The purpose of the Office of the Auditor General’s investigation of the escalation plan for 1999 to 2006 (Document 3:5 (2002–2003)), which was submitted to the Storting on 8 November 2002, was to investigate the quality of the county-municipal plans and the Ministry’s facilitation and follow-up of the plans. The plans were to form the foundation for the expansion of the mental health service, both before and after the regional health enterprises took over responsibility for the specialist health services. The audit was delimited to adult mental health care and the development of the District Psychiatric Centres (DPS).
The Office of the Auditor General’s investigation revealed that the Ministry of Health and Social Affairs was not clear enough in communicating to the county municipalities its requirements regarding the plans before the planning was started. Nor did the Ministry lay down any constraints concerning how needs were to be charted. Many of the plans were inadequate, and the quality and design of the plans varied enormously. For this reason, it took the Ministry a long time to approve the plans, which is also one of the reasons why it took such a long time for work on the expansion to be started. The rate of expansion will have to be increased, if the plan is to have been implemented by 2006.
The audit revealed that the county-municipal plans seldom explained how co-ordination between the primary and the specialist health services was to be improved. Nor did the Ministry of Health and Social Affairs comment on this issue in its approval of the plans. The Ministry of Health points out in its comments that the requirements in the health legislation concerning individual plans will improve co-ordination.
The audit revealed that the county municipalities have not charted the patient groups’ needs for health services. In total, the county municipalities would have to invest far more than the escalation plan suggested, but it was difficult to find the basis for this calculation of the investments. The county municipalities have not explained how they will increase staffing input and treatment in day wards and outpatient clinics. The Ministry of Health agrees with the Office of the Auditor General’s assessment of the weaknesses in the county-municipal plans, and will follow up the Office of the Auditor General’s annotations in the ongoing dialogue with the health enterprises and municipalities.
This report is available in Norwegian on the Office of the Auditor General’s website – www.riksrevisjonen.no – or can be ordered from the University bookshop Akademika, tel. +47 22 11 67 70.