Brennan Report - Department of Health and Children

Report of the Commission on Financial Management and Control Systems in the Health ServiceAs an important tool to facilitate the management of the health service, the Census has anumber of weaknesses:●●●●●●●●The Census for any one year is not usually available until well into the succeeding year.By that time significant changes in employment may have taken place. For example, the2001 data, only published in November 2002, is already one year out of date.The Census does not record staff employed in voluntary bodies/agencies that are grantfundedby health boards. Pay awards to health service personnel usually apply to staff atthese bodies/agencies, many of whom are paid at health service rates.The Census does not provide details of vacancies.The Census is taken at the year-end when employment patterns are atypical.The Census does not record the number of agency personnel employed. Agency nurses,for instance, are qualified nurses who, while they work on hospital wards alongside staffnurses, are not directly employed by the hospitals. They are used to fill vacancies inhospitals or temporarily substitute for absences.There is no method for validating the accuracy of the returns.The data contained in the Census is not consistent over time - i.e. ongoing refinementsto the data are not carried into returns for earlier years.It is not clear if uniform, accurate and relevant methods are being used throughout thehealth service, when carrying out the Census, for matters including the estimation ofwhole time equivalents.Because the health service is the biggest employer in the State, high quality information onemployment and pay is essential for effective management of the system.We have concluded that, once the appropriate information systems are in place (see Chapter10 recommendations), a formal annual Census coordinated by the Department of Health andChildren will no longer be necessary. Rather, such information should feed up from theemploying body based on existing records, such as payroll information etc. Responsibility for theprovision of employment information should reside with those organisations, principally thehealth boards, responsible for directly employing staff or funding their employment – as acondition of grant payment, voluntary bodies/agencies have a duty of accountability back to theState to provide the data necessary to manage national pay policy.Pending roll out of the necessary information technology systems, the Census will have toremain in place.94