“Significant improvements” are 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, a new report has found.
In the Financial Management and Internal Control follow-up report, Comptroller and Auditor General Lynn 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”.
Responding to the report, Health Minister Tom Binet agreed that “further efforts are required to improve efficiency” in financial management in Health.
But he added: “I think it should be noted that all of these recommendations have already been identified and are either being addressed or are in the process of being addressed.”
Deputy Binet pointed to the Financial Recovery Plan, launched in 2023, which he said had already delivered £12 million in savings and was on track to achieve £39 million by 2026.
“In addition, strong financial controls and a focus on value for money continue to remain central to ensuring the sustainability of our health system,” he said.
The Minister also praised the “considerable efforts” made by “hardworking staff” to improve efficiency in Health.
“I believe the report could have attracted more recognition for this,” he said.
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.”
