1. © IPA 2011 Governance Challenges in Healthcare Aidan Horan Institute of Public Administration 2 nd June 2011

2. © IPA 2011 Key Message Good Public / Stakeholder Engagement Good Governance Good Management & Performance Good Stewardship Good Outcomes It is a pre-requisite for legitimacy, credibility, reputation and authority

3. © IPA 2011 Good Governance Standard Informed, transparent decisions and managing risk Organisation’s purpose and on outcomes Performing effectively in clearly defined functions and roles Promoting values… behaviour Capacity and capability of the governing body Engaging stakeholders and making accountability real 1 2 3 4 5 6 6 Core Principles

4. © IPA 2011 The Commission agreed that the vision or framework around which the Irish health system should be based is as follows: Knowledgeable patients receiving safe and effective care from skilled professionals in appropriate environments with assessed outcomes The values underpinning this framework include openness, patient centredness, learning, effectiveness and efficiency, good governance, leadership, evidence- based practice, accountability and patient/family involvement.

5. © IPA 2011 What’s high profile in Governance? Expectations of Public / State Bodies –Programme for Government –C&AG Getting the Balance –Conformance/Performance Governance Guidelines - Codes Hard Law – Soft Law Assessing Corporate Governance Rules / Regulations – Values / Principles

6. © IPA 2011 Code of Practice for the Governance of State Bodies The Code of Practice provides a framework for the application of best practice in corporate governance Implications for all publicly funded, state and public benefit bodies State Bodies are to confirm to the relevant Minister that they comply with the requirements of the Code

7. © IPA 2011 International Federation of Accountants (2009) Evaluating and improving governance in organisations

8. © IPA 2011 Code of Practice for the Governance of State Bodies The Board and Directors (Section 2-6) Remuneration (Section 7) Risk Management, Accountability, Audit (Section 8-10) Relations with Oireachtas & the Minister (Section 11-13) Specific Procedures (Section 14-20) procurement, travel, tax, compliance, etc. Code of Practice for the Governance of State Bodies

9. © IPA 2011 It is important to acknowledge that despite our best efforts, medicine will never be a risk free enterprise. What we must do in our efforts to make the system as safe as possible for patients and staff is to ensure that we have the right checks and balances in place

10. © IPA 2011 Risk Appetite is defined as the amount of risk the organisation is prepared to accept or retain in the pursuit of its core priority objectives. What is the Risk Appetite within your organisation and does this have implications for governance?

11. © IPA 2011 Ensuring Good Governance Requires clarity Clarity of expectations Clarity of roles and responsibilities Clarity of performance obligations Effective Accountability Standards / Norms Values / Culture

12. © IPA 2011 www.ipa.ie / www.governance.ie  + 353 1 2403600  Institute of Public Administration © 57-61 Lansdowne Road, Dublin 4. 