministers and Department secretaries general accepted a 30 per cent cut in pay in 2011, it hurt. But it was seen as a necessary example at a time of financial crisis. A cap of €200,000 was introduced for top public servants, rising to €250,000 within the commercial State sector. Exemptions were made for individuals, following special Cabinet approval. But voluntary health agencies engaged in a deliberate policy to circumvent pay guidelines and to reward senior executives. The way in which they did so, by taking income from shops and parking services and, perhaps, from other fund-raising activities, has angered many people. Minister for Health James Reilly has insisted the practice must stop.
Blatant misconduct and a failure to impose discipline is not new. In 2005, the Comptroller and Auditor General reported that many voluntary agencies had declined to provide audited accounts or disclose pay levels of senior executives. Earlier this week, the National Federation of Voluntary Bodies expressed the view that the remuneration of senior staff was “a matter for the boards of the organisations concerned”. Such an arrogant and dismissive attitude towards established pay policy and public accountability should not be tolerated.
The Troika found public spending on the health services was too high. But the changes that were introduced concentrated on reducing personnel and services, rather than cutting salaries. And when a cap was finally imposed, some voluntary boards arranged for surreptitious payments. Salary levels should be transparent in these bodies and financial statements should be audited. Secret deals and dodgy funding are unacceptable at executive level.