Brennan Report - Department of Health and Children

Report of the Commission on Financial Management and Control Systems in the Health Serviceservices could impact adversely on the quality of the advice that will be available to theGovernment from the Department. There is also a risk that, when the Department isformulating advice on financing, policy and legislation, the Executive could dominate it.As a consequence of the changes we are recommending, the Department will also have to berestructured. The most important objective in this restructuring is to ensure that theDepartment has an increased capacity to carry out policy analysis and formulation. This rolemust go beyond simply promoting policy proposals put forward by the Executive. In carrying outits finance function, in particular, a key task will be to form its own view of the health services,based on ongoing critical analysis of service effectiveness and efficiency, so that the Governmentcan be satisfied that the maximum output is being achieved for the resources being madeavailable. It will also be vital that the working relationship that we outline in section 3.7 belowproves effective.The role, responsibilities and functions of the Department of Health and Children within arestructured health service will relate to the development of national health policy.The healthpolicy function covers all those areas that specifically relate to supporting the political processat national level (the Minister, Government and the Oireachtas) and includes the legislative,international representative and estimates functions.Recommendations on the Restructured Role of the Department of Health and ChildrenR3.6 The role of the Department of Health and Children should include:(i) Acting as advisor to the Minister and the Government;(ii) Developing and costing policy responses and strategies to achieve the necessary reform to addressidentified problems arising from existing policy;(iii) Developing and costing policies for future service developments;(iv) Dissemination and active sponsorship of best practice;(v) The Estimates process;(vi) Management of the legislative agenda as it relates to the health service;(vii) Acting as "regulator" in respect of national health care standards;(viii) International representation of the Irish health service (at the OECD,WHO etc.);(ix) Research and identification of ongoing developments in international best practice in the health areaand consideration of the extent to which they may be adapted for implementation in an Irish context;(x) Risk assessment/management; and(xi) Issues relating to public sector pay policy.3.6 THE ROLE OF THE EXECUTIVEThe role of the Executive should be focused on overall organisation and management of thehealth service as a national system – as indicated above, this is not currently being done within the existing structures.The work of the Executive must be to plan, organise and manage the total system in the sameway that a corporate HQ manages the context in which each business unit operates. Functionswould include:●Analysis of the changing patterns of need for different types of medical and socialservices.46