Brennan Report - Department of Health and Children

Report of the Commission on Financial Management and Control Systems in the Health ServiceRecommendations on the Role of the ExecutiveR3.7 We recommend that the role of the Executive should include:(i) Strategic planning and management of change in the health system, including location of services, aimedat improved service delivery;(ii) Managing the delivery of health services within budget;(iii) Manpower planning and needs assessment;(iv) Managing staff relations;(v) The resource allocation process;(vi) Analysing health spending annually by:(a) Programme/care group (childcare, hospital services, disability services etc.),(b) Health board region;(vii) Under each of the headings at (vi)(a) and (vi)(b) above, the following actions should be undertaken:(a) A comparison of performance, productivity, quality of care and value for money,(b) Summary results of the comparative analysis undertaken at (vii)(a) above should be published, ina standardised format, within 6 months of the end of the relevant accounting period;(viii) Identifying the problems and issues highlighted by the comparative analysis undertaken at (vi) and (vii)above;(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;and(x) Risk assessment/management.R.3.8In regard to recommendation R3.7(vii)(a), we recommend that the existing National Performance IndicatorsProject Team define appropriate measurable definitions and indicators of "performance", "productivity" and"value for money".This group should submit its recommendations to the Secretary General and Minister forHealth and Children.3.7 RESTRUCTURED GOVERNANCE ARRANGEMENTS FOR THE HEALTHSERVICERelationship between Department and the ExecutiveIn order to effectively discharge its responsibilities – on drafting legislation, developing policyand as principal advisor to the Government on health issues – it will be essential that theDepartment of Health and Children be closely in touch with the on-the-ground reality ofpolicy implementation. This will require close contact between officials at all levels of theExecutive and the Department of Health and Children in order that Departmental officials willhave a clear understanding of the practical issues and challenges related to health servicedelivery.Furthermore, the aims and objectives of the Department and the Executive will both be focusedtoward the same end – maximising efficiency, effectiveness and output within the health service.These congruent interests make a close working relationship between the two organisationsessential. If the relationship between the two parties does not work properly, it couldsubstantially compromise the capacity of the health system to deliver on its objectives. One ofthe key tests of the practical success of the organisational structure we propose will be theability of both the Executive and the Department to forge an effective working relationship andbuild appropriate synergies.In this context, we see the relationship between the Secretary General of the Department ofHealth and Children and the CEO of the Executive working along the lines of that which existscurrently between CEOs of non-commercial State bodies and their respective Secretaries48