Brennan Report - Department of Health and Children

More documents

Recommendations

Info

Report of the Commission on Financial Management and Control Systems in the Health ServiceRecommendations on the Role of the Executive Board, Chairman and CEOR3.9 The Executive board should be statutorily responsible for the execution of national health policy and shouldbe formally accountable for its performance to the Minister for Health and Children.R3.10 The Executive board at R3.9 above should assume the functions associated with the management of the healthservice. These would be similar to the normal functions exercised by any corporate board and would include:(i) Implementing the overall strategic direction of national health policy for the health service;(ii) Approval of the annual regional Service Plans;(iii) Monitoring performance against objectives and ensuring that corrective action is taken whennecessary;(iv) Ensuring that services are delivered within budget/determination;(v) Appointment of the chief executive officer (CEO) of the Executive;(vi) Establishment of an audit committee; and(vii) Approval of the Annual Report and Financial Statements.R3.11 The board of the Executive should be accountable to the Minister for Health and Children.R3.12 The CEO of the Executive should be accountable to the board of the Executive.R3.13 The CEO of the Executive should be an accounting officer.R3.14 The CEO of the Executive should be responsible for the provision of financial and other information necessaryto support the Secretary General of the Department of Health and Children in his/her role as accountingofficer and policy advisor to the Government.Membership of the Executive BoardAs the board of the Executive will have ultimate responsibility for implementation of healthpolicy and driving reform within the health service, it is critically important that members beof a high calibre and bring an appropriate mix of experience and expertise, both from withinand without the health sector, whether from Ireland or abroad.Recommendations on Membership of the Executive BoardR3.15 The Executive board should have not more than 12 members made up as follows:(i) An independent Chairman drawn from outside the health sector;(ii) Ex-officio, the CEO of the Executive;(iii) Ex-officio, the Director of Finance of the Executive;(iv) A nominee of the Department of Health and Children; and(v) Not more than 8 non-executive members, reflecting the balance of expertise required, appointed by theMinister for Health and Children.R3.16 In appointing the non-executive members at R3.15(v) above, the Minister should have regard to theappropriateness of each candidate’s skills and experience.Regional Health BoardsWe considered the issue of whether regional health boards should remain a feature of thehealth service.There was a consensus that regional health boards currently deliver advantagesin terms of local democratic representation within the health service.We were concerned thatproposals to replace the regional health board structure might compromise accountability forthe health service and the important corporate governance roles being carried out. However,50
Chapter 3 Managing the Health Servicewe acknowledge the need to review the number and functional areas of health boards.Our recommendations aim to retain the best aspects of regional health boards, while makingthe changes necessary to create a unified national management structure.Under current arrangements, around half of health board members are elected by countycouncils with the balance drawn from professional interests and three nominees of the Ministerfor Health and Children. We are not proposing any changes to these arrangements. However,with the establishment of the Executive, we envisage a strong reporting relationship betweenthe health boards, at regional level, and the board of the Executive in respect of corporategovernance functions. In practice, we would expect regional heath board chairmen to discussimportant local issues with the Chairman of the Executive.Role of the Boards of Regional Health BoardsAt present the boards of regional health boards have a range of reserved functions, specified inlegislation, including:●●●●●●Appointment and removal of chief executive officer (CEO);Adoption, supervision