The Board of the Health Service Executive has expressed concern that the health service Winter Plan was not submitted to it for consideration before publication.

According to the minutes of the HSE board meeting on 26 October, the board "noted that the Winter Plan had not been sent to the board for its consideration and approval prior to publication and a discussion took place in relation to the process with regards to the issuing of documents regarding strategic planning to the board in a timely manner, in line with the role of the board, its list of reserved matters and its governance responsibilities."

The report of the meeting says the CEO acknowledged and committed to conducting a review to ensure that such documents are submitted to the board in a timely manner.

The board discussed the Winter Plan, in particular, areas such as recruitment of Emergency Departments consultants and the five fundamentals outlined in the plan.

"Concern was expressed at commitments entered into in a number of aspects of the plan," according to the minutes of the meeting.

The CEO advised the board that the Winter Plan 2022/2023 was developed in consultation with and approved by the Department of Health and Minister for Health Stephen Donnelly on 11 October 2022.

That was 15 days before the HSE board meeting.

The Winter Plan approved by the executive team and published by the minister was "noted" by the board at its meeting on 26 October.

At the meeting of the Oireachtas Committee on Health with the HSE this week, some deputies described the Winter Plan as an unmitigated disaster.

The HSE was criticised for failing to plan for the record overcrowding crisis seen this month.

Sinn Féin's health spokesperson David Cullinane said the decision to avoid the HSE board and deny it oversight and input on the failed Winter Plan was "dysfunctional, bewildering, and highly concerning".

Deputy Cullinane said this pointed to serious dysfunctionality and contempt at the top of the HSE, driven by a minister in panic mode.

He said the board should always have oversight and an opportunity to consider and approve of multi-million euro plans before they are published.

"The purpose of the board is to ensure accountability. Avoiding the board is unacceptable," he said.

"There is a clear need for serious governance reform and an attitude change at the top of the HSE."

Additional reporting David Murphy