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On-message: What Irish hospitals spend on PR

By Catherine Reilly - 21st Nov 2019

Have you ever wondered how much resource your hospital and Hospital Group accords to public relations? Catherine Reilly investigates

Five Hospital Groups spent €390,639 on the services of PR companies last year, while nine voluntary hospitals within various Groups separately expended €408,703. The figures were compiled by the Medical Independent (MI) following a series of Freedom of Information (FoI) and administrative requests.

The total expenditure amounted to €799,342.

Of seven Hospital Groups, only RCSI Hospitals and University of Limerick Hospitals did not spend money on PR firms in 2018.

The highest spender was South/South West Hospital Group (SSWHG), which paid €120,685 to Heneghan PR. One of its hospitals, Mercy University Hospital, Cork, has a contract with Mills Public Relations worth €24,600 per annum. This type of overlapping expenditure was a feature in three other Hospital Groups.

Beaumont Hospital, Dublin, was the highest-spending voluntary hospital, paying €81,180 to Drury Porter Novelli in 2018.

Over 20 staff within Hospital Groups and voluntary hospitals have some form of communications remit (which may be only part of their duties and comprises more than media relations). There are also press/communications units in the Department of Health and HSE.

Mr Paul Connors, HSE National Director of Communications, said the expenditure by Hospital Groups on PR firms was declining.

According to previous data supplied to MI, Hospital Group expenditure on PR firms in 2015 was over €341,000, which is lower than in 2018. However, Saolta, Ireland East Hospital Group and Dublin Midlands Hospital Group, which all spent money on PR firms last year, have since ceased these contracts.

Mr Connors said Hospital Groups and Community Healthcare Organisations (CHOs) have been encouraged to develop in-house communications capacity.

It is anticipated regional communications resources in acute and community services will unify under the proposed six health areas. The current extent of in-house capacity varies across the regions.

Mr Connors said he would like “a few more” of these 16 organisations to have built up a better in-house resource.

“But I am not overly fussed about it, because I think in two years’ time or three years’ time with the health regions, they will have enough in the joining-up of both [community and acute resources] to have a reasonable standalone regional communication office without having to rely on PR agencies.”

In regard to voluntary hospitals’ expenditure on PR firms, Mr Connors said he had limited influence.

“It is not simple, because we don’t directly fund a voluntary to take on external PR resources, so we don’t give them a bag of money and say, ‘that’s for your PR’.

“We fund them to deliver services, and don’t forget that most of the voluntaries who have these PR agencies on their books also have a strong private [income] element.

“So it is hard to know, when they take their private and their public element, where exactly the spend from the PR is coming from. You could never necessarily definitely say the public is paying for their PR agency, and if you asked the voluntaries, they would say that could come from private [income]…”

Mr Connors said voluntary hospitals have their own governance structures and he does not have the authority to direct them to cease this expenditure.

“I would like to see better co-ordination… if they have communications resources and spend in the Group, that that could be shared better with the voluntaries so that they could reduce their spend…maybe that is something we will get closer to upon the establishment of the regions.”

According to Mr Connors, he is not privy to all advice and direction given by PR companies to Hospital Groups, but would have some knowledge via senior healthcare management. “If there is ‘bum advice’ being given … the truth will always out at some stage along the way.

“We have seen little enough of that to be honest, where a Hospital Group will come back and say, ‘well, that is what the PR firm advised us’ and it might have been a bad decision; you don’t really see that.”

Mr Connors said the PR firms have been providing “a good service”.

An inventory of media relations support in acute services follows, largely compiled from responses to FoI requests to the HSE, Hospital Groups and voluntary hospitals.

HSE National Communications Division

Under FoI, MI asked the HSE for details of number of staff employed in the organisation with a media/communications role.

The response outlined staffing at the national press and media team. It comprises the head of press and media (general manager) and four other staff (A/grade VIII officer; grade VII officer; grade VI officer; grade IV officer). See pay grades on p6 ▸

“The team provides frontline media relations for the health service and responds to approximately 5,000 media queries each year,” according to the HSE website.

