In light of the many discussions advocating the use of pay-for-performance and performance budgeting, this paper argues that discouraging experience with both approaches should temper expectations that performance measurement can be a reform that will make health care systems more "sustainable" or even more efficient. The link between sustainability and efficiency is tenuous, and attention to performance is not new. Measurement's accuracy tends to be overstated and its costs understated or ignored. Nor does it easily lead to changed behaviour. Yet some measurement is useful for managing any complex activity. In particular, there are situations in which measures are more accurate and the proper responses to shortfalls are generally agreed. Policymakers should look for those conditions and encourage the more limited, targeted improvement that measures then can make possible.
{"title":"Can performance measurement make health care systems more sustainable? Or at least more efficient?","authors":"Joseph White","doi":"10.1787/2b3d3059-en","DOIUrl":"https://doi.org/10.1787/2b3d3059-en","url":null,"abstract":"In light of the many discussions advocating the use of pay-for-performance and performance budgeting, this paper argues that discouraging experience with both approaches should temper expectations that performance measurement can be a reform that will make health care systems more \"sustainable\" or even more efficient. The link between sustainability and efficiency is tenuous, and attention to performance is not new. Measurement's accuracy tends to be overstated and its costs understated or ignored. Nor does it easily lead to changed behaviour. Yet some measurement is useful for managing any complex activity. In particular, there are situations in which measures are more accurate and the proper responses to shortfalls are generally agreed. Policymakers should look for those conditions and encourage the more limited, targeted improvement that measures then can make possible.","PeriodicalId":115409,"journal":{"name":"Oecd Journal on Budgeting","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132764229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
C. James, Ivor Beazley, C. Penn, L. Philips, Shaun Dougherty
This article sheds light on the role of subnational governments in health systems across OECD countries. The views in this article show a move away from traditional measures of decentralisation, such as the share of subnational government expenditure of total expenditure, to measures capturing a range of responsibilities in the health sector. The data comes from the 2017 OECD Survey on Performance Measurement Systems in the Health Sector and Responsibilities across Levels of Government. The results show that despite health representing a large sector of subnational government expenditure, central governments still have considerable decision-making power. This power applies to key policy-making and budgeting decisions. JEL codes: H51, H75, I18 Key words: Decentralisation, subnational, health system
{"title":"Decentralisation in the health sector and responsibilities across levels of government","authors":"C. James, Ivor Beazley, C. Penn, L. Philips, Shaun Dougherty","doi":"10.1787/c2c2058c-en","DOIUrl":"https://doi.org/10.1787/c2c2058c-en","url":null,"abstract":"This article sheds light on the role of subnational governments in health systems across OECD countries. The views in this article show a move away from traditional measures of decentralisation, such as the share of subnational government expenditure of total expenditure, to measures capturing a range of responsibilities in the health sector. The data comes from the 2017 OECD Survey on Performance Measurement Systems in the Health Sector and Responsibilities across Levels of Government. The results show that despite health representing a large sector of subnational government expenditure, central governments still have considerable decision-making power. This power applies to key policy-making and budgeting decisions.\u0000JEL codes: H51, H75, I18\u0000Key words: Decentralisation, subnational, health system","PeriodicalId":115409,"journal":{"name":"Oecd Journal on Budgeting","volume":"307 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133671352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ivor Beazley, Shaun Dougherty, C. Penn, L. Philips, C. James
This article looks at the application of performance measurement systems in the health sector across OECD countries. The data comes from the 2017 OECD Survey on Performance Measurement Systems in the Health Sector and Responsibilities across Levels of Government. The results show that the majority of countries have national performance measurement systems in place, covering multiple aspects of the health system. Despite varying objectives, measurement systems are usually aimed at improving performance of the health system, rather than at containing costs.
