Unnecessary nights in hotels and payments for business class flights for a consultant were discovered during an audit of expenses at one of the country’s busiest hospitals.
An internal audit at Tallaght University Hospital (TUH) in Dublin also found excessive mileage claims and that some staff had been paid emergency call-out payments without being taxed properly.
The review of staff expenses said they had found one case where a hospital consultant had flights reimbursed at business class rates on three separate occasions for medical training abroad.
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These should only have been paid back based on economy rates, the auditors said based on national guidelines from the HSE.
They also found four cases where extra nights in hotel accommodation were paid for “despite not falling within the dates of the conference to be attended”.
The audit said these nights had not been necessitated by the actual conference dates but acknowledged flight availability or long-haul flights with stopovers were sometimes an issue.
The audit also raised concerns over emergency call-out payments for staff with no system in place to track how many each were being paid for annually.
Under Revenue rules, only sixty callouts could be paid for without being subject to income tax, the internal auditors said.
However, they found that ten of eighteen staff examined claimed more than this with the average yearly number of callouts claimed amounting to 182 per staff member per year.
The audit said: “The resulting payments to staff for these calls were not subject to tax in the instance whereby they should have been treated as taxable income as required by the Revenue.”
Internal auditors also flagged issues over some hospital workers getting “emergency on-call” mileage payments for non-emergency, rostered, and pre-planned work carried out on site at TUH.
They said a review should take place of those payments as well as tax-free mileage reimbursements for staff who were also doing “rostered on-site work”.
The audit said: “[These services] are regular, routine services with staff rostered in advance to cover set on-site shifts, of which are certain to occur and with no ambiguity that the staff member will be required to attend work.”
Excessive claims were also discovered in 40% of a sample of twenty mileage claims that were looked at during the internal audit.
In one case, a staff member was claiming “17 excess kilometres” for every call-out they undertook resulting in a €187 overpayment on their claim.
Overall, the audit – in examining twenty separate mileage claims – found that there were overpayments totalling €520.
Another internal audit into staffing costs flagged concerns over an arrangement the hospital had with one company for which there was no service level agreement in place.
The firm were also being paid a significant commission rate of 13.85 percent on agency staff, much higher than market averages of between 4 and 5 percent, the auditors said.
The report added: “Additionally, it was noted that [the agency] apply this commission rate on the basis of premium pay, in contrast to the application of commission on basic pay, as would be the guidance set out in the HSE service level agreement for in-framework agencies.”
A spokeswoman for Tallaght University Hospital said they put a “great emphasis” on internal audit to ensure transparency in all their work.
She said recommendations from a review of their agency staffing process had been implemented and that deviations were due to “service pressures”.
The spokeswoman added: “With regard to the audit findings for the [credit card and expenses audit] this should be read in the context of a staff of over 3,000 many of whom provide a 24/7 service 365 days a year.
“In addition, it is vital that staff remain up to date with developments to ensure patients receive the best evidence-based practice through education and training opportunities. Process improvements identified are being addressed.”
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