IMPROVING LEADERSHIP AND GOVERNANCE IN THE HEALTH SYSTEM

IMPROVING CORPORATE GOVERNANCE THROUGH EFFECTIVE INTERNAL ADMINISTRATIVE CONTROLS BY: MR. GODWIN PONGO DEPUTY DIRECTOR (ADMIN.)

PRESENTATION OUTLINEDefinition of Corporate Governance

Principles Underlying Corporate Governance

Internal Controls defined

Mission of HASS vrs Internal Controls

Thematic areas under HASS and its internal control systems

CORPORATE GOVERNANCE DEFINEDSet of systems, principles and processes by which an organisation is directed or controlled.The structure provides the guidelines as to how the company can be directed or controlled such that it can fulfill its mandate/ goals and objectives in a manner that adds to the value of the company.Principles Underlying Corporate GovernanceCorporate governance (CG)is based on principles of integrity and fairness, transparency with regards to all transactions, making all the necessary disclosures, complying with all laws of the land, being accountable and responsible towards the stakeholders and commitment to conducting business in an ethical manner.INTERNAL CONTROLS (IC) IN CORPORATE GOVERNANCEInternal Controls defined: They are a set of instructions, guidelines, policies, procedures, practices, rules and regulations designed to implement a system of checks and balances within an organization

Internal Controls (ICs) Cont.They are vital parts of corporate governance as they can reduce, minimize or eliminate opportunity for theft fraud, corruption, mishandling of assets , collusion, operating losses of technology, failure, negligence, carelessness, legal fines etcControls ensure that we are focused and work towards the achievement of the organisational goals/mandateMission of HASSTo provide effective and efficient administrative and support services in the areas of Transport, Health Estate, Clinical Engineering, Procurement, Stores and Supplies, Human Resource and General Administration to promote health service delivery.

Mission of HASS vrs Internal Controls [I.Cs]The attainment of the mission of HASS shall be a mirage if internal controls are not employed in the pursuit of our functions, under all the thematic areas namely; Human Resource, General Administration, Estate, Stores and Supply, Clinical Engineering, Procurement and Transport.GENERAL ADMINISTRATION/ICsRegistry Practices [Mgt of Correspondence]: The following internal control systems must be operated at the Registry:

Letters Receipt Register: all incoming official letters must be date-stamped and recorded into this Register. Internal Controls at the Registry cont.Letters Dispatched Register; all outgoing official letters must be recorded in this ledger, indicating the date and time of dispatch among others.Messenger Receipt Book; for dispatching critical/controversial letters ; e.g queries, legal or contentious letters.All correspondences must be placed on appropriate files and the files must be under lock and key. Internal Controls at the Registry cont.The titles [names] and numbers of all Files must be recorded in a File Index Book for easy location and retrieval of files from the storage device.Copies of all outgoing letters must be placed in a Float File for easy reference and monitoring.Registry Practices/Internal ControlsOfficial Stamp of Head of BMC must be handled by a responsible officer and must always be under lock and key.Signing of official documents: All document meant for the signature of the Head of BMC should be scrutinized critically with respect to : date, time, figures, words, grammatical construction before being signed.All Attachments should be equally signed or initialed to avoid a possible replacement/short-changing

Reception & Telephone Exchange/ICsVisitors Logbook/registerTelephone Exchange Room must always be under lock and keyLedger for recording all outgoing callsRegular training of Receptionists/ Telephonists on use of telephone equipmentHuman Resource Management/I.CsKeeping and enforcing the patronage of Staff Attendance Registers to help monitor punctuality and regularity of staff to work.Keeping and encouraging the use of Accident/Incident Logbook at all units.Officers proceeding on leave [all kinds of leave] must sign the Leave Ledger on departure and upon resumption from leave.

HR Management/I.CsOfficers proceeding on approved Leave of Absence, Annual Leave, compulsory/voluntary retirement, Study Leave with/without pay must hand over properly to an authorized person.Handing over-[staff running shift] .

