Brennan Report - Department of Health and Children

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Report of the Commission on Financial Management and Control Systems in the Health Servicecontrol and other relevant matters. The audit committee should report on a regular basis tothe health board. In addition, the audit committee should prepare an annual report on itsactivities for presentation to the health board. The minutes of the health board auditcommittee should be available to the audit committee of the Executive and a nominatedmember of the Executive board should have a right of attendance at health board auditcommittees.The audit committee and the board should take whatever steps are considered necessary tocarry out the board/audit committee functions to the highest standards of corporategovernance.The Department of Health and Children should prepare a charter for audit committees in thehealth sector that sets out their powers, functions, details of membership and procedures. Theaudit committee charter should ensure that the detailed external and internal audit process andthe consideration of external and internal audit reports should be functions of the auditcommittee.In making recommendations on the establishment, and workings, of audit committees, it isimportant that such recommendations be responded to in a meaningful way. Recent globalcorporate scandals have shown that the mere existence of an audit committee is not sufficient.A necessary condition to the successful operation of audit committees is that they adopt bestpractice in a substantive and meaningful way.The principles outlined for audit committees of health boards should extend to (i) theDepartment of Health and Children, (ii) agencies and other bodies under the remit of healthboards and (iii) other statutory agencies in the health services.When making the necessary legislative amendments, to facilitate the recommendationsthroughout this report, consideration should be given to making audit committees amandatory feature of boards’ revised governance arrangements.100
Chapter 8 Audit ReformRecommendations on Audit CommitteesR8.1 The Secretary General of the Department of Health and Children, the board of the Executive, boards of theregional health boards, boards of agencies and other bodies under the remit of health boards and boards of otherstatutory agencies should all establish an audit committee.R8.2 The audit committee of the Department of Health and Children, of the Executive, of the regional health boards,of boards of agencies and other bodies under the remit of health boards and of other statutory agencies should:(i) Be chaired by:(a) an independent outside person in the case of the Department of Healthand Children;(b) a non-executive member of the board in all other cases.(ii) Comprise at least three members, all of whom should be:(a) independent outside persons in the case of the Department of Health andChildren;(b) non-executive members of the board in all other cases.(iii) Report on a regular basis to the Secretary General/board;(iv) Prepare an annual report for the Secretary General/board, which, inter alia, should include a copy of itscharter.R8.3 The audit committee should be required to follow best practice in ensuring independence and effectiveness inrelation to internal audit, risk management and external audit (including managing relations with the externalauditor).R8.4 If necessary, legislation should be amended to facilitate these recommendations.8.3 EXTERNAL AUDITThe annual financial reporting cycle is not completed until the external auditor signs off on thestatutory accounts. We are aware that the audit of health board accounts has, on occasion, notbeen completed until more than 18 months after the end of the year to which they refer. Thisis highly unsatisfactory.It is clear from the Comptroller and Auditor General’s management letters that timeliness is aproblem across the health service.This has already been discussed under problem 5 in Chapter 2.Timeliness of AuditsIt is a fundamental principle of accounting that information should be available in a timelymanner. Legislation reflects this by specifying deadlines within which health boards are requiredto report. There are two key deadlines:●●Health board Annual Financial Statements to be approved by the board of the healthboard and available “ready for audit” no later than 1 April in the year following the yearend.The audit of these Annual Financial Statements by the Comptroller and Auditor Generalto be available not later than 30 September in the year following the year end.Table 8.1 shows the actual audit completion dates for the eight health boards 1 for theaccounting years 1998 to 2000. In no case were audited financial statements of the healthboards available by the statutory deadline of 30 September. Breaches ranged from one monthto ten months. By January 2003, only two audits had been completed for the health boards in1Prior to the formation of the Eastern Regional Health Authority (ERHA) and its three area health boards, there were only eight healthboards – there are now 10, not including ERHA.101
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Commission onFinancial Managementan
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TABLE OF CONTENTSEXECUTIVE SUMMARY
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6.4 COMMUNITY DRUG SCHEMES 80Medica
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Executive SummaryEXECUTIVE SUMMARYT
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Executive SummaryWe do not underest
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Executive Summary"demand-led" schem
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Terms of ReferenceTERMS OF REFERENC
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GlossaryEstimates for Public Servic
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Chapter 1 Introduction and Backgrou
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Chapter 1 Introduction and Backgrou
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Chapter 2 Overview and Issues2.2 OR
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Chapter 2 Overview and IssuesFigure
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Chapter 2 Overview and Issuesother
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Chapter 2 Overview and IssuesTable
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Chapter 2 Overview and IssuesFigure
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Chapter 2 Overview and Issues●●
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Chapter 2 Overview and IssuesIn 200
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Chapter 2 Overview and IssuesThe an
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Chapter 2 Overview and IssuesTable
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Chapter 2 Overview and IssuesProble
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Chapter 3 Managing the Health Servi
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Page 65 and 66: Chapter 5 Accountability - Hospital
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Page 101: Chapter 8 Audit ReformCHAPTER 8AUDI
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Page 107 and 108: Chapter 8 Audit Reformaudit reports
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Page 123 and 124: Chapter 11 ImplementationRecommenda
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Page 127 and 128: Appendix 1Appendix 1COMMISSION MEMB
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Page 135 and 136: Appendix 3Name of AgencyIrish Blood
Page 137 and 138: Appendix 3Name of AgencyWomen’s H
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Page 145 and 146: Appendix 4Ratifying and Submitting
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Appendix 5Appendix 5DIAGNOSIS RELAT
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Appendix 5Figure: Ax.1 Casemix Adju
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Appendix 6Appendix 6AUDIT OF STRUCT
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Appendix 7(vii)(viii)(ix)participat
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Appendix 8Appendix 8 - Integrated M
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ADDENDUMNumber Recommendation IT Ti
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Brennan Report - Department of Health and Children

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