{"title":"Performance measurement systems in the health sector and their budgetary implications","authors":"Ivor Beazley, Shaun Dougherty, C. Penn, L. Philips, C. James","doi":"10.1787/d94fd384-en","DOIUrl":"https://doi.org/10.1787/d94fd384-en","url":null,"abstract":"This article looks at the application of performance measurement systems in the health sector across OECD countries. The data comes from the 2017 OECD Survey on Performance Measurement Systems in the Health Sector and Responsibilities across Levels of Government. The results show that the majority of countries have national performance measurement systems in place, covering multiple aspects of the health system. Despite varying objectives, measurement systems are usually aimed at improving performance of the health system, rather than at containing costs.","PeriodicalId":115409,"journal":{"name":"Oecd Journal on Budgeting","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114929808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kazakhstan has put in place a well-structured legal and institutional framework for preparing Public Private Partnerships (PPPs) at both the national and regional levels. The government has prioritised PPPs as a delivery mode for both economic and social infrastructure. The central emphasis on PPPs had a strong impact at the regional level with a large number of relatively small projects signed in the past years. At the national level the impact has been modest mostly due to financing challenges. In terms of priority areas for reform, the report outlines capacity building (particularly during the project preparation phase), the need to promote quality over quantity of PPPs, strengthening the methods used to guide the choice of delivery mode, and transparency and accounting of contingent liabilities
{"title":"Public Private Partnerships Review of Kazakhstan","authors":"A. Rivadeneira, J. Garin","doi":"10.1787/F7696C94-EN","DOIUrl":"https://doi.org/10.1787/F7696C94-EN","url":null,"abstract":"Kazakhstan has put in place a well-structured legal and institutional framework for preparing Public Private Partnerships (PPPs) at both the national and regional levels. The government has prioritised PPPs as a delivery mode for both economic and social infrastructure. The central emphasis on PPPs had a strong impact at the regional level with a large number of relatively small projects signed in the past years. At the national level the impact has been modest mostly due to financing challenges. In terms of priority areas for reform, the report outlines capacity building (particularly during the project preparation phase), the need to promote quality over quantity of PPPs, strengthening the methods used to guide the choice of delivery mode, and transparency and accounting of contingent liabilities","PeriodicalId":115409,"journal":{"name":"Oecd Journal on Budgeting","volume":"2014 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132512577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Budgeting in Greece","authors":"Delphine Moretti","doi":"10.1787/2F5E7D7A-EN","DOIUrl":"https://doi.org/10.1787/2F5E7D7A-EN","url":null,"abstract":"","PeriodicalId":115409,"journal":{"name":"Oecd Journal on Budgeting","volume":"34 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132526325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This case study represents the first in a planned series of studies on the ‘The Role of Evidence Informed Policy Making in Delivering in Performance’. The case study is based on both interviews with key stakeholders and desk research. It focuses on the social investment approach in New Zealand, which is an evolving approach to thinking long-term and making informed choices on how best to improve people’s wellbeing. Social investment brings together different tools and approaches to good governance, building on the respective strengths of performance management and evidence informed policy making. At its core, social investment involves using data and evidence to understand customer needs from a person centric and long-term perspective, proposing innovative solutions that meet citizens’ needs and deliver financial savings, evaluating programmes to identify what works and what doesn’t, and publishing these results openly and feeding findings into the next set of decisions. The case study concludes with a number of recommendations for improving the social investment approach in New Zealand. These recommendations are also relevant to other jurisdictions trying to strengthen the capacity for evidence informed policy making.
