The Health Service boss has admitted paying out more than €258,000 in agency fees because they couldn't find anyone to take on a job paying €116,000.
The Public Accounts Committee has heard that the Chief Operations Officer for the Mid-West hospitals group position was advertised twice - but no suitable candidate was found, and they were forced to go to an agency and hire in expertise.
"While the figure is as you have quoted, it's important to note that this is not an employee," Director General of the HSE, Tony O'Brien, told the committee.
"Therefore there are not [extra costs] on top of that, they're not permanent, they're here entirely at our discretion."
"It is far from ideal. We either have to accept inordinate and unacceptable risk to the quality and safety of our services - or we have to take such steps as are available to us to plug those gaps."