General Report on the Health and Social Care Sector by the Comptroller and Auditor General for Northern Ireland - 2009
The health and social care (HSC) sector in Northern Ireland spends more than £4 billion each year. Today Kieran Donnelly, Comptroller and Auditor General (C&AG) produced a report which focuses on the results of the 2008-09 financial audits of HSC bodies in Northern Ireland. It highlights a number of successes:
- the sector’s performance has undergone a step change improvement in recent years. On measures such as waiting times, prevention of and mortality from heart disease and cancer, the HSC sector is delivering a markedly better service than five years ago;
- financial stability was maintained, although this was coming under increasing pressure; and
- with revised structures under the Review of Public Administration (RPA), new pay regimes for health and social care professionals and staff and a considerable capital investment in the health estate, the building blocks for making and sustaining further progress were being established.
The report identifies several testing issues for the future:
- the response to swine ‘flu, and the need to hold back funding to balance forecast deficits in HSC trusts, could impact upon progress to date. For example, a range of service developments were necessarily delayed in the short term;
- further progress in reducing waiting times in Accident and Emergency and incidences of healthcare related infections is necessary; and
- continuing to embed good governance will require sustained efforts across the sector.
Realising the benefits of major change programmes of recent years is an important challenge. Progress has been achieved, undoubtedly, but direct evidence of the contribution to this made by, for example, RPA and the Agenda for Change is limited at this time. The Department of Health, Social Services and Public Safety (DHSSPS) has established plans to evaluate the benefits of these initiatives. The results are likely to have much to say to inform the major change process elsewhere in the public sector.
The report also highlights the need for improvements in some activities within the health and social care sector:
- learning the lessons from several IT projects, together costing more than £15 million, which have not, to date, delivered all of the benefits that were anticipated; and
- improving trusts’ management of the £41 million charitable funds donated to them by the public; and
- controlling nearly £21 million of money and property held by trusts on behalf of patients and residents. The patients’ and residents’ monies accounts of the Belfast Health and Social Care Trust were qualified in 2007-08 and 2008-09 due to weak controls and procedures.
- The report discusses the C&AG’s qualified opinions on the 2008-09 accounts of other HSC bodies.