{"title":"The Role of Evidence Informed Policy Making in Delivering on Performance: Social Investment in New Zealand","authors":"D. Acquah, Katazyna Lisek, S. Jacobzone","doi":"10.1787/74FA8447-EN","DOIUrl":"https://doi.org/10.1787/74FA8447-EN","url":null,"abstract":"This case study represents the first in a planned series of studies on the ‘The Role of Evidence Informed Policy Making in Delivering in Performance’. The case study is based on both interviews with key stakeholders and desk research. It focuses on the social investment approach in New Zealand, which is an evolving approach to thinking long-term and making informed choices on how best to improve people’s wellbeing. Social investment brings together different tools and approaches to good governance, building on the respective strengths of performance management and evidence informed policy making. At its core, social investment involves using data and evidence to understand customer needs from a person centric and long-term perspective, proposing innovative solutions that meet citizens’ needs and deliver financial savings, evaluating programmes to identify what works and what doesn’t, and publishing these results openly and feeding findings into the next set of decisions. The case study concludes with a number of recommendations for improving the social investment approach in New Zealand. These recommendations are also relevant to other jurisdictions trying to strengthen the capacity for evidence informed policy making.","PeriodicalId":115409,"journal":{"name":"Oecd Journal on Budgeting","volume":"59 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127084943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Delphine Moretti, Scherie Nicol, Emeline Denis, Tim Youngberry
The OECD Review of Financial Reporting in Ireland assesses opportunities and challenges associated with adopting accruals in Ireland for government accounting. Due to issues with the comprehensiveness and legibility of the current financial reports, the Review recommends that going forward, the Irish Government establish accrual financial statements compliant with international standards for its departments and offices and harmonise accounting standards used by entities within the general government sector. The report notes that accrual data would be a “building block” for richer, more reliable fiscal information, which would, in turn, help formulate improved assumptions for fiscal forecasts and be better equipped to identify fiscal risks. Beyond the adoption of accrual accounting, this report proposes that the Irish Government considers modernising its financial reporting framework by preparing integrated reports for departments and offices and consolidated financial statements. Integrated accounts for departments and offices would provide an overview of each department’s resources and spending alongside information on their strategy and performance. This would enhance and improve scrutiny and examination of departmental performance by the Committee of Public Accounts and by the Oireachtas Sectoral Committees.
{"title":"Financial reporting in Ireland","authors":"Delphine Moretti, Scherie Nicol, Emeline Denis, Tim Youngberry","doi":"10.1787/EA5CAE13-EN","DOIUrl":"https://doi.org/10.1787/EA5CAE13-EN","url":null,"abstract":"The OECD Review of Financial Reporting in Ireland assesses opportunities and challenges associated with adopting accruals in Ireland for government accounting. Due to issues with the comprehensiveness and legibility of the current financial reports, the Review recommends that going forward, the Irish Government establish accrual financial statements compliant with international standards for its departments and offices and harmonise accounting standards used by entities within the general government sector. The report notes that accrual data would be a “building block” for richer, more reliable fiscal information, which would, in turn, help formulate improved assumptions for fiscal forecasts and be better equipped to identify fiscal risks. Beyond the adoption of accrual accounting, this report proposes that the Irish Government considers modernising its financial reporting framework by preparing integrated reports for departments and offices and consolidated financial statements. Integrated accounts for departments and offices would provide an overview of each department’s resources and spending alongside information on their strategy and performance. This would enhance and improve scrutiny and examination of departmental performance by the Committee of Public Accounts and by the Oireachtas Sectoral Committees.","PeriodicalId":115409,"journal":{"name":"Oecd Journal on Budgeting","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134097323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Uruguay is the only country in the world which has a five-year budget. A budget is prepared by each new government taking office and voted within 6 months of its swearing in, for the whole five-year government term. Each year, an annual revision (“budget update”) takes place, where the government reports budget implementation to the Parliament and some adjustments to the coming year’s budget can be made. Uruguay has done significant improvements in budget management in the last decade since 2005, achieving great results in terms of financial stability and funding predictability for spending institutions. The governance of the budget process has shifted, with the leadership for the budget process being now in the National Budget Unit and the Macroeconomic Assessment Unit (both located in the Ministry of Economy and Finance), and the Office of Planning and Budget (located in the Presidency) developing planning functions. While the new roles and responsibilities seem quite clear today, they are not yet institutionalised. This budget review aims to provide a detailed description of how Uruguay’s budget institutions work today and present roles and responsibilities of each actor in the budget process. It also analyses Uruguay’s budget practices in the light of OECD countries best practices, and proposes policy recommendations for further modernising Uruguay’s budget process, in particular in the areas of aligning the budget with medium-term strategic planning and measuring results. EL codes: H50, H61, H80 Keywords: Uruguay, Five-year budget, Budget process, Strategic planning
