St James's Hospital Pays €1.4m to Staff-Run Firm for Urgent Patient Care

St James’s Hospital paid out nearly €1.4 million for radiology services to a company operated by members of its staff without following official procurement rules due to urgent patient need, it has said. Management at the Dublin hospital have apologised for the issue in a submission to the Dáil Public Accounts Committee and said the hospital “did not meet the standards expected of us”. The Comptroller and Auditor General, Seamus McCarthy, told the committee in November that St James’s had paid €1.4 million in 2024 to an unlimited company, owned by members of staff to provide diagnostic services. Hospital management are scheduled to appear before the Public Accounts Committee on Thursday. Eighteen members of hospital staff – all believed to be medical consultants – were directors of the company that provided the radiology services. In an opening statement to the committee, hospital chief executive Mary Day is expected to apologise that there had not been a public tender process to secure some radiology services in 2024. “I wish to assure the committee that this was driven by urgent patient needs in cancer in particular, but also in cardiology, to prevent delayed diagnosis and to deliver the best possible care to our patients. Occasionally, due to unforeseen or unpredictable circumstances, we in the hospital have to balance the need for public procurement with the need to respond immediately to urgent demand for scans in order to avoid potentially harmful delays in the diagnosis and treatment of our patients. “For example, in 2024, there were 28 adverse incident reports at St James’s Hospital related to delayed diagnosis associated with constrained access to diagnostic imaging.” Funding for services provided by the company operated by the staff at St James’s was provided by the National Treatment Purchase Fund (NTPF). The NTPF, as part of its work, pays for treatment for those waiting longest to be provided outside core working hours in public hospitals by staff working in their own time. [ Concerns about insourcing fed in to row over funding at Beaumont HospitalOpens in new window ] Hospitals and staff are paid additional sums for taking part in such initiatives. This process is known as “insourcing”. Ms Day is expected to say the price paid per diagnostic scan had been reasonable and within the preset maximum fee set out by NTPF and that the initiative created “effective additional capacity for our patients”. The opening statement is likely to say that since the Covid-19 pandemic, St James’s Hospital had “faced an exponential and sustained increase in demand for radiology services, particularly for patients with cancer and cardiovascular disease”. “In 2024, demand for radiology services exceeded capacity by approximately 28 per cent overall, with CT, MRI and ultrasound particularly affected.” “For our patients with suspected breast cancer, the breast diagnostic pathway relies heavily on imaging techniques such as mammography, MRI and ultrasound. The total number of patients attending for breast diagnostics has also grown significantly over the last six years, from 5,757 in 2019 to 7,044 in 2025.” “The current waiting list for urgent breast ultrasounds is 376. The waiting list for non-urgent breast ultrasounds is 1,660.” [ Dublin hospital paid €1.44m for services to company owned by staffOpens in new window ] Ms Day is expected to tell the committee that the initial arrangements with the company providing the radiology services were introduced without a competitive procurement process on the basis of emergency circumstances under Covid-era legislation, but these continued until 2024 without being regularised. It is understood she will say “18 employees of St James’s Hospital were directors of the vendor company” and all had all discharged their public work in compliance with their employment contracts. “The staff members concerned had been notified by the hospital on multiple occasions in relation to their obligations to complete a statement of interests for the year 2024. Of these 18 staff members, 12 provided a return which did not disclose this interest while the remaining six did not provide a return for the reporting period”. It is understood the staff concerned subsequently rectified their returns under ethics requirements.