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Management of patient monies by HSE should be last resort – Safeguarding Ireland Management of patient monies by HSE should be last resort – Safeguarding Ireland HSE manages finances of more than 5,000 patients in 154 care centres Safeguarding Ireland raised concerns about the management of patients financial accounts by third parties. File Picture A report highlighting weaknesses in how patient funds were managed by the HSE in 2019 has prompted renewed calls for additional supports for patients with limited capacity to manage their finances. Safeguarding Ireland has called on the Government to commence all provisions of the Assisted Decision-Making (Capacity) Act 2015 and said that management of patient funds by the HSE should only be a “last resort”. The call follows the publication of the 2019 Patient Private Property (PPP) accounts, which detail how the HSE manages the finances of more than 5,000 patients in 154 care centres across the country. The 2019 report identified one case of suspected fraud at a Dublin care centre, which is being investigated by gardaí.  The suspected fraud involved the handling of €450 in cash from a number of residents, all of whom have been refunded in full by the HSE. The report also highlighted weaknesses in the management of patient monies, with nine centres not adequately recording the handling of cash, 40 centres not using new documentation for the withdrawal of cash for residents, and 88 centres not having sufficient segregation of duties in the administration of funds. The PPP accounts, which amounted to around €100m in 2019, are largely managed by a central HSE unit (95% of all funds) and to a lesser extent by individual care homes. Safeguarding Ireland, which promotes the rights of vulnerable adults, welcomed the payment of all Department of Social Protection allowances and pensions directly to the central PPP unit. “This has not always been the case which led to abusive practices. It means that smaller amounts of money remain to be managed at local level,” Safeguarding Ireland chair Patricia Rickard-Clarke said. “These accounts are managed by the HSE on behalf of some of the most vulnerable members of society, many of whom lack financial decision-making capacity. It is important that funds are actively managed and safeguarded to a high level regardless of the amount involved,” she added. The organisation, however, said the management of patient monies by the HSE should only be a “last resort” and that the issues identified highlighted the need for action on assisted decision-making legislation which would allow care residents to appoint a person they trust to assist with their day- to-day finances with oversight by the director of the decision support service. “These issues point to a lack of / insufficient communication about processes, lack of training of staff in care centres but also highlight yet again the problem with the delay in the commencement of the Assisted Decision-Making (Capacity) Act 2015,” Ms Rickard-Clarke said. “The management of individual personal finances by the HSE should only be a last resort. It is necessary that as a society we plan ahead and put in place arrangements in the event that we are unable to make decisions for ourselves,” she added. The 2019 report also noted that the HSE is endeavouring to pay €14.5m in interest on PPP accounts to more than 22,000 residents or estates. By October 2020, €5.6m had been paid to over 4,700 residents.  “The exercise is more onerous than previously envisaged and will continue until all efforts have been exhausted to pay out the remaining funds,” the report noted.


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