It gets worse.
The revelation that more than half of the country’s voluntary hospitals and health agencies are breaching Government pay policy, by supplementing the salaries of senior executives, will have shocked people to the core.
There has been media coverage of this for some time. But when the matter was crystallised in an HSE report to the Minister for Health, Dr James Reilly, last Friday, it, frankly, bordered on the incomprehensible.
The report revealed that 24 of the 44 voluntary State-funded organisations had told the HSE they were topping up approved rates of pay for senior staff with either public or private funds.
The Minister said that a further eight institutions had not yet indicated whether they were paying extra allowances to senior executives. “Until such time as the situation in each organisation has been fully verified, none of these organisations can be deemed fully compliant,” he said.
One hospital pays its chief executive an extra 30,000 euro from profits from shops on the campus. How could this happen in the Ireland of 2013, battling the economic war with all its wretched fallout?
It is happening at a time when there are ongoing revelations about the withdrawal of discretionary medical cards from people with serious illnesses.
Time and again, in recent weeks, the Dail has heard story after disturbing story about the plight of those losing medical cards in what clearly is an HSE crackdown on what was once a haphazard system.
The Taoiseach, Enda Kenny, and his Ministers remain adamant that there has been no change to the guidelines on the allocation of medical cards. Yet, TDs of all parties are adamant that people who desperately need those cards are losing them.
And so the following astonishing scenario emerges. An Irish citizen visits a hospital to see a loved one or friend. He or she visits the shop on campus to purchase, say, a packet of sweets or a bottle of lemonade or whatever.
And little do they realise that their modest investment will be going towards topping up the salary of the chief executive. That is the Ireland of 2013.
Apart from the withdrawal of medical cards, the health services generally continue to throw up horror stories of people on waiting lists for treatment. In such circumstances, should not every item of income in a hospital, be it proceeds from the car park or the tuck shop, be allocated to patient care?
How was this allowed to happen? Where was the oversight by the HSE and successive Ministers for Health?
It is difficult not to conclude that all of this is a hangover from the culture of entitlement that existed in the glory days, God help us, of the Celtic Tiger.
That culture of entitlement existed among senior politicians, bankers and others with influence in Irish society.
After all, the Celtic Tiger was roaring and they, brilliant people that they were, contributed to it. And the people of Ireland should be grateful that they had such superb leadership.
That was the thought processes of those people who destroyed the country and caused untold grief to the Irish people.
Today, the fallout is everywhere, from mass unemployment to the terrible spectacle of forced emigration. Those in the higher echelons of Irish society, particulary in the past, justified large salaries on the basis that you had to pay good money to get the best people. This has been shown to be sheer, unadulterated nonsense.
At the height of the infamous Celtic Tiger, we paid people like Government ministers and senior bankers massive salaries. Even allowing for the economic upswing, later shown to be unreal, the salaries of ministers, for instance, were frankly obscene.
Senior executives in hospitals are well paid without being given a top-up.
There are many competent people who will do the job if those currently at the helm feel they are not adequately remunerated.
If handsome salaries yielded us the best results, this country should now be booming. Instead, it is broken.
The Government must clarify just who is being paid what. And it is critical that voluntary fundraising is in no way impacted on by these sorry revelations.
Explanations are due.