An evaluation of internal financial controls in public hospitals : A case study of Regional and Municipal Hospital, Sunyani and District Hospital, Bechem (Brong-Ahafo)

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The main objective of the study is to evaluate internal financial controls in public Hospitals using The Regional and Municipal hospitals in Sunyani and The District hospital, Bechem (Brong-Ahafo) as case study. It was also to establish the existence of internal financial controls. It was to find out the level of compliance. Further, to establish the consequences of compliance and non-compliance with regulations. Data was collected from three (3) Hospitals and twenty-five (25) members of staff. Purposive sampling and observation technique were used. Questionnaires and structured interview techniques were used to gather data regarding internal financial controls in the three Public Hospitals. Data analysis and presentation were done with the aid of Microsoft Excel but carefully done to give the researcher a hand-on experience in carrying out such an exercise. The research period covered six (6) months. It was discovered from the findings that there were existence of internal financial controls regulated by Financial Administration, Procurement, Internal Audit Agency Acts and indirect application of Committee of Sponsoring Organizations of the Treadway Commission (COSO). It was revealed that the level of compliance was high and this is very commendable and must be encouraged. It was also discovered there was fair amount of compliance but sanctions are rarely given to a person who does not comply with the laws and conventions of internal financial controls. It is recommended that punitive action need to be instituted to caution perpetrators, so people will not have the motivation to circumvent the internal control structures because it is not worth it. This would help to enhance and improve the internal control to achieve effective and efficient internal control operations. It was recommended that pre-audit should be done for all transactions and seriousness need to be attached to it. This would help to use conventions and regulated framework well. This would help to avoid so many avoidable issues which may not appear before external auditor in future. It was recommended that audit units need to be strengthened in the public hospitals. It was recommended that review of internal control need to be done from time to time, so that new standards can be embraced for performance and improvement.
A Thesis submitted to the Institute of Distance Learning, Kwame Nkrumah University of Science and Technology in partial fulfillment of the requirements for the degree of Commonwealth Executive Masters in Business Administration,