Brennan Report - Department of Health and Children

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138Number Recommendation IT TimeframeRequirementsDRUGS PAYMENTS SCHEMER6.11 Current arrangements for reimbursing pharmacists under the medical card scheme – i.e. none asapreimbursement on a cost of ingredients basis (without mark-up) plus a flat-rate prescription fee– should be extended to the Drugs Payment Scheme.R6.12 The operation of the Drugs Payment Scheme should be reviewed immediately by the Department of none ImmediateHealth and Children, in consultation with the Department of Finance, the GMS (Payments) Boardand the health boards. The review should actively examine:(i) Introducing a system whereby health boards would actively monitor and evaluateprescribing patterns by individual GPs, Consultants or Dentists and reimbursementpatterns by individual pharmacists, having regard to relevant demographic andepidemiological factors;(ii) Introducing incentive schemes for reducing levels of prescribing and drugs costs;(iii) In recognition of the influence of hospital generated prescribing on community drugsbudgets, each health board/hospital CEO should immediately establish Drugs andTherapeutics Committees, comprising Consultants, GPs from the hospital catchment area,supported by pharmacy and financial management expertise, to agree clinically costeffectivecommon drug formulary; and(iv) Relevant international experience and the lessons from this in containing drugs costs andthe rate of growth.R6.13 The existing agreement between the Department of Health and Children and the Irish none immediatePharmaceutical Healthcare Association should be evaluated against international experience withsimilar agreements (particularly in countries of the European Union).The results of this evaluationshould be used in the negotiation of any further agreement so as to assure value for money.R6.14 The Irish Medicines Board should have its remit extended to not just examine new drugs for their none asapefficacy and effectiveness, but also to:(i) Assess their cost effectiveness; and(ii) Approve the drug product for reimbursement under the community drugs scheme(including specifying the conditions on which it may be made available, for examplerestricted to named patients or in respect of defined clinical treatment regimes).R6.15 The Irish Medicines Board should also be charged with the responsibility to monitor the continuing none asapeffectiveness of existing drugs and to delist those which are no longer considered appropriate orclinically cost effective.Report of the Commission on Financial Management and Control Systems in the Health Service
Number Recommendation IT TimeframeRequirements139R6.16 Where the Irish Medicines Board determines that a cheaper, but equally effective, alternative exists, none Parallel with implementationonly the cost of the cheaper drug should be reimbursed by the GMS (Payments) Board. Where a of R6.14 and R6.15GP prescribes the more expensive branded drug, the cost difference arising should be regarded asentirely private prescribing.COSTING PAY AWARDSR7.1 Pending transfer of functions to the proposed Executive, the CEO of the Health Service none immediateEmployers Agency (HSEA) should report to the Secretary General of the Department of Healthand Children and be accountable to him for the financial consequences of pay negotiations and theinterim costing of agreements conducted by the HSEA.R7.2 Prior to any agreement being concluded, the final costing of pay agreements negotiated by the HSEA none immediateshould be prepared by the Department of Health and Children, drawing on the comprehensivedataset proposed at recommendation R7.6 below.EMPLOYMENT INFORMATION AND REPORTSR7.3 The CEO of each health board should be responsible for the provision of employment information none immediateboth for their own direct employees and for employees of all agencies funded by the health board.R7.4 Health boards should afford appropriate priority and resources to ensure the compilation of timely, none immediateaccurate and verifiable employment data.R7.5 Health board CEOs should report employee numbers and pay cost data to the Executive on a none immediate on completionmonthly basis within the revised Integrated Management Reporting structure recommended at R9.3. of R4.4 and see R9.3R7.6 The specific details of the pay and employment data to be provided in the health boards’ Monthly none See R4.4Integrated Management Reports should be determined by the working group referred to inrecommendation R4.4. At a minimum, these should include:(i)(ii)Detailed information on gross pay costs, by grade code;Details on the elements comprising pay (i.e. basic pay, overtime, shift allowances etc),by grade code;(iii) Details on costs of agency working;(iv) Identification of approved vacancies and progress in filling new posts to support servicedevelopment as set out in the annual Service Plans;(v) Comprehensive listing of voluntary bodies/agencies funded by each health board; and(vi) Similar detail as at (i) to (iv) above in respect of these voluntary bodies/agenciesAddendum
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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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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 10 Information SystemsStrat
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Chapter 10 Information SystemsRecom
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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
Page 149 and 150: Appendix 4advised of their existenc
Page 151 and 152: Appendix 4Approvals Required in lin
Page 153 and 154: Appendix 5Appendix 5DIAGNOSIS RELAT
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Page 157 and 158: Appendix 6Appendix 6AUDIT OF STRUCT
Page 159 and 160: Appendix 7(vii)(viii)(ix)participat
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
Page 175: Number Recommendation IT TimeframeR
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Brennan Report - Department of Health and Children

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