Brennan Report - Department of Health and Children

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130Number Recommendation IT TimeframeRequirementsREBALANCING FINANCIAL ALLOCATIONSR4.6 Funding of regional health boards should be evidence based and prioritised across identified needs. none Commence on completionIn particular, in allocating budgets between health boards, the Executive should take account of a of R4.7number of nationally agreed key factors, as they apply across health board regions, such as:Demographics Specialities Client Profile CapacityServices Activity Infrastructure Socio-economic profilesR4.7 Pending establishment of the Executive, a working group representative of the Department none To commence immediatelyof Health and Children, Department of Finance, and the regional health boards should beand report withinestablished:12 months(i) To conduct advance development work on defining the appropriate factors underR4.6 above;(ii) To detemine the relative weighting which should be ascribed to each factor in determiningeach health board’s allocation; and(iii) To examine the phasing arrangements that are appropriate to ensure a smooth transitionto the new arrangement.MULTI-ANNUAL BUDGETINGR4.8 Service Plans should be framed on a multi-annual basis. none 2004 Service Plan CycleReport of the Commission on Financial Management and Control Systems in the Health ServiceSUPPLEMENTARY ESTIMATESR4.9 If, notwithstanding the statement of the Minister for Finance in his Budget speech delivered in none n/aDecember 2002 that Ministers and their Management Committees will be required to managestrictly within the allocations given to them, there are to be supplementary estimates in the future,we recommend that the Department of Finance and the Department of Health and Children should:(i) Review the appropriateness and coverage of "allowable supplementaries";(ii) Make recommendations to the Minister for Finance in this regard; and(iii) Thereafter conduct biennial reviews by reference to the volume and content ofsupplementary estimates allowed in the intervening period.
Number Recommendation IT TimeframeRequirementsDEFINING UNIT OF ACCOUNTABILITY IN GENERAL HOSPITALSR5.1 We recommend that clinical Consultants and their practices in individual clinical specialties be While existing systems are immediatedesignated as the primary unit of accountability in the general hospital programme.sufficient to allowcommencement, full andeffective implementationwill require incrementalsystems developmentCONSULTANTS’ COMMON CONTRACTR5.2 The Consultants’ common contract should be reviewed, for existing Consultants, to ensure that the none asapfollowing principles are explicitly reflected in the contract:● Formal recognition and agreement by Consultants, as the key decision makers, of theirresponsibility to manage resources to which they are entitled to conduct their practicewithin agreed budgets at department, specialty and individual Consultant level.● Participation in arrangements for collective representation of Consultants at hospitalmanagement committee level.● Agreement of core hours of attendance.● Active management and optimisation by Consultants of resource allocation against agreedpractice, specialty and department Service Plans and budgets.● Cooperation with arrangements for measurable and transparent systems of continuouslymonitoring adherence to public and private practice contractual commitments.● Where there are competing public and private practice demands on Consultants’ timeand resources, the former should have priority call on such time and resources at alltimes.R5.3 All new Consultant appointments, covering new posts and the replacement of existing Consultants, none asapshould be on the basis of contracting the Consultants to work exclusively in the public sector.R5.25 The provisions of Consultants’ existing common contract should be enforced to ensure that the none immediatefollowing is undertaken:131(i)(ii)The setting of core times when a Consultant must be available to patients in the publichospital; andFormal active monitoring of work commitment in respect of public patients.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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Chapter 8 Audit Reform●●Penalti
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Chapter 9 External Reporting Proced
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Chapter 9 External Reporting Proced
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Page 119 and 120: Chapter 10 Information SystemsStrat
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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 163 and 164: ADDENDUMNumber Recommendation IT Ti
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Brennan Report - Department of Health and Children

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