Dáil Éireann Debate, Tuesday - 18 October 2016
562. Deputy Bernard J. Durkan asked the Minister for Health the extent to which his Department monitors expenditure throughout the various structures of the health service with particular reference to the need to identify areas incurring over-expenditure habitually; the action taken to date to address this issue; and if he will make a statement on the matter. [30981/16]
Amharc ar fhreagraMy Department’s Financial Performance Unit is responsible for monitoring and review of health service expenditure.
As part of the service planning process, the HSE prepares an annual budget for each service area, broken down into a monthly profile.
On a monthly basis the HSE reports, by service area, actual spend to date, profile and any variance, along with a commentary. For some areas, further analysis is provided (e.g. PCRS). These reports are examined and variations or trends are discussed with financial colleagues in the HSE.
In addition, my Department has a monthly meeting with senior HSE staff to review ongoing performance issues and the effective implementation of remedial actions.
The HSE’s Performance and Accountability Framework makes explicit the responsibilities of managers in relation to the four equally important domains of the Balanced Scorecard which are Access to services, the Quality and Safety of those Services, doing this within the Financial Resources available and by effectively harnessing the efforts of the Workforce.
A key change which has been made under the enhanced and strengthened Performance and Accountability Framework is the move towards the more visible exercising of personal responsibility and accountability at the primary service delivery unit level. Health service managers, designated as accountable officers, are explicitly and personally accountable for performing within their budgetary allocation. Accountable officers are named for each Hospital Group and Community Health Organisation and for the National Ambulance Service, Primary Care Reimbursement Service and Nursing Home Support Scheme.
The HSE has allocated maximum expenditure levels at this level and accountable officers are now fully responsible and accountable for managing the performance of services within their allocated budget. To facilitate this, the accountable officer is responsible for preparing a financial plan in line with their Performance Agreement with the National Director setting out the actions they will take to meet the agreed performance targets across the four domains of Access, Quality & Safety, Finance and Human Resources, within the financial allocation. This plan is required to be signed off by both the accountable officer and HSE senior management.
Commitment to the plan and associated targets and actions is formalised as part of the individual’s personal targets under their individual Performance Agreement. The sign-off of the plan includes clarity on the process of support, intervention and sanction, with specific reference to the sanctions that may be imposed where a situation of inadequate performance is not rectified.
The revised framework provides for public reporting of services which are the subject of escalation and, in particular, the named accountable officers whose services are the subject of escalation. In addition and as appropriate, senior HSE managers may be required to attend relevant Oireachtas Committees to account for service delivery, quality and financial performance issues.
