Brennan Report - Department of Health and Children

Report of the Commission on Financial Management and Control Systems in the Health ServiceAppropriation-in-Aid Receipts: where these fall short of the originally estimated level, theExchequer will meet the deficiency. On the other hand, where such receipts exceed theoriginally estimated level, the level of Exchequer funding will be correspondingly reduced.Pay: costs arising under the National Programmes, Benchmarking and major unanticipatedawards specifically agreed by Government. Health service employers will be required to meetthe costs of all other awards.Drug Payment Scheme/GMS Scheme (Drug Component) and RecombinantBlood Costs: which are effectively demand led.Professional Indemnity Insurance (including clinical negligence claims againstmaternity hospitals): which are subject, inter alia, to wider developments in the insurancemarkets and legal settlements.Tribunal Enquiries: costs arising from such proceedings are not amenable tomanagement/control by the Department of Health and Children.In relation to all of the above elements, it was confirmed that, in any event, realistic estimates ofthe prospective costs must be prepared and agreed for the inclusion in the Abridged EstimatesVolume.These arrangements have been modified by the Minister for Finance in his Budget speech for2003. He stated that "Ministers and their Management Committees will be required to managestrictly within the allocations given to them". The 2003 Letter of Determination to the healthboards specifically stated "there will be no consideration given to a Supplementary Estimate forHealth and Children in 2003, without exception".V. HEALTH BOARD REPORTINGInternal Management ReportsInternal Monthly Management Accounts: Each health board’s finance department preparesmanagement accounts on a monthly basis for review by the senior management team. Thesereports set out the overall financial performance of the health board, detailed analysis ofvariances by cost centre and non-financial information on hospital activity versus plan analysedby in-patient, day case and casualty attendances. Information on employee numbers is availablefrom both the payroll system and the HR system. Following month end, the finance departmentmeets with budget holders to review the position and agree corrective actions wherenecessary.Internal Quarterly Reports: A quarterly report is prepared by the finance department forreview by the each health board’s finance sub-committee. The report details the financialperformance and highlights any potential difficulties which may prevent the health boardmeeting its budgetary obligation. Following consideration by the finance sub-committee, thequarterly report is presented for consideration to the next full board meeting along with theminutes of the finance sub-committee meeting. Where corrective actions are required whichmight necessitate changing the Service Plan, the finance sub-committee makes necessaryrecommendations for discussion at the next full board meeting. The full board must adopt any168