and amendment of a Service Plan;Adoption of notified amounts of indebtedness;Adoption of Annual Financial Statements;Adoption of Annual Report; andEstablishment of committees of health boards.All other functions are executive functions of the CEO.We envisage a change in the role of regional health boards, such that they would no longer berequired to approve the annual Service Plan nor would they have any role in relation toindebtedness – these would be executive functions. However, we believe that the boards ofregional health boards must be consulted when regional Service Plans are being prepared. Wealso envisage that the appointment of the regional CEO will be a matter for the Executive.Regional health boards should retain important corporate governance roles as discussedearlier and would continue to carry out valuable consultative, monitoring and representativefunctions.Thus, to ensure proper accountability, each regional health board should have a boardwith the role of:●●●●Monitoring the implementation of national policy within their region;Reviewing the arrangements made by the regional CEO to execute necessary work within policy guidelines;Approving and adopting Annual Financial Statements and Annual Reports; andEstablishing audit committees.Regional CEOs and ChairmenCEOs of regional health boards would be directly accountable to the CEO of the Executive(rather than to the board of their regional health board) for the implementation of nationalpolicy within their functional area. However, regional CEOs should continue to meet with, andreport to, the boards of regional health boards on a regular basis to discuss local performance51
Page 1 and 2: Commission onFinancial Managementan
Page 3 and 4: TABLE OF CONTENTSEXECUTIVE SUMMARY
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
Page 19 and 20: Chapter 1 Introduction and Backgrou
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
Page 29 and 30: Chapter 2 Overview and IssuesTable
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
Page 51: Chapter 3 Managing the Health Servi
Page 59 and 60: Chapter 4 Service Planning, Budgeti
Page 65 and 66: Chapter 5 Accountability - Hospital
Page 79 and 80: Chapter 6 Accountability - General
Page 89 and 90: Chapter 7 Accountability - Employme
Page 101 and 102: Chapter 8 Audit ReformCHAPTER 8AUDI
Page 103 and 104:
Chapter 8 Audit ReformRecommendatio
Page 105 and 106:
Chapter 8 Audit Reformoutsourcing)
Page 107 and 108:
Chapter 8 Audit Reformaudit reports
Page 109 and 110:
Chapter 8 Audit Reformas relating t
Page 111 and 112:
Chapter 8 Audit Reform●●Penalti
Page 113 and 114:
Chapter 9 External Reporting Proced
Page 115 and 116:
Page 117 and 118:
Page 119 and 120:
Chapter 10 Information SystemsStrat
Page 121 and 122:
Chapter 10 Information SystemsRecom
Page 123 and 124:
Chapter 11 ImplementationRecommenda
Page 125 and 126:
Chapter 11 Implementationbeing brou
Page 127 and 128:
Appendix 1Appendix 1COMMISSION MEMB
Page 129 and 130:
Appendix 1He has held this position
Page 131 and 132:
Appendix 2SIPTU*South Eastern Healt
Page 133 and 134:
Appendix 3Name of AgencyBord na Rad
Page 135 and 136:
Appendix 3Name of AgencyIrish Blood
Page 137 and 138:
Appendix 3Name of AgencyWomen’s H
Page 139 and 140:
Appendix 4Department of Health and
Page 141 and 142:
Appendix 4collated and assessed by
Page 143 and 144:
Appendix 4The most detailed element
Page 145 and 146:
Appendix 4Ratifying and Submitting
Page 147 and 148:
Appendix 4changes to the Service Pl
Page 149 and 150:
Appendix 4advised of their existenc
Page 151 and 152:
Appendix 4Approvals Required in lin
Page 153 and 154:
Appendix 5Appendix 5DIAGNOSIS RELAT
Page 155 and 156:
Appendix 5Figure: Ax.1 Casemix Adju
Page 157 and 158:
Appendix 6Appendix 6AUDIT OF STRUCT
Page 159 and 160:
Appendix 7(vii)(viii)(ix)participat
Page 161 and 162:
Appendix 8Appendix 8 - Integrated M
Page 163 and 164:
ADDENDUMNumber Recommendation IT Ti
Page 165 and 166:
Number Recommendation IT TimeframeR
Page 167 and 168:
Page 169 and 170:
Page 171 and 172:
Page 173 and 174:
Page 175 and 176:
Page 177 and 178:
Page 179 and 180:
Page 181 and 182:
Page 183 and 184:
Page 185 and 186:
show all

Brennan Report - Department of Health and Children

Create successful ePaper yourself

Delete template?

Save as template?