Area Health Services and hospitals have developed programs which can provide clinical outcomes as good for patients as in-hospital care and can reduce the time they spend in hospital. They have operated for several years and show considerable potential. Ageing of the population, increasing costs and higher expectations of health care will continue to challenge health systems. Sometimes, unfortunately, the system struggles to cope. 

Parliamentary reference - Report number #182 - released 24 September 2008

The Better Practice Guide (BPG) aims to provide guidance for those implementing an amalgamation. It provides a series of questions identifying what needs to be done to achieve a successful amalgamation following the formal announcement of the amalgamation and the Administrative Orders for the new arrangements being finalised. The BPG’s aim is to alert those managing an amalgamation to actions that should be considered. How the Guide is applied will depend on circumstances. A lot will depend on how clear the expectations of the amalgamation are and on how complex it is.

Parliamentary reference - Report number #176 - released 5 March 2008

Both Commerce and DPI substantially achieved their stated amalgamation savings objectives as set by government. The departments are expected to achieve savings targets of about $150 million and $190 million respectively over their first four years. Our analysis indicates that there are two key factors in successful amalgamations. The first is effective early planning by departments based on clear objectives, supported by quick action. Second, significant synergies in service delivery can be achieved when departments with similar services and customers are amalgamated. The Department of Primary Industries is an example.

Parliamentary reference - Report number #175 - released 5 March 2008

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

In 1998 NSW Health developed Waste Management Guidelines to promote continuous improvement in waste management across the public health sector. Systematic implementation of the Guidelines was impeded in 1999- 2000 by resistance from the waste industry and transport workers. Since then, NSW Health has not actively promoted waste management in public hospitals. As a consequence Area Health Services (AHSs) and hospitals have developed separate and individual responses to waste management. This has resulted in inconsistent management of waste by public hospitals, inappropriate segregation of waste and additional costs of waste disposal.

Parliamentary reference - Report number #105 - released 10 December 2002

Reform of procurement in the NSW public health system is a huge, complex and difficult task. Much thought has been given to this reform. An immense amount of planning and preparatory work is required, and is apparent. In our opinion, at this time, the NSW public health system is making only limited progress towards achieving the economies in purchasing that its size and market dominance could deliver. While millions of dollars in savings are potentially available, much needs to be done to realise this. It is critical that all those involved, at all levels, ensure that reform is given priority, and driven through to fruition.

Parliamentary reference - Report number #102 - released 25 September 2002

The Audit Office is of the opinion that, while agencies are aware of the need to manage risk, their risk management falls short of better practice. Many agencies do not consider their risk management to be adequate. The survey suggests that some agencies, mainly those in the Public Trading Enterprise Sector have approached risk management in a systematic way and in accordance with the principles of better practice standards. Others, mainly departments not subject to commercial imperatives, have yet to progress the management of risk beyond the traditional response of insuring against the more common types of risk. Thus there is a danger that with a number of agencies, risk may not be managed adequately, especially in the General Government Sector.

Parliamentary reference - Report number #98 - released 19 June 2002

State Transit has developed fleet management plans and maintenance standards that meet its regulatory and contractual obligations as a bus operator and are consistent with vehicle manufacturers’ standards and best practice. However, assumptions used in fleet management plans to forecast fleet growth may not result in the most efficient and effective outcome for State Transit. Forecasts fail to take account of opportunities to redesign or reduce services where they exceed contract requirements and are difficult to justify on a commercial basis. Of greater concern are the consequences arising from bus maintenance practices not meeting State Transit’s own standards.

Parliamentary reference - Report number #97 - released 29 May 2002

The Roads and Traffic Authority (RTA) has taken positive steps towards continuous improvement in managing the environment. It is also one of the very few Government agencies to produce a separate Environmental Report. RTA is to be commended for its actions and the Audit Office considers that other Government agencies should follow suit. The RTA has implemented a structured process by which its environmental policy can be advanced. Whilst the process is comprehensive, especially at the project level, a more systematic approach in a number of areas would assist the RTA to achieve its stated objective and be at the forefront of environmental practices.

Parliamentary reference - Report number #95 - released 29 April 2002

SDRO deals well with very high volumes and collects substantial sums of money. However, there are a number of factors which limit the effectiveness of the fine enforcement process and affect SDRO’s capacity to recover debt. SDRO is confronted with conflicting roles as both law enforcer and debt collector. As a law enforcement agency, SDRO treats all matters the same. But as a debt collector, other approaches could be pursued which would recover more outstanding dollars.

Many of the factors which inhibit SDRO’s ability to collect unpaid fines are beyond its control and require legislative change or a coordinated inter-agency response. Until these problems are fixed, the credibility of the fine enforcement process, and people’s willingness to pay outstanding fines, will continue to be undermined.

Parliamentary reference - Report number #94 - released 17 April 2002