Brennan Report - Department of Health and Children
Brennan Report - Department of Health and Children Brennan Report - Department of Health and Children
BAILE ÁTHA CLIATHARNA FHOILSIÚ AG OIFIG AN tSOLÁTHAIRLe ceannach díreach ónOIFIG DHÍOLTA FOILSEACHÁN RIALTAIS,TEACH SUN ALLIANCE, SRÁID THEACH LAIGHEAN, BAILE ÁTHA CLIATH 2.nó tríd an bpost ó51 FAICHE STIABHNA, BAILE ÁTHA CLIATH 2.(Teil: 01-647 6000; Faics: 01-647 6843)nó trí aon díoltóir leabharDUBLIN:PUBLISHED BY THE STATIONARY OFFICETo be purchased from theGOVERNMENT PUBLICATIONS SALES OFFICE,SUN ALLIANCE HOUSE, MOLESWORTH STREET, DUBLIN 2or by mail order fromGOVERNMENT PUBLICATIONS, POSTAL TRADE SECTION,51 ST. STEPHEN’S GREEN, DUBLIN 2(Tel: 01-647 6000; Fax: 01-647 6843)or through any bookseller€10PN 12935
TABLE OF CONTENTSEXECUTIVE SUMMARY 5TERMS OF REFERENCE 11GLOSSARY 121 INTRODUCTION AND BACKGROUND 151.1 BACKGROUND 151.2 MEMBERSHIP 151.3 PROCEDURES 161.4 TERMS OF REFERENCE 161.5 IMPLEMENTATION 161.6 ACKNOWLEDGMENTS 172 OVERVIEW AND ISSUES 182.1 SUMMARY 182.2 ORGANISATION OF HEALTH SERVICE 192.3 ESTIMATES,ALLOCATIONS AND CONTROL OF THE SERVICE 192.4 POSITIVE ASPECTS OF THE SYSTEM 242.5 PROBLEMS WITH EXISTING STRUCTURES 24Management of the ServiceAccountability in the System2.6 CONSEQUENCES OF STRUCTURAL WEAKNESSES 25Consequence 1: Patient Costing is not at the centre of the systemConsequence 2: Clinicians are not the fundamental unit of accountabilityConsequence 3: Primary source data on patients2.7 SPECIFIC PROBLEMS DERIVING FROM THE STRUCTURAL WEAKNESSES 28Problem 1: Inadequate Planning and CostingProblem 2: Unapproved Capital ExpenditureProblem 3: Unauthorised Staff NumbersProblem 4: Non-imposition of ChargesProblem 5:Accounting DeficienciesProblem 6: Inadequate Records/Vouching2.8 CONCLUSION 392.9 CORE PRINCIPLES 403 MANAGING THE HEALTH SERVICE 413.1 OVERVIEW 413.2 CURRENT ROLE OF THE DEPARTMENT OF HEALTH AND CHILDREN 423.3 THE NEED TO EVALUATE CORE EXPENDITURE 42
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BAILE ÁTHA CLIATHARNA FHOILSIÚ AG OIFIG AN tSOLÁTHAIRLe ceannach díreach ónOIFIG DHÍOLTA FOILSEACHÁN RIALTAIS,TEACH SUN ALLIANCE, SRÁID THEACH LAIGHEAN, BAILE ÁTHA CLIATH 2.nó tríd an bpost ó51 FAICHE STIABHNA, BAILE ÁTHA CLIATH 2.(Teil: 01-647 6000; Faics: 01-647 6843)nó trí aon díoltóir leabharDUBLIN:PUBLISHED BY THE STATIONARY OFFICETo be purchased from theGOVERNMENT PUBLICATIONS SALES OFFICE,SUN ALLIANCE HOUSE, MOLESWORTH STREET, DUBLIN 2or by mail order fromGOVERNMENT PUBLICATIONS, POSTAL TRADE SECTION,51 ST. STEPHEN’S GREEN, DUBLIN 2(Tel: 01-647 6000; Fax: 01-647 6843)or through any bookseller€10PN 12935