NSW Health has progressed in identifying and addressing key R&D issues in a complex and difficult environment. The Infrastructure Grants Program (IGP) is an innovative program and reflects a commitment by Government to support research infrastructure. The IGP has as its aims the provision of significant funding accompanied by clear research objectives and criteria for accountability and introduces a rational basis for the allocation of infrastructure grants.

While NSW Health has progressed, there is an opportunity to make the IGP more efficient and effective. These opportunities are in the areas of addressing longer term planning issues in health, streamlining and clarifying eligibility and selection criteria, improving decision-making structures and processes and improving accountability.

Parliamentary reference - Report number #56 - released 25 November 1998

The Audit Office is of the view that:

• there is no system wide plan for the location of emergency departments. This function is undertaken by each Area Health Service

• coordination between the Department and the NSW Ambulance Service could be improved in aspects such as the collocation of facilities and direct communications between ambulances and emergency departments

• there is no policy framework that recognises the increasing role and impact of private providers

• the Department’s guidelines do not take into account demographic factors, the number of patients treated or the acuity of presentations as criteria for determining the size of an emergency department or the level and scope of emergency services that should be available at that location.

• the Department has introduced a range of initiatives over a period of time to improve the performance of emergency departments such as the establishment of the Integrated Bed Management Committee. Some have been quite effective, whilst others have had mixed success. There has been an overall improvement in emergency department waiting times for urgent cases. However, there has been little improvement in waiting times for less urgent cases and a decline in performance for access block (the time taken to be admitted to a hospital ward from the emergency department after a decision has been made that this is required).

Parliamentary reference - Report number #54 - released 21 October 1998

Information relating to the NSW public sector wide sickness absence levels, unlike in some other states, are presently not maintained or monitored centrally. The salaries and wages paid to individuals whilst on sickness absence on a public sector wide basis in 1996-97 was estimated to be $368.3m. This estimate does not take into account any flow -on effect resulting from sickness absence, eg overtime or other replacement cost.

Improved management of sickness absence provides an opportunity for the NSW public sector to gain benefits, including the reduction of salary costs associated with people on sickness absence. The salary differential between the sickness absence level currently existing and the sickness absence level reported for the private sector, is around $123m per annum. To assist with the management of sickness absence within the NSW public sector, The Audit Office of NSW developed a Better Practice Guide. This Guide has been referred to the Premier’s Department for consultation as a prelude to its completion and release.

Parliamentary reference - Report number #52 - released 27 August 1998

This Volume, Volume Two: The Survey - Detailed Findings, is the second of a two part Performance Audit Report on Management of Sickness Absence New South Wales Public Sector. The first volume, Volume One: Executive Briefing, identifies the main issues of sickness absenteeism identified during the audit.

This Report Volume, Volume Two: The Survey - Detailed Findings, presents the more detailed findings of the audit which were gathered from:

• the review and analysis of responses received from agencies to The Audit Office’s management of sickness absence survey

• fieldwork visits to selected public and private sector organisations, during the course of the audit, which supplemented the survey. 

Parliamentary reference - Report number #52 - released 27 August 1998

Fraud control in the NSW public sector needs to be better. Some agencies have approached the issue with vigour and initiative, and improvement since 1993 is evident in the major audit clients of The Audit Office. However, the overall achievement of NSW agencies in implementing fraud control strategies leaves much room for improvement.

There is a need for stricter requirements, better monitoring and improved central support to ensure that fraud control is properly addressed. This Report makes some suggestions in this regard, and highlights some issues for further research and guidance. There is a need to change management perceptions on the issue of fraud control. To this end, The Audit Office fully supports recent initiatives by the Chief Executives Committee (in constituting an Ethics Working Party) and NSW Treasury (in seeking to introduce a risk management approach to the public sector). These initiatives place fraud control into a broader context of effective ethical management, which is where it belongs.

Parliamentary reference - Report number #48 - released 25 March 1998

This audit examines the processes which led to the Government’s decision to demolish and sell the East Fairfield (Villawood) housing estate at a cost of nearly $32m gross ($17m net). In doing so, the audit focuses on whether the decision process demonstrates that it is an efficient and effective use of government funds.

The audit raises a number of concerns about the decision-making process. Although demolition and redevelopment may have been the most efficient and effective outcome, The Audit Office is not able to confirm this from the evidence presented. Audit found that the process used to arrive at this decision was not transparent, nor was it adequately justified by available evidence.

Parliamentary reference - Report number #46 - released 29 January 1998