Brennan Report - Department of Health and Children

Chapter 4 Service Planning, Budgeting and Supplementary EstimatesCHAPTER 4SERVICE PLANNING, BUDGETING ANDSUPPLEMENTARY ESTIMATESIn this Chapter, we look at the issues involved and the reforms required in the important areas of serviceplanning, budgeting and supplementary estimates. We outline how the provision of Service Plans must bereformed in a way that will facilitate an enhanced role for front-line decision-makers in the chain ofaccountability. At present, the process generally involves only limited input below the level of the hospital andthis must change.4.1 OVERVIEWHigh-quality data is vital to facilitate informed decision-making. At present, the preparation ofService Plans is an important process in identifying where and why the health service plan touse resources, funded by taxpayers.We believe the entire health service must take a new approach to service planning. Theexisting system (see Appendix 4) needs to be refined so that it is consistent with our coreprinciple of accountability for resources expended being devolved to those making the decisionsthat affect resource consumption and income generation.As well as outlining the symptoms of the current difficulties, we recommend how to dealwith the issues involved. We also look at rebalancing health boards’ financial allocations,multi-annual budgeting and supplementary estimates.4.2 SERVICE PLANNING - SUPPORTING THE MANAGEMENT FUNCTIONThe system of service planning is described in Appendix 4. Under the Health (Amendment)(No.3) Act, 1996, annual Service Plans must be prepared by health boards in response to theLetter of Determination issued by the Department of Health and Children. Under thislegislation, health boards are required to adopt and submit an annual Service Plan to theMinister for Health and Children, outlining the planned activity which they will deliver for thefunding they have received.Improved information flows on health service activities and their associated costs will benecessary to underpin the proposed changes in the business focus of the Department of Healthand Children and the Executive. Fundamental to this will be the further development of theservice planning process.Standardising Service PlansWe acknowledge that there has been an ongoing development and improvement of ServicePlanning since its introduction. However, currently Service Plans:●●●Differ substantially in format and content;Concentrate primarily on plans for service development (i.e. new) money; andHave very weak or no links between activity and funding.57