Budget execution - Chris James, OECD
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The document discusses key issues related to budget execution in the health sector during the 2nd Health Systems Joint Network Meeting for Central, Eastern, and Southeastern European countries. It emphasizes the importance of timely cash flow management, flexible budget reallocations, and effective monitoring systems in achieving sustainable budget execution. Additionally, it raises questions regarding the challenges of budget over-execution or under-execution and the role of early warning systems in addressing these issues.
Budget execution - Chris James, OECD
- 1. Budget execution in the health sector some key issues 2nd Health Systems Joint Network Meeting Central, Eastern & Southeastern European Countries 1-2 December 2016 Chris James
- 2. Poor budget execution worsens service delivery…
- 3. Predictable Minimal ad-hoc changes to budget Timely No delays in release of funds Flexible Funds can be shifted to respond to changing needs Accountable Funds spent on intended purpose Sustainable Expenditure ~= budgeted amount Performing Expenditures linked to outputs 3 Effective budget execution
- 4. Predictable Realistic budget envelopes Timely Cash flow management Streamlined procurement Flexible In-year budget reallocations Authorisations/Delegations Carry-overs Accountable Financial monitoring systems Authorisations/Delegations Sustainable Financial monitoring systems Performing Programme/output-based 4 Achieving effective budget execution
- 5. Effective budget execution & sustainability Source: OECD (2015) Fiscal Sustainability of Health Systems Size of budget overruns and underspending as % of budgeted spending, 2006-12
- 6. Early warning systems as a tool for sustainable budget execution 6 No EWS 38% There is an EWS, but an alert does not legally require action 19% There is an EWS, and sets in motion required action for the current year 35% There is an EWS and sets in motion required action for future years 8% Source: OECD (2015) Fiscal Sustainability of Health Systems
- 7. • Does your country face budget over-execution or under-execution? What explains this? • What are the main difficulties faced in budget execution by sub-national governments? What is being done to address them? • To what extent does the MOH have flexibility to move funds between programmes, budget lines and to the next fiscal year? • What are the main challenges your country faces in the execution phase of the health budget? 7 Issues for discussion