Audit report outlines fresh concerns about Health Department spending

CONCERNS about managing the cost of healthcare have been expressed by a financial watchdog just days after the Health Minister spelled out proposals to invest £350 million to tackle shortfalls in funding,

In an audit report, Comptroller and Auditor General Lynn Pamment said “significant improvements” were required in financial management and internal control at the Health Department in order to combat overspends in budget for each of the past five years.

As part of the audit, Ms Pamment criticised Health for not having a clinical strategy for delivery of acute services, in spite of this being recommended previously, and over the absence of a fully-documented workforce plan.

She said: “Without a strategy for acute services supported by a workforce plan it is difficult to assess the cost and budget requirements to deliver safe, high quality health and care services to Islanders.

The C&AG added that there was still “a significant body of work that is required within Health to develop and embed a strong internal control framework and a culture of compliance”.

Weaknesses identified in the report included the department’s delay in introducing a scheme for delegating financial decisions until February of this year, as well as more than 400 procurement breaches across 2023 and 2024. The same areas of weakness had been reported year on year, Ms Pamment noted.

The C&AG said the situation could improve, noting that “Health has adopted a more robust and evidence-based approach to budget planning for 2025 that builds on a number of the critical foundations I would expect to see in place”.

Spending in Health has been in the spotlight across the current political term, most recently earlier this month when Health Minister Tom Binet spelled out details of potential budget funding , including £220m towards infrastructure projects, including the regeneration of Fort Regent, and £130m for health measures and updating the department’s digital systems.

Politicians serving in Scrutiny roles subsequently expressed surprise that the details had been spelled out by Deputy Binet during a media interview.

The scope of the report stretched across all government departments, with Ms Pamment noting that the financial management and internal control framework had “improved significantly” since the introduction of the Public Finances (Jersey) Law 2019 and the Public Finances Manual.

In her concluding remarks on the follow-up audit, Ms Pamment said:

“The States of Jersey have taken action to improve financial management and the internal control framework since the publication of my predecessor’s report in 2019.

“Further work is required however to enhance the monitoring of expenditure, to improve compliance with the internal control framework and to deliver benefits from investment in IT systems.