Brennan Report - Department of Health and Children

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Report of the Commission on Financial Management and Control Systems in the Health Serviceparticular, we believe that it should be an essential pre-condition of investment in IT that thebusiness case include specification of:●●●●●●Staff (including their skills and qualifications) that will operate the new systems and/ordesign the outputs that will be drawn from the system;Specific organisational change that is necessary for the successful implementation of theproject;Changes in information flows and use and the advantages that such information willprovide vis-à-vis existing arrangements;Internal mechanisms to be put in place to make sure that the structural changes and theproject are delivered on time and within budget;Involvement of internal audit and finance staff to ensure that internal controls are notcompromised by the changeover to the new system; andA detailed programme for implementation.A business case that does not contain this level of information should not be considered. If weare serious about getting the best value from significant public investment in IT then we mustbe provided with the greatest possible degree of certainty that that value will be derived fromthe investment.Foremost among the conditions necessary to successfully implement and extract maximumvalue from IT investment is the need to invest in expertise (financial, IT and human resourcemanagement personnel) to analyse, evaluate and interpret the upgraded systems to fully exploitthe benefits they can offer. The barriers to recruitment of appropriately trained and qualifiedstaff must be addressed as a matter of urgency. In this regard, we noted in Chapter 7 that thepublic sector unions and employers have agreed, in recognition of the nature of the CommonRecruitment Pool system, to conduct a cross-sectoral review of pertinent recruitment issuesin the health sector. We believe that this provides the opportunity to introduce a newflexibility in recruiting the necessary expertise.The implementation of a programme of investment must also be placed within the widercontext of the process of structural and cultural reform set out in this report. If the deficits wehave identified are not addressed or if there are no substantive changes in the pervasive cultureof the system of financial reporting examined in Chapter 9, investment on its own will changevery little. Information systems are simply a tool, not an end in themselves. As such, the fullbenefits of investment in IT systems can only be realised within a restructured health servicewhere the focus, at all levels, is on continuing to improve effectiveness and efficiency and wherethere is a willingness amongst all staff to account for their performance in this regard.118
Chapter 10 Information SystemsRecommendations on Information SystemsR10.1 The information systems necessary to support financial management and control systems recommended in thisreport should be built around SAP and PPARS.R10.2 This investment should be subject to:(i) Prior arrangements being put in place to ensure that appropriate use can and will be made of newsystems as evidenced in a detailed business case as outlined in the text above;(ii) Parallel implementation of the wider organisational changes we recommend throughout this report; and(iii) The recruitment of certain key financial, human resource management and information technologypersonnel, necessary to the successful implementation of the recommendations of this report, should beby means of open competition i.e. from outside the Common Recruitment Pool (see alsorecommendation R7.10).R10.3 There should be an acceleration in investment so as to achieve the early implementation of the following:(i) SAP financials installed in all health boards and the major teaching hospitals 2 ;(ii) PPARS (Phase 1) fully implemented in the outstanding sites (South Eastern Health Board, Southern HealthBoard, Beaumont, Mater, St Vincent’s and Tallaght hospitals); and(iii) PPARS (Phase 2) 3 implemented in the health boards and the major teaching hospitals.R10.4 Roll out of PPARS should continue to be driven by the National PPARS Office, to ensure a consistent anduniform national approach, and that Office should liaise on a monthly basis with the Implementation Committeereferred to at R11.2.R10.5 Hospital information systems which provide information on patients and their procedures (i.e. number of tests,x-ray, lab time, theatre, drugs etc.) be rolled out to all acute hospitals and integrated with the financial and HRsystems at R10.3 above.R10.6 Funding for the IT strategy should be ring-fenced to ensure that:(i) The funding is solely for specified IT investment;(ii) There is increased transparency of where the investment occurs; and(iii) There is clear measurement of the improvements in management information resulting from suchinvestments.R10.7 Pending establishment of the Executive, the Department of Health and Children should have full control overhow this funding will be allocated and should report the results of such investments to the ImplementationCommittee recommended at R11.2.10.4 SUMMARYWhile recognising the IT deficit, we consider that substantial expenditure in this area can onlybe justified if it is accompanied by a more comprehensive business case than has appliedheretofore and by the parallel implementation of the wider structural reformsrecommended throughout this report.2St. James’, Beaumont, Mater, St.Vincent’s and Tallaght hospitals3Phase 2 has not been implemented in any site.119
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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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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 3 Managing the Health Servi
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Chapter 4 Service Planning, Budgeti
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Chapter 5 Accountability - Hospital
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Chapter 5 Accountability - Hospital
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Page 157 and 158: Appendix 6Appendix 6AUDIT OF STRUCT
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Brennan Report - Department of Health and Children

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