The five major Dublin public voluntary hospitals have failed to comply with a HIQA recommendation that they should hold their board meetings in public, two years after the health safety watchdog told them they should do so.

HIQA, in its report on Tallaght Hospital's emergency department services, published in May 2012, made specific recommendations for improvements in both Tallaght Hospital's governance and the governance of hospitals nationally.

Included in these recommendations was that the business of all hospital boards in receipt of State funds should be conducted openly and transparently. "All boards should hold the maximum amount of their board meetings in public by June 2013, including conducting an annual general meeting in public from 2013," HIQA said.

However, the 'big five' Dublin voluntary Hospitals - Beaumont, the Mater, St James's St Vincent's and Tallaght - all admitted to irishhealth.com that they are still holding their board meetings behind closed doors, more than a year after the deadline for public meetings set for them by HIQA.

The hospitals said they were in the process of implementing, or had already implemented, other Governance recommendations made in the HIQA report, although some appear in no great hurry to open their board meetings to the public.

A spokesperson for Beaumont Hospital said it did not currently hold its board meetings in public. "A new Beaumont Board has been appointed in recent months and is currently reviewing its structures and processes including frequency, location and reporting of meetings. The vast majority of the HIQA recommendations were in place in Beaumont prior to the Tallaght report.

The Mater Hospital told irishhealth.com that its board continued to meet in private. "The board is examining governance issues and is taking account of the HIQA recommendations."

A spokesperson for St James's Hospital said it was established under a statutory instrument which did not include a requirement to hold public board meetings. "Implementation of HIQA recommendations would require legislative change to the statutory instrument on policy direction from the Department of Health or the HSE.

However, there is no stipulation in the relevant statutory instrument stating that St James's board meetings must be held in private, indicating that the hospital, if it so wished, could decide to hold its meetings in public.

Asked about this, the hospital spokesperson said that in order for the hospital to hold its board meetings in public, the Department of Health or HSE would have to instruct it to do so. According to the hospital, the HIQA recommendations that could be adopted had been, but not all of them were as easily implementable as others.

St Vincent's Hospital said its board was currently examining governance issues and was taking account of HIQA recommendations, among other things, A spokesperson said the board continued to meet in private.

Tallaght Hospital, which was the subject of the 2012 HIQA report, is still not holding its board meetings in public.

A spokesperson said it currently publishes the minutes of its board meetings on its web page and it ultimately aimed to hold a certain amount of board meetings in public.

Tallaght said given that many of the recommendations on governance reform were of an ongoing nature, they cannot ever be regarded as complete. "The approach taken by the hospital in implementing the recommendations reflects a combination of continuously embedding robust systems and processes, ongoing vigilance and an open, proactive learning culture."

"The hospital recognises that the delivery of safe, dignified and high quality care is an ongoing process which required continuous focus," the spokesperson said.

The 2012 HIQA report identified serious safety issues relating to care in the Tallaght's emergency department and was critical of the way the hospital was run and governed.

HIQA said the board of the hospital did not have effective arrangements in place to adequately direct and govern the hospital, nor did the board function in an effective way.

The HIQA report on Tallaght also uncovered substantial 'top-up' payments made to senior managers at the hospital between 2005 and 2010, totalling around €700,000.

A later probe found could find no documentary evidence to explain the rationale or approval process for the hospital setting up a 'parallel payroll' fund which paid out around €700,000 in 'top-up' earnings to five high-level staff during this period.

This was the first indication of what later transpired to be widespread unauthorised top-up pay to senior managers in a number of voluntary hospitals and other State-funded agencies, which were revealed in HSE and Public Accounts Committee probes over the past year, and again highlighted transparency surrounding governance of these agencies.

The 2012 HIQA probe on Tallaght Hospital also queried the approval process behind substantial payouts in consultancy fees. A subsequent probe found that the hospital breached public tendering procedures when it hired outside management consultants at a cost of €1.4 million in 2010.