Dáil Éireann Debate, Tuesday - 15 June 2004
406 Mr. J. Bruton asked the Minister for Health and Children if his Department has achieved the target, set out in the initiation of the expenditure review initiative in 1997, that all Government expenditure be subject to a formal review under that initiative every three years; and if not, the areas of expenditure in respect of which the three-yearly review has not taken place. [17579/04]
View answer407 Mr. J. Bruton asked the Minister for Health and Children the areas of expenditure of his Department in respect of which an expenditure review under the expenditure review initiative has not yet been completed and published. [17594/04]
View answerI propose to take Questions Nos. 406 and 407 together.
As the Deputy will be aware, the initial target of the expenditure review initiative, or ERI, was to review all expenditure programmes over a three-year period. However, a review of the process by the Department of Finance, and the expenditure review central steering committee, or ERCSC, in 2000-01 found that the target had been over-ambitious and that a more focused approach to the selection of review topics was required. That view was supported by a Comptroller and Auditor General value-for-money study of the ERI in 2001, which proposed that a more realistic target should be set that took into account the level of evaluative capacity in Departments generally.
In June 2001, the Government decided, inter alia, that the Department of Finance and individual Departments and offices should compile and agree a work plan of review topics based on specific selection criteria, i.e. that programmes selected for review should reflect Government priorities or strategic result areas, involve significant levels of expenditure, etc. Subsequently, in May 2002, the Government approved a schedule of expenditure review topics proposed for the first year of the next three-year planning horizon, 2002-04, and noted the topics proposed for 2003 and 2004. In April 2003, the ERCSC asked Departments and offices to update their expenditure review plans, again in consultation with the Department of Finance. The committee emphasised the Government’s selection criteria and advised that Departments and offices should select a small number of programmes or areas involving major policy issues or significant levels of expenditure. On foot of that process, revised expenditure review plans were drawn up by Departments and offices.
In the case of the Department of Health and Children, it was agreed with the Department of Finance that, in the circumstances of the health reform programme and the demands associated with its implementation, further expenditure reviews under the expenditure review initiative, or ERI, would not be initiated until 2005. However, under the Department's business plan policy review is an ongoing process. Reviews currently under way include: a strategic review of disability services; the work of the expert group on mental health services; consultant contract negotiations, which include a review of consultant provided services; an analysis by the acute hospitals review group of acute hospital services as part of preparing a national hospitals plan; and joint evaluation and review of service plan templates with the Health Board Executive.
In the context of the programme of expenditure reviews for 2002, the issue of an expenditure review of the general medical services scheme was raised. My Department agreed with the Department of Finance that the review of governance and accountability mechanisms in the GMS schemes being undertaken by Deloitte and Touche fulfilled the criteria of an expenditure review.
The Deloitte and Touche consultancy review of governance and accountability mechanisms in the GMS schemes was received, in draft form, by my Department in February 2003. While the review was being considered by officials in my Department, both the Commission on Financial Management and Control Systems in the Health Service, or Brennan, and the audit of structures and functions in the health system, or Prospectus, reports were published. Since the contents and recommendations of both reports are relevant to the subject matter of the GMS review, my Department requested Deloitte and Touche to update the draft in that light, also having regard to the latest financial data from the General Medical Services Payments Board. The final draft of that review has been received by my Department. It is my intention to bring that review to Government as soon as possible, at which time its publication and implementation will be discussed.
