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The Bahrain Health Strategy provides the structure contained by which various entities across the health sector will function. It identifies main concerns and highlights major issues affecting the quality and performance of health care rescue in Bahrain. It aims to ensure that all efforts are directed toward continuous growth and development of health systems. It was developed subsequent the scientific process of strategic planning concerning Ministry of Health staffs at different levels, as well as a mixture of stakeholders in defining the vision for the future.
Vision: To improve the health of population in Bahrain by partnership with stakeholders, in order to provide accessible, responsive, high quality service for all through their lifetime.
Mission: To ensure the condition of evidence bases care at all levels based on proficient use of resources and encouragement of personal responsibility for health.
Strategy: Are bases for future decision making and provide comprehensive view for improvement and development.
Quality, clinical excellence
Organization and management
Education, research and development
Information and communication technology
1. Definition of a Budget and the legal laws that defines the budget.
Budget: An estimate of costs, revenues and resources over a specified period, reflecting a reading of future financial conditions and goals. One of the most important administrative tools, a budget serves also as:
Plan of action for achieving quantified objectives
Standard for measuring performance and
Device for coping with foreseeable adverse situations.
The legal laws that defines the budget:
Government Budget is an itemized accounting of the payments received by government (taxes and other fees) and the payments made by government (purchases and transfer payments). A budget deficit occurs when a government spends more money than it takes in. The opposite of a budget is a budget surplus. A government budget is a legal document that forecasts the government expenditures and revenues for a specific period of time. The period covered by a budget is usually a year, known as a financial or fiscal year, which may or may not correspond with the calendar year. A government budget is often passed by the legislature, and approved by the chief executive or president.
2. Accounting basis used to prepare the budget.
A new system that links priority to performance to budget will be applied. The system is introduced by the Ministry of Finance and will be applied to all government. The system is introduced by the Ministry of Finance and will be applied to all government. Currently it is piloted in two ministries that are Health and Education. Bahrain Health Strategy 2002-2010 is the starting point for the project. The Ministry of Health has a head start because of the availability of such a document.
Each government engages in a full budget cycle involving the preparation of own budgets and supportive documents. In Bahrain, important administrative changes and major reforms have been implemented aimed at improving the overall efficiency, effectiveness, transparency, performance, accountability and sound budget management. This has been through State Budget Law No. 39 for the year 2002 which applies to all ministries and government organizations. The Constitution of the Kingdom of Bahrain is the basic source of authority for the state budget, Article 109 (b) of the Constitution provides that the government draws up the annual budget. The MOF lays down the accounting standards, basis and financial rules which have to be followed by ministries and government organizations regarding revenues, expenditures assets and liabilities. As reported by respondents, the basis of accounting followed in budget preparation is the modified cash basis and expenditure such as wages and salaries are recognized on the cash basis and other expenditures on the accrual basis. Financing research proposal was mainly through the MOH regular budget and funds allocated from several international agencies like WHO, GCC Council, UNDP, UNFPA etc. But with the new structure of Health research the committee submitted a separate budget within the general budget purely for funding research and was approved by Ministry of Finance starting from the financial year budget.
3. Classification of the Budget.
The classification of the Budget is as follows:
Master Budget: The master budget is also known as the financial plan. Master budgets form the basis of the control systems form the basis of the control systems in organizations. The master budget in organizations. The master budget may take the form of a profit and loss account and form of a profit and loss account and a balance sheet at the end of the balance sheet at the end of the budget period. It shows the gross budget period. It shows the gross and the net profits and the important and the net profits and the important accounting ratios. The master budget has two components: the operating budget and the financial budget. The operating budget includes the sales operating budget includes the sales budget, cash collections from budget, cash collections from customers, and purchases budget, disbursements for purchases.
Fixed Budget: This is defined as a budget which is designed to remain unchanged irrespective of the volume of output or turnover attained. This budget will, therefore, be useful only when the actual level of activity corresponds to the budgeted level of activity.
Sales Budget: Sales budget is the most important budget based on which all the other budgets are built up. This budget is a forecast of quantities and values of sales to be achieved in a budget.
Production Budget: Production Budget involves planning the level of production which in turn involves the answer to the following questions:
What is to be produced?
When is it to be produced?
How is it to be produced?
Where is it to be produced?
Flexible Budget: CIMA defines this budget as one which, by recognizing the difference in behavior between fixed and variable costs in relation to fluctuations in output, turnover or other variable factors such as number of employees, is designed to change appropriately with such fluctuations.
Performance Budget: These days' budgets are established in such a way so that each item of expenditure is related to specific responsibility centre and is closely linked with the performance of that standard.
Capital Expenditure Budget: This is an important budget providing for acquisition of assets necessitated by the following factors:
Replacement of existing assets.
