The Royal Hospital Donnybrook. Financial Statements. Year Ended 31 December 2016

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Financial Statements Year Ended 31 December 2016

Financial Statements 2016 CONTENTS Page, INDEPENDENT AUDITORS' REPORT III ACCOUNTING POLICIES IV ORDINARY INCOME AND EXPENDITURE ACCOUNT V ORDINARY BALANCE SHEET VI SPECIAL FUND ACCOUNT VII SPECIAL FUND BALANCE SHEET VIII CASH FLOW STATEMENT IX NOTES TO THE FINANCIAL STATEMENTS X - XIV Page II

Independent auditors' report to the Governors of The Royal Hospital Donnybrook We have audited the financial statements on pages W to XIV which have been prepared in accordance with the accounting policies set out on page W. Respective responsibilities of the Board of Management and auditors The Board of Management's responsibilities for the preparation of the financial statements in accordance with the accounting policies are set out on page X. Our responsibility is to audit the financial statements in accordance with relevant regulatory requirements and International Standards on Auditing (UK and Ireland). This report, including the opinion, has been prepared for and only for the Hospital's Governors as a body and for no other purpose. We do not, in giving this opinion, accept or assume responsibility for any other purpose or to any other person to whom this report is shown or into whose hands it may come save where expressly agreed by our prior consent in writing. We report to you our opinion as to whether the financial statements have been properly prepared in accordance with the accounting policies in all material respects and present the state of affairs and results of the Hospital in accordance therewith. We state whether we have obtained all the information and explanations we consider necessary for the purposes of our audit and whether the financial statements are in agreement with the books of account. We also report to you our opinion as to whether the Hospital has kept proper books of account. tfiira We conducted our audit in accordance with International Standards on Auditing (UK and Ireland). An audit includes examination, on a test basis, of evidence relevant to the amounts and disclosures in the financial statements. It also includes an assessment of the significant estimates and judgments made by the Board of Management in the preparation of the financial statements and of whether the accounting policies are consistently applied and adequately disclosed. We planned and performed our audit so as to obtain all the information and explanations which we considered necessary in order to provide us with sufficient evidence to give reasonable assurance that the financial statements are free from material misstatement, whether cause by fraud or other irregularity or error. In forming our opinion, we also evaluated the overall adequacy of the presentation of information in the financial statements. ft In our opinion, the financial statements have been properly prepared in all material respects in accordance with the accounting policies and present the state of affairs of The Royal Hospital, Donnybrook at 31 December 2016 and its surplus and cash flows for the year then ended in accordance therewith. We have obtained all the information and explanations we consider necessary for the purposes of our audit. In our opinion, proper books of account have been kept by the Hospital. The financial statements are in agreement with the books of account. C f PricewaterhouseCoopers Chartered Accountants and Registered Auditors Dublin 31 May 2017 ll

ACCOUNTING POLICIES The significant accounting policies adopted by the hospital are as follows: Historical cost convention The financial statements are prepared under the historical cost convention. The market value of quoted investments is disclosed in a note to the financial statements. Income and expenditure Income and expenditure is recognised when earned or incurred and is dealt with in the ordinary income and expenditure account or the special fund account of the year to which it relates. The ordinary income and expenditure account reflects the day-to-day running of the hospital. The special fund account reflects voluntary activities, investment income and other receipts and bequests together with their application. The analysis of assets and liabilities in the balance sheet is consistent with this distinction. Expenses incurred by the hospital, less contributions from patients and other income, are recovered from the Health Service Executive by means of an allocation. Allocations from the Health Service Executive (HSE) The total allocation to the hospital towards the net expenditure for the year is included in the ordinary income and expenditure account. Any part of the allocation included in the ordinary income and expenditure account but not received at the year-end is included in the ordinary balance sheet. Allocations in respect of the excess of annual net expenditure over annual allocations are accounted for as and when agreed by the Health Service Executive. Pensions The liability in respect of pensions payable is underwritten by the Minister for Health and the net cost of pensions is included in the annual allocation towards net expenditure for the year. Staff pension contributions are credited to the ordinary income and expenditure account when received and pension payments are charged to ordinary expenditure when paid. Quoted investments Quoted investments are stated in the special fund balance sheet at cost when purchased, or market value when acquired by way of bequest or gift. The market value of all quoted investments at the balance sheet date is disclosed in a note to the financial statements. Market value represents the mid price as quoted by a recognised stock exchange. Fixed assets Fixed assets for which grants have been received or are receivable, or which have been provided out of the special fund account, are not reflected in the balance sheet. The cost of other fixed assets is charged to the ordinary income and expenditure account as incurred. Page IV

