Pona Hospital is a referral hospital fully owned by the Government. Two years ago, on recommendation by the
hospital's internal audit department, the management reviewed all aspects of hospital operations and implemented a
number of measures aimed at improving overall "value for money" for the users of the facility.
Your audit firm has been requested to perform a review of the following measures which have been implemented so
far:
1. Pona Hospital has one centralised purchasing department where all purchase requisitions for medical supplies
are forwarded. Upon receipt, the procuring team will research on the lowest price from suppliers and a
purchase order is raised. This is then forwarded to the purchasing manager who authorises all orders. The
small purchasing team receives in excess of 200 requisition forms per day.
2. The human resource department has experienced difficulties in recruiting suitably trained staff. Overtime
rates have been increased to incentivise permanent staff performing extra duties due to staffing gaps. This
has been popular and reliance on expensive temporary staff has been reduced. Monitoring of staff hours had
been difficult. However, the hospital has implemented time card procedures for clocking in and out. The
hours clocked are used to calculate payments.
3. The hospital has invested heavily in new surgical equipment. Although the surgical equipment are very
expensive, more surgeries can be performed and patient recovery rates are now faster. However, there is a
shortage of appropriately trained medical staff and the equipment is underutilised. A capital expenditure
committee has been established, made up of senior managers, to authorise future procurement of any
significant capital expenditure items.
Required:
(i) Analyse four strengths within Pona Hospital's internal control environment.
(ii) For each of the strengths analysed in (a)(i) above, recommend further improvements in order to provide best
value for money.
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