All newly appointed staff should be given proper orientation about the Service, its Structural Arrangements, Culture, Values, Code of Conduct, Rewards and Motivational Schemes, etc.

HR Management/I.CsRegular Staff Durbars should be organized by Management to interact with, and explain policies to staffContinuous and persistent interpretation and explanation of all policies on HR [ Appts, Promotions, Postings etc] to staffCreation and maintenance of an accurate regular database [both manual and electronic] on staff to guide in effective HR management decision making

HR Management/I.CsOrganizing periodic capacity building workshops for all staffProper documentation of all matters relating to staff [e.g disciplinary actions, commendations etc]Keeping and utilization of Performance Monitoring Logbook on all staff

Supply Chain Mgt./I.CsQuality health service delivery can never be achieved without the availability of the required medicines, non-medicine consumable and other logistics at the service delivery points. This must be done prudently to eliminate wastage from the system. There must therefore be internal controls at all levels of service delivery to ensure cost efficiency.Supply Chain Mgt/I.CsThere must be a functional Procurement Committee at all service delivery pointsAll stakeholders in the procurement cycle must be involved in the process.Procurement decisions must be properly documented, signed and filedThere must be an approved procurement plan; and this must guide all procurements at the BMC

Supply Chain Mgt/I.CsProcurement function should be separated from storage , distribution and payment [ e.g storekeeper must not double as procurement officer].Regular stocktaking to be encouraged[ statutory requirement, reconcile issues against deliveries, damage/expiry items identified]Inspection of materials after procurement and inspection reports issued before payment

Supply Chain Mgt/I.CsThere must be properly signed requisitions by the designated authorised officers before items are issued from stores.All stores must have unserviceable items ledger to register all unserviceable items.Regular unannounced supervisory visits to the stores are highly encouraged.

Transport, Estate & Equipment Mgt. /Internal ControlsPlanned Preventive Maintenance [PPM]; key to the sustainability of the Services infrastructure [transport,all equipment,buildings,plants etc] for uninterrupted service delivery.All works /repairs must be requested for and authorized by the appropriate officer.Servicing agreements to be entered into where local/in-house capacity is not available.

Transport, Estate & Equipment Mgt. /Internal ControlsVehicle Request Form must always be used.Unauthorised persons must not drive nor use the Services vehicles.Unserviceable items disposal certificate to be signed after disposal by the Head of BMC preferably.Coding/Embossment of assets and properties[private properties not to be mingled with the Services property]

Transport, Estate & Equipment Mgt. /Internal ControlsWorks completion certificate must always be the authority for payment.Adherence to policies and procedures regarding staff accommodation[formal allocation,rent,responsibilities etc.All unserviceable items declared must be properly documented and sent to the stores for safe keeping.Disposal of unserviceable/expired items should follow laid down procedures with all the necessary checks and balances.[involvement of relevant agencies ].

Other Managerial and Admin. Internal Controls [ICs]Statutory/Operational Committees must be operational at every BMC i.e. District/Hospital Management Committee, Disciplinary Committee, Procurement and Material Inspection Committees, QAC, DTC etc. Minutes of meetings of the Committees should be produced signed and properly filed.Organisational structure indicating reporting/communication relationships should be clearly displayed and respected to ensure discipline and orderly behaviour. [Anything short of this would not promote good governance]

Other Managerial and Admin. Internal Controls [ICs]Open Days: A very good platform to interact with the public/stakeholders to showcase achievements, challenges, operational procedures, etc.

ConclusionIn conclusion internal control systems should be effectively employed to reduce waste, fraud, corruption and ultimately improve governance. For us, as a Service to achieve our ultimate goal of providing quality health care, good corporate governance practices must be visible in all health facilities. Effective and efficient Internal Control systems are therefore indispensable in the attainment of organisational goals.

THANK YOU FOR YOUR ATTENTION