ORDINARY INCOME AND EXPENDITURE ACCOUNT Year Ended 31 December 2016 Note Ordinary expenditure Pay expenditure Non-pay expenditure 2 16,175,201 15,532,690 3 4,379,636 4,405,451 20,554,837 19,938,141 Ordinary income 4 2,657,882 2,667,590 Net expenditure for year Allocation from HSE towards net expenditure for year 17,896,955 17,270,551 17,961,302 17,017,429 Surplus/(deficit) for year Accumulated surplus brought forward 64,347 (253,121) 20,925 274,047 Accumulated surplus carried forward 85,272 20,925 On behalf of the Board of Management Jerry Kelly Robin Simpson Page V

ORDINARY BALANCE SHEET 31 December 2016 Notes Ordinary assets Allocations due - Revenue - Capital Debtors and prepayments Bank balances and cash Ordinary liabilities Creditors and accrued expenses Patient Funds 6 1,736,831 1,839,669 - (49,016) 190,166 253,411 730,063 528,228 2,657,060 2,572,292 (2,141,242) (2,088,069) (430,546) (463,298) (2,571,788) (2,551,367) 85,272 20,925 Represented by: Accumulated surpluses carried forward 5 85,272 20,925 On behalf of the Board of Management Jerry Kelly CIS Robin Simpson Page VI

SPECIAL FUND ACCOUNT Year Ended 31 December 2016 Income Investment income Rents receivable Voluntary gifts and donations Deposit interest Bequests 528 14,402 200 47,035 58,746 2,958 9,912 81,247 303,220 145,642 372,606 Expenditure Other payments 158,459 81,777 158,459 81,777 Income less expenditure Balance at beginning of year (12,817) 290,829 4,427,951 4,137,122 Balance at end of year 4,415,134 4,427,951 On behalf of the Board of Management Jerry Kelly Robin Simpson Page VII

SPECIAL FUND BALANCE SHEET 31 December 2016 Note Special fund assets Quoted investments Debtors and prepayments Bank balances and cash 7 252,136 252,136 30,047 25,060 4,143,813 4,171,942 4,425,996 4,449,138 Special fund liabilities Creditors and accrued expenses (10,862) (21,187) 4,415,134 4,427,951 Represented by: Special funds 4,415,134 4,427,951 On behalf of the Board of Management Jerry Kelly Robin Simpson Page VIII

CASH FLOW STATEMENT Year Ended 31 December 2016 Notes Net cash oufflow from operating activities Returns on investments and servicing of finance Capital expenditure 8 (17,951,424) (17,601,186) 9 14,476 9,146 9 - - Net cash outflow before financing Financing (17,936,948) (17,592,040) 9 18,143,406 17,141,651 Net cash inflow/(outflow) Increase/(decrease) in cash 206,458 (450,389) 10 206,458 (450,389) Page IX

NOTES TO THE FINANCIAL STATEMENTS I Statement of responsibilities of the Board of Management The Board of Management is required to prepare financial statements for each financial year and have them audited. In preparing these financial statements, the Board of Management is required to: select suitable accounting policies and then apply them consistently; make judgements and estimates that are reasonable and prudent; prepare the financial statements on the going concern basis unless it is inappropriate to presume that the hospital will continue in operation. The Board of Management is responsible for keeping proper books of account which enable it to ensure that the financial statements are prepared in accordance with the accounting policies adopted by the Hospital. The Board of Management is also responsible for safeguarding the assets of the hospital and hence for taking reasonable steps for the prevention and detection of fraud and other irregularities. 2 Pay expenditure Administration 877,161 798,063 Medical 381,707 314,799 Nursing 6,174,755 5,902,132 Allied health 2,073,129 2,052,510 Support services 5,034,900 5,056,515 Maintenance 176,833 177,067 Pensions payable 1,456,716 1,231,604 16,175,201 15,532,690 Superannuation administration In 2016 pension payments exceeded superannuation deductions by 406,077 (2015: 19,034), as follows: Pensions payable - once off payments on retirement (212,966) (42,305) - ongoing pension payments (1,243,750) (1,189,299) (1,456,716) (1,231,604) Superannuation deductions 1,050,639 1,212,570 Pension (deficit) for the year (406,077) (19,034) Page

NOTES TO THE FINANCIAL STATEMENTS - continued 3 Non-pay expenditure Drugs and medicines 474,788 551,743 Blood and blood products - 76 Medical gases 32,964 26,830 Medical and surgical supplies 404,895 414,749 Medical equipment 214,428 195,246 Food and catering fees 1,013,527 967,373 Catering equipment 7,319 6,850 Furniture, crockery and hardware 19,072 26,752 Heat, light and power 355,107 402,311 Cleaning and washing 613,777 595,364 Maintenance and renovations 163,983 118,424 Bedding and clothing 8,502 11,076 Education and training 43,490 45,741 Farm and grounds 34,319 55,650 Transport and travelling 4,475 3,307 Transport of patients 16,901 19,212 Bank interest and charges 2,883 1,494 Insurances, audit, legal and other professional costs 106,406 121,675 Other professional services 168,627 171,756 Office expenses 29,695 40,923 Computer equipment 73,717 67,085 Other services cost 262,212 249,257 Office equipment 125,715 131,663 Sundries 202,593 180,840 Bad debts 241 54 4,379,636 4,405,451 4 Ordinary income Patient maintenance 1,238,867 1,387,658 Superannuation deductions 1,050,639 1,212,570 Staff restaurant income 68,103 66,220 Sundry income 300,273 1,142 2,657,882 2,667,590 Page XI

