The Health Service Executive has been criticised in an unpublished internal audit report about how it procured millions of euro worth of ventilators at the start of the Covid-19 outbreak.

The report found there was unsatisfactory governance, documentation and risk management in the procurement of the ventilators, for which the HSE pre-paid vendors more than €80 million.

The HSE's own auditors gave the executive worst-possible rating they could in the report, which has been obtained by RTÉ's Morning Ireland under a Freedom of Information request.

The HSE said it accepted the recommendations of the audit.

The report noted the ventilators were prepaid and sourced from 10 suppliers who were previously unknown to the executive.

It said the quantity of orders was "far in excess" of what was required.

But only around one fifth of these ventilators were delivered, and none of them were put into clinical use.

When the initial delivery arrived from China, the ventilators did not pass tests carried out by the HSE.

These failings and further delays in delivery led to orders being cancelled.

The HSE is now owed more than €35 million in refunds.

The audit found due diligence was not performed in all instances before making prepayments.

The HSE said it accepted the recommendations from the report, and said it is important to note that it was operating in a volatile market and under considerable pressure to secure equipment.

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The Minister for Health has welcomed the findings of the internal audit, but said the reality is the HSE had to procure ventilators from all over the world in "a war-like situation".

Speaking on RTÉ's Morning Ireland, Stephen Donnelly said the main concern was that the health service would not run out of ventilators.

"We have to remember the context, they were being screamed at to get these ventilators in.

"Of course due process should have been followed' but "we need to remember what was happening in those times," Minister Donnelly added.

Reporting Una Kelly