Written Answers. - Health Services.
Gay Mitchell
Question:
205
Mr. G. Mitchell
asked the
Minister for Health and Children
the measures he has taken to ensure greater value for money and improvement in the audit process since his appointment as Minister for Health and Children.
[25500/01]
There is currently a wide range of structures in place to monitor and evaluate productivity throughout the health sector at both national and health board levels. These structures include a variety of mechanisms such as health strategies, programme expenditure reviews, service plans with performance indicators and audits by the Office of the Comptroller and Auditor General.
The delivery of health care services is under continuous review and evaluation through a variety of mechanisms by my Department. One such mechanism is the Casemix Programme. The Hospital In-Patient Enquiry, whereby public hospitals record and report on their activity levels, together with the specialty costs programme, form the basis for the Casemix programme which now operates in over 30 hospitals and continues to grow. The purpose of Casemix is to assist hospitals to define their products, measure their productivity, and assess quality. Services cannot be planned and managed without knowing who the customers are, what they want and what the cost of providing such services is. Casemix is one of the best management tools available for monitoring and evaluation of services.
The collection of relevant, accurate and timely information is critical to assessing productivity in the health sector. There is an ongoing development of information communications technology aimed at enhancing the delivery and cost effectiveness through integrated care processes. These developments are contributing to the efficiency of service provision and the provision of better management information to assist in the pursuit of further cost effectiveness. The national development plan provides for increased investment and development of these systems. In addition, my Department is currently preparing a national health information strategy.
In order to realise the full potential of the information being collected throughout the health sector, systems and processes need to be in place to ensure that it is utilised for planning and accountability purposes. Under the Health (Amendment) (No. 3) Act 1996, health boards are required to submit an annual service plan to my Department setting out the level of service that they will deliver for the financial determination they have received. The service planning discipline and structures now in place in health agencies and the ongoing developments in this area continue to enhance the delivery of health care services. Service plans are not just about financial accountability in the narrow sense but also provide an opportunity to show how we are progressing towards our goals.
Health is a very expensive commodity, and it is incumbent on my Department to ensure the best possible use of public funds in the pursuit of health and social gain. An important ingredient in health care costs is the materials and supplies which are required in the operation of the health care system. The Healthcare Materials Management Board was established to ensure that the strategies outlined in the report of the materials management advisory group are implemented in the most effective and practical manner. This structure aims to guide health agencies in adopting best practice in this area to ensure that value for money is being achieved in each agency and through the combined purchasing power of all the health agencies.
The Government decision of 25 March 1997, approved proposals for a process of expenditure reviews aimed at providing a systematic analysis of what is actually being achieved by expenditure in each programme and providing a basis on which more informed decisions can be made on priorities within and between expenditure programmes. Reviews of the intellectual disability programme, the dental treatment services scheme and the nursing home subvention expenditure scheme have been completed.
Since coming into office, you will be aware that I have initiated the development of the new National Health Strategy which is being informed by the Value for Money, VFM, audit of the health services. Following on from the Government's review of its Action Programme for the Millennium, consultants were appointed to carry out a comprehensive VFM audit of the health services. The consultants were asked to look back on the provision of health services over the past ten years so as to examine, among other things, trends in demand, resource inputs and outputs and differentials across health boards and hospitals over the last ten years.
A special report by the Comptroller and Auditor General on "Internal Audits in the Health Boards" was presented to Dáil Éireann in 2001. The report made recommendations on how the boards internal audit function should change. Arising from this report a review group was established by the chief executive officer's of the health boards-authority to address the issues raised by the report. This involved an Comptroller and Auditor General's examination of how the function of internal audits would be enhanced and to develop an outline structure, role, strategy and standards.
My Department has welcomed both reports and will actively promote continuing development and best standards in the area of internal audits.
The new Health Strategy is expected to be completed shortly. It will set out how we see the health services developing over the next seven to ten years. It will set out our new health goals and how we intend to pursue them. The strategy will have regard to the need for an effective and productive health care system that is truly people centred.
