Brennan Report - Department of Health and Children

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Report of the Commission on Financial Management and Control Systems in the Health ServiceAppendix 9INVESTMENT IN INFORMATION TECHNOLOGY INTHE MIDLAND HEALTH BOARDSAP is a fully integrated software package with available modules including financials, materialsmanagement, human resources, payroll, asset management and asset maintenance. PPARS(Personnel, Pay, Attendance and Recruitment System) is the human resource module of SAP.The investment in IT, particularly SAP, has led to significant improvement and changes evenwithin the current organisational culture and structures.The following are some examples from a financial perspective:Financial Performance prior to SAP:(1998 AFS)- Cumulative deficit: ¤ (1.2m)- Stock value: ¤ 3.3m- Stock held as a % of expenditure: 2.1%- Patient debtors: ¤ 1.3m- Patient debtors as a % of income: 9.1%Financial Performance since SAP:(2001 Draft AFS)- Cumulative surplus: ¤ 0.7m – a turnaround of ¤ 1.9m- Stock value: ¤ 3.9m- Stock held as a % of expenditure: 1.3% - improved utilisation of working capital- Patient debtors: ¤ 0.86m- Patient debtors as a % of income: 3.5% - improvement in debtor managementAs well as the obvious financial improvements, SAP has enabled the Midland Health Boardexploit business process improvements. Examples include:●●●●●●●●●●●Electronic Fund Transfer Payments instead of manual chequesConsignment stock and reduced investment in working capitalE–procurement and automated stock replenishmentReduction in Store locationsAutomated purchase to pay processCommitment reportingControl and approval at point of orderOn line bank reconciliationControls embedded in system – facilitates budget managementBar coding – reduction in stocks and stocktakingReal time integrated financial information for improved budget management184
ADDENDUMNumber Recommendation IT TimeframeRequirementsTHE NATIONAL MANAGEMENT OF THE HEALTH SERVICER3.1 We recommend that the national management of the health service should be carried out by an none asap"Executive" outside the Department of Health and Children.R3.2 Establishment of the Executive must involve the consolidation of many of the existing none asapagencies within its functions.R3.3 There should be no net increase in staffing levels within the health service to give effect to none n/arecommendation R3.1.R3.4 Staff of the Executive should be recruited by way of open competition and not restricted to none n/athe civil or public service.R3.5 Recruitment of the CEO of the Executive should be by means of an international search none n/aand selection process.THE RESTRUCTURED ROLE OF THE DEPARTMENT OF HEALTH AND CHILDREN125R3.6 The role of the Department of Health and Children should include: none On establishment of(i) Acting as advisor to the Minister and the Government; the Executive(ii) Developing and costing policy responses and strategies to achieve the necessaryreform to address identified problems arising from existing policy;(iii) Developing and costing policies for future service developments;(iv) The dissemination and active sponsorship of best practice;(v) The Estimates process;(vi) The management of the legislative agenda as it relates to the health service;(vii) Acting as "regulator" in respect of national health care standards;(viii) International representation of the Irish health service (at the OECD,WHO etc.);(ix) Research and identification of ongoing developments in international best practice inthe health area and consideration of the extent to which they may be adapted forimplementation in an Irish context;(x) Risk assessment/management; and(xi) Issues relating to public sector pay policy.Addendum
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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 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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Chapter 8 Audit ReformCHAPTER 8AUDI
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Chapter 8 Audit ReformRecommendatio
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Chapter 8 Audit Reformoutsourcing)
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Chapter 8 Audit Reformaudit reports
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Chapter 8 Audit Reformas relating t
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Page 123 and 124: Chapter 11 ImplementationRecommenda
Page 125 and 126: Chapter 11 Implementationbeing brou
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
Page 149 and 150: Appendix 4advised of their existenc
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Page 153 and 154: Appendix 5Appendix 5DIAGNOSIS RELAT
Page 155 and 156: Appendix 5Figure: Ax.1 Casemix Adju
Page 157 and 158: Appendix 6Appendix 6AUDIT OF STRUCT
Page 159 and 160: Appendix 7(vii)(viii)(ix)participat
Page 161: Appendix 8Appendix 8 - Integrated M
Page 165 and 166: Number Recommendation IT TimeframeR
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Brennan Report - Department of Health and Children

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