Criteria for Evaluating Public Investment Management for Health Care

The State Budget is submitted to the National Assembly when the comments and assessments on the financial management situation - State Budget within the country (including the Ministry of Health) are agreed upon by the relevant ministries, the Government Office, and the State Audit Office. In addition, information from the people, from relevant mass media, from the conclusions of the Government Inspectorate, from the State Audit Office's reports, from the National Assembly's monitoring reports, etc. are all reliable channels that the Prime Minister can refer to, and when verification is needed, he can request the appropriate authorities to intervene. The multi-dimensional use of information ensures that the Prime Minister approves and signs the state financial reports and the State Budget Management Reports submitted to the National Assembly for approval with the highest level of authenticity.

1.2.4. Criteria for evaluating public investment capital management for health care

Multilateral financial institutions, led by the World Bank, have made efforts to fund research on evaluating the effectiveness of public financial management. By 2005, a tool for evaluating financial accountability and public spending - PEFA (Public Expenditure and Financial Accountability) was issued [70]. To date, PEFA has become a widely used tool in many countries around the world. Vietnam is also one of the countries that has been making efforts to research and apply PEFA to evaluate the effectiveness of public spending management. As one of the typical public expenditures, the management of public investment capital for health care can choose the criteria of PEFA to serve the evaluation of the effectiveness of managing this expenditure. The criteria that can be selected for evaluating the management of public investment capital for health care include:

1.2.4.1. Budget reliability

Budget reliability reflects information related to the accuracy of budget revenue and expenditure figures between implementation and approved estimates. Assessment of budget reliability of health care investment capital is based on the following indicators:

PI-1 Total actual expenditures compared to approved original budget.

The ability to implement expenditures according to the allocated budget is an important factor that helps the Ministry of Health to be able to carry out the task of building the sector's infrastructure in the year according to the approved DTC plan. This index reflects that by measuring the total actual expenditures compared to the total original budget for expenditures allocated by the Government.

Assessment content (Scoring method M1):

Prostitute

Minimum requirements (M1 scoring method)
A	Actual expenditure differs by an amount equivalent to more than 5% of the expenditure budget, in no more than one year of the last three years.
B	Actual expenditure differs by an amount equivalent to more than 10% of the expenditure budget, in no more than one year of the last three years.
C	Actual expenditure differs by an amount equivalent to more than 15% compared to the expenditure budget, in no more than one year of the last three years.
D	Actual expenditures differ by an amount equivalent to more than 15% of the expenditure budget, in two or all three of the last three years.

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Source: [70, p.13]

PI-2. Actual expenditures compared to the approved original budget.

If the actual expenditures differ significantly from the original budget, the budget will no longer be a useful document expressing policy intentions. Scoring according to this indicator requires an empirical assessment of expenditure results compared to the original budget at the expenditure content level. Because the capital investment plan for health is usually approved and managed on the basis of the total amount and structure for each type of program or project; and within each program or project, the capital use structure is also linked to the purpose of each investment capital for compensation for site clearance, construction, equipment, management costs, consulting costs, contingency costs or other costs.

PI-2 measures the extent to which reallocation or transfers between budget lines contribute to variances in expenditure items, over and above variances in total expenditures. To assess this, it is necessary to calculate the total variance in expenditures, compared to the overall variance in primary expenditures for each of the past three years.

The difference is calculated as the weighted average difference between actual expenditure and the original budget for expenditure, as a percentage of the original budget for expenditure, based on classification according to the cost structure constituting the total investment of the program or project.

Assessment content (M1 Scoring Method):

Point

Minimum Requirements (M1 Scoring Method)
A	The difference in expenditure content is higher than the difference in total basic expenditure by no more than 5 percentage points, in any year of the last 3 years.
B	The difference in expenditure content is higher than the difference in total basic expenditure by no more than 5 percentage points, in no more than one year in the last 3 years.
C	The difference in expenditure content is higher than the difference in total basic expenditure. not more than 10 percentage points, in no more than one year in the last 3 years.
D	The difference in expenditure content is higher than the difference in total basic expenditure by no more than 10 percentage points, in at least two of the last three years.

Source: [70, p.14]

PI-4. Balance and monitoring of outstanding debt in payment of expenses.

High levels of arrears are an indicator of various problems such as poor control of expenditure commitments, short-cuts in budget management, inadequate budgeting for contracts, under-budgeting for specific expenditure items, and lack of information. They are included in arrears in the management of health capital investment when

The last day of payment according to the contract signed between the investor and the contractors, but the investor has not yet paid. From this date on, the investor becomes the capital appropriator (debtor) of the contractors.

This indicator is intended to measure the extent of outstanding arrears, and the extent to which systemic problems are being addressed and resolved. While special measures to identify and resolve arrears are necessary, they will not be effective if new arrears continue to arise. However, it is fundamental to assess the existence and completeness of arrears data.

Assessment content (Scoring method M1):

Prostitute

Minimum requirements (M1 scoring method)
A	Low outstanding balance (less than 2% of total expenditure) Reliable and complete data are generated through periodic procedures on outstanding balances, at least as of the end of the fiscal year (including time evolution).
B	Outstanding debt accounts for 2 - 10% of total expenditure; and there is evidence that it has decreased significantly (over 25%) in the last 2 years. Data on arrears are generated annually, but may be incomplete. certain expenditure items or specific budget units.
C	Outstanding debt accounts for 2-10% of total expenditure; and there is no evidence that it has decreased significantly in the last 2 years. The arrears data is compiled through a case-by-case assessment. overall in the last 2 years.
D	Outstanding debt accounts for over 10% of total spending There is no reliable data on arrears for the last 2 years.