{"title":"Budgeting in Uruguay Towards modern budgeting practices in Uruguay","authors":"Camila Vammalle, A. Rivadeneira","doi":"10.1787/4FF4BFCE-EN","DOIUrl":"https://doi.org/10.1787/4FF4BFCE-EN","url":null,"abstract":"Uruguay is the only country in the world which has a five-year budget. A budget is prepared by each new government taking office and voted within 6 months of its swearing in, for the whole five-year government term. Each year, an annual revision (“budget update”) takes place, where the government reports budget implementation to the Parliament and some adjustments to the coming year’s budget can be made. Uruguay has done significant improvements in budget management in the last decade since 2005, achieving great results in terms of financial stability and funding predictability for spending institutions. The governance of the budget process has shifted, with the leadership for the budget process being now in the National Budget Unit and the Macroeconomic Assessment Unit (both located in the Ministry of Economy and Finance), and the Office of Planning and Budget (located in the Presidency) developing planning functions. While the new roles and responsibilities seem quite clear today, they are not yet institutionalised. This budget review aims to provide a detailed description of how Uruguay’s budget institutions work today and present roles and responsibilities of each actor in the budget process. It also analyses Uruguay’s budget practices in the light of OECD countries best practices, and proposes policy recommendations for further modernising Uruguay’s budget process, in particular in the areas of aligning the budget with medium-term strategic planning and measuring results.\u0000EL codes: H50, H61, H80\u0000Keywords: Uruguay, Five-year budget, Budget process, Strategic planning","PeriodicalId":115409,"journal":{"name":"Oecd Journal on Budgeting","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127031178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This paper aims to study the distribution of fiscal power between the legislature and the executive in each of the 70 countries analysed - by comparing Legislative Budget Institutions of 70 countries. This paper also provide practical insights for developing financial strategies that would ensure an appropriate distribution of fiscal authority between the legislature and the executive.
{"title":"Who has power over the budget-The Legislature or the Executive?","authors":"Chunsoon Kim","doi":"10.1787/EFC0708A-EN","DOIUrl":"https://doi.org/10.1787/EFC0708A-EN","url":null,"abstract":"This paper aims to study the distribution of fiscal power between the legislature and the executive in each of the 70 countries analysed - by comparing Legislative Budget Institutions of 70 countries. This paper also provide practical insights for developing financial strategies that would ensure an appropriate distribution of fiscal authority between the legislature and the executive.","PeriodicalId":115409,"journal":{"name":"Oecd Journal on Budgeting","volume":"49 3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124206951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Financial management is a critical capability for governments, enabling them to deliver on their priorities and fulfil promises made to parliament and citizens. Skilled human resources are the foundation of these capabilities. The Organisation for Economic Cooperation and Development’s (OECD) “Skills for a high performing civil service” framework identifies professional expertise as one of the three core skill areas that drive public value, together with strategic orientation and innovation. The task of providing the civil service with the right skills to carry out financial management functions has however become more challenging.
{"title":"Financial Management in Government: Insights on Skills Development","authors":"Ivor Beazley","doi":"10.1787/52185BF3-EN","DOIUrl":"https://doi.org/10.1787/52185BF3-EN","url":null,"abstract":"Financial management is a critical capability for governments, enabling them to deliver on their priorities and fulfil promises made to parliament and citizens. Skilled human resources are the foundation of these capabilities. The Organisation for Economic Cooperation and Development’s (OECD) “Skills for a high performing civil service” framework identifies professional expertise as one of the three core skill areas that drive public value, together with strategic orientation and innovation. The task of providing the civil service with the right skills to carry out financial management functions has however become more challenging.","PeriodicalId":115409,"journal":{"name":"Oecd Journal on Budgeting","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128851324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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