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GHA tightens financial controls after ‘staggering’ deficit, Costa says

The Gibraltar Health Authority, by far the largest area of government spending, ended the financial year with “a staggering and unacceptable” deficit, Health and Justice Minister Neil Costa told Parliament this week as he revealed measures to tighten financial control.
Mr Costa, who was appointed Health Minster last October, said he would work to bring GHA spending within budget in his first year in the post while improving patient care.
“My mantra has become to increase patient care at better value for money,” he said.
He said he had set up a series of financial control measures in conjunction with the new head of finance, Jessica Montado, who has “thrown herself in the deep end with an enviable degree of commitment and attention to detail.”
“The most salient part of our reforms consist of a monthly meeting, held on the first Friday a week after the close of the month, with all heads of departments, where we review every, single head of expenditure, line by line,” he said.
“If any subhead is in deficit, I require a full explanation for the reasons and the steps being taken to ensure that the next month will reflect expenditure within budget.”
Mr Costa said he was being assisted in the task by Economic Development Minister Joe Bossano and by the Financial Secretary, Albert Mena.
The Finance Department is improving processes to will deliver better budgetary control and financial balance, while the GHA has also commissioned a review by PWC UK, which will assist it to deliver more robust financial governance in the future.
Additionally, daily financial analysis reports are being generated for budget holders enabling them to query purchases and allocations.
The GHA is also making changes in its procurement processes.
In another development revealed in his budget statement, Mr Costa said the GHA had set up a review system to ensure the care of sponsored patients was properly overseen locally in a bid to avoid unnecessary travel.
The new software system certifies that patients are being seen regularly and coordinates care with the external hospital, ensuring that patients do not have to travel unnecessarily to Spain or to the UK.
“I am sure that we all agree that patients that can be medically attended to at home, should be seen at home, to avoid the unnecessary and additional stresses of travel,” he said.
“It is possible for a medical service outside Gibraltar to wish to continue to see a patient simply because that is the system they run locally, without taking in to account the very tiring experience of travelling for a medical appointment or review, and the stressful experience of being away from home and family while undergoing treatment.”
The GHA has set up a Tertiary Services Review Board to review the details of every patient who travels out of Gibraltar for medical care.
This newly constituted board met for first time on May 4 and is comprised of highly specialised and experienced clinical staff who are able to make decisions on where best to provide the optimal care for a patient, Mr Costa said.
“Cases are reviewed on an individual basis to guarantee a personal and compassionate review on best care,” he added.
The GHA is also in the process of repatriating as many services as possible to Gibraltar so that patients can be treated at home, Mr Costa said.
This includes services such as complex urology surgery, vascular surgery, cardiology, paediatric surgery and MRI services.
“This is likely to occur by expansion of our already very successful visiting consultant service and the employment of more specialists to work at the GHA,” Mr Costa said.
Mr Costa also provided a detailed snapshot of the most significant developments in health and the work of the Care Agency.
He highlighted the opening of new facilities including the Bella Vista Dementia Day Centre, Hillsides Dementia Residential Home and the Ayling Buttigieg Chemotherapy.
In respect of the Justice portfolio, Mr Costa noted that following an independent report the Royal Gibraltar Police has been restructured to better meet its demand profile.
He also highlighted the legislation which is currently being progressed in the justice field, including Bills for a Law Commission Act 2017.
He announced that Puisne Judge Justice Prescott, Stipendiary Magistrate Charles Pitto, John Restano, QC, Mark Isola, QC, Dr Joey Britto, Dr Liesel Torres and Lawrence Podesta had agreed to be appointed Law Commissioners.

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