The Importance of Internal Audit Professionalism for the Quality of Healthcare Services: Challenges of Applying Global Standards in Lithuania

The efficiency and quality of healthcare services increasingly depend on the application of advanced governance, risk management, and control models. Internal audit, when conducted in line with international professional standards, has the potential to act not only as a control mechanism but also as a strategic partner contributing to organizational resilience and value creation. In 2024, The Institute of Internal Auditors (IIA) introduced the Global Internal Audit Standards, strengthening the emphasis on professionalism, independence, competence, and strategic alignment of the internal audit function across all sectors, including the public healthcare system. This article examines the challenges of applying these global standards within the Lithuanian healthcare sector, focusing on a specific regulatory requirement that mandates medical or health sciences education for the head of internal audit (the so-called internal medical audit). Through a systematic analysis of the Global Internal Audit Standards, national legislation on public sector internal audit, and sector-specific regulations issued by the Ministry of Health, the study identifies a fundamental normative tension between international audit professionalism and sectoral qualification restrictions. The article argues that internal audit effectiveness derives primarily from professional audit competencies, independence, and risk-based methodologies rather than from subject-specific clinical education. Drawing on an analogy with information technology audits, the analysis demonstrates that complex, knowledge-intensive sectors can be audited effectively through professional internal auditors who engage subject matter experts without compromising objectivity. The findings suggest that the current regulatory model risks professional isolation of healthcare auditors, reduced audit value, weakened organizational resilience, and inefficient allocation of scarce healthcare resources. The article concludes that aligning national healthcare audit regulation with the Global Internal Audit Standards would strengthen governance, enhance risk management, and enable internal audit to function as an integral component of professional management and innovation within healthcare institutions.