Purchase of additional assets to meet increased production
Installation of improved type of machinery to reduce
Cash Budget: This budget gives an estimate of the anticipated receipts and payments of cash during the budget period. Cash budget makes the provision for minimum cash balance to be maintained at all times.
Personnel Budget: This budget gives an estimate of the requirements of direct labor essential to meet the production target. This budget may be classified into:
Labor requirement budget
Labor recruitment budget
Research and Development Budget: This budget provides an estimate of expenditure to be incurred on research and development during the budget period. A Research and development budget is prepared taking into consideration the research projects in hand and new Research and Development to be taken up.
Zero Base Budgeting: The zero base budgeting is not based on the incremental approach a previous figures are not adopted as the base. Zero is taken as the base and a budget is developed on the basis of likely activities for the future period.
4. Does the government use appropriate lapse/remains open?
Disputed claims which are six months old or more from the date of delivery note or the date of goods supply or the performance date of services and works required is not subject to the provisions and procedures of this Sub-Section if the dispute is settled after the lapse of more than six months. Old claims may not be paid if their right to claim lapses for reason or prescription in accordance with the applicable laws of the Kingdom of Bahrain. Periods of maintaining documents and records, which are referred to in 24-1-10 above, shall extend so that financial documents and records specified in the attached Schedule and relating to any disputed rights between the government and third parties until such a date when such rights are finally resolved, or until the date they are lapsed or prescribed in accordance with the applicable laws.
Ministries and government entities may save the financial records and documents through microfilm or scanner, if it appropriate to keep copies for such documents after the expiry of the maintenance periods specified therefore due to their significance.
Maintain the financial documents and records of ministries and government entities in a manner appropriate with the period of maintaining them as specified in the attached Schedule.
Government authority should apply appropriate regulations to control the use and allocation of the wireless equipments by their employees.
Coordination must be made with the Central Information Organization (CIO) on the technical matters and the necessary appropriate security safeguards which must be taken in using the internet.
Governmental attaché shall control expenditure out of its allocated budget and shall implement procedures which ensure the following:
Complying with provisions and procedures in this sub-section.
Spending within the allocated budget.
Using the budget for its intended purposes.
Charging the expenditure to the appropriate budget costs.
5. Is there a balanced budget or not?
The Ministry of Health will implement global and program budgets, for all service providers. Operating under Boards of Management, the institutions and programs will have more autonomy yet be more accountable and compliant to performance standards. This will encourage innovation and improve practice as they work to balance quality service with cost. Develop a balanced financing strategy for Health that recognizes not only expenditure programs but revenue supports the Ministry of Health Policy plan.
6. Is there reversion of the budget if yes in which item?
The unencumbered balances of the appropriations provided in the following citations shall revert to the fund balances of the funds from which the appropriations were made.
7. Outline in details the steps followed in the preparation of the budget by using a flow chart.
The World Health Organization (WHO) defines health financing as the "function of a health system concerned with the mobilization, accumulation and allocation of money to cover the health needs of the people, individually and collectively, in the health system." It states that the "purpose of health financing is to make funding available, as well as to set the right financial incentives to providers, to ensure that all individuals have access to effective public health and personal health care" (WHO 2000). Health financing has three key functions and defined: revenue collection, pooling of resources and purchasing of services.
Revenue Collection: Revenue collection is apprehensive with the sources of revenue for health care, the type of payment and the agents that accumulate these revenues. All funds for health care, excluding donor assistance are collected in one way or a different from the general population or positive subgroups. Collection instruments include taxation, social insurance contributions, private insurance premiums and out of pocket payments. Collection representatives could be government or independent public agencies, private insurance funds or health care contributors.
Pooling of resources: Pooling of resources, the second main feature of health financing, is the gathering and managing of funds from individuals or household in a way that insures individual suppliers against the risk of having to pay the full cost of care out of pocket in the occurrence of illness. Tax-based health financing and health insurance both occupy pooling. Note that fee for service user payments do not engage the pooling of resources. Some fees, however, may be set to "cross-subsidize" certain services or groups by alleging more than the cost of production for a service or a group to allow less than the cost to be stimulating for another service or to another group.
Purchasing: Purchasing of health services is done by public or private agencies that spend money either to provide services directly or to purchase services for their beneficiaries. In many cases, the purchaser of health services is also the agent that pools the financial resources. Purchasers of health boards, insurance organizations and individuals or household. Purchasing can be either passive or strategic; passive purchasing simply follows predetermined budgets or pay bills when they are presented, whereas strategic purchasing uses a deliberate approach to seeking better quality services and low prices.
For good performance of the health system, the financing agents need to produce an appropriate amount of revenues relative to what is possible in the country; pool risk effective; create appropriate incentives for providers and distribute resources to effective, efficient and equitable interventions and services. These purposes should be managed efficiently, minimizing administrative costs.