Health Service Executive CEO Bernard Gloster has said he will refer any evidence of misuse of public funds to gardaí.
He was responding to a report in the Sunday Times, which suggested an internal investigation by Children’s Health Ireland (CHI), had found a consultant breached guidelines by referring public patients to his own private weekend clinics.
The report claims the consultant was paid thousands of euro via the State's National Treatment Purchase Fund.
Mr Gloster said he was shocked by the report and also taken aback that the first time he heard of the allegations was yesterday.
The outgoing CEO said he had spoken to CHI CEO Lucy Nugent this morning, and that she had been able to establish that some of the matters under investigation had been addressed.
But he added that if there was any "inappropriateness in the context of public money, I’ll only be sending that [in] one direction, and that’s to the gardaí".
Children's Health Ireland was established as an entity in anticipation of the new children's hospital being completed.
It is funded by the Health Service Executive, which has has certain levels of oversight and service level agreements with the agency.
The Sunday Times report follows ongoing concern about the cost and completion of the New Children's Hospital, as well as last week’s publication of an audit into unnecessary hip surgeries on children at a number of hospitals.
Mr Gloster said that given the scale of the concerns expressed by the Minister for Health, relating to a "succession of issues with CHI" in recent times, all options about the future of the entity were now being considered.
He said there was no presumption as to what those options were, but he said it was quite a significant step to place HSE board members onto the board of CHI.
He said a request by Minister Jennifer Carroll MacNeill that he increase operational oversight on the entity, "to a level that we wouldn’t normally apply", was also noteworthy.
Mr Gloster said he understood the minister was "seriously considering all of the options", in consultation with Cabinet colleagues and said this was needed because any decision to change or alter CHI would be a very significant one.
He said the fundamental issue was to determine what the best approach was to ensure the best provision of specialist healthcare for children into the future.
"The minister has raised this with me a number of times," he said.
"There can be no question that there are a series of successive events that do give rise to concern, at an enterprise level, in terms of governance and overall assurance in the CHI system."
He said this had to be dealt with, but that it should not take from the fact that there are many good people and services being provided by Children’s Health Ireland.
Mr Gloster said there was no doubt that there were weaknesses in systems and weaknesses in governance and said "the apparent inability to get on top of them" needed to be addressed.
Speaking separately on RTÉ's This Week, Mr Gloster said he has for a copy of the report which alleges that the consultant treating children moved patients from a public waiting list to their own weekend clinics, adding: "I have said to the CEO of CHI that I expect, other than highly personal information, that that report should be published in the public interest.
"I have made it clear that I reserve my position based on what I see in that report as to whether or not further questions arise.
Gloster apologises to families affected by hip surgery audit
Mr Gloster also apologised to families affected by the recent audit into child hip surgery.
He said that there was no question that an apology was owed, due to the levels of concern and anxiety raised following the publication this week.
"The level of anxiety, the level of concern and the level of concern which will prevail for some time for a number of families and children is something we have to apologise for and we have to accept that this is a very difficult time for those parents," he said.
"I certainly want to say that I apologise to parents that they have that concern because of something that's happening in the health service."
Mr Gloster said that novel procedures were carried out by surgeons who were of a view that they were preventative of further issues.
"What I understand the surgeons themselves have put forward is that this was a novel procedure where the belief was that the surgical intervention at an earlier stage would prevent significant problems later," he said.
"The rationale offered by some of the surgeons was not found to be reasonable by the auditor, and I have to take that as the basis of concern, no matter what the original intentions of the surgeons were across these two facilities," he added.
Mr Gloster said that there was now a significant public confidence question arising from the findings of the audit, as well as governance issues and "a succession of other issues".
He said that follow-ups for the children affected was now the priority.
"The most important thing is that these children are followed up.
"The auditor himself observes that in fact, it might well be the case that many will be well and fine, because this surgery is adopted partly in response to a diagnosed condition and partly in response to prevention of further difficulties for children down the road.
"There is quite a bit of work to be done, but all 2,259 children comprehended by the issues raised and these orders will be followed up comprehensively, and then there will be further expert assessment as to whether or not the surgery was actually indicated as necessary in each individual choice case, and that will be done in consultation with parents," he added.
Expert analysis will be commissioned by HSE, says Gloster
Mr Gloster said that each child will be clinically reviewed, and that there will be an option for parents to opt in for a specific examination to be carried out to make a definitive assessment.
He said that the expert analysis would be commissioned by the HSE, despite the HSE and CHI being two separate entities.
"If parents don't wish to avail of that, but wish to avail of their own second opinion, we will both assist them with that and we will fund the cost of that," he added.
Mr Gloster said that correspondence with affected families will begin this week, and gave a six-month timeline for all clinical reviews to be carried out and completed.
He said that he wanted more inquiries into the current condition of the children and the necessity of the procedures carried out.
"I want further inquiries first and foremost to establish how those children are. I want further inquiries to establish the necessity in respect of the surgery, in other words that the condition was present.
"If there is element of failing or harm identified in that, then two things arise. One, it arises to be assessed as a question potentially for individual practitioners. However, it also arises here because a novel procedure is something that must be done within particular circumstances. So there are also questions that may arise in relation to governance aspects of the institutions," he said.
Mr Gloster added that he saw the triggering of the audit by a whistleblower as positive.
"That does give me some sense of hope in the midst of all of this most concerning situation," he said.
