Brennan Report - Department of Health and Children

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Report of the Commission on Financial Management and Control Systems in the Health Service1.3 PROCEDURESWe held our first meeting on 7 June 2002 and met on 17 further occasions until our finalmeeting on 31 January 2003. At each meeting, we considered various papers that wereprovided to us by:●●●●●The Secretariat,Staff at the Department of Finance,Staff at the Department of Health and Children,Staff at health boards, andIndividual members.In addition, we commissioned an analysis of international best practice from Dr. GerardineDoyle (see Appendix 1 for further information about Dr. Doyle).Our conclusions and recommendations were reached during an intensive eight-month periodof examination and consideration of:●●●●The information provided in respect of the existing systems,Research into international practice,Submissions and oral contributions, andOther material arising from the procedures adopted.Given our original reporting deadline of end-2002 and the focused nature of our terms ofreference, we decided that it would be inappropriate (within the time limit) to seek submissionsthrough public advertisement. Instead we invited submissions from a range of interested partiesthat might reasonably be expected to have a substantive contribution to make to ourdeliberations. Invitations were issued to a total of 46 groups and individuals.They were askedto provide written submissions consistent with the terms of reference by the end of July 2002.In all, written submissions were received on behalf of 20 groups. Appendix 2 lists the personsand organisations that were invited to make submissions, indicating those from whomsubmissions were received.In addition, we met with representatives of the chief executive officers of the health boards, adelegation from the Irish Hospital Consultants Association and the Comptroller and AuditorGeneral.1.4 TERMS OF REFERENCEIn line with our terms of reference (reproduced at the start of the report) we limited ourselvesto consideration of systems of financial management and control together withrecommendations for improving their effectiveness. We addressed only those structural andorganisational issues that we felt to be essential to the improvement in the management ofpublic expenditure referred to in the December 2001 Budget speech by the Minister for Financewhen he stated "we must focus on what we are achieving in terms of real outputs … increasedexpenditure is not always enough on its own".1.5 IMPLEMENTATIONWe have no role in relation to the implementation of our recommendations, nor in relation to16
Chapter 1 Introduction and Backgroundhow they might be funded. These are matters for Government. However, we consider theimplementation of our 136 recommendations vital to facilitate the necessary overhaul of thecurrent system. For this reason, we have included a separate chapter on implementation(Chapter 11).1.6 ACKNOWLEDGMENTSOur report on such a large, complex and controversial area as the health services was producedin a period of eight months. This could not have been done without the support of ourSecretariat, Derek Moran (Secretary),Tom Murphy, Fiona Prendergast, Deirdre Galvin and PatCreedon. Initially, they provided us with many briefing papers, often liaising with third parties inobtaining information in response to our many requests. Their inputs as authors of a largenumber of high quality papers and draft chapters were the catalysts to the progress we wereable to make in such a short timeframe.Their knowledge of the health services, combined withtheir ability to bring together in a coherent way the output of our many vigorous debates, istestament to their skilled professionalism.We also thank all the individuals, groups and organisations that made submissions and providedus with information.These were informative and of considerable assistance in progressing ourdiscussions and deliberations. Also of great assistance were our meetings with representativesof chief executive officers of the health boards, with a delegation from the Irish HospitalConsultants Association and with the Comptroller and Auditor General.As has already been mentioned, Dr. Gerardine Doyle, who has a particular knowledge ofcontrol systems in the health services, provided us with information on best practiceinternationally. Ceara Roche volunteered her considerable expertise in assisting with the finalproduction of this report.17
Page 1 and 2: Commission onFinancial Managementan
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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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Chapter 11 Implementationbeing brou
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Appendix 1Appendix 1COMMISSION MEMB
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Appendix 1He has held this position
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Appendix 2SIPTU*South Eastern Healt
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Appendix 3Name of AgencyBord na Rad
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Appendix 3Name of AgencyIrish Blood
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Appendix 3Name of AgencyWomen’s H
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Appendix 4Department of Health and
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Appendix 4collated and assessed by
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Appendix 4The most detailed element
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Appendix 4Ratifying and Submitting
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Appendix 4changes to the Service Pl
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Appendix 4advised of their existenc
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Appendix 4Approvals Required in lin
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Appendix 5Appendix 5DIAGNOSIS RELAT
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Appendix 5Figure: Ax.1 Casemix Adju
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Appendix 6Appendix 6AUDIT OF STRUCT
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Appendix 7(vii)(viii)(ix)participat
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Appendix 8Appendix 8 - Integrated M
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ADDENDUMNumber Recommendation IT Ti
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Number Recommendation IT TimeframeR
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Brennan Report - Department of Health and Children

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