A publicly-funded department within a local administrative authority provides a health advisory service to its local community. This is not a hospital. Its function is purely advisory in respect of preventive medicine and focuses on good health promotion and prevention of accidents and illness. In recent years, the funding for this service has been reduced in real terms, requiring greater levels of efficiency to be provided. The manager of the service has recognised the need to make economies. Despite receiving criticisms and complaints from the local administrative authority's elected representatives, the manager has reduced the level of service provision in an attempt to remain within budget. However, there has been no reduction in the staffing level which accounts for about 80 per cent of expenditure. n23 Last year, an independent public audit report criticised the management of the service. The report focused on the fact that the service overspent its budget, was considered to be inefficient in its methods of delivery, and wasted resources allocated to it. The report went on to state that according to annual performance statistics, there was a decline in the numbers of people using the service. It concluded that the service was failing to operate economically, efficiently or effectively. The result of this was that the local administrative authority reduced the funding still further and gave the manager a written warning that the whole service would be reviewed if there was not an improvement in this financial year. The manager has responded by making further cuts to the service, but has protected the staffing levels. It is projected that the service will remain just within its budget allocation this year. Requirement Discuss the reasons why the service has received criticism. Explain how the manager can improve the effectiveness and efficiency of the service while ensuring that it remains economic and within its allocated budget. (25 marks)