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16/10/2019   The National Audit Office points out the ineffective management of fixed programmes

Today at the Seimas, the National Audit Office (NAO) present opinions on the national set of financial statements for the year 2018, financial reports of the State budget and the budgets of six funds (Reserve (Stabilisation) Fund, Compulsory Health Insurance Fund (CHIF), State Social Insurance Fund (SSIF), and other resource funds), as well as the execution thereof. Pursuant to its constitutional duty, the NAO draws up these opinions annually.

Each autumn, prior to the approval of the State budget, discussions are held regarding additional sources of funding necessary for the performance of new commitments. The NAO draws attention to the fixed funding system for programmes which has been operating in Lithuania for almost 30 years. In 2018 due to this system nearly 706 million Eur (which comprises 5 per cent of the total State budget expenditure) were allocated to the programmes funded without any negotiation.

“Over half of the programmes assigned to the fixed funding system have been running for longer than 16 years. And yet, the objectives of, as well as the criteria for, the application of this funding type have not been established, and decision-making regarding the approval or change of the amount of funds allocated to these programmes never includes any type of cost-benefit analysis or the consideration of performance results. There is currently no requirement to repay the remaining balances of the fixed funding programmes (except for one) to the State budget – in 2018, balances amounted to almost 208 million Eur. The fixed funding method fails to encourage the results-oriented budget formation and implementation,” said Auditor General Arūnas Dulkys at the press conference.

The NAO also conducted an audit on the CHIF which included the assessment of the process which Territorial Health Insurance Funds (THIFs) and health care establishments use to conclude their respective agreements. The same Fund is currently administered by the National Health Insurance Fund and five THIFs.

“Upon assessing the contracting process of Territorial Health Insurance Funds and health care establishments, we have determined that residents, depending on which Territorial Health Insurance Fund they belong to, have different opportunities for receiving health care services, and two residents who were provided with services at the same establishment, but who belong to different Territorial Health Insurance Funds, may have been charged different rates and may have had to wait in queues for a longer period of time. This should not be the case – we all pay our contributions under the same conditions,” said Auditor General Dulkys.

According to the auditors, this situation results from the fact that THIFs set their own procedures for concluding agreements, as well as interpret the procedures established by the Ministry in different ways, or simply fail to comply with them in the first place. This means that both residents and health care establishments are subject to unequal conditions of competition and may receive different amounts of funds from different THIFs for the same services.

Although the NAO appreciates the efforts of the Government in reforming the strategic planning and budget formation system as well as the implemented transitional measures, more fundamental changes to the aforesaid system are expected to take place in 2021.

Following the audits, the NAO submitted recommendations the implementation of which could make a contribution to achieving the anticipated impact, namely – the development of a results-oriented budget formation process, the purposeful and transparent use of funds from the State budget, and the provision of health care services based on the same, unified principles.

Summary information on the results of conducted audits and monitored risks by areas:

 

Responsible for the information Communication Division
Last updated on 4 December 2019

National Audit Office of Lithuania

Pamėnkalnio St 27, LT-01113 Vilnius, Phone: + 370 5 266 6793, + 370 5 266 6752, Email: nao@vkontrole.lt.