Brennan Report - Department of Health and Children

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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
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
Page 1: Commission onFinancial Managementan
Page 5 and 6: 6.4 COMMUNITY DRUG SCHEMES 80Medica
Page 7 and 8: Executive SummaryEXECUTIVE SUMMARYT
Page 9 and 10: Executive SummaryWe do not underest
Page 11 and 12: Executive Summary"demand-led" schem
Page 13 and 14: Terms of ReferenceTERMS OF REFERENC
Page 15 and 16: GlossaryEstimates for Public Servic
Page 17 and 18: Chapter 1 Introduction and Backgrou
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Page 21 and 22: Chapter 2 Overview and Issues2.2 OR
Page 23 and 24: Chapter 2 Overview and IssuesAppend
Page 25 and 26: Chapter 2 Overview and IssuesFigure
Page 27 and 28: Chapter 2 Overview and Issuesother
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Page 31 and 32: Chapter 2 Overview and IssuesFigure
Page 33 and 34: Chapter 2 Overview and Issues●●
Page 35 and 36: Chapter 2 Overview and IssuesIn 200
Page 37 and 38: Chapter 2 Overview and IssuesThe an
Page 39 and 40: Chapter 2 Overview and IssuesTable
Page 41 and 42: Chapter 2 Overview and IssuesProble
Page 43 and 44: Chapter 3 Managing the Health Servi
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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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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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