The Department of Health and Children should have formally written to Dr David McCutcheon, the chief executive officer of Tallaght Hospital, rejecting the hospital's 1998 service plan which indicated excess spending of £5.9 million, according to the consultants' report.
The report says the adoption of the service plan by the hospital board did not "meet the standard of good governance" since it involved almost £6 million in excess of the Department of Health and Children's letter of determination setting out the budget.
The plan covered the period of the move to Tallaght and the merging of the three base hospitals, the Adelaide, Meath and National Children's Hospitals.
It was received by the Department on April 8th, 1998, having been approved by the board.
According to the Deloitte & Touche report, the board should have rejected the service plan "whatever the circumstances and the perceived inadequacy of the Determination".
It was evident from the chronology of communications between the two parties that the Department had emphasised to the hospital that its service plan must be "within determination" and that no further funding was available.
While the consultants accepted that the Department had "on many occasions" made its position clear, it should have issued a formal written response to the chief executive rejecting the service plan, and calling on him to bring the matter to the attention of the board.
This approach might have been taken by the Department out of recognition of the workload and pressures falling on the board since the opening of the hospital was just 10 weeks away.
"It is not possible to gauge whether a more formal rejection of the service plan by the DOH&C would have encouraged the hospital to pursue a cost minimisation approach to expenditure in the hospital; it could not have detracted from it", the report says.
The letter of determination, the approved level of expenditure for 1998, was sent to the CEO in December 1997, advising that the non-capital allocation was just over £53.5 million.
The letter of determination outlined requirements the Department wished to see fulfilled. These stressed the need to implement the plan within the financial limits determined by the Minister, and required the CEO and members of the board to monitor expenditure.
In March 1998, at a meeting with the three base hospitals, the Department expressed concerns that a service plan had not yet been agreed.
According to the consultants' report: "The DOH&C also indicated at the meeting that it was not going to walk away from Tallaght in terms of its needs, but its wants are a different matter.
"The DOH&C notes of the meeting record that they `thought that we had put enough funds aside, while it does not look like that, now the amount is set' ".