Several of my recent audits have identified a need to improve our public transport system – both for the benefit of travellers and to assist in achieving better air quality.

Bus Transitways can provide a good public transport solution for lower density population areas, potentially at a relatively low capital cost. This audit examines the transitway running between Liverpool and Parramatta, the first of several planned for Sydney. This audit should contribute to a better understanding of the lessons learnt from this first project, and so to future transitways providing better value for money.

But this audit also raises broader issues.

It highlights the importance of accurately projecting the total cost of major infrastructure projects before governments lock in their decisions. It also highlights the need for sound decision-making processes when government agencies compete with the private sector. The principles and recommendations flowing from these issues are ones I would draw to the attention of all agencies, and to the Government.

Parliamentary reference - Report number #146 - released 5 December 2005

Periodically we review the extent to which agencies have changed their practices as a result of our audits. This gives Parliament and the public an update on the extent of progress made.

In this follow-up audit, we examine changes following our September 2002 report, to assess whether NSW Health has improved its buying of hospital supplies using electronic systems.

NSW Health spends over $1.3 billion on hospital supplies. It is the largest expenditure area after employee costs. Reform of this area has the potential to make significant savings that could be redirected to frontline services.

As part of our series of audits in the area of e-government, our previous audit looked closely at the extent to which technology was being used to deliver potentially major savings in purchasing hospital supplies. This is a key area of so-called “process re-engineering” in the “e” field, and NSW Health provided an ideal case study.

Whilst implementing large-scale e-procurement has many technical aspects, it is not chiefly a technical issue. The key requirements for success reside in effective change management, in particular being clear as to who has the authority to make change decisions and be held accountable.

This audit looks at NSW Health’s successes to date, and its frustrations and challenges in making further progress in this field. Many of the issues raised in this report may provide lessons for any agency that is seeking to drive a significant change program.

Parliamentary reference - Report number #145 - released 23 November 2005

About one in every twelve Sydney people travels by train each weekday.

Unplanned disruptions to services are inevitable, even on the best-run railways.

Because of the complexities of Sydney’s rail network, a single event can disrupt many services.

From a passenger’s perspective, three issues are important –

• how quickly the disruption is fixed (“When will my train arrive?”)
• the accuracy of information provided about the disruption (“Should I change my travel/meeting/other arrangements?”)
• how often the disruptions occur (“Should I give up on rail travel?”).

In this audit, we looked at how well RailCorp responds when there are routine disruptions to its CityRail passenger services. We focused on how RailCorp manages passenger journeys and informs passengers.

This report informs Parliament and the community about the limitations of the current system, and what more needs to be done in order to minimise the impact of disruptions on passengers.

It should also help passengers judge the extent to which they can rely on the information they receive, and to better understand some of the obstacles faced by staff.

Parliamentary reference - Report number #139 - released 22 June 2005

Periodically we review the extent to which agencies have implemented the recommendations they accepted from our earlier audits.

This gives Parliament and the public an update on the extent of progress made.

In this follow-up audit, we examine changes following our May 2002 report on how well the:

• State Transit Authority maintained its buses
• Ministry of Transport administered contracts for the provision of regular passenger bus services.

Parliamentary reference - Report number #138 - released 14 June 2005

It is estimated that one in five people will be affected at some stage by a mental health problem or illness. The increasing prevalence of mental illness means that at some point in time most of us will either be affected or we will know of someone who is.

Although most people with mental illness can be treated in the community, at times some may require emergency treatment or admission to hospital for shortterm intensive therapy.

Not only are more mental health patients presenting to an emergency department for treatment than ever before, they are reportedly sicker and a greater number require admission to a hospital bed for further treatment. And, because of its very nature, those suffering from acute mental illness may not understand what is wrong or be able to communicate their problems clearly.

This makes access to emergency mental health services a significant issue for government that requires continuing attention.

The focus of this report is on the provision of 24-hour crisis services to adults. Emergency mental health services play a vital role in providing timely and appropriate care. Without proper treatment the severity of the illness may escalate, increasing the risk of self-harm or harm to others.

There have been many changes to mental health services over the last decade to deal with increasing demand. Much has been done to improve access to, and the quality of emergency services through significant increases in funding, the opening of new beds and the employment of more mental health staff.

Yet recent reviews have highlighted problems with accessing mental health beds and inadequate levels of psychiatric support in rural areas.

I believe that our report will provide valuable assistance to area health services on alternative models of emergency mental health care that better manage patient risk and further improve service quality.

Parliamentary reference - Report number #136 - released 26 May 2005

We believe that school reports are an excellent concept. However, in their present form they are not an effective means of holding a school accountable. Successive performance audits by our Office have identified significant shortcomings in the reports. This is not so much the fault of the schools. The reporting content is largely optional. There is limited opportunity to compare performance. And the highly restrictive reporting protocols lead to reports which are not able to release important and relevant information.

Parliamentary reference - Report number #126 - released 15 September 2004

This audit follows our earlier studies on ambulance response times, on waiting times for elective (i.e. non-urgent) surgery and on the ‘Code Red’ status of hospital emergency departments. Those audits indicated that matching resources to the ever-increasing numbers of people seeking emergency treatment was certainly an issue, but not the only issue. We found that problems were also occurring at the ‘interface’ between different parts of the health system – when patients arrive in ambulances at emergency departments or when they need to be admitted from emergency departments to hospital wards.

Parliamentary reference - Report number #125 - released 28 July 2004

All three hospitals followed the Department of Health’s guidelines for judging capacity and had systems in place to notify hospital staff and ambulance crews of changes in status. We found discrepancies in the records kept by all three hospitals when compared to the records maintained by the Department of Health. Our view however, is that these records do not need to be a perfect match for the intended purpose, which is to guide ambulance crews to the shortest queue.

Parliamentary reference - Report number #121 - released 15 December 2003

We recognise that managing waiting times is a difficult and complex task. Waiting times are influenced by many factors, some of which are outside the control of NSW Health. There are, however, steps which NSW Health could, and should, take to ensure that the processes to manage waiting times are efficient and effective. By all measures used by NSW Health, patients are waiting longer for elective treatment today than six or seven years ago. In March 2003 patients admitted to elective medical or surgical treatment had waited, on average, 1.8 months, whereas in March 1997 they would have waited on average 1.1 months.

Parliamentary reference - Report number #116 - released 18 September 2003

In our opinion there are inadequacies in the current arrangements for detecting unauthorised driving. For example better information is needed on the extent of unlicensed driving. This may require giving the NSW Police power to conduct random licence and registration checks. In addition, there are technological and legal constraints to the efficient and effective detection of unauthorised driving.

Parliamentary reference - Report number #115 - released 4 September 2003