Committee seeks full breakdown of HSE top earner’s pay

The HSE has not delivered a detailed breakdown of its top earner’s pay to the Public Accounts Committee, despite being asked for it a week in advance.

Members of the committee asked for a breakdown of hours and services provided by the employee, who received more than 616,000 euro for additional work.

The consultant, who works in Cavan General Hospital, was paid almost 910,000 euro in total in 2025.

Additional work in 2023 and 2024, including overtime fees and session payments, totalled 324,000 euro of that amount.

The remaining 586,000 related to work carried out in 2025, but the consultant had submitted claims, and been paid for additional work, only up to May 2025, “so significant additional outlay still may arise”, Cathaoirleach John Brady told the Public Accounts Committee.

PAC was brought to a pause to give the HSE an opportunity to gather and deliver the information, but after the recess, the information was not provided.

The culture of overtime pay has to be examined, according to Social Democrats TD Aidan Farrelly, who suggested the committee took a break for the data.

“Certainly, with regard to hidden items like fees and sessions, cross cover,” he said.

“The questions that I have surround the culture of such significant overpayments to the extent where it looks like you can nearly be earning double your salary in overpayments in a year.

“That concerns me.”

Four of the top 10 paid consultants are in Cavan General Hospital, the committee heard.

While these top consultants are being paid over half a million euro, the area is struggling for medical resources, according to Cavan-Monaghan Sinn Féin TD Cathy Bennett.

“That’s the area I come from, Cavan-Monaghan, and we are dying for services, the people, we can’t cope.

“You’re telling me today that you paid 910,000 euro for one consultant in Cavan Hospital? Do you know how long we’re waiting to get an MRI machine?

“It’s absolutely shocking. Shocking, shocking, that this amount of money will be paid to consultants, and we can’t get staff in Monaghan Hospital

“It’s an extraordinary amount of money when we are suffering in every hospital around the country. People are lying on trolleys. People are lying on floors.”

The committee heard that 11 HSE medical consultants were paid more than 500,000 euro each last year, with the top 10 earners in the HSE receiving a combined 6.8 million euro.

The committee also heard that the HSE incurred charges of 8.4 million euro for Covid vaccines in 2025 that had reached their expiry dates or were determined to no longer be clinically suitable for use, along with 1.5 million euro for stocks of legacy and obsolete PPE.

Another 6.7 million euro was spent to dispose of this obsolete stock, the committee heard.

The HSE had a total expenditure of 30.4 billion euro last year, up 7% from 28.3 billion euro in 2024, Mr Brady told the committee.

The executive’s financial statements report a deficit of 1 billion euro. However, this includes the 2024 deficit brought forward, according to HSE chief executive Anne O’Connor.

Excluding the prior year’s deficit, the underlying deficit incurred during 2025 was around 240 million euro, representing less than 1% of overall income, she said.

The financial statements reflect a year of significant challenge and change for the health service, Ms O’Connor said.

“Demand for health and social care services continued to grow, reflecting Ireland’s population of approximately 5.5 million people, with particularly strong growth in older age groups and increasing levels of complexity across the services we provide,” she said.

“Notwithstanding these challenges, the health service continued to deliver substantial levels of activity during 2025, including over 1.6 million emergency department attendances, over 25 million home support hours, significant increases in community-based services, and the treatment of record numbers of patients across many service areas.”