Brennan Report - Department of Health and Children

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Report of the Commission on Financial Management and Control Systems in the Health Servicefor a multi-annual programme of infrastructure development in the health service covering theperiod 2000 to 2006. The Health Capital Programme falls within the Economic and SocialInfrastructure Operational Programme. Funding on a global rather than project-specific basisfor each year of the Plan was indicated at the outset and this indicative funding forms the basisfor discussion with the Department of Finance for the annual Estimates, together with issuessuch as inflation, essential projects, and other estimates adjustments.At the outset, in 1999, each health board was, for planning purposes only, provided by theDepartment of Health and Children with details of indicative allocations analysed by care group(i.e. acute hospitals, disability services, services for older people, mental health, communityhealth and childcare). The indicative allocations for individual health boards were determined inline with the regional criteria set for the overall National Development Plan and by referenceto the overall indicative funding level.For multi-annual planning purposes, health boards were requested to draw up capitalexpenditure plans for the period 2000 to 2006, for submission to the Department of Health andChildren, in line with their indicative allocations and taking account of all contractualcommitments being carried forward from projects commenced prior to the NationalDevelopment Plan. The purpose of these capital expenditure plans was to identify, in broadterms, how each health board foresaw the development of health infrastructure within its areaand within each care group over the life of the National Development Plan, working within theannual funding limits available. Each health board’s capital expenditure plan is subject tocontinuous review by the health board’s chief executive officer and National Development Planmanager to reflect inflation, changes in funding, service delivery, etc. The Hospital PlanningOffice is responsible for managing the Health Capital Programme under the NationalDevelopment Plan in association with the appropriate line division within the Department ofHealth and Children.Project Approval Process: Notwithstanding the indicative allocations flowing from theNational Development Plan, each capital project requires specific approval from theDepartment of Health and Children. All capital projects costing in excess of ¤ 6.3 millionrequire approval from the Department of Health and Children at up to 17 separate stages aswell as approval from the Department of Finance at both design and tender stages. Minorcapital works (i.e. those costing less than ¤ 6.3 million) and equipment procurement also requirethe specific approval of the Department of Health and Children (see below).172
Appendix 4Approvals Required in line with Procurement Procedures for Capital Projects.Major/Medium projects● DoHC agreement to develop project● Approval to establish Project Team to develop design briefDOF approval at this point.● Approval of design brief (including setting construction cost limit) and advertising fordesign team selection● Approval to appoint selected design team● Approval of Development Control Plan (Stage 2)● Approval of Sketch Design Stage (Stage 3)● Approval to advertise for contractorsDOF approval at this point.● Approval to seek tenders● Approval to tender acceptance● Approval to significant nominated sub-contracts (e.g. mechanical/electrical etc.)● Approval to appoint site staff● Approval to appoint project manager (where appropriate)● Approval of variations over an agreed cost threshold (where appropriate)● Approval of construction contract final account● Approval of equipment lists● Approval of equipment tenders● Approval of project final costMinor Capital● Approval of Project Brief and project costEquipment (stand alone)● Approval of proposed requisitionHealth boards must also adhere to normal public sector procurement processes such as thoserelating to National Procurement Procedures and EU Directives.Each project is managed by the relevant health board with provision for professional and linedivision input from the Department of Health and Children for all major projects as required.The various stages involved are set out in detailed procedural manuals, based, inter alia, on theDepartment of Finance’s "Guidelines for the Appraisal and Management of Capital ExpenditureProposals in the Public Sector", which have been further developed by the Department ofHealth and Children.Public Capital Programme: The National Development Plan contains indicative capitalallocations only. Actual capital expenditure allocations are determined in each year as part ofthe annual estimates negotiations described above. The capital allocation is published, initially,in the Estimates for Public Services (Abridged Version) and, subsequently, in the RevisedEstimates for Public Services. The Public Capital Programme published simultaneously with theRevised Estimates for Public Services contains greater detail on the range of public capitalexpenditure, including that for the health services.Funding Capital Projects: The Department of Health and Children provides, on an ongoingbasis, cash to fund projects, through the contracting authority (usually a health board) on a173
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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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Executive Summary"demand-led" schem
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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 1 Introduction and Backgrou
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Chapter 2 Overview and Issues2.2 OR
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Chapter 2 Overview and IssuesAppend
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Chapter 2 Overview and IssuesFigure
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Chapter 2 Overview and Issuesother
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Chapter 2 Overview and IssuesTable
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Chapter 2 Overview and IssuesFigure
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Chapter 2 Overview and Issues●●
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Chapter 2 Overview and IssuesIn 200
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Chapter 2 Overview and IssuesThe an
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Chapter 2 Overview and IssuesTable
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Chapter 2 Overview and IssuesProble
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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 6 Accountability - General
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Chapter 7 Accountability - Employme
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Page 123 and 124: Chapter 11 ImplementationRecommenda
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Page 127 and 128: Appendix 1Appendix 1COMMISSION MEMB
Page 129 and 130: Appendix 1He has held this position
Page 131 and 132: Appendix 2SIPTU*South Eastern Healt
Page 133 and 134: Appendix 3Name of AgencyBord na Rad
Page 135 and 136: Appendix 3Name of AgencyIrish Blood
Page 137 and 138: Appendix 3Name of AgencyWomen’s H
Page 139 and 140: Appendix 4Department of Health and
Page 141 and 142: Appendix 4collated and assessed by
Page 143 and 144: Appendix 4The most detailed element
Page 145 and 146: Appendix 4Ratifying and Submitting
Page 147 and 148: Appendix 4changes to the Service Pl
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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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Page 161 and 162: Appendix 8Appendix 8 - Integrated M
Page 163 and 164: ADDENDUMNumber Recommendation IT Ti
Page 165 and 166: Number Recommendation IT TimeframeR
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Brennan Report - Department of Health and Children

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