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 Authority has achieved staff reductions and salary related savings in line with targets. That said, the amalgamation was not project managed effectively. It has been slow to implement some of its key objectives against plans and the costs of the amalgamation have increased to the extent that it is unable to meet key objectives. Stakeholders are dissatisfied with the amalgamation outcomes. This dissatisfaction would have been mitigated with better communication.The Authority’s approach to implementing the amalgamation varied from that originally proposed by government. But it did not record the changed approach in an amalgamation plan.

Parliamentary reference - Report number #178 - released 3 April 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

The decision to seek development of Walsh Bay without a Master Plan and/or detailed study as to the state of the precinct presented significant problems throughout the life of the project. Now, four years later, negotiations still continue on the details of the final scheme. Based on the latest estimates, it will not provide a financial return as was originally expected. The audit found no evidence to indicate why the former Government wished to expedite Walsh Bay, but it is aware that there was an election due. Many of the problems which have been encountered could have been avoided with more careful and more extensive consideration at the start, particularly in the light of Property Services Group's recommendations.

Parliamentary reference - Report number #58 - released 17 December 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