HSE National Director of Communications Mr Connors told MI “to my mind, it is probably the most challenging press office in the country. It’s also a fantastic training ground with a great team,” he added.

The response under FoI excluded other relevant roles, including Director of Communications (pay grade €151,497) and Assistant National Director of Communications (pay grade €98,393-€119,965).

The HSE communications division also has staff for programme and campaigns, internal communications, digital, and client services.

The latter team comprises of nine staff across a number of divisions and national offices of the HSE.

These client directors are “the expert communications professional” for their division and help the division’s health services “get the most” from their communications programmes.

There are also press officers assigned to the nine community healthcare organisations.

Mr Connors said he could do with more staff across the communications division but was conscious that many services would share this sentiment.

Department of Health communications unit

€18,580 to Q4PR in 2018

The Department’s communications unit includes a head of unit at principal officer level; one assistant principal officer; two higher executive officers; three executive officers; and one clerical officer. See pay grades on p6 ▸

The health and wellbeing programme has two communications project leads at principal officer level.

The Sláintecare programme implementation office has one communications lead at principal officer level; two assistant principal officers; one higher executive officer (part-time); one administrative officer; and one executive officer.

Minister for Health Simon Harris has one press adviser who is on the principal officer salary scale.

A Department spokesperson said the services of Q4PR were procured in 2018 for preparation of the launch of the Sláintecare implementation strategy and developing a communications and engagement strategy. The value of the contract was €18,580.

South/South West Hospital Group — 9 hospitals (eight HSE; two voluntary)

€120,685 to Heneghan PR in 2018

The South/South West Hospital Group (SSWHG) paid €120,685 to Heneghan PR in 2018. This year to July, the Group expended a further €57,533.

Heneghan PR was awarded the contract after a tendering process in December 2015 and started working with the SSWHG in April 2016. The company provides services to the Group and its 10 constituent hospitals on a 24/7 basis, according to the FoI response.

The firm also advises the Group CEO on a range of activities, including public relations, media training, issues management, and “proactive development” of stories on innovation, research and education.

Heneghan PR has had a rolling contract since its appointment. SSWHG said it is working with procurement in relation to re-advertising the PR/media relations contract.

The SSWHG also has “a number” of staff with a communications/PR function as part of their overall remit. However, there are no dedicated communications/PR staff within the Group.

Mercy University Hospital, Cork (South/South West Hospital Group)

€24,600 plus VAT to Mills Public Relations in 2018

The annual contracted amount spent by Mercy University Hospital is €24,600 plus VAT to Mills Public Relations. The contract was last renewed in October 2018 and is due for renewal this month (November).

The scope of the service includes preparation and issuing of media statements, ad hoc media preparation for approved staff, and liaison with HSE PR services on behalf of the hospital. Mills Public Relations also provides “professional support and advice” to the CEO’s office.

The hospital does not employ any staff with a PR/communications remit.

Saolta University Health Care Group (six hospitals, all HSE)

€89,544 to a “communications provider” in 2018 (contract has ended)

Saolta paid €89,544 to a “communications provider” for media relations services in 2018. The contract ceased on 31 August 2018.

Saolta’s communications department did not disclose the name of the provider.

The communications department provides a “full range of communications services” to the Group and its constituent hospitals.

There were two staff up until August 2018 and a third and fourth were appointed in August and September 2018, respectively.

Central HSE communications support to the Group’s hospitals ceased from August 2014 and support services were provided by an external agency/company.

From January to April 2019, Saolta’s communications department was staffed by a general manager; grade VI officer; grade V officer; and three grade III officers.

From April 2019 to date, it is staffed by a general manager; grade VIII officer; grade V officer; and grade III officer, ie, total complement is four.

Dublin Midlands Hospital Group — seven hospitals (three HSE; four voluntary)

€39,239 to PR360 in 2018 (contract has ended)

The Dublin Midlands Hospital Group (DMHG) ceased its external PR arrangements in 2018, when it spent €39,239 on the services of PR360.

