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The OAG's investigation of efficiency and goal attainment in the Norwegian Directorate of Health

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Background and objective of the audit

The Norwegian Directorate of Health has a significant number of employees and manages considerable financial resources. The Directorate defines the premises for designing services in the health sector, both in the municipal health services and in the hospitals, and has a great impact on the health of the population. The consequences for society in general of deficiencies in the Directorate of Health can be substantial.

The purpose of audit has been to consider whether the Directorate of Health discharges its tasks in an efficient manner, whether the management has established suitable systems for managing and following up the activities, and whether the Ministry of Health and Care Services' agency management in relation to the Directorate is sufficiently sound.

Findings and recommendations

The Ministry of Health and Care Services' mission statement for the Directorate of Health is too extensive, too detailed and mainly concentrated around one of the three roles assigned to the Directorate

The OAG believes that the Ministry of Health and Care Services should improve its management dialogue with the Directorate of Health. This should include further developing the Ministry's management of the Directorate in line with target and performance management principles, and improving the facilitation of a balanced approach to the Directorate of Health's three assigned roles.

There are significant weaknesses in how the Directorate of Health manages its activities

The OAG is of the opinion that the Norwegian Directorate of Health should strengthen its internal management of the activities through a more unified approach to internal control and by improving the information basis in order to follow up whether assigned tasks are efficiently discharged.

Legal interpretations take too long and are not disseminated well enough

The OAG recommends that the Norwegian Directorate of Health further develop its case processing management tools and establish a better system to publicise fundamental legal interpretations.

The Directorate of Health does not systematically check how funding to the municipalities reaches the target groups and what results the funding schemes achieve

The OAG recommends that better information be prepared on how funding is distributed between target groups, as well as on the effects of the funding schemes.

The work on national plans does not apply previous experience to any significant extent

The OAG recommends that the Directorate of Health systemise the work on national plans and use this as a basis for development of new plans.

The work to implement guidelines and manuals lacks a systematic approach

The OAG recommends a more systematic approach in the implementation of guidelines and manuals.

About the Directorate of Health:

  • 52 national professional guidelines and 153 manuals
  • Responsibility for 36 national plans
  • 40 funding schemes aimed at municipalities, with a total budget of NOK 7.9 billion
  • Regulatory body for 28 health-related acts with associated regulations (as of 2012)

Riksrevisjonen, Storgata 16, P.O. Box 6835 St. Olavs plass, 0130 Oslo, Norway

Phone: +47 22 24 10 00 974 760 843