Brennan Report - Department of Health and Children

Report of the Commission on Financial Management and Control Systems in the Health Serviceis reviewed by the health board’s senior management team and is signed off by the chiefexecutive officer.Each Integrated Management Report must be accompanied by a commentary from the chiefexecutive officer, detailing the causes of any variances and how the health board intends to dealwith such variances prior to the end of the year. The commentary is a central element of thereturn. Although the figures may appear satisfactory, the commentary may provide theDepartment of Health and Children with an early warning of emerging problems. Where thefigures are indicating a problem the commentary must set out both the cause of the problemand the steps the chief executive officer is taking to bring expenditure back withindetermination. Where the commentary shows excess in particular service areas, the IntegratedManagement Report is copied to the relevant line division in the Department of Health andChildren for observations. All line divisions have desktop access to the Integrated ManagementReports.Consolidated Monthly Integrated Management Reports: These are due from theDepartment of Health and Children to the Department of Finance (except in January). This isessentially an analysis of the various Integrated Management Reports as submitted to theDepartment of Health and Children, detailing the variances against budget to date beingexperienced in the system, and containing summary financial, activity and employment controlinformation at a national level. It also sets out problems and pressure points in the system.The Department of Finance requires that a separate report on the performance of thevoluntary hospitals should be appended to the monthly health board returns. Specific returnsare also presented for the General Medical Services (Payments) Board.Quarterly Performance Indicator Reports: In 2001, a set of performance indicators wasagreed between the health boards and the Department of Health and Children and these arebuilt into the Service Plan. Their purpose is to enable both the Department of Health andChildren and the health boards to reach a better shared understanding of the position inmonitoring and evaluating the attainment of Service Plan objectives by the health boards. TheQuarterly Performance Indicator Reports are used as an indicative picture of each healthboard’s position in relation to the delivery of the Service Plan goals. This process is still in itsvery early stages with joint Department and health board teams working to further enhancethese performance indicators.Working Capital: Under Section 8 of the Health (Amendment)(No.3) Act, 1996, each healthboard is required to manage within the level of indebtedness specified by the Minister for Healthand Children in the Letter of Determination. Health boards must submit details of theirworking capital levels to the Department of Health and Children on a quarterly basis. This isdesigned to ensure that excess debts, which would allow financing of current expenditurebeyond approved levels, cannot accumulate.Service Plan Reviews: Formal review meetings take place between senior staff at theDepartment of Health and Children and each health board on a regular basis over the courseof the year to assess progress on delivery of service plan objectives. Prior to the reviews, thehealth boards are required to report to the Department with regard to their performance todate against plan. These reports are placed on the Department’s Intranet and line divisions are170