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The Directorate of Health must strengthen the activity management

There are weaknesses in the Directorate of Health's management of professional activities and how it applies its own resources. - The Directorate's internal control and follow-up and the Ministry's general management of the Directorate must be improved, says Auditor General Jørgen Kosmo.
Published 11/19/2013 11:05 AM

Document 3:3 (2013–2014) The OAG's investigation of efficiency and goal attainment in the Norwegian Directorate of Health was submitted to the Storting on 19 November 2013.

The investigation shows that there are weaknesses in how the Directorate of Health manages its activities. For example, there are deficiencies in the Directorate's information about its own activities e.g. in relation to what the Directorate's resources are used for. The investigation also reveals that the Directorate lacks a unified approach to internal control, and that internal work processes are rarely evaluated, mapped and systemised.

Lowered quality

The deficiencies in the management of the activities lowers the quality of the professional capacity and the efficiency of how the Directorate of Health solves its tasks. The investigation shows that the processing of inquiries relating to legal interpretation takes a long time, and that the Directorate does not use the reporting from the recipients of the funding to evaluate the organisation and results of the funding schemes, and that the Directorate does not work in a sufficiently systematic manner to contribute to ensuring awareness and use of guidelines and manuals in the health and care services sector. The investigation also shows that the Directorate of Health's work on national plans rarely takes advantage of the lessons learned.

- With more systematic work and clearer follow-up from the management, the Directorate of Health could achieve better results from its expertise, says Kosmo.

Too extensive

Every year, the Ministry of Health and Care Services assigns a very extensive mission to the Directorate of Health. The large volume of objectives, assignments and activity requirements is concentrated around the Directorate's role as an implementer of adopted policies. This creates an imbalance between this role and the Directorate's two other roles, as a specialist agency and administrative body.

- The fact that the Directorate of Health must perform assignments and activities ordered by the Ministry to this great extent monopolises too much of the Directorate's overall resources. The Ministry must take a larger role in governing the Directorate in accordance with the principles for sound target and performance management, says Kosmo.

Calling for measures

In the response to the OAG, the Minister of Health and Care Services writes that the Directorate of Health has worked for some time to develop the management of its activities in several areas. The Ministry of Health and Care Services will ask the agency to present measures designed to further develop its management systems and thus provide good overview and control of the agency's overall activities.

Both the Ministry and the Directorate consider the OAG's comments and recommendations to be constructive as regards the Directorate's activities in relation to legal interpretation, management of funding and work on guidelines and manuals, as well as the follow-up of national plans. The Ministry will ask the Directorate to present an action plan for how to follow up the comments from the OAG. The Ministry will, together with the Directorate, evaluate how the agency management can facilitate a better balance between the Directorate's three roles.

You can download the document through the link to the right.

Public institutions can order the document from the Government Administration Services, tel. (+47) 22 24 20 00, Others can order it from Fagbokforlaget AS, tel. (+47) 55 38 66 00,

The deferral of public access to documents prepared by or for the Office of the Auditor General in connection with Document 3:3 (2013-2014), cf. the Act relating to the Office of the Auditor General section 18 second paragraph, is hereby set aside.

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Director General Therese Johnsen, tel +47 22 24 11 74/+ 47 911 52 826

Riksrevisjonen, Storgata 16, P.O. Box 8130 Dep, 0032 Oslo, Norway

Phone: +47 22 24 10 00 974 760 843