Source: [70, p.16]

1.2.4.2. Budget cycle

PI-19. Level of competition, efficiency of capital use and control in procurement bidding.

In principle, public procurement expenditure for health should be implemented through the public procurement system. A well-functioning public procurement system will ensure that funds are used effectively and efficiently. Open competition through bidding is considered the basis for achieving the highest efficiency in procurement of inputs and ensuring the effective use of public procurement funds. This index focuses on assessing the quality and transparency of the legal framework for procurement and bidding by identifying the use of open and fair competition as the preferred procurement method; and identifying appropriate methods other than open competition if justified under specific circumstances.

The procurement system will benefit if there is a common control environment within the management system, including internal controls and external controls by external auditors.

However, the nature of the procurement process is that it involves the direct participation of private sector actors, along with citizens. A good procurement system is one that can leverage stakeholder participation as part of the control system by establishing a clearly defined process that facilitates the timely reporting and resolution of complaints by private sector actors. Accessibility to the complaints process and information on complaints allows interested stakeholders to participate in the control of the system.

Assessment content (M2 scoring method):

Criteria

Minimum score requirements by assessment content

(M2 Scoring Method)

i) Use open competition for high-value contracts

Score = A: There is accurate data on the method used in awarding contracts, showing that over 75% of contracts valued above the threshold were awarded on an open competitive basis.

Score = B: There is data on tendering, showing above 50% but below

than the nationally determined threshold for small purchases

75% of contracts above the threshold are awarded on an open competitive basis, but the data may be inaccurate.

Score = C: There is contract award data, which shows that less than 50% of contracts valued above the threshold were awarded on an open competitive basis, but the data may be inaccurate.

Score = D: Insufficient data to evaluate the method of award; or available data indicate that the use of open competition is

limit.

(ii) There is justification for using less competitive procurement methods.

Score = A: There is justification for using less competitive methods, consistent with clearly stated regulatory requirements.

Score = B: There is justification for using less competitive methods, consistent with regulatory requirements.

Score = C: Justification for using less competitive methods is weak or lacking.

Score = D: Regulatory requirements do not clearly define the edge

Open canvas is the shopping method to use.

(iii) The existence and operation of a complaint mechanism in bidding procurement

Score = A: The (legally documented) process for reporting and resolving complaints promptly is operational and monitored by an external agency and data on complaint resolution is publicly accessible for monitoring.

Score = B: The (legally documented) process for reporting and resolving complaints is in place, but there is no ability to escalate complaints to a higher level of external authority for resolution.

Score = C: There is a timely complaint reporting and resolution process in place, but it is poorly designed and does not operate to resolve complaints promptly.

Score = D: There is no defined process for reporting and

Resolve complaints related to the implementation of the procurement process.

Source : [70, p.39]

PI-21. Internal Audit Effectiveness

Adequate and regular feedback to management is required on the effectiveness of the internal control system, through the internal audit function (or equivalent systems monitoring function). Such a function should meet international standards for internal auditing, including: (a) an appropriate structure, particularly with regard to professional independence; (b) adequate scope of duties, access to information and authority to report; (c) use of professional audit methods, including risk assessment techniques. The function should focus on reporting on significant systemic matters relating to: the reliability and integrity of financial and operating information; the efficiency and effectiveness of operations; the safeguarding of assets; and compliance with laws, regulations and contracts.

Specific evidence of an effective internal audit function (or system oversight) also includes the level of focus on high-risk areas, and management action on internal audit findings.

The internal audit function can be performed by an organization that covers many units within the Ministry of Health.

Assessment content (M1 Scoring Method):

Point

Minimum Requirements (Scoring Method: M1)

Internal audit operates in all units within and under the Ministry of Health, and generally meets professional standards. This work focuses on systemic issues (at least 50% of staff time).

The report complies with the prescribed time schedule and is disseminated to the audited units, the Ministry of Finance, and the State Audit Office.

Management's action on internal audit findings is

quickly and comprehensively in all units of the Ministry of Health.

Internal audit operates in most units belonging to and directly under the Ministry.

Healthcare, and largely meets professional standards. This work focuses on systemic issues (at least 50% of staff time).

Reports are issued regularly to most audited entities, and are disseminated to audited entities, the Ministry of Finance and the State Audit Office.

Many (but not all) managers acted quickly.

and comprehensive.

Internal audit is active in at least most of the key units of the Ministry of Health, and there is some systematic assessment (at least 50% of staff time), but it has not yet met recognized professional standards.

Reports are issued regularly to most audited entities, but may not be sent to the Ministry of Finance and the State Audit Office. Many managers take some level of action on these issues.

large, but often delayed.

There is little or no internal auditing focused on system monitoring. Reporting is either absent or infrequent.

Internal audit recommendations are often ignored.

Source : [70, p.41]

PI-24. Quality and timeliness of annual budget reporting.

State financial reporting and the State Budget Report require regular and timely information to monitor the performance of the health sector; at the same time, help the sector manage issues under their accountability. This criterion focuses on the ability to produce comprehensive reports from the accounting system on all aspects of the budget. Capturing expenditure at both the commitment and payment stages is important in monitoring budget implementation and the use of allocated funds.

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