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Brennan Report - Department of Health and Children

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<strong>Report</strong> <strong>of</strong> the Commission on Financial Management <strong>and</strong> Control Systems in the <strong>Health</strong> ServiceRecommendations on Risk Assessment <strong>and</strong> ManagementR8.12 A systematic assessment <strong>of</strong> all risks (including financial, operational <strong>and</strong> clinical risks) must be a central <strong>and</strong>integral part <strong>of</strong> all policy development <strong>and</strong> ongoing operational activity.R8.13 A Risk Assessment Unit should be established with immediate effect by the Secretary General <strong>of</strong> the <strong>Department</strong><strong>of</strong> <strong>Health</strong> <strong>and</strong> <strong>Children</strong> with the task <strong>of</strong>:(i) Supporting policy makers; <strong>and</strong>(ii) Driving the implementation <strong>of</strong> risk management policy <strong>and</strong> procedures down to local <strong>and</strong> agency levels.R8.14 In respect <strong>of</strong> R8.13(i) the role <strong>of</strong> the Risk Assessment Unit should be to:(i) Support in an integral <strong>and</strong> ongoing way national policy developments <strong>and</strong> negotiations;(ii) Provide technical support <strong>and</strong> advice to individual <strong>of</strong>ficers/sections on the identification <strong>and</strong> management<strong>of</strong> risks at policy design stage;(iii) Advise on the design <strong>and</strong> execution <strong>of</strong> control measures to minimise risks; <strong>and</strong>(iv) Review the conduct <strong>of</strong> risk assessment procedures on new services/schemes within the <strong>Department</strong> <strong>of</strong><strong>Health</strong> <strong>and</strong> <strong>Children</strong>.R8.15 In respect <strong>of</strong> R8.13(ii) the role <strong>of</strong> the Risk Assessment Unit should be to:(i) Develop, implement <strong>and</strong> communicate risk management strategy, policy <strong>and</strong> procedures across the healthservice;(ii) Develop <strong>and</strong> co-ordinate risk management information requirements, reporting thresholds <strong>and</strong>mechanisms for determining priorities;(iii) Develop, promote <strong>and</strong> maintain common methodologies for identifying <strong>and</strong> assessing risk <strong>and</strong>determining adequacy <strong>and</strong> cost effectiveness <strong>of</strong> controls;(iv) Identify <strong>and</strong> assess accumulations <strong>of</strong> risk across the health service <strong>and</strong> interdependencies; <strong>and</strong>(v) Co-ordinate risk management activity, training <strong>and</strong> technical support, across the health service.R8.16 A working group should be established to bring forward a report on best practice in terms <strong>of</strong> risk assessment<strong>and</strong> risk management in the health sector.R8.17 The Risk Assessment Unit should make half-yearly reports to the Management Advisory Committee <strong>of</strong> the<strong>Department</strong> <strong>of</strong> <strong>Health</strong> <strong>and</strong> <strong>Children</strong> on the ongoing effectiveness <strong>of</strong>, <strong>and</strong> compliance with, national riskmanagement policy.R8.18 Internal audit units in all health service agencies should make half-yearly reports to the Chairman <strong>of</strong> their localaudit committees on the effectiveness <strong>of</strong> the risk management procedures in place in their organisation. Anylegislative amendments to facilitate this should be implemented.8.6 FRAUDIt is essential that all staff in the health services be aware <strong>of</strong> the possibility <strong>of</strong> fraud <strong>and</strong> beconscious <strong>of</strong> their individual duties <strong>and</strong> responsibilities in preventing fraud. The health serviceshave a budget <strong>of</strong> almost ¤ 9 billion in 2003. In view <strong>of</strong> the wide range <strong>of</strong> operations in the healthservices it is possible that fraud may occur. In order to give assurance to the Irish taxpayer, topatients <strong>and</strong> consumers <strong>and</strong> to staff, it is important to have a clear policy on fraud that shouldbe communicated <strong>and</strong> applied consistently throughout the health services.There are a number <strong>of</strong> elements that assist in preventing fraud. These include:●●●●Staff awareness <strong>of</strong> the potential for fraud;Strong internal controls built into all operations;Consideration <strong>of</strong> internal control <strong>and</strong> risk management in designing new developments,schemes etc;Strong internal <strong>and</strong> external audit functions;108

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