NOTES TO THE FINANCIAL STATEMENTS - continued 5 Accumulated surpluses/(deficits) carried forward In respect of prior years: - 1999-2000 - 2001-2002 - 2003-2004 - 2005-2006 2007-2008 - 2009-2010 - 2011-2012 - 2013-2014 - 2015-2016 3,566 3,566 112,009 112,009 (103,415) (103,415) 90,580 90,580 9,193 9,193 17,391 17,391 8,760 8,760 (3,250) (3,250) (13,909) (13,909) 543 543 (14,668) (14,668) 232,158 232,158 336,365 336,365 (90,917) (90,917) (290,387) (290,387) (19,972) (19,972) (253,122) (253,122) 64,347-85,272 20,925 6 HSE allocation due In respect of: - prior years - 2014-2015 - 2016-199,330 (670) 1,640,339 1,737,501-1,736,831 1,839,669 7 Quoted investments At cost when purchased, or market value when acquired by way of bequest or gift, and as reduced to market value Market value 252,136 252,136 375,316 366,035 8 Reconciliation of net expenditure to net cash outflow from operating activities Net expenditure for year Interest included in expenditure Payments from special fund account Decrease/(increase) in debtors and prepayments Increase/(decrease) in creditors Net cash outflow from operating activities (17,896,955) (17,270,551) 2,883 1,494 (158,459) (81,777) 58,259 (37,108) 42,848 (213,244) (17,951,424) (17,601,186) Page XI

NOTES TO THE FINANCIAL STATEMENTS - continued 9 Investing and financing activities Returns on investment and servicing of finance Interest received 2,958 9,912 Interest paid (2,884) (1,494) Investment income - 528 Rents receivable 14,402 200 14,476 9,146 Capital expenditure and financial investment Expenditure on premises and equipment Financing Capital grants received (49,016) - Revenue grants received (Note 11) 18,064,140 16,779,685 Bequests 81,247 303,220 Voluntary gifts and donations 47,035 58,746 18,143,406 17,141,651 10 Analysis of the balances of cash as shown in the Change in balance sheets year Bank balances and cash 4,873,876 4,700,170 173,706 Patient funds (430,546) (463,298) 32,752 4,443,330 4,236,872 206,458 11 Analysis of changes in financing during the year Revenue allocations At beginning of year Allocation for the year Cash received At end of year 1,839,669 1,601,926 17,961,302 17,017,429 (18,064,140) (16,779,686) 1,736,831 1,839,669 Page XIII

NOTES TO THE FINANCIAL STATEMENTS - continued 12 Premises As stated in the accounting policies on page IV, fixed assets for which grants have been received or are receivable, or which have been funded from the special fund account, are not reflected in the hospital's balance sheet. These fixed assets include the hospital premises, which were acquired in 1792 and have been developed over subsequent years from the special fund account and capital grants. 13 RHD retirement benefits The majority of the staff employed by Royal Hospital Donnybrook are members of either the Voluntary Hospitals Superannuation Scheme (VHSS) or the Single Public Service Pension Scheme ("the Single Scheme"). The VHSS was established by the Minister for Health in 1969 and the Hospital has administered the scheme, on behalf of the State, in relation to VHSS members who are current or retired staff of the Hospital since this date. The Hospital has been directed by the Department of Health/HSE to retain the VHSS contributions paid by current Hospital staff and this has been treated as income in line with this direction. On receipt of written authorisation and direction from the HSE, pension entitlements are paid to retired Hospital staff who are members of the VHSS. These pension payments are funded by the deductions retained from current staff and additional HSE revenue grant funding which is periodically adjusted by the HSE to reflect changes in the pension liabilities to be paid and the terms of the scheme. These financial statements do not include pension liabilities and assets of those staff who are members of the VHSS as the Board believes that the funds required to pay current pension liabilities under both schemes, as they arise in the future, will continue to be provided by the State/Department of Health. The Board has arrived at this position having taken into account a range of factors including the precedent set on the closure of certain other healthcare facilities. This issue is similar to that applying in the majority of other publicly funded hospitals. From 1 January 2013, the VHSS was effectively closed to new members and was superseded by the Single Scheme in line with its introduction across the entire public service. The single scheme is a multiemployer scheme as defined by FRS 102. 14 Related parties During the year the hospital had no material transactions with the Royal Hospital Donnybrook Voluntary Housing Association or the Friends of the Royal Hospital. 15 Approval of financial statements The Board of Management approved the financial statements on 27 April 2017. Page XIV