Its communications office provides a variety of internal and external communications for the Group and its constituent hospitals.

The range of services include supporting internal staff communications, media relations, arranging appropriate media interviews for staff and providing preparation and briefing to support interviewees, and managing communications in the event of a crisis/serious incidents, etc.

In 2018, there were two staff in a communications role, an acting general manager and a grade VII officer appointed in August 2018.

St James’s Hospital, Dublin (Dublin Midlands Hospital Group)

€45,380 to Heneghan PR in 2018

Heneghan PR is used by St James’s Hospital, which spent €45,380 on its services in 2018. This year’s expenditure to August was €3,308.

There are three staff members in the communications department, which is also responsible for PR and media. It said media communications/PR support is provided by the DMHG.

Tallaght University Hospital (Dublin Midlands Hospital Group)

€43,579 to Q4PR in 2018

Tallaght University Hospital (TUH) paid €43,579 to Q4PR in 2018 and €14,264 this year (to October). The contract went to tender in 2017, and this will be repeated in 2020.

The TUH communications department is resourced primarily by one full-time staff member (grade VII), along with 18 hours’ administrative support (grade V).

The in-house communications officer manages and implements a variety of broader communications activities relating to the hospital.

The officer’s key responsibilities include co-ordinating communications among staff and with the wider community of Tallaght and south and west Dublin.

Key tasks include the outward communication of all key hospital activity and developments to the above audiences.

Coombe Women and Infants University Hospital, Dublin (Dublin Midlands Hospital Group)

€35,305 to FTI Consulting in 2018

FTI Consulting is retained by the hospital to provide PR services at a monthly amount of €2,942 including VAT.

In 2018, the hospital spent €35,305. From 1 January-30 September 2019, expenditure was €26,479.

A Coombe spokesperson said: “Historically, PR/media relations external provision supplied by FTI Consulting [and its predecessors] would have been contracted by the Coombe Women and Infants University Hospital following open competitive tender.

“With the advent of the Office of Government Procurement Framework Competition, FTI was recently (October 2019) replaced by the Murray Group on a one-year contract, with an option to extend for a further 36 months (3 x12) should the Coombe desire it.”

The Coombe also has one whole-time equivalent (WTE) staff member at grade VII level who, as part of this role, acts in a liaison capacity with the HSE external organisations, including PR firms and the public.

The hospital has access to DMHG’s communications support “as the need arises, in conjunction with formalised and existing hospital communications/PR arrangements”.

Ireland East Hospital Group — 11 hospitals (five HSE; six voluntary)

€36,222 to Teneo (formerly PSG Communications) and €21,915 to Red Flag in 2018 (contract with Teneo has ended; Red Flag’s services were short-term)

The Ireland East Hospital Group paid €36,222 to Teneo (formerly PSG Communications) last year. The expenditure for January-August 2019 was €15,080.

In 2018, Red Flag provided short-term strategic specialist counsel to the CEO and chair of the board at a cost of €21,915. The figures are exclusive of VAT.

“Teneo (formerly PSG Communications) was awarded the PR/communications contract after a tendering process in May of 2015 and officially started with the Ireland East Hospital Group in September 2015 and the contract expired in September 2019,” according to the response.

“Teneo have fulfilled an important role in supporting and advising the Group chairman and Group CEO and constituent hospitals on more complex issues, such as public affairs communications, media training and crisis management.”

In November 2015, the HSE national communications office “withdrew their communications services from all statutory hospitals and transferred all communications responsibilities including internal and external communications to the Hospital Groups”.

In August 2015, a grade VIII communications manager was appointed to the IEHG to manage the press office, FoI, internal communications, events and digital communications, liaise with HSE national communications and other organisations, and any other duties as required under the communications remit.

In July 2017, the IEHG employed a grade VII digital and communications content officer to support the development of the communications office and the communications manager. Part of the digital content officer’s remit is to edit the Group’s annual report, CEO messages, newsletters, and manage and update the IEHG website and social platforms.

