Understanding internal control environment in view of curbing fraud in public healthcare unit

Abstract

This study extends on the phenomena of control environment of Intensive Care Unit (ICU) in Brazil through narratives of physicians, nurses and auditors and also analyzes the results with interpretative discourse analysis. The structuration theory based on Giddens and discourse analysis toeing Laclau and Laclau and Mouffe were also used to reflexively discuss the data constructed. Based on one-onone discussion held with the interviewee we infer that unawareness of control consciousness of the public servants in the healthcare units reflects on the behaviour that emanates unintended consequences of flaws in internal control procedures. The identity in the social structures makes them believe in what they do, which keeps them abreast of the awareness of the societal responsibility and this seems to drive the control environment. Finally, it is understandable that effective control environment cultivates certain dynamics in order to curb fraud. They are transparency on outreach and employee welfare, non-dogmatic management style upon succession, non-idolatry of corporate governance, and sense of continuous control awareness. Others are consistent process of active AIS, clear perception of risk of non-compliance, reward for dedication, holding to strategic alliances and positing sustainability.