Summary of Findings (1) i. Generation, management ii. Other - PowerPoint PPT Presentation

Summary of Findings (1) i. Generation, management ii. Other policy documents include MOH’s Auditing, Treasury and and utilization of internal Financial (ATF) instructions issued funds are anchored several in August 2009 and MOFEP’s pieces of legislation notably directives on igf generation and • Articles 174 & 179 of the 1992 utilization contained in various Republican Constitution of budget guidelines Ghana • iii. The sector does not comply fully MDA (Retention) of Funds Act, Act 753 of 2007 with Part III of the FAA • Fees and Charges particularly in the areas of Miscellaneous Provisions Act, • Classification of igf generated Act 793 • Preparation of annual • Fees and Charges (Amendment) estimates for each class of Instrument of 2011; LI 1986 non-tax revenue and • Part III of the Financial • Disclosure Administration Act, Act 654 of 2003 iv. Most health facilities, agencies • Part II of the Financial and departments that generate Administration Regulation of internal funds do not comply with 2004 Part II, Regulations 18, 19 & 20 of • Non-tax Revenue Act FAR

Summary of Findings (2) v. Trend analysis shows positive ix. As to how igf is utilized, an annual average of 6.3% is paid as personal increases in igf generation and emolument; 25.4% administrative collection over the study period. expenses; 55.9% for service IGF generation grew at 34.5% in expenditure and 4.2% for investment 2008/9 and 35.3% in 2009/10. expenditure. vi. The share of igf from services x. Teaching hospitals and statutory contributed more to health regulatory bodies (SRB) tend to spend facilities than those from drugs. more on service delivery while GHS, Psychiatric hospitals and Health training vii. Throughout the period, insurance institutions expend more on claims contributed a minimum of administration. CHAG tends to spend 58% of igf generation compared on investment activities. with 42% from out of pocket xi. Debt stock is accumulated from various payments (cash). sources namely viii. At the institutional level, district • Tax arrears hospitals contributed 45.1% of the • Credit purchases from the sector’s igf; teaching hospitals medical stores 22.4%; regional hospitals 12.7%; • Credit purchases from various polyclinics & health centres 11.5% suppliers and service and health training institutions providers 5.4%.

Summary of Findings (3) x. On average, the debt stock xv. IGF generated by Teaching constituted 6% of Teaching hospitals, GHS and Psychiatric hospitals are Hospitals’ IGF; 8.3% of GHS’ run adequate to cover their respective health facilities; 4.1% of CHAG’s expenditures excluding staff cost which is facilities; 6.3% of SRBs’ internal covered by Government. The annual average expenditure/IGF ratios were 83.5%, 49.1% and funds and 165.8% of Psychiatric 57.9% respectively. Hospitals xvi. The following agencies CHAG, xi. Psychiatric hospitals increased SRBs and Health training institutions do not their debt burden by 42.6% in generate sufficient igf to cover their respective 2008/9 and 44.6% in 2009/10. expenditures in 2008 and 2009. xii. Debt stock of GHS’ facilities grew xvii. The annual proportion of at the rate of 10.1% in 2008/9 and their expenditure to IGF averaged 120.7%, 26.5% in 2009/10. 102.4% and 106.3% respectively for those two years. xiii. With regard to reimbursement of xviii. CHAG and SRBs had since outstanding igf claims, an average 2010 reversed this trend with their respective of 77.9% of claims made by expenditure to IGF declining to 87.3% and Teaching hospitals were 86.9%. reimbursed compared with 70.8% of GHS’ facilities. xiv. Reimbursed claims of Teaching hospitals declined from 93.9% in 2008 to 72.4% in 2010 while those of the GHS witnessed consistent decline from 82% (2008) to 55.5% (2010).

Recommendations and Policy Issues i. All agencies, departments and units iv. Write off the debts of the Psychiatric that generate internal funds should be hospitals made to comply with Part II, Regulation v. MOH should provide general 18 of FAR 2009 which states that guidance on the effective and “A department that has legislative efficient usage of internally approval to retain all or a portion of internally generated funds generated funds particularly the collected, must first lodge the utilization at the sub-itemized levels. retained internally generated vi. Heads of facilities and institutions as funds in gross into the chief spending officers and vote Department’s operational bank controllers should be held personally account designated by the responsible for non-compliance and Controller & Accountant General misapplication of internally before disbursements are made” generated funds. ii. The sector should develop, in the shortest possible time, an operational guideline bringing together all the pieces of legislation and policies guiding generation, management and utilization of internal funds. iii. Create a reliable electronic database to serve MOH and its agencies