In July 2018, a grade V communications clerical support staff was hired to respond to parliamentary questions for the Group and its hospitals and to support the communications manager and digital content officer.

Mater Misericordiae University Hospital, Dublin (Ireland East Hospital Group)

Hospital had not responded to FoI request.

National Maternity Hospital, Dublin (Ireland East Hospital Group)

€48,120 to the Murray Group in 2018

The National Maternity Hospital paid €48,120 to the Murray Group in 2018. From 1 January-19 August this year, the expenditure was €68,468.

“No contract exists; work is carried out on an ad hoc basis,” according to the FoI response. “In relation to the tasks and projects worked on for the hospital, almost all public relations work done involves responding to external media queries and requests. The level of work is led by the level of media interest in the hospital, which at times is extremely intense.”

The hospital does not employ any staff with a PR/communications remit.

St Vincent’s University Hospital, Dublin (Ireland East Hospital Group)

€59,040 to MKC Communications in 2018

St Vincent’s University Hospital, Dublin, paid €59,040 to MKC Communications in 2018. The hospital also has one 0.4 WTE grade VII officer with a communications role.

RCSI Hospitals Group — six hospitals (four HSE; two voluntary)

Zero payment to external PR firms in 2018

Last year, the Group employed one group communications manager at grade VII.

In 2019, it employs one Group information governance and communications manager at grade VIII. “Both these roles have a wide remit of duties, with media being a small part of the roles.”

There is one position currently in place.

Rotunda Hospital, Dublin (RCSI Hospitals)

€53,664 to Heneghan PR in 2018

The Rotunda Hospital, Dublin, paid €53,664 to Heneghan PR in 2018. Expenditure for 2019 (January to August) was €30,067.

The Rotunda’s response indicated a communications officer (grade V) commenced in March 2019.

A Rotunda spokesperson said: “The tender for public relations services was advertised by the Rotunda Hospital on Heneghan was awarded the contract and signed a service level agreement on 1 February 2016. This contract is renewed every four years.”

Beaumont Hospital, Dublin (RCSI Hospitals)

€81,180 to Drury Porter Novelli in 2018

Beaumont Hospital paid €81,180 to Drury Porter Novelli last year. Expenditure to September this year was €26,235.

“We ran a new tender which resulted in a reduced price from Drury for 2019 as they were the successful bidder,” stated the hospital. “The contract is due to be renewed in December 2022. The purpose of the contract is the provision of a media monitoring service and PR and communications support on an as-needed basis.”

The hospital does not employ any staff with a communications/PR remit.

Children’s Health Ireland — three hospitals (all voluntary)

€83,034 to Q4PR in 2018

Children’s Health Ireland (CHI) paid €83,034 to Q4PR last year, and a further €38,376 from January-30 June this year.

CHI is the statutory body responsible for the provision of acute paediatric services, currently in Crumlin, Tallaght and Temple Street, which will move to the new children’s hospital on the St James’s campus, with outpatient/urgent care centres at Connolly Hospital and Tallaght.

CHI engaged the services of Q4PR in 2015 in order to “deliver and manage effective communications on paediatric services issues” across these sites.

Q4PR was awarded the contract following a competitive tendering process. The original term was for three years with an option for an extension. The contract has been extended until 2021.

The company provides “a range of communications support services”.

CHI has two communications staff roles — a communications manager WTE (grade VIII) and communications officer WTE (grade VI) (from August 2018).

The team has a wide range of functions, including internal and digital communications.

Children’s Health Ireland at Crumlin (formerly Our Lady’s Children’s Hospital, Crumlin)

€17,835 to Fleishmann Hilliard in 2018

CHI at Crumlin paid €17,835 to Fleishmann Hilliard in 2018. From January-31 May 2019, €8,689 was spent.

The services of Fleishmann Hilliard were engaged to deliver “effective out-of-hours communications support, as well as strategic advice on crisis management issues”.

CHI at Crumlin has a communications manager WTE (grade VII).

