Brennan Report - Department of Health and Children

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Report of the Commission on Financial Management and Control Systems in the Health ServiceCHAPTER 11IMPLEMENTATIONIn this Chapter, we set out our views on how the recommendations in this report should be implemented.I1.1 OVERVIEWWe do not underestimate the challenge of implementing our recommendations. The scale ofthe changes we envisage illustrates the size of the task.These include:●●●●●●The creation, re-organisation and consolidation of agencies;Changing staff conditions;Engaging clinicians in resource management in a meaningful way;Addressing the issues in their contracts to enable this happen;Addressing the control culture amongst some managers; andThe legislative programme.To ensure that the major changes we have recommended are implemented pending theestablishment of the new Executive, we recommend that a National Implementation Committeeunder an independent Chairman be set up to drive the implementation process.II.2DECISIONS BY GOVERNMENTIn addressing our report, early decisions are needed by Government on the following:●●●Whether to establish a new Executive agency and make the changes to thesystem of governance we have recommended.Which existing organisations will have their functions transferred to the new Executive.Whether to make funding available for the recommended investment in informationtechnology systems.II. 3MANAGING CHANGEOnce these decisions are taken and owing to the wide-ranging nature of the variousrecommendations and the multiplicity of groups required to give effect to them, it will beimportant that there is a single driving force at the centre to bring the various strandstogether.Concentrate on Core Health ActivitiesIn addressing the very substantial reform agenda we have proposed, it will be important toconcentrate on core health activities. We are conscious that over the years the health systemhas been assigned responsibility for a number of what might be regarded as non-core healthactivities (income support, environmental health, food safety etc.). In this context, we believethat the Government should consider assigning some or all of these non-core health activitiesto other Government departments.120
Chapter 11 ImplementationRecommendation on Core Activity of Health ServiceR11.1 Government should give consideration to assigning non-core health activities, currently undertaken by agencieswithin the health service, to other bodies.Implementation CommitteeThe most important task for the implementation of our recommendations is to put in place aplan and timescale that realistically takes into account the risks whilst seeking to minimiseuncertainty in the system. Pending the establishment of the Executive, we believe that this taskshould be undertaken by a high level and well resourced Implementation Committee. Toexpedite matters, consideration should be given to appointing an interim board of the newExecutive on a non-statutory basis.We acknowledge that many of our recommendations require considerable work and furtherdeliberation in order to tease out the detail and the mechanics of their application. With thatin mind, we have, throughout the report, recommended the establishment of various workinggroups, primarily at Department of Health and Children and health board level in order to givefurther consideration to those areas where we considered it to be inappropriate to be overlyprescriptive.We acknowledge that a substantial amount of work, including consultation with relevantparties, will be required to progress these working groups. However, their successfulcompletion is essential if the wider changes recommended throughout the report are to beimplemented. Accordingly, we consider that appropriate priority should be attached to them toensure their completion.121
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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 2 Overview and Issues2.2 OR
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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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Page 127 and 128: Appendix 1Appendix 1COMMISSION MEMB
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Page 153 and 154: Appendix 5Appendix 5DIAGNOSIS RELAT
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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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