Children’s Health Ireland at Temple Street (formerly Children’s University Hospital, Temple Street)

Zero payment to PR firms in 2018

The hospital has a head of communications WTE (grade VIII).

University of Limerick Hospitals — six hospitals (five HSE; one voluntary)

Zero payment to PR firms in 2018

As of July 2019, the hospital has two WTE at grade VI in a communications role. Prior to July 2019, it had one WTE and two 0.3 WTEs at grade VI.

Lessons for media on CervicalCheck — HSE Comms Director

The CervicalCheck controversy erupted in April 2018 when Ms Vicky Phelan spoke out about her case. Ms Phelan was not told about an incorrect 2011 smear test until September 2017, despite an audit by CervicalCheck in 2014 showing that the 2011 sample showed abnormalities. She was diagnosed with cervical cancer in 2014. Ms Phelan reached a settlement (without admission of liability) against Clinical Pathology Laboratories Inc, Texas, US.

At the centre of the CervicalCheck controversy was a failed attempt to disclose the results of a retrospective audit to a large group of women who had developed cervical cancer. In his scoping inquiry report on CervicalCheck, published in September 2018, Dr Gabriel Scally cited serious gaps in governance structures in the screening services and a highly unsatisfactory policy and practice on open disclosure.  But he made no adverse finding on quality management processes in the contracted labs and found no evidence of conspiracy, corruption or a cover-up.

Much of the media coverage contributed to public confusion on the issue, particularly around the benefits and limitations of screening.

According to HSE National Director of Communications Mr Paul Connors, with some exceptions the media “lost the run of itself on the CervicalCheck issue”.

Mr Connors made reference to media reportage of the HSE “killing” women.

He acknowledged the HSE could not provide basic information at that time. However, he said the CervicalCheck governance issues identified in the Scally report demonstrated why this was the case.

“This thing was in chaos because we didn’t have this basic information — simple things like how many women were part of this, how were the women selected, we didn’t know… the main reason we didn’t know was because the [CervicalCheck] clinical director, who had done a fantastic job in lots of respects, saved an awful lot of lives, had this information very much as part of her work and when she stepped down, we were missing that source of information. We were then cobbling together people who half-knew what she knew… while that was happening, all the damage was being done.”

There are lessons for the media but also for HSE communications, he said.

“We need to work harder and not just get in a huff with the media and say ‘you didn’t treat us well in that period’.

“We have to work harder and ask the question, how do we get to the stage where, when you are reporting things, that you give some benefit of the doubt and listen to what we are saying? 

“Give us time to get the information so we can answer your questions, and not run off down a populist route of saying something is something when it isn’t.”

Mr Connors said a good example was quality of the labs. He said Dr Scally ultimately concluded the labs were adequate, despite media coverage stating the contrary.

Could he not use his influence as HSE Director of Communications?

“I’d love to say that is the case, being in this job for 11 years and knowing all of the people very, very well. It just didn’t work that way, and that is what I mean — we didn’t get the benefit of the doubt, I didn’t get the benefit of the doubt. Which was a pity, but it was such a ‘perfect’ story [for the media], an emotional story.”

While acknowledging “the anguish” of the families impacted by the controversy, he said the media did not allow space for the HSE to find the relevant information and that the central issues of concern became confused in the coverage.

“You could have the conversations, journalists would listen, but whatever editorial control was there, it was decided to go off down and push that emotional coverage…

“So the stories were quite damaging to CervicalCheck as a result.”

He said the biggest learning from his perspective is around preparing communication on risks, where these are known.

Another key learning was the importance of partnerships with medical colleges and other stakeholders.

 “When everybody took time to take a breath, you found the colleges did start to become more visible, explaining what screening was [etc].

“Did we go looking for them to become visible? I think that is another question… we were going through such a difficult period ourselves, we were in [Oireachtas] committees three times a week, people didn’t have time to scratch themselves at that point. So to actually sit down and say ‘it would be very strategic to do something’, we were not given that opportunity.”

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